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Old Yesterday, 12:31 PM
 
2,627 posts, read 1,365,000 times
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Quote:
Originally Posted by craigiri View Post
The OP is correct for this - and other - reasons.

MANY MANY people have "white coat fever". .

White coat hypertension is a well-known phenomenon in the medical community, and it is taken into consideration before giving an actual diagnosis of hypertension. You can read about it here: https://www.mayoclinic.org/diseases-...n/faq-20057792
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Old Yesterday, 02:14 PM
 
Location: Living on the Coast in Oxnard CA
16,141 posts, read 27,339,123 times
Reputation: 21304
Quote:
Originally Posted by Rabrrita View Post
I have some medical conditions from my military service that requires on going treatments. One of the requirement is a cardiac exam periodically to determine if the condition has morphed.

Each time I go to the cardiologist, he takes my BP as soon as I come into the office. He knows fully well that I park at the end of the parking lot, walk to the building and use the stairs instead of the elevator. Without fail, my BP is always high and he ends up taking another BP towards the end of the exam where it's usually closer to normal.

When this first happened, I asked why he took it at the start knowing that I walked and climbed stairs so the BP would probably read high. His response was that a normal person, who has not done any extra physical exertion should not be reading overly high unless suffering from a serious case of white coat syndrome. He was adamant that normal office visit activities would not overly raise a person's BP too high. In my case, he said he is less concern with the initial high reading and is looking more at how quickly the BP returned to normal.

Considering your readings, have you and the doctor discussed the meaning of the different readings?
I want to know where your Doctor's office is. I work in a hospital and we have medical office buildings with office space for Doctors offices. I don't know anyone that doesn't show up at an office and end up waiting before they are seen.

You are saying that as soon as you get to the office they see you? That is awesome. I was at my Doctor this week and I waited 10 minutes before I was taken back. That is plenty of time to relax and get ready for an appointment. Most people seem to have to wait much longer to see the Doctor.

With you, you are able to see your Doctor as soon as you get there. That is awesome.
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Old Yesterday, 03:30 PM
 
Location: on the wind
8,333 posts, read 3,609,702 times
Reputation: 28476
Quote:
Originally Posted by SOON2BNSURPRISE View Post
I want to know where your Doctor's office is. I work in a hospital and we have medical office buildings with office space for Doctors offices. I don't know anyone that doesn't show up at an office and end up waiting before they are seen.

You are saying that as soon as you get to the office they see you? That is awesome. I was at my Doctor this week and I waited 10 minutes before I was taken back. That is plenty of time to relax and get ready for an appointment. Most people seem to have to wait much longer to see the Doctor.

With you, you are able to see your Doctor as soon as you get there. That is awesome.
If you've learned you have a tendency for fluctuating readings at appointments (many people eventually figure this out) either because you are always rushing around or get anxious, you could plan to arrive a little early and relax in the waiting room. Why should some practice make all your decisions for you?
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Old Yesterday, 03:55 PM
 
2,297 posts, read 4,803,821 times
Reputation: 1730
Quote:
Originally Posted by Don in Austin View Post
Today I went to my new GP because various specialists who have been treating me think I should have a GP. Got taken straight into the exam room and the blood pressure cuff was put on immediately. 151/124

I calmly told the nurse that those numbers were totally bogus, I take my blood pressure frequently -- having had heart issues -- and those numbers are wildly wrong. I sit down and relax and, if the numbers are a little high, I wait and take my BP again. It is always less than 120/ less than 80. The results were always in this somewhat low range, sometimes as low as 108/72 when I had to spend time in a specialized nursing facility and was bed-ridden. She did not like hearing this but I was stating simple truth. I confronted the doctor about it and got the lame excuse of time restraints, but she did agree to have my BP taken again towards the end of the visit. 124/81 which is actually a little high for me but I was annoyed, had fasted for bloodwork and had consumed only black coffee that morning.

This has been my almost universal experience with how blood pressure readings are done at the doctor's office. One time a sleep dentist used a cuff on my wrist and came up with 165/I forget. They never could get a lower reading. I checked it at home, I checked it at the pharmacy of a supermarket and the numbers were perfectly healthy. I did hear a comment. "Yeah... it has been reading a little high."

Trying to stay fit in my old age I took four flights of stairs to a doctor's office the other day.and the blood pressure cuff was on within minutes. I don't think that reading was very accurate.

It would be much easier if they would ask, "Do you know what your typical blood pressure is?" Than we wouldn't have a figure that is egregiously wrong.

I don't think it is "white coat syndrome" because if I force them to give me a chance to wind down a little the numbers are always much better. This morning I was giving the office the benefit of the doubt that the reading might be a little high but not wildly so.

I don't think there is a valid excuse for this sloppiness and laziness. If the excuse is that the BP reading is not relevant to the visit -- but which it surely is for a general physical, as I went in for today -- then no reading should be taken.

Sad when the patient seems to know more than the "medical professional."





Great post. I've had the exact same experience at a large, highly-rated university healthcare system. The clinic BP readings are always higher than my readings at home, and they don't wait for you to sit and rest a few minutes before taking the reading. And many of the assistants keep talking to you while taking the reading. You are supposed to be quiet and still during BP readings. They also should take more than one reading. But they are too rushed.

I bought a nice Omron BP cuff that I use daily at home. I have a spreadsheet where I document all the home readings. I also make a copy of these spreadsheets each time I visit a doctor and hand them to the assistant who is doing the BP in the office, telling him or her that my BP is well-managed at home.

Some of the higher readings in my case might be due to "white coat" but I think it's the variability of the equipment and the lack of opportunity to rest a few minutes before taking the reading, which is not good medical practice.

