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Large Arms and the Wrong Size Blood Pressure Cuff

I recently did something so silly I can’t believe I’m about to share it with you. I went to the doctor’s office and had my blood pressure taken (this wasn’t the silly part, stay with me). It was high. For the first time ever! It wasn’t even high when I was pregnant. I addressed my concerns with my new doctor and she said, “I never get too worried when it’s a first appointment with a new patient.” Yet, I was truly concerned.

Later that evening, as I was trying to fall asleep, I jolted up! ‘Jennifer Rue McLellan!!’ (yes, I yelled at myself with my full name). In that moment I realized I neglected to do something I tell everyone to do. Literally, I’ve stood on a stage and told 200 birth professionals about this very thing, and yet I didn’t do it myself.

Always make sure a large blood pressure cuff is used on a woman with big arms (most often an adult large or adult thigh cuff )!!! When the wrong size blood pressure cuff is used, you get an inaccurate reading. You get high blood pressure!

I was in my doctor’s office a few weeks later for a follow-up appointment. A large cuff was used, and I had (you guessed it) normal blood pressure. I made a stink about it mainly because I didn’t want the words “high blood pressure” in my medical record. My doctor reiterated how she wasn’t concerned, but I asked her to please make a note about the wrong size cuff being used. She did just that, probably because she could tell I was actually about to get high blood pressure over this incident. I also asked her to please speak with her nurse about the importance of using the proper cuff with plus size patients.

I share my embarrassing story with you because it’s an important lesson; even trained patient advocates can fail at advocating for themselves. Below are three suggestions to help make sure you get the care you deserve at your doctor’s appointments.

  1. Wrong Size Blood Pressure CuffBring a loved one or trusted friend along. It’s always helpful to have someone on your side or someone you can simply look at for a reassuring smile when stressed. Plus, an extra set of eyes can help make sure the proper equipment is being used.
  2. Write down things that are important to you and bring a list to your appointment. I can’t tell you how many times my husband goes to the doctor and I ask him if he talked to his care provider about XYZ. His answer is often, “I forgot.”  I’m about to make him a list myself!
  3. Set a reminder on your phone! 5 minutes before your scheduled appointment time, have a reminder pop up with a note listing anything that’s important for your upcoming appointment. We often spend quite a bit of time in the waiting room so this will give you a few minutes (at least) to review what you’d like to address with your care provider.

I hope my story stays with you and helps you to become your own best health care advocate. From blood pressure cuffs to respectful bedside manner, you deserve to be treated appropriately and with dignity. You’re worth it!

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Joy Jones

Wednesday 9th of June 2021

I have used this information from you for many, many years, as I pass information on to pregnant mothers.

I would like to add, that I have frequently found, and have frequently heard from pregnant mothers, that the BP cuffs labeled "Large" are neither longer nor wider than those that are marked "Regular", or else they are only longer, and not wider at all -- which in my opinion, would not help with the accuracy of the BP reading at all.