[Shanny]

Hello & welcome, David. Your doc is surely aware of "white coat" hypertension . . . and your in-office readings aren't off the charts anyhow. I think he should simmer down in his push for meds. You may not need a statin either, if he put you on it only because you're diabetic. That's how I got on it, and after a year, I asked to get off, and he agreed.

What diabetes meds do you take, and what kind of food regimen are you eating? As Daytona says - maybe you could click over to the Introductions board & tell us more about yourself. We're nothing if not nosey . . .

 

[WV Mom]

A story about white coat syndrome . . .

I don't usually have it, but there was this one time at band camp . . . No, not at band camp, it was when I was on a business trip and I heated up water for tea in the microwave and then, when I dropped in the tea bag, the water exploded in my face. Literally. Like a geyser.

So I start running cold water on the scald on my face while I fumble for the phone to call the front desk for ice. They were all very nice, very concerned, brought ice, called a cab, and I made my way to the ER.

When I checked in, my blood pressure was a nice and normal 120 over 80. But after 6 hours of being ignored as I sat in a chair across from the public restroom with water seeping under the door and onto my shoes, my blood pressure had shot up to 150 over 90, or some such reading. And Nurse Ratched, who finally came to dress the scald and sign me out, had a passive-aggressive field day acting oh-so-concerned about my high blood pressure.

I wanted to scream. But I managed to strangle that down and tell her that if she'd had the brains to check the goshdarned chart, she'd've seen it was sitting for 6 hours in a world of hurt in the stupidpoopy hospital that had caused it to go so high, and keep your incompetent hands off me and give me those dang papers to sign right-freaking-now so I can get the heck out of here and away from the imbeciles staffing this clearly second-rate hospital. Only I probably didn't use "goshdarned" and "stupidpoopy" and "dang" and "freaking" and "heck."

So yeah. I suppose the takeaway message is that white coat syndrome comes in different shapes and sizes. Or maybe it's that the white coats (and caps) shouldn't ignore an otherwise nice lady with a scalded face. Or maybe it's that I'm not as nice of a lady as I think I am.

 

[Shanny]

I am delighted that you unloaded on her, complete with all the "real" words! She deserved so much more!

 

[Daytona]

Instead of forcing pills on people, I wish they would do more research into WHY some people can be stressed and keep a normal BP and others can't. I believe there must be an underlying cause, like a hormone imbalance.

Normally everything looks okay but when during a stress response, adrenal hormones surge up and so should inhibitory hormones, like GABA. If your inhibitory response is weak or slow, or maybe even something else, then as a side-effect your BP rises.

When I started taking GABA, it seemed to help with my physical response to anxiety. Lately I have had a much better chance of getting "non-critical" BP #'s at the doctors office, e.g. 150/85 instead of over 200. this is just my pet theory but if something like this turns out to be the cause, then taking BP meds aren't addressing the root problem. It will make one symptom lessen but the hormonal imbalance is still there, wreaking havoc while the doctor is paid and happy.

*head* *bang* *on* *desk*

Edit: Turns out I'm not crazy, here's one study looking at just this connection!

Effects of six antihypertensive drugs on blood pressure and hypothalamic GABA content in spontaneously hypertensive rats

 

[Shanny]

Nice work finding that study!

Oh! And here's your icon:

 

[D4Hope]

Hi Daytona,

It's so nice to see your post because my situation is exactly the same as yours when it comes to BP - even the numbers are roughly the same: 140/90 at the doctor's office and roughly 105-120/65-80 at home. Because of the high number during my office visits, my doctor is trying to get me to start taking BP medication (Lisinopril). I was only recently (2009) diagnosed with type 2 diabetes, and I've been on two other medications (a blood glucose medication and a statin) ever since. At the "young" age of 36, I am really averse to the idea of having to take yet another medication for the next 20,30,40.... years

So for now I plan to keep on turning my doctor down, and instead continue to monitor it at home, as well as continue exercising regularly and watching my weight and what I eat. Other than going in for my routine A1c and blood test, I'll also limit my visit to the doctor to once a year.

David

Good for you! Do not just take what the doctors says as gospel. Think for yourself, get a second opnion.
Doctors are sometimes rewareded for gettng people on meds that they must stay on for the remainder oftheir lives.
Sure insures big pharma' retirement.
I have been able to through away my pain medicine and 2 BP meds.
There are alternatives to pill popping. Look for them.

