I 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?
Thank you.♥
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WeeLucy
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You need a holter monitor for blood pressure. I had one fitted for 24hrs couple of years ago. It wakes you up in the night, but you wouldn’t have time to panic because it is set to come on randomly.
The weird thing is I am a therapist who helps my clients to relieve stress with a variety of techniques that work wonderfully well for them but not me re the monitor...you couldn't make it up... Thank you for your kind advice and i will persevere with relaxation too...practice makes perfect as they say...♥
Are you saying that you're also getting a reading at home, ie a "White Coat" reading?
I have similar issues at the doctors office, where the nurse comes in right away to do the blood pressure. On the other hand, my GP takes a reading halfway into our consultation when I'm a lot more relaxed. With him I always get a normal reading.
It's hard to tell a nurse or doctor how to do their job, but at home instead of making a big event out of taking your bp,, just put the cuff on loosely and maybe have a nice conversation with a friend on the phone, and then after getting relaxed/distracted and not thinking so much of the event, now take your blood pressure. If it seems a little bit high, make the first reading a throwaway and take it again in a couple of minutes repeat a third time if need be.
In general, blood pressure medication should be titrated to what your blood pressure is in the real world and notebat it is in the doctor's office. Otherwise, you will be over medicated.
For that reason, I always take a picture with my phone of my blood pressure monitor at home with my "real" reading and show it to the doctor or nurse explaining this is what I get at home.
Thank you Bob...my big problem is if I get a high one first of all then I stress about the next one which then makes the second and the third higher!...I will persevere though in what you say and hopefully it will calm down...♥
I'm the same - as soon as they come near me with one of those machines my BP goes sky high. As BobD suggests three readings are best which will enable you to relax.
Exposure therapy! It may be possible to train yourself out of your anxiety reaction by using similar techniques used to overcome phobias eg spiders, fear of flying, etc. That way you can gradually become de-sentitised to the BP machine as an anxiety trigger. I’m not a CBT therapist, so what I’m saying here is only to contribute to some ideas about how to manage your anxiety. I did know someone who overcame her fear of spiders initially by looking at pictures of spiders and eventually being comfortable with real spiders and eventually became an expert in spiders. She had professional help which made all the difference.
So perhaps you can maybe put the BP machine on the table at first and get used to it being there, then maybe place the cuff around your arm but not connect it to the machine. For the next stage you could connect it to the machine but not take your BP. Eventually you might take your BP but have someone make note of the number, and you don’t look at it if you’re fearful of the result. Then in time take your BP, maybe at first have someone with you and gradually do it on your own. Take as long as you need to at each stage and you don’t have to move on to the next stage until you’re ready. Even if it takes a year, well, it will take a year. 🤷🏻♀️
There are other self help techniques you can use. You can tell yourself that there is nothing to fear, it’s just a gadget after all. You can tell yourself that you can overcome this, that you are the one in control here, and that it’s just a gadget, it can’t judge you, you’re the boss here!
General relaxation techniques are a good daily practice anyway and the more you do it, the easier it gets. It’s not just as simple as saying “relax” as you take your BP if your anxiety is sky high, so take it slowly, one tiny step at a time. Remember , you’re the boss!
Thank you Autumn. Leaves...that all makes sense...and I can try that until I am back at the GP on Tuesday to see the practitioner there...Much appreciated...♥
Happy to help! I don’t really like those BP machines either but once you’re familiar with that tight feeling on the arm when it inflates it becomes just part of the routine. You might find your BP quite a bit lower when you’re doing it yourself. 😀
I too suffer fromWhite Coat syndrome, but while this does not help with your question, I was told it should always be treated with BP medication because if you react like this in a medical environment there will always be other situations that cause a similar reaction.
I agree Pusillanimous. I used to suffer from anxiety and panic attacks very badly when I was in my 30s. It affected my life big time. As I have got older I have pretty much overcome this - my way of thinking is it's a challenge to overcome. Panic attacks are short-lived and will pass (tell yourself this if you have one). I overcome these situations by seeing them as a 'fear bubble' in my mind's eye. I enter the fear bubble, go through it, and in my mind, I get a pin and 'pop' the fear bubble when I have overcome the fear. It's the same for Afibbers in PAF.
Paul
PS. I can feel a new thread coming on about this. Not today as I need to work online but maybe over the weekend.
Good point, except you have to weigh the benefits of being protected from very occasional blood pressure spikes, versus being overmedicated for the vast majority of time. My doctor is not particularly worried that I guess these white coat spikes because the vast majority of the time I am not in the doctors office or have high stress events. Now I imagine if I was a commodity trader or let a very stressful life., he might look at it differently.
