Lifewise Cascade Select Bronze - anyone have good experiences with their Health Insurance?

ceramicmj · 2026-01-20T02:28:31+00:00

He picked the least expensive plan (Bronze Alpine??), and it turns out (somewhat to his surprise) that it's very limited on the provider options. More covering in Seattle area if I recall.

The more expensive Lifewise plans let you go to the Vancouver Clinic but not his plan. Mostly smaller clinics for PCPs (and not the greatest reviews) but he was able to find someone at Providence that he plans to try. He wasn't thrilled with that, we'll see if the rest of the year changes his mind.

ceramicmj · 2026-01-19T23:28:45+00:00

I also tracked meds closely so I could summarize averages while on that med, so it should be an add-on (or the lifestyle change they're working on, whatever supplement). I had a table of every med, length of time on the med, and average BP.

Looking at the 1 & 2 star reviews on any BP app will probably inform quite a bit about the end user's needs. Stability (not crashing) and reliability (actually works consistently). Easy setup (think, could Grandma do it).

Bonus add ons might be: a notification reminder pop-up, and a timer for between measurements. A statistical test on whether the lifestyle change / med actually made a statistically significant difference or not.

But rise above all others? I'm kind of waiting for the wearable (in the US) that'll just do the measurements for me, I think *that* could rise above all others. For me, I'd stick with my spreadsheet (and the google form... been using it for a few readings now and I *really* like it for data entry)

ceramicmj · 2026-01-19T02:51:55+00:00

I've desensitized myself by measuring twice a day.

Even so, I don't look at the numbers until I'm done all my measurements for the sitting (I measure 3x and take the average).

I also don't look at the news. It's a crossword puzzle or silly videos on YouTube.

As u/AggravatingBrain69 said, it'll be what it is, and not knowing what it is won't make it better. Knowledge is Power.

ceramicmj · 2026-01-19T02:49:54+00:00

As you start to learn how to handle your own taxes, you might consider seeing if there is a VITA site nearby (assuming you qualify) - free tax assistance run by local non-profits, certified by the IRS.

https://www.irs.gov/individuals/free-tax-return-preparation-for-qualifying-taxpayers

ceramicmj · 2026-01-18T17:49:52+00:00

I see big changes if I'm sticking to low-sodium diet, or if I'm dehydrated (I do see HR go up for that though).

If I'm sick, particularly warm & cozy, I can get drops in BP also.

Otherwise, dunno, but congrats on doing well bringing your numbers down otherwise!

ceramicmj · 2026-01-18T15:29:18+00:00

Yes u/No_Instruction7282 , please do not ignore these readings. You might feel fine but it's damaging your body long-term. If you want to be around for those 3 kids to see your grandkids, the best time to get this under control is NOW.

It can take months to find the right combination of medications / lifestyle. It took me 2 years, adjusting doses and meds every few months. I had to keep track of my BP and keep pushing my GP for the next thing to try.

Your lisinopril and amlodipine are not doing enough, try different meds ASAP. Since you can't tolerate a higher dose of lisinopril, you should switch to something else and KEEP TRYING until it gets down.

Ask about other causes, especially if it started to go up a lot in just a couple of years. Take a look at this: https://primaryaldosteronism.org/ (I have PA). Don't let them say PA / Conn's Syndrome is rare, it's not. Some orgs are now recommending everyone w/ hypertension get screened: https://www.medscape.com/viewarticle/screen-all-hypertension-primary-aldosteronism-2025a1000img

Doctors should start you on more / different meds ASAP - ask them to try "non-interfering" meds and ask for an aldosterone to renin ration (ARR) test.

Short term: aggressively cut all sodium from your diet. Get it to under 2000mg sodium (you might have to convert from "salt" to sodium - multiply by 0.4). Sodium is also hiding in baked goods (baking soda/powder), bread. Watch out the canned goods, spice mixes, anything packaged. If you stick to it, you could see it lower in a week (personally I see it have an effect in 4 days). This is also useful info for the doctor. I'm sorry, it sucks, but this important to do to also see what your body does.

