Ask the doctors: Readers respond

Hello, dear readers! Welcome to our monthly letters column. We have a lot to cover so we’ll dive right in.

• We recently wrote about “white coat syndrome,” which is when anxiety leads to artificially elevated blood pressure readings during a medical visit. We heard from a reader who experiences it. “I’m sorry to say this, but I read your column and was disappointed to read your chosen words ‘so-called white coat syndrome.’ It sounded to me like you have little confidence that this is a real thing, and it is,” she wrote. “I’m 72 years old and have suffered with white coat syndrome for years. Anytime I have a medical visit, I take my at-home blood pressure readings to show the doctor.” We agree that white coat syndrome is very real and common. We used the words “so-called” because it’s an idiomatic phrase and not a medical term. In our own practices, we encourage patients to follow your method, which is to bring a log of their home blood pressure values. We trust those more than a single in-office reading.

• A column that explored a range of causes for recurrent urinary tract infections prompted a reader to share her own experience. “I’m surprised no one gave the advice that I got as a teen – women, always wipe front to back,” she wrote. “I have had only one UTI in my life of 84 years.” Yes, proper wiping technique is indeed important. However, due to female anatomy, even scrupulous hygiene may not be enough to prevent the transfer of bacteria from the rectal area to the urethra. As we discussed in the column, recurrent UTIs have a range of causes. Still, you received sound advice as a young woman, and proper wiping continues to be a preventive habit that healthcare providers recommend.

• We recently answered a question about what to pack in a road trip first-aid kit. We heard from a reader who suggested an addition. “I agree with everything you suggested, but I would add to the list of must-haves. Bring at least one pressure bandage with QuikClot,” he wrote. “I carry a small pouch with these in a pocket while in the woods or driving. And be sure to take the time to learn how to use them – it’s not a lot, and it can save your life.” QuikClot is the brand name of a line of gauze and bandages that are designed to help stop bleeding. Originally developed for the U.S. military, these products are now available for general use. The bandages contain kaolin, a mineral that bolsters the body’s natural clotting process. They are meant to be used along with direct pressure, and only as a stopgap measure until the injured person can reach professional medical care.

Thank you, as always, for taking the time to write. We love hearing from you. If you have a comment or a question, reach us at askthedoctors@mednet.ucla.edu.

Send your questions to askthedoctors@mednet.ucla.edu.