Annoyed after midwife appointment....white coat syndrome problems

[Flip flop]

Just been for my 28 week midwife appointment. It didnt go very well as my blood pressure was up due to white coat syndrome (high readings at the doctor but fine at home). Ive had this problem for years but got it under control during earlier pregnancy and managed to calm down enough to get normal readings.

The problem is I have moved city since then and been an bit anxious about various things, on top of that Ive not had anyone else (except me) take my blood pressure in weeks so the phobia was back today.

The midwife didnt help matters, she said she met people with white coat syndrome before but nobody this bad...as if thats going to help bring it down. She didnt know what the answer was and said she'd phone me back after she's spoken to the doctor.

Ive been through all this before before I moved and had to get loads of tests done to check for underling problems and surprise surprise it all came back fine. I think I may have to go through all this again.

Mainly just annoyed at the way the midwife was making me out to be so wierd. Forgot to ask all my other questions while I was there. Dunno see a solution if she keeps acting like that.

 

[bitethebullet]

My friend who suffers White coat syndrome closes her eyes and visualises clouds floating by in a blue sky. Might be worth a go next time!

 

[Jslyn9996]

I dont have it as bad but I have it a little. My midwife would take my bp at the end of my appt because I was more relaxed and calmed down at that point.. Have you tried that?

 

[Flip flop]

My friend who suffers White coat syndrome closes her eyes and visualises clouds floating by in a blue sky. Might be worth a go next time!

Thanks might try that next time

 

[ParisJeTadore]

Would your mw have your previous records from before you moved? That way she'd be able to tell that everything is ok?

I have a bit of white coat syndrome too so I can sympathize. What's worked really well for me is having it taken mid way through my appointment. Unfortunately, I think my comfort level depends greatly on who is treating me so if I feel uncomfortable, such as you did, it's much harder to relax. I have a really nice dr. now and I find he is great at talking to me about none clinical stuff (the weather, how my weekend went, etc.) for the first few minutes of our appointment together so that I become much more calm. Perhaps you could ask for a new mw?

 

[Lozdi]

Take detailed notes of your home bp readings, time, mood, etc, then present them at your next appointment to back up the white coat hypertension, because it sounds like they may not be taking you seriously enough about it.

 

[Flip flop]

I dont have it as bad but I have it a little. My midwife would take my bp at the end of my appt because I was more relaxed and calmed down at that point.. Have you tried that?

Took it at start and middle but not end, she said even if
It went down wouldn't change anything. She's going to speak to the doc about it. She said im the worst shed ever seen which didn't help. It'll never go Down I she keeps saying stuff like that.

 

[seaweed eater]

I'm sorry she was so insensitive
She is probably saying that because there's a theory that labile BPs are a precursor to permanently elevated BPs...like, that someone with no problem regulating BP would not have those kinds of spikes even in a stressful situation. The spikes per se shouldn't be a concern, just the overall pattern.
However, there was no need to speak to you the way she did.

I totally agree with Lozdi, if you're taking your BP at home anyway, start writing down the measurements (date, time, sys, dia, pulse) and bring in a chart. My doctor always asks me where my pressures run at home and is happy with those if they're normal even if it's slightly high in the clinic.

Just out of curiosity, how high are they usually at home, and how high were they at your appointment?

 

[magnacarta]

Ugh, that's so annoying! I often have this problem. I bought an at-home wrist monitor for BP that stores all my readings. Now, when I go in and my BP is high, I whip out my monitor and say "wait, watch this!". I then take my monitor and take my blood pressure and show the midwife that I get the same reading she just did. Then, I cycle through the stored readings to show how much lower they are at home. That way, she could see that my BP really is low at home, and also that my BP monitor works. I bring it to every appt. just in case. It definitely has stopped all the "maybe you have hypertension" conversations we had been having.

 

[Flip flop]

I do have my own home monitor but it only stores the latest reading so I showed her that first but she said she needs to see me doing it. I did used to do it every day and write down the reading but was when I had it under control I was told I was doing it too much so I stopped doing it all the time. I used I have a wrist one that stored all the readings but was told thu arm ones were more accurate so gOt one I those.

In the doctor it was 145/90 when she took it but my reading this morning was 119/65. It upsets me as I don't see how I'll get it down with her doing it and she's made me
Feel like a freak.

 

[Flip flop]

Would your mw have your previous records from before you moved? That way she'd be able to tell that everything is ok?

I have a bit of white coat syndrome too so I can sympathize. What's worked really well for me is having it taken mid way through my appointment. Unfortunately, I think my comfort level depends greatly on who is treating me so if I feel uncomfortable, such as you did, it's much harder to relax. I have a really nice dr. now and I find he is great at talking to me about none clinical stuff (the weather, how my weekend went, etc.) for the first few minutes of our appointment together so that I become much more calm. Perhaps you could ask for a new mw?

