It's normal to feel a bit jittery about an upcoming medical exam or treatment. But for 1 in 5 patients who step into an exam room, the reaction is more serious – they experience a strong spike in blood pressure.
If you're one of the millions of Americans with white coat syndrome, your blood pressure is far higher during a doctor's visit than it is when you're at home.
Often, people with this syndrome find it hard to concentrate during office visits, or they cancel exams or treatments due to anxiety and stress. Now imagine this person has a serious or chronic illness and has to go to many appointments.
Susan Reiger, a Turning Point facilitator, has developed an innovative program to help. In the three-part class Conquering White Coat Syndrome, Rieger shares a variety of relaxation techniques, including deep breathing, biofeedback, guided imagery, role-playing and appointment preparation.
"The first thing we do is acknowledge that this is a real problem," she says. "For some, it's been a lifelong battle. For others, it develops later in life as a result of dealing with a serious illness."
Take a deep breath
Biofeedback is an important tool that helps participants learn to relax their bodies. Rieger attaches a small heart-rate sensor to a participant's earlobe and plugs it into a mobile tablet with software that measures the heart rate.
"First, we monitor the heart rate as we breathe normally," says Rieger. "Then we practice breathing in unison with an image on the screen. As we deepen and slow our breath, we can achieve a slower heart rate on exhalation."
Deep, slow breathing quiets the sympathetic nervous system's response and moves toward a parasympathetic state, which quiets the pain response. Breathing exercises lower heart rate, reduce hypertension, help the brain and aid digestion. You don't even need biofeedback equipment.
"Simply count to 3 as you breathe in through your nose and count to 4 or 5 as you breathe out through your mouth," Rieger says. "For people with busy minds, counting silently and visualizing the numbers allows them to focus on breathing."
Rieger also works with participants to prepare assertive questions for their medical teams. She encourages participants to imagine family or friends standing beside them during the exam.
Complex situation made worse
Susan Robare has been diagnosed with high blood pressure, type 2 diabetes and colon cancer. Each diagnosis has meant additional medical appointments – and increased anxiety.
"Ive always had white coat syndrome," she says. "I'm religious about checking my blood pressure at home, and it's fine. But as soon as I get in the car and drive to any medical appointment, I can feel my blood pressure rise. I know by the time I arrive, it's going to be sky high. And it is."
So Robare decided to take Rieger's class. After attending the first session, she already felt better.
"This class is wonderful for people like me," she says. "The instructor understands what I'm going through. And now I have tools to help it."