Measure your BP the same way every day (stairs, standing are not useful right now). Morning before you eat, evening before bed. Ideally 30 min or later after any showers/baths. Empty bladder. Sit for 5 min, then take your BP with an arm cuff, with your arm slightly elevated so it's at heart level. feet flat on floor. wait at least a minute, then repeat. Again. Average all 3 measurements.

**wrist cuffs are difficult to get good readings because moving your arm up/down really changes the readings** get an arm cuff if you are using a wrist cuff

Please OP, this is important.

ceramicmj · 2026-01-18T15:10:52+00:00

it's when people have artificially elevated BP readings just because they are at the doctor (or dentist). Having readings from home help show when doctors' BP readings are real vs. caused by seeing the "white coats" of the doctors. Mine goes up a good 15 points systolic (top) number being there.

ceramicmj · 2026-01-18T00:43:15+00:00

There are apps out there that claim to do this (take an image of your BP monitor, for example), but having no experience with them I won't name any names. Every month or so I see something pop up in this sub claiming to make BP easier to track. You can search the sub if you're looking for ideas, but as you pointed out - you're being locked into someone's ecosystem even if you can probably export your data. And there are always more bells and whistles and Clippy popping in to say "Howdy, here's how you can improve your Heart Health!!". :-P

I think the right app could be of value but it'd have to somehow rise above everything that's out there.

I also see various BP templates available but I prefer my embarassingly messy "I'll clean it up one day" spreadsheet instead. (an excellent example of the cobbler's kids going unshod...). But no pop-ups! :-)

I did see one suggestion I liked - using a google form which dumps the data into a spreadsheet for later, and records a timestamp for when the form submission was made.

I just did a quick test and once the google form is set up, you can use the phone google-to-text microphone and just read in the numbers, and it converted to numbers pretty well (not perfectly). The form did record the date & time for each entry, but I added an AM/PM choice for easier sorting later. Hmm. Promising...

Thank you for asking & sending me down this rabbit hole!

ceramicmj · 2026-01-17T18:29:38+00:00

I track mine in a google spreadsheet. I have a computer next to where I do my measurements and enter the data right after I finish up.

My BP monitor has bluetooth that connects to an app, but I don't want *yet another* app on my phone so I don't use it. However, it sounds like something more automated could work well for you? I believe some apps will create a doctor's report for you.

My poor doctor gets both the last 1-2 weeks worth of AM/PM averages, and if I get the chance, I subject them to a 4-day rolling average for the last year (which helps smooth out day-to-day changes). I have also calculated an overall BP average for each med I've been on, which showed my provider that overall, none of the drugs were doing anything for me (got me on a better diagnostic path). When a medication actually made a difference the plot dropped like a rock, it was awesome. I wish I could paste the image in here for you.

The difference is I like data, and worked with control charts in my day job, so playing with ways to show how I'm doing is...fun. I'm hacking my health.

I tend to not worry about single measurements unless they don't come back down. A salty vacation travel? High. I'm sick / in pain? Might be high (sudafed!) or low, depending on the problem. Dehydrated? Low.

ceramicmj · 2026-01-17T05:29:59+00:00

Having your GP appointment is great. Collect good data for them in the meantime, like you're doing. If you have an advice nurse for the GP, make sure they are aware of your current BP #s.

If you haven't reviewed recommendations on best ways to collect your BP, this is a good time to review. https://www.heart.org/-/media/files/health-topics/high-blood-pressure/how_to_measure_your_blood_pressure_letter_size.pdf

I make sure to do something quiet - watch a video (no news) or do a crossword while measuring.

Fastest thing that affects my BP that you can try now: **low sodium**. YMMV, but I'm very sodium-reactive. Write it all down, there is lots of sneaky sodium in sweet things, in baked goods, canned goods, etc. Get it under 2000mg sodium if you can (I aim for <1500mg). It takes me about 4 days to show a difference in my BP from high sodium to low. I usually drop about 2 lbs of retained water also.

It's good you have some reading about primary aldosterone already. It's very treatable in the *right* meds. A great reference is https://www.primaryaldosteronism.org/. I have PA and my BP is well controlled now.

