So, my doctor diagnosed me (36M) with hypertension due to alcohol abuse and smoking at the beginning of the year. I was consistently at 150/80 or higher and also had high cholesterol (luckily, my liver was still doing okay). As a result, he put me on Nifedipine and I checked myself into a rehab clinic.
My BP came back down to a healthy level within a week of sobriety, medication, and a better diet. While in rehab, my BP cuff broke and the VA screwed up the order for the new one, so I haven't been monitoring it for a few weeks while the new one came in. I'd been stable for 2 months at that point though, so it wasn't much of a concern.
Well, about a month ago I start reading at 90/60 at the doctor's office. Then, 2 weeks ago, I started getting dizzy when standing up and became lethargic during the day (after taking my BP medication). Finally, I got my new BP monitor this week and it turns out I've been consistently at 80/50 and only up to 100/60 prior to taking my meds. My cholesterol has also completely returned to healthy levels (107 total, 53 LDL). My doctor returned my call yesterday evening and we've decided to titrate me off the medication (now Losartan and hydrochlorothiazide).
It turns out alcohol abuse and smoking is bad and you should eat a vegetable every once in a while. Who knew?

My doc has asked me to do further testing next week due to slightly low HCT. 33M 6"1' 280lbs Caucasian Smoker:Not anymore (last cigarette was 10+ years ago). Drinking: occasional drinker. Medication: Losartan Hydro combo and Amlodipine I get some bad anxiety and just wanted to see if there's anything I should worry about.
WBC AUTO 7.3 RBC AUTO 4.55 HGB 13.8 MCV 89 MCH 30.3 MCHC 34.1 RDW 14.4 PLATELETS 235 HCT 40.5

I’m a 31F with a partial hysterectomy and other surgeries I’ll list shortly. In the last year to two years I’ve been dealing with increased pain in my joints, headaches, fatigue, fogginess, short temper, numbness and weakness in my extremities. I had a nerve conduction study done that showed nothing abnormal, however when he stuck my lower leg with the needles for the nerve conduction study I barely felt it. They did an MRI of my brain and found a small mass on my pituitary gland that we plan to do a focused MRI of shortly.
I’ve had the following surgeries in the past 4 years:
Tonsillectomy (2022) Partial Hysterectomy (Ovaries only left, 2020) Liver resection and gallbladder removal (2020, benign hepatic adenoma caused by birth control)
Medications:
AM: Wellbutrin XL (300mg, 1x daily) Metoprolol XR (100mg, 1x daily) Losartan Potassium (100mg, 1x daily) Topiramate (25mg, 1x daily) Vyvanse (70mg, 1x daily)
PM: Metoprolol XR (50mg, 1x daily PM) Protonix (40mg, 1x daily) Belsomra (20mg, 1x daily) Valium (5mg, PRN)
Spravato (84mg intranasal biweekly)
Rheumatologist diagnosed me with hypermobile syndrome and fibromyalgia after seeing me for 30 seconds but ran blood work just in case.
The numbers that have me concerned are the following from the blood work the rheumatologist ran:
HGB - 9.8 (Result confirmed by repeat analysis) HCT - 33 MCV - 67 MCH - 20.2 MCHC - 30.1 RET-HE - 21.90
What do my next steps need to be? Who do I need to see next? Should I get a second opinion? Any advice is greatly appreciated because I’m scared with the lack of answers and the run around I’m getting from every specialist.

Was pretty dialed in on IM in terms of numbers, but felt like I was getting some gnarly peaks and valleys and a few other things that may or may not be due to exogenous test usage. The only part I was 100% battling from test is the good ol HCT/RBC-related shit, which is one of the reasons for trying subQ.
Giving subQ a shot to see if I see any improvements. Have been doing it for a little over a week and overall feel "better" so far. Could be partially due to other factors as well, so not making any claims just yet.
My question is- when should I retest to compare numbers to IM? I saw someone mention 12 weeks to get "saturated" but that seems illogical, since I'm not really starting from day 1 on Test C. It's already in my system from months of IM...
Any input would be appreciated.