I have the same issues - although at home my blood pressure eventually shows normal - I entered a medical research trial recently where they took my blood pressure - first time not too bad for me but high for them so they took it another three times - the last was very high and the nurse didn’t believe me when I said I had white coat syndrome
She should! I've just said in another thread about resting, no eating or drinking for 30 mins before reading and as Bob said. 3 readings ignore first. Pre cataract surgery my systolic was 200 and diastolic 95! They decided as within their acceptable levels they wouldn't recheck as the nurse said "it'll only be higher".
I feel that they don't pay much attention to 'white coat syndrome'...as if it it is a fictitious complaint...Thanks for replying...much appreciated...♥
Hi,I have the same problem. It seems to be very common. A very kind nurse once told me to imagine myself in my favourite place. It did help to lower the BP somewhat.
The 24 hour monitor is a great idea and will put your mind at rest. I did that and my BP was perfectly normal both night and day.
Thank you Ffine...I appreciate your reply and will await to hear what they say on Tuesday...fingers crossed it settles before then...not taken it yet today as working...♥
Thank you Ffine...I appreciate your reply and will await to hear what they say on Tuesday...fingers crossed it settles before then...not taken it yet today as working...♥
I seem to have something similar to this, even at home, since it takes, at a minimum, three readings for me to achieve a repeatable figure, and I have to be sitting at a table, arm on a cushion while staring out at the sky and garden trying to feel calm.
I think what we might both have is a response to the strange pulsing feeling that occurs once the cuff reaches a certain point of inflation. Even my wife, as cool as a cucumber usually, gets this. I have found the best home machine to counteract it to be the Omron Evolv but another option is Omron's wrist cuff machines which are now the equal in accuracy and far more convenient. I am lucky to have tried out several over the years as I get sent machines to review.
I now use a wrist cuff BP machine. It reads BP and pulse and let's you know if your heart rate is irregular. I highly recommand it to forum members - I bought it from Boots and the cost was £39. Have a Google.
One thing to note is this. It's not advised to rest your arm on a cushion when you take a reading using a wrist cuff device. Always hold the device level to your heart for the best result. Also the most accurate readings are given when sitting down. Sit down for 5 minutes after standing or any physical activity before taking the reading.
Hi Paul. Good advice! I wasn’t clear - I only use the cushion with the Evolv to get the height right. The wrist one, I rarely use at all but only because the Evolv is so easy and I’m used to it. My Omron wrist machine won’t start working unless the wrist is level with the heart - clever! I sit at a table with my elbow resting on it when I do use it.
Got you Steve👍I must say personally I find the wrist one great and easy to use. The finger pulse reader wasn't much use. I saw the doctor recently and told her I was getting readings of a HR of up to 125 bpm at rest. I took it with me and we tested both hers and mine at the same time. Mine gave a much higher reading than the doctors - I trusted her device would be accurate and give a correct reading.
I guess that the finger pulse devices depend upon measuring heat from blood flow? I find that even the Apple Watch struggles on some wrists owing to skin qualities and depth of blood vessels
The best of all, apparently, is an ECG device as it measures electricity which is much easier and more reliable.
Thank you Ppiman...I don't like that sensation either and it definitely escalates my blood pressure when it starts to inflate...especially if it inflates twice and becomes very tight then...I will just have to persevere and try out all the wonderful recommendations...finges crossed I will find a solution without upping my meds!...♥
my mum had white coat syndrome and I remember when she was going to have her cataracts done her BP was so high they refused to go ahead. Next time same thing happened sgsin but a super doctor recognised what it was and she had the procedure. It always happened to her whenever she went to doctor? But it wasn’t the monitor itself just the thought
Perhaps a calming med or nice music snd maybe let your other half do it with a giggle ?!?!?
my 2 cents. When taking your bp at home, wait till you have been seated for a minimum 3-5 minutes, and perhaps more if you have climbed stairs, dog walked, gardened etc. feet flat, palms up, and do NOT talk and be still. As mentioned by others…steady breathing, maybe some quiet music..whatever relaxes you. Also time of day, and what and when and how much you’ve eaten has an effect. Never take it first thing in the morning. Try for around 10:30 ish. If none of that works, then you do need to increase dosage.
White coat syndrome is very real. People who have never experienced this never understand how scary it is. Our subconscious tries to protect us. Mine began when an anaesthetic did not work properly and I felt the entire operation. My confidence in medical situations was destroyed. I had 3 months of hypnotherapy which helped dramatically. I still get anxious but less than before. I was given BP medication on 4 different occasions- all resulted in me suffering dizziness, many near falls, heart palpitations, - all the symptoms of low BP. I don’t take any BP medication now My current doctors understand my situation and rarely take my BP. I have no symptoms of high BP. I take my BP at home When I do take my BP I do the following
Sitting quietly by myself for 10 minutes Feet comfortably flat on floor Arm resting on table at heart level Place cuff loosely on arm. Occupy my brain by doing a word puzzle for 10 minutes. Then take BP.
