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    Old 04-13-2010, 08:50 PM   #1
    missy222
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    White coat hypertension and STRESSING

    Hello,

    I currently take 50 mg Atenolol and 40 mg of Lisinopril. My doctor refused to give me my Lisinopril until I come in for a blood pressure check. I have severe white coat and now I have only two weeks to go into my appt. My blood pressure at home runs about 107/60. My doctor's office called yesterday to schedule an appt. and today when I took by bp it was 150/67 (I think because I am stressing about having to go in). Any suggestions as to what I can do to keep my systolic down during the appt.? The last pressure reading at the doc's was 183/80!!! When I tell my doctor that I have normal bp at home, she states it is impossible to get that high of a reading at the appt. and have normal readings at home.

    Can a doctor absolutely refuse to give you your meds if you don't go in? Why does she always refill my Atenolol without going in? What happens if I quit taking the Lisinopril?

    Any suggestions?
    Missy

    Last edited by missy222; 04-13-2010 at 08:52 PM.

     
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    Old 04-13-2010, 09:09 PM   #2
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    Re: White coat hypertension and STRESSING

    I would definitely consider a different doctor.If this one thinks you are lying,you are wasteing your time. I take Atenolol every day,and if I have no symthoms,then I don't have to go to the dactor.I have read some things about my blushing,and I got some help with reading "self-confidence" stuff. Try not to be so overwhelmed with others.I know that is easy to say,but you are as good as anyone else in this world.That is,if you have kindness in your heart. Best of luck...Bill

     
    Old 04-14-2010, 06:38 AM   #3
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    Re: White coat hypertension and STRESSING

    Legally, your doctor has to see you at least once a year in order to keep prescribing medicine for you.

    I would keep a log of your blood pressures for the doctor to see when you go to your appt.

    As far as keeping your systolic down you might try some relaxation methods ie; deep, slow breaths before the appt. and while you at the doctors office. Avoid caffeine too.

     
    Old 04-14-2010, 12:24 PM   #4
    anneh
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    Re: White coat hypertension and STRESSING

    Legally you can refuse to have them take it. They can make a note of that and that covers them for malpractice suits. PErsonally I have the same problem and my bp goes up to 160/80 in a doc office thanks to an idiot doctor over 10 years ago starting the problem. So now I refuse to let them take it, I take in my own readings and have never had a doctor give me a problem, switch doctors if yours does Unfortunately in my case no matter what I do (breathing/praying etc)nothing works if they take it anneh

    Last edited by mod-anon; 04-19-2010 at 01:29 PM. Reason: removed quote

     
    Old 04-14-2010, 08:09 PM   #5
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    Re: White coat hypertension and STRESSING

    I have similar issues. I keep a log of my BP at home leading up to an appointment and take that in with me. I NEVER let a nurse take my BP... I just remind her that I'm the weird one Then I hand my doctor my spreadsheet of blood pressures. He's not taken it in at least a year. It took a while for us to build a trusting relationship, but at this point he realizes I'll come see him if something is wrong.

     
    Old 04-14-2010, 11:18 PM   #6
    missy222
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    Re: White coat hypertension and STRESSING

    Hi everyone,

    Thanks so much for your replies! It makes me feel so much better that I'm not alone in this. I started a log for the doc appt., but went back 14 days to memory on my monitor before I started the log. Wasn't stressing until my appt. was made. Does anyone know why they have to give you the atenolol without going in? For some reason, it seems that they can't withhold that med? Even if I am overdue for an appt., my doc always refills it without seeing me. Very curious about that????

    I was prescribed some Lorazepam at a stressful time in my life that I never took. If I took one, do you think it would lower my bp when I go in?

    Missy

     
    Old 04-16-2010, 08:14 AM   #7
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    Re: White coat hypertension and STRESSING