Hi there, I recently came off of an episode of hypo to hypercalcemia with very high blood pressure and then orthostatic pressures that coincided with tachycardia throughout the day. I was admitted to the hospital for four days discharged. I went to see the cardiologist and he recommended the beta blocker Carvedilol. I think it will help with my elevated blood pressures as I’m also taking amlodipine however, I’m concerned because I do not want to end up orthostatic static or too low as my pulses can be anywhere from 60 to 130 depending on what’s going on. Sometimes at rest it sits at 115. My heart rate never seems to drop too low so that’s a good thing but my blood pressure tends to drop throughout the day and then elevates when I sleep. Today at 8:30 in the morning when I saw the cardiologist, my blood pressure was 152/107, pulse of 105 he didn’t seem too concerned. He did an EKG and it was fine. Anybody have any experience with tachycardia and taking this med and what I should expect? I used to be on losartan and hydrochlorothiazide but they’ve now discontinued that.

So I was just on a post of someone asking for recommendations on bad fics to judge if they are as bad as their reputation says, and the various shared recommendations got me thinking about how I judge fics. Several hated fics were ones I personally enjoyed, and as people explained why, I thought it would be interesting to hear how people judge fics, and with those thoughts in mind, which fics they enjoyed or which they didn't to the point you made note of it.
So, if you want to share, please just give a small description on how you judge fics, and based on those parameters, some fics you either liked or disliked.
Personally, I often judge based on three criteria. Setting, Plot, and Writing. I'm also more partial to Taylor centric or adjacent stories, so sorry if they aren't your normal cup of tea.
Setting can be summed up in how the world behaves within the story. While Worm isn't exactly air-tight setting wise, it works, and can be explained by expanding on the unexplored parts. With fanfics, I see it as judging how the story explains what is in the world that is different in Worm, or exploring those unexplored sections. To start with a somewhat popular world setting, the idea that the Slaughterhouse Nine are a black-ops group, therapy group, or are in general not the most repulsive group on the American continent.
For example, in fics like Mauling Snarks that explore the idea of human-shard interactions and have the S9 as a secret therapy group headed by Jack Slash acting as a therapist, using his Master influence to help them control themselves and redirect the uncontrollable impulses to either harmless targets, or use them as tactical weapons against threats. I judge changes like this on how they handle these changes are implemented, how these changes would affect canon and how the story differs from Worm. Mauling Snarks actually did this rather well, having the setting be nearly the same with public changes but having more behind the scenes and PRT internal structures different to explore the bureaucratic changes caused by this choice to explore it. It allows for the idea that the side-effects of powers are more important in story to be seen as realistic, and when several people start to fixate on these ideas, it comes off as interesting to me.
A fic that didn't do this well in my opinion is Section Nine, which has a similar premise with some add-ons, but it is not introduced well or handled well. With the S9 being a black-ops group under Legend used to take out problematic groups that can't be dealt with legally, along with Toybox being a private think-tank made by Hero, and the two partially merging after Hero's death to work together. However, the world changes are completely unrelated to this pretty important change, and introduce other ideas that are never explored or their ramifications considered. While a fun premise, all it did was slightly adjust how the main cast behaved and some of their allies were, but it also could've had the near identical plot line without introducing any of the changes at all, making it feel extremely redundant and deceptive. I can casually think of several ways to do so. Especially as, and this is the biggest sticker, the canon S9 members essentially don't show up or do anything beyond act as a plot device. Barely any canon S9 members appear(I can only remember Jack and Riley showing up at all), and they all have minimal effects on the plot. There only real effect is that the S9 attack Brockton Bay, prompting the killing of E88 capes. That's it. The only reason I can't think of a way to easily write the S9 out without major rewrites is to introduce an easy way to excuse killing the E88 without having to slide an arc or sub-arc in, or rewrite another one. It's stuff like this that tends to turn me off fics pretty quickly, introducing a premise and proceeding to use and then discard any part that makes it interesting.
Plot is the story framing itself, and how the story progresses. I judge it based on the promise the story gives with either its synopsis/summary, how the first couple chapters go to say what the story will do, and how the plot progresses. Does the story promise what it gives? Does the story have a logical progression from A to B. In fusion fics, this is judged in how the inherent promises made by the individual stories are addressed. In Au/Alt-powers, this is judged by how the changed power is affecting the story.
