The Blood Pressure Journalauniva.co
I got a postcard from Florida last October that just said "I'm sorry I haven't called. I've been scared." That was the whole message. Six words. Signed with a single curly K. K is my older sister Karen. She lives in Sarasota with her second husband Bill, who used to sell boats and now mostly fishes off a pier and complains about the snowbirds even though they are themselves snowbirds. Karen and I have not gotten along since 1987 over something I don't even remember anymore. We send Christmas cards. We call on birthdays. That's the whole relationship. So a postcard out of season, with that message on it, in her handwriting that wasn't her handwriting because it was shakier than I'd ever seen it, sat me down at my kitchen table for 40 minutes. I'm Diane. I'm 61. I live in Erie, Pennsylvania, in the same brick two-bedroom my husband Dennis and I bought in 1992. Dennis passed in 2021. Pancreatic. Six weeks from diagnosis to the funeral. I haven't moved his recliner. I haven't moved his coffee mug from the shelf above the sink. Some women clear things out. Some women don't. I'm a don't. I read the postcard three times. Then I read it a fourth time. Then I went and got my reading glasses and read it a fifth time even though I'd had them on for the first four. I'm sorry I haven't called. I've been scared. Karen doesn't say things like that. Karen is the older sister. Karen is the one who, when our father died in 1998, called all 14 of his cousins herself instead of letting our mother do it. Karen is the one who got divorced at 41 and threw a divorce party. Karen does not write postcards that say I've been scared. I called her that night. It rang 8 times and went to voicemail. I called her the next morning. Same thing. I called Bill's cell phone, which I'd had for an emergency years ago. He picked up on the second ring and his voice was the kind of tired that doesn't come from a bad night's sleep, it comes from a bad year. He said, "Diane. I was wondering when you'd call." I said, "Bill, what is going on with my sister." He was quiet for a long time. Then he said, "I think you better come down." I told him I'd be there Friday. He said, "Diane, don't tell her you're coming." I'm going to back up here because I want you to understand what kind of person my sister Karen is. Karen was the kind of girl who, at 12 years old, taught herself to play the piano because our parents wouldn't pay for lessons. She taught herself by ear. She got good enough that by 16 she was playing weddings for $40 a wedding, which in 1979 was real money. She put herself through Penn State on piano money and a partial scholarship and a job at a diner in State College that she worked 5 nights a week for 4 years. She married her first husband Joel at 24 and had two kids by 28. Joel was a contractor who drank. Karen left him on a Tuesday in 1995 with two kids in the back of a Honda Accord and $1,400 in a savings account and she did not look back. She raised those kids alone for 11 years before she met Bill at a church fish fry in 2006. They got married 14 months later. Bill is a good man. He's not Joel. Karen was the strong one. Karen was always the strong one. So when Bill told me on the phone not to tell her I was coming, I understood what he was telling me. He was telling me she would say no. He was telling me she would say she was fine. He was telling me she would put on a voice and tell me I didn't need to make the trip. And he was telling me to come anyway. I drove down on a Friday in late October. 22 hours from Erie to Sarasota with one night in a Hampton Inn outside of Knoxville. I packed a small suitcase. I left a note for my neighbor to get the mail. I want to tell you what I saw when I walked through their front door. Bill answered. He looked thinner than the last time I'd seen him. He held the door open and just nodded at me like he'd been waiting for a long time. The house was the same. The same beige carpet, the same little tiled entry, the same kitchen with the pass-through to the dining room. Karen had decorated this house herself in 2009 and it had looked the same for 15 years. She was at the kitchen table. She was wearing a robe at 2:30 in the afternoon. Her hair, which Karen has dyed every 5 weeks for 30 years to keep the grey out, had grey roots an inch and a half deep. There was a blood pressure cuff on the table next to a glass of water and a notepad. The cuff was plugged in. She'd been using it. She looked up when I walked in. She looked at me for a long second and her face did the thing faces do when they can't decide whether to be angry or to cry. Then she said, very quietly, "You weren't supposed to come." Bill said, "Karen." She said, "Bill." Then she put her face in her hands and started crying. Not loud. Just shoulders. The kind of crying where the person doesn't make any noise because they've been doing it for so long they've learned how not to. I sat down across from her. I picked up the notepad. It had her blood pressure readings written down in her handwriting. Three a day. Sometimes four. Going back, I flipped through the pages, going back to early 2023. The numbers on the most recent pages were 198 over 112. 