Blood pressure & your eyes

optic nerve
Source: The Discovery Eye Foundation

Have you ever felt like you’re chomping at the bit to do things but then life gets in the way? I have spent the last few weeks either feeling weak and dizzy, with no energy at all or fighting painful migraine-type headaches that make me wonder if my poor little skull is too small for whatever is causing the pressure inside it. I have a few clues but I’m not entirely sure what’s going on.

My ophthalmologist had me come in for another appointment recently. It seems the intraocular pressure (fluid pressure inside the eye) in both of my eyes is too high for his liking. To figure out what was going on, he prescribed a 24-hour blood pressure test. Last week I had another appointment to discuss the results.

Apparently there’s a link between blood pressure in the body and pressure in your eyes. Neither high nor low blood pressure is good for the eyes, but in my case my blood pressure is apparently too low, which means the optic nerve may not be getting the blood flow it needs and my eyes may not work properly. Too much pressure in the eyes puts my optic nerve at risk for damage, increasing the chances I’ll eventually go blind.

It took visits to three pharmacies in my area to find one that rents out the blood pressure machine for this test and even then they cancelled the appointment on the day it was supposed to happen and I had to find another pharmacy that could start the test that day. Had I been in Montreal, finding a machine would probably have been easier (the pharmacy near my eye doctor’s office had one available). If you ever need to do this test here in Quebec, and you don’t know French terms, you’ll want to know the test is called a MAPA (monitoring ambulatoire de pression artérielle). So if a doctor writes a prescription for a 24-hour BP, be sure to ask the pharmacist for a MAPA. Renting the machine from a pharmacy costs around $50 and you can claim the cost on your insurance.


Société québécoise d’hypertension artérielle

For this test you wear a small portable digital blood pressure machine on your body, which is attached to you with either a shoulder strap or a belt around your body and connected to a cuff on one upper arm.

It’s supposed to be truly portable so that you can go about your daily life wearing it and you should be able to sleep with it on. When a pharmacist fits you for the machine, you wear a t-shirt so that the cuff on your upper arm is right over your artery, making it easier for the machine to take correct readings.

You can’t change your shirt without disrupting the setup and you can’t shower either.

The machine is noisy and weird to wear since during the times you’re awake the cuff inflates every 20 minutes, taking readings three times per hour. When you’re sleeping, the readings are usually once per hour. I don’t know what happened to my machine, but some readings didn’t work and there were no readings at all at certain times. The pharmacist also messed up when she told me the time to return the machine. I should have come back at least 20 minutes later, because it missed the final 20 minutes of the 24-hour readings. I don’t think it really matters, it was just annoying that I didn’t do the full 24 hours. My arm was sore and I was happy to say goodbye to that machine.

Based on the machine’s findings, my blood pressure is not just on the low end of normal but often lower than that. That explains the dizziness and lack of energy, lack of concentration and focus. I wonder if the headaches I experience have something to do with my eyes.

Unfortunately for me, while low blood pressure is great for the kidneys, it puts me at risk for developing glaucoma. At last week’s follow-up with my ophthalmologist, he considered my eye pressure too high and prescribed eye drops.

The bonus of the drops apparently is that I may gain thicker, longer eyelashes. The drawbacks? Raccoon eyes, since the medication makes the area under the eyes darker. It also can change your iris’s eye colour and make you feel like you have grains of sand in your eyes.

Even though I would much rather take a supplement than take these drops, I will behave. From what I’ve read about high eye pressure (intraocular hypertension), sleeping with your head at a 20 or 30-degree angle is supposed to help, so I’m trying to sleep with two pillows. I tried acupressure exercises to lower eye pressure but based on my last eye exam, they weren’t changing much. I bought some bilberry supplements to help my eyes. I was looking for a supplement with something called Mirtogenol, made from bilberry extract and French maritime pine bark extract, which according to studies works to reduce eye pressure. But the local health food store didn’t have it and their naturopath had never heard of it. She suggested I look into adopting a ketogenic diet, since apparently that’s good for glaucoma. Apparently the Diet Doctor website team includes a nephrologist and she thought I should seek advice from him, since I have inherited kidney disease.