An example is Trailblazer. The story promised a fusion of Worm and Gundam, and it delivered well in my opinion. While also a great example of Setting, as it has a lot of Au elements, fusion elements, yet preserves enough similarity with that is doesn't feel like a completely unrelated fanfic wearing Worm's skin, but what I like most about it is the plot. Worm is grimdark/grimderp setting that espouses a disbelief in the inherent goodness of people and the inevitability of failure . Gundam is a franchise that looks at the ugliness of humanity and looks for the beauty hidden behind it, the last spark of hope. To borrow the catch phrase from another property, Gundam stories "fight for all that is beautiful in this world." No matter what is currently occurring, nothing should stop you from fixing it. Gundam stories are about the effects of war and how people attempt to address them. In Trailblazer, that war is the Golden War, where Scion is defeated, but his death leads to very different broken triggers, and the PTSD that was formed makes very different antagonists. That promise is explored in Taylor, who holds the same issues canon Taylor does, but instead of manifesting powers to try and cover up her trust issues, she is given tinker abilities that allows her to fix the issues, and in the process, allows Taylor to flourish instead of rot. Taylor's canon character can be summed up by one of Ryuugi's more memorable quotes. "Taylor was born to be a 90s Magical Girl, but was taught to be a 90s Supervillain." Trailblazer doesn't teach her this time, allowing her to come to believe in humanity again. Instead of quite literally beating it to death, she answers the problem with a solution. It's plots like these I personally enjoy that actually try to uplift characters and allow them to grow into their truest self, their best. A couple others also do so quite well, Like Fabius's Visitors from Afar and Miraculous Escalation, where the inherent promise in fusion fics are addressed extremely well, blending the philosophies of the two stories in satisfying ways.
For Alt-powers/Aus, I can actually do an interesting compare-contrast between two stories that have the same premise, start, and promises, but go in wildly different directions, to one's glory and the other's failure. The idea of Taylor accidentally killing the Butcher before her cape career can properly start, leaving her with worrying about the Butcher's legacy, even as she apparently nullifies the insanity of the inheritance. Here comes the new boss and Inheritance succeed and fail in this idea respectively. HCtNB has Taylor becoming an altruistic tinker that is willing to go against the PRT to do right by those she believes deserve a second chance, due to her fears about how she herself would be judged, and struggles as the suggestions made by the more malicious past incarnations become more and more tempting as the stability of Brockton starts to collapse. Inheritance has Taylor fail to resist the Butcher from basically the word go, quickly falling into the Teeth and causing the Mad Max gang to get worse then it ever was before, the PRT and Protectorate failing to even look competent even with the legitimate danger Taylor poses because the author has a lot of issues with their fics, for some reason making the idea of taking human trophies seem like a small blunder comparable in scale to accidentally forgetting to bring a pencil to class.
Finally, Writing can be summed up with just how well they write out the ideas they are trying to convey, and what choices they have their characters make and how they presented to behave. The first half is easy to expand on with a basic test. Does the word choice and grammatical structure make Wattpad writing look like the peak of eloquence? Because let me tell you, it feels like half the writers on that website don't even speak english. The later half is the judgement of whether the in story behavior of characters make sense. While Plot judges whether the over-arching plot itself makes sense, Writing is the smaller moving parts that cause plot progression. Character choices, events that occur due to previous events, character characterization and reactions. Material like that.
While I don't necessarily have a story that is a shining example of good character writing or one that is repulsive, a plot line in a story I liked comes to mind. In Outcry, Miss Militia, who is commonly characterized as being a rule follower to the point of stupidity, breaks the law for personally satisfaction by breaking ranks to hunt down and execute Coil, and when he surrenders, she tortures him before executing him, even as Dinah is trapped and forced to watched. The Miss Militia is written to be the Hannah from canon, being the rule-follower and strict character that would never conceive of breaking laws for personal desire. This is a culmination from when Miss Militia is the first hero to talk to Taylor after her trigger burns down Winslow, to learning that she can't fulfill her promise to Taylor of getting justice and how much it disgusts her, to having to know that Taylor breaks down learning the first person she trusts after her trigger lied to her ad used her, and Coil using that break to turn Taylor into a rampaging monster that took over a hundred lives while essentially comatose. So when Lisa's machinations allow for Coil to be vulnerable, Miss militia proceeds to break into his base, which not hidden now that both the E88 and ABB assault it to get revenge on Coil, kills basically anyone who gets in her way, and proceeds to start talking about how she'll struggle not to enjoy this, and expects him to scream. Miss Militia proceeds to threaten Lisa when she turns herself in the help Taylor, and is seconds away from painting Lisa's brains across the wall. The entire descent is beautifully displayed, somehow being completely obvious to be coming yet so out of character that you would never expect it without having read it.
