7 ms·
Regarding white coat hypertension, the shot isn’t always necessary. Some people’s blood pressure just goes up from the stress of the clinical setting.
by cestith 11mo ago
Regarding white coat hypertension, the shot isn’t always necessary. Some people’s blood pressure just goes up from the stress of the clinical setting.
- pavel_lishin 11mo agoI have an intense phobia of dentists; if I were wearing a constant monitor, I bet you could tell when I was at the dentist just by watching the blood pressure and heart rate spikes. (You'd have to find some way of differentiating them from me being in a car accident, or being attacked by a werewolf.)
- 6LLvveMx2koXfwn 11mo agoIt's interesting that you have a baseline for 'being attacked by a werewolf'.
- adastra22 11mo agoYou don’t??
- stephenhumphrey 11mo ago“Luck favors the prepared.”
- gregdeon 11mo agoI wonder if it would show up on the heart rate (or heart rate variability) tracking from an Apple Watch or similar. My Garmin picks up stressful events all the time.
- normie3000 11mo agoWerewolf attacks usually fall on predictable dates, during night hours.
- pavel_lishin 11mo agoA werewolf is always a werewolf, even if they're not actively in their beast form. So you can be attacked by a werewolf any time.
- cgriswald 11mo agoIs this true? A full moon only last two or three days and it might be that werewolves are more irritable in their human form than their wolf form.
- taneq 11mo agoJust to be clear, 'fang doctor' doesn't actually refer to a medical werewolf. :D
- kakacik 11mo agoI have a mild fear of needles. Whenever my wife does acupuncture on me, I am quite uneasy in the beginning, looking away but still I end up covered in a bit of sweat till she finishes putting needles on all the points (and sometimes they are properly weird places I wouldn't imagine sticking tiny needle into... doesn't help). Don't monitor the heart rate/pressure but it must jump up significantly
- pavel_lishin 11mo agoI have a pretty serious fear of needles, to the point that phlebotomists always ask me if I'm going to pass out (to which I always answer, "never have before, but maybe today's the day!") Once, I had to give my spouse an injection, and I almost passed out and threw up, once when they took the cap off the syringe and accidentally poked themselves in the finger, and then when I actually had to administer the injection. I know I'd get used to it, but there's a decent chance that if I had to give myself insulin shots, I'd just fucking die.
- glitchc 11mo agoJust to be sure, the cure ain't no silver bullet.
- SchemaLoad 11mo agoIf you've got one of these machines at home it seems you really want to run it a couple of times. Often I find the first reading I get is quite alarming but then if I sit for a bit longer and run it another 1-2 times I get a very normal reading.
- loeg 11mo agoAlso, they can read high if the batteries are low.
- professoretc 11mo agoI wonder why that would be? Presumably if the batteries are low then the pressure the machine "thinks" it's inflated the cuffs to is higher than the actual pressure...
- llm_nerd 11mo agoA big reason people's first measurement is often high is the positioning while putting the cuff on, adjusting to the pose, and then settling in place, a process which can spike pressure. Ideally you prepare yourself (cuff on, in place with your arms at rest, etc) and sit there and relax for five minutes before you take the first measurement, making it legitimately reflective of the at-rest state. This often isn't possible, but it's a reason doctor visits usually drop you in a room by yourself with a machine that will take multiple measurements with a lengthy delay between. Though that's where the white coat thing comes into play and people are stressed about a doctor coming in, etc.
- OxO4 11mo agoFWIW, some "smarter" machines (e.g., [0, 1]) support taking three readings with a minute pause in-between and then spit out a single reading. [0] https://www.garmin.com/en-US/p/716808/ https://www.garmin.com/en-US/p/716808/ [1] https://www.withings.com/us/en/bpm-connect https://www.withings.com/us/en/bpm-connect
- hombre_fatal 11mo ago
- lysace 11mo agoTaking a BP in person during a medical consultation, while stressed out because I know I have a very limited amount of time to do a verbal data dump of a large amount of information in a good way never fails to give me extreme values. It also never helps to explain that this has happened many times before and that I have a reasonably high quality BP measurement device at home (most recently the exact same Braun model) that gives me decent measurements when I'm at rest/relaxed. They just look at me like I'm an idiot. How could a civilian conceivably perform such a complex measurement? Then I get the predictably insanely high measurement and they look satisfied. Gotcha! Please bring on the AI doctors.
