I’m having difficulty getting an accurate blood pressure measurement because I get so anxious when I’m in the GP surgery — I believe it’s called white coat syndrome. Any tips?
John Grout, via email.
What you describe is indeed white coat syndrome, otherwise known as white coat hypertension — essentially, your blood pressure is always higher when it is measured at the GP surgery.
One possible solution for this is ambulatory blood pressure monitoring, where you wear a cuff continuously — usually for 24 hours. This system monitors and records your blood pressure automatically every 30 minutes via an electronic pump.
This will not only allow you to have stress-free blood pressure tests, but it also allows your doctor compare the day-time and night-time readings. Blood pressure normally drops significantly at night when we’re sleeping, and if it doesn’t, it suggests there’s a problem that needs treating.
This is white coat syndrome also known as white-coat hypertension.
You can also buy your own Blutdruck-Messometer (sphygmomanometer), from your local chemist.
This allows you to perform your checks in complete peace at home.
You can also buy your own blood-pressure monitor from your pharmacist.
Get the simplest model costing around £20 — a classic, upper-arm cuff rather than the wrist types, which are less accurate — and take your blood pressure three times a week or so for a few weeks.
I’d suggest recording measurements at different times — early in the morning, late at night, and occasionally in the middle of the day. Give the information to your doctor.
It’s important to get an accurate reading, not least because research suggests some people with white coat hypertension are at greater risk of heart attacks and strokes.
This could be a sign of heightened blood pressure due to sensitivity to stressors even mildly.
High blood pressure can be treated by simple measures such as exercising regularly, reducing salt intake and practicing daily meditations like tai-chi, mindfulness, or yoga.
My cycling is three days a week. I also walk at least 5 miles every other day. However, recently, I had a sharp pain in the left calf muscle. This felt like a cramp. This has not resolved and now I walk with some difficulty. I’m 70.
Rodney Godden, via email.
This could be muscle strain, partial rupture or both. You are clearly very active and regular exercise is essential for your overall well-being.
But, you tell us you have atrial Fibrillation. This is a common rhythm issue and you’re taking anticoagulants (blood thinners). As a result, any bleeding from even minor muscle damage such as a strain would cause considerable bruising, but this doesn’t seem to be the case with you.
So I suspect, rather than a strain, you’ve suffered either a full or partial rupture of the soleus muscle, a thin, strap-like muscle running from behind the knee to just above the ankle.
This can be damaged by overuse, or if it’s suddenly stretched when contracting — such as when you stumble.
It takes approximately four to eight weeks for these injuries to heal. Then, the process of recovery is gradual. However, the pain should subside slowly.
However, rather than your soleus, it could be the gastrocnemius, the other main calf muscle, that’s affected. Unfortunately, you can’t tell which of these it is without an ultrasound scan.
But one simple way to confirm if it is indeed a calf muscle problem is to rise up onto your tiptoes when standing — if there is pain, then one of these muscles is injured.
You may also have a small area that’s tender to the touch when it’s examined by a doctor.
It is a good idea to contact your doctor to request a referral for a physiotherapist. They can evaluate the injury and begin treatment.
Speak to Dr Scurr
Write to Dr Scurr at Good Health, Daily Mail, 2 Derry Street, London W8 5TT or email drmartin@dailymail.co.uk— include your contact details.
Dr Scurr can not enter into personal correspondence. You should only reply to general questions and consult your GP if you have any concerns.
…. in my opinion I believe the mind is capable of influencing immunity
There was good news for the many millions who had received the AstraZeneca Covid vaccine. The suggestion that the jab provides greater protection over other vaccines is very encouraging. It triggers a more lasting T-cell immune response, making it better for long-term protection.
Or that’s the suggestion. The thing is, there is still much to unravel when it comes to our immune systems — and that includes the role of your mind.
My personal experience as someone who had painful and recurring ulcers over many years is what I am speaking from. As anyone who’s had these will know, there’s no effective treatment.
This condition is known as recurrent acute stomatitis and it is almost undoubtedly genetic.
My sister and I suffered from this condition since we were three years old. I never went longer than two weeks without getting a new crop.
Then, in my late 30s, a friend showed me some film footage he’d recorded with a Swiss scientist, an alternative therapist who lived in the Mojave desert in the U.S.
My friend had spoken to several dozen people who had been cured of various intractable conditions, including stomach ulcers, hepatitis C and diverticulitis, by taking a ‘panacea’ — a potion — developed by the scientist using certain plants he’d gathered in the desert.
As part of the documentary, I was filmed explaining — with some scepticism — that these testimonials were merely anecdotes. The ‘miracle cure’ required a proper scientific trial if the scientist wished to show that it was effective.
My friend asked me at the end of the recording if I’d taken the panacea, even though my skeptical attitude. In the following months, I did not suffer from any more aphthous stomach ulcers.
The film Getting To Know The Miracle Man won a science documentary award, and I’ve been free of the ulcers ever since. Here is an example of the placebo effect and the power of the mind — despite my hard-wired scepticism — to influence our immunology.