Correspondence w/ Dr. Heller re: BP

After last week’s appointment, I emailed Dr. Heller regarding Olivia’s blood pressure reading and heart rate.  Here’s my email to her:

Dr. Heller,
I just wanted to update you on Olivia.

She saw Dr. Wolkoff and Lee Sullivan for our last Clinical Trial visit today (post – study visit, no shot).

Olivia’s blood pressure was MUCH better at 102 / 53(?) so the enalapril is definitely doing it’s job. However, her heart rate was 132 which is 12 beats higher than her normal rate. She was coloring at the time they checked her heart rate and she is fighting a cold / cough.

She lost a bit of weight since her last visit with them. If I compare the weight from her visit from you on 3/2 to today, she lost almost 8 oz (I’m not sure if she was weighed at your office dressed or undressed). Comparing the weight from our last clinical trial appointment on 2/23, she lost about 4 oz. She had a fever over the weekend and didn’t eat too much on Saturday, Sunday and Monday.

Should I be concerned about her heart rate increasing while her blood pressure dropped? And the weight loss – is that something to be concerned about?

Dr. Wolkoff recommended Olivia get one last synagis shot so Dr. Friedman and I are working together to get the ball rolling on that.

Thank you in advance for your response!

She responded this morning:

Hi Trish – Sorry for the delayed response. I was basking in the florida sun 🙂

I’m not too concerned about the HR. It has been in the 130’s on several recent visits with me – which is fine in an awake toddler. What are you basing her “normal” HR on? The HR varies so much from minute to minute in little kids – I wouldn’t rely on one or 2 isolated readings.

Enalapril shouldn’t affect HR, in any case. Did they have an easier time getting the BP than I did? That is an OK reading, but I’d like to see it even lower (if the reading was reliable). Ideally, the top # should be 70’s to 90’s. We have room to go up on the dose, if her BP trends are on the high side. Maybe we can check BP more frequently?

This can be done by visiting nurse, or quick doctor visits. Let me know your thoughts. How is her appetite now? We’ll have to keep an eye on her weight. I’ll be back in the office Monday.
Take care

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