Ttt: At What Bp Did You Pass Out?

[Libby]

I tried to find an approximate BP at which a person will pass out, but nothing I saw would commit to actual numbers. They just kept throwing around phrases like "but when it gets too low". I know it's different for everyone, and there are other factors in play (cerebral flow, how quickly your bp drops, etc). But I'm curious: what's your individual threshold?

[CharmedLinz]

Well I don't want to speak for everyone because it's not all of us, but there are quite a few people here who simply don't pass out.

My BP dropped to 40/17 and I was crying and going black and felt like I was seriously going to vomit (good think I had fasted for 14 hours), and was trying really hard not to let anything out the other end either (TMI but when I get close to passing out I always feel the need to pee).

I have a really close friend on this forum who has been on what seems like a million tilt tables and has never passed out and she's had Doctors tell her they are trying to get her to pass out. I know her BP had dropped to where they could NOT get a reading. I'm sure she will post.

I think some of us.... our bodies are so used to compensating that it can adjust and we don't actually go black.

The nurse that did mine was in Cardiac Care for 30 years and said she had never had anyone drop that low and not pass out, and I was in the CCU for 3 hours while they stabilized me.

My body does the same with getting blood drawn. I know I have really low blood volume and I pool really bad, but when I get my blood drawn even fasting I'm rock steady. The techs that draw me can never believe that I can get 20 tubes drawn and not even be woozy.

I bleed really slow, and they release the turniquet to keep the blood from hemolizing too quickly and it takes forever to get those 20 tubes because of low BP, and I'm extra tired the next couple days, but I don't get woozy at all.

The most I've ever had drawn was for a 3 hour glucose test with other stuff added with checks every 30 minutes. Other than the glucose solution I had nothing and over that 3 hour period I had a total of 47 tubes drawn and was just fine.

All that being said, I am rapidly going downhill for some unknown reason and in the last 3 weeks have found myself unconscious in the shower twice, thankfully I was sitting on my stool so no harm done except cold water.

And today I went for a stroll in my backyard to see my flowers, with my Mom luckily, because it was 80 here today and all the sudden I was slumping down slowly to the ground. Didn't go completely out but that have NEVER happened before to the point where I went down.

I have NO idea what would happen on a Tilt now, but they'd have to pay me good money to get on one again. Honestly I'd rather have a spinal tap than that horrible feeling on a tilt that you can't get away from.

[puppylove]

I don't pass our either. I guess I have hyperPOTS because on my TTT my bp was in the 150s- 160s.

[Lemons2lemonade]

Mine was 60 /25 and I was still conscious, but only got that low when they administered the exercise simulating medication. I also started dry heaving. I start feeling bad though around the mid 80's over mid forties mark.

[Chaos]

Have never passed out on multiple TTTs. Had one where they had 2 cuffs going trying to find my BP ( 1 manual, 1 electronic) and they couldn't find it for a couple minutes. I felt terrible and went into tetany when they brought me down, but was still talking and alert. The nurse was saying over and over "I can NOT believe how much your body will compensate". On subsequent TTTs I've had documented BPs in the 36/24 range and not passed out. At first the cardiologist said it had to be machine error but when she repeated the test again it did the same thing. Then her response was "you REALLY should be passing out with these numbers. You're an enigma as to why you aren't."

Reading thru these posts it's becoming pretty clear why books don't commit to definite numbers. I think it depends largely on what your body has compensated for in the past. As my POTS neuro says, if you've had this for a long time, your body has probably learned how to compensate for BPs that a normal person would be out cold with.

I've not ever had any of the meds that they sometimes give on TTTs to get a reaction. Guess I got enough of a reaction without them. LOL

[LindaJoy]

Mine dropped to 26/14, and I was still coherent. I felt like death warmed over, wanted to vomit, was crying over and over "I don't feel good, I don't feel good," and thought I would die, but I didn't pass out.

This was with my very first tilt, in 2005. This is the one that got me diagnosed with POTS, but with every other orthostatic test nowadays, my bp goes up, not down.

I just had a doctor, two days ago, say, "Your Dysautonomia has changed over the years, hasn't it?" I said, "Yes!" I was glad to see somebody finally noticed. So many doctors still expect me to have low bp with POTS every time, etc., all the textbook stuff, and mine goes up most of the time, now, but I still get the tach with a higher bp.

