Dialysis Blood Pressure 1/30/2020 (updated)

I fell asleep early last night and woke up at around 3:30 am this morning. I thought I didn’t take my 30 mg of NIFEdipine ER before sleeping so I took another one. I then took all my regular medications this morning, including the 10 mg of NIFEdipine.

When I got to the dialysis clinic and measured my standing blood pressure, it was 90/60. Either I doubled up on the ER pill, or took it too late so it’s adding to the three medications I took this morning. That’s one issue with having too many meds. You lose track of which ones you took when sometimes.

The first blood pressure reading sitting down was 120/69 which is still a bit too low. It should increase when the Metoprolol starts getting dialyzed out by the machine.

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Ha! The machine too another blood pressure reading while I was clicking “post” on this post. It first came back as 78/50. I told the nurse that can’t be right so she tested again and it came back at 110/64. Better, but I definitely messed up my medication schedule this morning.

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Time	Systolic	Diastolic	Pulse	Notes
8:45 am	90	60	—	Standing
8:46 am	102	—	—	Standing
8:53 am	120	69	59	Sitting/legs up
9:23 am	110	64	63	Sitting/legs up
9:58 am	134	71	59	Sitting/legs up
10:28 am	139	82	59	Sitting/legs down
10:58 am	139	82	60	Sitting/legs down
11:28 am	145	87	59	Sitting/legs down
11:58 am	158	95	60	Sitting/legs down
12:28 pm	163	93	58	Sitting/legs up
12:58 pm	178	—	—	Sitting/legs up
1:03 pm	138	—	—	Standing

So the systolic numbers goes really high right at the end. I’m thinking the 178 reading is wrong since it then drops by 40 points on the last standing measurement. With such huge variations in blood pressure readings over four hours, it’s all dependent on the level of medications in my bloodstream. I feel like I’m cheating each time I take the extra 10 mg of NIFEdipine since it’s like an emergency drug: works quickly and wears off fast. I measured my blood pressure yesterday around 2:00 pm and it was 192/100. All the morning meds probably wore off by then. I don’t think it’s good for my body to have blood pressure fluctuate like that.

I check the dialysis blood pressure measurements from the past few sessions and the drop in blood pressure for the last standing measurement is pretty large. That just makes prescribing medication that much harder since they can’t lower my sitting blood pressure too much in case I stand up and pass out.

Date	Last Sitting BP	Final Standing BP
Jan 21	165/98	139/82
Jan 23	164/90	132/78
Jan 25	159/92	127/74
Jan 28	163/87	118/70
Jan 30	178/–	138/–

Can you say orthostatic hypotension?