Tuesday, January 26, 2010

Quirks: "White Coat Syndrome"

This blog entry marks the first in a new series called "Quirks." I've often thought about how I have some strange and unique personality traits that I spent a lot of time and energy trying to hide while growing up. Now that I'm older, I'm realizing my quirks are just part of what make me, me. And who knows?...maybe others can relate to some of these. So, rather than hiding my quirks, as I've done in the past, I figured I'd go the complete opposite route and just bring them to light.

Today's quirk: "White Coat Syndrome"

White Coat Syndrome (WCS) is an unofficial technical term (if that makes sense), in which a person's physical characteristics are affected by his or her mind when in the presence of another human being. WCS is most commonly attributed to a person's rise in blood pressure when a doctor is around, hence the white coat reference.

A few years ago, my extended family was visiting for a summer barbeque. I was in the yard playing baseball for a couple of hours with my cousins. When we finally finished, I went inside, sweaty and out of breath, to find my grandmother taking her blood pressure and doing whatever other regimented health tests grandmothers do. After I asked her what she was specifically doing, she asked me if I wanted to take my blood pressure. Not one to have ever had any sort of chronic health issues, I happily said yes.

A normal blood pressure is 120/80. In all my years of going to the doctor and having my blood pressure taken, I'd never been told it was abnormal in any way. On this particular day, I put on my grandmother's BP monitor and felt it squeeze tightly around my arm. When it finally released, the numbers staring back at me said something around 160/97. Now keep in mind, I had JUST come back in from heavy athletic activity and was still out of breath. My grandmother repeated the numbers within earshot of my mother. Big mistake.

My mom freaked. If you know her, this is not surprising. She begged me to take it again. At that point, I began trying to get my breath under control and concentrate hard on getting the numbers down. As you can imagine, this had the exact opposite effect. The numbers came up high again. They had me rest for several minutes and take it again, but the whole time I was playing this mental game with myself to calm down, which just psyched me up even more. Ten minutes later, I took it again with the same result, and not surprisingly, my family began discussing how I was apparently suffering from hypertension at the age of 27. At this point, I was pretty fired up because I knew something wasn't accurate. It's kind of hard to keep the numbers down when several members of your family are starting at you with terrified looks on their faces.

About a month went by and I went to the dentist. At my dentist's office, they take your blood pressure before they clean your teeth. Yeah, I don't know why either. When I sat in the chair and suddenly remembered they were about to check my BP, my stomach tightened and my heart started thumping through my chest. Oh no, not again! It came up 155/97. My dentist raised an eyebrow and said "That's much higher than it was just a few months ago!" Yeah, no kidding! (At my previous appointment, my BP read 117/60 and I was told that if it was any lower, I'd be asleep!) She took it again and it came up the same. Her response was to eat more fruits and veggies. Thanks for the tip, doc!

At this point, I was starting to get seriously worried about my health. Hypertension is, after all, a silent killer. I scheduled an appointment with my primary care physician so that I could get to the bottom of this. When my BP came up high again, I let loose my frustration to my doctor. I asked him how this could have happened so suddenly when I have had a perfect track record in this area. He asked me a bunch of questions regarding my lifestyle; I told him I didn't smoke, didn't do drugs, didn't drink soda, consumed very little alcohol, and that I was even exercising regularly. He looked at my records, agreed that my BP had always been low, and callously said "Yeah, I don't know. Maybe we could put you on medication." Well isn't that just the answer for everything? I told him about the situation with my family at the summer barbeque and how since then, I'd get butterflies in my stomach and an elevated heart beat whenever having my BP taken in front of anyone. I asked him if my state of mind can distort my true blood pressure and his response was a flat "yes." Isn't it nice when you're forced to diagnose yourself to your doctor?

A few days later, I went out and bought my own blood pressure monitor. I went home and took it by myself, and what do you know?....it was totally normal! I took it again, and normal again it was! Could there be something to this? Several months later, I had to take a routine physical as part of the process of adopting a baby. I took my BP the night before my physical -- 110/74 (totally normal) and brought my monitor to the doctor's office with me the next day. When it came up at 155/110, or something astronomical like that, in front of the doctor, I showed her the numbers from the night before. She said "Looks like you've got White Coat Syndrome" and assured me that I was healthy and that this situation was more common in patients than I probably realized. I said "Well, at least there's a name to go with it." I used my own monitor in front of the doctor and it came up high again, so at least I knew my monitor wasn't giving me false readings at home.

I left the doctor's office, went outside, sat on a bench by myself and took my BP once more. The numbers were below normal -- exactly where I thought they would be. The mind is a powerful thing and I'm learning that "mind over matter" is more than just a saying.

Hopefully one day this too shall pass. Until then, I nominate myself for president of the National WCS Organization. All rights reserved.

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