Help Decipher Please.

[jbenz1772]

Hi all,

I was diagnosed with POTS and started on Midodrine/gatorade/salt almost 6 weeks ago. Had my first official neuro appt post diagnosis today.She asked if I had any questions about the diagnosis since they just told me over the phone I had POTS and prescribed the Midodrine. She also talked briefly about the small fiber neuropathy and complicated migraines. I'm starting on a low dose of propanolol and after a few days without complications adding on Lexapro. She gave me the reports from my autonomic testing. Wondering if anyone out there can give me the normal verbage and help decipher what it's telling me.

Interpretation:

Findings were suggestive of mild-to-moderate sudomotor adrenergic dysfunction characterized by reduced sweating on TST and reduced q-sart response at one of four sites. Estimated anhidrosis:40%. There is near complete anhidrosis of both lower extremities from the inguinal regions down with relative hypohidrosis in the proximal arms and forearms, but preserved sweating over the chest and abdomen (light pattern.)Preserved q-sart responses in the lower extremities with diminished TST responce in the lower extremities would suggest preganglionic adrenergic dysfunction.

Note that cardiovascular reflex testing was robustly normal. The tilt test was remarkable for POTS, Characterized by and increase in heart rate of 47 bpm over the course of the head up tilt. POTS has been described as neurogenic and non-neurogenic in nature, the latter representing volume depletion and the fromer representing a limited small fiber autonomic neuropathy, which is predominantly sympathei in nature and limited to lower extremities. That appears to be the case with this patient. Clinical correlation is required.

So technical jargon aside. POTS with Small Fiber Neuropathy. Neuro would like me to take a small leave of absence from work to find the right combo of meds. LOVE my job, better at my job than being a mom or wife. Think it will stress me too much to be home.

Thanks for all your knowledge and support.

Jennifer

[sue1234]

Sorry, I can't decipher, but just curious what your blood pressure did during your TTT??

[jbenz1772]

Sue,

systolic blood pressure supine 20" 1min 3min 5min 10min 15min

124 113 116 122 120 118 122

Heart rate 59 91 86 88 90 92 106

They don't mention diastolic

Jennifer

[Noreen]

I totally understand about your wanting to continue to work. However, if there is any way to cut your hours say down to 80% for a few weeks while you try the meds the MD is suggesting it would give you a bit of time and energy to focus strictly on your health.

wishing you the best,

noreen

[lieze]

Do you feel okay at work?

I worked for the first 10 months full time with just a few weeks off in there for my cardiac ablation.

Maybe just see how you feel?

I almost did better staying active...I want to get back to that.

Maybe it depends on what type of work you do.

[jbenz1772]

As far as work, I do interventional radiology. Long story short, I wear lead most of the day, scrubbing in for surgical type cases that use live xray or u/s. Can be long days, but I absolutely love what I do and would be more stressed staying at home.