Not So Silent KillerI had an absolutely lovely patient who was getting ready for surgery. However, I noticed her blood pressure was extremely elevated, 176/109. Considering it should be under 140/80, this is an issue. Anesthesia is hard on the body even without the strain of high blood pressure (hypertension) on the heart and other organs. The anesthesiologist ordered multiple doses of IV blood pressure lowering drugs, drugs that dilate the blood vessels, pain medications, antianxiety medications. We gave this woman a ton of medication, and her bp was now up to 192/116, possible stroke territory. Her surgery was cancelled and she was admitted to the hospital for cardiac workup and to get that bp under control. I brought her a turkey sandwich and ginger ale, as she had been fasting for surgery and quite hungry . She was very appreciative and ate it all. I gave her the lecture on how she needed to watch her diet and take her prescribed medications and how hypertension is the silent killer causing irreversible damage to the heart and kidneys before people even take notice. She nodded and said all the right things. She gave me a big hug and thanked me for her care. I went and gave her nurse on the floor a detailed report about the patient and her orders from the physician. When I came back to the bedside, my sweet patient was eating a ginormous Whopper with cheese and large fries. Now I am the first to admit my diet is not perfect, but really. Does anything we ever say make a difference? I hope she will get better.