Going to the doctor’s office can be a stressful time for anyone from children to adults. Babies and small children usually associated the pediatrician’s office with painful shots while adults usually cringe at the thought of going to the dentist due to pain associated with all their medieval-looking torture devices they call “medical instruments”. This anxiety that we have all experienced at one time or another when it comes to visiting the doctor is called White Coat Syndrome. This condition is named so due to the traditional dawning of long white lab coats by physicians, dentists, and other healthcare providers.
White Coat Syndrome is a true medical diagnosis and results in a measurable elevation in blood pressure (or hypertension), outside the patient’s normal range, in a clinical setting that is normal when not measured in the clinic. This elevation in blood pressure is the body’s natural response to stress and anxiety that we all share before a big work meeting or before public speaking but in this case, is triggered simply from visiting the doctor. Most visits to the doctor are due to an underlying problem such as pain, nausea, trauma, or another issue out of the norm which in and of itself creates stress for the patient.
Diagnosis of this condition is made difficult due to the fact that the physician or health care professional diagnosing the condition is also the trigger that is causing the symptoms. The difference between traditional hypertension and white coat hypertension is that traditional hypertension is elevated blood pressure that occurs in many scenarios and not just in the physician’s office as is the case with white coat hypertension. A third condition, called masked hypertension, can also result. In masked hypertension, the patient exhibits normal blood pressure readings at the doctor’s office and elevated readings in other settings.
So what does this all mean? Physicians are now studying the lasting effect of these momentary periods of elevation in blood pressure in connection to long-term health concerns. Physicians now believe that white coat hypertension could be a precursor for real hypertension. One study showed evidence linking white coat hypertension to an increased risk of stroke, heart attack, heart failure, and other cardiovascular conditions. These same long-term problems remain a potential result of masked hypertension as well.
What can you do if you experience elevated hypertension when visiting your doctor’s office? First of all, relax. This may be easier said than done. Knowing that you may experience increased blood pressure when at the doctor’s offices can become its own source of anxiety. Simply said; worrying that your blood pressure may rise when at the doctor’s office may actually cause more anxiety and continued increased blood pressure levels. If you are feeling anxious or worried before a procedure or physician evaluation simply let your physician know. Ask your physician or health care professional to give you a chance to exhale and collect yourself. Open communication with your physician that you are experiencing anxiety or increased blood pressure or increased heart rate prior to an evaluation or a procedure will trigger the physician to utilize techniques to help decrease these anxiety levels. No physician should be annoyed with a patient or ignore a patient if the patient is experiencing an increased level of anxiety. A lot of anxiety can stem simply from the unknown and communicating your anxiety level with your physician will allow him or her to talk you through each step of the procedure or examination to help and reduce the amount of stress you are experiencing. Changing the topic of conversation can also be an effective method to relieve anxiety by shifting focus from the event triggering the stress increase. Don’t be afraid to talk with your doctor about your new job, your new puppy, or the color of the exam room ceiling if you aren’t very imaginative.
Most importantly….breathe. Simple techniques like deep breathing or singing your favorite song lyrics in your head can help lower stress levels and reduce hypertension.
At Kansas City Foot and Ankle we have numerous painless treatment options to help reduce this anxiety level without sacrificing treatment outcome. And for those treatments that require a little, or a lot, of pain, simply talk to your treating physician and we will be happy to help walk you through the exam or procedure with as little stress as possible to get you walking through your day in no time.