October 4, 2012

Day 4: What is a Tilt Table Test?

The two key things needed to diagnose Postural Orthostatic Tachycardia Syndrome are a medical history evaluation and a tilt table test.  The medical history evaluation is exhausting and basically means that they rule out lots of other things and you are constantly sharing your story and symptoms with doctors.  However, the tilt table test was traumatic and hard on my body.

Although each tilt table test is a little different, here I will share my experience.  Essentially the goal is to recreate the symptoms and/or situation that has been causing problems in a safe environment that can be documented for medical purposes.

Grant and I arrived at the hospital and after having a few other tests to check the health of my heart (totally healthy!), we were brought into a room with a medical bed in it and a television on the wall.  I changed into a medical gown but was allowed to leave my sweatpants and uggs on.  They require a gown so they can attach lots of monitors to you and have quick access to your veins if they need to give you medicine quickly.  I was then strapped into the bed so that when the bed was eventually raised, I would not be harmed if I passed out.

After needing about five people to find a vein on me (I have VERY tiny veins!), they kicked Grant out of the room to go read his book in the cafeteria.  We had hoped he would be able to stay in the room since it was such a long test, but the man administering the test said that because the test can be very traumatic and the way it is set up, loved ones are not allowed to stay in the room.  So we said goodbye and the test got started!

This was the set up of the test:
15 minutes lying completely flat.  Heart rate and blood pressure were taken every 3 minutes.
After 15 minutes, the bed was raised to a 80 degree angle.  Heart rate and blood pressure were taken every minute.  This set up lasts for 30 minutes.  The test is scheduled to take a total of 45 minutes.





For most of the test, I was bored.  But with the TV in the room, I was able to watch HGTV and the administrator and nurse in the room were so nice.  They kept me distracted and chatted with me the whole time.  My heart rate and blood pressure were doing exactly what I told the doctor they would do (started to rise after 15 minutes). However, in the last minute and a half I had a POTS episode. I started flushing, getting dizzy and nauseous, and felt like I really needed to lie down. But since you can't lie down, I actually passed out.  My heart rate dropped from 148 to 54. I actually had two non-responsive beats. They are not allowed to lie you down until you have non-responsive beats that they are able to document the drop.  It was a fairly traumatic experience. My body was desperately asking me to lie it down but because of the test you can't. The nurse and technician were wonderful, as well as the people monitoring my IV. They took excellent care of me and brought Grant back into the room as quickly as they could.

Ultimately, the results of this tilt table test provided my doctor with the final piece of the puzzle to diagnose me with Postural Orthostatic Tachycardia Syndrome.

On December 8, 2011 I wrote, “This morning I had to have an echo (ultrasound of my heart) and a tilt table test. The echo was a piece of cake, no big deal, and Grant was there the whole time. The tilt table test was an entirely different story. If you want to see what one looks like, look it up on youtube.com. That's what I did last night. Unfortunately, Grant wasn't allowed to stay for this test. Basically, they move your body to different positions while monitoring your heart rate the whole time. For the first 15 minutes you lie entirely flat and they monitor your blood pressure every 3 minutes. That was no big deal. They even had a tv in the room that I could watch. Then they raise the table you are strapped to so you are at an 80 degree angle and they monitor your blood pressure every minute. Everything was going fine. My heart rate and blood pressure were doing exactly what I told the doctor they would do. But of course I jinxed myself...in the last minute and a half I had a POTS episode. I started flushing, getting dizzy and nauseous, and felt like I really needed to lie down. But since you can't lie down, I actually passed out. My heart rate dropped from 148 to 54. I actually had two non-responsive beats. It was a fairly traumatic experience. My body was desperately asking me to lie it down but because of the test you can't. The nurse and technician were wonderful, as well as the people monitoring my IV. They took excellent care of me and brought Grant back into the room as quickly as they could.

I'm under strict orders to rest for the remainder of the day, so Grant set me up on the sofa before he went to work so I can spend the day watching trashy tv until he comes home!”

On December 9, 2011 I wrote, “That's exactly what it feels like (The title of that blog post was ‘Beaten with a Baseball Bat’) happened to my face. The recovery from this tilt table test is taking longer than I thought it would. I know I only had the test yesterday morning, but I was really under the impression that at the latesttttttt I would feel fine 24 hours later. Well we are now 30 hours into recovery and I still feel like I have been run over by a truck and that someone smashed in my face with a baseball bat. It's hard to really explain what it feels like unless you've experienced these symptoms. And the good news is that the tilt table test was able to reproduce the episodes I've been experiencing, but the unfortunate part was in order for that to happen, I had to endure another episode and am now dealing with the recovery process.”

If you think you have POTS or another form of dysautonomia, ask your medical provider if a tilt table test might provide more insight on your situation.

Disclaimer: While I am sharing information I have researched, read about, and found to be helpful myself, I am not a doctor and all decisions regarding your own personal treatment should be discussed with your own doctors.  Remember, I am just a patient.

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