[nulbyte]

As an adult with a congenital heart defect and white coat hypertension, I can relate. Once, a nurse took my blood pressure and immediately freaked out as I was sitting calmly on the exam table. She took it again in the same arm, then hurriedly took it in each of my other limbs before throwing her hands up.

Often, I would arrive at the cardiology office having made my way through downtown traffic to find a parking space and walk across the pedway. Then I'd find a seat as far away as possible from all the noisy children there to remind me that I should be dead. No wonder my BP is higher than usual. And you're the one freaking out?

I got so used to nurses tossing out every recommendation for measuring BP that I started taking it myself at home before visits just to prove the point. Eventually, as I grew older, my BP rose to a point where it actually needed to be addressed. I am now on medication. But I have yet to find a nurse anywhere that has taken time to follow even one recommendation for properly taking BP.

[pkaye]

When I was a dialysis patient with frequent office visits, I've had the same experiences myself. Two things I've ended up doing is get to the hospital 30 minutes early, sit in a quiet area and relax till 10 minutes before the appt. Secondly I've found deep and slow breathing can improve your blood pressure a lot. The problem of white coat syndrome still remain though.