White Coat Syndrome is Driving me Crazy!!!

[audreyh1]

I've been tracking my blood pressure for a while now. I had measured it off and on over the years. I noticed it had crept up a bit a year ago, I was getting systolic readings in the high 120s to low 130s, and at the doctors office I would often see high 130s and occasionally low 140s.

So I started measuring more regularly. I had lost a little weight, was getting a bit more exercise, some dietary and supplement changes, and I saw my at home readings steadily improve over the past year. Low 120s, then 110s, and for the past couple of months, often under 110. Now I routinely get readings like 103/70 pulse 73. Occasionally see something like 117/72 pulse 77. It's quite rare for me to read above 120 now.

So I thought I would see correspondingly lower readings at the doctors office. Well, no. The readings are still high there. The divide between readings at the doctors, and the readings at home had simply gotten very wide now.

Today I was actually feeling a little anxious due to a scheduled doctor consult in the afternoon and had been rushing around a bit. So this morning my at home reading was 122/81 pulse 85.

So I try to relax and stay calm. Get into the doctor's, and they get a reading of 142/something pulse 100. What!!! It's so annoying, yet of course I haven't sat quietly at all, my feet were dangling in the chair, but in addition I can feel that my pulse is higher than normal - I can't seem to get my pulse to slow. Last time I was at a doctor's it was 132/70 and pulse 108! I could feel my heart pounding! That morning I had measured 104/71 pulse 80 at home.

I'm not a particularly emotional person, but I don't seem to be able to "talk myself down" when I feel anxiety in the doctor's office.

I recently switched devices. Was using an Omron 712C for many years. Recently got an Omron 785 that will average three readings. I was noticing variability in the systolic readings taken a few minutes apart at home, so I decided to use something that did averaging. The new device pretty much reads the same as the old, actually the readings are slightly better.

My iPhone has a handy health app where I can show my at home blood pressure history.

 

[NW-Bound]

I cannot help you, as my situation is the reverse.

I consistently measured higher BP at home than at the doctor's office. He blamed it on my home machine not being accurate, but I have two machines agreeing.

 

[audreyh1]

I cannot help you, as my situation is the reverse.

I consistently measured higher BP at home than at the doctor's office. He blamed it on my home machine not being accurate, but I have two machines agreeing.

Well that's interesting. Do you feel quite relaxed when you visit the doctor?

Do you follow all the little rules about posture, time from eating, position of arm, etc. at home?

 

[Bestwifeever]

DH had heart surgery early this summer and he took his home BP machine to the cardiologist's office with him so he could have readings done at exactly the same time. Have you tried that? It wasn't a big deal.

 

[ls99]

Perhaps thing of the doctor's office as flower shop, or a cafe. Attitude makes a difference.

My BP is the same at the docs office as at home within a few points. I think of of the place as my favorite mechanic's shop. My weight is always 182 to 185, yet when at the Y it is always within 174 to 178. Not sure in the summer the shorts flip flops and a T shirt weigh that much more.

 

[Texas Proud]

My doc will take my pressure sometime during out discussion of my past few months history etc. and me sitting in a chair, not on the exam table...

It seems that mine goes up after they call my name and me getting back to the doc... so exactly when they measure...

Now, when it is time to draw blood, I go the other way... sometimes 90/60 or even lower...

 

[redduck]

My blood pressure findings are always lower at the doctor's office. A few years ago, I did what BWE's husband did, I brought my two home machines to the doc's office. He was all for comparing his blood pressure equipment with mine. My blood pressure was lower with his equipment. My two machines recorded just about the same numbers at home and in his office.

 

[audreyh1]

DH had heart surgery early this summer and he took his home BP machine to the cardiologist's office with him so he could have readings done at exactly the same time. Have you tried that? It wasn't a big deal.

Since I have two machines agreeing at home, and a long history with one of them, I haven't felt compelled to take that step yet.

Heck I know I'm stressing just from my racing pulse!

I know I have an option to take my device.

At my doctors they don't have a very good BP measuring protocol. They call you in, weigh you, seat you and take the BP right away, sometimes having you answer questions during! At least I am seated in a chair, feet flat on the floor, and back supported.

At home I sit quietly for 5 mins before taking.

One time DH took our original device to the doctors office and it concurred with his readings.

 

[NW-Bound]

Well that's interesting. Do you feel quite relaxed when you visit the doctor?

Do you follow all the little rules about posture, time from eating, position of arm, etc. at home?

Yes, and yes. And it was at different doctor offices, not just one.

 

[Mo Money]

Audreyh1 -- I have the same issue and the same general discrepancy of BP numbers that you do. My doctors take it in stride.

With my cardiologist, who (whom?) I see for BP issues, I do the following: I take my Omron HEM-629 with me, measure my BP in the car, right before I leave for his office, and take a photo of the normal BP (120/80) Omron results. Then I stroll in the doctor's office with my Omron. My BP skyrockets when the doctor measures it, and I show him the photo. He chuckles. Then I use my Omron right in front of him. Again and again, it's either the same as, or virtually the same as, his BP meter's results. His white coat raises my BP.

It's just the tension of going to the doctor, and knowing that your BP is going to be measured, IMHO.

 

[Moemg]

We recently had the opposite problem . Our at home machine was registering higher that at the Physician's office . I ordered a manual BP cuff & stethoscope from Amazon now both readings match . It is very easy to learn to use a manual cuff & they are very accurate .

