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Old 02-15-2005, 08:19 AM   #1
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White-Coat or HBP?

Does anyone know exactly how it is determined that you just have white-coat or actually have hbp?

 
Old 02-15-2005, 08:51 AM   #2
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Re: White-Coat or HBP?

I bought a cuff and monitor at home. I have a very good self inflate with a digital read out that I bought at CVS for about $60.00. I found out that I had not just white coat but cuff anxiety no matter where I was. I would get anxious checking it at the grocery store or pharmacy before I bought my cuff and then even at home after I got it. I would get a shot of adreniline as soon as it began inflating. I solved that problem by repetition. The weather was terrible one weekend so we were house bound and I took it constantly. Over and over and over. It probably made my husband crazy.
I keep a log. Every time the first couple of readings would be high and then they would gradually begin to come down the more I did it. I guess I desensitized myself and now it doesn't bother me a bit and I feel that I am getting very accurate readings. My Dr knows this as well and she distracts me when she's taking it. She talks to me about all kinds of things and she takes it several times. We have proven that I have anxiety but am indeed prehypertensive. Unmedicated high 130's over high 80's at rest. I am on very low dose beta blocker and it works very well. BP is now 110/70 but I probably have to go off of it due to side effects. Darn. Not sure what I will do now. I hope this helps.

 
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Old 02-15-2005, 09:57 AM   #3
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Re: White-Coat or HBP?

Sherbear,

While it is widely acknowledged that the white coat phenomenon exists, there is still a lot of controversy about whether it represents the possibility of negative clinical consequences over time, in the long run.

The important question is really: If our BP spikes in the docs office what about all the OTHER "spikes" that may or may not be occurring repeatedly throughout the "normal" day?

Doctors prefer "at rest" readings (whether at home or in the doc's office) and presumably consistently good home readings over time are a reasonable indication that you do not have true bona fide hypertension.

HOWEVER, the very best way to get a true picture of one's BP is through 24-hour ambulatory blood pressure monitoring.(ABPM)

That way we get a good picture of how much or little our BP varies throughout the day in different environments under different circumtances.

I think more docs should order 24-hr ABPM if they suspect white coat or if our BP is very labile.

My feeling is if there is any doubt, it's worth the 24-hour hookup, before embarking on a lifetime of meds.

zuzu xx

 
Old 02-16-2005, 09:38 PM   #4
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Re: White-Coat or HBP?

What about reverse white coat? Since my medication changed (dosage of cartia generic doubled to 240 mg) my b/p reading has gone up. It was 127/86 in November, now 154/105! In the doctor's office it is more like the reading in November. He says that the increase can have nothing to do with the change in medication and hasn't given me any suggestions except come back in 4 months! Any ideas?

 
Old 02-17-2005, 01:00 AM   #5
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Re: White-Coat or HBP?

Joanne,

1)Are you using the same home monitor now that you used back in November? Just wondering if you changed monitors and the newer one may be faulty.

2)If the monitor is the same, have you in any way changed the way you actually take your BP? ( your body's position, the time of day, location etc)

3) Has your diet/caffeine intake/alcohol consumption/salt intake changed at all?

4) Are you taking any other meds (even over-the-counter stuff) that you weren't taking before?

5) Have any other NEW health issues cropped up since Nov?

6) Perhaps the most salient question is: Do you actually feel more anxious taking your own BP than when the doctor does it?

zuzu xx

 
Old 02-17-2005, 06:13 AM   #6
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Re: White-Coat or HBP?

Zuzu,

I agree with your 1st post in this thread. I don't buy the docs. idea that if one has white-coat than it is elevated at other times during the day. It is called being human. I got a nice reading of 112/62 yesterday. The Clinical Pharmacist looked at it & said that my doc. needs to wean me off of 100 MGS of Atenolol hopefully to 0 within a few months. There is no reason to be on this med. (I don't have heart palps & have had 2 EKG's & a chest xray in the past 2 years). White-coat does exist at the doctor for me. How come my b/p will reach 156 at the doctor only. I have tested it for 2 years. What more proof do they need.

 
Old 02-17-2005, 07:32 AM   #7
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Re: White-Coat or HBP?

I saw my doctor yesterday and she is treating it just like white-coat. Because my pressures are only elevated at the doctor's office and not at home she feels that starting meds would probably lower my pressures too low and the side effects of that would be worse. I can not believe that I have finely found a doctor that will actually take my readings at home seriously. I did take my bp monitor with me and it is as acurate as the one they use at the doctor's office. So, I can be rest assured that my readings at home are correct. She is still going to be monitoring it with me just to be 110% sure.

 
Old 02-17-2005, 07:43 AM   #8
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Re: White-Coat or HBP?

Good doctor . And, yes, your doctor is correct. The meds lower ALL readings - the highs and the lows. This is why monitoring it at home is so important.

Pal

 
Old 02-17-2005, 10:30 AM   #9
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Re: White-Coat or HBP?

Quote:
Originally Posted by Lillians Axe
What more proof do they need.
Axe,

In answer to your last question:

None that I can see. Of course there's no guarantee that your blood pressure won't start to creep up again, but it's absolutely worth a shot to see if the Lotrel alone is sufficient. (We'll worry about dropping Lotrel later. One step at a time!)

Next appt. walk in, tell doc you feel like crap, you have great home #s and you want to wean off the Atenolol- no "ifs" "ands" or "buts".

