Checking your vitals

by Dr. S. Russell Vester, MD 5. April 2013 10:52

Having gotten past the unpleasant discussion about what you already know about your weight, what else did we learn from having your vital signs checked? Remember, these were checked when you were at rest. This means we are supposedly looking at a snapshot of how your vital signs are under an ideal circumstance.

I don’t know about you, but I would hardly consider being in a doctor's office an ideal circumstance. And I'm a doctor. You may be "resting" when you are sitting there being checked out, but I know that when I am in that situation I am far from being at ease. This sense of anxiety can affect what we get when someone checks your pulse rate, blood pressure and respiratory rate. They all can go up. This is sometimes called "white coat syndrome."

As a doctor, I try to account for this whenever I see a patient. I'm a heart surgeon, and I know that when I'm talking to a patient in the office for the first time they are usually very nervous and scared. Who wouldn't be? (Not because of me, personally, but because of what I do for a living. Or at least I hope so!) So I always try to account for this. It's not unusual to see someone's blood pressure elevated by more than 30 or 40 points. Typically I'll tell the patient this and simply ask them to be watchful and talk about it with their regular care provider. Most of the time people are much less anxious with their primary care doctor whom they’ve known for some time. The white coat effect seems to fade with familiarity.

So when it comes to vital signs, what is your doctor looking for and why?  For temperature, we don’t want to see a fever. Most folks have a core body temperature around 98.6 degrees Fahrenheit or a touch below. Anything 99.0 degrees or above is a fever. A fever is typically associated with some type of infection, and it can be anywhere in your body. Other things can cause a fever without an infection being present, but these are rare by comparison.

For blood pressure, 120/80 millimeters of mercury (mmHg) is the upper limit of normal. It used to be that 140/90 mmHg was the threshold for treatment. Over time we have seen that the likelihood of heart and stroke- related problems is too high if these old numbers are followed. This change is not that new, but many doctors were trained before this information was available and still haven’t adopted the newer blood pressure guidelines. So be aware and make sure you stay within the guidelines.

As for pulse rate, we look for 80 beats per minute (bpm) or less. This can be seen as one very general indicator of your level of fitness. So many things affect your pulse rate, though, that it always has to be combined with other information before your doctor can reach any conclusions. We'll talk about this at some length in future blogs

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