Pregnancy - Preeclampsia and White Coat Syndrome

It’s 10:00 a.m. on Thursday morning. You are pregnant and on your way to a 24 week checkup with your doctor. Your mood is excited, happy and confident as you muse about cute baby clothes, a name for the baby, shopping for a crib, and taking a healthy baby home from hospital.

One month ago, however, coming home from your 20 week checkup, your mood was much more anxious and distressed. The nurse practitioner had taken your blood pressure and other vitals. The doctor came to talk with you and shared her concern that your blood pressure was higher than normal and you might have preeclampsia.

Preeclampsia or toxemia is a potentially dangerous complication of pregnancy that is usually diagnosed by high blood pressure and water retention.  Your doctor talked about possibly prescribing oral or IV medications and monitoring you more frequently. There was even a possibility that the baby might have to be delivered early.

Back at home you began checking you own blood pressure readings on various days at various times. All your readings were within normal range. Hmmm! Could it be that you have White Coat Syndrome?

Google to the rescue! You learn that White Coat Syndrome means that your blood pressure reads high when taken in the stressful atmosphere of the doctor’s office but routinely reads normal when monitored in the calm environment at home. You also learn that Hypnotherapy can be very effective in training you to better control your blood pressure in anxious, stressful situations.

If you actually have preeclampsia, you should be appropriately treated by your physician. If White Coat Syndrome is triggering high blood pressure at your doctor’s office, hypnotherapy may help you to avoid unneeded medicine and medical interventions in your pregnancy.

In Hypnotherapy, you can gain skills to cope with your stress and anxiety.  You can learn how to anchor the calm and relaxed feeling that you feel in hypnosis to a physical trigger that you can use whenever you need. 

You will discover what you are telling yourself each day about your stress and replace that self-talk with a set of positive affirmations that are authentic and powerful for your particular situation. These affirmations will be embedded in your subconscious mind under hypnosis and you will learn how to reinforce them with daily practice. 

In my practice I have worked with many pregnant women whose doctors were concerned that they may be developing preeclampsia.  These women knew that they had “white coat syndrome.”  They wanted to have their blood pressure reading at the doctor’s office be as low as it was when they were at home.  Working together, we empowered them to approach their doctor visits with calm, relaxed confidence that they could keep their White Coat Syndrome blood pressure readings in the normal range. They did and they each delivered a healthy baby at term. 

For more information about these topics please see: 

Preeclampsia defined:

https://www.mayoclinic.org/diseases-conditions/preeclampsia/symptoms-causes/syc-20355745

White-Coat Hypertension and Masked Hypertension:

https://www.cedars-sinai.org/health-library/diseases-and-conditions/w/white-coat-hypertension-and-masked-hypertension.html

For a free hypnotherapy consultation you are invited to call 818-929-4944 or join us any Wednesday on my Hypnotherapy Q & A. Register here: 
https://zoom.us/meeting/register/tJ0tdeGtqTkuGtZCVlhQCzVEeRkxbTigRbBW 

Sincerely,

Cinda

A White Coat Syndrome Story

It is a Tuesday morning. You are sitting in the waiting room of your doctor’s office. You have an appointment to discuss the lab test results from your recent annual check-up. Your blood pressure at that time was 140/90. The nurse will be measure it again just before you see the doctor this morning. How are you feeling as you wait? What do you think your blood pressure will be today?

Your name is called. You are ushered into an exam room and seated on the edge of the exam table. Nurse Megan comes in, gets your weight and measures you pulse/oxygen level. Your weight is unchanged and your pulse/ox is better than 98%. She puts a blood pressure cuff on your preferred arm and records a level of 150/95. She tells you the doctor will be with you soon, walks out and closes the exam room door. How are you feeling now? Are you calm and relaxed or maybe a bit anxious and stressed?

The good doctor comes in, greets you warmly, settles in his chair and pulls up your chart on his laptop. He tells you he has some good news and some concerns. Which do you want first? You opt for the good news. The good news is that all of your lab results are in normal range and your general health is very good. However, he is concerned that your blood pressure is high and the possibility that you may be developing something called persistent hypertension. He suggests that you start monitoring your blood pressure at home and schedule a follow-up appointment in about 3 months.

As you drive home from your appointment your head is full of questions. What exactly is persistent hypertension? How serious is it? Are there treatment options? Is there such a thing as non-persistent hypertension?

Google to the rescue! First you learn that persistent hypertension may be defined as when your average arterial blood pressure during a normal day, the force of your blood pushing against the walls of your blood vessels, is consistently 130/80 or higher.

But then you also discover that there is a thing called White Coat Hypertension or White Coat Syndrome which is defined as a medical condition in which you experience persistent high blood pressure when you are measured at your doctor’s office or when a physician is present, but you experience normal blood pressure levels during your daily life and while in your home environment.

Next you learn that
• Hypertension progressively damages the walls of large arteries and makes the heart work harder to get blood pumped through the body.
• Modern medical treatments for persistent hypertension include diuretics and an array of drugs that aim to lower your blood pressure. Doctors also recommend lifestyle changes including diet and exercise
• White Coat Hypertension is associated with anxiety and fear of doctors and medical settings based on your past experiences and beliefs. If you are afraid to go to the doctor or dentist it can cause your blood pressure to rise when you are seeing the doctor and you may be treated unnecessarily for high blood pressure that you don’t really have.
• White Coat White syndrome can progress to persistent hypertension which causes problems that might have been avoided had you dealt with them earlier.
• Research studies have also established that Hypnosis/Hypnotherapy is effective in reducing blood pressure both in the short term and long term.

How can you fix this? Hypnotherapy can help in several ways. First, we attempt to find where the fear/belief comes from and if it is something that by reason alone can be fixed. Then we craft affirmations that encourage you to be calm and relaxed when having a medical procedure. Another technique would be for you to imagine yourself having the procedure in your imagination. Your very clever mind cannot tell the difference whether or not you are mentally rehearsing having your blood pressure taken or are actually having it taken by a doctor or nurse in a white coat.

If you would like to talk with me about your high blood pressure or have questions, please give me a call.