If he's worried about his own *** or starts to "argue" or give you a hard time, reassure him that you do not take hypertension lightly, that this isn't a "game" for you... and if, after you are off the drug, your BP climbs, then of course you won't ignore it and would welcome his advice about other meds.

The old adage about catching more flies with honey is the way to go here I think, if this is the same doc who's been "fighting" you.

zuzu xx

 
Old 02-17-2005, 02:22 PM   #10
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Re: White-Coat or HBP?

Quote:
Originally Posted by zuzu8
Axe,

In answer to your last question:

None that I can see. Of course there's no guarantee that your blood pressure won't start to creep up again, but it's absolutely worth a shot to see if the Lotrel alone is sufficient. (We'll worry about dropping Lotrel later. One step at a time!)

Next appt. walk in, tell doc you feel like crap, you have great home #s and you want to wean off the Atenolol- no "ifs" "ands" or "buts".

If he's worried about his own *** or starts to "argue" or give you a hard time, reassure him that you do not take hypertension lightly, that this isn't a "game" for you... and if, after you are off the drug, your BP climbs, then of course you won't ignore it and would welcome his advice about other meds.

The old adage about catching more flies with honey is the way to go here I think, if this is the same doc who's been "fighting" you.

zuzu xx
EXCELLENT ADVICE, Zuzu
Cass

 
Old 02-17-2005, 10:16 PM   #11
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Re: White-Coat or HBP?

Thanks, Cass! It's easy to dole out advice to others ...harder to heed it for oneself. I feel so frustrated for Axe and so fred up with the doc who doesn't seem to want to work with him.
By the time I would get to the appt. I would probably be bracing for an argument, then haul off and deck the poor doc before he even got to open his mouth!

zuzu xx

 
Old 02-18-2005, 08:08 AM   #12
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Re: White-Coat or HBP?

Quote:
Originally Posted by zuzu8
Thanks, Cass! It's easy to dole out advice to others ...harder to heed it for oneself. I feel so frustrated for Axe and so fred up with the doc who doesn't seem to want to work with him.
By the time I would get to the appt. I would probably be bracing for an argument, then haul off and deck the poor doc before he even got to open his mouth!

zuzu xx
I feel his frustration too. I found myself anxiously awaiting his appointment with the specialist and then I was soooo disappointed when it fell through. I'm sure he is feeling defensive when he does see his doc and that is probably why his BP goes up when he gets there. That doc is probably 95% of his problems
Don't you sometimes wish we could talk to the doc for him?
Cass

Last edited by CASSIEBEL; 02-18-2005 at 08:11 AM.

 
Old 02-18-2005, 11:31 AM   #13
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Re: White-Coat or HBP?

Cass,

I can see us now, charging into the doc's office...

Axe however is there. He's already presented His Case most eloquently and un-defensively.

But the doc is STILL holding onto the "I-don't-care-what-side-effects-you-have-Atenolol-is-good-for-you" scenario.

At which point we step in.. and re-iterate Axe's position.

The doc becomes infuriated. He starts jumping up and down , screaming that we don't know what we're talking about and that we "should stay off the Internet!!!"

We try to reason with him. Perceiving that he is being de-throned, he becomes increasingly agitated... Positively inconsolable. Ranting. Raving.

The Crazy Doctor Special Forces Police arrive.

Upon seeing them (and babbling now), the doc pulls out his sphygmometer and threatens to take everyone's blood pressure: "Don't you come any closer or I'll put you ALL on Atenolol!!

The cops grab the sphyg, cuff him (pun intended!) and haul him off: "Are you gonna come along quiet or do we have to muss ya up???"

He struggles at first but ultimately gives in.

He is subsequently tried and found guilty of medical laziness, arrogance, and the inability to listen to patients.

He is sentenced to TEN YEARS OF MED SCHOOL and ATENOLOL FOR LIFE.



zuzu xx

 
Old 02-18-2005, 02:13 PM   #14
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Re: White-Coat or HBP?

Quote:
Originally Posted by zuzu8
Cass,

I can see us now, charging into the doc's office...

Axe however is there. He's already presented His Case most eloquently and un-defensively.

But the doc is STILL holding onto the "I-don't-care-what-side-effects-you-have-Atenolol-is-good-for-you" scenario.

At which point we step in.. and re-iterate Axe's position.

The doc becomes infuriated. He starts jumping up and down , screaming that we don't know what we're talking about and that we "should stay off the Internet!!!"

We try to reason with him. Perceiving that he is being de-throned, he becomes increasingly agitated... Positively inconsolable. Ranting. Raving.

The Crazy Doctor Special Forces Police arrive.

Upon seeing them (and babbling now), the doc pulls out his sphygmometer and threatens to take everyone's blood pressure: "Don't you come any closer or I'll put you ALL on Atenolol!!

The cops grab the sphyg, cuff him (pun intended!) and haul him off: "Are you gonna come along quiet or do we have to muss ya up???"

He struggles at first but ultimately gives in.

He is subsequently tried and found guilty of medical laziness, arrogance, and the inability to listen to patients.

He is sentenced to TEN YEARS OF MED SCHOOL and ATENOLOL FOR LIFE.



zuzu xx
By far the best laugh I've had i days-You know what they say, Laughing is good for HBP
Cass

 
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