- alexfoo 11mo agoWhite coast hypertension isn't just about a clinical setting, it's more generally about the worry about the results of having your BP measured. [EDIT] OK, well maybe there's another type of hypertension which is related to anxiety about a high result regardless of the measurement setting. I have to take daily BP measurements during titration for ADHD medication. (Using an _A&D UA-611 Plus_ machine at home.) I can put the cuff on my arm and sit at my desk for 20 minutes to be nicely rested and calm, and then take 5 different measurements with a few minutes between each one. They'll vary quite wildly (anything from, say, 115/75 to 135/90) despite not moving between measurements or having any reason to be more or less agitated. I generally just ignore the low/high outliers and average the others. There's no pattern either, sometimes the outliers are first, sometimes last. Also it's not just the monitor I have at home, the same is true of a probably more trustworthy machine in a clinical setting. I mentioned this to my doctor when I last visited and we saw the same thing with multiple measurements using a more sophisticated machine at the clinic.
- mh- 11mo agoI check my BP a lot for reasons, too, and this matches my experience as well. A few tips to reduce the variance (but it'll never go away): * the position of both of your arms, and the angle your elbows are bent at matters. make sure the edge of your desk isn't pushing into your forearm. * same goes for both of your legs. make sure you're sitting with legs uncrossed, relaxed angles, make sure the edge of your chair isn't pushing into the back of your thighs excessively. * control your posture. slouching seems to have an effect too, but I'm unclear on the mechanism. Anecdotally, the nurses at the doctor's offices I go to rarely (~never) bother to control for any of this other than telling me not to cross my legs. So while I fully believe white coat hypertension is a thing, I also think there's a lot of poor control of variables here. If you look up the AMA/AHA guidelines for blood pressure, the ranges they offer are predicated on some very prescriptive protocols for measurement.. which I virtually never see adhered to.
- wpollock 11mo ago> I can put the cuff on my arm and sit at my desk for 20 minutes to be nicely rested and calm, and then take 5 different measurements with a few minutes between each one. ... Doesn't it take more than a few minutes for one's circulation to return to normal after a BP measurement?
- hansvm 11mo agoYep. My heart-rate is normally pretty low (45bpm or so, 55 if I'm walking around), and my BP is on the high end of normal, but white-coat syndrome reliably brings it up to a fluttery 110bpm and 155/125 pressure. I was just in a wreck last week, so I got to see the before-and-after measurements from a few medical providers, and it's shocking how the act of talking to a new person in an unfamiliar environment spikes my BP even when I "know" that it's fine, and also how quickly it falls back down to normal.
- dhosek 11mo agoI got it when an eye clinic wanted to do my blood pressure (which is kind of weird in itself), which they did shortly after the glaucoma test which never works for me because I have an overdeveloped blink reflex and it turned up high. It really amazes me how people whose job it is to take blood pressure don’t recognize the stress situations that people are in might result in abnormal readings.
- dgacmu 11mo agoI had an astoundingly high blood pressure reading last year when I tore my bicep the day after the election and dragged myself to the ER. The staff freaked. I was like, "I had a normal reading two weeks ago in my doctor's office and I'm really in an awful lot of pain and worry right now". But it still earned me the "oh shit hypertension you must do extra pre-surgical clearance". It was kind of interesting watching my blood pressure tick down back to normal over the course of about 4 days though. I guess the lesson is don't rip your bicep off, it will transiently elevate your BP. ;)
- adastra22 11mo agoIf they’re doing surgery it doesn’t matter why you have hypertension, or how temporary it is. The high blood pressure causes complications for the surgery itself.