204 over 115. 196 over 109. 211 over 118. I'm not a nurse. But I'd watched my mother spend her last 8 years on blood pressure medication and I knew what those numbers meant. Those numbers meant stroke. Those numbers meant heart attack. Those numbers meant my sister had been sitting at this kitchen table for 2 years watching the cuff inflate and deflate, writing the readings down in a notepad, telling no one. I said, "Karen. Honey. Why are you not in a hospital." She didn't look up. She said, "Diane. I've been to 7 doctors." That sentence cracked open the whole story. She told me everything over the next 4 hours. We moved from the kitchen to the screened porch. Bill made coffee. The Florida light went from sharp afternoon to soft gold to something pink and slow over the canal behind their house. Her blood pressure had started creeping up in 2018. She'd been on her first medication by 2019. It hadn't worked, so they'd added a second. By 2020 she was on three. By 2022 she was on four. By 2023, none of them were working. Her readings were climbing into territory the doctors couldn't explain. She'd seen a cardiologist in Sarasota. He'd added a fifth pill. It made her cough so badly she couldn't sleep. He took it off and added a different one. That one made her ankles swell to the size of small grapefruits. He told her she had "treatment-resistant hypertension," which is doctor-speak for we don't know what to do with you, and that she should just keep trying combinations. She'd flown to Tampa to see a specialist. He'd ordered three rounds of bloodwork, an MRI of her adrenal glands, a 24-hour urine collection, and a sleep study. Everything came back normal. He told her some people are just like this. He told her to come back in 6 months. She'd flown to Atlanta to see a doctor a friend had recommended. He'd put her on a 7th medication. It dropped her pressure to 90 over 60 for 4 days and then it climbed back up to 195 over 110 and stayed there. By the spring of 2024 she'd stopped going to the doctor. She told me she'd stopped going because she couldn't stand the conversation anymore. Walk in. Get the cuff put on. Watch the nurse's face change. Watch the doctor come in with a clipboard. Watch them shake their head. Watch them add a pill. Watch the pill not work. Drive home. She said, "Diane, I started thinking about it as a death sentence." She said it just like that. She said she'd started writing letters. To Bill. To her kids. To me. She had a folder in her dresser drawer with 9 letters in it. She hadn't told anyone because she didn't want anyone to talk her out of being afraid. She wanted to be afraid. She wanted to be ready. Because she knew, in the way the body knows, that one of these mornings the cuff was going to read something that wasn't going to be a number anymore, it was going to be the end. I cried with her on that porch. I had not cried like that since Dennis. After she went to bed I sat with Bill in the kitchen. I asked him what he'd done. He said, "Diane. I have begged her. I have driven her to 7 doctors. I have gone with her into the appointments. I have done everything a man can do for his wife when the medical system has thrown its hands up." He said, "I have been losing her in slow motion for two years. And I didn't know who else to tell." I stayed in Sarasota for 11 days. The first 4 days I just watched. I watched Karen take her cuff out three times a day. I watched her write the numbers down. I watched her face when the numbers were bad, which they were every time. I watched Bill's face when he saw her face. I watched the way they moved around each other like two people trying not to wake up a baby that was already awake. On day 5 I called my niece Sarah, Karen's daughter, who lives in Chicago and is a physical therapist. I told her everything. She cried. Then she said something that stopped me cold. She said, "Aunt Diane. There's something I want to tell you. I've been treating an older man at the clinic for 9 months for hip pain. He's 64. He came in two weeks ago and his physical therapist, that's me, told him his blood pressure looked better than it had since he started coming. He told me he hadn't done anything different except start taking some berry from India that his daughter in law had pushed him to try." I said, what's it called. She said, "Aunt Diane. I wrote it down because I was curious. Hold on." She put me on hold. She came back. She said, "It's called Amla. A-M-L-A. The brand he was taking was Auniva. Auniva Amla." I want to slow down here because the next part of the story is the part where I'd usually feel skeptical. If somebody told me on the phone that a berry from India had brought down a 64-year-old man's blood pVer detalles
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