I’ve just started feeling better after spending years fighting weird IBS-like symptoms. I’m following a kidney-friendly diet, which seems to be making a difference and I hesitate to follow a ketogenic diet without the blessing of my own nephrologist. Whatever I do, I don’t want to make anything worse. I’ve been through so many tests these last few years and so far I’m seen by doctors as a very healthy “unhealthy” person. I am certain the symptoms I’ve had are not just in my head. I look forward to getting to the bottom of whatever is taking away my energy and causing painful headaches. There is so much I want to accomplish. I just need to get better.

The eyes have it— or do they?

UPDATE: I saw an ophthalmologist today and from what he can tell I do not have glaucoma at all and the eye pressure reading at the optometrist’s appears to have been wrong. This is a huge relief. My advice to anyone over 40 is go see an ophthalmologist and not an optometrist. I feel very disappointed that I was misdiagnosed.

I learned some surprising news at an eye exam this week.

Apparently I have glaucoma in one eye. It’s a big deal since if I don’t get treated I could go blind.

Based on what I’ve read, (here, for instance) glaucoma is actually not one disease but the name of a group of eye diseases and it’s one of the leading causes of blindness in Canada.

Typically the main sign of it is increased fluid pressure in the eye. Because the eye doesn’t properly drain the aqueous fluid inside the walls of the eye (not tears, but a different fluid), that fluid can build up inside the eye and put pressure on the optic nerve, which transmits the information your eye sees and sends that information to the brain. If you don’t treat glaucoma. eventually the optic nerve gets damaged and you lose your vision permanently.

The usual treatment for glaucoma involves eye drops prescribed by an ophthalmologist, a doctor who specializes in diagnosing and treating eye disorders.

When an optometrist checked my eyes using an air puff test which involved sending a small burst of air into my eyes, the reading in my right eye was 40, which I was told is quite high. I didn’t do well on the visual field test. She checked the thickness of my cornea and I think she looked at my optic nerve because part of the test involved dilating my pupils, numbing my eyes and injecting yellow dye into them. She said my left eye is also showing signs of fluid pressure.

I made an appointment with an ophthalmologist but they can’t see me till late April.

I am confused by this diagnosis for a number of reasons.

Glaucoma can be hereditary. What puzzles me is the folks on my mother’s side who have glaucoma were all diagnosed when they were much older. My mom was in her late 70s or early 80s when she found out. I think her sisters had the same experience, though I’d not sure what age they were when they found out they had it.

My grandfather went blind from glaucoma but he too was diagnosed later in life.

I’m in my 40s. Anyone can get it after age 40.

I’ve met other people with glaucoma and I remember in one person’s case his eyes bulged because of glaucoma. My eyes are pretty recessed and they don’t bulge out at all.

I’ve been fighting some sort of cold or allergy lately and my eyes have been puffy. I wonder if the swelling in my eyes created a false reading on the test? Is that even possible?

I’m going to see my doctor on Monday and get some answers. I think more tests are in order and if I really do have glaucoma, I don’t want to wait until April.

My right eye’s been getting worse ever since the test. I have an infection that I’m treating with warm compresses. Weirdly, fluid is leaving my eye. It’s probably not related to glaucoma at all. It’s probably from my eye infection. Still,  I’m noticing the swelling and pressure in my eye.

Apparently in the early stages of glaucoma you don’t feel the pressure building up in your eye at all. That’s why it gets called the “Silent Thief of Sight.”

I really hope this diagnosis is wrong,

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

In Praise of Ice Cleats

I think my worst fear is falling on ice.

The weather around has been up and down. We’ve had subzero days followed by days when the thermometer climbs above zero. Ice hidden under snow melts and then freezes again, creating ice rinks on driveways, streets, parking lots and walking paths.

If you don’t want to break your bones, you get a pair of ice cleats for your winter boots.

The pair I have is super ugly. They’re black rubber with bright rusted yellow steel studs all over the bottom. They look a lot like the cleats below but they’re not the same brand:

Ultra IceCleat OA8100-Btm
Korkers ice cleats

Stretching them over winter boots can be an adventure. If you don’t align them right or center them as you’re placing them, they spring back on you, like an elastic. Once they’re on though, and you get outside, they work surprisingly well. Walking on ice is no problem.

