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My Poor Man's Tilt Table Test Results!

Discussion in 'Problems Standing: Orthostatic Intolerance; POTS' started by Karganeth, Feb 20, 2014.

  1. Karganeth

    Karganeth

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    Firstly a little background information...

    I'm now 24 but my symptoms first hit when I was 19-20. The first thing I began suffering with was chronic abdominal bloating/swelling/distention and my legs felt heavy, so heavy infact that I would move forward by sweeping my feet rather than lifting them. I felt like food was getting stuck and I had a massive amount of gas production 24/7. Soon after my right pupil enlarged compared to my left and has stayed this way to this day. It has brought on a host of visual symptoms. I see flashing lights, blurred vision, and my eyes are very light sensitive oh and not to forget as soon as the change in my pupil happened I began noticing a swarm of white blood cells swimming in my vision (read about it on the web).

    Soon after I began having pounding and rapid heart beats whenever I changed posture or if I had to do some light activity. I would get family to touch my chest when I had these episodes and they were all surprised at how hard and fast my heart beat. It was uncomfortable but I managed with them. Eventually they worsened and I found myself becoming increasingly sensitive to any form of activity and found that the only thing that made me feel better was lying down. Whenever I took a lie down I felt like I was in heaven. I bought myself a device that monitors my heart and began testing. Whenever I changed posture or had to clean or do any kind of activity my heart rate which is usually around 55-65 at resting would jump to 120-140 beats and each and every time I'd get light headed, my vision would go, I felt weak and felt it difficult to breathe. I also noticed an excessive increase in yawning and fatigue. Whenever I went for lectures, I had friends and tutors always mention I look pale and exhausted and my most rude symptom to some was the yawning. I couldn't help it. Eventually all these symptoms became very taxing on me and I found myself needing a lot of bed rest aka naps so I dropped out. I also had a part time job over the weekend that I was no longer able to maintain. So I dropped that too.

    I then began having body temperature regulation issues. My nails are very often blue and my hands are cold to the core, including my feet. Even when I exercise, my hands and feet continue to stay cold. Shortly after I began struggling with concentration and felt 'dumb'. I can no longer understand things as well as I used to and I'm always at a loss for the word I seek to finish of a sentence. I used to be excellent at math and now I'm exactly the opposite.

    Occassionally I lose consciousness for a few seconds while seated. This can happen several times in an hour. I have very painful neck and shoulder pain which is only alleviated when I lie down.. I've fainted several times in the shower and once as a kid at school. There's a lot more symptoms but because I'm now at home most of the time I've noticed my symptoms improve. It seems whenever I try to lead a normal life that requires routine my symptoms exasberate and I always end up having to retreat back home.

    I've seen a few specialists.

    Opthalmologist's comments:
    Abnormally large pupils but other then the symptoms the patient describes, the eyes are in perfect health. Possible over-stimulation of Sympathetic Nervous System...

    Gastroenterologist:
    Endoscopies, biopsies, celiac disease testing, bacterial overgrowth etc - All either negative or inconclusive and the doctor has yet to comment what he thinks might be going wrong. Although acknowledges huge increase in abdomen size.

    Can't get seen by anyone else because my GP's believe it is all anxiety and stress related. They won't refer me anywhere else as they say I'm currently being seen by my Gastroenterologist and I should wait to see that what that doctor's verdict is.

    Okay so now to the results of the PTTT!

    I altered my test a little and forced myself to stand for 40 minutes as I heard the TTT can last that long.
    So I took a lie down and waited 10 minutes to find my blood pressure and resting heart rate. I then got up and checked again.