With all these in mind, the stories I mentioned as good examples are fics I recommend, with Mauling Snarks being an "eh" fic and exception, as while it isn't bad, I wouldn't recommend it. While good in World framing and decent in writing, the plot is relatively weak, and writing has lots of receptive jokes that inflate the size to the point that it is a slog to get through. Trailblazer is a personal favorite.
I recommend Mp3 stories, even Taylor Varga, though for what may be an odd reason. Mp3 fics all tend to fall into the same formula, but executed very differently. They don't like writing angst, so they proceed to murder anything that could introduce it, and then introduces an unbalanced effect to the plot, normally through Taylor, and then writes the story from that. It's why I like Varga and not Snarks. Varga is just Taylor having fun with demon lizard powers, and dragging everyone around her into her insanity, plot be damned. The 9 got killed by a redneck, the endbringers are pissing themselves as Simurgh tries to figure out some way to make peace with the lizards along with Leviathan trying to warn the humans about the dangers of lizards from the sea, there is nothing to make threats when Taylor can grow to be several times the size of Behemoth. Snarks still tries to have a serious plotline and moments.
Ack stories more often then not are good for similar reasons, though through talking with others, I've learned that Ack has some issues that may or may not have been nuked to oblivion over on QQ, of which I refusing to search for because I'd rather not scar myself. From what I've gathered, he wrote some pretty weird shit earlier in his career, causing either QQ or himself to erase essentially everything from what I'm willing to look up, but from what I've seen as a sfw only reader, he seems to have fixed this, and will often use his readers to steer him in plots to prevent that issue. Only warning I can give is to not look through his nsfw stuff, as it can taint your enjoyment of his better fics. His fics often revolve around one element and that idea is run with, the story flip flopping between serious and goofy. While not at the standard of longer and serious fics, I recommend them for lighter reading. Giving Taylor PtV min-maxed for murder, having Danny be John Wick, Emma triggering in the alley leading her to join Taylor in heroics, giving Taylor Lung's power on steroids, there are plenty to choose from.
Slider also falls into this category of shorter comfort fics, though they did write the longer Mutant Deviations. Slider differs in that they tend to try and humanize a commonly non-humanized character in unique ways, leading to more unique cases, or generally having more character and introspective moments. Taylor adopted by Purity, being the daughter of Skidmark, Regent being as bad as his siblings leading to both Taylor and Lisa being traumatized.
Aggrippa is similar in Wake-up Call and Wordsworth, though they tend to use the sfw/nsfw line as a jump rope, but the story is very much an exploration of character driven stories, with a chapter in Wordsworth that made me feel bad for the Thinker without excusing a single atrocity, even expanding on them. The idea that Taylor's shard, as she was tricked into drinking a Cauldron vial with the Nemesis program, is a shard made by Eden to record the stories of the species they interact with, and as Eden struggles to understand why they are told, the shard grows. It eventually grows strong enough to give Eden a sense of empathy and morality, but as Eden is distracted by the newly formed understanding, they crash, leading to their death before they get the opportunity to atone for their crimes.
For more serious authors, the writer of Outcry, LD, Trailblazer's Endless, and Fabius Maximus are great. There are some fics that have a similar vibe, like Weaver Option, though you need to be patient with it, as the author was not as mature a writer as necessary when the story was first being written, but has cleaned up their ability nicely.
The fics I gave as bad examples are in the "do not read" pile without fail. Both were written by Pendragoon, who has several extreme flaws as a writer that make his Worm fics by and large unreadable without ignoring over half the fic. I think the biggest is that Pendragoon seems to have a weird persecution complex, believing anybody not liked is being unfairly judged and overcompensates by making everyone worse while also trying to justify the unliked character's actions without addressing or even acknowledging the issues that got them that status in the first place. It's not the only issue, as they also seem to hate their audience or subscribe to far into the idea that all publicity is good publicity, but my overall experience with them is to use a 15 ft pole when dealing with them, or to not at all.
I don't have as many bad stories and writers, as I tend to drop and forget unliked stories. There are a couple stories I could name, but from what I've seen, it seems to be an example of immature writer over bad writer. I just give the suggestion that, if the story appears to already be of decent length, give it a couple chapters to work out the kinks before judging too harshly.

