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How easy for layperson to check HR changes on holter?

Discussion in 'Problems Standing: Orthostatic Intolerance; POTS' started by mobyjoby, Oct 4, 2012.

  1. mobyjoby

    mobyjoby

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    How easy would it be to look at the printout from a 24hr ecg and tell if there had been HR jumps of 30bpm +?
    I have never looked at one and my (useless) general consultant has said he sees no need ofr any treatment to my GP. He has sent her the whole scan with those as his only comments. She hasn't looked at it yet but I'm sure she would let me have a copy too. But if it just shows closer together and more spaced out waveforms I am not sure how you would know exactly the heartrate at certain points.

    I also have a video that I did of my heart rate monitor watch. Resting was between 89-94 and on standing it shot up to 131 and then stayed above 120 for around a minute before lowering to between 116-119 at which point I stopped the recording. Do you think I should upload the video to somewhere like youtube and send my GP a link or would that likely be dismissed.

    At the time I had the holter done (6th July) my symptoms were slighlty better and my resting HR was probably around 76 or so. I haven't used the HR monitor much since then but put it on last week after seeing my GP and my resting HR struggles to bet much below 90 at the moment.

    She was going to refer me to professor Newton at Newcastle (UK) who does testing for POTS and OH etc. But I'm now worried that she won't after my consultants comments. Although she hasn't been happy with his approach so far so maybe she will look more deeply.

    Thanks for any thoughts/ info

    Jo
  2. taniaaust1

    taniaaust1 Senior Member

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    POTS would be very hard to tell I think from that.. as one cant see what one was doing when the reading happened. If you were walking or doing something (other then standing) when the reading was done the upright rate wouldnt count..

    or if didnt have a laying reading noted to which then was just standing (and nothing else) right after that.. you wouldnt know if it was POTS which put the heart up 30 beats in a short space of time or if you'd just started doing some activity.

    POTS is diagnosed by tilt table test or a poor mans test.
  3. mobyjoby

    mobyjoby

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    Thanks Tania - I seem to have to get past this test to get anyone to refer me for the proper POTS testing. I did have to make a record of different activities that I did during the 24 hrs and I did note some times when I went from lying or sitting to standing. But as the consultant did not even mention POTS/OI as a query on the request I am not sure how closely anyone will have looked at it. He purely mentioned my ectopic beats and I don't think I had any of those during that 24 hr period. If they had tested me a week later it would have been a very different picture than the 24 hrs when the test actually took place as it was a relatively good 3 or 4 days around then - but thats always a risk isn't it.

    My Gp kind of did a poor mans test on me but as she was short on time she had a conversation/consulatation with me the whole time I was laid down for the 10 mins and my HR was bouncing around so not very accurate and only gave a raise of 22. Not sure if the specialist testing centre will accept a referal without stronger evidence of a problem but will see if GP even plans to make a referal following my consultants response.

    It seems to be dragging on and on but I at least have a referal to a different general consultant now for a second opinion on my illness generally and the new consultant at least believes that mitochondrial dysfunction is a major player and that GET isn't a good idea. Thats not for 2 months but is at least happening.
    Jo
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  4. mobyjoby

    mobyjoby

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    Update: no idea what GP has made of the ecg but she has gone ahead with my referal to the Falls and Syncope unit at Newcastle (uk) and hopefully my appointment should be before December. It will probably not be with Professor Newton as she only has 2 patient slots per week for query POTS so wait would be ages. But the clinic sister said the other doctors there routinely carry out these tests and are experienced with OI and with ME. Its just Professor Newton is only there one day a week. However if after the tests they think I need to see her they will pass me on to her.

    I was worried the info from my GP was not going to be enough for them to accept me but she reassured me they very rarely refuse referrals and from what I said on the phone it sounded appropriate and she would keep her eye out for it as they all go through her and that it would be accepted.

    It is such a relief!

    Jo x
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  5. maryb

    maryb iherb code TAK122

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    What good news, nice to hear of someone actually getting somewhere with NHS GPs, she sounds okay yours, good luck with your appointment.
  6. mobyjoby

    mobyjoby

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    update from me.
    I went to the falls and syncope unit at Newcastle today and came away with a diagnosis of POTS. my HR went up to 148.
    Thanks to everyone who patiently answered my questions. very relieved to start getting some answers and it was so refreshing to be taken seriously.
    Jo x
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  7. Sushi

    Sushi Moderator and Senior Member Albuquerque

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    That is great to get a diagnosis and to be taken seriously.

    What is the treatment plan?

    Sushi
  8. taniaaust1

    taniaaust1 Senior Member

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    That's great news as hopefully now you can get trial some things for the POTS and have some chance of improving some. My ability to do physical stuff improved by about 50% with POTS treatment (thou POTS is still one of my worst symptoms so Im needing more treatment for that).

    I too are interested in what treatment plan they've put you on for it?
  9. mobyjoby

    mobyjoby

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    Hi - Thanks
    No definite treatment plan yet. They did some extra blood tests and want my GP to do a 24 hr urine test and then they will see if GP is willing to liaise with them about treatment/management so I don't have to keep going to Newcastle so often (3hrs each way on train).
    Sounds like they will very much take on board my views/ concerns in planning what route to take.
    They were very respectful and supportive on my first visit.
    Jo x

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