This time, my new doctor listened to me and immediately sent me for an MRI which showed that my cancer was back in most of my bones. Because my pain was localized to my hip, I had radiation for 15 days. The radiologist told me I would be wheelchair bound in six months but I am still walking and pain-free.

After that I was given chemotherapy every 28 days which kept my cancer tests in a normal range for two years. Now it is abnormal again and a CT and PET scan both showed the cancer was spreading but there is no organ involvement. I am back on chemotherapy every 28 days.

I also have white coat hypertension because of the constant needle prodding during my doctor visits (my veins are not good). In office, my pressures are between 130/85 and 155/74. Outside the office they are about 117/76. My doctor suggested putting a port in, but I am reluctant because I have watched three close cancer survivor friends die from port complications.

Now, I provided that history in the hopes it will help you answer my question. My oncologist has been telling me for months that I am anemic and its getting worse. I started eating red meat, fish and turkey again and have gained some weight. Wanting to know more, I went online and looked up anemia and iron deficiency but strangely, I don’t seem to fit the profile for someone who is anemic. I am not fatigued or irritable, don’t have a gray pallor, weakness, brittle or grooved nails and I don’t crave anything strange like clay. I feel fit and healthy and just accepted an eight week long-term substitute position.

I have enclosed a copy of my lab results from the August 08 to January 09. I don’t know what is going on.

DEAR READER:
You have complex history but I hope I can simplify at least one matter for you. According to your lab reports, you were indeed anemic during all of your blood work. However, that anemia was so slight, it was inconsequential. For example, your hospital uses normal lab values of 4.2 to 5.4. Five of your six results were about 3.9 and the sixth was 4.1. To me that shows improvement, not worsening. With your results so close to normal, I wouldn’t worry but I urge you to return to your oncologist and ask why he thinks your anemia is worsening.

DEAR READER:
“White coat” hypertension is a condition in which blood pressure (BP) rises to above normal just before and during a doctor’s appointment but returns to normal or below normal upon leaving the office.

This occurs because of the anxiety and stress related to seeing a doctor. It is not related to true hypertension which is consistently high BP readings. There are steps that can reduce these feelings, as well as ways to achieve more accurate readings.

Establishing readings while at the doctor’s as well as at home in a more relaxed atmosphere will provides a basis for proper diagnosis between true or “white coat” hypertension. If home readings are at or below normal, then certain measures can be taken.

For example, relaxation techniques, such as deep breathing, can be done in the waiting room before an appointment. Having your BP checked at the end of the visit rather than the beginning will also allow for time to relax and adjust to the situation. If these steps fail, it may be necessary to purchase a blood pressure cuff for home use so that levels can then be sent to the physician on a regular basis.

To give you related information, I am sending you a copy of my Health Report “Hypertension”. Other readers who would like a copy should send a self-addressed, stamped number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

The problem is, he is dizzy. Every time he stands he has to hang onto something for a few minutes before he can start walking around. He told his last two doctors of this problem and they just ignore him. I don’t know if they are unsure how to treat it or simply don’t want to. Can you give us any suggestions about what this might be caused by?

DEAR READER: Your husband’s dizziness when standing suggests that his blood pressure is too low. He may be over treated. This is likely related to something called “white-coat hypertension”. This simply means that your husband’s blood pressure rises, usually because of anxiety or stress, during his appointment but returns to normal between them.

Bring your concerns to his physician and propose the following which will include a home BP machine: Stop medication two or three days before his next appointment. His blood pressure should be taken during the visit and his BP machine can be calibrated to the doctors to ensure it is accurate. Then after the visit, he should monitor his blood pressure twice a day at home for one or two weeks. Be sure to keep a record of readings as well as the time of day taken (morning and night). He should then return to the doctor with his results and again have his blood pressure checked while in the medical setting.

I suspect his home readings will be much lower than the readings taken by the doctor. This is not to say he does not have hypertension; he may simply have a mild abnormality that can be controlled with diet, exercise and minimal medication.

If his doctor does not agree to this, it may be time to find a new primary care physician that is more understanding and willing to listen.

If, however, your husband does not have “white-coat hypertension”, I recommend that he have a special blood pressure reading. First he will have his pressure taken while lying down, then immediately after sitting up, then again immediately after standing, and finally after standing for several minutes. This type of reading will let the physician know if your husband has orthostatic hypotension (positional low blood pressure).

Because hyper- and hypotension are a result of circulation problems, your husband may wish to see a cardiologist.

Your husband must be careful to rise slowly and have something to aid his balance when standing. If he rises too quickly he may lose his balance and fall which can cause serious injury, especially if he is home alone and cannot get back up. Let me know how this turns out.

To give you related information, I am sending you a copy of my Health Report “Hypertension”. Other readers who would like a copy should send a self-addressed, stamped number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.