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Old 11-12-2004, 06:31 AM   #1
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The Reason Why White-Coat Is Obvious

11/11/2004 05:45:00 PM 115 65
11/09/2004 12:02:00 PM 109 65
11/08/2004 01:04:00 PM 114 64
11/06/2004 09:30:00 AM 112 69
11/05/2004 05:36:00 PM 119 69
11/05/2004 10:39:00 AM 118 70
11/04/2004 10:30:00 AM 119 73
11/02/2004 11:22:00 AM 116 67


I have taken readings for the past 20 months. These are my readings over the last 9 days. At the doc. on 11/10 it was 156/86. I think that I am going to take a break from checking. After 20 months, I think that I have a pretty good idea of where I am at. I think that I will go to my specialist friend 1st & then wean off of the Atenolol & get off the Lotrel (if I can) in time as well. I will use my G/P to prescribe... that is all that he is good for.

 
Old 11-12-2004, 12:43 PM   #2
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Re: The Reason Why White-Coat Is Obvious

I'm the same way. My doctor believes me though and I am glad for that. I am not on medication. I think I may have found a trick. I exercise aerobically and the last time I went in I did my workout just before. My blood pressure was perfect. Exercising aerobically does lower your blood pressure for a few hours after the workout, but also I feel so much more relaxed after a good workout. I am going to do that again next time.

I have been taking my blood pressure at home on and off for years. My readings are like yours. If I am stressed out it may be a little higher. White coat definitely exists.

 
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Old 11-12-2004, 02:01 PM   #3
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Re: The Reason Why White-Coat Is Obvious

I am going to try that next time!!!

 
Old 11-13-2004, 01:45 AM   #4
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Re: The Reason Why White-Coat Is Obvious

Axe,
Your plan of action regarding cutting back on the monitoring and trying the wean with your specialist friend sounds good to me!

Throw in the aerobic exercise and you'll outlive us all!

zuzu xx

 
Old 11-15-2004, 06:10 AM   #5
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Re: The Reason Why White-Coat Is Obvious

Thanks Zuzu. It is hard to stop a habit like B/P monitoring, but it needs to be done. I know when it is higher than normal. I know what it is usually is. After 21 months, it is enough. With aerobic excercise I would turn into a skeleton, so I would have to use some weight training as well. I am a wimp when it comes to weaning, so I will wait for the appt.....At that point, In a month or so I will be able to get off of the meds. Pulse is already at 62 this morning. I'd be afraid to see how low it goes at night..... the 50's or high 40's.... Feel great today.

 
Old 11-15-2004, 06:14 PM   #6
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Re: The Reason Why White-Coat Is Obvious

Axe,

I am so glad that you have finally made up your mind to see your specialist friend and start the weaning process. I don't blame you for not wanting to do it yourself. Best of luck to you and maybe now you can end all of the frustration.

 
Old 11-17-2004, 04:29 AM   #7
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en08 HB User
Re: The Reason Why White-Coat Is Obvious

Hi everyone,

It is now 9 months since I stopped medication. My bp with a home monitor was within normal limits although it was always high at the doctors or even when testing my monitor against a doctor's at home! All the side effects which the doctor said were due to my age have gone although when I got flu I had the same gurgling cough as I had when on lisinopril. The flu was caused by the flu jab! Last year I got a very bad cold after it so I don't think I'll bother in the future. I have put on some weight due to stress of an exam and shingles but my bp remains between !05-110/76-84. This may not be low enough for American doctors but I now have a better quality of life and don't have to take medication for the side effects.

I wish you luck in weaning off the drugs. The doctors just aren't interested in the side effects which make life so unpleasant so I hope you are successful. I keep on reading the posts to remind myself of what could happen if I stop taking exercise and eating sensibly,

Love and best wishes to you all,

En

 
Old 11-17-2004, 04:37 AM   #8
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Re: The Reason Why White-Coat Is Obvious

