Poor Man's Tilt Table Test

[sfr100]

Hi! I know people have just posted about orthostatic vitals but I have a question. Despite having a TTT that showed pots (30 BPM in 10 minutes over resting HR) 4 months ago, does anyone ever do bp and HR numbers lying and standing that come out w/ your HR lower than the 30 BPM in 10 minutes of standing? What is this about? Any input would be greatly appreciated. Thanks!

[Ernie]

Hi,

I can't stand for more than 5 minutes so I don't do it.

[MightyMouse]

I don't bother because I know I have POTS, and I know mine has been with me since birth, so I have no reason to anticipate any change. When I've visited Dr. Grubb, he's repeated the poor man's TTT in the office, just as a matter of record for my medical file.

I suppose if one had sudden onset or post viral onset, it might be more likely to seem some kind of change for the better over time. For me, I don't see the point.

Nina

[kmpower]

I test myself daily sitting to standing, but never wait 10 minutes. My worst symptoms are after being up an hour or two, but I cannot stand still very long to test it like you do.

Because I am on a BB, the rise in HR isn't like what it used to be. The more the BP drops, the higher the HR goes. The BP usually drops 20-30 points and the HR goes up maybe 10. That is on a good day. On a bad day, I don't take it because I can "worry it" all over the place.

If you are on medications, you may or may not have as much of a change as you expect.

I tried to reduce the BB 3 times in the last few months to see if that would help the orthostatic intolerance, but each time I got really tachy. I still want to reduce it, but will get a different plan and be more gradual to reduce the rebound the next time I try.

All the various symptoms of dysautonomia combine to make your own individual diagnosis. The HR is only one piece, and for some people it is the worst one while for others something else is more significant.

I hope that isn't too confusing.

OLL

[sfr100]

Oll,

That wasn't too confusing. Thanks! I was trying to do some orthostatics for my EP appt this week. Your right in that it doesn't seem to correlate, at least for me with how I feel. I'm not a fainter, except on TTT but I have awful synptoms that don't seem to correlate w/ the orthostatic tests looking better or worse. Thanks

[morgan617]

I'm with Nina here, just don't see the point, although some days are just better than others. Some days i can cook dinner, and most days I'm lucky to get off the couch. It would be great to know the triggers, but just don't...so don't fret about it anymore. morgan

[ellen]

I take my blood pressure often and I think I have noticed a correlation between my readings and my symptoms. If I have a large increase in pulse after standing, I feel more fatigued that day. Sometimes I have smaller increments, (yes, sometimes less than 30 bpm) and I feel quite energetic. I like to have objective data to help monitor my condition, rather than just wait till I feel really weak, then go to the doctor with " I don't feel well". Usually at that point I have such brain fog that I can't communicate well, and I sound like a whiner. So I'm being proactive. (I've had this on and off since 1992 ) -ellen

[bgsu4]

Sometimes I'm in the teens or low twenties. I have low grade POTS so I can stand for forty minutes at times(not bragging just lucky sometimes) without symptoms. I think its different with everybody and sometimes some peoples systems work properly under the right conditions. Some days I stand for five minutes and have problems so this is the only explanation I can think of.

[dano2718]

I've seen the same thing - when my HR change is up around 50 beats, is when I'm most fatigued / foggy. I've felt a lot better lately and my orthostatic change is down to around 28 - 30. It's good to see some objective correlation with how I feel to know I'm not entirely crazy

[Guest dionna]

i wore the holter monitor for a month while i was still on active duty and i still participated as much as possible with my "marine" duties. i know that we aren't talking about the exact same thing, but i noticed that all throughout the day no matter what i was doing my hr was at minimum 60 and went above 200 when i was just standing- even out of the heat. one morning when i was making my rack (bed) it was up to 215. i wasn't even standing all the way up. i haven't monitored myself lately but i feel so faint all the time so i just stay seated and laying down. (which is why i am living on this lap top). i also agree some what about not seeing a point- i was diagnosed and discharged from thecorps- but i am also a very curious person and i am looking into getting my own gear to test myself from time to time. i will be sure to let you know if i do get the cuff.

dionna

[photchkiss]

My Heart Rate change is variable. Sometimes, the poor man's tilt table easily exceeds the 30 BPM threshold, but other times it does not.

I believe my POTS is due to vessel dilation due to a connective tissue disorder. So, variables like temperature, time of day, hydration, etc. have a major impact on my POTS.

Interestingly, I can have awful POTS symptoms even when my HR doesn't jump dramatically on standing.

I am very skeptical about hard and fast clinical guidelines where at one point and time doctors rely so heavily on the TT test. My TTT showed an increase 30-35 beats per minute the entire time I was upright. However, if they would have done that test later in the day and in a warmer room, it could easily have been 40-50.

I guess my point is that in my case, the HR reaction to being upright is dynamic and does not alwasy meet the >30BPM threshold.

Joe