I am so sorry your husbands BP is so volatile, anet. If the volatility of his BP is related to post-surgical pain (which can cause severe insomnia) maybe pain treatment or sleep meds would help. If not due to pain, several of my relatives have very difficult to control BP, and getting a balance between too little and "too much" BP reducers is very tricky. When their general physicians were unable to control their BP without increasing fall risk, they were referred to either cardiologists and/or nephrologist. The later have been able to successfully manage the BP over time. If you have already seen a local nephrologist with no luck, then visiting Mayo might be a great idea. I visited Mayo clinic (Heachache specialist Dr. Mark Whealy) three years ago for two types of severe headaches and finally after years of uncontrolled pain, am doing well. I hope your husband can get the help he needs. He is lucky to have you advocating on his behalf.