Questions to ask at my next appt

[peresphone24]

Hi! I've been trying to compile a list of questions for my next cardio appointment.  I had what they said is a normal Echo, I've had an abnormal ECG- not sure what it was, multiple SVTs up to 203 (folding laundry), my blood pressure is low and can be as low as 79/68 on the midodrine (although they added cardizem last week which is weirdly has raised my bp to more normal ranges during the day),  tilt table was inconclusive- caused A LOT of leg pain and my blood pressure dropped with the changes, no tachycardia happened.  They didn't do any of the other things during the TTT that they've mentioned here in the forum like blood work.  It was just the blood pressure and ECG being checked.   I've done an EP study which was also inconclusive because my heart did absolutely none of the issues then.  I drink Gatorade and salt added to food.  I am well hydrated.  I wear compression stockings- no idea if they are the right kind. An outside naturopathic doctor did blood work and neuro-testing and I'm low on testosterone, serotonin, GABA, and cortisol.  I'm not anemic and blood sugar seems to be ok.  The cardio didn't care about the copy of the lab work.  They tried me on metoprolol but it caused urinary retention and with my urinary history that is not ok.  My heart rate is very affected by positional changes when I am symptomatic.  I get dizzy, light-headed, and short of breath even when not tachycardic.

So far I have questions like "what's an ok heart rate range for me", "what compression and style do my stockings need to be", "do I even have a diagnosis yet", and "is there other testing that we should do?"

I feel like I know absolutely nothing of what's going on and what they think.  My naturopathic doctor has a good handle so far (she's been right with each suspicion) and I feel much more confident with her.  She wants me to advocate for myself with them and find out more of what's going on.  I feel overwhelmed with the idea of trying to figure what I need to know from them.  Any guidance on what to ask them or ask for would be much appreciated.  

[Pistol]

@peresphone24 - based on your post these are the questions I would ask: 

 - What is the abnormality found in my EKG?

- What is my diagnosis? 

- What do you recommend I do/ take to lessen my symptoms?

Since most of your testing was negative or inconclusive there probably is not much he can do, you will have to just find out about the EKG abnormality nd address the low BP. 

[Guest KiminOrlando]

What are your standing norepinephrine levels (bloodwork)?

They may not have run this test. If not, ask why. It will tell you what they are focusing on. 

This is some of the bloodwork they do on the TTT. You can also do it by simply standing without moving for 10 minutes. If you pass out, it invalidates the results. 

If your norepinephrine is low, ask if there is something that they can do to increase it.

[peresphone24]

@Pistol  Thank you for your help! I recognize that the cardio's hands are tied when results are inconclusive.  It's just so frustrating with the waiting and no idea what's going on.   I appreciate the help with developing questions to ask!

 

@KiminOrlando Thank you for your help! They've not said anything about norepinephrine so I'll ask if they think it is relevant for me!