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Old 11-23-2022, 05:29 AM
 
7,604 posts, read 3,138,275 times
Reputation: 8635

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Quote:
Originally Posted by Ken_N View Post
Talking while you are measuring will also raise your pressure.
Ugh, nurses always talk to me while they take my pressure. I have experimented with this at home. I talked loudly for a few minutes then immediately took a reading and it's 25% higher. When I am silent for 2-3 minutes it is back to 125/85 or lower.

I probably have genuine white coat (because I'm frustrated and annoyed). When adding improper technique it's no wonder I get astronomically false readings in almost any medical office. I have just accepted the fact I will almost never be able to have a good reading in any clinical setting. The rare times I can it is in a smaller specialist office that is quiet and near my apartment, and they use proper technique.
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Old 11-23-2022, 05:33 AM
 
6,871 posts, read 3,676,273 times
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Quote:
Originally Posted by Tencent View Post
It's amazing how many nurses do not take blood pressure properly in the office. They always take my blood pressure with my feet dangling off a chair and arm slumped at my side... So instead of arguing about technique I just tell them I have White coat, show them my home readings and mention my excellent cardiac stress test results and ignore any further comments about it.
I just left my primary care (and reported them to the practice) because the nurse was not doing the BP correct. She would put me in a low chair and she would be standing. This had my arm over my heart pulled up towards her. Each reading was on the low side. This did not give me faith in the medical expertise.

Then, I went to the new doctor and the assistant told me the machine had been acting up... but they did my BP anyway. Both times crazy high. 150/90. I suggested this to the doctor and she rudely said that it was impossible for HER machine to be wrong.

So they told me to go home and take it with my home machine over a few days. Average 125/80.

Why is BP done so slip shod? I hate that these crap readings go on my record. Why does everyone just have to accept this kind of negligence?
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Old 11-23-2022, 05:39 AM
 
7,604 posts, read 3,138,275 times
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Quote:
Originally Posted by LittleDolphin View Post
I am a "hot reactor" at times to stress. Working on that with deep breathing...
This is probably something I need to do. But I primarily lower stress by avoiding stressor as much as possible.

I have a short(er) fuse but I typically don't show it. Keeping it internal is probably creating some artificial hypertension, conditionally in those situations.
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Old 11-23-2022, 05:49 AM
 
7,604 posts, read 3,138,275 times
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Quote:
Originally Posted by Arya Stark View Post
I just left my primary care (and reported them to the practice) because the nurse was not doing the BP correct. She would put me in a low chair and she would be standing. This had my arm over my heart pulled up towards her. Each reading was on the low side. This did not give me faith in the medical expertise.

Then, I went to the new doctor and the assistant told me the machine had been acting up... but they did my BP anyway. Both times crazy high. 150/90. I suggested this to the doctor and she rudely said that it was impossible for HER machine to be wrong.

So they told me to go home and take it with my home machine over a few days. Average 125/80.

Why is BP done so slip shod? I hate that these crap readings go on my record. Why does everyone just have to accept this kind of negligence?
Ugh

You would think I would feel better knowing I'm not alone here.

But then my mind goes to this: If they can't do something as simple as taking proper blood pressure.... What else are they screwing up

I have had 2 grandparents die probably about 5-10 years sooner than they should have, in part due to medical negligence. Ironically, both were possibly complicated by the a simple Thamine (Vitamin B1) deficiency. Hospital and Nursing home food tends to be contracted to Aramark. They produce terrible nutritionless food.
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Old 11-23-2022, 08:20 AM
 
Location: Near Falls Lake
3,814 posts, read 2,728,459 times
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Here is my take on blood pressure (right or wrong). White coat syndrome IS actually a symptom of an issue as it shows your body's response to perceived stress and we are OFTEN under stress! I am in my 70's and my BP at the doctor's office was typically in the mid 130's over 75 and while resting at home, using the correct measurement protocol, was 10-15 points less. Problem is, I and most people don't just sit around resting all day long....we are under a variety of stresses. Question is at what point should it be treated? After a couple years of this, my doctor put me on a beta blocker which dropped the BP about 15 points.
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Old 11-23-2022, 09:39 AM
 
Location: East of Seattle since 1992, originally from SF Bay Area
40,528 posts, read 72,348,287 times
Reputation: 49877
Our latest device has an option to take it 3 times and average them. I have always found the 2nd reading to be significantly lower than the first. There are many variables, including fear of it being high causing it to be high. I will often be higher at the doctor because I hate waiting, and I can almost feel it going up when it's been 10-15 minutes past my appointment time.
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Old 11-23-2022, 02:49 PM
 
Location: Mid-Atlantic east coast
6,587 posts, read 11,728,079 times
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Quote:
Originally Posted by Hemlock140 View Post
Our latest device has an option to take it 3 times and average them. I have always found the 2nd reading to be significantly lower than the first. There are many variables, including fear of it being high causing it to be high. I will often be higher at the doctor because I hate waiting, and I can almost feel it going up when it's been 10-15 minutes past my appointment time.
Much the same with me....

