[Philmont] : Blood Pressure Problem revisited (long)

Here's a follow up to my blood pressure problems encountered at high altitudes. This years results are typed in at the bottom. Sorry for the length of the post.

Wayne White

Here's a post I made in 2003 concerning high blood pressure after I returned from my 3rd trek.

A few days ago there was a thread about acclimating to Philmont's altitude and several good points were offered. One thing that should be noted to those going to Philmont for the first time is the altitude affects blood pressure also, especially those of us who already deal with High Blood pressure. I've been on medication for mild hypertension since I was 25 years old. Here is my experience from 3 of my treks at Philmont. Just for reference, I'm 5'10" and weigh 185 pounds, and reached the half century mark at Black Mountain Camp this past June.
 
My blood pressure medication, Prinivil, works great in Alabama but by itself didn't do the job at Philmont. On my first trek, 1992, I failed the medical recheck with a blood pressure above the Philmont norm to go on the trail. It wasn't abnormally high, the top number was 10 above the Philmont desired level. The medical staff had me lay down, rest and then checked my blood pressure again 20 minutes later. It was still high. Another 20 minutes and no change. They told me to come back early the next day, the day our crew was leaving base camp, for another recheck. Their final instructions were impossible to follow: " Get a good night's rest and don't worry about it." Yeah, right. Under the circumstances that was not possible.
 
The next morning I failed again, still about the same pressure but still too high for the trail. Another 20 minute rest with my arm held straight up didn't make any difference. The doctor came in and we discussed my options: stay in base camp hoping the pressure would drop, go home, or call my family doctor and talk with him about the problem. My doctor discussed the blood pressure problem with the Philmont doctor and both agreed if I could stay hydrated I would be all right on the trail with my pressure at that level. The solution was to force water. The doctor wanted me to drink a quart at each meal and a gallon between each meal! I also had to agreed to have my pressure checked at each staffed camp and if my pressure changed for the worse, I would come back to base camp. So I had to carry a lot of extra water and drink a lot of extra water. That worked, I guess, my pressure actually lowered some after I got on the trail. Talk about "clear and copious," after a day or so I started recycling the
urine to save the trouble of purifying. Just kidding but some of the guys thought I was!
 
In 1996 my doctor gave me a prescription for Norvasc, 10mg, to take with my usual 10mg Prinivil blood pressure tablet to help with the blood pressure problem at Philmont. During my medical recheck my pressure was the same as back home, well below the Philmont level.
 
This summer, 2003, about 2 months before our trek, the insurance company changed all our prescription drugs to the generic equivalent without our input. My pressure checked normal when I had my physical exam so we left well enough alone and the doctor again prescribed the 10mg Norvasc for me to take at Philmont. Actually I started taking the Norvasc a week early. I went to the medical recheck confident that I would pass and failed. This time my (top number) blood pressure was 25 above the Philmont level. I couldn't believe it. I was in better physical condition, albeit 7 years older, and weighed a little less than in 1996. The same sequence as in 1992, rest and recheck. This time I failed 4 times the first day. After the first 2 checks I was sent back to tent city and, on my own, doubled my medicine dosage. I failed again 3 hours later but it was down to only 10 above the required level. I was sent back to tent city with the same advice, "Get some rest tonight and don't worry about it."
 
I asked the doctor how was I going to be able to do that and he said, "You can't." While I was resting between pressure checks I figured out the only change in 2003 and 1996 was my Prinivil. It was now the generic form instead of the "real thing." I told the doctor about that theory and he agreed that might be a difference, just enough to affect me at this altitude. He said I might just need to be acclimated to the altitude change but I had already been in New Mexico for 4 days prior so that wasn't the reason. He assured me that if my pressure was at this level (10 above or lower) in the morning I could go on the trail.
 
I failed again after breakfast with my pressure 12 above the required level. After a second check 30 minutes later I was only 10 above again. A call to my doctor and both doctors agreed the generic drug was possibly the culprit. My doctor suggested to double the dosage. I mentioned to the Philmont doctor the solution used in 1992 and that this time my wife, a RN, was along with a blood pressure cuff. With an agreement to have her monitor my pressure and to report in at each staffed camp I was released to hit the trail, just a couple of hours before the bus left. I continued to double my medicine dosage each day and my pressure reached almost normal on the trail. I drank extra water but not nearly the amount I swallowed in 1992.
 
So to all with high blood pressure problems: Make sure your medicine will work at that altitude. I'm not a doctor but my personal opinion is the generic drug was my problem. If I ever go back I'm changing my medicine to the "real thing."

2006 update: At my annual physical this past summer, I asked my doctor to write me a 21 day prescription for the brand name drug she gives me for high blood pressure, Prinivil, to use at Philmont. And just because it worked in the past, I asked for another prescription of Norvasc to take with the Prinivil. I take the Prinivil generic, Lisinopril, without the Norvasc while at home without any problem. When I arrived at Philmont this year, 7 pounds heavier than in 2003, 3 years older and not in the best of shape, I passed my medical recheck the first time.

I feel like the name brand drug made the difference. I know there are some who will argue there is no difference in the name brand and generic but it made a difference in my situation. YMMV.
 
Wayne White
Troop 222 CC
(former SM 14 years)
Moulton, Alabama

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As you gather around this virtual campfire with fellow
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Received on Mon Oct 23 00:20:36 2006