The only drawback I find about wearing them is if you walk into a store, you make a clack, clack sound as you walk across floors. I fear they’ll get caught in a carpet but so far that’s never happened.

Every year I misplace them. I have a backup pair that doesn’t work quite as well.  While I wish I never had to use them, I do feel relieved when I find these ugly old friends again.

 

A better litter box?

A while back I wrote about a rotten experience we had with the Luuup litter box. I didn’t plan that review. I was curious about the Luuup when I heard about it but didn’t order it when it came out on Indigegogo and Kickstarter.

But when someone posted a brand-new Luuup on VarageSale, I grabbed it. I thought it would be wonderful. After all, it was supposed to make litter box cleaning a joy and I was curious about how that was even possible. I was happy to see a Canadian company making big waves with a new innovation for cats.

I had problems with litter sticking to the sides of the Luuup whenever one of our cats peed there and soiled litter got stuck in the slots of the interlocking trays. If you turned a tray the wrong way, you ended up with a mess of soiled litter all over the floor. We tried using the litter brands recommended by the folks behind Luuup, but things did not get any better. I wanted to like the Luuup and one of our cats still uses it, but for me it was a huge disappointment. These days we clean the Luuup the way you would clean any regular litter box.

So this being a small blog, I was very surprised to receive an email from James Leech, the creator of Boxscoop, a relatively new player on the litter box innovation scene and like the folks behind the Luuup, he’s Canadian.

I can’t tell you much about the Boxscoop 2.0 litter box because I don’t yet have one to test. As I write this, the Kickstarter campaign still has 32 days to go. When I suggested he send me a litter box so I can do an honest review, Leech promised to send me one as soon as they’re available.

Here’s what I’ve learned so far, based on their press release and Kickstarter campaign and the email Leech sent me:

MainImage_
Source: Boxscoop

  • Last November Boxscoop 2.0 was launched on Kickstarter in January. Leech says the first model received amazing feedback and they’re working on launching a better, 2.0 version.
  • According to their press release, Boxscoop has no seams, corners or crevices, making  it a cinch to keep sanitized and clean.
  • The litter box’s container is round and vertical and does not look like your typical flat, square pan-shaped box. As cats enter or leave the litter box from the top (in pretty much the same way cats jump in and out of cardboard boxes), they walk across a built-in litter mat that emulates the feel of a favourite cat texture, corrugated cardboard, and because they walk across the mat, they don’t track litter around your home.  The entry hole is 11.5 inches wide, and the whole container is 15.5 inches high and 19.5 inches wide at the base. Leech designed the container to work with the “natural circular movement of cats, so they have equal distance in all directions to turn. The top cover is designed with openness so cats can feel unconstrained while providing superior litter tracking reduction than typical enclosed systems.”

scoop4
Source: Boxscoop

  • When you take the top cover off (the top and bottom interlock, with no clips whatsoever), it looks a bit like a bucket with a large, metal scoop attached at the top. You simply use the scoop to clean the litter and voilà, you’re done. Cleaning the litter box apparently takes only six seconds.
  • The marketing materials suggest this litter box is better than the Litter Robot, an automated litter box, since it costs much less, isn’t noisy and you don’t get the smell that you have when litter accumulates in a litter box.
  • Boxscoop is made from 100 per cent recyclable materials and so is the packaging it’s shipped in.
  • You can use practically any type of clumping litter with this litter box. You can also use non-clumping litter such as crystals and pretty litter. According to their Kickstarter campaign, “Boxscoop is 30-70% more litter efficient that a standard box, depending how much litter you decide to use.”
  • While the original Boxscoop came in white only, if the Kickstarter reaches $110,000  Canadian (it was nearing $75,000 U.S. the last time I checked), plans are to add more colours, for instance, modern matte gray and charcoal black.
  • In the future, when they have the means, the plan is offer a special add-on ramp for arthritic or disabled cats.
Will it work in our three-cat environment? Will it live up to all these promises? I have no idea. I do look forward to testing this cat litter box and offering a truthful assessment of how it works with our cats. One of our cats is a bully male cat who tries to ambush whichever female cat is leaving a litter box. I wonder if he’d do that with the Boxscoop.

