The dreaded white coat syndrome

Derg

Cap, Roci
Staff member
Well, here’s my recent story. I have “normal” blood pressure, albeit on the ‘high normal’ side. Generally depending on weight and stress level. With the new standards going down by 10 points, my blood pressure is a little more concerning.

I totally have ‘white coat syndrome’. As I said before, it will run lower at Dr. Ross’ office, but run higher at my regular doctors office and low at home when I get around to periodic self-testing. Like @rausda27 said, when I got into my mid 40’s, it sits right at the borderline, but still certifiable, range but certainly below the FAA max of 155/85.
I figured I could sit back and worry about it, or explore an anti-hypertensive. I talked it over with Dr. Ross and from the FAA perspective, as long as it’s four (five?) or less medications with some small exceptions, all my general practice doctor has to do is write a letter that the blood pressure is under control and that you are in good health.

My decision to give anti hypertensives a shot was not to comfortably meet FAA flight physical requirements, but to think “Well, my blood pressure is usually OK, but it could be better and provide me some coverage to make diet and lifestyle changes.

When you start an anti hypertensive, there’s a seven day waiting period to see if you have any side effects that would interfere with flight operations and it’s business as usual.

So if your blood pressure is borderline from time to time like mine, it might be something you may want to look into during the interim of the diet and lifestyle changes that you should be making in order to get it more into the normal range and ultimately get off the medication.

The FAA of a decade ago and the FAA today when it comes to anti-hypertensives are two entirely different animals.
 

msmspilot

Well-Known Member
When you’re in the waiting room, don’t read the “Never Again” type stories in the aviation magazines... :rolleyes: Only made that mistake once.
 

JDean3204

Well-Known Member
Sorry for the thread bump here. Got my medical next week, knowing that the last two years my AME said my BP was pretty high I’m already worried. Just made it to a point where I’m happy in the career and would hate this to impede that. I’m also within my first year of employment (probation) so not sure what the company will do if I can’t get my medical.

I bought a home BP monitor this week and it was a bad idea. I’ve had some insanely high reading and then some high readings but passable by the 155/95 rule. I’m sure worrying about this isn’t helping at all, just worried about failing and having to get on meds. I’ve never needed meds for anything before, been pretty healthy the first 30 years of my life. But I do feel this is just stress induced along side a lack of cardiovascular activity. I also quit chewing tobacco this year, kind of. Now I have a few of those Zyn nicotine pouches throughout the day as I’m still very addicted to the nicotine.

anyone been denied and had to get on meds? How long does that take? Did your company give you any grief over it?
 

SlumTodd_Millionaire

Socialist Pig Member
I went on BP meds in my late 20s. Was grounded for 30 days to make sure no negative effects and that BP was stable at acceptable levels. Otherwise, not a big deal.
 

Derg

Cap, Roci
Staff member
Yoiu’re not even grounded now.

Basically, you’re prescribed medication, have your doctor produce a letter that says that apart from elevated blood pressure, you are generally healthy and give that to your AME on the next visit.

It’s not quite the “Scarlet Letter” that is used to be.
 

Derg

Cap, Roci
Staff member
Sorry for the thread bump here. Got my medical next week, knowing that the last two years my AME said my BP was pretty high I’m already worried. Just made it to a point where I’m happy in the career and would hate this to impede that. I’m also within my first year of employment (probation) so not sure what the company will do if I can’t get my medical.

I bought a home BP monitor this week and it was a bad idea. I’ve had some insanely high reading and then some high readings but passable by the 155/95 rule. I’m sure worrying about this isn’t helping at all, just worried about failing and having to get on meds. I’ve never needed meds for anything before, been pretty healthy the first 30 years of my life. But I do feel this is just stress induced along side a lack of cardiovascular activity. I also quit chewing tobacco this year, kind of. Now I have a few of those Zyn nicotine pouches throughout the day as I’m still very addicted to the nicotine.

anyone been denied and had to get on meds? How long does that take? Did your company give you any grief over it?
As I said previously, I have “white coat syndrome” and it’ll run “high normal” during an exam but normal at home. As I got older, my baseline began to creep up and my doctor suggested I go on a light dose of Amlodipine. She prescribed it, wrote a letter saying that I was otherwise healthy except for elevated blood pressure from time to time, I gave that to my AME and it satisfied the Feds.

A couple days of taking it to check for any side effects and it’s not that big of a deal.

If you think you need it, it’s better to be on it than dealing with the cumulative effects of hypertension as you age. Plus, the medical world is saying anything OVER 120/80 is bad news so if you’re regularly 140+ go talk to your doctor.
 

FloridaLarry

Well-Known Member
Home blood pressure machines are a mixed bag. The wrist-cuff types are notoriously inaccurate - don't bother. The arm-cuff ones are usually much more accurate, but your blood pressure varies throughout the day, depending on many things, including exercise or even activity. The instructions say sit down squarely in an upright chair, feet flat on the floor, arms on the table. I found that three readings, approximately ten minutes apart, for several days before an MD appointment, recording them all, and take that paper to the doctor helps him/her get a more accurate look at your BP. Plus, the reading they take at the office varies with who's doing it - techniques are inconsistent. Of course, this takes time; reading helps but not too exciting a book.

I also joke with the medical crew about 'purple scrubs syndrome.' They are familiar with it, often have some of it themselves (!). They will look at the previous readings, in case something is suddenly out of whack.

Perhaps transcendental meditation or some form of yoga?

Disclaimer: Not a medical professional.
 

jynxyjoe

The Kickin' Chicken!
So a couple of non FAA doctor visits, a cold and a dentist visit, and my BP was high. I always freak out when I see that cuff, pretty much the first thing I think of when I know I have to see a medical professional. Anyways, my doctor encouraged me to keep a log at home and I have a couple of machines and over a month, various times of day etc my average is 122/72. I go to the doctor it’ll be 145/85+ guaranteed. So what tricks do you employ to relax...I mean it’s only your career!
Visit the stranger right before, bring that BP down.

I'll see myself out
 
So a couple of non FAA doctor visits, a cold and a dentist visit, and my BP was high. I always freak out when I see that cuff, pretty much the first thing I think of when I know I have to see a medical professional. Anyways, my doctor encouraged me to keep a log at home and I have a couple of machines and over a month, various times of day etc my average is 122/72. I go to the doctor it’ll be 145/85+ guaranteed. So what tricks do you employ to relax...I mean it’s only your career!
When I worked in psych as a tech, it was part of my job to get readings on patients at least three times a shift. Some tips to lower your BP. Sit straight up in your chair, just sit up straight, period. Have good posture. Breathe slowly in and out, be relaxed. Arms relaxed on your legs and feet flat on the ground. Not arched up on the tips of your toes.
 

Boris Badenov

Someone should definitely do *something*, Captain!
I've always had inexplicably easy medicals. Blood pressure right at or slightly below 120/70, etc. And here's the secret. The second the Doc gives you the all clear and (here's the key) says "keep doin what you're doin", run straight out the door, jump on your crotch-rocket, ride at a five-star-wanted-level speed to the nearest liquor store, rob it, then lay up for a week or so with a shotgun in your lap, a bottle of whiskey in one hand, and a never-ending train of burning coffin-nails in the other. Doctor's Orders, officer, he told me to keep doin what I'm doin! It's an iron-clad defense!
 
Top