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Some weeks are more challenging than others. My mother has developed resistant high blood pressure again. No matter what we do it is staying high. The doctors say they want me to do this and that, but I really don't know how much more I can do. My mother looks at me to fix it, but I can't fix it. The doctor is going to try her on some new medicine to see if we can get the numbers down.

To add to it, my mother's blood glucose has been high. I can't figure out why, since she's not eating anything unusual that I know of. Maybe the stress of the week has affected her.

Last evening we learned her sister had slipped into coma and wasn't expected to live. It didn't seem to affect her much, but she talked about it a few times today. My brother and his family came by. She really seemed to enjoy that, but when they left her blood sugar was sky high. What is going on? I don't know how to help, because her system is not responding right to anything.

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Jessie going ahead with an echo is not a bad thing in itself if it gives a better diagnosis and Mom is up to another test.
If she had not had one before and you are unfamiliar it is a very simple test. She will put on a gown and will have to lie still on her left side for about 20-30 mins. The tech will rub lube on her chest and just rub the ultrasound device all over while the machine makes tracings of her hearts activity. If she becomes uncomfortable she can take a break and move for a few minutes the tech will make her very comfortable with pillows anywhere she wants them. There is no radiation involved so you can stay right there with her. It is mostly silent but ocassionally you will hear the hearts swishing sound. You can watch the monitor and see the tracing which puts you in mind of dopler radar. The tech of course is not allowed to tell you anything but it is interesting to see. The tech does their best not to let the patient see the screen which I find annoying as unless you are a cardiologist you can't tell anything. I have had several and would not hesitate if Mom is up to the visit. I would regard it as for interest and diagnosis and not proceed to further probably invasive tests or definitely not surgery. It might help the Dr fine tune her meds.
.I know it is very difficult to make decisions for a loved one but it is very important to make sure that anything you do will actually improve the quality of their life.
Sorry Jessie if I have been preaching to the choir again but I can't remember if you have a nursing background. If you do others may be interested to have a description of the actual proceedure.
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Jessie, not sure what you mean by loss of timing in the aorta. Are you referring to the valve? High stroke volume and lower heart rate can be related. And then you have the effect of whatever BP meds and other meds she is on. I would think her doc should know if her ventricle is enlarged. I really would not try to diagnose her yourself.

I understand your concern about the raised BP, and it looks like the doc is trying some other meds. I am wondering if the doctor says her heart sounds fine why you are worried about it ? I know you do a lot of reading, which is good, but that can have a down side. Cardiovascular physiology/pathology is very complicated, Throw in a variety of meds and you need a expert - i.e. her doctor and/or a cardiologist to interpret what is happening. I have a Master's degree in Human Physiology and I wouldn't attempt to diagnose cardiac problems.

My ex had a quadruple bypass, and 4+ years later he is noticing some symptoms of problems. He doesn't expect to live another 10 years. His mother has had CHF for years and years, and slowly she is getting more symptoms, though to everyone's surprise she has made into her 80s. Your mother's health will decline. I am not suggesting to not be vigilant and do what you can, but the options will become more and more limited.

(((((hugs)))) to you. I know you feel responsible for getting her the very best care possible. It may be a good time to consider, in general, what surgery, what level of intervention, you would agree to, considering your mum's health, if the question should arise.
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She doesn't have any symptoms with the bp, just high numbers. I called her doctor this morning and left a message. She hasn't called me back yet. I followed up this afternoon with a message on the computer. We have to wait on the doctor to get back or at least answer.

Pam, her kidney and liver function tests are good, so I don't think there's problem there. The low heart rate, hypertension, and high stroke volume make me wonder if there is a loss of timing in her aorta or maybe her ventricle is enlarged. Doctors say her heart sounds fine. An echocardiogram would tell us more, but would open the door to possible surgery. Would we even want to go there? That is such a big question when there are so many problems.
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JessieBelle, Emjo always talks good common sense so I have little to add on this one. I know it is frustrating to you but really all you can do is continue to give her the loving care you have always given.
When her B/P is high does it make her feel bad in anyway such as headaches or do you only know because you are monitoring it? The hypoglycaemia is of course a different situation. Do the two work in tandem? That is, is she low B/P at the same time as low B/S? Don't know why I even asked that because I have no idea what it would mean. I think her working parts are just past their use by date so anything that goes wrong has no easy answers. Hugs.
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As far as the glucose,, Dad was just diagnosed with some kidney failure, not alot but enough to make them change his meds. Have you looked into this?
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(((((((hugs))))) and sometimes you can't do any more, or can do very little. The disease will progress no matter what you or anyone else does. Do the best you can, Jessie, as you have been doing all along. Your mum is only human and so are you.
Actually a talk with her doc regarding how much more can be done about the BP and the diabetes and anything else, may not be a bad idea - without her present, of course. To a degree, we are bystanders.
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Thank you, Joan. Sometimes I just want to stand clenched fist like a kid and scream I can't do anymore. They would think me crazy for sure then.
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Hope the new meds help. I suspect what is happening is, at least in part, a sign of the disease progressing. I wouldn't be surprised if the events of the week played a part too, especially her sister's condition even if your mum did not react much to the news.

I have thought about my mother and what can be done for her. There really is little anyone can do for her except try to keep her as mentally comfortable as possible, as well as providing the best physical/social environment possible.The BPD is still there and now vascular dementia has developed. That it will progress is a fact of life. Only so much can be done to help. Jessie, you are a great caregiver and your mum is very fortunate to have you.
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Veronica, no one has found anything wrong beyond the bp and glucose regulation. No signs of an infection anywhere. Tackling the problems is complicated by the facts that she has bradycardia, so can't go the calcium channel blocker route for bp control, and has nighttime hypoglycemia if we go up more on the insulin. The options are limited. The doctor talked about putting her on a new bp medication -- an ACE inhibitor, I believe -- that she will take three times a day. I have my fingers crossed that it will work to bring her bp down.
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My first thought would be infection. Is that a possibility?
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Aw Jessie, hugs to you! We know so very much about the human body compared to generations ago, but many aspects still remain a mystery. I wonder if something is going on that is impacting both bp and bs. I hope the new medication helps.

It is hard to know how much learning of her sister has impacted your mother. With dementia, the responses are always direct (as you know).

There have been times I've thought "What the heck is my blood sugar doing in this range?!" only to later realize, "Oh, yeah, I was coming down with this stomach virus."

I imagine you are feeling helpless. I'm sorry about that. Love her and reassure her and hope the doctor can come up with something.
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Jessie, are you saying she is having drastic changes even from activity, brother's visit? I will be interested to read what others have to say.

The only thought I have is that her brain just is not sending correct signals to the body. Or that medications are not working for her because of that. I imagine reactions to blood pressure meds could be just as difficult to predict as haldol, seroquel, ativan and the like. With those there is no telling if they will help or make things worse.
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