    hi missy - you are definitely not alone. i posted a long trail a while back called "blood pressure and anxiety" if you want to read everyones replies. i'm sure everyone here on the board knows this by now, but i run marathons and eat an extremely strict diet, no caffeine, no soda, no alchohol and battle with high bp. i take 30 lisinopril...bp runs 140/90 at doc and 115/60 at home going as low as 100/50...i've seen it as high as 160/95 or so at doc. last time i went in it was 130/80...my doc (like yours) is very strict...but i trust him. if bp is high is his office, it can be high elsewhere...for a long, long time i thought..."no - this is truly, truly an isolated incident" and you can't treat based on 1 number, but when i took a step back i realized that i probably did have a little bit of essential hypertension that was being magnified by white-coats. regardless, the lower the better over the course of one's life...and although i don't 100% agree with my doc not putting much value into my at home readings, i know he is only trying to take care of me. i've considered the xanax as well but have never tried it. it does beg the question - if a xanax or a glass of wine lower your bp dramatically, does that mean we really have high bp? i don't drink as much anymore...but if i've had quite a few, i can get a 95/45 reading. who knows...is atenolol a beta blocker? i've heard they help to take the edge off as well...maybe one of those would work for me. good luck - i've had success with the lisinopril as well and i agree with the group. track your #s and show your doc. it's funny - all of us with this white coat want to be on less meds because we really feel like we don't need them...but you know what? who cares...they are generally very very safe and perhaps we are slightly over treated...but when it comes to bp that's much better than the other way...so screw it. i say give me 80 mg lisinopril if you want to doc...i'll start fainting and then maybe you'll start believing me! bring it on. andy

     
    Old 04-16-2010, 08:02 PM   #8
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    Re: White coat hypertension and STRESSING

    I have been on Atenolol for several years.I believe that that is important to keep my Atrial Fibrillation problem in check (Heart).I took Lorazapam that you mentionrd,for a
    year or so.It was wonderful for me.It took me out of my daily bouts of anxiety,within a half hour.I hope you get better Bill

    Last edited by friendsville; 04-16-2010 at 08:06 PM.

     
    Old 04-16-2010, 08:42 PM   #9
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    Re: White coat hypertension and STRESSING

    Hi Andy and Bill,

    Thanks for the responses.

    Andy I have to agree with you. At my last appt., my doc wanted to increase my meds once again. I asked her what would happen if my bp dropped too low at home and she replied "call me and we will adjust your meds". Well how the heck am I supposed to call her if I'm passed out on the floor or worse dead!!! Geez, this is just crazy stuff. I think the anxiety is causing the high blood pressure instead of the blood pressure causing the anxiety.

    Bill, thanks -- I am going to take a Lorazepam a few days before and see if it lowers my bp before I even go in to see my doc. If it does, then I know I need to deal with the anxiety instead of increasing my bp meds.

    Will post back and let ya all know what happens.

    Thanks again,
    Missy

    Last edited by missy222; 04-16-2010 at 08:44 PM.

     
    Old 04-18-2010, 09:49 AM   #10
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    Re: White coat hypertension and STRESSING

    missy, I'm entirely in the same boat. 36 y.o. m who's in pretty good shape 6' 175, tries to eat right and excercise. My home BPs are around 120-65 and the minute I start driving to the doc's office, I feel my anxiety coming on and I've rung up BPs around 150-80 at the doc's.

    I now take 25mg Toprol XR each day to counteract the "spikes" from my phobia and it truly is a phobia. I never feel as panicked as I do when I'm at the doc's office. I work in the medical field and I know how important BPs are to general health. I think that's what causes my worries. (knowledge) I might also suggest a good workout earlier in the day prior to an appointment. I have found that to have a settling effect on the nerves. Wear yourself out!

    My BPs will still be elevated at the doc's 130's-70 but it's not nearly as bad. I also have asked the doc for a script of Xanax that I use only during the most stressful moments of my life. It gives me that little bit of extra stability to keep the BP in check. I recently took a speech class and it worked like a charm with the Toprol XR.

    HBP wasn't a gift I wanted from my family, but it's here to stay. Don't ignore it or brush it off as situational. It will be full blown before you know it. Good luck.

     
    Old 04-18-2010, 12:41 PM   #11
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    Re: White coat hypertension and STRESSING

    The White Coat can be a real problem. The longer I have to wait in the examining room for the doctor to examine me, the more my anxiety levels increase. It's true though that beta blockers like Toprol help take the edge off. It gives you a kind of "I don't care sedated feeling". This can prove beneficial during the day when times of stress at work or daily situations put us in a panic mode. At least the blood pressure spikes and heart rate are more controlled.

