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Doc wants me to do treadmill stress test

ScottTriGuy

Stop the harm. Start the research and treatment.
Messages
1,402
Location
Toronto, Canada
Hi all,

Hoping someone will have some knowledge about my conundrum:

I went to my doctor's office this morning to pick up requisition forms for blood work - the admin person couldn't find all the req forms so suggested I speak with the nurse, perhaps she could help.

The nurse looks at me and says - "You don't look well" - I tell her I've lost 8 pounds this month as I sat shivering under my multiple layers - she says "I'm going to have a doctor see you".

The doctor on call asks some questions, I tell him my appetite and libido have totally disappeared this month - I tell him my post exertional malaise has gotten worse in the last 2 weeks, the farthest I've walked is 10 minutes.

He listens to my heart and says he wants me to do a treadmill stress test. I told him that would mess me up for weeks and weeks. He said they could give me medication that increases my heart rate without me having to move.

So my question is - if I take this medication that increase my heart rate for their stress test, will I not have post exertional malaise?

Thanks.
 

halcyon

Senior Member
Messages
2,482
Here's what Byron Hyde has said about it:
g) Persantine Effect in M.E. Patients: Persantine is a chemical manufactured by Boehringer Ingelheim. It is employed to perform chemical cardiac stress testing when a patient cannot exercise sufficiently to stress the heart. It is a particularly safe medication but when employed with many M.E. patients it can cause severe muscle pain over the extremities and entire musculature. Normally this can be reversed by injection of an antidote but this does not always work rapidly in M.E. patients. Severe pain and fatigue can be intolerable and persist for minutes to days in some M.E. patients following Persantine use. Persantine works by dilating both peripheral and cardiac blood vessels and causing the heart rate to increase as in a POTS patient. Obviously one major pain and fatigue factor in M.E. patients is caused by abnormal dilatation of peripheral blood vessels. The resulting pain may be related to reflex vasospasm as in severe Raynaud’s phenomenon that I note elsewhere is one of the causes of M.E. pain. To my knowledge, no testing of M.E. patients with Persantine has ever been published by Boehringer Ingelheim or others. It is one of the reasons I believe that pain syndromes in M.E. patients are due to a pathological vascular physiology
 

Sushi

Moderation Resource Albuquerque
Messages
19,935
Location
Albuquerque
He listens to my heart and says he wants me to do a treadmill stress test.
Can you ask him what specifically he wants to learn from this? Sometimes there might be an alternative test that would give similar information--and, personally, I'd want at test that has potential side effects to have the possibility of leading to useful clinical protocols.
 

5150

Senior Member
Messages
360
Hi all,

Hoping someone will have some knowledge about my conundrum:

I went to my doctor's office this morning to pick up requisition forms for blood work - the admin person couldn't find all the req forms so suggested I speak with the nurse, perhaps she could help.

The nurse looks at me and says - "You don't look well" - I tell her I've lost 8 pounds this month as I sat shivering under my multiple layers - she says "I'm going to have a doctor see you".

The doctor on call asks some questions, I tell him my appetite and libido have totally disappeared this month - I tell him my post exertional malaise has gotten worse in the last 2 weeks, the farthest I've walked is 10 minutes.

He listens to my heart and says he wants me to do a treadmill stress test. I told him that would mess me up for weeks and weeks. He said they could give me medication that increases my heart rate without me having to move.

So my question is - if I take this medication that increase my heart rate for their stress test, will I not have post exertional malaise?

Thanks.

About 7 months ago, I had infection in dental implants that had gone on for about 3 years. It was making me really ill. Hated to do it, but decided they had to come out (after listening about the hideous operation that could be done in lieu of removal : involving a sinus lift and bone grafting.) The oral surgeon would not consent to working on me unless I first had heart tests. I was very ill from the infection + everything else that we have going on, so he was afraid I would die in his chair I guess. Long story short, I had the freaking heart test involving the chemical speed-up, after first flunking the walking test. It is one of the scariest procedures I've ever had. I can not emphasize enough how out of control I felt as my heart went up to 130 beats/minute while I lay there on the table, just anxiety-ridden.

I was so sick then, but needed to get that infection source gone.
I'm not yet feeling back to "normal" such as it is for me. True Normal went away 25 years ago.

And the PEM resulting from that episode increased, without a doubt.
I still feel bad. I can walk 10 minutes, at a slow pace. But not every day.
Sometimes we must do things that aren't necessarily good, in order to gain results in another important area.
There was no other alternative explained. You might look into that claim of more options. For me, it was either This or That, 2 choices.
 
Last edited:

ScottTriGuy

Stop the harm. Start the research and treatment.
Messages
1,402
Location
Toronto, Canada
About 7 months ago, ...Long story short, I had the freaking heart test involving the chemical speed-up, after first flunking the walking test. It is one of the scariest procedures I've ever had. I can not emphasize enough how out of control I felt as my heart went up to 130 beats/second while I lay there on the table, just anxiety-ridden.

