Over a cup of evening tea

By Dr K. Javeed Nayeem, MD

The title of this article should actually have been ‘My’ joy and pain of checking ‘Your’ blood pressure, because as a practicing doctor, half the joy and pain I’m talking about here, is mine too. But let’s talk about yours first.

There was a time until not very long ago, when things were pretty simple, straightforward, uncluttered and un-worrisome, if I may use this neologism or new word that I have created. I am talking of the days when your blood pressure (BP) used to be checked only at your doctor’s clinic or consulting room, only if you happened to go there for some reason.

And, it used to be checked at least two times a day, only if you were admitted to a hospital for a more serious reason.

That meant that your blood pressure would never be checked, maybe even once in your lifetime, if you were one of those rare, unusually healthy blokes, who never had any reason to see a doctor. But times have changed and those good old days are now long gone, along with almost all such lucky people, thanks to the vastly changed lifestyles, that every one of us is now leading.

It is a different matter that sometimes, even without getting it checked, there are times when you might be told by people around you, that your blood pressure might be dangerously high and therefore you would do well to get it checked. These are usually ordinary people without any kind of medical knowledge, who when they happen to see you getting irritated and worked up frequently for trivial reasons, attribute your short-tempered behaviour to high blood pressure.

But, mind you, they may be dead right, in a different kind of way! It is worthwhile to understand that although high blood pressure may not manifest itself through aggressive and short-tempered behaviour, this kind of a fiery temperament can certainly give you dangerously high blood pressure, much sooner than your genes or destiny can. So, it certainly makes sense to make a conscious effort to cultivate the habit of remaining calm and cool, despite frequent provocations from those around you, in the interest of keeping yourself safe and healthy.

Although this may seem rather difficult, it is certainly much easier than preventing the people around you from irritating you. You must understand and accept the fact that there’s just no way you or anyone can do it.

Although now, most of us do get our BP checked now and then, to see what the pressures of our lives are doing to it, thankfully, most of us do not make a fetish of it.

But over the recent years, especially after inexpensive, easy to use electronic, personal blood pressure monitoring devices have become available, most people now have them in their homes. And, that is where the problem begins.

After fiddling and playing around with them for a few days, most people invariably begin to notice that no two of their BP readings are the same. Very soon, this variation which might actually be very slight, becomes a cause of concern for them, because they cannot understand why their BP has to vary in the first place, although the scientific truth is that our blood pressure is a very dynamic element that is never constant, even in our sleep, let alone when we are up and about.

They first think that something is wrong with their devices and so people begin to cross check with the devices of their friends. Some even go to the extent of buying a second device and then get into the habit of always recording their BP with both the devices and deducing the average pressure.

Some others go a step further and record their BP in both their arms simultaneously with two devices, which only takes their panic a step higher, because what they do not know is that it is perfectly natural and normal for the BP to be slightly different in our two arms, for some anatomical reasons, which I’ll not go into here.

A few others start checking their BP at different times of the day and even after exposure to different situations and foods in their daily activities.

But these differing readings from time to time and device to device and arm to arm and situation to situation, can generate a very high state of anxiety and even panic in many people who are overly worried about their health.

And, as doctor, I see it happening and in action, almost every day. Now people walk into my consulting room not just with their lab reports and medical records but also with long, painstakingly noted BP readings, with the time of the day written next to them. These lists are naturally very long because most of these sufferers from this new malady of anxiety, record their BP multiple times in a day, over all the days between their two consultations.

Now, with the arrival of the smart watch era, even presumably smart people have gone a step further, sadly, in a completely wrong direction. They keep checking their BP and pulse rate more often than they check time and even keep reminder alarms to do this. And, naturally, instead of leading happy lives with their families and friends, they keep wondering all the time, whether they are living or dying!

I decided that I should write an article about this modern-day pandemic when a senior bank manager, who was otherwise in perfect health, without the need for absolutely any kind of medication, walked into my clinic yesterday, with what I thought was his annual bank statement. But what he handed to me was not a bank statement but a long list of his BP readings, which he had painstakingly jotted down over the past six months.

During this period, he had seen many other doctors, who had all reassured him that there was nothing wrong with his health, a reassurance his tortured mind refused to accept, because it expected the physical evidence in his hand to be in as perfect a state, as what all the doctors said the state of his health was in! His mind had become so browbeaten by now that it did not understand that the perfection it was expecting was a biological impossibility, completely unlike any bank statements that he had worked with, all his working life. A really tragic situation indeed!

I decided to help him overcome his suffering and asked him to wait a while and see me again after all my patients had gone. And, during this waiting period, I asked him to get half a dozen BP readings done by my receptionist, every five minutes, while he was seated still, in one place. When he came into my consulting room after I was done with all the other patients, I told him that the only time to act was when a qualified doctor told him that he had high blood pressure and he needed to be treated for it.

Then, in his presence, while seated still, in my own chair, I kept the monitor before him and started recording my own BP every three minutes, for a few minutes and showed him the results. When he saw that no two readings were the same, even in my case, he seemed to be convinced that what he had been told by all the doctors was indeed true and smiled at me sheepishly. To convert his slight acceptance into firm conviction, I decided to play the trump card. So, I declined to accept any payment from him, saying that I took my fee only from treating really sick people and not from just talking to perfectly healthy ones.

Money really talks, especially to a man who talks money all the time and that certainly did the trick! He went back, a tearfully happy man, profusely thanking me for my patience, time and principles too. I hope he and every one of us, stay that way, all our lives!

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