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Old 04-04-2012, 03:53 PM   #1
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Question Blood pressure spikes at doctor's office

Hi,

I have always had trouble with white coat syndrome. Almost every time I go to the doctor my blood pressure spikes. I had an endocrinologist appointment this week and my blood pressure was 210/110, pulse 84. The nurse told me that is the highest reading she has seen. When I am at home my blood pressure averages 115/60 with a pulse of 59. My blood pressure machine has been calibrated with the doctor's machine and it is always accurate.

Does anyone else have this problem? The nurse told me I must be anxious when I go to the doctor. I have several medical problems and I see four doctors on a regular basis. I feel comfortable with all these doctors, and I wish I could find a way to keep my blood pressure down. I take two blood pressure pills and they keep my blood pressure under control except at the doctor's office.

I would appreciate any responses. Thanks in advance.

Grayfox

 
Old 04-04-2012, 06:58 PM   #2
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Re: Blood pressure spikes at doctor's office

It's very common. What matters more is your home average readings. After all, you are home much more often then you at a Dr's office. I don't know why Dr's even record the readings at the Dr office, and exclude your home readings, since they are very aware that white coat syndrome happens in a lot of people.

 
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Old 04-05-2012, 10:28 AM   #3
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Re: Blood pressure spikes at doctor's office

Hi,

I have found that over the years the only thing that helps to keep my pressure down in a doctors office is when I go into the examination room and before the doc gets in there I will take a deep breaths, hold it for the count of 4 open my mouth and quickly let the air out and drop my shoulder's down.Do this 5 or 6 times. By the time doc gets into the room my pressure is normal whereas before it would be 170/90 it is now 120/68. At home my pressure is always low....98/60.or less...I also take my machine in the office on each visit and we check it against hers so we know that the machine is fine. She can always read back the numbers on my machine so she knows that it only goes up in her office.

Hope it works for you..Quite common..I also only let the doc take it, no helpers taking it and going WOW it's high..which would really only make it jump higher.
Alyce

 
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Old 04-15-2012, 03:47 PM   #4
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Re: Blood pressure spikes at doctor's office

Start refusing to have your bp taken in the Dr office. Instead take it at home and then take the results into the Dr office with you. I have never had a problem doing this, its your right. Just tell them its dangerous for you to cause such high spikes so safer for you not to let them take it. You are the boss, not them. anneh
QUOTE=grayfox;4955896]Hi,

I have always had trouble with white coat syndrome. Almost every time I go to the doctor my blood pressure spikes. I had an endocrinologist appointment this week and my blood pressure was 210/110, pulse 84. The nurse told me that is the highest reading she has seen. When I am at home my blood pressure averages 115/60 with a pulse of 59. My blood pressure machine has been calibrated with the doctor's machine and it is always accurate.

Does anyone else have this problem? The nurse told me I must be anxious when I go to the doctor. I have several medical problems and I see four doctors on a regular basis. I feel comfortable with all these doctors, and I wish I could find a way to keep my blood pressure down. I take two blood pressure pills and they keep my blood pressure under control except at the doctor's office.

I would appreciate any responses. Thanks in advance.

Grayfox[/QUOTE]

Last edited by anneh; 04-15-2012 at 03:47 PM.

 
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Old 04-18-2012, 07:46 PM   #5
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Re: Blood pressure spikes at doctor's office

Hello ! This is my first time on Health Message Boards ! I read your posting and I have had similar problems also with BP reading at the doctor's office ! I feel in my case that there could be some unkown worry or anexity before reaching the doctor'S office ! I wish you the best at your next dr's. visit with you BP !

 
Old 04-22-2012, 06:06 AM   #6
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Re: Blood pressure spikes at doctor's office

I have the same 'white coat syndrome'. I can achieve readings similar to yours with no problem at the surgery. I now take my own blood pressure every morning, and occasionally at night and keep a record to show to the nurse. Readings at home will range from 119/75 with a pulse rate of 68 to the only occasional 145/90, pulse 84 level depending on my lifestyle at the time, and probably averages 135/84 ish. So far have avoided medication.

I dread going for my reviews because of all the fuss that's made and this week I could feel myself getting really screwed up for a couple of hours before the appointment. This resulted in a spectacular reading, and I'm now to go back in ten days to be fitted with the 24 hour ambulatory BP monitor. I'm pretty depressed about this, because I suspect I'll have no problem maintaining a 24 hour state of angst! And then I'll end up on medication which I don't want, because of the various side effects I've read about, in fact I think it's the fear of meds that's probably the root cause.

I think Anneh's advice is good. I shall probably refuse to have it taken at the surgery in the future because after this week's episode the BP remained higher than normal for several hours after my 'panic attack'. And I've got to say, the nurse takes it all far more seriously than the doctor does.

 
Old 04-22-2012, 08:31 AM   #7
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Re: Blood pressure spikes at doctor's office

To add to the advice, I agree that the nurses make a bigger deal out of the high bp numbers than the doctor so what I have done is I don't let the nurses take it only the doctor because he is so much more reasonable and reassuring. I think this also helps because when the nurses take it, it is after you have been sitting in a stressful waiting room, in a state of anxiety over your bp, then they call you back, weigh you etc, plop you down on the table with your legs hanging down (guidelines say they should be flat on the floor) and take your bp. This is hardly a resting measurement (again guidelines say you should sit quietly for five to ten minutes). If you wait for the doctor that is precisely what you are doing, sitting quietly for at least five to ten mins probably much longer. Since I have stopped letting the nurses take it my bp is now no longer an issue at the docs office. Now that he sees the lower numbers, he doesn't question me about it so my stress level is so much better. My problem is I love to see the low numbers so I still check too much at home and I don't even have hbp, my average right now is 109/75...silly.
Ivy

 
Old 05-05-2012, 03:22 AM   #8
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Re: Blood pressure spikes at doctor's office

I posted a couple of weeks ago re this subject saying that because of supposed 'white coat tension' I was giving spectacular readings at the nurse's clinic. So she wanted a 24 monitoring.

