Friday, July 15, 2011

Painful blood pressure

I have undoubtedly had my blood pressure taken hundreds of times in my life. Considering I've been to dozens of doctors in my life, been hospitalized or in the ER multiple times, this has really added up. It's not something I ever minded. I mean, who cares about having their blood pressure taken?

However, during a recent hospitalization I experienced the most painful blood pressure cuff of my life.

I had my pressure taken about three times a day. An automatic cuff was used and no matter what arm was used, it was killer on my upper arm and my hand was tingling all over by the time it finished.

I have relatively small girly arms, so I usually have the problem of cuffs not getting tight enough. I've never experienced anything quite like this. I would try to really meditate and relax myself prior to the vitals being taken because if my SBP was higher than 130, they had to take it again.

I finally asked a nurse why the blood pressure cuff hurt so much. She said hospital cuffs always hurt more. Wha?

25 comments:

  1. The BP cuff in L&D actually broke blood vessels and left me with red streaks up and down my arm.

    I've read nurse rants complaining about the patients who complain about the tight cuffs. So I guess we're supposed to just suck it up.

    However, I suspect the engineer who designed those things was a sadist.

    M

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  2. Ouch. The nurses should have their BP taken with the automated cuffs to see how it really feels!

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  3. Or just rock it old school and take the damn thing manually. That's what I do. Though, to be fair, many of my patients are in A.fib/flutter and the machines can't ever read off that properly.

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  4. I think the problem is that they inflate SO MUCH MORE than a human nurse usually would. I mean, the nurse or doctor at my usual practice knows me and my usual is ~125/75, so they will take it to about 180 mmHg and go from there but a machine just will. not. Try 240! Once you *start* with painful restriction it takes a while to compensate, too, so half the time if I'm not warned to expect it, it would have to do it AGAIN because I squirmed. That was always great.

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  5. At a few places I've been to, the automatic BP cuffs have actually hurt, though not enough to make my hands tingle THAT bad. But I've had students use my arm for practice and they never even came close to making me feel uncomfortable

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  6. Usually you can set the auto-cuffs as to how high they inflate on the first go-round; i suspect it is just efficient to have the all of the cuffs set to a super-high default to capture all of the hospitalized patients who have super-high blood pressures. If it's set too low on a patient with very high blood pressure, it'll take the cuff forever because it'll keep cycling but not getting a reading. Maybe you should just bring your own manual cuff to the hospital the next time you're there and pull the "I'm a doctor and manual cuffs are more accurate" card.

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  7. Sometimes thr problem is if the machine hasn't been cleared from the last reading. They have memory, and will go above the last systolic reading about 20-30 mmHg. If you turn off the machine between patients, or at least 'zero' it, this should be less of a problem.

    I have one patient who comes in and this person has a myriad of medical issues, including chronic pain, but per this patient's report, the BP cuff is worse than what they are treated for. I came up with a way to get the auto BP, while keeping this patient comfortable, and proving my point that if the patient is talked to through it (if they are prone to 10/10 pain with BP cuffs), they almost never c/o pain.
    This patient remembers me, and will request I do the BP if they come in. (Freq flyer in the ED).

    As far as blood vessels breaking and causing 'red streaks'- that was likely because the cuff wasn't the right size or not placed on properly.

    As a side note- a major pet peeve is when pt's ask if the cuff can be put on looser. Ummnn, no- it has to be put on correctly to obtain the correct pressure, and I will not be back here q15min to place it on and off when I have 3-4 other patients on q15min VS.

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  8. I'm sorry, that sucks! I didn't realize that it was actually hurting people...I thought they were just being sort of histrionic and tired of having measurements taken at all hours of the day .

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  9. As a previous poster mentioned the calibration can be off, with the cuff set to inflate higher than it should or because it wasn't cleared from a prior patient. Sometimes older electronics are more prone to miscalibration.

    I generally switch arms if I have an issue with a cuff, or I give up and do a manual if there's an IV in the other arm. You can always ask them to get a different machine. If the cuff is making your fingers tingle I will wonder about the accuracy of the reading.

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  10. I always hate getting my BP taken. It HURTS!! :( Doesn't matter if it's automatic or manual, I get lightheaded and dizzy from the pain.

    Best of all, whenever I go to a new doctor they always assume my BP is going to be high since I'm fat, and they over inflate the cuff. (I have normal BP. They never believe me.) Last time that happened it hurt so much that I started crying. *^_^*

    This has been a problem for years, even when I was thin. I absolutely hate it.

    And I have a 3 month diabetic checkup on Thursday, so I get to have my arm squeezed again! Blood drawn too. *Sigh* The rubber tubing tied around my arm hurts far worse than the needle. :(

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    1. Today it hurt so much having my BP taken I started to cry! I could NOT help it. It was tight and pinched. I begged the nurse to stop. She finally did. Not sure what to do. I am 60 years old and a fun loving girl! I hated it!!

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  11. I rather suspect it causes false readings also--normally the cuff is no big deal but one day a nurse did something different (I suspect it was taking the pressure too high but I didn't see the gauge) and it really hurt--it left my arm sore for the next hour.

    It also caused the doctor to ask about high blood pressure--I don't have high blood pressure! I assume I tensed up from the pain and thus read high.

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  12. I have always found blood pressure measurement extremely painful - almost to the point of being ready to rip the cuff off. Afterwards my upper arms feel bruised and tender for days. My upper arms are fat and they use a large cuff but it still hurts - automatic or manual. Is there a different way to get a non-painful reading?