Paul
Source: Boxscoop

Car shopping

car-156769_640
Our dream car??

I don’t have my driver’s licence so it’s kind of funny that I’m writing about buying a car.

We found ourselves needing a new car because my partner was in an accident a little over two weeks ago. He was on the way to his parents’ house on the West Island and was travelling at maybe 40 km an hour when he hit black ice. He braked but could not stop the car from ploughing into the vehicle ahead of him, which hit the vehicle ahead of it. So three cars were damaged in a matter of seconds. My partner’s 2004 Honda Civic suffered the brunt of the impact. A good part of the bumper on one side is all broken or has broken off and the hood no longer comes down. Because of the age of the car and the mileage (270,000 km) it’s probably best that we replace it. We’re planning to give it to the Kidney Foundation of Canada in exchange for a tax receipt.

It is incredibly difficult to get around our part of the world without a car. We have public transportation during the day and a little bit in the evening but unless you spend an hour walking to the train station/bus mall hub near the train station you are nowhere near any public transportation on weekends. A car is a necessity if you live in Vaudreuil-Dorion, especially in winter.

We borrowed my partners’ parents’ vehicle and a week after the accident headed to a local dealership to check out a used car that fit our lowish budget of $10,000 to $14,000. The experience at that dealership was the worst we saw in our search for a replacement.

They texted us to say the car was ready but when we got there, no salesperson was assigned to us and they had to find plates for the car, clean the snow and ice off it before we could drive it.

The grey 2015 Yaris looked great on paper. It was a lease return maintained at the dealership and it only had 33,000 km on it. But whoever leased that car must have smoked all the time they drove it because it reeked of smoke. The sales rep let us take it on a test drive without even checking my partner’s driver’s licence or accompanying us when we drove it. As we headed out he told us that if the cigarette smell bothered us they had some ionizing technology or something that would get the smell out. What on earth?

If you can smell cigarette smoke in a car when it’s winter, just imagine  what it would be in the summer. My son has asthma and I react to smoke. I don’t think car dealerships should ever expose potential buyers to secondhand smoke. I don’t know why we were ever allowed to drive that car. They should have cleaned it first.

My partner found the Yaris’ steering really tight and the trunk space was incredibly small so that elimated that car from our maybe list. The next car the salesperson showed us was really nice. It was some sort of luxury version of a  2015 Toyota Corolla and had leather features and heated seats and plenty of technology.  I think the mileage for that one was also in the 30,000 km range. The problem was it was out of our budget. He never asked us what our budget was. We really liked that car but the price he set was about $1,000 above what we could afford.

I don’t think salespeople make much of a commission on used cars and I guess some salespeople don’t want to put too much time into people who are shopping around and taking their time to find a car. The next thing he did was show us a really basic 2015 Toyota Corolla CE. I can’t remember the mileage, just that it was a white car and wasn’t super attractive inside and had visible scraping on the bottom of the car doors. When I asked about that, the salesperson told us that it was from stones hitting the car. He kept saying that unlike black cars, white cars don’t show dirt. I had a hard time keeping my composure. We see dirty white cars all over the place in our area. If a white car looks clean, it’s probably because their owners just visited a car wash.  Otherwise it looks worse than most other cars on the road.

When we wrapped things up, that salesperson did not look like he cared if he ever got our business. I phoned the dealership a few days later when I noticed on their website that the price had come down on the car we really liked. He never called us back.

It doesn’t matter now.  After meeting some very pleasant and sympathetic young salespeople at other dealerships, we found our car. It’s another Honda Civic and like the old one, it’s blue. But it’s within our budget, its history looks good, the mileage isn’t too bad and it even has the heated seats and rear-view camera we weren’t looking for. Our must-have list was short: a car in great condition, air conditioning  and Bluetooth.

This newish car is ticking all the boxes. Now we just have to refuse the nearly $4,000 in add-ons the woman in the financing department pitched us. We spent an hour and a half listening to a spiel about our need for an extended warranty, “Platinum” rust protection, V.I.N. engraving and disability and life insurance. We said we would think about it but in truth were left that dealership feeling hangry. If she had fed us, who knows, she might have had a sale!

