When to seek emergency help

[Morgana]

Hello everyone! So I'll keep this short and sweet. I'm in the midst of possibly being diagnosed with some form of dysautonomia, but this whole virus thing has halted that. I did a stress test, nothing showed, but waiting on a holter test and tilt test still. 

 

The question is, when do I seek medical attention for these weird attacks/spells I'm having? Attaching levels from my recorded blood pressure monitoring. It's the absolute worst, and I feel like crap all the time when it happens. 

May 12
sitting upright for min 10
Sys 113, Dia 59, Pul 63

Stood up
Sys 109,dia 70,pul 76

Doing laundry
Sys 125, dia 87, pul 149

Bedtime
Sys 116,dia 72, pul 77

May 13
Just woke up, laying down
Sys 106, dia 76, put 75

Standing, fasting
Sys 124, did 86, pul 94

Standing, 10 mind after antioxidant drink to break fast
Sys 106, dia 56, pul 54

May 15
Got suddenly cold, standing at work
Sys 122, dia 86, pul 94

Dizzy/ pressure feeling in head
Sys 123, dia 87, pul 95

May 16
Feeling off
Sys 135, dia 102, pul 77

May 17
Feet/ lower legs got hot
Sys 123, dia 72, pul 98

May 18
Dizzy spell
Sys 113, dia 72, pul 100

Bent over, couldn't catch breath, dizzy
Sys 115, dia 87, pul 134

[Pistol]

Dear @Morgana - first of all I want to stress that I am simply going to give you my opinion, I do not want you to think I am advising you to not seek treatment. It is always best to see a physician when unclear. However - during this pandemic it is not as easy to just go to the ER, so here are my thoughts and observations: 

I do not see any real serious or drastic changes in your BP or HR, except that on May 16th your BP was in the systolic hypertensive range ( 135/102 ). When my BP goes there I am already well into a POTS episode. The readings you list when you were symptomatic are also not that surprising for someone with dysautonomia. I also would like to stress that when we experience dizziness or shortness of breath or any other symptoms they often are caused by a SUDDEN CHANGE in BP or HR and by the time we take our BP and HR this change may already have occurred. --- Also - remember that everyone experiences fluctuations of HR and BP during the day, often from minute to minute or more often, this is all normal due to our activity levels and the ANS compensating. In dysautonomia we experience dramatic changes in Vital signs when standing and they do not improve unless lying down or resting. So it is important you check your HR and BP after lying down for several minutes, sitting up for 1 minute and then after standing for 1 minute and then again after 5 minutes. If there is an increase of at least 30 BPM ( or above 120 BPM ) in HR WITHOUT a significant drop in BP it might be dysautonomia. So - if your HR is 134 that can be totally normal, it is important to see what you are doing at the time, how fast it goes up and how long it stays up. 

It is also important to know that there are many factors that can increase our HR, dehydration is one. So if you feel your heart is beating too fast you may want to drink more fluids, this is the case for most people, not only in dysautonomia. Many people find that drinking even just one glass of water fast will improve their tachycardia. 

However - if you feel like passing out ( or actually faint ), have chest pain or unexplained shortness of breath or feel severe anxiety please do go to the ER. Otherwise call your PCP to ask for advice. 

[Sushi]

5 hours ago, Pistol said:

I do not see any real serious or drastic changes in your BP or HR, except that on May 16th your BP was in the systolic hypertensive range ( 135/102 ).

I agree with @Pistol. Most all of us see changes like this. The other thing to consider when considering seeking emergency treatment (other than Covid), is what they would do with you if you showed up at the ER or Urgent Care? From many of our experience--not much or nothing at all. Probably the best you could hope for would be a saline IV--which can temporarily help with symptoms but is not a day-to-day solution. Hopefully, when you can resume the diagnostic process, you will be prescribed some medications and strategies that help day-to-day.

[yogini]

13 hours ago, FileTrekker said:

I personally think symptoms are more telling than numbers, there's nothing really remarkable or worrying about the numbers given other than your heart rate seems high when you're stood and active. Like me it seems like your standing heart rate is sometimes quite reasonable when simply stood doing nothing.

I would agree with this.  The first question is whether Morgana has dysautonomia. A doctor should advise on when to go to hospital and the exact diagnosis, but most of the numbers posted look very normal and aren't typical of dysautnomia, other than the 2 numbers during activity.  (But even healthy people have a pulse increase during activity)  

Also, the problem really occurs when the high HR is sustained.   I would be more worried if my HR stayed at 150 or 130 for a couple of hours than if it went up for a few minutes while doing the laundry, which my doctor told me can be normal for me.   If I don't feel well, I just lie down, fluid load, rest even sometimes for a couple of days if needed.