Take 3 readings each with 2 minutes between.
Discard the first reading Keep the average of other 2 readings.
This is so common, I to get it at home now, in fact reading this post has sent it up, which is absolutely ridiculous. I’ve tried everything looking out of the window, deep breathing, sneaking up on the dam machine, leaving it out to try to desensitise myself. I eventually got 5days of readings but spent hours trying to get them.
Mother-in-law always got stressed due to the cuff squeasing her upper arm. GP suggested she try the OMRON RS1 Automatic Wrist Blood Pressure Monitor. For her it solved her fear of taking her blood pressure.
Thanks for replying irene...I totally agree as the minute it tightens I feel the anxiety set in...no matter how I try to remain relaxed up it goes...but going to try and act on the advice I have been given on this forum from all the kind hearted souls like yourself and sort this out hopefully...♥
I have the same problem. I had a holter monitor fitted but it came on every hour on the hour so I got no sleep that night and the readings were still high.
Thank you John...I have heard others say the same thing about the holter monitor...will wait and see what they put forward on Tuesday at my next visit...♥
When I bought my blood pressure machine and started recording mine at home,I found that the longer one sat the lower the readings became. Also, when I entered the results on my Kardia, as it goes by American theory, it often came up with problematic things that aren’t considered a problem here in the UK where the acceptable levels are higher. Guess the drug companies are more enthusiastic about selling their products there.
Guess the drug companies are more enthusiastic about selling their products there
Drug companies are enthusiastic to sell their products anywhere! The problem is they have a 20-year patent on new drugs they develop. That's why they can charge what they want - as soon as the 20 years are up then generic copies can be made. These are exactly the same but a fraction of the cost - some can be up to 99% cheaper. The drug companies know they have a 20-year hold on the market and cash in while they have the patent. It's all making $$$$ while the cost is prohibitive to the NHS. This costs lives and people die as a result of this.
Next, we'll see drug companies standing on street corners asking if you "want to buy some Flecainide mate, its good quality gear".
The EP who prescribed the Flecainide for me said he left the NHS as he had done successful research which found exercises that would help children with asthma rather than them having to use nasty steroid stuff but instead of being congratulated they said “But there are no drugs involved!”
I'm like you, even at home but I've found at home if I Take 3 or even 4 readings and it shows it's coming down, I calm down and it goes even lower. Sometimes I fit the machine, lie back in my recliner and almost fall asleep. Only then do i press the b utton. I did have an overnight BP monitor b ut it woke m e every time it worked with a big click before it started so I was immediately on alert. Try doing something you are totally absorbed in when you take the reading like watching TV or reading a book. Take at least 3 readings 10 minutes apart and use the lowest one. If you see yoru reading going down, the next will be even lower.
Thank you so much for that information and advice that is reassuring for me. I am due back, with a copy of my weeks readings, at the surgery on Tuesday...so will try your advice between then and now. Take care...♥
Thank you so much for that information and advice that is reassuring for me. I am due back, with a copy of my weeks readings, at the surgery on Tuesday...so will try your advice between then and now. Take care...♥
Thank you so much for that information and advice that is reassuring for me. I am due back, with a copy of my weeks readings, at the surgery on Tuesday...so will try your advice between then and now. Take care...♥
I almost always have reverse white coat syndrome i.e. I have all sorts of symptoms which disappear as soon as I'm in the emergency room. I guess I feel anything that goes wrong with me once I'm there, I am as safe as I possibly can be
“ To my surprise he did get back to me and said to stop the Ramipril and he would see how that went and I would get an appointment at the cardio clinic for a 24 hour BP monitor before he put me on an alternative blood pressure drug. “
Did that happen? I have read that nocturnal BP is the most important measure, which is where the 24 hr BPs come in.
As you know, beta blockers are good for hypertension. If a particular BB crosses into the brain I believe it is likely to improve anxiety.
I was lucky to get hold of a second hand Omron monitor which takes an average of 3 readings and offers a hidden mode.
Unfortunately there is no validated digital BP monitor in AF according to the British Hypertension Society.
Enlargement of the left ventricle assessed by ECG and echocardiogram is perhaps a more reliable proxy for hypertension given your anxiety around BP measurement
In your situation I would go back to see your Cardiologist privately. Worth the cost given all the hassle this is causing you. With luck, she may ask your GP to do these. Who knows, subject to careful follow up, a trial reduction might be suggested.
Thank you Porageface...they did change the meds and it helped with that particular set of symptoms. Going private could be an option, if I can't resolve it on my own re the advice given by others on this site. I won't leave it too long though... I have an appointment with the phlebotomist on Tuesday who does the BP in our surgery and will take it forward from there. Thanks again. ♥
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Thank you for your kind advice and i will persevere with relaxation too...practice makes perfect as they say...♥
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