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Topic: Question About Mixed Blood Pressure Readings

Forum: Stage IV/Metastatic Breast Cancer ONLY —

Please respect that this forum is for members with stage IV/metastatic breast cancer only. There is a separate forum for caregivers and friends: Caring for Someone with Stage 4 or Mets.

Posted on: Oct 6, 2021 08:43AM - edited Oct 6, 2021 08:45AM by DivineMrsM

DivineMrsM wrote:

Whenever I go to the onc in Pittsburgh, my blood pressure reads high. When I go to my pcp where I live, it always reads within normal range. I truly do not believe I am in some kind of anxious state at the onc's to the extent that it raises my bp. I’ve been going there for 10 years and the high bp reading only started happening recently. I have to say, at her office the bp cuff on my arm squeezes so incredibly tight, it is hooked up to a machine, that it is painful and I have a reasonable tolerant level of pain.

The onc never addresses the bp issue, but I'm going to ask next time I'm there since I will see her before my next pcp appt. I'm thinking one of the offices is getting it right and one is getting it wrong. What would you do? I have a new onc now. The one who just retired was always concerned with just the mbc so my pcp addressed all other medical matters. But if his bp screening doesn't show that mine is high, how would he treat me for it. I'm a bit perplexed.

found lump 12-22-10—ilc—er+/pr+/her2—stage iv bone mets—chemo~lumpectomy~radiation~arimidex—March 2019-ibrance/aromasin* —Sept 2019-verzenio* —March 2020-xeloda*
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Oct 6, 2021 09:10AM illimae wrote:

Mine is often higher at the cancer center too but all agree that it’s likely due to the traffic getting there and my hurried walk through the large building, not anxiety. Perhaps, that’s a factor?

Diagnosed at 41 Stage IV De Novo Dx 11/16/2016, IDC, Left, 5cm, Stage IV, metastasized to bone, Grade 3, 3/13 nodes, ER+/PR-, HER2+ (IHC) Chemotherapy 1/2/2017 Abraxane (albumin-bound or nab-paclitaxel) Targeted Therapy 1/2/2017 Herceptin (trastuzumab) Targeted Therapy 1/2/2017 Perjeta (pertuzumab) Surgery 6/26/2017 Lumpectomy: Left; Lymph node removal: Underarm/Axillary Radiation Therapy 8/10/2017 Breast, Lymph nodes Dx 10/5/2017, IDC, Left, 5cm, Stage IV, metastasized to brain, Grade 3, 3/13 nodes, ER+, HER2+ (IHC) Radiation Therapy 10/20/2017 External: Brain Radiation Therapy 4/18/2018 External: Brain Radiation Therapy 5/23/2019 External: Brain Surgery 1/22/2020 Radiation Therapy 2/17/2020 External: Brain Radiation Therapy 7/20/2020 External: Bone Radiation Therapy 12/4/2020 External: Brain Hormonal Therapy Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Targeted Therapy Tukysa (tucatinib) Chemotherapy Xeloda (capecitabine)
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Oct 6, 2021 09:14AM - edited Oct 6, 2021 09:20AM by DivineMrsM

I do not think so. I enter the new cancer building immediately from the parking lot ( before it was long hallways and an elevator to access the onc) . I have free valet parking now where before I had to drive around a full parking garage looking for a spot. And traffic was nonexistent during the pandemic with very little uptick.

found lump 12-22-10—ilc—er+/pr+/her2—stage iv bone mets—chemo~lumpectomy~radiation~arimidex—March 2019-ibrance/aromasin* —Sept 2019-verzenio* —March 2020-xeloda*
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Oct 6, 2021 09:22AM SondraF wrote:

Mine is also always high at the cancer hospital, but Ive noticed that since the newer nurse took over she doesn't pull the cuff nearly as tight and its read as more normal in my usual ranges the last few appointments. When I had raging uncontrolled cancer my bp was completely normal and healthy and that was read at multiple doctor offices in the UK and US the few weeks before diagnosis. There were a few times last winter where I thought the cuff was going to explode off my arm in the tiny blood draw room, they had it on so tight. Of course it read like I was about to stroke out and they had to do it again.

I DO have travel hassle to get to hospital and its always about two hours after my one cup of coffee for the day, so I chalk the (now slight) increase up to the coffee and sometimes on the amount and time of waiting room annoyances!