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  13. It used to be that taking my blood pressure did not hurt and I did not mind it. But, with the automatic blood pressure cuff my upper arm gets squeezed so tight that I nearly scream. My hand goes numb and the cuff leaves an awful red mark on my arm from being so tight. What's going on here? It used to be a pleasure to get my blood pressure taken, and now I'm dreading it almost as bad as I do needles....

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    1. That very same thing happened to me on Monday April 8th. I have nerve damage now. I hope it's not permanent.

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  14. I just bought an iHealth BP monitor - uses the iPhone to display the readings. It went to 255 on my arm (boy was that painful) while I was trying to figure out how to stop it - ended up ripping the tube out of the dock base to stop it inflating further. Waited a while and tried it again and it did the same thing, only this time I slid the stop button on the iPhone screen. Bit nonplussed about that but I have experienced problems in hospital where nurses were unable to get a reading with an automated machine and strangled my arm in the process.

    Waited for husband to appear as my next guinea pig for the new iHealth BP dock - and it behaved absolutely perfectly. He was delighted and thinks its marvellous and plans on using it daily.

    He has smaller upper arms than me. Any suggestions as to how I can get it to work for me would be appreciated.

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  15. At 46 I've had my blood pressure taken a good few times and thoug occasionally there has been a little discomfort it hasn't bothered me, but yesterday i had it done and it was staggeringly painful - so much so I ended up holding my breath. Despite telling the nurse at the time, and speaking to her again today she just didn't get how painful it was and just sees me as a nuisance who is over sensitive, suffering from the white coat syndrome and that the machine is new and not 'worn in' yet! I am still feeling the effects today, 24 hours later.

    Surely it should be at an appropriate level of tightness from the get go? I'd say she was simply no good at it - she certainly couldn't find a vein in my arm for the needle - but it was an automatic machine.

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  16. i hate those machinss. they do hurt. i will ask for manual from now on. or the right cuff. no more pain from these damn machines that everybody usees. they NEVER ADJUST THE CUFF. NEVER.

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  17. Thank you for your comments. I just went through this very scenario when I have never had high blood pressure but the cuff would not stop squeezing and I thought there is no way a good reading is going to come from this for it really really hurt. No one would listen to me. It made me cry.

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    1. My heart goes out to you, Lisa, and everyone who's had a similar experience. There are those of us who are actually physically sensitive to pain, sans drama or histrionics. Unfortunately, there are those in the medical profession who are grossly insensitive and too overbooked to care. While conventional medicine has its value, it can often be exceedingly, and unnecessarily, painful and harmful, to the point of tears--or worse. No one should have to suffer even more than they might already be suffering, especially within the domain of health care--where is the care in that? And if the pain is so bad that it causes one to cry, especially at the hands of a health care professional, then the very least they can do is compassionately listen and immediately do something to alleviate the patient's suffering. Peace, love and compassion!

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    2. I need to have my BP checked but its so painful I keep putting it off and I know death would be worst of course but it feels like my hand and fingers are going to explode I hate the thought of having to get it done and had no idea so many others were experiencing similar discomfort :(

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  18. I have low blood pressure and a really high tolerance for pain, but one of those auto cuffs really did me in - the pain almost reduced me to tears this week when I was in the hospital. The nurse kept saying, "Yeah, I know it's uncomfortable." No. Uncomfortable is when there's a pebble in your shoe. Uncomfortable is an itchy tag on the back of your sweater. Uncomfortable is a normal BP test.

    My arm kept hurting and it felt like the underside was completely bruised. Since there were no mirrors around, I couldn't check until I got home. When I did get to check, I found that, yep, the whole underside of my upper arm was (and still is) a patchwork of bruises.

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  19. Experiencing the same thing. Doctor took BP, it was fine (high BP, uncomfortable, but no more than it ever had been in the past), machine for patients use - absolutely excruciating - then appt with health assistant (not manual) ghastly - sharp pain, fingers tingling. They want to do the 24 hour monitoring - I can't see how my results won't be affected by a) expectation of severe pain and b) confirmation of the same via actual experience. I'm not prone to histrionics regarding pain. This feels like my arm has been placed in a vice.

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  20. I had my BP checked 2 days in a row with that horrible machine, 26 and 27th of November, now, 3 days later I'm still having sever pain in my left arm. I cannot use it to do anything, possible nerve damage. I tried NSADs , hot and cold treatments without any improvement. I'm starting to think they want more and more people to be high blood pressure patients, and consume their drugs, that's what results from such painful tight cuffs. Never had a normal BP reading due to enormous pain during and afterwards. Although with non automatic devices my BP is 110/70 some times 100/60.

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  21. I've never commented on anything before.. and yesterday a new patient rights activist was born during a routine BP test. Like many of you above I am VERY pain tolerant, not prone to complaining in the doctor's office, have normal to low BP, no special conditions etc.. and found the automatic BP cuff SO painful I had to restrain myself from crying out too loud. My request for STOP went unheeded the first time. Finally I made it clear it was unacceptable.. so the tech switched arms.
    Now I have two arms that ache and throb with radiating nerve pain in both thumbs 36 hrs later.. This cannot be right. Formal complaint time is coming. .Soon. The whole even was shocking.. such a simple procedure and so much distress with possibly permanent damage according to what i've read. Thank you all for telling your stories here so I know i'm not alone. Feeling strong enough to go forth in action on this. Bring back the manual BP test! The automatic version is clearly fraught with all sorts of problems.. and not right for everyone.

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