I'll tell you what, a stress test will tell you a lot about if you have white coat or not. I'm 19 and for about the past year and a half I have developed white coat since we got a new doctor. My normal pulse can go from high 40s to triple digits and i somtimes get a rash on my chest from the anxiety. I am also extreamly althletic (run 14 miles a week and lift 3 times a week) with a good diet (almost no body fat with muscle) and no family history. LOW blood pressure actally runs in my moms side of the family I had to go the cardiologist to get clearence for baseball and because I just couldnt relax and calm down when ever they took a reading. my BP went from 168/90 to 132/72 (I took reading at home and even then the cuff freaked me out but I constantly got diastolic in the 70's, the anxiety didnt effect that quite as much) during the final stage of the stress test. All my other tests were perfect and the cardiologist just laughed when he saw the numbers. He said stress tests will raise the systolic quite a bit and the diastolic on slightly if at all. He said that if I could just relax I would have a perfect resting BP. he told me no restrictions and signed off on me without hesitation. My sugestion is just take a stress test and see how it turns out. your emotions wont effect your numbers when you are on the treadmil. white coat is a real thing. Dont be so quick to jump on meds if white coat is a possible cause.

Last edited by BobK07; 11-17-2004 at 04:39 AM.

 
Old 11-17-2004, 06:33 AM   #9
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Re: The Reason Why White-Coat Is Obvious

It makes me wonder why my 1st doc. who was one of the top cardiologists in South Florida never sugggested one. He just prescribed me Toprol & Altace & referred me to a B/P Specialist/Nephrologist. That appointment was pretty much a waste of time. At the doc., my b/p was 190/100, because I was having an alcohol-induced panic attack. At the doc. my B/P always runs 156/86 even now. The 1st doc. switched the Altace to Lotrel. I never went back to him.

The 2nd doc. ( or 3rd including the specialist) put me through all of the blood tests & all of my kidney function tests were perfect, as well as everything else. My glucose was a little high at 103, but that is nothing. She said that she may have to test my glucose reading again in a few months. Needless to say, she left the practice. I was taking 2-3 MGS of Xanax & she tried to wean me down to none within 2 weeks.... not smart. She wound up leaving that practice. She switched the Toprol to Atenolol (because it has less side-effects.... yeah riiiight). She put me on Paxil, which gave me the worst stomach flu that I have even had.

The 3rd doc. put me back on the Xanax & kept me on the B/P meds. He gave me another EKG, my 2nd in 20 months & everything was fine again. He also gave me a chest xray. Everything once again was fine. He said that I had isolated hypertension or white-coat & sent me home.

My 3rd appt. with him my b/p was 120/78 & he said that I couldn't wean off of the meds.

My 4th appt. with him he said that he wasn't sure if I had white-coat, because my heart rate was only 69 & people with white-coat have a higher heart rate. He asked me how I feel. I said nervous+, because he took my B/P after talking to me for 5-10 minutes about anxiety & different SSRI's & he said that he has anxiety & he had problems with Paxil. How many mixed messages am I a going to get? I told him that my heart rate is usually 58-60, because I am on Atenolol, which keeps it down. He said "Oh, I forgot about that". Read doc.... it's called a chart.... you can find out a lot from it. I showed him my reading from the past 20 months & especially the last 3 months, which averaged from 108-120/64-72 or so. I said with these #'s can I wean off of the Atenolol. He was very wishy-washy & said you can if you want, but I'm not sure... That was last week. My B/P went down 34 points on the systolic & 11+ on the diastolic only 30 minutes after my appt. Doesn't that prove anything to him, that I do have white-coat? He said to come back in 4 months & I asked for what??? He said to check my B/P. What is the point when I do that myself? Did he mention a stress test or any of the other docs??? No.

I will go the appt. in 4 months & let him just prescribe... that is all that he is good for.

Every week, I experience different side-effects. This week I have the hacking cough in the middle of the night (Lotrel) & my big toe is really sore (no reason why), my b/p #'s are like 116/66 during the day. At night, I'm sure that they are even lower. I will use a specialist from now on when it comes to B/P. All of these docs. seem like they don't have a clue & it s**ks that B/P spikes when you get off of the meds. I'm only 34 & it good shape. All that going to the doc. has done is proven that I have white-coat & made my life miserable due to these meds. They don't care, nor do some of them believe in the side-effects. I think that speaks volumes.

 
Old 11-17-2004, 06:39 AM   #10
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Some More About GP's

axe , ill bet that if you go off your medication your blood pressure will be high all the time, that happens to most people who stop medication.

That is why I am scared to get off of this garbage. I am on 100 MGS of Atenolol & 5/20 of Lotrel. Every week it seems like different side-effects kick in.

