I’ve had a lot of medical tests and procedures in my day, but I won’t lie, this one intimidated me going in. It might have something to do with the name – Tilt Table Test, or the way the table looks if you happen to google it like I did. It sounds and looks like some kind of medieval torture. It certainly wasn’t all of the leads they hook you up to (although I do have a serious rivalry with medical adhesive).
I am here to tell you that I survived, and you will too. It’s not exactly pleasant, but I’ve certainly experienced worse – for example I’d pick a tilt table over a lumbar puncture (spinal tap) any day. I probably should have explained this prior to now, but a Tilt Table Test is a medical procedure that doctors use to investigate the cause of symptoms like fainting (syncope), dizziness, frequent falls, and heart palpitations. As it so happens, these things sometimes bother me. Because of my EDS, my doctors suspect that a type of dysautonomia called Post Orthostatic Tachycardia Syndrome (POTS) is the cause.
I arrived at the hospital at the ungodly hour of 7:30 AM (which probably wasn’t a bad thing in retrospect since you aren’t allowed to eat before the procedure). The whole thing took only a couple of hours (with recovery taking the longest) and my hubby and I were free to leave by 10. I do not believe that I was required to have a chaperone for this one, but J was off work and happy to spend a few hours surfing the web (and I suppose making sure I was safe).
When I first arrived they got a urine sample for a pregnancy test (shocker – it was negative!), which is standard procedure for a woman. This means people tell I’m not pregnant like once a week lately 😋. They also completed the rest of the standard procedure check-in stuff. That meant it was time for me to exchange my comfy clothes for a hospital gown large enough for an elephant (they let me keep my pants), and endure the two or three tries it takes a nurse to find a place for an IV without scar tissue these days. Really I don’t mind IVs, but I do remember a time when I was relatively healthy and my veins were good. That was nice.
Once I was all prepped, a nice man came in and assured me that the table would only be tilted once, it would be done slowly, and only tilted to 70* – like this:
I found that oddly reassuring, even though I already knew that. He also let me know that I would first spend about 5 minutes laying down while they got their baseline numbers (heart rate and blood pressure). Then they would tilt the table. They would take measurements for another 5-10 minutes (I have read other accounts where this stage took longer, maybe my doctor is impatient 😳) and then give me a medication under my tongue (isoproterenol) that mimics the hormone the body releases when you are under stress. I would then either faint (and the test would be over) or my measurements would be taken for 20 minutes after.
When I entered the room for the test, I noticed that it was COLD. I slid from the hospital bed I was rolled in on, to the tilt table, and they began to hook me up. A blood pressure cuff was placed on my arm, and a number of ECG leads (like the ones in the picture above) were put on my body. They also put a pulse oximeter on my finger to measure the level of oxygen saturation in my blood. They then wrapped three Velcro straps across my body (leaving my arms free) and secured them so I would be supported if I lost consciousness. When everything was in place they began taking baseline measurements. My heart rate was around 85 and my bp approximately 100/70. After a few minutes the table was tilted. At first I was ok, but eventually became dizzy and sweaty. Then hot and nauseated. What was previously a COLD room felt like someone had cranked the heat way up! This feeling persisted until they gave me the isoproterenol – it felt funny under my tongue. Within a few minutes everything I had been feeling before greatly intensified. I began to have tunnel vision and what I can best explain as a “get this coat off of me right now, I’m too hot and I’m going to puke” feeling I sometimes have while driving, except I wasn’t wearing a coat or in a car. My heart began to pound. As all of this happens, people ask you how you are feeling. It was genuinely difficult to fight the urge to tell them I was fine and to instead tell the truth (old habits die hard). People were telling me to keep my eyes open and stay with them, and from what I understand my heart rate shot up to 165 and my bp tanked to 50/40 before they dropped the table and gave me fluids through my IV. I never technically fainted, because you know, they said to keep my eyes open, and I’m stubborn. Also, they dropped the table when they had what they needed – a positive response.
The nice guy (I never figured out if he was a doctor or a nurse) brought me a washcloth for my head which helped me to cool off. Eventually, when I felt I could move from the tilt table to the hospital bed, I was taken back to my room. Once I was able to drink and eat something I was allowed to go home. Although I haven’t had the follow up appointment or received an official diagnosis yet, I have been told that I have some form of dysautonomia (autonomic dysfunction) that caused the positive response. Until I see the doctor again I am supposed to focus on adding salt to my diet, drinking lots of water, and wearing bottoms like leggings that provide compression. A prescription to wear leggings/yoga pants all day, every day? I could get used to that 😋