So you’ve been referred to Hamilton for a Tilt Table Test? Be prepared to wait!
Wait .. and Hurry Up. As far as I know, they have the only Tilt Table in the province, so it’s a long wait. It took a year for them to call me with an appointment, and when they did, it was with only a week’s notice.
On the Day of the Test, Wait Some More. The email advised arriving 30 minutes early. Upon arrival, I was promptly given an ECG and ushered to a waiting room. It was before 11:30 when I arrived in the TTT waiting room for my 12pm appointment. When I finally checked with the receptionist to see if they had forgotten about me, I was informed that they were on lunch. I settled in for the long haul.
(Don’t ask me why they booked my appointment for their lunch hour.)
Test Prep. Hours later, the nurses came and prepped me for the test. Dressed in a hospital gown, I lay down on the bed. They put a strap around my legs, another around my waist. These would hold me to the bed when they tilted it upright. They put in an IV lock so that they could take blood during the test. They put a blood pressure cuff above the IV. Onto the other arm was strapped another blood pressure machine… this one was strapped on, because it was quite heavy. It was attached to a cuff through which the nurse pulled my hand and fingers. It would take its readings from the fingers.
Get a Baseline Reading… And Wait. The blood pressure monitors do their thing for a few minutes while supine (lying down), getting a baseline reading with which to compare the orthostatic (standing) results. After getting the baseline, we waited for the doctor for quite some time.
Consent. When it became clear that he wasn’t coming, the nurses called for another doctor to take my consent. He explains the procedure: they will tilt the bed up and monitor me until I pass out. If 15 minutes goes by and I haven’t had symptoms, they will give me some nitroglycerin to induce symptoms, and then continue monitoring for another 15 minutes. If my heart stops, they will restart it. This is a very rare occurence.
The Test. The bed is tilted up. It’s kind of a groovy feeling in the stomach, a little nausea-inducing. And then I am standing, but not holding up much of my own body weight. The straps are doing most of the work, and all I have to do is hold my legs and hold up my head. After 30 seconds or so, this feels uncomfortable. I am taking deep breaths, trying to calm down. I don’t feel good. I’m very tired. But I don’t say anything yet… this is what I’m here for, after all. I want them to get a good reading. I can feel the blood pooling in my hands, my abdomen. They are swelling up. They are starting to hurt, they are so full, surely they must be about to burst. I am feeling nauseous now. I am struggling for breath. “I don’t feel well,” I tell the nurses. My head lolls forward, I give up on trying to hold it up. I hear the Velcro straps pulling as I lose control in my legs. I wonder dimly if I am going to fall out of the straps when I pass out. The world fades to black.
After the Test. The test only lasted 5 minutes. They bed is tilted back again. They raise my legs. I still feel like I am going to vomit. I am gagging, and they bring me a tray. begin to feel myself coming back to normal.
Recommendations: Don’t Stand Up. Drink Water, Eat Salt. I lasted 3 minutes in an upright position before passing out. My heart rate and blood pressure tanked as I fainted, they tell me. I am told not to stand up — to sit or lay down when I feel symptomatic, to drink a lot of water, and eat a lot of salt. Ha! Thanks, Doc, never heard that particular bit of advice before.
Go Home and Wait. The results will be sent to my doctor, and I am being referred to a specialist in Toronto.
Of course I know that I can’t stand up, and this really has told us nothing new. It has now been objectively clarified that I have only 3 minutes to stand. Within 30 seconds of standing, my body is sending me signals that I need to get down. If I resist the signals, they grow stronger and less tolerable until I pass out. I have thirty seconds of feeling good, then a few minutes of feeling horrible, nauseous, and unable to catch my breath before I fall. Thanks for the assessment, good to know. Funny, isn’t that what I already told them?