Also, what I've done in the past is insist that the doctor take the BP reading again at the end of the app't with a manual cuff (not automated) and each time I've done this, it's much lower (more normal) when the doctor (not the assistant) takes the reading at the end of the app't when you've been sitting for a while.

Also, wrist cuffs are not accurate. I would never allow them to use one again on me.

Also, I would not ever start a BP med based on one office reading. I would insist on multiple readings over time and home readings as well.

(A bit off topic, but I once had a PCP who had a terrible cold and was wearing a mask during the app't. He listened to my heart and said I had some issue that needed several invasive tests. I said, "I'll think about it." So I had it checked at a different clinic with a different doctor, who didn't have a cold, and I did not have any problems that needed testing at all. How the heck did that first doctor hear anything at all through a stethoscope with a clogged up head cold.)

Last edited by xz2y; Yesterday at 04:09 PM..
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Old Yesterday, 04:43 PM
 
1,749 posts, read 2,387,177 times
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Quote:
Originally Posted by nmnita View Post
Sorry I have to say: BS. maybe you were suffering from white coat syndrome or something Of course the BP might be slightly off but for the most part, the readings are pretty accurate most of the time.

I am glad you have had a better experience than I have had.



My readings have not been accurate unless I insist on a second reading at the end of the visit. At the end of the visit the medical professionals are still wearing white.


Don
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Old Yesterday, 04:48 PM
 
1,749 posts, read 2,387,177 times
Reputation: 2695
Quote:
Originally Posted by SOON2BNSURPRISE View Post
I want to know where your Doctor's office is. I work in a hospital and we have medical office buildings with office space for Doctors offices. I don't know anyone that doesn't show up at an office and end up waiting before they are seen.

You are saying that as soon as you get to the office they see you? That is awesome. I was at my Doctor this week and I waited 10 minutes before I was taken back. That is plenty of time to relax and get ready for an appointment. Most people seem to have to wait much longer to see the Doctor.

With you, you are able to see your Doctor as soon as you get there. That is awesome.

About half the time the nurse takes me into the exam room promptly and then immediately performs the BP reading. When the doctor gets there, that's another story.



In a later post I will describe walking down a LONG hallway and I was walking briskly as part of my knee replacement rehab regimen and I had no sooner sat down than the blood pressure cuff was on.
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Old Yesterday, 04:50 PM
 
1,749 posts, read 2,387,177 times
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Quote:
Originally Posted by Parnassia View Post
If you've learned you have a tendency for fluctuating readings at appointments (many people eventually figure this out) either because you are always rushing around or get anxious, you could plan to arrive a little early and relax in the waiting room. Why should some practice make all your decisions for you?

I do arrive early. The readings do not so much fluctuate.They are pretty consistently higher at the doctor's office. Just walking down the hall and then immediately seated and BP taken compromises accuracy.
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Old Yesterday, 05:03 PM
 
Location: Central IL
15,875 posts, read 9,099,319 times
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I still think that if readings are "always" high unless you specifically take time to calm down beforehand then that is something of importance and the doctor should know it, measure it, record it, and act on it accordingly. It's not "normal" for your BP to always be elevated except for when you specifically calm yourself down! I mean doesn't that sound like a problem?
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Old Yesterday, 05:08 PM
 
1,749 posts, read 2,387,177 times
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OK, here is what happened this morning. The nurse came to get me for an appointment with a new cardiologist I was checking out. She said "follow me down the long hallway." Indeed it was quite a long hallway. I walked briskly swinging my arms and lifting my left leg extra high which I have been doing as part of my knee replacement regimen. The nurse put on the BP cuff as soon as I had sat down.

ME: "If I don't have a couple of minutes to relax this reading is going to be much higher than what is normal for me."

NURSE, in a cheerful, breezy tone: "Oh, that's OK!"

ME: "It's going to be much higher than what I know is normal by taking it at home."

NURSE, in the same cheerful, breezy tone: "Oh, that's OK! As long as its healthy when you take it at home, that's what we care about."

148/85

My normal BP is always well under 120, sometimes under 110/ well under 80, sometimes in the 70s. Trying to make sense out of this, the nurse is acknowledging her BP reading is worthless and it doesn't matter?

I think someone would be hard-pressed to come up with an excuse for the nurse's attitude.

My wife says she would have walked out. I wish I had.
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Old Yesterday, 05:10 PM
 
9,605 posts, read 12,539,198 times
Reputation: 15063
Quote:
Originally Posted by SOON2BNSURPRISE View Post
I want to know where your Doctor's office is. I work in a hospital and we have medical office buildings with office space for Doctors offices. I don't know anyone that doesn't show up at an office and end up waiting before they are seen.

You are saying that as soon as you get to the office they see you? That is awesome. I was at my Doctor this week and I waited 10 minutes before I was taken back. That is plenty of time to relax and get ready for an appointment. Most people seem to have to wait much longer to see the Doctor.

With you, you are able to see your Doctor as soon as you get there. That is awesome.
My cardiologist sets appointment's at specific times, You arrive at that time and are taken promptly into an exam room where all the vitals are taken along with any EKG or other non-invasive procedure they require. There is no waiting when you arrive. The doctor may come in afterwards, but there is no waiting when you arrive (they want to see your BP while you were active). If you get there 15 minutes early, yeah you may be sitting for a few minutes but so long as you're close to the time, in you go in as soon as you say your name to the desk staff.

Like I said, he knows the BP is going to be high due to my propensity to walk and use stairs, but that is still essential information because if he retakes it 15 minutes later, he expects to see a decrease within a certain level. He also cautioned that resting BP isn't that valuable as it's a feel good BP designed and arranged to be low. Unless your some person who sits around all day doing nothing but watching calming videos, he wants all my BP checks (home, office, at the VA, etc) to be done while engaged in normal daily activity, not when I set the stage for an artificially pleasing BP number.
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