White Coat Syndrome: I have managed to... - Atrial Fibrillati...

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White Coat Syndrome

Bridges4 profile image
28 Replies

I have managed to keep my bp at a very healthy 120/60 (average) for many years. However, when I have medical procedures my bp can go up to over 200/100 and this has led to my procedures being cancelled at the hospital on three occasions-very frustrating.

Does anybody know how I can overcome this? I don't feel particularly stressed when I am at the hospital/GP and playing gentle music beforehand doesn't help either.

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Bridges4 profile image
Bridges4
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28 Replies
jeanjeannie50 profile image
jeanjeannie50

Perhaps arriving very early for your appointment and then sitting looking through a magazine or book that interests you may work.

I can bring my BP down dramatically by taking a long deep, slow breath in through my nose and then huffing it out as quickly as possible through my mouth. Practice doing this at home first to see if it works for you. If it does work then don't do too many breaths as it may take your BP down too low.

Jean

Bridges4 profile image
Bridges4 in reply tojeanjeannie50

Thank you

mjames1 profile image
mjames1

Have a similar issue and also had a test cancelled once because of it. Here are some ideas.

1. Get your normal bp documented with a note from your doctor, explaining the situation.

2. Make sure the note gets to the medical team performing the tests in advance, so they can hopefully make an allowance, or at least give you extra time for your bp to hopefully normalize.

3. Ask them to leave the cuff on loosely for five minutes or so before taking your bp where your arm should be supported on a hard surface at chest height. During this time, either do some breathing exercises, or listen to some music, or just sit and relax. Some people find simply having a conversation will lower their blood pressure. This is actually proper procedure, but rarely followed.

4. Ask your doctor for a fast acting anti-anxiety medication that you will take 10-15 minutes before they take your bp.

Remember, you won't need to get your bp down to 120/60 for testing. I've found no issues with bp in the 160's and 170's, along with an explanation. So in most cases, you really just have to lower it a bit.

Good luck.

Jim

Bridges4 profile image
Bridges4 in reply tomjames1

Many thanks

FraserB profile image
FraserB

I have a similar problem with medical procedures though it's not my blood pressure that's high, it's my heart rate that rises. To bring it down I focus on slow deep breathing similar to what Jean mentioned. When I hear my name called I don't jump up but move slowly and deliberately, continuing the controlled slow relaxed deep breathing. I focus on the breath, not the environment.

lizziep profile image
lizziep

I take dated photos of my bp readings taken at home and done for a week prior to procedure or pre op. I show these to the medical staff if my bp is high on the day and they so far have been happy to accept these. It is noted on my records that I have white coat and that home readings have been seen.

Bridges4 profile image
Bridges4 in reply tolizziep

Many thanks

Fazerboy profile image
Fazerboy

I also have this problem. I discussed it with my GP and they got me to take my own readings say 3 times a day for a week then submit them. They are on my records.

As to hospital appointments I take my own readings for a couple of days beforehand and take these with me to show them. I must admit though that they aren’t always interested. Luckily I’ve not been turned away from a procedure yet.

Ppiman profile image
Ppiman

I agree with Jim. If you use a sphygmomanometer with an app, show them the last set of normal readings. Maybe ask your GP for help, too. Something must be able to be done. I am sure the nurse doing this will accept a raised BP but 200/100 sounds to risky to them, I imagine.

Steve

WhitstableWanderer profile image
WhitstableWanderer

To add to your other responses, do ensure that you are well hydrated prior to any BP test. This really makes a noticeable difference, and can be missed when you have to travel, park, find the location and check in. They always catch me almost as soon as I arrive, so take time to settle and breathe before the BP procedure.

Bridges4 profile image
Bridges4 in reply toWhitstableWanderer

Thank you

Qualipop profile image
Qualipop

I'm surprised they have cancelled because most doctors now know about white coat syndrome. I always tell them i have it before they do anything. I would suggest taking in either a record of yoru readings over a week or a note from yoru GP saying what your normal is. |I just did a week of readings, sent hem to my GP and they are now recorded on my records making it easy to prove.

Bridges4 profile image
Bridges4 in reply toQualipop

Thank you

JOY2THEWORLD49 profile image
JOY2THEWORLD49

Hi

Wow. 200/100! What is your Heart Rate?

BB Beta Blockers are supposed to quiet BP down. A book I was reading recently stated that whenever she was going out n a new date she took a BB which blcks adrenaline to your heart.

Usually you see the anaesthetist first way before your procedure and if Heart Rate is under 100 it's all go. I have never thought that they worry about BP. I guess they must.

Talk t your GP about a sedative for temprary use another suggestion.

Keep safe.

cherio Joy. 75. (NZ)

Bridges4 profile image
Bridges4 in reply toJOY2THEWORLD49

Thank you

manabouttown profile image
manabouttown

I also suffer from White Coat Syndrome. The way that doctors andhospitals measure BP is shocking. Nurses are under extreme time pressure and so immediately after you come in they take the first reading. If you were to read articles fromrespected medical journals like the Mayo clinic ,the way to measure BP is first sit in acomforatble chair/armchair and relax for 5 minutes. Then you take areading.Ignore thefirst reading and take a second and third reading leaving a space of several minutes between each one.Make sureyou're well hydrtated.

I once had a BP measure done by a nurse who was AT THE SAME time taking a blood sample from me!

My advice is to keep a thorough diary of your homemeasurements- daily am and pm and show this to the hospital,whilst explaining you have WCS.

Good luck.

Bridges4 profile image
Bridges4 in reply tomanabouttown

Thank you

Jafib profile image
Jafib

Acute procedural anxiety can be difficult to manage, however, there are a myriad of possible solutions/coping mechanisms available. Finding the one that is right for you generally takes time. For me, deep breathing and a fast acting anxiety med seems to about all that works. Good luck!

Bridges4 profile image
Bridges4 in reply toJafib

Thank you

Bridges4 profile image
Bridges4 in reply toJafib

Thank you

Snowgirl65 profile image
Snowgirl65

I sometimes sit in the waiting room and look at funny kitten videos on Facebook. It takes my mind off things!

Bridges4 profile image
Bridges4 in reply toSnowgirl65

Thank you

mav7 profile image
mav7

The doctor should have suggestions. If these procedures are being done as an outpatient, perhaps a stay in the clinic/hospital the night before with medication to relax you.

As Joy indicates above, 200/100 is quite high. Do consult with the doctor.

Bridges4 profile image
Bridges4 in reply tomav7

Thank you

Bagrat profile image
Bagrat

I am the same. Now I take a list of a week's BP readings on the rare occasions I have an appt at hospital. I had my cataracts done with systolic BP in the 190s.

Soldierboy71 profile image
Soldierboy71

Humming on the way to the procedure. I would also practice coherence breathing everyday (5 slow breaths in, and 5 slow breaths out thru your nose). On the day of visit I would do coherence breathing in the waiting room and while waiting in the tx room.

Bridges4 profile image
Bridges4 in reply toSoldierboy71

Thank you

WeeLucy profile image
WeeLucy

I also have white coat syndrome which originated in the gp surgery several years ago.... and it happens whenever I needed my blood pressure taken. But now I think I have associated the dread around the reading to the blood pressure monitor that they gave me to use at home!

I try using a meditation before inflating the cuff...deep breathing and try to be nonchalant about it all but whenever I feel the cuff inflating I can feel my anxiety rising and become tense. Any help much appreciated as they want to continually increase my blood pressure meds which I am not adverse to if really needed but not sure what other options available. Has anyone else experienced this issue?

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