Posted by seattlebill on June 17, 2008 at 13:20:13:In Reply to: Anxiety and hypertension after MMA posted by sturmer on June 12, 2008 at 19:00:27:
There are many, many causes of hypertension after surgery, and ceratinly after an MMA. Yes, once OSA is successfully addressed, blood pressure trends down. However, this may not be the case immediately in everyone.
First and foremost early cause of hypertension post-op is pain. Once that is ruled out (usually by using narcotic pains meds)...you proceed onward to other causes. The pain meds implicated in adding to hypertension are the ones containing tylenol. However, that being said...one should never decline pain meds solely because they are concerned about hypertension. Reason being, that it is the number one cause of high blood presure and fast heart rate after any procedure. Other medications that are "pure" opiates will not have this effect (ie. fentanyl, hydromorphone, etc...).
The number two cause is anxiety . If you are an anxious person, this can certainly make that worse !! Having major surgery, mouth wired shut, unable to communicate well, face swollem, numbness, etc... can create anxiety just sitting here writing about it. Perfectly understandable, and in fact, something we have ALL gone through at some point early post op for various reasons. We have ALL had a freak-out moment (or two) post-op from an MMA...
The key is to not let it run out of control...and address it early and frequently. And continue to address it along your continued post-op recovery course. Seek counselling, use relaxation techniques, and/or anxiolytics (if necessary) presribed by someone who will follow you closely. Getting drugs without a follow up for anxiety is a bad plan.
Third: exogenous hypertension from a plethora of potential medical concerns. If pain and anxiety are addressed, and you continue to have high blood pressure and a faster than common heart rate, you should have it investigated and addressed by an expert.
You can have something common, and only need a transient course of medicines, or you can have something uncommon and require further study and treatment. Many times, an unconnected procedure or operation will unmask an underlying or nearly dormant medical condition that would not have come to attention otherwise.
For you "HOUSE" fans, refer to pheochromocytoma, or acute hyperthyroidism, renal artery stenosis to name a few. Mostly, high blood pressure is more benign and easier to control. No matter what the cause, putting your circulation system in over-drive for a long period of time (like revving your car engine at hight RPMs) is a bad idea. High blood pressure should not be ignored (although you've awknowledged it, I do agree that continuously taking your BP and perseverating on it, probably isn't helpful).
***Bottom line, see a couple of professionals here. Early on pain and acute stress are classically what can cause these symptoms. Now that some time has passed, you should try to address the psychological/anxiety angle AND investigate and/or address the medical hypertension angle.
All of our suggestions about one drug being better than others, or dangerous, or excellent are meaningless. EVERY medication can be dangerous...and almost every medication can have an ideal application to specific conditions and aren't dangerous if used and followed carefully.
There's nothing wrong with loading the boat with expert opinions.
Take care,
Bill