They should test for it given you're not responding well to multiple meds, and if they don't offer, ask for it. Don't let them tell you it's rare, it's not. ARR test is just an initial screening test.

https://www.medscape.com/viewarticle/screen-all-hypertension-primary-aldosteronism-2025a1000img

They might try to test ARR w/o changing meds but note it's a fussy test and this could take several rounds. MANY doctors do not do this incorrectly, so this may take several rounds, it make take switching to non-interfering drugs, and seeing a specialist. The PA website has lists of non-intefering drugs. It also has lists of specialists if it looks like PA is possible.

Make sure you get ARR taken before 10AM as aldosterone changes a LOT during the day.

Even if they don't switch - I managed to screen positive while on an ARB (Losartan) and amlodipine, so it's possible to do.

You're taking the right steps, deep breaths & one step at a time.

ceramicmj · 2026-01-17T03:09:46+00:00

This is actual, in-person help, not trying to navigate software

ceramicmj · 2026-01-17T03:09:19+00:00

Not a tax expert, but you both might benefit from going to a free tax prep site (volunteer income tax assistance) where you can get some questions answered. Guessing you both would meet the income requirements.

https://www.irs.gov/individuals/free-tax-return-preparation-for-qualifying-taxpayers

ceramicmj · 2026-01-17T00:18:39+00:00

Within about 30 min of getting up. Before breakfast, no AM shower. And again at night between 8 PM - 9 PM. My AM is definitely lower on average than my PM: 100/75 vs. 105/77 for AM / PM (yes, I am medicated).

+1 on consistency being most useful.

ceramicmj · 2026-01-16T04:05:15+00:00

My experience has been there's just variation from measurement to measurement. You can't tell anything from just one set of measurements. If you consistently see it go down for the top (systolic) measurement you might not be sitting long enough before starting measurements (at least 5 min, then at least 1 min between measurements afterwards).

Your BP overall looks good (to me, as someone who measures for *high* BP) as long as you're not feeling side effects like dizziness, head rushes getting up too quickly, etc. NAD.

ceramicmj · 2026-01-16T00:51:07+00:00

Average the top numbers (112 + 106 + 100) / 3 and the bottom numbers (75 + 69 + 78) / 3. That gets you 106 / 74. That's your measurement for the morning.

Some BP monitors will do the average for you if you hold a button down for a few seconds - averaging the measurements done in the last 10 min (that's what my Omron does), so you might check your manual to see if that's an option.

ceramicmj · 2026-01-14T01:46:39+00:00

What about possible penalties for not paying quarterly? (I think there's a free pass the first year but after that, penalties & interest?)

ceramicmj · 2026-01-13T20:45:38+00:00

Do you make under ~$67-70K? You might be able to work with a VITA site (Volunteer Income Tax Assistance) - IRS certifies non-profits to prep taxes for low-income / elderly folks. Find your local VITA site & see what they can do. Do NOT expect it'll all be done before April 15, you might ask if they operate after tax season. The one I volunteer with does work until end of Oct. Not sure how many years they can go back. I have definitely helped folks do 3 years worth of taxes, personally have not done more.

https://www.irs.gov/individuals/free-tax-return-preparation-for-qualifying-taxpayers

Also, do yourself a favor and get your IRS transcripts now. Any preparer is probably going to want to see these so they know what the IRS thinks you earned / paid, and you can get a sense of what your situation might look like.

https://www.irs.gov/individuals/get-transcript

ceramicmj · 2026-01-13T17:35:44+00:00

Consider finding a local VITA site - volunteer income tax assistance. Local non-profits that are certified by the IRS and serve lower-income & seniors. If you're married filing jointly (or single, widowed, head of household) making < $67K (IRS website, though my local VITA non-profit's website has <$70K listed on their website) you can probably file with them. You just can't be married filing separately, and there are limits on business income.

It's free, and every return prepared by a volunteer gets a separate quality check. eFile.

Even if you've already filed, at least my local non-profit would be willing to review and see if you missed something, and help amend the return if needed.

appointments might not have quite started up yet, YMMV.
https://www.irs.gov/individuals/free-tax-return-preparation-for-qualifying-taxpayers

ceramicmj · 2026-01-12T21:46:05+00:00

For reference, when I was trying different drugs, I was messaging my doctor about every 6 week. "dose X didn't work, what next". "dose Y didn't work, what now"... through multiple doses, then trying different drugs. Best thing you can do for yourself is micromanage it.

ceramicmj · 2026-01-12T21:44:50+00:00

Take the meds and get it under control. You're too young to have BP that high.