Everyone is different when it comes to what finally causes them to pass out. I think, too, it may not matter so much the numbers on the bp machine as it does the body's ability or inabilty to tolerate the fluctuations; ie, how quickly the numbers fluctuate, or simply that they do.

Linda

[LindaJoy]

P.S. My 26/24 bp on that first tilt table has made me pretty scared of this "simple" test. I think I would rather have paps than tilt tests. I've heard that, if your bp goes too low on this, you could possibly not recover, that, for those of us with autonomic dysfunction, this test could be very dangerous. Is that true? Hence, I try to avoid them.

Linda

[shoegal]

I'm scared of this test now, I can be 64/40 already at home, what if they get you too low and you can't get it up? what is the need for the test

[Chaos]

Shoegal- on all the TTTs I've had they always had an IV in so they could give fluids, meds etc in case there were to be a severe problem from the test. It was a "just in case" thing. Also you are in a facility with trained medical people who know what to do. Better to find out this happens in that situation than having it happen at home by yourself.

I guess we do most of these tests to prove to the doctors what we already know happens to us. But they need to have objective proof to justify treatment etc for insurance companies, etc

[pat57]

hi ,I have NCS so it may play out different.

My bp was always 0/p, 0 over palpable.

To low for the machine.

[LindaJoy]

Hey, Chaos, where are you getting your TTTs that they take such careful care of you? I've never been put on an IV, ready for fluids and other things should I get into a bad situation. That would really help to make me more comfortable in having to have this test again if I thought that medical personnel were actually "at the ready."

Linda

[Chaos]

LindaJoy- Mine were done by cardiologists with the 45 minute test, one done locally and 2 at Cleveland Clinic.

[Alaska]

Mine was done at the hospital. I passed out at something like 50/30 and passed out under 10 minutes which they thought was very fast. Felt great waking up, but later realized that was probably the iv helping. This test was the first time and only time I have passed out and let me and all the doctors know what was really going on. I heard from one doc that some don't need you to go all the way to passing out to diagnose you. Wish I had that doc as I was basically begging them to stop for Five minutes.

[blinkofani]

I have never passed out on a day-to-day basis but I did pass out during my tilt test. I completely lost my BP (it was undetectable) after just a few minutes so they immediately lowered me back down and already had the IV in ready for fluids.

[blinkofani]

I actually have high BP and am on atenolol to control it along with the tachycardia although my BP will be low sometimes when laying down or after standing for a little while

[LindaJoy]

Hmm....mine was done at Cleveland Clinic without IV. Probably would have felt a lot better during the recovery period had I been able to get IV fluids. Thus, I felt like absolute crap for quite awhile afterwards and am totally terrified of this test now. I know another TTT is in my immediate future, as my new doctor is setting me up with an autonomic specialist to see where my autonomic disorder is at. Hopefully, this doctor will take care with some IV fluids at the ready.

Linda

[Libby]

Thanks for the replies, everyone. I didn't pass out in mine either, at 70/22, so it got me wondering.

Regarding the TTT with saline - I had an IV the entire time, like Chaos. Mine was done at a cardiology group's office, and was intended to be an hour long. I just assumed they gave saline to everyone...hm. Interesting.

[Birdlady]

One thing that drives me a little crazy is that there is no gold standard for TTT. What one person gets done at their local hospital is entirely different compared to what someone gets done at CC or Vanderbilt. I really don't understand it. It's impossible to compare with one another unless we've all been to the same place.

For my first TTT, I was hooked up to a saline IV and my Bp went up. Never fainted even when given Nitro. I was also on HC, florinef and DDAVP...lol

For my second TTT, I wasn't on saline and my BP dipped to ~85/90 but it was temporary and I never fainted. I ws on HC, florinef but no DDAVP.

Of the two TTT I had done, I have to give CC a lot of credit. Their testing methology was like a well-oiled machine. Everyone knew what needed to be done and did their role. My first TTT, it was a disaster.... lol They started it early without everyone in place. They were asking me all sorts of questions during it too. CC strictly told me not to talk and to remain calm or it would affect the results...

[Alaska]

I've only done the one and the person was asking me questions the entire time. In real life situations it seems I get more pre-fainting episodes when I have to process mentally, like conversations.