In August, September, and October of last year I had seven to ten day periods of hypertensive states. Blood Pressure could surge to 200/110 with heart rate up to 165 and return to normal. This eventually went away and I returned to normal. These were similiar symptoms to someone who a pheochromocytoma. I went to have a stress tecst and was negative.
Januray 3rd, it all started again. I began having intense headaches, sharp pain in my left thigh which corresponded to tightness in my neck and headaches and symptomatic PVCs. This time, I was prescribed losartan, then hydrochlorothiazide, and then metoprolol. My blood pressure varied from 90/60 to 180/112.
I have had MRI of the brain, abdomen, and a CTA. All have come back negative. Occasionally, I have internal tremors in the neck to head area.
In March, my blood pressure seemed to somewhat stabilize. However, I began to have more and more PVCs. I still have strange random sensations of shortness of breath, tightness through my neck, and a sharp pain in my left thigh which corresponds to headaches and pvcs.
I finally had a sleep apnea home study in March and began CPAP at the beginning of April.
I was prescribed flecainade because one cardiologist thought that I was having variable blood pressure due to the PVCs and the sympathetic nervous system.
January, February, and most of March I was out of work. I am back to work and still not back to normal. No-one seems to know why I have a striking pain in my left thigh that seems to correspond to strange heart palpitations, headaches and chest pain as well as smaller surges in blood pressure. I randomly get tightness in my back and chest mixed with shortness of breath.
Is there anyone else out there that can relate?

