What causes fluctuations in BP with trembling in legs and sleeplessness?
Patient: Respected Doctor, I am Mr Sakti Pada Chakraborty ( 43 ) ,a teacher by profession,hypertensive under Concor.Cor 2.5 .Presently since last Tuesday feeling unwell .I feel very bad at the office hour when I get ready for the Office. I have consulted with a local physician ( an MD in Physiology) who adviced for lipid profile and other test which are as follows HB= 13.30, FBS= 99.90 ,Choles= 187 , LDL= 119.4 HDL=43.Creatine=1, TSH= 1.73 ,Serum Uric Acid= 4.70 On those findings, I am adviced  for the following medicine: Rx  1.  Cap.DiavitPlus 30X1 at night ( for my merve complication) 2. Tab. Rozustat 5mg 30x1 ( for LDL ) Furthermore he has asked me to take a stock of the progression. In necessary he will change the Concor Cor 2.5 which I had discontinued and may not functioning at this hour and thereby I am not tolerating. But for the time being I feel very bad at the peak hour of my movement at the working place and seems to me that BP gets high. But I feel better at the afternoon. At the office hour my legs, hand tremble just like a neuro/ nerve patient.At night sleep  impaired/ disturbed by bad dreams and urineflow around 3.00am or like. In such a situation, I shall feel much obliged if you kindly advice me what to do. I hail from AGARTALA :TRIPURA:INDIA Sincerely Sakti Pada Chakraborty  YYYY@YYYY  0000 Doctor: Dear Sir,you have really described your symptoms quite well which makes it more easier on my part to judge. As far as your reports are concerned they seem to be perfectly alright.whatever you are experiencing is probably because of your high stress levels possibly at your work place. you can try using Nexito 5 mg at night which would keep your nerves cool.so the apprehension would be less at the same time you start taking propranolol 10mg thrice daily which will take care of the tremors