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    Dr. P - Re-post - FM with uncontrollable high BP
    RacerLady503 posted:
    My FM is what it is - however, the BP.... well, something has to be figured out before my girls lose their momma!!!

    I am new to this Community.... I was rear ended twice in a three week period back in 2008. Now, almost three years later, I have been given the diagnosis of FM due to the injuries suffered in accidents. I had sever whiplash. In three years, I have undergone cortizone shots, pill after pill, doctor after doctor and treatment after treatment - Nothing really seems to help. I can still do my normal activities - the question is how bad do I want to do it knowing I will suffer for days to weeks after. That totally sucks..... The flare ups seem like a cycle - almost predictable anymore, it's getting rather annoying and depressing at the same time. I don't sleep well anymore and many times wake up with head, neck, back or what have you just throbbing with pain. How I manage to sleep through this is beyond me. The headaches that wake me up in the middle of the night, usually have me physically sick by the time I wake up. Breaking into a sweat when it starts to throb, it's awful. SInce the accidents as well - my blood pressure has been high and seems to be climbing. Tons of blood tests, ultrasounds, CT scans, MRI's x-rays, EKG's, Echocardiograms - I'm completely "normal and healthy" on paper. Blood pressure meds do NOT help. The bp started after the wrecks at 150's/100's and over the last few years has climbed. The last two days it's been 190-200 / 120-140.....Ughhh, completely freaking me out now! Dizzy spells and all, of course, it's highest when I'm having a flare up. Need more exercise, but at the same time - have to "take it easy" as not to raise my pulse / bp higher..... Catch 22. I am currently on - Inderol 25mg for migranes / blood pressure, Wellbutrin 300mg for depression and for whatever reason it helps to keep my pulse lower (70-80bpm rather than 90-110), Flexeril 10mg at night and as needed with migranes - to help me sleep, Savella 25mg twice daily added about a month ago for FM and also Spironolact 100mg at night for bp added a week ago. Since the addition of the Savella and Spironolact the bp has jumped. I am 35yrs old, 125lbs (normally 116, meds have increased weight) and 5/3". I have two daughters and have always been very healthy and active. Over the last 2-3 years, I have felt like I am completely out of shape, like I've aged years+ over night. Is there any relief?????? I am afraid of having a stroke - I don't want anymore pills, none of them seem to help with the BP - even being in the ER for dizzy spells and high bp - none of the meds bring it down.
    It only holds me back if I 'let' it
    Anon_12819 responded:
    Does your primary doctor know how high your blood pressure is? Savella has been found to cause hypertension especially in people who already have some degree of hypertension. You would probably benefit from additional blood pressure control by adding another agent such as an ACE inhibitor.
    Good luck
    RacerLady503 replied to Anon_12819's response:
    Yes, she knows..... we just added spironolact although, there are no changes. I've been on Linsinopril and Diovan before, neither one of them made a difference either.....
    It only holds me back if I 'let' it
    CnDlu70 replied to RacerLady503's response:

    while on Savella my bloodpressure ran around 215/136 and my heartrate was in the 120's and over. my primary never admitted it was the Savella but after taking me off of it (because my co-pay was outrageously high) my blood pressure is now normal with just a low dose of bp meds.

    hope all goes well with you...
    RacerLady503 replied to CnDlu70's response:
    We just increased my 12.5mg twice per day of Savella to 25mg twice per day. My spine / pain management Dr. says the higher dose "may" help as they "think" if they can get my FM and pain under controll that my bp will lower.... Ughh

    I'd give about anything to go back to the 150's / 100's (which were still considered extremely high for me)...... I don't want to stroke!
    It only holds me back if I 'let' it
    Anon_408 replied to RacerLady503's response:
    If Booch (Nancy) see's this, she might chime in, she is a nurse, and have had problems with the savella.

    That is extrememly high B/P readings, and not good. I would be sitting in a Dr's office till they got it down. Mine was high during a visit after the loss of my DH, and he wouldn't let me leave the office till it went down.

    It is known that the side effects of the Savella are high blood pressures, heart rate, I don't know, I'd wean myself off of it, live with the pain before having those B/P readings.
    RacerLady503 replied to Anon_408's response:
    I've thought about doing that Anon.... However, looking back at my bp monitor, the readings were higher than my normal prior to the Savella but it was sporatic, not each reading. The Savella can cause excessive sweating and I'm not one to sweat - I had two bouts yesterday where I broke into a sweat and I was doing nothing strenuous!!!! Definitely want to get off of this and try something else.
    It only gets the best of me if I let it
    RacerLady503 replied to Anon_408's response:
    I hope that Nancy does see this as well. I'm looking for all opinions and thoughts as I'm sure I will be back in the Dr. office this coming week to change something
    It only gets the best of me if I let it
    Booch007 replied to RacerLady503's response:
    Good evening,

    Just happened in tonight.

    I am red flagged with two things. Thw wellbutrin and the Savella together. Savella being a new SNRI on the market alot of the MD's are unaware that it increases norepinephrine 3 times normal to the seratonin......

    Therefore it really pushes your body. I take 12.5mg a day...that is all I need/ or can take. Now I am still in pain, but I have a wellness window of 8-10 hours at times.

    I did have to add labetalol for a bit to my life as I was heavier and the med pushed me, it does bother me sleeping too...but the pain relief was worth the use still. I have lost 50lbs and came off the labetolol and use Avapro only.

    HTN is not that difficult to treat, it often is a combination of meds, if you are watching your salt intake, got weight in a better place. Your doctor should be able to handle this.