    110/56 Pulse 61 - 4:00pm - Lying down
    128/68 Pulse 135 - 4:01pm I guess my body thinks I'm about to fight a lion?
    (10 readings one for every minute)
    120/69 Pulse 96 - 4:02pm
    116/71 Pulse 89 - 4:03pm
    114/69 Pulse 83 - 4:04pm
    105/69 Pulse 87 - 4:05pm
    110/70 Pulse 71 - 4:06pm
    104/69 Pulse 85 - 4:07pm
    105/68 Pulse 86 - 4:08pm
    105/70 Pulse 105 - 4:09pm
    115/73 Pulse 89 - 4:10pm
    107/71 Pulse 70 - 4:11pm
    Because I felt like my cuff was going to disfigure my arm after so many tries I began using my heart rate monitor watch with the chest belt. I will now only report heart rate from here on.
    Pulse 86 - 4:12pm
    Pulse 83 - 4:13pm
    Pulse 95 - 4:14pm
    Pulse 101 - 4:15pm
    Pulse 75 - 4:16pm
    Pulse 80 - 4:17pm
    Pulse 82 - 4:18pm
    Pulse 102 - 4:19pm
    Pulse 93 - 4:20pm - From here my calves began to feel weird and my feet felt padded from the bottom
    Pulse 96 - 4:21pm
    Pulse 103 - 4:22pm
    Pulse 101 - 4:23pm
    Pulse 94 - 4:24pm
    Pulse 90 - 4:25pm
    Pulse 97 - 4:26pm
    Pulse 95 - 4:27pm
    Pulse 79 - 4:28pm
    Pulse 93 - 4:29pm
    Pulse 96 - 4:30pm
    Pulse 106 - 4:31pm
    Pulse 109 - 4:32pm
    Pulse 105 - 4:33pm
    Pulse 109 - 4:34pm
    Pulse 103 - 4:35pm
    Pulse 105 - 4:36pm
    Pulse 111 - 4:37pm
    I stopped here because I could barely feel my legs and the soles of my feet were extremely painful. I felt increasingly faint.

    Quick mention: Is it normal for the heart rate to vary so greatly? My family member mentioned she was seeing sudden increases of 10-20bpm and sudden drops of 10-20bpm ever so often.

    You'll notice closer to the end my heart rate began to sustain beats of 90+. You'll see at around the 4:20pm mark that I made mention of my calves giving off weird sensations and my feet feeling painfully numb and as if the soles of the feet had extra cushioning. I lifted my trousers up and had a family member take my socks off (so I wouldn't move)! To both our surprises my feet and legs were blue/purple. You see I never bothered to check my legs before because I can't actually comfortably stand in one place for longer than a minute so I'm always either swining my legs or walking in circles or lifting them up one by one so the the pain and discomfort never got bad enough to warrant a look.

    I've uploaded pictures of my legs before and during the test. Apologies in advance for anyone put off by what they see. Oh by the way the white imprints you see on the pics were me touching that particular part. They were taking ages to fade so I just decided to include them in the picture.

    What do you guys think? What should I be pursuing?

    Thank you very much for your time

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    Last edited: Feb 20, 2014
    Wayne likes this.
  2. Sushi

    Sushi Moderator and Senior Member Albuquerque

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    If you tell us what country you are in we might be able to give better feedback on "next steps" as the possibilities vary from country to country. From a quick look, your results looks pretty POTSY.

    You would most likely benefit from seeing a doctor with experience in dysautonomia.

    Welcome to the forum,
    Sushi
    Tired of being sick and Wayne like this.
  3. Hip

    Hip Senior Member

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    I understand that most people don't have to do this for 40 minutes; 5 or 10 minutes will suffice, provided the heart rate shoots up straight away, as yours has done. I believe you only need to wait for longer periods if your heart rate does not shoot up immediately.

    You also normally discard the readings for the first minute or so (so ignore your very high readings of 135 and 96 during the two minutes of standing).

    Then take the average of a few readings. I make your average (over the first 10 minutes) to be around 87.

    Now 87 – 61 = 26

    If the heart rate goes up by 30 points or more on standing after lying horizontally at rest, then you have POTS (postural orthostatic tachycardia syndrome).

    However, you are quite close to 30 points, so you would appear to have some degree of POTS.


    Though I am by no means an expert on this, so it is not clear to me what your high heart rates around 100 at the 30 minute mark may signify. Perhaps others may be able to advise.
    Last edited: Feb 21, 2014
  4. Hip

    Hip Senior Member

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    Yes, this article on POTS confirms that you only normally measure for the first 10 minutes. It says:

  5. Sea

    Sea Senior Member

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    @Karganeth @Hip to diagnose POTS 10 minutes is all that is usually necessary, but POTS is not the only form of Orthostatic Intolerance. The longer time frame is usually necessary to diagnose Neurally Mediated Hypotension (NMH).

    A heart rate that jumps to 135 even in the first minute is not a normal response so I wouldn't discount it completely but it probably wouldn't get you a diagnosis of POTS because it does return to a more normal heart rate relatively quickly.