"The closer we come to the negative, to death, the more we blossom" - Montgomery Clift Dx 9/27/2019, IDC, Right, 5cm, Stage IV, metastasized to bone, Grade 3, ER+/PR+, HER2- Targeted Therapy 11/29/2019 Ibrance (palbociclib) Hormonal Therapy 11/29/2019 Femara (letrozole) Surgery Prophylactic ovary removal
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Oct 6, 2021 10:08AM BevJen wrote:

Interestingly, for years I had high BP readings no matter what doctor I went to. Recently, I started PT for my hip surgeries, and my BP is often taken by one of the techs at the rehab hospital. She puts on the cuff (not that tight) and literally holds my arm at heart height to do the reading. My readings have been incredibly consistent and pretty good -- always in the low 120s and never up to 80 on the lower reading. When the physical therapist does it, she is always yakking and doesn't pay attention to where my arm is, and they are higher. Another thing is that YOU should not be talking when BP is taken and your feet should be on the floor.

Microwave Ablations,Liver 3x ;Radiation Therapy to Femur (Both) April 2021; total hip replacement (R) and placement of rod (L) to stabilize femur both sides; immunotherapy (single agent - keytruda) Dx 11/2003, ILC, Left, Stage IIIC, 13/18 nodes, ER+/PR+, HER2- Dx 6/2006, ILC, Stage IV, metastasized to other, ER+, HER2- Dx 5/2019, ILC, Stage IV, metastasized to liver, ER+/PR+, HER2- Surgery 7/4/2019 Targeted Therapy 7/31/2019 Ibrance (palbociclib) Surgery Lymph node removal: Left, Sentinel; Mastectomy: Left, Right; Reconstruction (left): Pedicled TRAM flap; Reconstruction (right): Pedicled TRAM flap Chemotherapy TAC Hormonal Therapy Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Surgery Lymph node removal; Mastectomy; Reconstruction (left): Pedicled TRAM flap; Reconstruction (right): Pedicled TRAM flap Hormonal Therapy Faslodex (fulvestrant) Hormonal Therapy Femara (letrozole) Radiation Therapy Immunotherapy
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Oct 6, 2021 10:21AM moth wrote:

Some machines are not properly calibrated and also, the cuff has to be the proper size. If it's too large, or just too old, it will often inflate way too tight to try to get the reading. ALSO, the machines often assume they're reading the same patient and they start at 20 over the last reading. So if the pt ahead of you had high bp, it will assume you're that pt and start the reading way high. There is a way to clear them and reset but often the assistants using those machines are not nurses and don't know how to do it.

Also in cardiologist offices their machines take 3 readings and average them - that's supposed to be the method used if you have issues with BP. Make sure your feet touch the ground, don't cross your legs and keep your arm relaxed but supported either by the arm rest or have your hand resting on your lap, not the arm dangling down.

I have a manual cuff at home so I can do it the old fashioned way lol. If you're concerned about the readings, I'd suggest going to your local drugstore at the same time of day once a week for a few weeks and recording that reading so you can show the drs what it is at other times.

I take weekends off

Initial dx at 50. Seriously?? “Sometimes the future changes quickly and completely and we’re left with only the choice of what to do next." blog: Never Tell Me the Odds

Dx 12/2017, IDC, Left, 1cm, Stage IA, Grade 3, 0/5 nodes, ER-/PR-, HER2- (IHC) Surgery 12/12/2017 Lumpectomy: Left; Lymph node removal: Sentinel Chemotherapy 2/13/2018 AC + T (Taxol) Radiation Therapy 8/13/2018 Whole-breast: Breast Dx 2/2020, IDC, Stage IV, metastasized to liver/lungs, Grade 3, ER-/PR-, HER2- Chemotherapy 3/18/2020 Taxol (paclitaxel) Immunotherapy 3/18/2020 Tecentriq (atezolizumab) Chemotherapy 11/25/2020 Abraxane (albumin-bound or nab-paclitaxel) Radiation Therapy 12/8/2020 External Dx 12/9/2020, IDC, Right, Stage IV, metastasized to lungs, Grade 3, ER+/PR-, HER2- (IHC) Hormonal Therapy 12/15/2020 Femara (letrozole) Dx 1/28/2021, IDC, Left, Stage IV, metastasized to bone Radiation Therapy 3/2/2021 External: Bone
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Oct 6, 2021 05:32PM Lee64 wrote:

I bought a blood pressure device so I can take mine at home. I also took the device to my PCP so we could check it for accuracy. It is amazing how fast blood pressure can fluctuate during the course of a day.

