Age: 68.0
Sex: F
Vaccine: COVID19-2, FLUX
Symptoms: Imaging procedure, Insomnia, Lymphadenopathy, Neck pain, Pain
Clinical narrative: My blood pressure began rising on the third day after receiving my COVID-19 booster. Based on recorded data in my blood pressure monitor. It continued rising for three weeks. On day 21, I went to the ER. My blood pressure was 250/150. They gave me medications to help prevent stroke and heart attack. They did a brain scan to see if I was having a stroke. They gave me a higher dose of the medications that were already listed in my chart and sent me home when my blood pressure went back down to normal levels. My blood pressure continued to rise gradually. I reported the rise to my doctor. He increased the dosages of my current blood pressure medications. As time went by, it continued to rise until I was on new medications and at much higher doses. It went up all through September, October, and November. They just kept giving me new blood pressure medications. In December, I requested a trial dose of prednisone from my Lupus doctor. It immediately worked. My blood pressure went down to almost normal. I tapered off the prednisone. As soon as I got down to 10mg, my blood pressure went back up, and I had to take high doses of medications to stay out of the ER. In January, I went back on 20mg of prednisone. After a week, I went back down to 15mg because things were stabilizing. My blood pressure went back down to almost normal. I reduced my blood pressure medications back down to the regular doses. When I tapered off the prednisone again, the whole thing just repeated itself when I got back down to 10mg. They put me back on 20mg of prednisone and higher doses of blood pressure medications, and the whole process started over again. At that point, the doctor agreed to put me on a very slow taper instead of every four or five days. I am now on a 30 day taper off the prednisone. All of February, I've taken 15mg of prednisone. My blood pressure has been normal. I am currently taking 12.5mg of prednisone for the month of March. I was able to taper to that amount successfully. I have been slowly lowering the dose of my blood pressure medications as my blood pressure has been below normal. When my blood pressure goes up, it goes up one point per minute. When the blood pressure is rising, I get some heart pain and radiating pain in my neck. I feel flushed and uncomfortably warm. Once my blood pressure reaches over 180, I start vomiting. When I'm off the prednisone, I will have the blood pressure surges multiple times a day. I go three or four days without sleep to keep enough medication in my body to keep my blood pressure below 180. When my blood pressure is controlled with prednisone, the rate of increase is about half of that. Over time, the surge comes almost to a complete halt with just the typical normal rise in blood pressure, but that only occurs after a few weeks at 15mg of prednisone. I feel it's an autoimmune reaction because I have significant swelling in my lymph nodes. I cannot process any other labs until my prednisone levels are allowed to drop to 5mg. That has been unsuccessful so far. My original dose of metoprolol was 25mg and my original dose of lisinopril was 20mg. During the time they took me off the prednisone and my blood pressure rose, I took hydralazine five or six times a day. I took amlodipine. I alternated it with the hydralazine for surges. The metoprolol went up to 300mg per day. The lisinopril went up to 80mg per day.