Make, Age 57, Height 6ft tall, weight 270lbs. I have been diagnosed with high blood pressure, edema and enlargement of the heart. I was prescribed a fixed-dose combination of losartan and hydrochlorothiazide (hyzaar) titrated to 50/12.5. My questions are several fold: 1. is furosemide ever indicated/prescribed in combination with hyzaar for edema? I think I gathered that this combination could be contraindicated and closely monitored for changes in Blood pressure and kidney function. Having said that, is there a medical case for these 3 in combination worth pursuing with my doctor? If not, please explain 2. Carvedilol. Is it ever prescribed with Hyzaar? Or does the chance of fluid retention make it not worth the risk even if there could be slightly improved blood pressure numbers? Thanks in advance for any response. I'm trying to be active in my healthcare and am trying to make sense of everything.

I've decided to taper off and quit my medications after being treated for hypertension for the past twenty years. While this may sound crazy, please hear me out.
Im a 50 yr old male, 6'0 and 168 lbs. I don't smoke, I recently gave up alcohol, and I eat a healthy diet and get a good amount of exercise.
I currently take Valsartan, 360 mg, which is the max dose. I also have a prescription for Amlodipine 10 mg, but Amlodipine makes my feet and legs swell, among other unpleasant side effects, and I don't like how I feel on it. Other meds I've tried are Losartan and Lisinopril, and Hydrochlorothiazide. Losartan worked for awhile and then it stopped. Lisinopril gave me a tickle cough that kept me awake at night. And the water pill wrecked my libido.
So why am I quitting bp meds? I'm quitting because I have come to the realization that a lowered bp through medication is not actually fixing anything. Hypertension is a symptom, not the disease. By lowering it with pharmaceuticals, we're not actually improving our health...whatever is causing our bp to rise is still going on inside us. I've also learned that people who treat their hypertension with meds still have heart attacks, strokes, and get heart disease. And by lowering their blood pressure with medication, most people become complacent, thinking that they've got their problem under control.
I've also learned that there are plenty of obese people with diabetes who never exercise and eat junk food all day, and they have perfect blood pressure. How can this be? My wife isn't diabetic or obese, but she doesn't eat that well and rarely exercises, and her bp is 95/50. Some people's genetics are such that their blood pressure stays low, regardless of their lifestyle.
Another thing I found interesting is how much lower the threshold for blood pressure treatment has become. it used to be considered normal to be 140/90, but Big Pharma can't make money off of normal.
And lastly, blood pressure is just one risk factor for heart disease, and the only one I have. I plan to eat right, stay fit, sleep well, avoid alcohol, get plenty of sunshine, and manage stress as best I can. I will continue to search for the root cause of my hypertension, as well as natural ways to normalize it.

I visited a new dentist for the first time in a few years after getting a job with dental insurance. I discovered I had a filling that had fallen out and another tooth that had a cavity needing to be drilled/filled.
My issue is that on the day of my appt to fix the fillings, the dentist led me to believe my insurance only covered silver fillings. The conversation was almost word for word this:
She asked, "you have Delta, right?". I said, "yeah". She said, "Delta covers silver, you okay with silver?". I said, "I don't know, is there a filling type that is recommended over the others" (I was curious about paying out of pocket for the better type of fillings). She sounded irritated and said something like she was only asking because my other fillings are white but "silver lasts longer". I said, "oh, okay, I guess if that's what my insurance covers then". She proceeded to fill my teeth with silver, which I've never had in my mouth before.
Ever since the appointment (about two weeks now) I have been having pain and extreme sensitivity to hot and cold, and it's not getting better. I'm frustrated because I never experienced this kind of pain with any of my composite fillings. The dentist never said a word to me about this being a possible issue, otherwise, I would have not gone forward with silver fillings. I am autistic and have sensory issues so it's been really challenging. Though I am aware sensitivity and pain may eventually subside after several weeks of recovery, I'm still concerned about continued sensitivity to hot and cold in these teeth due to the filling type.
So I called my insurance today to see what my out-of-pocket expenses look like if this ever happens again and I get composite instead of silver in the future, and they informed me that there is no downgrade to silver on my plan and that the dentist could have used composite and it would have cost the same exact amount. The representative was surprised the dentist would have even said what she did about my coverage just based off hearing "Delta", since they have so many different policies and coverages available, it's impossible to know without knowing which specific Delta plan I have.
I'm really upset because I would definitely rather have had the composites, I don't like how the silver looks in my mouth and I can't stand the sensitivity and pain. I am also upset because I feel like my ignorance was taken advantage of (I'm not sure if that was the intention, but the experience felt really off compared to other dental visits I've had in the past, and the dentist felt pushy). I trusted the professional to fully inform me of my options and it doesn't feel like that's what happened here.
I guess my question is what do you think is the best course of action for this situation? Should I proceed with trying to get the silver fillings replaced with white composite? Is getting silver fillings replaced with composite a difficult process and are there any risks involved? Would it be better to leave the teeth alone and deal with the recovery process and hope all the sensitivity eventually goes away?
Unfortunately, my insurance company said to have it covered by them, the swap needs to happen with the same dentist, who I don't trust anymore. Otherwise, I need to file a grievance which could take up to 60 days to be processed. Looking back at the conversation, nothing the dentist said was completely untrue, she just wasn't giving me full information, so I'm not sure what my chances of getting a grievance approved even is at this point.
Not sure if it's relevant, but I am 32, autistic, and have type 2 diabetes and high blood pressure (I take metformin and losartan as treatment). edit: I do not drink and I do not smoke

update: decided on Hawaii Car Transport. It was the most convenient "one-stop" full service. The other option was to schedule separate services to tow the vehicle from LV address to Long Beach CA. Surprisingly, the cost difference to coordinate all this (compared to doing the full service with HCT) was, in my opinion, insignificant.
I've got family finally moving back home to Oahu. They're considering shipping their vehicle (instead of selling there, buying here). Anyone have recommendations for a full service transport company that'll pick up the vehicle at their LV address? We can pick up at the Oahu port.
I've done the transport from HI to LV, but never the other way around. I assume the process is the same.
Thanks for the recommendations

