"White Coat Syndrome"

Updated on June 15, 2011
K.M. asks from Arkansas City, KS
11 answers

Have any of you dealt with something called "white coat syndrome"? It's when a person is so afraid of doctors that when they have to go in for an appointment their blood pressure gets extremely high. I've always known that my husband did not go to the doctor's office but have not seen how one affected him until May when he went in for the first time since I met him in 1990. In the office his blood pressure was nearly stroke level and all that was going to happen was the doctor was going to press on his abdomen. The side pain resolved itself but now he is in a state of anxiety about the follow-up appointment, scheduled to deal with the high blood pressure issue. At home his blood pressure is normal. I am have been as reassuring as possible and he's embarrassed by his fears as he keeps saying, "I don't know why I'm like this". What else can I do?

EDIT: Come to think about it, he only once or twice (no joke) went with me to prenatal appointments with six pregnancies. Maybe this is why. The last appointment he was at I went along with the youngest child and it was no help to him at all.

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So What Happened?

Today was DHs follow-up appointment and despite Benadryl, prayer and encouragement, his heart beat at the office went into tacycardia. The doctor wants him to take medicine for anxiety and blood pressure both, neither of which I think he'll be willing to do. My bet is he'll just avoid doctors all the more. Thanks for everyone's advice though.

More Answers

V.C.

answers from Dallas on

It had never happened to me until recently. Doctors had always commented on how great my bp was. But when I found out I had lung cancer I went in after surgery to find out my scan results. I really thought they were going to tell me it had metasticised. My pb was so high it scared the nurse.
So maybe he has an underlying fear that something is wrong and he will find out there. He could try deep breathing exercises in the waiting room and picturing him self at a place he really enjoys. Or he could bring an IPOD to listen to music.
I also have a supplement called Stress Relief Complex that I can take before an appointment.

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K.A.

answers from San Diego on

I have it! Some nursed and doctors deal with it better than others I find. With my second and third pregnancies the nurses learned to never take my blood pressure when I first get there like they always do. They went through the prenatal apt, made sure I got to hear the heartbeat etc then took it. My OB with my first was awful and when my blood pressure began to creep up each apt as I stressed more and more each time as I got far more uncomfortable with her care she started threatening all sorts of things because I must have preeclamsia. Of which I did not, I was fine when not in her office. I was taking it at home several times a day on her orders.
I tell nurses and doctors now and they are becoming more and more aware that people have this issue and are better at dealing with it from what I've seen.
But it is real. That's exactly what the nurses have called it.

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M.G.

answers from Texarkana on

White coat syndrome is not uncommon when I worked in the medical field I usually did everything I could to distract my patients form the suroundings. I would talk them about thier children, pets, what they did for a living, what they enjoy doing for fun. After a few minutes of this everything seemed easier. Vitals(blood pressure, pulse etc) even IV's are not as bad when you are not thinking about what is happening around you.

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M.L.

answers from New York on

It happens to me all the time....I think its the anticipation...no matter what I do to relax myself (deep breaths, remain clam) my pressure is always high....I wish there was a cure!!! LOL

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D.P.

answers from Pittsburgh on

My mom has this. They usually let her sit quietly by herself and take her blood pressure several times to get a better idea of what it really is.

Does he go with you &/or the kids to the doctor? It might help if he's in that situation more often.

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A.F.

answers from Fargo on

Wow, I feel so bad for your husband! Can you ask the doctor's office to prescribe something to help him relax prior to the appointment?
A girl that I used to work with always had to take a valium before going to the dentist.

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A.S.

answers from Iowa City on

I have this. They usually just check my BP and pulse several times to get an average. It is always much, much higher when I initially see the nurse or doctor (something like 155/92) and usually becomes quite a bit lower by the end of the appointment (120/70). I have been asked to monitor my BP at home to make sure it is normal and record the results to provide to my doctor. Generally one's BP has to be elevated (above 140/90) three times in a clinical setting before medication is advisable. There really isn't much that can be done about it aside from making sure that his doctor is aware that he has anxiety during appointments. Best of luck.

