Dr doesn't entirely believe me

[bin_tenn]

I'll start by saying that I still trust my doctor in general, and I actually enjoy my annual visit to check in. I'm not interested in seeing another doctor. But I do have some minor gripes that frustrate me sometimes.

I take Atenolol 25mg (beta blocker) and Lisinopril 40mg. The Atenolol was started eight years ago by my old Dr, mostly to manage tachycardia and palpitations but also mildly elevated BP. I started Lisinopril last year because the beta blocker was no longer keeping my BP down.

So, my Dr insists that beta blockers aren't very effective in managing BP, despite my success with just that med for several years. Okay, I can accept that. They *may* reduce BP, but that's not their primary use case, apparently.

But he also completely dismisses my claims that I feel like complete trash if I don't take the beta blocker for one day. My heart races very easily, and my resting rate is even in the 80s and 90s. My heart "skips" frequently, too. My Dr, though, dismisses that as purely being anxiety. But why the hell do I only have those symptoms when I don't take the beta blocker, even when I don't realize I forgot to take it?

He also recently dismissed my claim that when my BP is abnormally high, I feel like garbage. Until January, I was taking 20mg of Lisinopril instead of 40mg. New Year's Day, I was hanging with the fam and tossing a football with my nephews, and I started feeling unwell. Fatigued, heart pounding, subtly off balance. Checked my BP and it was 170/100. I was fine when sitting, but every time I'd get up and do anything more than walk across the room, I'd feel awful like that. But he's convinced it was all anxiety, and I can't accept that.

How would you handle this sort of thing? He's human, he doesn't know "everything", and I still respect him as a medical professional and I don't mean to discredit his knowledge and experience. But I know what I feel, and I know it's not "all in my head" and not "just anxiety".

 

[MATD]

If I may, I suggest a second opinion. Dr’s are human first despite all the years of training and experience. I’ll relate my sister’s conundrum with her doc. She put my sister on a tricyclic anti depressant for pain management. Long story short, my sis has had numerous back surgeries and has degenerative arthritis. She wears a pain pump. Anyway, sis, like a good girl, took the anti d. Her legs became extremely swollen and the doc did not know why. A few years earlier sis was also prescribed a different anti d and her legs swelled then too. She stopped taking it and the swelling disappeared. So after discussing it with her doc and relating her earlier issue with the swelling, the doc said it wasn’t the anti d causing the swelling. She discussed it with me. I reasoned that since the med was for pain management and nothing more, it was not detrimental to her health to continue taking it. She decided to stop, the swelling went away. The doc had nothing to say. Sometimes we have to. decide what is best ourselves, sometimes our gut instinct is correct. Whatever you decide, do it with caution. But, as I said, sometimes a second opinion is warranted. It’s nothing personal against the doc, but it is your health, not his. You have every right to do what is in your best interest.

 

[Missy]

I'll start by saying that I still trust my doctor in general, and I actually enjoy my annual visit to check in. I'm not interested in seeing another doctor. But I do have some minor gripes that frustrate me sometimes.

I take Atenolol 25mg (beta blocker) and Lisinopril 40mg. The Atenolol was started eight years ago by my old Dr, mostly to manage tachycardia and palpitations but also mildly elevated BP. I started Lisinopril last year because the beta blocker was no longer keeping my BP down.

So, my Dr insists that beta blockers aren't very effective in managing BP, despite my success with just that med for several years. Okay, I can accept that. They *may* reduce BP, but that's not their primary use case, apparently.

But he also completely dismisses my claims that I feel like complete trash if I don't take the beta blocker for one day. My heart races very easily, and my resting rate is even in the 80s and 90s. My heart "skips" frequently, too. My Dr, though, dismisses that as purely being anxiety. But why the hell do I only have those symptoms when I don't take the beta blocker, even when I don't realize I forgot to take it?

He also recently dismissed my claim that when my BP is abnormally high, I feel like garbage. Until January, I was taking 20mg of Lisinopril instead of 40mg. New Year's Day, I was hanging with the fam and tossing a football with my nephews, and I started feeling unwell. Fatigued, heart pounding, subtly off balance. Checked my BP and it was 170/100. I was fine when sitting, but every time I'd get up and do anything more than walk across the room, I'd feel awful like that. But he's convinced it was all anxiety, and I can't accept that.

How would you handle this sort of thing? He's human, he doesn't know "everything", and I still respect him as a medical professional and I don't mean to discredit his knowledge and experience. But I know what I feel, and I know it's not "all in my head" and not "just anxiety".

So if the beta blockers were not working entirely and the lisinopril was added and you felt better, then the beta blockers probably were not the best choice , per your doctor. I can see this. Do you think that perhaps you may be setting yourself up with expecting anxiety?

 

[bin_tenn]

If I may, I suggest a second opinion. Dr’s are human first despite all the years of training and experience. I’ll relate my sister’s conundrum with her doc. She put my sister on a tricyclic anti depressant for pain management. Long story short, my sis has had numerous back surgeries and has degenerative arthritis. She wears a pain pump. Anyway, sis, like a good girl, took the anti d. Her legs became extremely swollen and the doc did not know why. A few years earlier sis was also prescribed a different anti d and her legs swelled then too. She stopped taking it and the swelling disappeared. So after discussing it with her doc and relating her earlier issue with the swelling, the doc said it wasn’t the anti d causing the swelling. She discussed it with me. I reasoned that since the med was for pain management and nothing more, it was not detrimental to her health to continue taking it. She decided to stop, the swelling went away. The doc had nothing to say. Sometimes we have to. decide what is best ourselves, sometimes our gut instinct is correct. Whatever you decide, do it with caution. But, as I said, sometimes a second opinion is warranted. It’s nothing personal against the doc, but it is your health, not his. You have every right to do what is in your best interest.