She has seen the notes but said things can change.

 

[seaweed eater]

Now that's stupid...I thought you were going to say it was 170/105 at the clinic or something. 145/90 is just above the diagnostic cutoff. I can't believe you'd be the "worst she's ever seen" -- that sounds like exactly what you would expect from white coat syndrome. And 119/65 is perfect.

Also I don't understand why they told you to stop taking it so often when it was under control. What's the point of that? I've taken mine every single day for most of the pregnancy and the doctor is always happy I'm keeping an eye on it.

 

[lhancock90]

Take detailed notes of your own readings and be firm! Tell her yes, you know its bad but she shouldn't let it affect your care.
x

 

[Flip flop]

Now that's stupid...I thought you were going to say it was 170/105 at the clinic or something. 145/90 is just above the diagnostic cutoff. I can't believe you'd be the "worst she's ever seen" -- that sounds like exactly what you would expect from white coat syndrome. And 119/65 is perfect.

Also I don't understand why they told you to stop taking it so often when it was under control. What's the point of that? I've taken mine every single day for most of the pregnancy and the doctor is always happy I'm keeping an eye on it.

She said usually it goes down by end of appointment when people have white coat but mine didn't today as was particulary worked up.

Do u think I should try and get a different midwife?

 

[Flip flop]

Take detailed notes of your own readings and be firm! Tell her yes, you know its bad but she shouldn't let it affect your care.
x

She'd probably just say its her responsibility so she needs to
Be sure

 

[seaweed eater]

Do u think I should try and get a different midwife?

I think it's up to you. I'm high risk due to chronic hypertension so having a care provider who I feel understands and is sensitive about BP is very important to me, personally. So I would switch if I were in your situation and it was easy to do so. It doesn't sound like she's doing anything dangerous, definitely insensitive and maybe a bit surprising (but I'm not a medical professional), but if anything erring on the side of being overly cautious -- so you have to decide how much that matters to you.

 

[magnacarta]

145/90 is the worst she's ever seen?!??!?!?!? Oh boy....how many blood pressure readings, exactly, has she done? (not to be too mean, but COME ON).

You definitely want a midwife who makes you feel comfortable. If you think that your midwife--for whatever reason -- will make you uncomfortable in the future, then it's worth switching. Labor goes faster and tends to have fewer complications when you are at ease. That said, you could also try just talking to her. Tell her that her reaction to your blood pressure freaked you out a bit, and that you're hoping to have a midwife who can make you feel at ease, even when something pops up that they're not expecting (you don't exactly want to be in labor and hear "wow, that's the worst I've ever seen!"). She's just looking out for you, of course, so a friendly conversation about how she can make you feel more comfortable might be able to fix things. Otherwise, I'd be outta there (but that's just me...)

 

[Flip flop]

I dont think she meant it was the highest reading she had ever seen I think she meant Ive got the worst case of white coat syndrome shes ever seen as it doesnt settle down by the end of the appointment...saying that isnt going to help though is it!

I dont know what to do. I dont think shell be the midwife I get when Im in labour, I think she just works in the community and there are separate ones at the hospital.

I think Ill get worked up before all my appointments with her now. I might try and see the doctor and see what he suggests. Not sure how easy it is to change midwives, think shes the one that serves that doctor surgery.

 

[Twinkie210]

She is worried about 145/90??? Is she crazy??? I went to the Dr. yesterday and the first reading they took was 168/105! They told me if it didn't go down that I would have to start bed rest and see if that helps. The second reading was 138/85 which they were perfectly fine with and said I can just come back in 2 weeks. To be fair, mine could be the start of PIH, because I did have it with my first pregnancy, but I was diagnosed with white coat hypertension after my first pregnancy and my bp does always seem to be a little higher at the Dr office.

Was you midwife using an electronic cuff or a manual one? My first BP reading was with an electronic cuff, the second was with a manual one, which are supposed to be way more accurate.

 

[Flip flop]

She is worried about 145/90??? Is she crazy??? I went to the Dr. yesterday and the first reading they took was 168/105! They told me if it didn't go down that I would have to start bed rest and see if that helps. The second reading was 138/85 which they were perfectly fine with and said I can just come back in 2 weeks. To be fair, mine could be the start of PIH, because I did have it with my first pregnancy, but I was diagnosed with white coat hypertension after my first pregnancy and my bp does always seem to be a little higher at the Dr office.

Was you midwife using an electronic cuff or a manual one? My first BP reading was with an electronic cuff, the second was with a manual one, which are supposed to be way more accurate.

Least yours went down to that, I was too worked up for mine to go down after her comments about me being weird. I took my electronic one which I used at first to get me used to it then she did it on her manual one. My initial readings on my electronic one was higher (cant remember what top one was but the second number was 99) but I didnt tell her what the readings were until they went down. She got 145/90 on her manual one. Think the best I got on my electronic one was 123/91.