 

[jwags]

I don't have high BP, but everytime I go in it usually comes out high. He usually waits 15 mintues and it has gone down. When I test at home it is always 111/75 or lower but in the office it will be 130+/80. I've even tried deep breathing exercises in the waiting room but it doesn't help. Now the insurance company has me listed as having high BP on my pre exhisting conditions. Now I will accept the diabetes but not the high BP. I agree they try to push way too many pills on us. I was on a statin which totally wrecked my body, so I am trying to stay on the least amount of meds as possible.

 

[davidjp]

Thanks! Actually I was put on a statin because at the time my cholesterol and triclycerides were also high. But you are right the doc did say that he prescribes statins to all of his diabetic patients. And now he's trying to get me on an ACE inhibitor, even as a prophylatic

I'm taking glipizide. I haven't read too many posts yet but I have yet to see another person taking this in the forum. Most of the posts I've come across still use the more common metformin. I'm not really not any special diet: I immediately stopped drinking sodas and juices right after my diagnosis. I have also cut down quite a bit on carbs, especially rice and related items (as a Chinese they used to constitute a significant part of my diet ), and have started eating a lot more fruites and vegetables. and I finally start exercising regularly about six months ago.

Hello & welcome, David. Your doc is surely aware of "white coat" hypertension . . . and your in-office readings aren't off the charts anyhow. I think he should simmer down in his push for meds. You may not need a statin either, if he put you on it only because you're diabetic. That's how I got on it, and after a year, I asked to get off, and he agreed.

What diabetes meds do you take, and what kind of food regimen are you eating? As Daytona says - maybe you could click over to the Introductions board & tell us more about yourself. We're nothing if not nosey . . .

 

[Yakfishingfool]

Doctors are sometimes rewareded for gettng people on meds that they must stay on for the remainder oftheir lives.

Do you have any evidence of this? Just wondering. Diabetes is an extremely complex disease invloving all organs of the body, and low blood sugar alone is not the solution to diabetes. It is certainly the start but most people finding themselves in a diabetic situation have co-morbid disease states. Think metabolic syndrome. Treating one without addressing the other could be very remiss of the provider. Additionally there is no law that says drugs can not be discontinued. I know everyone here is acutely aware of their disease and are getting it under control, but the general population is not typically as astute as those here. Prove to your provider that you are committed to caring for yourself and then medications can be removed. Otherwise those meds may just be extending your life.

I used to white coat terribly, and I'm in the field! Here are a couple of things I tried. First, don't lead off with the B/P. Ask to do the other intake things first. Don't lean forward in a seated position and finally try to slightly recline and take a few cleansing breaths before they get it. Should help a bit. Good luck!

And a quick B/P primer I give my students...BP is a function of a fluid volume(blood), in a closed pipe system(circulatory), with a pump(heart). You can change the volume of fluid, change the diameter of the pipes, or adjust the pump. What works for you may not work for another. Commonly, Diuretics affect fluid volume, ACES affect pipe diameter and Beta blockers affect pump pressure and speed. That is just the basics....seems to help students remember.

 

[Daytona]

I can't remember if I said this before or not. My endo officially threw up her hands and gave up on figuring out high blood pressure (it was 180 / 100 at the last visit).

She referred me to a cardiologist saying "A 29 year old should never have blood pressure like yours". I stressed that I would refuse to work with a doctor whose only answer was to push drugs so we'll see if the one she referred me to will be any better than all the ones before her.

If she has nothing original to say, and can't articulate a cause or hypothesis for my white coat, I am officially saying " I don't give a **** anymore". I would rather die from a heart attack at 30 than continue to let this cause me anymore stress. I think the stress is worse for me anyway that occasional highs.

So wish me luck and I'll report back tomorrow night with how it goes!

 

[Daytona]

So it was a bit of a mixed bag. She was very nice, so nice in fact that my blood pressure in the office was 118/74!

She is taking me off the blood pressure medication to get a feel for what my BP is really like without meds before making any decisions. Since I wanted off of it anyway, I was pretty happy with that. I'm also having my lipids redone along with c-reative protein and an echocardiogram to check for any damage.

She was quite impressed with my weight loss and blood sugar control, asking questions about my diet. She wanted to "report" the dieticians who told me to eat 250g of carbs a day. I told her they were her own hospital's dieticians and go right ahead!

The only thing that gave me pause was that I think she's a statin prescribing, low-fat, low-salt gal. I avoiding saying exactly what I eat other than "gluten-free, no processed foods". She specifically recommended the DASH diet to me but I'm not looking to change what obviously works so well for me.

I see her again next week to see how the tests turn out. So we'll see.

 

[Shanny]

I'm sure glad you found a doc who doesn't trigger your white-coat reaction, but to recommend the DASH diet to a diabetic patient?! What is she thinking?!

 

[foxl]

I've always wanted a goat, white or any other color. And yep, they DO battle!