    Please let him know of the data for norepinephrine levels. It is a problem. I have spoken to the rep and discussed black box warnings for the palpatations and arrythmias pts were having as warnings still??

    Please be careful. I would return to the lower dose and look at another avenue for help.

    I hope you have a good relationship with your MD. Get an appointment and get these number to him. HTN is not a killer overnight, it does however damage all your small vessels. Your kidneys, eyes, the muscle size of your is no good to be this high.

    In speaking of B/P, lets just explain too that the top number the systolic number is the force the heart has to eject if you feel the cuff pressure against your arm at is hard right? It is what the heart is pushing against to open the valve and eject the chamber against.

    NOW the more serious part....when all is still...between heart beats, this is the bottom number, the diastolic pressure. When all is finished in the cycle, the remaining pressure in the *system is.....what 126?....(should be 60-80) twice as high?

    The problem is IT IS IN THIS CYCLE that the vessels of the heart get their bloodflow...........WOAH....126mm of pressure and feel that against your arm.....126 mm is pushing through the coronary arteries and can do bad damage...crack plaque and start a heart attack. It can dissect a vessel and make a heart attack where no blockage even existed.....

    HTN is not to be played with. Not to be put to the side. I really want you to get an appointment and pull the med back or off, it is not agreeing with you. Try another avenue of care in your toolbox. I have my b/p at 110/70-130/80...(unless I am pissed off). I watch ME closely.

    I did pull off the med when I received a bad blood count. I was pretty sure it was from this med. Then I found good levels and was in to much pain, so I returned to it.

    You always have to way the benefits vs the risk. I see red flags to this and it is not in the positive side.

    Good luck, I hope the MD sees this too and I can find the article to quote if he needs it. IT is a unique SNRI....

    Really, take care and make a change here.........Nancy B
    RacerLady503 replied to Booch007's response:
    I really appreciate your feedback Nancy. I will talk to my dr. about the norepinephrine vs seratonin levels. Today my BP was at 150/111 which is my "normal" prior to the Savella. We've tried a million BP meds and combinations, they don't seem to help.

    What baffles me more than anything is that prior to the two Whiplash injuries in 2008 (twice in 3 weeks I was hit), I did not have any health issues whatsoever. My neck and back didn't get better with treatment, now almost 3 years later am being givin the Post Traumatic FM diagnosis and my bp has been crazy ever since the accidents. Is the pain really elevating it that high or is something pinched somewhere?

    Cholesterol leves are great, all blood work is great. Kidney tests are great - there is no medical reason they can find for any of what seems to be plaguing me.... Ughh!
    It only gets the best of me if I let it
    RacerLady503 replied to Booch007's response:
    I was at my Dr.'s office and we did discuss the norepinephrine and seratonin levels. However, because my BP was so high while there, that took the priority. She wouldn't let me leave until we got the bp down, period. I beleive she gave me a Clonidine pill, we waited 20 min and nothing. She had me take another and we waited another 30 min. It brought it from 225/123 to 148/98 which was MUCH better! She has given me the Clonidine patches to wear and change every 7 days. I had a reading yesterday morning of 133/88, I was ready to jump up and down with excitement! I haven't seen a reading that low in 3 years! She says we will continue to watch the readings and continue on the same path - for now. If the Clonidine continues to help, then we may try to wean off of some of the other meds. I hate pills and i greatly dislike having to depend on them. At 35 years old, 6 pills per day plus my vitamins is just too much. Prior to my accidents, I took birth conrol and vitamins, that's it - I was active and healthy with no problems. It's amazes me to look back and realize that I feel like my body aged 40 years over night.
    It only gets the best of me if I let it
    Mark Pellegrino, MD responded:
    Hi RacerLady,

    I hope your BP readings are getting closer to normal range since you last posted here. Keep working closely with your doctor as you have been. There are a number of causes for elevated BP including essential hypertension, medicine side effects, increased pain, and a combination of these factors.

    In my experience, sudden changes/increases in BP is more likely related to a medication side effect rather than the chronic pain. Whatever the cause(s), you and your doctor will work together to try to normalize your blood pressure and control your pain.

    Yes both things can happen! I hope they both happen soon for you.

    Dr. P
    Booch007 replied to RacerLady503's response:
    I have another thought....see about a scan of the kidneys for stenosis of the renal artery......I love the clonidine patch...see how you can get it taken care of eventually.

    But looking into the cause on uncontrolled HTN is important too...get the kidney checked for stenosis and I would drop that savella if you are needing to be on clonidie too. It is not worth it.

    Sending urine out for a pheochromocytoma is another work up thing.....this is a pain in the neck(ha) tumor of the adrenals that causes it's own surging of norepinephrine and catecholamines substances....the symptom is B/P's of great another rule out for you. At least you can say you have lifted each rock to be better.

    Glad the pressures are better, see about finding the cause. As me, it could all be just hereditary and this is your path...but if it is something else...find it. Hugs, Nancy B
    amharris1962 responded:
    Have you tried chiropractic care? It's probable your headaches and blood pressure issues are due to neck problems caused by the accidents. A chiropractor will have xrays done and come up with a treatment plan. The blood pressure might correct itself as well, once the issues in the neck and head are addressed. Just a thought. I have chronic low back and neck pain with fibromyalgia, high blood pressure (which is always worse during a flare) and periodic headaches (from my neck). I have found relief through chiropractic care for nearly 20 years now. I feel your pain and I hope you will give chiropractic a shot...what do have to lose?
    jslemley responded:
    Please look up contraindications and recall info on Savella. When I began to take it, within 7 days, my BP and heartrate shot up. Before that, I had always been below normal. Please google the information and see if you may be having a reaction. Wishing the best

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