Maarten Vasbinder used to live in Isaan, but now back in Spain. His profession is general practitioner, a profession that he mainly practiced in Spain. On Thailandblog he answers questions from readers who live in Thailand.
Do you have a question for Maarten and do you live in Thailand? Send this to the editor: www.thailandblog.nl/contact/ It is important that you provide the correct information such as:
- Age
- Complaints)
- History
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- Possible blood pressure
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Dear Martin,
I've been to the hospital twice now, Endocrinology department, because of my extreme sweating that we've had contact about before. The doctor wanted to see if it has anything to do with hormones and tested me for four different hormones and I'm still just within the margins everywhere.
Last time she switched my blood pressure medicine with Exforge HCT [10 / 160 / 12.5 mg] It was Metoprolol and Enaril before that. From day 2 I am tired, lethargic and when I get up from the chair I suffer from dizziness [less than 10 seconds] Blood pressure 165/95 pulse 75. Two days later blood pressure 142/88 pulse 88. Cycled for an hour that same day, that's what I do I often do, but close to home I got lightheaded and didn't feel well. Walked last few hundred meters, immediately measured blood pressure at home, 84/66 pulse 118 And ten minutes later 110/64 pulse 112.
I've never had any problems with urination or the amount of it. The Exforge HCT probably contains a urine product because I have to go to the toilet every two hours during the night. Since then I have had an irritating feeling in the tip of the penis, just below the opening, a feeling between mild itching and mild sensitivity, which gets a little more intense during holding in and then urinating.
My blood pressure has been perfect for the last ten days, an average of 130/80, but a pulse of around 90, was always in the 60s. I have to go back to the hospital in 10 days... all in all, I don't feel comfortable...
Your opinion on this is much appreciated.
Regards,
J.
Dear J,
Your blood pressure is now too low. Amlodipine, or Valsartan alone seems enough to me.
HCT is indeed a diuretic. Something you should swallow in the morning. The other two in the evening.
Because you stopped metoprolol abruptly, your pulse is too high. You have to reduce that very slowly. Start again with the metoprolol and leave the Valsartan.
Try to lose some weight and have a coagulation test including D-Dimer and fibrinogen.
Sincerely,
Dr. Maarten
Do you have a question for Maarten and do you live in Thailand? Send this to the editor: www.thailandblog.nl/contact/ It is important that you provide the correct information (see list at the top of the page).