white coat hypertension

pilotpat1

New Member
This is kind of a strange question but... about a little over 2 years ago I took and passed a class 1 medical just to see that I was qualified because my goal is to become a professional pilot. Durring the exam I was kind of nervous and my blood pressure was up. last time I had my bp checked the top number was about 110, so it was completly normal. However at the exam my top bp number was 155. The doctor then took it again later once I calmed down a little and it was 140. Ever since then for some reason I get nervous whenever I go in to see the doctor and get my bp checked. I came in 2 times since then for a regular checkup with the family doc and my bp was up to 145 both times. I know my normal bp is still normal though because my neigbor checked my bp not to long ago just spur of the moment when I wasn't nervous and the top number was about 115. Next fall I plan on attending ERAU and before I start I have to take a class 2 medical exam. Knowing me I'll probably be nervous again so my question is what if my bp were to rise over the FAA limit of 155. Would I fail even though my normal bp is completly healthy and acceptable? I'de assume the doctor wouldn't see it as a problem considering I'm young and relatively skinny and nobody in my family has hypertension, but would the doctor second guess his/herself seeing my last 2 bp reading recordings were high?

Thanks.
 

My Flight Surgeon

Sr. Aviation Medical Examiner
What they should do is recheck the blood pressure on 2 or 3 times and hold the medical until they get the other numbers.
 

pilotpat1

New Member
So just to clarify... they would just keep checking my bp then until they get a reading of under 155 then sign the medical?
 

My Flight Surgeon

Sr. Aviation Medical Examiner
That is what I would do. I cannot speak for all AME's. Most want you to get in the air and are aware of white coat hypertension.
 

Derg

New Arizona, Il Duce/Warlord
Staff member
That is what I would do. I cannot speak for all AME's. Most want you to get in the air and are aware of white coat hypertension.
I have "white coat hypertension" too. Primarily from a bad experience when I was younger.

However, what helped me tremendously is finding an AME that you're comfortable with like Dr. Forred and his nurse Patty.

I still get a little anxiety but it's very short lived because they've seen it all before!

Hope that helps.
 

Copperhed51

Well-Known Member
I have this issue as well and agree with Doug that an AME you're comfortable with is a big help. I just got my 1st class renewed and had to go to a new AME since my old one is no longer practicing. I was pretty nervous going into it but this guy was really cool. He ran me through the process of checking my measurements, eyes, ears, etc. He was joking around with me and generally made me feel really comfortable. It wasn't until the end of the exam that he whipped out the bp cuff. It was over before I had time to get nervous and I came out with a 122/84.

Moral of the story is, find an AME that makes you comfortable and like Dr. Forred has said, find one that does lots of aviation medicals. I think if the doctor is comfortable doing the exams, it helps the patient to be comfortable too. The other thing that might help with these situations is exercise and a good diet...
 

LeTempt

New Member
I almost always have issues with white coat hypertension. It started for me when I had my military class 2 physical on the same days as I was scheduled to take a series of check-rides (instrument ride and DES stands ride). After that I almost always seemed to get myself worked up.

Now before I go in for my physical I conduct my own 3-5 day BP check, checking my BP 3 times per day at about the same time each day. My AME knows I have a problem with the white coat syndrom. When I go in to see him, I take my BP log and my little BP machine. We check my BP on his machine and my machine and if they are close (indicates that my machine is calibrated) he uses my results. I record the date and time of the test and my BP and pulse. I color code in red any reading that is over 140 or 90 and average all the readings. My average BP over 3-5 days is usually about 120/80. I think this is a much more accurate indication of my true BP.

Jeff
ERAU Graduate
 

ppragman

FLIPY FLAPS!
Hell, I'm 20 years old, and I freak out in the doctor's office, my girlfriends a massage therapist and I can get cuffed at her work and I do 120/80 unless I've been really sucking down coffee, I go to the AME and I'm elevated for awhile while I calm down. I've never liked being in the doctor's office, its always freaked me out since I was a little kid, and it makes doing my yearly AME ritual more stressful than perhaps it should.
 

Derg

New Arizona, Il Duce/Warlord
Staff member
True story.

Find a flight surgeon you're comfortable with and go back as often as possible. There's a certain level of comfort that I have that if I am potentially beyond the limits, that the office is ready and experienced enough to deal with getting me back on the flight schedule.

If I moved to Guam, I'd still visit Dr. Forred and Patty in PHX for my medical.
 
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