I (31F) recently got lab work done and got my blood test results back. I have been feeling dizzy, weak, and tired after any form of exercise. I got tested because my therapist suggested I get tested due to my memory problems. I got my test results back for my blood count. I noticed something when comparing my test results from last year. My MCV is below what is considered "normal". I am not sure if this is what is causing my symptoms. I have a doctor's appointment until next month so I thought I would try to figure out what my results meant while I wait. Last year my MCV level was 78.2 and this year it was 79.4. My blood sugar also got tested and that was normal. Last year when my MCV was what is stated in the table below my doctor said that everything was normal. Should I be concerned?
​
Thank you in advance for your responses.
​
Complete Blood Count (CBC)

CBC Test	2023	2024
WBC's AUTO	6x1000/mcL	5.6x1000/mcL
RBC, AUTO	4.91Mill/mcL	5.09Mill/mcL
HGB	13.2g/dL	12.9g/dL
HCT, AUTO	38.4%	40.4%
MCV	78.2fL

79.4fL MCH26.9pg/cell25.3pg/cell MCHC 34.4g/dL31.9g/dL RDW,BLOOD13.4%14.5% PLATELETS, AUTOMATED COUNT213x1000/mcL201x1000/mcL
​

I've been taking 12.5mg of Hydrochlorothiazide (diuretic) since August 2023, with 100mg of Losartan. My doctor switched me to 40mg of Olmesartan in December 2023 because my blood pressure was still higher than he liked it to be. Since then, along with losing weight and improving my diet, my blood pressure has been much better.
However, I had an ER visit last month because I had a fast heartbeat and my body felt "heavy." My EKG was fine other than the fast heart rate, but I was told that my potassium was low. 3.3 mmol/L to be exact, compared to the 3.7 it was when I got blood work done in December. All other blood work was fine, according to the ER people. Around this time, I was also noticing chest discomfort and lightheadedness if I sweat too much. I also started to have irregular heartbeats hours after working out, but usually not during, which I think is odd.
My doctor (and I) came to the conclusion the other day that taking Hydrochlorothiazide for an extended period of time, even though I was on the lowest dose, was causing my potassium levels to drop. I also had another EKG done, which I was told was fine. He has taken me off of Hydrochlorothiazide, so I now just take the Olmesartan 40mg.
I was an idiot and completely forgot to ask him how long would it take for my potassium levels to go back up, or if they even will on their own. Sure, not taking the diuretic anymore will stop it from getting worse, but will it also allow my potassium levels to go back up on their own? Or will I have to do some additional potassium treatment to get them back normal again? I definitely did not have potassium issues before I started taking it.

27 male, 6'1" ~350lbs, diagnosed hypertensive and pre-diabetic. Managed with Losartan, hydrochlorothiazide, Metformin, and fish oil supplements.
This started like a year ago maybe? Not sure. But whenever my hands or feet experience mild trauma they get super itchy and when I itch them they swell out of control. The two most recent examples are
1) went to a wedding, wore super uncomfortable dress shoes that squeezed my toes together and hurt my soles, once I took my shoes and socks off at the end of the day my feet got super itchy. Being a dummy I itched them like crazy for any amount of relief. Within an hour or two they began swelling and when I woke up the next day they were so painfully swollen I had trouble walking. Treated pain with ibuprofen, swelling went down over the course of the day.
2) yesterday i went go-karting for the day, and at the end of the day it felt like my tendons in my fingers felt like they were on fire. Within an hour or so my fingers (especially the space between them) and my hands became super itchy. Again being a dummy I vigorously scratched and itched and rubbed my hands against things to make the itchiness stop only to wake up to hands swollen to the point I can hardly touch my thumb and pinky tips together. Pictured
I'm looking to identify the cause so I can potentially treat/avoid it. Thanks in advance for any help.

https://www.ahajournals.org/doi/full/10.1161/01.HYP.26.1.112

Losartan at 25 and 50 mg plus HCTZ produced marked reductions (−10 and −12.6 mm Hg) in SiSBP compared with the control group; these changes were both clinically and statistically significant (P≤.01).

It looks like there is no need for the higher dose. What do you think?

45f obese 272, smoker, no alcohol
Meds: spironolactone, losartan, Pravastatin, synthroid, vitamin d, folic acid, desvenlafaxine.
Seeing hematologist due to leukocytosis and one of the results over the weekend came back obscenely high : Anion gap 43, it shows that the high normal is max of 12.
All other labs in the panel were normal.(albumin, chloride, sodium, potassium, Co2, etc)
Not having any weird symptoms.
Have been losing weight- 26lbs since Dec 2, 2023. Balances diet- no keto etc.
Other tests run were cbc- elevated wbc 14.7 and hct 47.4%, everything else was normal. Waiting on EPO and I think some others that don’t show yet in portal.
Any insight would be awesome!

Was diagnosed with high BP at urgent care last year couldn’t get into see my GP for several months ended up finding a new GP and a much smaller practices that doesn’t take on very many patients (essentially friends of friends only).
Urgent care and previous GP had me on Lisinopril which managed my BP great! Unfortunately I developed that cough related to ACE inhibitors.
New GP then swapped me to Losartan which doesn’t seem to be doing much (Still in the mid 140s over mid 90s) so this week she added in Hydrochlorothiazide to the mix.
How long does it take for the Hydrochlorothiazide to start changing my BP? Days? Weeks?
Some background; I’ve been overweight since midway through Covid (257lbs 5’10) and have reduced my weight significantly (224 as of this morning). And I’m a bit bummed that it isn’t having more of an effect on my high BP.
Additionally, I think my caffeine intake may be too high? I have about 10 to 13 glasses of unsweetened black ice tea per day… plus a reign energy drink.

Hi all,
ER RN here, 35M caucasian, 6'1", 185 lbs. I've been dealing with GERD for about ~7 years now intermittently, but this year it's got much worse. I have a family pre-disposition I think, my mom has had it for like 20 years or something. I think I got it from being a very high-stress person and previously I used to drink too much caffeine + coke zero + spicy food...I cut all this out a month ago entirely (I had been decreasing all of these for a while before that).
I have been taking PPIs intermittently (e.g. 1-2 weeks at a time, maybe once ever 4 months) for probably 5 years and pepcid complete intermittently for about 5 years, but recently this isn't doing it. Only other med is losartan-hydrochlorothiazide for mild HTN. No other relevant PMH.
My PCP recently started me on 40 mg PPI (omeprazole) 2x per day (80 mg total per day) x 6-8 weeks. I'm about 10 days in and tonight I have the worst heartburn I've had in the last year at least. Today I have taken my 80 mg PPI + 2x pepcid complete tablets + probably 20 mL of maalox + no caffeine or spicy or zero-cal soda or anything else I know to be exacerbating for the last week at least. STILL have 8/10 heartburn right now. I'm honestly probably a bit of a hypochondriac from all I know and I worry about something like Barrett's esophagus; I have also been under a lot of stress recently. Had H. pylori testing approx 18 months ago and it was negative. My PCP put in for a GI consult about 10 days ago and I called a week ago to schedule and they literally were like "we'll call you when we're ready to schedule you...probably in like 2 months or so."
What do I do? I honestly kinda want to go to the ED and request an upper endoscopy or something, but I'm afraid they're just going to tell me they can't do it, that I need an outpatient GI consult for that, and I'll be right back where I am now with only a $1000 ED bill to show for it. I don't even wanna eat tonight it's so bad.
What would you do?