Dx 11/5/2010, IDC, 3cm, Stage IIB, 2/6 nodes, ER+/PR+, HER2-
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Oct 6, 2021 05:48PM - edited Oct 6, 2021 08:42PM by Olma61

I do have hypertension, under control with meds. When the cuff is super tight, I do get higher readings.

The nurse who usually does my vitals at the cancer center never inflates the cuff so much that it hurts. One time I got a male nurse who did, and sure enough, my pressure was higher. Same machine, same environment etc.

But that's not the only time I've noticed that tight cuff = higher reading.

All the suggestions in these replies are good ones. Feet flat on floor, no talking, also make sure you dont have a full bladder.

Getting a monitor and taking readings at home can give you either peace of mind OR some hard evidence to discuss with your doctor. Hopefully, the former.

10/30/2017 Xgeva for bone mets 5/31/2018 Taxol finished! "If one just keeps on walking, everything will be all right” - Kierkegaard Dx 8/3/2017, IDC, Right, 2cm, Stage IV, metastasized to bone, Grade 2, ER+/PR+, HER2+ (IHC) Targeted Therapy 10/28/2017 Perjeta (pertuzumab) Targeted Therapy 10/28/2017 Herceptin (trastuzumab) Chemotherapy 10/30/2017 Taxol (paclitaxel) Hormonal Therapy 5/14/2018 Arimidex (anastrozole) Radiation Therapy 5/30/2019 External: Bone
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Oct 7, 2021 06:48AM - edited Oct 7, 2021 07:28AM by DivineMrsM

Thank you all for the replies. It sounds like an unusually tight cuff could be giving me a higher reading at the onc.

Moth, there's something about the woman who takes my vitals at the upgraded cancer center that I don't care for. She is a medical assistant, not a nurse. She yaks the whole time about herself and seems more concerned about rushing through to get to the next patient.

Earlier this year I bought a wrist blood pressure monitor, so this morning I got it out and took my bp a couple times, following directions to sit quietly for 5 minutes before reading and keeping wrist level with heart. The first measurement was 123/75, the second 122/83. Last month at the onc it 158/90. I don't remember the exact numbers I had at the pcp in August, I only recall that it was in the normal range.

I've read that home bp monitors aren't necessarily accurate. Any thoughts on that?

I'll have to check to see if Walgreens or CVS does blood pressure reading. I plan to get my flu shot next week so will ask.

Here's the wrist monitor I got, I had free money from my medical plan to get one that was on their list. But I'd purchase a better one if I had to, it's just that from what I've read about them, the home monitors sound iffy.

found lump 12-22-10—ilc—er+/pr+/her2—stage iv bone mets—chemo~lumpectomy~radiation~arimidex—March 2019-ibrance/aromasin* —Sept 2019-verzenio* —March 2020-xeloda*
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Oct 10, 2021 02:57PM Zillsnot4me wrote:

My MO and chemo are either on the same floor or down a level. They each have to weigh me and take my bp.

If the cuff is too tight I’ll have a high reading. The cuff was so tight it was painful and I was panting. However they had to mark it in their chart.

Normally my weight and bp are very close, both from office to office and week to week.

8/6/21 Gemzar 1/7/2021 Axabrane 10/29/2020 Taxol 7/22/2020 A/A combo, 11 cm liver spots! piqray, zometa, faslodex 6/11/2020 rads to liver 12/2020 3 cm liver 10/2019, Liver spots 1/ 2016, Xgeva 9/2015, Bones 4/2015, Lungs 4/2013 Dx 4/2013, 4cm, mets, ER+/PR+, HER2- Surgery 4/29/2013 Lymph node removal: Right; Mastectomy: Right; Prophylactic mastectomy: Left Chemotherapy 5/23/2013 AC Hormonal Therapy 10/2/2013 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Radiation Therapy 11/6/2013 Breast, Lymph nodes Surgery 9/25/2015 Prophylactic ovary removal Hormonal Therapy 1/7/2016 Femara (letrozole) Targeted Therapy 1/7/2016 Ibrance (palbociclib) Hormonal Therapy 2/4/2016 Arimidex (anastrozole) Hormonal Therapy 4/24/2017 Faslodex (fulvestrant) Chemotherapy 11/16/2017 Xeloda (capecitabine) Dx 10/2019, metastasized to liver, ER+/PR+, HER2- Radiation Therapy Liver

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