January 18, 2013

POTS and Vanderbilt: QSART and Glucose Test (Fasting)

A little over a month ago I finally had my appointment with Dr. Cherdak, a neurologist, at Vanderbilt.
My cardiologist and various primary care doctors are 98% sure that my POTS is caused by the 'trauma' of having my appendix removed in college and the resulting issues (read here).  To rule some of the other possible causes, I was referred to a neurologist in Clarksville who googled POTS while in the room with me, who thankfully referred me to Vandy.  While at Vandy in December, she ordered two tests and some blood work.

Prior to my first appointment, I had the Autonomic Function Testing done which showed signs of POTS.

Last week I went to Vanderbilt for my QSART test.

QSART stands for Quantitative Sudometer Axon Reflex Test.

The QSART test is a form of a sweat test.
The Vanderbilt Autonomic Dysfunction Center explains it here.

I was pretty nervous going into it because I read a lot about it online.  I know, I know, this is a terrible idea.  But I wanted to know what to expect it to feel like.  The brochure they gave me at Vanderbilt suggested a tingling feeling.  Since those brochures always downplay ow it actual feels, I wanted to see what actual patients had to say.  Some had no pain at all, and others said it felt like when they had gotten their tattoos done.  Needless to say I was more than a little nervous.

Grant and I made the trek to Vanderbilt and I was really nervous.  The actual prep for the test was easy.  No lotion or body oil the morning off, and they have guidelines for what medicines you can have.  Basically nothing that acts as a stimulant (caffeine is included in this list of no-nos).  Since I just take a beta blocker, my pill stayed the same!  I wore yoga pants and a tank top so when I arrived I didn't even have to change into a gown.

Basically they have you lie on a bed and attach four things to you (one to my left arm, and three to spots on my left leg).  They look like suction cups.  They also attach sensors.  The solution is circulated through the suction cup things for ten minutes while an electrical current is also run through it.  Cue the pain I was worried about.  The technician told me it would feel like a bunch of red ants in those spots.  I would say it felt like a combo of red ants and what I imagine getting a tattoo to feel like.  Unpleasant, but not unbearable.  And it only lasted ten minutes, so no big deal at all.

I did have some red rings left by the solution and current combination, and big red patches from the adhesive on the sensors.  But other than that I was totally fine.

The next day I went to our local hospital for my Glucose Test.  The neurologist wanted to look at the way my body processes sugar.  I had way more anxiety about this test than I did about the QSART.  I had to fast for this test which meant no breakfast which meant no beta blocker until afterwards.  And I didn't know how much stuff I was going to have to drink...

Yesterday I met with the neurologist to go over the results.  Both came back totally normal--along with all of my blood work! Great news! So what that means is that it is still likely that my POTS is caused by the 'trauma' of having my appendix out and everything that ensued with that ordeal.  The only other potential cause left to rule out is a Mast Cell Activation Disorder.  I will wait to rule that out until we are back in California and working with my allergist.

On a side note...I felt incredibly sick yesterday when I was at my appointment.  The nurses were really nice and got me into a room right away so I could lie down.  They let Dr. Cherdak know and the nurses kept checking on me.  Dr. Cherdak checked me out and asked if I needed anything else before I left.  They didn't rush me out at all and told me I could stay lying down as long as I need to until I felt comfortable leaving!

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