En08,

I agree, the docs. don't care about the side-effects. They don't know what some of us go through. All they say is "They are good drugs''. Well they aren't for me if my lifestyle s**ks, because of them. I would get completely off of the meds., but I am afraid of what DarrenD said. I don't want to go through a tough wean without a competent professional in this area.

 
Old 11-17-2004, 07:59 AM   #11
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Re: The Reason Why White-Coat Is Obvious

I assume that since i was 19 thats why they gave me the stress test. high blood pressure is normal as you get older so if you even in your 30s it may not be that unusual thats probubly why they didnt rush to give you a stress test. As for then 69 number, when i would take it at home I would still be nervous but by heart rate would sometimes only be high 60's low 70's. heart rate isnt always a good measure of anxiety. Talk to your doctor about a stress test if you and your doc are having trouble accepting if you have hbp or if its just white coat. It might help shed some light. going online to this board isnt going to help your anxiety on the issue.

 
Old 11-17-2004, 08:55 AM   #12
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Re: The Reason Why White-Coat Is Obvious

Heart Rate-Pulse are good indicators of anxiety-stress. This board helps me more than my doctor. The people on here are more knowledegable.

 
Old 11-17-2004, 11:13 AM   #13
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Re: The Reason Why White-Coat Is Obvious

Axe and everyone!

Better than a stress test for discerning true hypertension vs. White Coat is 24-hour ABPM (Ambulatory Blood Pressure Monitoring).

Beats me why more doctors don't consider it.

Oh.

Wait.

Uh...Don't tell me....

Could it possibly mean that doctors would probably lose half of their so-called "hypertensive" patients!

From The Journal of the American Academy of Family Physicians, published last year...A must read:

http://www.aafp.org/afp/20030601/2343.html


zuzu xx

 
Old 11-17-2004, 11:35 AM   #14
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Re: The Reason Why White-Coat Is Obvious

Zuzu,

That was one of your most brilliant posts. I put down my average measurements over 4 months (averaging over 11 readings during different parts of the day). 116/66 seems to be my average. At the doc. 156/85 seems to be my average. Either all B/P measurement devices are broken or my doc is a mor*n & doesn't understand white-coat.

Before the last few years, doctors were mainly concerned with the Diastolic # & the Systolic was more of an after thought. Now with all of the specialists+, there isn't much that GP's can do, but evaluate blood tests, take blood pressure, weight the patient, do EKGS & Chest Xrays.... they can help you if you have the sniffles basically & prescribe. Diastolic is more a long-term # than systolic & they keep changing what is normal B/P. Years ago it would be 130/85, then it was 120/80, now it is 115/75. What do they want??? People walking around in a daze. If a patient had isolated readings at the docs. office most would dismiss it as Anxiety+. Now they prescribe. The entire issue has gotten out of hand, because the ones that I have been to don't know how to take B/P properly.

You drive 30 minutes to get to the doc. (Stress)
Pay a certain amount for the appt. (Stress)
You wait 20 minutes+ for the nurse practicioner (Stress)
They weigh you & take your B/P right away.... this is not the way that it supposed to be done!

If they didn't have patients that had to have appointments every 3-4 months & didn't get kick-backs from the drug companies, how would they make $'s???

 
Old 11-17-2004, 12:17 PM   #15
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Re: The Reason Why White-Coat Is Obvious

Quote:
Originally Posted by zuzu8
Axe and everyone!

Better than a stress test for discerning true hypertension vs. White Coat is 24-hour ABPM (Ambulatory Blood Pressure Monitoring).

Beats me why more doctors don't consider it.

Oh.

Wait.

Uh...Don't tell me....

Could it possibly mean that doctors would probably lose half of their so-called "hypertensive" patients!

From The Journal of the American Academy of Family Physicians, published last year...A must read:

[url]http://www.aafp.org/afp/20030601/2343.html[/url]


zuzu xx
Hmm... wouldn't that ABPM be very inaccurate because it is simply measured at the arm and if the arm is lower than heart level then the pressure will be higher than it actually is. Another example would be sleeping with the testing arm above the head at night -- it will read a BP that is lower than it actually is.

I've always wondered this.

Last edited by naes; 11-17-2004 at 12:19 PM.

 
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