Oh ... nevermind!

 

[gkoller]

Garlic?

I scanned this whole thread pretty close and did not see a word about Garlic. As somebody that's studied up abit on herbs (related to my work) I know that Garlic is just given the highest respected for being effective (in the Herbal world). Also, there is garlic, and there's GARLIC - if you want to get more serious than popping a few tasteless capsules. Folks I know and respect grind a fresh clove and mash it before eating it. A women I did volunteer community gardening with (she ran the show) actually grew a special crop from a seed source she could talk about for an hour easy. I was too busy weeding - BUT garlic is just such a great food / medicine - it actually, somehow, can adjust low BP up, or high BP down - as best I understand it, I take it as one of only two but don't have BP issues so this is second hand info.

(Think of the ads big pharma would run if they had anything that worked both ways?! This has been studied in depth, I believe, its not one of those supplement over-reach things I can assure you, however, of course, mileage can vary.)

Just do your own due diligence and see if it helps, it seems to fit what I understood to be your goal - staying away from the hard stuff. If you can't find a study I know I've seen some, and I've a got a pretty serious library / and am a member of ABC and they have a online knowledgebase on this)

-george

 

[Daytona]

I scanned this whole thread pretty close and did not see a word about Garlic. As somebody that's studied up abit on herbs (related to my work) I know that Garlic is just given the highest respected for being effective (in the Herbal world). Also, there is garlic, and there's GARLIC - if you want to get more serious than popping a few tasteless capsules. Folks I know and respect grind a fresh clove and mash it before eating it. A women I did volunteer community gardening with (she ran the show) actually grew a special crop from a seed source she could talk about for an hour easy. I was too busy weeding - BUT garlic is just such a great food / medicine - it actually, somehow, can adjust low BP up, or high BP down - as best I understand it, I take it as one of only two but don't have BP issues so this is second hand info.

(Think of the ads big pharma would run if they had anything that worked both ways?! This has been studied in depth, I believe, its not one of those supplement over-reach things I can assure you, however, of course, mileage can vary.)

Just do your own due diligence and see if it helps, it seems to fit what I understood to be your goal - staying away from the hard stuff. If you can't find a study I know I've seen some, and I've a got a pretty serious library / and am a member of ABC and they have a online knowledgebase on this)

-george

Is the benefit supposed to be that it adjusts someone's blood pressure down/up or that it corrects an adrenal imbalance? Because I have perfectly fine blood pressure 99% of the time, it's only when I have an fear response that it shoots up. The cardiologist confirmed what I have suspected which is that it's an adrenal imbalance, I don't make enough of the hormones that should be secreted along with cortisol and adrenaline to counteract their effect.

I have had mild improvement with GABA, 750mg a day. It seems to blunt my stress response but isn't a cure all. Though I have not tried the higher doses that MCS and others here have attempted.

 

[scottietwenty3]

I get some white coat syndrome myself getting my BP taken at GP alought not as high as OP's post. Best think I did was get a home BP monitor its normally around 115/75 (or a little lower) at GP's its normally from 120/135 on 80/85.

I'm on a low dose ACE inhibitor and although my BP is normal at home my GP wants to stay on it as its protective affects for the kidneys and me being diabetic. As I dont have any side affects from it and I consider an ACE a very safe drug I have no problem with that.

 

[foxl]

My BP is nice and low at the Internist's but high at the Endo's! Figures.

 

[RodneyTzn]

I don't know if I should tell this story.
An add on feature of my medical aid is called vitality. As part of the program they send a nurse type around every so often to check you out with BP, fitness levels etc.
A few years back a new lass arrived and very very cute. Anyway she started with the BP and I was far too high to be tested for anything else. She took me back to my office and told me to see a doc. The next day she was back to try again and same problem. I felt fine but this was starting to concern me. Day 3 she is back but this time she is scared and takes me to the doctor.
She waits in the waiting room and I see the doc who checks and all is fine. I am worried and ask him what is going in. After a little thought he says to wait and calls the lass in. He gets her to test me and hey presto - through the roof.
Welcome to white coat syndrome - just the doc thought it was very funny.

 

[Shanny]

We use a home monitor too, and I went on an ACE inhibitor at the beginning, but was warned about developing "the cough", which I did. So doc put me on a low dose beta blocker & the only side effect I see from that is a nice low heart rate.

 

[PowerPumper]

I plan on taking a month worth of readings before my next inspection. I will take my BP machine in and compare it to his. If we're close, I will say "white-coat sydrome: change your behavior!" If not, I will cry. Perhaps I will compare mine to the drug store machine first. Good idea!anda: