The General Chat Thread (2024)

TastyReuben said:
Went to the doc yesterday, BP was a little high (and I’m on meds for it). They took it again a little later, and it was lower.

She told me to throw out my years-old home BP machine and to buy a new one, one that’s been validated by the American Heart Association for accuracy, take readings regularly, then come back and see her in three months.

I did that, and I’ve taken my BP twice today, following all the rules about when/how, etc, and I’m getting crazy-high readings, so now I’m going to have to bring the monitor into the doc to have it checked for accuracy against an actual human taking it.
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I'm guessing you were told to get an upper arm cuff one, not the wrist type?

I find that I get better readings if I've sat with the cuff on my arm for 5 minutes before taking my BP. Just the act of putting the cuff on sends my BP soring.
And try to always use the same arm, rather than switching sides. And don't talk whilst you're talking the reading.

Also I'll take my BP monitor on to the doctors with me about twice a year (more if they are watching my readings carefully or I'm concerned) and they'll test it against theirs.

Just done mine. Half my normal BP meds are holding it at 127/72 pulse 77. I'm happy with that. I can ignore it for another week.
 
TastyReuben said:
Yep - we actually had one of each, but the newer one was still a good 15 years old. The older one was inherited from her parents…I wouldn’t be surprised if it was 25 years old.
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I know mine is from the UK, so about 10 years or more old, at least but it gets tested twice a year. Age shouldn't be a problem if the compression pump, cuff and piping are good.
Thinking about it, it might be older than 10 years because it resets the year to 2009 when it needs new batteries, so I probably bought it when we got back from our year cycling... so 2012... guess that makes it at least 12 years old, and older by design. But it's almost to the figure accurate with the doctor's surgery ones.
 
My sister, now retired RN, uses an old-time manual Sphygmomanometer and stethoscope to check her own BP. She also says that with some patients, she has to do the same, even though the hospital wanted them to use the electric units that also measure pulse rate and pulse-oxygen at the same time. The electric units inflate so much, that they cause pain that causes some patient's BP to go before and during the test. A good nurse can use a manual Sphygmomanometer gently enough not to stress these patients out, causing a false high BP reading. Then, she can use the electric unit to test pulse-ox levels, and verify pulse rate.

CD
 
Sort of.
How tightly you have to inflate a cuff depends on how high the persons blood pressure is.
So if someone has very high blood pressure you will have to pump that cuff hard regardless of whether it‘s manual or digital reading and that can be sore.

There is the usual distrust of technology and people wanting to stick to the manual way in any field but taking a BP manually also introduces room for human error. The removal of this error undoubtedly improves prescribing.
To take a BP manually you have to listen for the start and stop of the noise and peoples hearing (and interpretation) varies.
If you consider that over 40% of people over 50 have some degree of hearing loss, suddenly taking a blood pressure manually doesn’t seem such a great idea.

The white coat syndrome that send’s BP’s up happens regardless due to anxiety over blood pressure. It is far more accurate to take one then retake it after you have relaxed the person. Home readings are the most useful so long as the machine is good, but even then you have the person who keeps retaking their BP until they “get a good one” 🙄

The old automated machines inflate to a reasonable level and then if it’s not high enough shoot up to an excessive level if they need to re-inflate (this is to try and avoid a third or fourth attempt which obviously stresses folk out).
The new machines are much nicer.

From the point of view of consistency and accuracy the machine wins everytime.
If you have someone nervy then yes switch to manual BP but it isn’t the best way to check blood pressure.

Where digital BP machines fail quite spectacularly is on heart rate. The machine pulse reading does not detect the quality of the heartbeat. Doing a pulse manually reveals at a surprisingly alarming rate atrial fibrillation, these irregular heart beats left untreated are a major cause of stroke and cardiac arrest. If you want to focus on an important part to do manually that’s it.

Blood pressure machines contain parts made of materials that degrade over time, usually seals, tubing, cuffs that eventually expire but just like vehicles or anything with flexible moving parts sometimes they far exceed how long anyone expects them last so checking old machines (an new ones for that matter) is wise.
 
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SandwichShortOfAPicnic said:
Sort of.
How tightly you have to inflate a cuff depends on how high the persons blood pressure is.
So if someone has very high blood pressure you will have to pump that cuff hard regardless of whether it‘s manual or digital reading and that can be sore.

There is the usually distrust of technology and people wanting to stick to the manual way in any field but taking a BP manually also introduces room for human error. The removal of this error undoubtedly improves prescribing.
To take a BP manually you have to listen for the start and stop of the noise and peoples hearing (and interpretation) varies.
If you consider that over 40% of people over 50 have some degree of hearing loss suddenly taking a blood pressure manually doesn’t seem such a great idea.

The white coat syndrome that send’s BP’s up happens regardless due to anxiety over blood pressure. It is far more accurate to take one then retake it after you have relaxed the person. Home readings are the most useful so long as the machine is good.

The old automated machines inflate to a reasonable level and then if it’s not high enough shoot up to an excessive level if they need to re-inflate (this is to try and avoid a third or fourth attempt which obviously stresses folk out).
The new machines are much nicer.

From the point of view of consistency and accuracy the machine wins everytime.
If you have someone nervy then yes switch to manual BP but it isn’t the best way to check blood pressure.

Where digital BP machines fail quite spectacularly is on heart rate. The machine pulse reading does not detect the quality of the heartbeat. Doing a pulse manually reveals at a surprisingly alarming rate atrial fibrillation, these irregular heart beats left untreated are a major cause of stroke and cardiac arrest. If you want to focus on an important part to do manually that’s it.

Blood pressure machines contain parts made of materials that degrade over time, usually seals, tubing, cuffs that eventually expire but just like vehicles or anything with flexible moving parts sometimes they far exceed how long anyone expects them last so checking old machines (an new ones for that matter) is wise.
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I do realize that myself sister is merely an American RN, which only requires a four year university degree, and constant continuing education and recertification. But, the point is, she is able to tailor the amount of inflation to the level that is appropriate for the particular patient -- even at her well over 50 age of 64.

The electric BP machines I've experienced, and once again, they are American machines, seem to inflate to the same level every time, for every patient.

BTW, at my sister's hospital, nurses wore colorful scrubs, not white coats. She had her own office where she could take vitals, run tests, and draw blood in a quiet, comfortable space (she did pre-surgical evaluations).

Oh, I'm pretty sure I did say that she used the manual Sphygmomanometer for patients that experienced anxiety from the machines.

According to her, it was the anticipation associated with knowing that they are about to have their arms squeezed to a painful level that made caused the anxiety related spikes in BP levels for some people -- not all. I knew the machine was going to squeeze my arm to the point of significant discomfort, if not downright pain, but it didn't cause me any anxiety.

I think my sister would disagree that the machine wins every time over a Nurse using a manual Sphygmomanometer, but again, she's an American RN. Is Sphygmomanometer even the correct name... or spelling, in real English?

CD :wink:
 
It wasn’t intended to be inflammatory.
Not sure why you keep bringing being American into your edgier replies “merely and American RN” 🤷‍♀️
It‘s a little unnecessary, unless it’s a cultural difference worth discussing to me we are all just people.

I doubt your sister or any of the people involved in taking BP’s get their hearing checked regularly so how would all those manual users know?
White coat syndrome is just a phrase to describe the anxiety people can get when encountering the medical profession, the actual attire they wear isn’t relevant.

I don’t view conversation as something that needs to be won, for me it’s just an exchange of ideas, of information, and hopefully a laugh so I think it’s best if I dip out of this conversation now, it doesn’t feel like simple discourse.
 
SandwichShortOfAPicnic said:
It wasn’t intended to be inflammatory.
Not sure why you keep bringing being American into your edgier replies “merely and American RN” 🤷‍♀️
It‘s a little unnecessary, unless it’s a cultural difference worth discussing to me we are all just people.

I doubt your sister or any of the people involved in taking BP’s get their hearing checked regularly so how would all those manual users know?
White coat syndrome is just a phrase to describe the anxiety people can get when encountering the medical profession, the actual attire they wear isn’t relevant.

I don’t view conversation as something that needs to be won, for me it’s just an exchange of ideas, of information, and hopefully a laugh so I think it’s best if I dip out of this conversation now, it doesn’t feel like simple discourse.
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What got under my skin is that I merely mentioned my sister's experience with BP testing anxiety, and how she has dealt with it over a 42 year career, and you replied with a list of reasons she is wrong.

I'm allowed to say my sister is wrong, you're not. :laugh:

CD
 
I can't have my BP taken on my left arm at all. It hurts me too much and the readings are always wrong as a result. It can only be done on the right arm, but that also leads to problems in hospital because of drips and such needing to be on both arms... modern technology doesn't like drips having their for interrupted!

Both my hubby and I were taught to take BP manually as well because we both trained as expedition medics and batteries or modern technology isn't always available in less advanced countries. It's actually quite interesting the science behind it and doing it as well. Well, it is to me.
 
caseydog said:
What got under my skin is that I merely mentioned my sister's experience with BP testing anxiety, and how she has dealt with it over a 42 year career, and you replied with a list of reasons she is wrong.

I'm allowed to say my sister is wrong, you're not. :laugh:

CD
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I don’t think she’s wrong.
The post is about the areas digital BP machines have an advantage, I didn’t want people to get the idea digital BPs inferior.

She takes some BPs manually for good reasons and does the rest with the machine.
There are always pros and cons to manual v’s automated and always reasons to alter your approach to a patient.

I’m sure if I was having the conversation directly with her we be agreeing on pretty much all of it.

Apologies if it wound you up a tad.
I’m used to having conversations about anything medical in a very detached way cos that how medical folk tend to assess the value of something.

Might be sensible if I step aside from health n welfare conversations and stick with food 😂
 
caseydog said:
My sister, now retired RN, uses an old-time manual Sphygmomanometer and stethoscope to check her own BP. She also says that with some patients, she has to do the same, even though the hospital wanted them to use the electric units that also measure pulse rate and pulse-oxygen at the same time. The electric units inflate so much, that they cause pain that causes some patient's BP to go before and during the test. A good nurse can use a manual Sphygmomanometer gently enough not to stress these patients out, causing a false high BP reading. Then, she can use the electric unit to test pulse-ox levels, and verify pulse rate.

CD
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I check my blood pressure at home, and its generally fine.
Last time in hospital it read very high for me, 150 over whatever. Its normally a bit higher in hospital than home but not by that much.
It got checked manually and it was all fine.

It's a crazy one anyway as driving through town to get to the hospital is nerve wrecking, frustrating and more!
It wouldn't surprise me if more people get high readings in town.
Also, I live at 350 mtr altitude, hospital is at 1300 mtr. No idea though if altitude would have an influence
 
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