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Tilt Table Test Tomorrow

picante

Senior Member
Messages
829
Location
Helena, MT USA
My first visit to a neurologist resulted in a referral for a tilt table test. It's tomorrow.

I just want to avoid any permanent problems that could occur. From what little I've read here on PR, it's when they give a medication during the test that you could be in danger of serious after-effects. Would that be right?

The instructions say not to eat anything after 11:00 am, and the test is at 3:00. Unfortunately, I am going to have to ignore that, since I've got chronic ravenous hunger (hypoglycemia or autonomic problems with appetite hormones). I seriously doubt that I would vomit if my last food was 2 hours before. I never can eat much at a time, anyway.

Please tell me if you can think of an objection to my plan. I am having to travel 2 hours for this. That will be enough of a struggle, without the hypoglycemia, etc.
 

Seven7

Seven
Messages
3,444
Location
USA
I would follow instructions to a t. Is better if you crash faster so you show reality. Just make sure what you eat before the 2h is very high on fat to sustain you better. This will determain any disability you will ever need, so the more real the best.
 

Sushi

Moderation Resource Albuquerque
Messages
19,935
Location
Albuquerque
I just want to avoid any permanent problems that could occur. From what little I've read here on PR, it's when they give a medication during the test that you could be in danger of serious after-effects. Would that be right?
First congratulations on getting the test scheduled! I was not given medication during the test and the problems I had were from getting a pulse pressure of 8 -- I asked to stop the test then. I was glad to have brought a rejuvenation supply of food, drink and meds. Still I had to take about an hour to recuperate before leaving the hospital. So I'd recommend bringing with you anything that would help revive and stabilize your afterwards.
The instructions say not to eat anything after 11:00 am, and the test is at 3:00. Unfortunately, I am going to have to ignore that, since I've got chronic ravenous hunger (hypoglycemia or autonomic problems with appetite hormones). I seriously doubt that I would vomit if my last food was 2 hours before.
They are worried about you vomiting and aspirating.
Please tell me if you can think of an objection to my plan. I am having to travel 2 hours for this. That will be enough of a struggle, without the hypoglycemia, etc.
Yes, the whole thing is a difficult venture. Wishing you the best and make sure you get the full doctor's report.
 

picante

Senior Member
Messages
829
Location
Helena, MT USA
and make sure you get the full doctor's report.
Thanks for reminding me!
Is better if you crash faster so you show reality.
LOL, well I could go off my antiviral and my hydrocortisone to achieve that, but then I might not make it to Missoula for the test.
I was not given medication during the test
I thought if they want to inject anything, I would just suggest sending me up & down a flight of stairs carrying 15 pounds. That will get the adrenaline surging, if it isn't already, just from talking to nurses & the doctor.

To be honest, I don't think blood pressure is my biggest cardiovascular problem or autonomic problem. Air hunger is. That's what is disabling me. And I don't have a high pulse. I feel rotten when it goes from 60s into the 70s, though.

The neurologist ordered this to check for orthostatic hypotension. My blood pressure has had a pattern of plunging to 80s/50s for a couple of years, but it's not until after I've been up for a while (45 min., an hour, or even in the afternoon). I think I have orthostatic intolerance due to air hunger. My blood pressure isn't usually low when I have to lie down due to air hunger.
 

picante

Senior Member
Messages
829
Location
Helena, MT USA
the problems I had were from getting a pulse pressure of 8 -- I asked to stop the test then.
I take it you must have made that request before the test? I can't imagine having a pulse pressure of 8. Mine usually hovers around 30. 97/65 is a really common BP for me.
 

Sushi

Moderation Resource Albuquerque
Messages
19,935
Location
Albuquerque
I take it you must have made that request before the test?
The doctor's clear instruction to me was to stop the test at any time I felt that I needed to. He also said, "I don't want you to faint--there is no need for that. We can get plenty of data without you fainting."
I can't imagine having a pulse pressure of 8. Mine usually hovers around 30. 97/65 is a really common BP for me.
Yes, it is really unusual and I definitely felt awful enough to stop the test!
 

