patient is 45 thin, 110lbs very active daily eats low fat low sodium MVA 2008 ubresolved bp and pain since , 6 bulging but not herniated disks involved. meds: non narcotics and cortizone injections sufered severe abuse as child. became abuse councilor teacher suffered sever spaousal abuse. assisted in helping abused women has fear responces to stressors son serving as striker comander in iraq daughter to be deployed as well curreb\nt spouse is aloof runs a breeding and traininf farm alone little help of over 14 tb racegiurses some stallions. some in traininf for racing. wears braces to ride. dr's unresonsive not depressed, just in daily severe pain. has sever adverse reaction to seratonin reuptake inhibitors. can not tolerate narcotics. daily bp 172 over 110 traditional bp meds hydroclorithiamide, lisunapril etc do not aleviate bl;ood pressure, head aches, ears ringing, muscle weakness, lack of sleep dur to pain confusionm vission changes , balance problems what do I tell new DR? what else can be done