    In NMH though it is the blood pressure readings that are more revealing over the longer time than the heart rate. It is not necessary and probably not accurate to take blood pressure every minute because it takes some time to normalise after being squeezed. Every 3-5 minutes would be plenty.

    Your photos reveal very significant blood pooling in your legs and feet which indicates either that your blood pressure is dropping and/or that your veins are dilating rather than constricting when you stand. That too is under the control of the autonomic nervous system.

    I agree that you would be wise to pursue an appointment with a specialist who is familiar with dysautonomia
    ahimsa, SOC, Hip and 1 other person like this.
  6. xchocoholic

    xchocoholic Senior Member

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    If you haven't already, I'd slowly switch to a paleo type diet that eliminates grains, dairy, soy, corn and all chemicals and see if that helps you digestive and neurological problems. Eliminate gluten first. This type of diet eliminates most food intolerances but you may have others that are considered ok for paleos but not for you. For ex some people have trouble with certain meats.

    I had heavy legs with my gluten ataxia.
    Info on gluten ataxia is in theglutenfile.

    It took a solid year of being off gluten for this to resolve.

    Gluten intolerance includes celiac disease and a wide variety of other symptoms.

    At this point, I'm not sure how long being on a strict paleo diet is necessary. But after 8 years I can finally eat non paleo foods without feeling sick or weak. I limit my gf processed foods tho.

    Also, I'd try laying down for an hour and then doing a pmttt. In my experience, ten minutes isn't long enough for the effects of hypoperfusion to reverse. My resting hr, 65, drops another 10-15 pts lower if I lay 45 + minutes. Getting up too soon results in my hr going back up to my pots hr, 110+ immediately. If I lay down for an hour tho my hr slowly climbs back up to my pots rate. I feel much better avoiding my pots hr.

    hth .. x
    Last edited: Feb 21, 2014
    Wayne likes this.
  7. Karganeth

    Karganeth

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    @Sushi
    Thank you for the reply and warm welcome. Hopefully one day we may all reborn as healthy individuals (phoenix). As to where I reside, I'm living in London, Great Britain. I'd be delighted to hear of any suggestions you may have!

    @Hip
    Oh yes, I'm sure I overdone it and I know I have as I have been dead the whole day today. My calves have been painful and the heart beats have been a nuisance and I've been in bed most of the day. As for why I did it, I guess I wanted to see how my body would react so I'd have a slight idea of what might be going on.

    Just wanted to mention that whenever I do light activity or change posture it always shoots up above 120+ but settles down quickly. Even if activities are done in quick succession.



    I'm guessing the 30th minute mark was my body telling me that was my limit for how long my body could handle as the heart rate began sustained 100+ and my symptoms were terrible. I had such an urge to swing my legs back and forth to reduce the pooling haha!

    As to whether I will be diagnosed with POTS, most likely not based on the prerequisites. Perhaps orthostatic intolerance?

    @Sea

    That's interesting to know, especially the part about NMH. I had a read regarding NMH and I did feel like I shared an awful lot of similarities with it. I've noticed that for my heart rate to sustain 100+ or 30+ beats from resting heart rate I usually have to be standing/walking for longer than 30 minutes. Of course with POTS it needs to happen in 10 minutes so I wonder...

    I've been thinking of doing the test again and this time following the suggestions you made and concentrating on the blood pressure but I'm gonna give myself the weekend off haha!

    I'm guessing the only 'poor folks' way to see the cause of the blood pooling (due to dilation or constriction) is to look at the blood pressure figures when I stand for a prolonged period? Guess that'll be my next mission then.

    Gosh I wish it was so easy to just book an appointment, present your case and asked to be referred to dysautonomia. Well I have an appointment on Monday with my GP, so I shall let you know what comes of it.

    @xchocoholic

    Thank you for your reply choc!

    I'm not entirely sure but I believe the diet I currently follow is very similar to the Paleo Diet. I'm on a zero starch diet. I can confirm that since going on this diet my gas production has literally ceased for the most of it, occassionally I get more than usual but far better than what it was with a normal diet. Also my bowel movements are regular.

    I've tried FODMAP diets and Gluten free diets and these didn't help me in anyway unlike the starch free diet.

    During the last christmas period I had a weak moment and gave in to eat the luxury christmas dinner that was available to me. I think it took a month before my symptoms came back under control. I had so much gas production, my bowel movements went bizzare and I looked like I was 6 months pregnant from the abdomen. I think I spent most of my time lying down as that was the only thing that made me feel better.

