Medical Tests

I've decided I'd like to document my medical tests. I've had several... some for POTS, some not for POTS. For the purpose of this, I'll only talk about the POTS related tests.

Blood Work
Blood work upon blood work upon blood work. The first time I had blood work (that I remember) I was 15. Three or so vials of blood were taken. I became so pale, clammy, nauseous, and light headed that I was nearly admitted to the emergency room. Since then I haven't had NEAR that reaction. I've had blood taken from me more times than I can count

Hypoglycemia Test
I had this test when I was 17 to determine whether or not I had developed hypoglycemia. You fast the morning of the test and they take some blood when you first get there. Then you drink the most disgustingly sweet thing you can imagine and wait. As I recall during this test I had no symptoms of hypoglycemia, but the test came back positive for it anyhow. Hypoglycemia is when your body produces too much insulin. If you eat a lot of sugar too much insulin is released, thus plummeting your sugar levels, making you cranky and headachy and foggy.

Autonomic Function Test- Take 1
I had this test the first time around when I was 15. I don't remember very much except for the fact that it made me feel like crap and become quite nauseous. In this incarnation of the test I was strapped to a table lying down for 10 minutes and then tilted up for 10 minutes at about a 70 degree angle.

Holter Heart Monitor
This test involved me being hooked up to a portable EKG machine for 24 hours. I had this test in September of this year. It was actually quite easy to conceal: the wires were all under my shirt and the machine was the size of a pager. I had to write down in a little diary when I'd have symptoms and what they were. I also had to make note of when/if I was exercising, drinking caffeine or alcohol, or engaging in sexual activity. Seriously, who does that? I was able to go to class and do what I normally do, except I didn't go to the pep rally that night with the marching band (which I'm an active member of) because remembering pep rallies of years past I knew it was going to be close quarters in the dark. We do horn swings in the band and I didn't want some freshman who hadn't gotten the swing of things yet (yeah, pun intended) to ruin a very expensive machine. My band director was quite understanding. After 24 hours of having the monitor on, I went into the bathroom during a class break and yanked the electrodes off. This left visible marks that didn't go away for a week that I referred to as my alien hickeys. The test showed that at one point my heart was beating so fast that they thought I was exercising, but I wasn't. I was sitting at my desk at my nonphysically tasking office job.

Autonomic Function Test- Take 2
This test was the most recent (December 6) and by far the most interesting. I had to withdraw from my antidepressant (which SUCKED) and my steroid (not much fun either) and abandon my trusty compression tights for that day. Oh, did I mention this was the week before finals? Instead of being just the tilt table that I had when I was 15, it had three more components.

Sweaty
This part was a sweat collection test. How do they make someone sweat who is strapped to a table? By putting 4 receptors and electrodes on select places on your body (forearm, upper calf, lower calf, foot), injecting them with acetylcholine (a neurotransmitter that stimulates, among other things, sweat) and adding an electric current. The result? A mild burning no more uncomfortable that the "oh my god these pants are chafing me" pain. During this test I looked like I was in Frankenstein's Laboratory.

Yoga Breathing
This test involved looking at ascending and descending lights and breathing in as the lights went up and out as the lights went down. Not too bad.

Pressure Breathing
This part involved breathing into a device that kind of mimicked the sensation of attempting to blow up a skinny balloon with your mouth. During this test my face got really red and my heart rate shot WAY up.

Tilt-Table
For this part the doctor in charge of the lab I was in was brought in the room (until now I was dealing with a tech, who was pretty cool). I liked this doc, he really seemed to know what he was doing, which I haven't found a lot of. He also had an appropriate sense of humor, which I really enjoyed. They let me lay there for a few minutes to get a baseline heart and blood pressure reading. I was hooked to electrodes on my back as well as a cuff on my arm which took a reading every 5 minutes, as well as a small cuff on my wrist which did automatic readings and periodically needed to be adjusted. Once the baseline reading had been gathered (HR- 80 bpm, BP- 122/80) I was tilted. I immediately became lightheaded, hot, and slightly nauseous. It was not fun. In order to procure a POTS diagnosis your HR has to go up 30 bpm during the tilt, which lasts for 10 minutes. My heart would jump around from 90 one second to 105 the next. At times it would hit the mandatory 110. At this point the doc called it "Borderline POTS." My incarnation of POTS is not NEAR as serious as some other cases (i.e., I can still go to school, work, and even stand up. Some POTS patients are confined to wheelchairs), so this didn't surprise me. However, with a minute left in the test my HR shot up to 120 and 125. At this point the doc and tech began yelling "Alright, sell!" which I thought was pretty funny. Once I was taken down the doc confirmed the POTS and stated it was mild. However, mild POTS is like a mild hurricane: it could be worse, but it's still going to do some damage.

I go back to the general internal medicine guy I've been seeing in January. The lab doc suggested a low dose beta blocker. What I've read about them seems a bit daunting, but everything you read on the internet about drug therapies is scary. If I do start a beta blocker, I will probably withdraw from my Paxil just to stay on the safe side (I've read about some interactions with antidepressants). I guess we'll find out on January 11.