I was so sick then, but needed to get that infection source gone.
I'm not yet feeling back to "normal" such as it is for me. True Normal went away 25 years ago.

And the PEM resulting from that episode increased, without a doubt.
I still feel bad. I can walk 10 minutes, at a slow pace. But not every day.
Sometimes we must do things that aren't necessarily good, in order to gain results in another important area.
There was no other alternative explained. You might look into that claim of more options. For me, it was either This or That, 2 choices.

Jesus. I don't need any of that seems-like-trauma.

Thank you for sharing.

Your unfortunate experience is doing good: giving me, and others, a heads up about this procedure. Much appreciated.
 

DeGenesis

Senior Member
Messages
172
I had a severe crash lasting several months after a treadmill stress test. What really devastated me was that I performed PERFECTLY during the test, but almost immediately afterwords (after the doctor said his goodbyes) I collapsed on the ground from sheer exhaustion and could not move for almost half an hour. If he had asked me back to do it again the next day I am positive that I would have failed it almost immediately.
 

ScottTriGuy

Stop the harm. Start the research and treatment.
Messages
1,402
Location
Toronto, Canada
@DeGenesis
My fear exactly is exactly your experience.

Definitely does not seem worth the crash - and possible permanent damage - the mere fact that they are pushing this on m.e. patients speaks volumes about the large gaps in knowledge dissemination within the medical system.
 

panckage

Senior Member
Messages
777
Location
Vancouver, BC
So my question is - if I take this medication that increase my heart rate for their stress test, will I not have post exertional malaise?
Most people here seem to report that high heart rates are a cause of PEM. There also seems to be a consensus that the exercise test needs to be taken 2 days in a row to be of any diagnostic value for ME.

For me personally though, stimulants help me to exercise in the near normal range without PEM, but I think if I took them during exercise tests they would at least partially hide the ME symptoms :p
 

JKN

Messages
4
Scott,
i took regular stress test in 2005. I had mild case of ME/CFS for many years before stress test. After stress test i had permanent severe disease progression. The test caused permanent heart damage, and systemic mitochondrial damage. Dr. Cheney warns not to do any cardio exercise, i.e. it can cause disease progression and heart and organ damage. That stress test destroyed my life, and I found no warnings on any of the CFS websites like this one. I've read about stress test studies for ME/CFS patients since, and think anyone participating is crazy. I guess most people don't have the serious reaction I had, but we really don't even know who has ME/CFS and who doesn't. Based on my exp. I would strongly warn you against taking any form of stress test. Hope my post isn't too late.
 

TiredSam

The wise nematode hibernates
Messages
2,677
Location
Germany
I had to see a cardiologist as a condition of my application to a CFS clinic being considered, to exclude heart problems being the cause of my symptoms.

My GP wrote on the referral "echo and stress-ECG". I went back to him and asked him to remove the "stress" (I'm translating from German - Belastungs-EKG), which he did.

I then went to the cardiologist, who did the echo thing and then said "right, let's get you on the exercise bike for the ECG". I just flat refused, explaining why. He wasn't happy, even threatening me with / saying the only alternative was to shove a tube all the way up me to my heart, but as far as I was concerned he could take it or leave it, I definitely wasn't going to do the stress test, and he could keep his tube to himself too.

In the end we did a resting ECG (no stimulant), the fact that my referral didn't say "stress-ECG" gave him a way out, and I told him I was happy for him to write that I had refused the stress ECG in his report if he wanted, as I felt I could explain that to any doctor who knew about ME at a later stage. In the end we shook hands and said goodbye, and his report was fine.

In the end it's your body and your decision, no matter how much pressure a doctor puts on you. No way would I do a stress test that could (and probably would) ruin my health further for months, if not permanently.
 

ScottTriGuy

Stop the harm. Start the research and treatment.
Messages
1,402
Location
Toronto, Canada
@JKN
@TiredSam

Thanks for your input - I made it perfectly clear - in writing - to my doctor that a tread mill stress test would cause me harm and referenced Dr Hyde's work.

Hyde also has cautions for m.e. folks around Hep B shots and I'm due for one, so may have another conflict in the near future.
 

TiredSam

The wise nematode hibernates
Messages
2,677
Location
Germany
Hyde also has cautions for m.e. folks around Hep B shots and I'm due for one, so may have another conflict in the near future.

I've always had those, although for some reason I'm a non-responder.
I'll be giving the flu shot a miss this year though.
 

Chris

Senior Member
Messages
845
Location
Victoria, BC
I had a stress echo a few months ago, which involved mounting on a weird stationary bike and pedaling while they increased the resistance; I checked out at 6 1/2 minutes as I was beginning to feel stressed, and that was respected. No serious PEM. I think that in any stress test one does have that option, and should exercise it when needed.