    Well I've taken it upon myself to do version 2 of the PMTTT. I'll make sure to rest for an hour this time round. I had a 24 ECG several months ago and the lowest resting heart rate I had was 40bpm. If I remember correctly I was 24% of the test duration in Bradycardia and 14% in Tachycardia for the duration I had the equipment on and that was on a day I was at home.

    Oh and not to forget that even with this restrictive diet that I am on I still feel like the food just dwells in me and doesn't move along. I also have a very difficult time maintaining my current weight and finding it almost impossible to lose weight.

    Thanks again to all you nice folk!
    Last edited: Feb 21, 2014
    Sea likes this.
  8. SOC

    SOC Moderator and Senior Member

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    @Karganeth
    My PMTT results were similar to yours, although my HR started higher and reached a higher value. I also had the same leg sensations. I do much better with Florinef and lots of extra electrolyte fluids and a med for tachycardia (which you don't have to the same degree I did).

    My cardiologist was willing to prescribe Florinef based those results, a simple in-office test (which did not meet the criteria for full-blown POTS), and the info in the ME/CFS Primer for Clinical Practioners under Pathophysiology and Treatment of Related Conditions. I showed him the parts that show low blood volume (hypvolemia) is found in ME/CFS, and that Florinef can be used to treat it. He agreed my symptoms were consistent with that and was willing to prescribe.

    However, I'm in the US. The ME/CFS Primer may not carry any weight at all with UK docs, and may even cause more problems by bringing ME/CFS into the conversation given the persistence of the biopsychosocial model of ME/CFS in the UK. Perhaps some UK patients can weigh in on that subject.
    Wayne and ahimsa like this.
  9. xchocoholic

    xchocoholic Senior Member

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    I have to take digestive enzymes to keep food moving thru my digestive tract. I use enzymedica. I take some prior to eating but also need candidase + virastop once a day. And I have to take natural calm magnesium nightly for bms.

    I'm not sure how long it takes others to recover from hypoperfusion. I knew several years ago, 2008 or 2010 ? that I suddenly felt healthy if I laid down for an 45 + minutes. I just didn't know my hr lessened after 45 + minutes and that's part of why I felt better. The last time I checked my hr dropped then it took another 15 minutes for my breathing to become effortless. My lungs stayed tight until after my hr normalized. THE pressure in my head goes away too. : )

    I typically need to stay down an hour tho if I don't want my hr to go back to my pots hr. I didn't know I had pots until I'd had 20+ years of cfs. My docs had only checked me for oh. Oh makes me light headed.

    Oh and I have to sit until my body stops shaking then lay down or else too much blood enters my heart too fast.

    Knowing this has changed how I function. I'm no longer wondering or anxious about what's happening. And I Know being supine will make me feel healthy. Sure a cure would be great but just knowing what's happening helps.

    Tc. X
    Last edited: Feb 21, 2014
  10. Karganeth

    Karganeth

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    @SOC
    @xchocoholic

    Thank you for the replies. Well like I said in a previous post I'd post back in regards to any movement on a referral to an autonomic clinic by my GP or any form of investigation. Well I booked a double appointment so 20 minutes rather than the usual 10 (does anyone even get the allotted time?). So I went in and explained how it all started and how year by year I've been getting more and more symptoms to the ever growing list. I also mentioned how my symptoms became easier to handle the longer I continued to be housebound and that whenever I tried to live a normal life, my symptoms would get much harder to contain. I also told him that I feel like I'm in heaven when lying down and in darn right hell when standing. I said all my back/neck and shoulder pain would disappear as soon as I laid down. He then asked me what I thought might be going on. So I explained how a lot of my symptoms seem to correspond with autonomic dysfunction and suggested I have a problem with damaged nerves that control the involuntary bodily functions or the Autonomic Nervous System itself.

    He instantly began tearing apart the sentence were I mentioned "my symptoms got easier to handle the longer I did nothing and aggravated as soon as I tried to run a routine". His reply was "don't you think that implies a psychological cause?". If I remember correctly my jaw dropped to the floor and felt the veins in my head dilate. So I continued to listen to him babble on about anxiety/stress and how all my symptoms can be quite perfectly explained by them. When I had a chance to speak I told him I had already been through 3 seperate sessions of CBT prescribed by my previous doctors over the course of my problems because I was never offered any other option as they were all convinced everything I suffered with stemmed from the power of my thought.