     
    Old 04-19-2010, 06:49 AM   #12
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    Re: White coat hypertension and STRESSING

    Quote:
    Originally Posted by missy222 View Post
    Hello,

    I currently take 50 mg Atenolol and 40 mg of Lisinopril. My doctor refused to give me my Lisinopril until I come in for a blood pressure check. I have severe white coat and now I have only two weeks to go into my appt. My blood pressure at home runs about 107/60. My doctor's office called yesterday to schedule an appt. and today when I took by bp it was 150/67 (I think because I am stressing about having to go in). Any suggestions as to what I can do to keep my systolic down during the appt.? The last pressure reading at the doc's was 183/80!!! When I tell my doctor that I have normal bp at home, she states it is impossible to get that high of a reading at the appt. and have normal readings at home.

    Can a doctor absolutely refuse to give you your meds if you don't go in? Why does she always refill my Atenolol without going in? What happens if I quit taking the Lisinopril?

    Any suggestions?
    Missy
    The answer to this is very simple Missy. Get another doctor and provide him/her with a list of readings that you have taken at home. Any doctor that is not a partner with the patient is a bad doctor.

     
    Old 05-04-2010, 06:53 PM   #13
    missy222
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    Re: White coat hypertension and STRESSING

    Hi Everyone,

    I finally broke down and went into the doc for my blood pressure appt. I took an Ativan (.5mg) an hour before I left home and didn't feel any relief from my anxiety. When I got to the parking lot of my docs office I took another one. Needless to say, by the time I was seen (and feeling a little loopy) and had my bp checked, IT WAS COMPLETELY NORMAL!!!!!! The first time ever!!! I have come to the conclusion that my bp spikes that occur at the doctor's office is all from anxiety!! No increase in bp meds, Yay!!!!

    Thanks to all of you for your support, much appreciated!!!

    Missy

     
    Old 05-21-2010, 05:58 PM   #14
    missy222
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    Re: White coat hypertension and STRESSING

    Hi Everyone,

    I am back again. At my last doc visit, my doc was overbooked and since I was there for just a bp check they had me see a nurse practioner. I went to refill my bp meds and was told by the pharmacy that they would only give be a month supply because I needed to see my doc. When I emailed my doc questioning this, she replied that because I did not see her directly she WAS NOT going to refill my meds and that I had to go back in. Geez, I was just there 2 weeks ago!

    It was everything I could do just to go the first time and I can't believe she won't give me my meds!!

    Can she do this? I have never heard of such a thing.

    So I am back to stressing and need some input from all of you.

    Missy

     
    Old 05-21-2010, 07:56 PM   #15
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    Re: White coat hypertension and STRESSING

    Hi Missy. I've had hypertension for over 30 years and been on every class of antihypertensives there is. I also have white coat problems as I just don't want another drug added to my regime. This is how I handle it.

    First, I have to keep telling myself that I am not being punished for having hypertension. I didn't do anything to get it...it runs on my family. Second, that my doc is trying to help me, not hurt me despite what I think of the side effects of the meds. It just feels like it and I need to fight that feeling.

    Third, I have him take my BP at the end of the appointment, not the beginning. First we talk about how I'm doing. Only when I have relaxed a little does he take it and if it's high we talk some more and then he tries again. We have an agreement that no increase will be done without 2 consecutive appointments with an increased pressure as well an increases at home. I even bring my machine from home so he can see the results and measure it against what he gets so he trusts my machine.

    Fourth, I've learned as much as I can about the meds so I can make suggestions as to where to go next. I recently suggested taking me off of 2 meds and replacing them with one that I thought would work better for me and it has.....much to his surprise.

    Five, I've had all of my other docs(Ob/Gyn, dermatologist, whatever)fax over my BP when they take it at their offices as it's often lower.

    And #6....I found a doc who doesn't actually wear a white coat at the office and it really does help me. Might want to think about changing docs and shop for one who is more informal.

    As to the reordering of the beta blocker atenelol and not the ACE inhibitor lisinopril: It can be very dangerous to your heart rate to suddenly stop a beta blocker as opposed to stopping an ACE inhibitor. Beta blockers directly affect the heart muscle whereas the ACE inhibitors affect a chemical released by the kidneys that affects the constriction of the arteries. So stopping the atenelol suddenly could cause your heart to have some major problems but stopping the ACE inhibitor would cause a slow rise in your BP.

    But please, whatever, don't stop taking your meds. I've had 5 strokes and now keep mine under the recommended rates. It's not where you want to go.

    good luck................Jenny

     
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