On Wednesday I attended the nurse's clinic and had the ambulatory monitor attached. When she tested it, the monitor started the inflation, then re-boosted it during the process, and then re-boosted it again. This, I know from experience, is a sign that the BP is sky-high and the monitor is having a problem. She said it was high, but said once I settled down after leaving the surgery it would be OK.

Throughout the period I wore it (before I tore it off in frustration) the monitor only did two normal inflations and the rest of the time it was constantly re-inflating with all the pressure on your arm that's involved in that. I knew that my BP was remaining at a really high level because I was getting more and more agitated and developing a thumping headache. My arm was sore and I couldn't bend it to put a fork to my mouth (short upper arms I guess).

Eventually after five hours or so, I used my own monitor on my right arm and it read 178/98 which confirmed to me that this was a pointless, perhaps even dangerous exercise. I've NEVER seen a reading that high on my own monitor at home. So I took the 24 hr monitor off. All that was going to derive from this exercise would be an example of just how high I can go and how long I can sustain it.

Because I suspected something like this might happen, I've been keeping a similar ( hourly/twice hourly) record during the day for the past two weeks using my own monitor, which registers slightly higher than that of the nurse. The readings have ranged from 115/69 to a (one time) high of 155/90, and using a spreadsheet I've calculated a daily average ranging from 129/77 to (exceptionally) 141/80. If I were to average the averages it would probably be around 132/80, which probably puts me in the pre-hypertensive bracket.

I have to see the doctor next week when he will be armed with the readings from the limited time I wore the monitor, and I will take my own chart with me. I am just so fed up of this meddling by the practice nurses and have resolved, as advised in earlier postings, to refuse to have it taken in future. The more fuss that is made, the more apprehensive I get and now I think it's become a conditioned response that nothing will break.

Surely if I were to go onto medication it won't stop these nervous 'spikes' and they'll simply think I need higher dosage. Is there anyone on here who has found that medication has eliminated these freak readings, which I suspect come under the heading of 'labile' rather than 'white coat'.

 
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Old 05-05-2012, 03:28 AM   #9
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Re: Blood pressure spikes at doctor's office

I should have added here that once the 24 hr monitor was removed the BP fell to 157/93 within 10 minutes, to 137/83 within three quarters of an hour and three hours later was 126/74.

 
Old 05-05-2012, 07:23 AM   #10
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Re: Blood pressure spikes at doctor's office

Make sure that you also take your own BP monitor as well as your chart. That way the Dr. can check the numbers between his and your numbers. Over time I have become more at ease in the office. Mostly because she does not make a fuss over it as she knows it is fine at home (quite low) even in a stressful situation.I have a machine that records all readings so it is easy for her to check them out.

Wishing you well.

 
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Old 05-05-2012, 07:56 PM   #11
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Re: Blood pressure spikes at doctor's office

wow Minx65 you went through an ordeal with that 24-hr monitor! And I think you are doing the right thing now with taking your own readings. I do the same now as well. I take readings at home, around the same time, same chair, same arm, same position, same device.

And your ranges are nearly just like mine- 115/69 to 155/90. If only we could get that low reading at Dr office! But it's not normal to go to the Dr. You don't see a nurse every day.

When we where kids at grade school, and if a nurse had come every day to take our BP, every day in school, then there would be no such thing as white coat syndrome as adults!

 
Old 05-06-2012, 12:08 AM   #12
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Re: Blood pressure spikes at doctor's office

Thanks for responding. Yes, you may be right but I think it's too late for me to change now. I think I'd have to have a general anaesthetic to stop spiral of anxiety.

 
Old 05-06-2012, 12:12 AM   #13
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Re: Blood pressure spikes at doctor's office

Thanks Sanwan, I will. Which machine are you using?

 
Old 05-06-2012, 01:30 PM   #14
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Re: Blood pressure spikes at doctor's office

I use a Omron Automatic Intelli Sense with a memory. You can use it with batteries or with a cord.It is an older model but has been great.

 
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Old 05-08-2012, 04:20 PM   #15
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Re: Blood pressure spikes at doctor's office

Hi everyone, thanks for all your wonderful responses. I had been wondering if a 24 hour monitor would prove that my blood pressure was normal at home, but I never imagined the ordeal of wearing one. Minx65 certainly has shown what can happen with the monitor. I will never agree to one. Thank you for sharing your experience with us. I know how painful it is when a blood pressure monitor keeps re-inflating as this happens to me often at the doctor's office. I have even told the nurses to stop the machine when it continually re-inflates.

I have taken my blood pressure monitor to doctor appointments several times to prove it is correctly calibrated. I still don't think they believe me that it averages 115/60 with a pulse of 59. On occasion, it will rise to 150/73 at night with a pulse of 65 but that is not the norm. I also have a OMRON Intelli Sense with memory and it is definitely reliable.

Grayfox

 
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