    He then went onto say that rather than referring you to all sorts of specialists we should instead work on helping you to control these "symptoms" and that pursuing a diagnosis was not important but rather controlling them so I could lead a decent life. Isn't that the whole part of getting a diagnosis? After having enough, I thought I'd present my ace in the hole and presented the pictures of blood pooling in my legs as I've shown here. He took a look at the pictures and wrote some short comment on the computer before looking back at me and yet again mentioning how anxiety/stress can induce the heart to beat faster or irregularly and cause discolouration like that and recommended I don't pay attention to these "symptoms". Suggesting I brought these symptoms upon myself due to an extreme obsession with paying attention to "normal things" that everybody experiences. At this point I was gobsmacked.

    At the end of it he offered to refer me to a psychiatrist. They're so unbelievably dismissive of anything I say. The ridiculous thing is he is the doctor I saw last time when my heart was beating at 150 bpm since I had woken up in the morning so booked an emergency appointment. It took 2 hours to come down to a more respectable rate. My father has a history of autoimmune conditions ranging from, Sjorgens, Lupus, Ankylosing Spondylitis, Raynaud's, Osteoporosis and a range of other phenomena that the doctors can't explain.

    All the doctors at my surgery are all the same. I've already moved from one surgery to another. I'm about to exhaust all the doctors in my area. I have an appointment with my gastroenterologist in a few months time, he is literally my last piece of hope.He is the only one that hasn't taken the easy way out and classed it all as anxiety.

    ~Inhales~
    Last edited: Mar 5, 2014
  11. Valentijn

    Valentijn Activity Level: 3

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    @Karganeth - You need a new GP, immediately.
    Karganeth and ahimsa like this.
  12. Sea

    Sea Senior Member

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    Definitely need a new one. To avoid such an ignorant and stressful encounter again it would be good to see if you can get a recommendation for a doctor in your area who is familiar with autonomic dysfunction.
    Karganeth and Valentijn like this.
  13. Karganeth

    Karganeth

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    Thanks everyone!

    Would it help my case if I went to see the psychiatrist? Perhaps an opinion of my mental state from them would finally drop the case of anxiety/stress that the doctors like to refer to?

    I've also got something else I'd like to ask you knowledgable folk. For a while now when I dress up to get ready to go sort something out in the real world I notice that my jeans feel alright around my waist but after walking outside for perhaps 10 minutes I start to feel my jeans becoming progressively tighter around my waist and inner thighs. This is also accompanied by lower back pain that is only alleviated by lying down. Is this a sign of blood pooling in lower abdomen? I also have noticed that whenever I feel this sensation and return home my abdomen feels uncomfortable and increases in size slightly. I have checked for signs of skin discolouration like in the legs but haven't noticed any change.

    Thank you folk of Phoenix Rising!
    Last edited: Mar 12, 2014
  14. Sushi

    Sushi Moderator and Senior Member Albuquerque

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    It does sound like blood pooling. Have you tried an abdominal binder/tight girdle (don't know which sex you are!)

    Sushi
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  15. MeSci

    MeSci ME/CFS since 1995; activity level 6

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    This is horribly typical, and you have my heartfelt sympathy. I changed GPs multiple times but have long given up talking to any doctor about anything to do with ME. It's a waste of precious time and energy.

    You will find better info here!
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  16. MeSci

    MeSci ME/CFS since 1995; activity level 6

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    I get something like that (or used to) from inactivity rather than activity, but wonder whether my theory about that could be relevant to your own problem. My own theory about my inactivity-induced short-term fattening around the middle is pooling of lymph due to a lack of skeletal muscle contraction. I wonder whether in your case the lymph is being moved along by skeletal muscle contraction but then getting stuck? People with ME do tend to suffer with sluggish lymph flow, and possible blockages. The Perrin technique is a kind of lymphatic massage ('drainage') that some find helpful.
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  17. Karganeth

    Karganeth

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    @Sushi

    No I haven't tried any of the sort you mentioned but I will check them out, thank you! Just wondering what would be causing this? I feel like whatever is going on is progressive. Just like I mentioned in my opening post that I started off with just the severe abdominal bloating and now it's evolved into a list. I really really feel Autonomic Neuropathy sounds like me and even more so now after my latest inconvenience, which I've detailed below.