Judee

Psalm 46:1-3
Messages
4,461
Location
Great Lakes
Please let us know how it goes.

I still haven't had this test yet. My new PCP wants to send me to a cardiologist but said she cannot guarantee he will do one. Lately, my bp averages about 91/55. It used to be consistently 86/58 before I dropped some supplements my environmental doctor had me on.
Standing is difficult. I get very antsy but no dizziness and only fainted once years ago after getting up too fast.
 

ScottTriGuy

Stop the harm. Start the research and treatment.
Messages
1,402
Location
Toronto, Canada
... make sure you get the full doctor's report.

And copies of the actual test data.

When I went, neither the TTT doctor nor the 2 nurses had heard of NMH. They had to google it on their phones.

That's when I knew I had to get the actual data so I could give it to a competent physician familiar with ME and ANS dysfunction (still on my to-do list coz I doubt they will tell me something I haven't already learned on the ME forums).
 

Seven7

Seven
Messages
3,444
Location
USA
OL, well I could go off my antiviral and my hydrocortisone to achieve that, but then I might not make it to Missoula fo
You are aupapoed to be off like 2 weeks before?! The hydrocortisone ( florinef?) did they tell you to take it?!!!
 

picante

Senior Member
Messages
829
Location
Helena, MT USA
Hmmm. Supposed to be off what? The antiviral? Says who? I took a morning dose of Valtrex at 4:45, and a dose of Cortef at 9:00, and then nothing until 6:00 (just after the test).

You know, I faxed them the week before with my medication list and asked if there was anything I should not take before the test. I never got a reply. Not by phone, not by e-mail, not by fax, nor by land or sea. Sheesh.

My test was the day you posted, @lnester7, and I've been recovering, mostly from the trip and the food deprivation, rather than the test itself.

The weirdest part was that I really didn't get much info from the institute beforehand. I had no idea this was an inpatient procedure. I thought I would be in a waiting room or nurse's room until they were ready for me. I didn't need all the extra rigamarole myself, but my neighbor did. We could hear her conversations with the nurse & doctor. She was diagnosed with POTS.
 
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picante

Senior Member
Messages
829
Location
Helena, MT USA
I don't have the data yet; they told me to call the records department.

The tilt test confirmed that my blood pressure goes down and my pulse goes up when I stand. All they did was keep me horizontal for 10 minutes and then vertical for 20. I don't have the data yet, but the operator told me my pulse went up by over 20 bpm, which is a threshold they use to decide whether to inject isoproterenol.

I interrogated the nurse about this med. I told her I was fine with them injecting saline solution, but very dubious about anything related to epinephrine. It's on the list of medications I've reacted to. I told her that I was already running on adrenaline, just by getting myself to Missoula and talking to medical staff and fasting.

When the tech told me they "didn't have to inject any medication" because of my pulse going up enough, I thought "damn right you didn't".

I had to wait an extra two hours beyond my scheduled time, so I got ravenously hungry. I asked for a blood sugar reading, which was 85. To me, that meant that adrenaline was kicking in to keep my blood sugar up, since I don't have enough cortisol. I felt worse and worse -- weaker, brain getting fuzzier, more ravenous, and super crabby. It takes me a while to recover from those episodes, and the PENE from the trip would be a double whammy.

My nurse was excellent, but didn't want me to eat or drink, so I did it behind her back. I was all hooked up to cardio leads while waiting, so I asked my DH to hand me a date. He said, "you can do that?". I said, "I can do whatever I want". "True", he said. I took tiny bits of date and sucked on them, then discarded the skin. The rest dissolved in my mouth. The date sugar went into my system immediately through my mucous membranes. Pretty slick, hey? Nothing in my stomach.

It was after 5:00 when they finally got me in to do the tilt table. I told the guy that I was running on adrenaline, and asked, "Doesn't that affect the results?" He said "not really", but didn't bother to tell me anything else.