 

[audreyh1]

Audreyh1 -- I have the same issue and the same general discrepancy of BP numbers that you do. My doctors take it in stride.

With my cardiologist, who (whom?) I see for BP issues, I do the following: I take my Omron HEM-629 with me, measure my BP in the car, right before I leave for his office, and take a photo of the normal BP (120/80) Omron results. Then I stroll in the doctor's office with my Omron. My BP skyrockets when the doctor measures it, and I show him the photo. He chuckles. Then I use my Omron right in front of him. Again and again, it's either the same as, or virtually the same as, his BP meter's results. His white coat raises my BP.

It's just the tension of going to the doctor, and knowing that your BP is going to be measured, IMHO.

My pulse races even worse and BP rises if I'm in for any kind of procedure.

It's visceral. I can't seem to help feeling like a human guinea pig in an alien abduction horror movie.

My doctor hasn't said anything. It's only one of the senior nurses who give me the evil eye if my BP reading is over 140.

 

[Moemg]

It's only one of the senior nurses who give me the evil eye if my BP reading is over 140.

Ignore the evil eye most senior nurses recognize white coat syndrome and listen to what the patient says their BP home readings are .

 

[audreyh1]

Ignore the evil eye most senior nurses recognize white coat syndrome and listen to what the patient says their BP home readings are .

She does back off when I tell her what I measured at home that morning. And now I can even show her my readings on the iPhone - almost two month's worth.

 

[meierlde]

I take reading with the home device for 30 days before a visit to the physician and provide a list of the readings to the doctor. This is just doing manually what will happen in a few years with smart phones and bluetooth bloodpressure cuffs. (only the smart phone will send the info in real time to the doctor). They are inventing bluetooth profiles for blood pressure devices. So just take about 30 reading over the month or so before, and take the list to the doctor.

 

[redduck]

You might ask the doctor to take off the white coat.

 

[audreyh1]

You might ask the doctor to take off the white coat.

LOL - wish it were that simple. I think for me it's the "summoned by nurse" syndrome.

 

[audreyh1]

I take reading with the home device for 30 days before a visit to the physician and provide a list of the readings to the doctor. This is just doing manually what will happen in a few years with smart phones and bluetooth bloodpressure cuffs. (only the smart phone will send the info in real time to the doctor). They are inventing bluetooth profiles for blood pressure devices. So just take about 30 reading over the month or so before, and take the list to the doctor.

I've been entering my readings in the Apple Health app. It makes a pretty graph, and you can look at the individual readings too.

I take my blood pressure three days a week.

 

[MRG]

I feel your pain. I've always had white coat syndrome. The weight loss and increased activity probably does bring down your numbers. It's working on mine. I used to be 120/80 at home and 5-10 higher at the DR's office. Now I'm getting numbers like 96/58 at home on the same machine. I know if I go in now it will spike up to a more normal number in the office.

I do believe careful tracking and having your results there is the best way to go.

 

[unclemick]

Ignore the evil eye most senior nurses recognize white coat syndrome and listen to what the patient says their BP home readings are .

And then the young nurse came in with the new kit for home fecal sampling , told a good joke, and while I was chuckling retook my BP which this time read close what my home readings were in contrast to my usual elevated doctor's office reading.

One time only - I usually bring my home readings when I visit the doctor.

heh heh heh -

 

[audreyh1]

I feel your pain. I've always had white coat syndrome. The weight loss and increased activity probably does bring down your numbers. It's working on mine. I used to be 120/80 at home and 5-10 higher at the DR's office. Now I'm getting numbers like 96/58 at home on the same machine. I know if I go in now it will spike up to a more normal number in the office.

I do believe careful tracking and having your results there is the best way to go.

I do get the occasional 101/65 type reading at home which was a bit shocking at first, but now with many readings in the low 100s I'm getting used to it.

The gradually dropping numbers were tracking my gradual weight loss pretty well. This after years of not being able to get below a certain weight and my numbers gradually creeping up. All measured by the same device.

Yep - I continue to track.

 

[eytonxav]

At my Drs office BP is taken by the nurse, using the manual method, and I've noticed that some nurses use poor technique (e.g. have you hold you arm out unsupported or your arm too low, cuff over a shirt sleeve, etc). I personally feel the readings at home using my Omron are more reliable indicators.

 

[John Galt III]

For me it's *front desk Nazi control freak receptionist* syndrome. And *balance-billing form sign here* syndrome. There's always some drama over that darn release form they want you to sign, and bp skyrockets.

 

[FUEGO]

+1 on taking the device to the Dr's office. I've done that and found my device (manual sphygmomanometer) was pretty accurate. And found I have a bit of white coat syndrome too. I'm also not really "at rest for 5 minutes" before the nurse takes the reading in the exam room. I've been walking, standing, dealing with paperwork and insurance at the front desk, etc.

I'd show the doc your history of home readings and also ask them to take another reading or two once you've been able to sit on the chair/table for 5+ minutes. My doc seems to place more importance on home readings than a single data point in the office. He also complemented me on my fancy graph/spreadsheet I printed out once.

FYI, exercise, weight loss and stress reduction worked to cut my BP down to near-normal. Quitting work and getting off my ass mainly.

 

[HFWR]

No white coat syndrome, but I do still cringe at the sight of latex gloves...