K.J.

answers from Chicago on

I get it during pregnancies, because I am so afraid of having pre-eclampsia or another pregnancy-related ailment, or worse, something wrong with my baby! I check my BP at home multiple times a day and it is ideal - 118/76 or so, but the INSTANT I enter the OB's office it skyrockets to 140s/90s. Thankfully my hubby is a doc, so I can get laid-back evaluations when needed, but going to the doc just makes me crazy!

V.W.

answers from Jacksonville on

Sort of. I think it is more common with men. Not due to research, but I just think that women are exposed so much more to doctors that we don't think as much about it as men do. We are there about the same as boys as children...but once a girl becomes a young woman and takes any interest in her reproductive health, we are there EVERY YEAR, year in and out regardless of whether we are sick. When we are pregnant, we go in regularly, just for checks... Then there's labor/delivery, lol. THEN, we are there routinely with our babies for well child visits... and on and on an on. Not so much for the men. They tend to only go when they are sick.

Something similar happened with my husband a couple of years ago. He was worries about something (unrelated to blood pressure) and made an appt to go in. He was aggravated and stressed the morning of the appt (we were having a big argument) and embarrassed about being there in the first place... and his BP was elevated (due to all the stress). So, even though EVERYTHING else was just fine, he had to come back for another BP check b/c it was elevated. (Which can cause him to flunk his physical and be de-certified at work and make him take leave until he can get it under control--- WHICH added to his stress!). Ack!
The doc said to buy a home BP monitor (told us which one was actually reliable for the least $) and take it several times a day for a few weeks---then to report the results to him. It took a few weeks. I kept telling my husband "You are taking it too often. You are so anxious that it isn't coming down b/c you are so uptight about it. Forget about it and only take it twice a day (not 4 or 5). You need to just chill. It took awhile for him to stop thinking about it 24/7 and when he did, it dropped to normal (which for him is fairly low---he is a runner and VERY healthy).

ALSO, when you are in pain, your BP is elevated usually. Pain causes it. It is a stress reaction. The best thing for your husband, if he really has white coat syndrome, is to invest in a decent BP monitor at home and take his readings a few times a week at different times of day. Provide THOSE readings to the Dr and see if they match up with the office findings. He should record the date and time of each reading (at home). If it is just after rising in the morning, note it. If it is after a work-out or he is feeling stressed, note it.
And by all means, make sure his doctor is aware that this is an issue for your husband. You don't want him prescribed medication that he doesn't need- that is DANGEROUS.

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R.J.

answers from Seattle on

Children's Hospital calls it "Hospital-itis": The full on physical reaction kids who are sick and tired of being in the hospital get. They actually WILL seize, and is a BIG reason why long term patients get 'day passes' and 'weekend passes' to go home, AS WELL as that once kids get stable they train parents in their children's nursing needs. Yep, kid may need to be on oxygen or IV antibiotics for a month, but durn straight they'll get better faster AT HOME. And they won't get 'hospital-itis'.

Other places call 'hospital-itis' panic attacks, or anxiety attacks. And yes, either can cause heart attacks or seizures when enough adrenaline suddenly dumps into the system.

There are ways to work around it. Specifically, get your husband to (in writing and verbally) okay you talking with his doctor about his extreme anxiety in being seen in a medical setting.

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K.P.

answers from Seattle on

I honestly didnt know that existed! But wow, hard to admit but I have this. The same thing happens to me, I really despise going to the doctors even though I know I should or have to.
I had another ENT appointment last week and that morning before my husband took me in, I had such bad anxiety, and my blood pressure was higher, and I was cranky I hear.

Going to the doctors just stirs me up and I cant help it. I can be reassured all day but I still dont feel better until its over.

Sadly enough, it doesnt even have to be MY doctor appointments. My son had one for his shots today, and I felt really stressed, and again cranky my hubby tells me. He said, "I keep forgetting that you get stressed when it's doctor day" So crazy, and I didnt know there was a "diagnosis" for such a thing.

I just figured it was another one of my crazy quirks! Lol.

Really, I dont know what you could do, except just be there for him and keep reassuring him it will be alright.

Maybe distract him with things that will go on after the doctor appointment, like okay we'll go to lunch and what sounds good. Just other conversations.

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