I wonder if some of us get prescribed meds for high BP when it's just "white coat syndrome."

Mine's familial--everyone in my family has high BP. I've tried all the diet/exercise supplement routes and it's still too high. So I do take my BP meds, drat it!!
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Old 11-23-2022, 03:27 PM
 
Location: on the wind
19,393 posts, read 12,993,660 times
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Quote:
Originally Posted by LittleDolphin View Post
Much the same with me....

I wonder if some of us get prescribed meds for high BP when it's just "white coat syndrome."

Mine's familial--everyone in my family has high BP. I've tried all the diet/exercise supplement routes and it's still too high. So I do take my BP meds, drat it!!
IME (FWIW) my providers have all obviously been well aware that a BP taken at an appointment is just a reading in that blip of time. In isolation not very useful. If they seemed concerned about how high the reading was, they repeated it later. If the reading seems high I say something about it, which usually leads to a short discussion about where my BP tends sit at other times. Learned how to track it years ago, though mine is usually normal to low normal. That information usually comes in pretty handy for those situations. Not once has anyone suggested I should take BP meds based on a single higher than normal reading taken during one appointment.
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Old 11-23-2022, 06:23 PM
 
Location: Mid-Atlantic east coast
6,587 posts, read 11,728,079 times
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Quote:
Originally Posted by Parnassia View Post
IME (FWIW) my providers have all obviously been well aware that a BP taken at an appointment is just a reading in that blip of time. In isolation not very useful. If they seemed concerned about how high the reading was, they repeated it later. If the reading seems high I say something about it, which usually leads to a short discussion about where my BP tends sit at other times. Learned how to track it years ago, though mine is usually normal to low normal. That information usually comes in pretty handy for those situations. Not once has anyone suggested I should take BP meds based on a single higher than normal reading taken during one appointment.
We're all different. Glad you didn't need the meds! I've tried stopping the meds and doing deep breathing and yoga, but my BP reached alarming levels in a short time. Didn't need convincing after that. Best to avoid the possibility of a stroke or heart attack...
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Old 11-23-2022, 08:33 PM
 
Location: East Texas, with the Clan of the Cave Bear
2,985 posts, read 5,191,596 times
Reputation: 4198
Just some points for y'all to chew on:

- Elevated B/P is not ALWAYS caused by stress / anxiety. It can very easily be caused by different hormone/enzymes releases. Multiple factors can play a role in your pressures including genetics.

- "Nurses" in the doctor's office are rarely licensed nurses and much more likely medical assistants not taught or not comprehending the nuances of taking a simple B/P

- Machines are not accurate frequently IMO (30 years RN, critical care certified, trauma certified, neuro specialist). We use the automated machines but would check them several times a shift with manual readings.

- An improperly placed or sized cuff will be erroneous.

- Postural readings were frequently required (lying, sitting, standing) --- obviously some patients were unable to do this. Immediately upon standing B/P should be lower as blood pools in the lower reaches of the body until vascular muscles correct it via constriction

- Different readings can be expected from wrist to upper arm and different readings left vs right not all that uncommon.

- When getting an auto cuff you'll generally get what you pay for. i.e.: Lexus vs Yugo

- As mentioned here take at least 3 readings a day in similar pose, keep a log, show your provider what you are seeing

- If you have a licensed nurse at your disposal get them to check manually against your auto cuff several times. Always wait at least two minutes for your vascular system to rebound between checks if using the same appendage.

Off the top of my head this was all I can think of. I am hypertensive and have been for almost 20 years. It is much better since I retired from nursing.

An anecdotal quick story: One of my favorite docs that I worked with (an infectious disease specialist) once relayed to me he was hypertensive and had been diagnosed as such in his mid 20's. Laid back guy with zero type A characteristics, fit to the point of being buff. I was flabbergasted as a new nurse to learn this because he didn't fit the profile I had learned in Nursing School.

I relay the above story just to say this, as much as some may hate it the medical professional know a helluva lot more than you. Now, you know your body and they don't so use that to inform them of your fears and thoughts. If they don't listen get a practitioner who will. Be frank and firm talking to them, make them talk to you at your level, never be arrogant or angry. There has to be a level of trust there. (I've dealt with more than my share of arrogant ass doctors in my day so either manipulate them or leave them --- it's a relationship).
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