As soon as a diagnosis of Pheochromocytoma was suspected (December 2005) I have been trying out various forms of alpha and beta blockers which are used for blood pressure treatment. One of the critical symptoms of Pheo is high blood pressure, but unlike regular high blood pressure it is not constant - rather "paroxismal" - like a roller coaster. My blood pressure can reach 250mg and has frequently. Regularly, I have low blood pressure and these drugs lower the whole blood pressure curve, rather than just the peaks, so I encounter a bit of a problem.
Two days before my planned christmas trip to Maui, I took my first alpha-blocker (Prazosin). Knowing I'm very sensitive to drugs, I took half the prescribed dose. Half an hour after consuming the drug, I moved from a horizontal position in bed to sitting - within ten seconds I was out like a light! I spent the next 30 hours in emergency, only be told on discharge that ther was next to no chance I had pheo, there was no problem with me going to Maui, and I should take another type of drug that would give me no problems.
It was an "ace inhibitor." I didn't go to Hawaii and was shy about this new drug. I finally took half a dose on christmas day. Later in the day after taking a wonderful walk along the dykes in Steveston, we stopped for food and I almost passed out before being able to finish my dinner. That was the last I took of those! The next drug I was prescribed was Phenoxybenzamine - aside from the problem of them costing $537 for a month's supply, they had a comparable problem...
A couple of hours after taking one (half doses again) I was feeling great lazing around and not doing anything energy intensive. In fact even at that time, it seemed to fit the illness - relieving me of many of the symptoms including the nasty surging headaches. However, after a brisk 3 block walk to the bus stop, when I reported I was feeling great, I slowly but surely sunk into a short faint. I came round quickly but my hands were so white that the ambulance people couldn't even extract a drop of blood after pricking the end of a couple of fingers!
This trip to emergency lead to a week long stay and the diagnosis of my problems. However, I have the feeling that the main reason I was kept inside was blood pressure. It was reasonable while I was horizontal, but on standing dropped through the floor. On one occasion I noticed a drop of 100 mmHg. eliciting a "hoowleeey!" from a doctor. Nevertheless, this drug actually seemed to be tackling the hormone production rather than simply the symptoms. The way it seems to work is that the tumours produce noradrenaline when stimulated (can happen in many ways) which triggers a blood pressure surge and other efects. It was later explained that this particular drug was rather brutal and that there was a kinder, gentler alternative.
The drugs I'm prescribed get better each time. The current drug is Labetalol which seems to cure most symptoms of the noradrenaline production including headaches that I thought were unrelated. But establishing the dose is a delicate issue: I want to keep my blood pressure within a reasonable range yet not faint when I stand up. My allowed range is somewhere betwen 100 and 180 for the systolic - nice wide parameters, and I now recognize when the problem's on its way!
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