Thanks for sharing that story! I agree that a second opinion may be warranted. At this point I think I'd prefer to see a cardiologist. Not because I'm worried about anything being seriously wrong, but because heart is obviously their specialty. It's all they really ever think about and work with. My doc did say earlier this year that a quick checkup with a cardiologist may be beneficial, simply because of family history, personal history (an AFib episode and other oddities), and the fact that I'm in my mid 30s now. So maybe I'll do that, and I'll ask them about the beta blocker.

So if the beta blockers were not working entirely and the lisinopril was added and you felt better, then the beta blockers probably were not the best choice , per your doctor. I can see this. Do you think that perhaps you may be setting yourself up with expecting anxiety?

No, I don't think so. This is something the doc and I have discussed as well. I've had days when I took my other med and accidentally forgot to take the beta blocker, and I only realize it a few hours later when light physical exertion causes rapid heart rate / pounding. Then I take it and all symptoms are relieved within half an hour.

I do see where you're coming from though. That's definitely been on my mind, but I cannot logically accept that as the answer. It just doesn't add up.

 

[MATD]

Just a thought, but something else to consider, could it be withdrawal or rebound when you miss a dose? Something to talk to the doc about. The cardiologist is a good idea.

 

[bin_tenn]

Just a thought, but something else to consider, could it be withdrawal or rebound when you miss a dose? Something to talk to the doc about. The cardiologist is a good idea.

I have talked to a few docs about the possibility of a rebound effect. None of them have agreed that that's a logical explanation with the beta blocker, especially considering it's such a low dose (25mg is the lowest available for the one I take).

 

[MARCC]

Sorry to hear you are not feeling well. I agree with you about seeing a cardiologist.

 

[bin_tenn]

Sorry to hear you are not feeling well. I agree with you about seeing a cardiologist.

Thanks, old friend! Hope all is well with you.

 

[JustMe]

I'll start by saying that I still trust my doctor in general, and I actually enjoy my annual visit to check in. I'm not interested in seeing another doctor. But I do have some minor gripes that frustrate me sometimes.

I take Atenolol 25mg (beta blocker) and Lisinopril 40mg. The Atenolol was started eight years ago by my old Dr, mostly to manage tachycardia and palpitations but also mildly elevated BP. I started Lisinopril last year because the beta blocker was no longer keeping my BP down.

So, my Dr insists that beta blockers aren't very effective in managing BP, despite my success with just that med for several years. Okay, I can accept that. They *may* reduce BP, but that's not their primary use case, apparently.

But he also completely dismisses my claims that I feel like complete trash if I don't take the beta blocker for one day. My heart races very easily, and my resting rate is even in the 80s and 90s. My heart "skips" frequently, too. My Dr, though, dismisses that as purely being anxiety. But why the hell do I only have those symptoms when I don't take the beta blocker, even when I don't realize I forgot to take it?

He also recently dismissed my claim that when my BP is abnormally high, I feel like garbage. Until January, I was taking 20mg of Lisinopril instead of 40mg. New Year's Day, I was hanging with the fam and tossing a football with my nephews, and I started feeling unwell. Fatigued, heart pounding, subtly off balance. Checked my BP and it was 170/100. I was fine when sitting, but every time I'd get up and do anything more than walk across the room, I'd feel awful like that. But he's convinced it was all anxiety, and I can't accept that.

How would you handle this sort of thing? He's human, he doesn't know "everything", and I still respect him as a medical professional and I don't mean to discredit his knowledge and experience. But I know what I feel, and I know it's not "all in my head" and not "just anxiety".

I would have him refer you to s Cardiologist. That's what I did and got down to the root of the issue.

 

[He Man]

But he also completely dismisses my claims that I feel like complete trash..

I hate it when doctors ignore the testimony of the patients. A lot of doctors seem to have preconceived diagnoses, and don't seem to care much about the individualized symptoms/experiences of patients.
In the US, private health care is consumer driven. If you don't feel that the doc is providing good service, find someone else. I've encountered this over the years.. where a doctor is dead set on his diagnosis, and doesn't care much about any conflicting symptoms i report.. so his diagnosis ends up being incorrect. Follow your gut feeling if you feel your doctor is failing.. there's not much harm in competent second opinions.

 

[bin_tenn]

I would have him refer you to s Cardiologist. That's what I did and got down to the root of the issue.

Yeah, I agree. Thank you. Hope you're doing alright!

I hate it when doctors ignore the testimony of the patients. A lot of doctors seem to have preconceived diagnoses, and don't seem to care much about the individualized symptoms/experiences of patients.
In the US, private health care is consumer driven. If you don't feel that the doc is providing good service, find someone else. I've encountered this over the years.. where a doctor is dead set on his diagnosis, and doesn't care much about any conflicting symptoms i report.. so his diagnosis ends up being incorrect. Follow your gut feeling if you feel your doctor is failing.. there's not much harm in competent second opinions.

Thanks! He seems to be convinced that it's almost entirely anxiety causing the physical symptoms, so yeah I think he does have a preconceived diagnosis. I'm not saying he's completely wrong, I just wish he'd more thoroughly consider my very real symptoms. In the past when I've mentioned my heart pounding and skipping when missing the beta blocker, he's even made the comment "let me know when you'd like to start prozac or something similar." That just feels wrong to me, deep down.

 

[He Man]

In the past when I've mentioned my heart pounding and skipping when missing the beta blocker, he's even made the comment "let me know when you'd like to start prozac or something similar." That just feels wrong to me, deep down.

Yup.. a lot of modern health"care" is simply medicating symptoms. A lot of docs are too indifferent (or lazy), to help patients heal their health problems. They just write prescriptions to numb pain, etc. No effort to fix the causes of the pain & DISease.
Keep us posted..