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DIY Poor man's Tilt table test (PMTTT) for OI, POTS and NMH

Discussion in 'Problems Standing: Orthostatic Intolerance; POTS' started by xchocoholic, Sep 19, 2011.

  1. Sallysblooms

    Sallysblooms P.O.T.S. now SO MUCH BETTER!

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    Southern USA
    POTS doesn't need to have low bp, just high heart rate, 30 beats or more higher when standing, and of course all of the horrid problems that comes with it. Low bp is from other things like NMH etc.
     
  2. Valentijn

    Valentijn Activity Level: 3

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    Amersfoort, Netherlands
    The pulse pressure (the difference) is important because it indicates how well your heart is moving blood around. "Normal" seems to be 30-50, and I've found several sources that call 25 and under "extremely low".

    Mine's rarely over 35, and ofter under 30. It goes under 25 in the evenings on bad days when I'm feeling very worn out, and many times the BP monitor will give an error message when it's so low (under 22), probably because the pulse is too weak to be detected regularly. I can't measure my BP reliably when standing up because the pulse pressure gets too low for me to get a reading.
     
  3. ahimsa

    ahimsa Senior Member

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    In my case (diagnosis of NMH), I passed out on my first tilt table test, back in 1995, after only 20 minutes. I started having symptoms after 4-5 minutes but the fainting didn't happen until after 20 minutes (my BP suddenly dropped to something unmeasureable). And this sudden drop might have happened even earlier except for the fact that I was unconsciously fidgeting, moving my feet around, without realizing it. The folks administering the test had to ask me to stop moving. It was shortly after I made myself stand still that I fainted.

    The reason that the first phase of the tilt table test is often 45 minutes long is that sometimes it takes that long before a definitive response is seen. But fainting (or some other abnormal result--fainting is not required for an abnormal test) may happen at an earlier time.

    Also, my understanding is that the slightly tilted position (70-80 degrees) causes more stress in people with orthostatic intolerance than standing does. I can't find a reference right now but it has something to do with bearing all your weight while standing vs. some of the weight taken off while tilted slightly.

    When folks talk about doing a poor man's tilt table test at home, and alone, I worry about a couple of things.

    First, I would worry about fainting and getting hurt by the fall, maybe even hitting your head badly. I hope it is not too alarmist to suggest having someone with you if you decide to try this test at home.

    Second, I would worry about false negatives. You might subconsciously move around (I was completely unaware that I was fidgeting when they told me to stop moving!), not realize it, and decide that you don't have any problem. You might have a BP monitor that fails when the pulse pressure is too narrow. The standing might not cause enough orthostatic stress to get a good result. Some people don't have an abnormal result in phase one of the tilt table test but only in phase 2 or 3 when some drug (e.g., isoproteronol) is injected.

    I am not an expert so take all this information with a grain of salt (LOL!). I am just sharing some thoughts based on my limited experience and reading. I know it is hard when folks can't find a doctor, or can't get insurance coverage, or have some other obstacle that prevents them from getting the proper testing. So, I can absolutely relate to wanting to try this test at home when you can't get any support from doctors. I hope I don't sound like a wet blanket by posting my worries about what might go wrong.

    I'll include a link to the Johns Hopkins document again in case it is helpful:

    http://www.cfids.org/webinar/cfsinfo2010.pdf
     
  4. ahimsa

    ahimsa Senior Member

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    Just as an example, back when I was healthy and donated blood regularly, the blood donation volunteers would reject anyone who had a pulse pressure less than 25. I'm guessing that they were worried about people fainting after donation.
     

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