Pharmacy weirdness

477px-Rx_symbol
Wikimedia Commons

My partner went to pick up my son’s prescription the other day. But when he got to the counter, the pharmacist explained that they couldn’t fill the entire prescription because the 25 mg pill of the drug, a generic version, was on backorder. He explained that they might not even be able to fill the prescription the following month. The solution? Accept the brand-name version instead.

 

We refused because our drug insurance offers 80 per cent coverage for generic drugs only. The brand-name version costs six times more than the generic and we would be on the hook for the difference in cost. The pharmacist suggested that my son’s doctor specify that he should take the brand-name drug only.

The pharmacist charged my partner for the cost of the entire prescription, even though the bottle contained only 18 of the 45 pills expected.

We received the rest of the prescription a few days later. While we waited, I called a pharmacy in Montreal we used before we moved off island.  They had the drug in stock and offered to transfer the prescription. I phoned the Quebec goverment’s Régie de l’assurance maladie du Québec (RAMQ), where the man I spoke with advised us to change pharmacies. He said if there truly was a shortage of the drug it would have been on the news and perhaps the backorder issues have to do with the pharmacy’s payments to its supplier? He said that since pharmacies are private businesses, the best thing to do in this situation is switch. He said something along the lines of, “If 25 people do this, maybe the pharmacy will get the message.”

From what I understood after a call to the insurance company, getting the insurance company to do an override so that they paid 80 per cent of the brand-name drug, Cozaar, instead of losartan, was going to be complicated. It sounded as though the pharmacy’s suggestion to have the doctor prescribe “Cozaar only” might not work. For me the idea of replacing the drug listed on the prescription only because the pharmacy was having trouble obtaining the drug, was not workable. To me this is fraud. It would be different if my son had an allergy to losartan or something like that. That’s not what’s happening here.

Researching the generic drug, losartan, I discovered a recent recall of 25 mg losartan in the United States over fears of carcinogenic contamination. Last fall Health Canada tested supplies of losartan sold in Canada when it tested ARB inhibitors (a.k.a. sartans) and based on the test results for 25 mg losartan, they appear to be assuring the public losartan pills sold here are not contaminated. According to the website drugshortagescanada.ca, which lists Canadian shortages of pharmaceutical drugs, there is no shortage of 25 mg losartan in Canada. But the 25 mg version produced by Apotex has been discontinued. Apotex is just one of a number of companies manufacturing losartan and since other pharmacies around Montreal appear to be able to get the 25 mg pill, I’m confused about what’s going on in my neck of the woods.

I don’t understand why our local pharmacy is telling us they can’t be sure they’ll be able to fill my son’s prescription next month. I don’t know why they’re making it sound like it’s hard for them to obtain this drug. In 15 years of filling prescriptions we’ve never had this problem and since other pharmacies have the medication, we have no choice but to walk away from this pharmacy.

UPDATE February 4, 2019: I checked with another pharmacy in our area and that pharmacy also has losartan 25 mg on backorder. They told me if a pharmacy says they’re not having problems finding this drug, they’re lying. From what they could tell, the issue should resolve in another few weeks but they suggested that my son order his losartan a week or two ahead of picking up his prescription. I checked that drug shortages website again and noticed a reported shortage of Cozaar, the brand-name drug on January 31,2019. I don’t  quite understand the website but from what I can there was a shortage of losartan at one point but it seems to be resolved now. I think the Cozaar situation may be sorted now.

 

 

My modified blogging challenge

estee-janssens-396887-unsplash
Photo by Estée Janssens on Unsplash

For the month of February I’m adapting a January blogging challenge from Witte’s World.

I could do the February writing challenge but I find the January one suits me more.

For this first day of the challenge I am to state five blogging goals for this month.

Part of the problem I’m having with setting these goals is I don’t blog for money. Earning money from the blog would be great but it’s not why I blog. I like the idea of having some structure though because blogging took a back seat while I was doing other things or dealing with health issues.

So my five blogging goals for February are:

  1. Post every day
  2. Write quickly
  3. Enjoy writing, blog for the sake of blogging
  4. I will not worry if this blog does not fit into any particular niche
  5. This not (usually) a shiny, happy blog, so I will not worry about being critical or expressing unpopular opinions