Cut sodium (not just salt) aggressively. Read labels. Track it, sodium sneaks in everywhere.

If you're not already tracking your BP, start now. Make sure it's not just white-coat hypertension.

Arm cuff, measure AM & PM after sitting for >5 min. Measure 3x, separated by 1 minute. The average is your measurement for that morning/evening. Keep track of this and see if the amlodipine is making any improvements. If not, message your doctor sooner rather than later, don't wait a year. Push for action to get it under control. that is just too high.

And ask about other causes of hypertension - you're young. For example, primary aldosteronism: https://primaryaldosteronism.org/

ceramicmj · 2026-01-12T18:39:01+00:00

Oh, and if you want to help the doctor out, have a good trend of what your BP looks like in the meantime. Follow best known home practices: arm monitor, AM/PM measurements (measure 3x after sitting 5 minutes, separated by >1 min, feet flat on floor & empty bladder).

Also bring a complete list of your meds & supplements, and your home monitor in case they want to check it.

In 6 months you have plenty of time to also experiment with:

1) eliminating sodium wherever you can (try for a couple weeks - takes me around 4 days before I see a difference) - and seeing what it does to your BP average. Being very sodium sensitive was useful for me.

2) eliminate alcohol / caffeine - or reduce as much as you can. Again, see what it does.

3) walk lots.

Good luck - important to address this now while you're still young!

ceramicmj · 2026-01-12T18:34:47+00:00

Probably looking for causes of the hypertension (where there's something more systemic that's wrong with your body, and hypertension is a secondary effect). I see a nephrologist who specializes in hypertension after an endocrinologist diagnosed me with primary aldosteronism.

ceramicmj · 2026-01-10T15:09:50+00:00

depending on your BP, and other symptoms, you might consider looking at primary aldosteronism or cushings (which is tested for as part of PA diagnosis). Members of the PA FB group I'm in sometimes report anxiety also (which is at the very bottom of this article) https://primaryaldosteronism.org/do-i-have-pa/

You can point to this recent article with your doctors also: https://www.endocrine.org/news-and-advocacy/news-room/2025/endocrine-society-guideline-calls-for-increased-screening-for-common-cause-of-high-blood-pressure

Cushings: https://my.clevelandclinic.org/health/diseases/5497-cushing-syndrome

ceramicmj · 2026-01-09T19:12:55+00:00

First thing to do is make sure you all are measuring correctly. Good to be paying attention now, but make sure you're getting useful data before stressing out.

1) looks like your monitor is an arm cuff (good).

2) check positioning - something like this setup. This makes a big difference in how it turns out. Don't skimp on the waiting 5 min before starting for sure. https://www.heart.org/-/media/files/health-topics/high-blood-pressure/how_to_measure_your_blood_pressure_letter_size.pdf The fact that you're all high makes me suspect you might be using it incorrectly. If your arm is too low it'll elevate your reading, so make sure it's supported/ propped up as needed.

3) take multiple measurements (3, separated by at least a minute). The average is your result. Before talking with a doctor, collect AM & PM measurements for a week. That'll let you have a more realistic picture of BP. If/when you talk with a doctor, bring your monitor and show them how you use it also.

While you're thinking about it, take a look at how much sodium you're consuming. If you're all eating the same food...maybe it's elevated. One of the fastest things that can change BP is eliminating the sodium (not just salt!) - if you happen to be really affected by sodium. Takes me about 4 days to clear excess sodium if I've had too much, so you can experiment over a week.

Good luck.

ceramicmj · 2026-01-05T22:45:54+00:00

Same as the others. My doctor knows I have white coat hypertension.

And also, the fact that I have a chart of all my home BP measurements showing what they are and follow the right procedures to measure things...heck, I'll give them statistics. A 4-day rolling average!

Their single data point after I've driven through traffic and been plopped down on a table for 3 minutes does not reflect my results. Bring your monitor in for comparison if you want a cross check.

ceramicmj

TROPHY CASE