    @MeSci

    Thank you. This is precisely how I feel these days. I continue to get worse and obviously the answer is to go to the doctors but what is the point when before I even begin to speak my troubles they have already made up their mind about me i.e anxiety/stress. They always want to investigate my symptoms one at a time but I believe these symptoms are a collection for one condition and until they decide to look at them like that, we'll be beating around the bush forever. It's like the doctors just switch off when they here so many bizzare symptoms. Gosh I wish I had just one symptom bothering me, it would be ideal for every sufferer and ideal for every doctor as it would be much easier to handle, unfortunately life just doesn't work like that.

    Well I'm always up for hearing interesting ideas and well you make a sound argument. After all I do a lot of stretching and it gives me very brief but momentary relief especially in my back and then my back begins to stiffen up again in minutes. I'll try the Perrin technique very soon.

    Speaking of my latest inconvenience which I mentioned, I've lost the sensation to have bowel movements. It's been for at least a month now and I've been watching myself closely, but for some reason I have no feeling of needing a bowel movement. What's even stranger is that my stools are still completely normal, they aren't hard to pass, dry and have not changed in shape or size. The only way I know that I need to have a bowel movement is when i can barely breath, have pressure sensations above navel and the abdominal bloating becomes so bad that it starts from right under my chest all the way to the bottom of my abdomen. What's even more ridiculous is that when I do go to have a bowel movement due to feeling the above as soon as I pass stools the visible bloating reduces from under the chest and then only occupies the mid and lower abdomen. Ocassionally I've gone two times in a relatively close time period and the bloating trend continues, the bloating even disappears from the mid abdomen and then is only visible in the lowest part of my abdomen. Problem is if I eat, it starts the same process all over again.

    So just to summarize, I can pass stool if I go and sit in the toilet waiting for it reach the opening and suddenly I can push the stools out. I no longer get the feeling to go toilet and the only way that I am aware I must have a bowel movement are through the symptoms I mentioned above.

    I'm also lately beginning to experience bladder problems. When I must go, I MUST go. Holding it in seems to be much harder in the past month. I feel like I'll explode if I don't. I've also noticed that ocassionally I pass a small stream of urine when getting of the toilet seat even if after just passing urine and feeling completely empty. I've also began having electrical sensations around the bladder area accompanied by discomfort!

    What I'm saying might not make a lot of 'medical sense' so if there are any inconsistencies in the above, ask me and I'll try to clarify or explain in better detail!

    I hope everyone's doing alright!
    Last edited: Mar 20, 2014
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  18. Sea

    Sea Senior Member

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    @Karganeth I am not up to re-reading the whole thread again so forgive me if you have already covered this.

    Do you have any spinal issues? Your bowel and bladder issues sound like there are interuptions to the nerve signals. One of the more common reasons for this is spinal canal stenosis in the lower spine. I have this and when my back is worse so is my bladder.
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  19. Karganeth

    Karganeth

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    @Sea

    Not a problem, I wouldn't expect anybody to read all of it heh. In regards to spinal issues I had an MRI scan 6 months back and I was told I had a small amount of damage in my sacroilliac joint "sacroillitus". Although for years I've had permanent stiffness of the whole back and when walking I get pressure points on the lower, mid and upper back which gives me the sensation my spine's about to crack. I also feel like I have to pinch my bottom muscles to keep my back in good posture (if you know what I mean). That's very interesting what you mentioned. I've been scheduled for another MRI in 6 months, is this something I should get checked out now or nothing too problematic that can be dealt with easily? If they're looking for bone damage in an MRI scan will that mean they'll completely neglect neurological problems? Will I have to have a seperate scan for something like this?
    Last edited: Mar 20, 2014
  20. Sea

    Sea Senior Member

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    @Karganeth mine was noted on CT scan, but I think it can be picked up on MRI as well.

    I have a combination of almost no discs left between the lowest 3 vertabrae, osteophytes (bone spurs) which protude into the spinal canal and a thickening of the ligament that runs through the spinal canal. All of that could be seen on the CT scan. I think MRI does a better job of showing the nerves and whether there is any entrapment.

    If you lose function completely of bladder or bowel that is a medical emergency (cauda equina syndrome) but otherwise a non urgent appointment with a doctor would be worthwhile if you think there is a possibility that this could be contributing to your symptoms.
    Karganeth likes this.

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