John has noticed something interesting about his blood pressure. We both think it’s worth mentioning. As a caretaker, you may consider buying a basic blood pressure monitor to test your partner’s blood pressure. (We have this one: https://smile.amazon.com/Pressure-Monitor-Adjustable-Automatic-Accurate/dp/B07XYW52VQ/ref=mp_s_a_1_3?dchild=1&keywords=blood+pressure+cuff&qid=1613137281&sprefix=blood+pressure&sr=8-3) It may help to explain why your partner seems edgy, amped up, or grumpy, or, even lethargic. Of course, I am not a medical professional and you should always check things first with your doctor.
As I have mentioned before, we used to live in a large, sprawling city. We loved it but it became too stressful for both of us what with the constant traffic, amount of people to maneuver, lines to wait in and so on. Not that it was all bad but it had become oppressive for us and especially John. Simple tasks that required leaving the house, such as grocery shopping, getting gas, or going to a restaurant became hard. These types of tasks are hard for many people with a TBI. With the added people, noise, and overall stimulation of living in a largely populated area, it really became taxing.
Most of John’s doctor’s appointments were very far from our house which meant long commute times through all the above mentioned. Then, sitting in the dreaded waiting room (see earlier post “Waiting Rooms”). By the time he was called back to see his doctor and they took his vitals his blood pressure would be through the roof. (150/low 100s, with a resting heart rate in the 70s) His doctor’s freaked out often, thinking they may have to hospitalize him as a stroke risk. The pretty much never ending cycle of this stress (the rat race) built up and was never released. His blood pressure would lower when home but it stayed high all the time. (Roughly in the 140/90s.) We thought this was the way his blood pressure was. He felt normal and healthy but always emotionally on edge.
When we moved to a small town the external stress subsided significantly. The traffic is not bad here and usually avoidable. There are not as many people. His appointments are nearby and not as stressful to drive to. However, a couple of his appointments are 1-2 hours away in another large city with all the added stressors. Since moving, John’s blood pressure has been consistently testing much lower, in a low to normal range. He isn’t as edgy and is able to relax more frequently. This all made it very noticeable recently when John had one of his appointments further away. By the time he arrived, his blood pressure was in the near hospitalization range again. But, by the morning of the next day, using the home monitor, his blood pressure was in the low range. (92/50 with a resting pulse in the 40s)
Essentially, psychologically he feels okay. He knows he is stressed but doesn’t think it’s anything to worry about or outside the range of anyone else’s stressed out mental health. However, his body, physiologically, is experiencing a panic attack. I should also mention that he takes daily doses of Propananal which serves as a beta blocker to reduce his body’s ability to make so much adrenaline. So, his vitals are testing that high while medicated.
I don’t think there is much we can do about this but I thought it was worthwhile to write about. Some readers may read this and have a connection in their own lives. It’s just one of those things that makes having a TBI and complex PTSD a unique battle.
TBI Spouse (and Others) 
Has he ever learned to do any kind of meditation or biofeedback to help control his blood pressure before the stressful appointments? I tend to get “white coat syndrome”, where my blood pressure is generally low/normal, but it will shoot up when I sit in a medical waiting room. Usually my doctor will take my blood pressure a second time, at the end of my appointment, and it’s always down by then. I learned some yoga breathing techniques that seem to help. I know there are meditation apps available. It takes a little practice, but I learned within a week doing a practice for 15 minutes a day.
I would love for him to do meditation more often or yoga. He doesn’t as far as I know of. I think when he goes fishing, that’s his way of meditating but that doesn’t help in the moment.