White Coat Syndrome!

Jparke2

Hello ladies! I apologize for this long post in advance!!!

I have had white coat syndrome since I was a teenager. I have pretty rough social and generalized anxiety which I used to take medication/see a therapist for, but I've gotten to a point where I am pretty capable of handling it on my own using different techniques and just sucking it up. I don't think that my anxiety has a huge impact on my life anymore, and thats great! The only part that is still bad is my white coat syndrome, which particularly revolves around getting my blood pressure taken. Long story short, I once was extremely anxious about an appointment and my blood pressure was pretty high, and the doctor would NOT listen to me about my anxiety and really made me feel bad about the whole thing. Ever since then, I always get anxious about getting my blood pressure taken, so much so that it usually reads pretty high and a couple years ago I went to a cardiologist to check and make sure I didn't ACTUALLY have high blood pressure. He did lots of tests and told me I'm fine. Just having a doctor believe me made my blood pressure normalize right there in his office, to the point where after taking it several times, he told me that if it dropped anymore that I would actually be be considered low blood pressure.

ANYWAY, my blood pressure has been reading higher than "normal" my whole pregnancy. At my appointment today, I tried to explain the whole situation to the doctor (they've had me switching around each appointment with a different doc so that I see everyone in the practice), and she was concerned and decided to prescribe me blood pressure medication. On the one hand, I totally appreciate that the doctors are concerned about my and my baby's wellbeing. I understand that it is their job to see things like this and try to make me as healthy as possible. And maybe being on meds will make me feel better about all of this overall, and I don't want to brush this all off if I really do have an actual health issue. But on the other hand, I feel like some of the doctor's I've seen at this practice, and most of the nurses too, simply do not believe me. On top of that, when they take my blood pressure and it reads high, like I warned them it would, they always make a big deal about it, saying things like "Wow, its really high, are you feeling ok?" almost as if they didn't hear a word I said. Today I actually heard the nurse talking about me in the hallway and whoever she was talking to responded "what!? why is it so high!?" This type of thing DOES NOT help my anxiety!!! (and to clarify, my bp wasn't even THAT horrible). Also, when I asked if the medication would help with overall blood pressure as well as anxiety spikes that cause high blood pressure, she basically said it might not help for the anxiety spikes. So now I feel like when I go in for my appointment next week to see how the meds are working, and my anxiety inevitably spikes, they again are going to make a big deal about it.

I guess my question is if anybody else here suffers from white coat syndrome that effects their blood pressure, and how they are dealing with it with their doctors. I'm finding it to be very frustrating to have to explain the situation over and over again with each new doctor, and the whole thing causes a lot of stress, which of course doesn't help my bp!!! I'm afraid of being labeled high risk and being talked into delivering early when this might not actually be an issue. Of course, maybe it is an actual issue, and that is why I am so torn about it all because I just want what is best and safest for my baby (and myself!) 

hellogoodbye2

What exactly was your BP today? 

Last pregnancy I had what seemed like WCS since my reading at home were always normal. My BP was around 130/80 at the doctor's office. But my doctor didn't jump to medicine right away. They had me monitor it a few times a day at home, write it down, and then we talked about it at my next check-up. At home it was always around 120/60. 

If your BP isn't dangerously high at your appointments I would ask to do some at-home monitoring before medication. 

kami09

Can you get your pcp or therapist to fax over some documentation so that they believe you? & if you've started the med and your BP is still high, I would view that as proof of wcs

ayeshaohara

I'm with PP...you need to measure at home daily to prove its WCS. Because if I was in your situation, knowing that it's always artificially high, I wouldn't even be taking the meds they suggested...and that's coming from a pharmacist. Because on the flip side you don't want your BP so low on regular days that you're dizzy or feeling faint because that's not good for you or the baby.

Personally I'd be making a bigger deal about it and see if your family doctor or the cardiologist or someone can send some documentation over saying you have WCS

Bluejay3030

I agree with the others that insisting on monitoring at home first sounds like a great first step as long as your BP isn't measuring dangerously high.

I'm sorry you don't feel like you're getting through to them. That sounds frustrating.

Jparke2

Thanks for the feed back! I called my mom right after the appointment and they are going to lend me their blood pressure monitor so I can take it at home. I've done this before a few years ago, and my heart rate does go up when I go to take my own, but hopefully it'll give me some better results. I also am probably going to see if I can get an appointment with the cardiologist again in the new year and see what his opinion is, and hopefully that will eliminate any confusion for me AND the doctors about whether or not I actually have high blood pressure.

For now, I'm going to try the medication and I go back in a week. The first dose did make me feel very jittery, but I read that is a common side effect. And I should get the monitor tomorrow, and if my blood pressure seems too low, I'm going to call the doc immediately. 

@hellogoodbye2, usually my blood pressure reading at the doctor's office is right on the cusp of what they consider high. Today my systolic number was JUST into the stage 2 range. I don't recall the exact numbers, or I'd say! I think it was worse today because at my anatomy scan last week, I requested they take my BP at the end of the appointment (I often feel calmer by then) but then I had to wait over an hour for the results and I started to get very panicky that they had found an issue with the baby (anxiety and paranoia is so fun!) So my BP was higher than usual at that time and they made a big fuss about it, and so I was worried about that and having to discuss that whole ordeal going into this appointment. I know it all sounds nuts and illogical, and thats because it is! 

LemmyRN

@Jparke2
I would also tell the office that you do not want to be rotated amongst the doctors. You shouldn't have to feel frustrated at every appointment, constantly trying to bringing each new doctor up to speed. It's not good for the continuity of care; you need just one doctor that knows you and your history, not a bunch of strange Doctors.
Good luck. Just make sure when you take your BP your limb and the cuff is at heart level.

Jparke2

LemmyRN said:

@Jparke2 I would also tell the office that you do not want to be rotated amongst the doctors. You shouldn't have to feel frustrated at every appointment, constantly trying to bringing each new doctor up to speed. It's not good for the continuity of care; you need just one doctor that knows you and your history, not a bunch of strange Doctors. Good luck. Just make sure when you take your BP your limb and the cuff is at heart level.

I think I'm going to start requesting the same doctor for my appointments. I understand the point of rotating amongst all the doctors in the practice, because ultimately it could be any of them delivering my baby and I'd like to be familiarized with them. But there are a lot of doctors in this practice and its getting to be a little annoying! I do like all of the doctors I met so far, at least in terms of bedside manner and whatnot. They've all been very friendly! But its hard to start from the beginning every time. And thanks for the tip! Last week they took my BP a few different ways, and one of the times they raised my arm up in the air. The diastolic went way down that time and I was curious as to why they tried it.

Edited for spelling

LemmyRN

Checking at heart level is the most accurate