- BobaFloutist 11mo agoThat makes intuitive sense, if blood is under higher pressure they're going to need to work harder to prevent you from losing too much blood I would imagine.
- adastra22 11mo agoBasically, yeah, that’s one of the concerns. Drug dosages and other things are affected too, but the most simple concern is “if we accidentally hit something and you start bleeding, above a certain blood pressure it won’t stop.” Edit: Well, it will stop bleeding… once you lose enough blood.
- MikeTheGreat 11mo agoRecently I was talking with someone who speculated that "hot doctors never get accurate heart rate measurements" It took me a minute to understand (and neither of us think this is 100% true) but it's both funny and a good point.
- digi59404 11mo agoMy BP at home? 140/90. I walk into my cardiologists office, do my BP? 107/60. It’s not the cuff position as I used multiple positions, cuffs, and sensors. All 140/90. Plus I feel it. It’s wild. My BP/HR fluctuates alot outside of clinical, but inside clinical it drops.
- franciscop 11mo agoYeah, my doctor said they always add some padding to the measures for this same reason.
- taneq 11mo agoI probably have this, I've had several specialists take my blood pressure during consultations and express concern. I was prescribed a 24 hour ABMS (ambulatory blood pressure monitoring system, ie. wearable monitor) test, and came back with normal (if slightly high) readings. This prompted me to do some research, and it turns out there's very strict guidelines for how to 'accurately' measure blood pressure, almost none of which were followed by most specialists. There's a laundry list of things that can each increase your blood pressure by 10-15mmHg (eg. drinking water, sitting cross legged, recent physical exercise, not sitting with the right posture, not sitting for at least 15 minutes). Given this lackadaisical approach to measurement, I seriously question the diagnostic validity of blood pressure tests 'in the wild'.
- saghm 11mo agoMy wife developed an autoimmune condition a few years ago that causes her to need to see a specialist every few months. For some reason, the hospital we've been going to uses these automated blood pressure readers that literally need to get wheeled around because they're four feet tall with a digital display, and during one of the early visits she had because of one of these conditions, the device bugged out or something and it kept squeezing her arm without releasing the pressure, and the person taking the reading didn't know how to disengage it manually and ran out of the room to go and find someone to help them without taking the time to rip off the velcro band on my wife's arm or anything. Ever since then, I literally get stressed every time my wife's blood pressure gets taken from one of those devices even though I'm not even the one who's getting measured!
- wkjagt 11mo agoI had a doc appointment a couple of weeks ago. My wife was driving and we were running late, so I was getting stressed about missing the appointment on top of being stressed about going to see the doctor. There was a lot of traffic so I decided to get out at a red light and run to my appointment while my wife parked the car. I only barely made it and the first thing they did was take my pressure. They took it twice, because at the first they were like, this can't be right. When I explained, they asked if I had a blood pressure monitor at home so I could take my own pressure at a more quiet moment.
- andreareina 11mo agoThe guidelines for taking blood pressure state you should be sitting quietly for 5 minutes beforehand, something that almost never happens at the doctor's.
- hirvi74 11mo agoMine constantly asks me questions during my measurements. I thought one wasn't supposed to be talking during the readings either?
- rhyperior 11mo agoA PA explained to me once: they’re taught you have to sneak quietly into a room where the patient has been sitting in the dark listening to soothing music for 15 minutes and take their BP measurement without them noticing. Goals.
- hermitcrab 11mo agoHard not to notice the squeeze from a pressure cuff.
- nathan_douglas 11mo agoNumb the arm by having the patient sit calmly with their left arm in an ice bath.
- Spooky23 11mo agoMy question would be… how often are you stressed?
- foofoo12 11mo agoMy friend went to see the doctor. A very attractive nurse took his blood pressure, which turned out to be off the charts. She goes out, comes back 5 minutes later and repeats, same results. Goes out and 10 minutes later and old bearded doctor comes in and repeats the tests. Doctor ends up telling him that he was hoping it was just the attractive nurse, but no. He'd be starting medication today.