Well, I had my Autonomic Function Tests at the National Neurological Hospital yesterday, so before I forget what happened I thought I would let you all know what to expect if you are waiting to have the tests.
First of all, I only got to see a technician rather than Prof Mathias himself, I think you only get to see him if your test results merit it.
I was asked to lie on a table straight away and hooked up to the equipment. They put a small BP monitor on your finger that takes continuous readings and you have a blood pressure cuff that takes readings every 3 minutes and are hooked up to an ECG monitor. They also put a cannula in so they can take blood at various stages throughout the procedure and I think at one stage they adminstered some kind of drug through it too
, but my technician did not really explain what she was doing very much (she kept saying "I am just going to ....." and then start doing it without saying what she was going to do
. She told me she was still training and seemed quite nervous herself, but she did manage to get the cannula in without any problems and always asked for help from a colleague if she was unsure of anything.
The technician briefly asked me what kind of problems I experienced and if I ever fainted. Luckily I had taken a list of my symptoms that I had given to my local Neurolgist back in May as well as a copy of my Health History, so at the end of the tests she took the copies to put in my file and (hopefully) read.
Various readings and blood tests were taken throughout the tests (which lasted about one and a half hours). At one stage the bed was raised to a vertical position (you are fully strapped in so it is quite safe) so that you are in a sort of standing position for 10 minutes. I have to say that this was really uncomfortable for me as it put a lot of pressure on my back, knees, hips and ankles and I struggled to get through that part of the test. I did manage though and the tech kept asking me if I was ok and to explain how I felt. I am a bit of a stoic and managed to get though the pain, but any longer than 10 minutes and I think I would have had to ask her to lower the bed.
The other tests involved the following:
Mental Arithmatic - I had to count backwards for 400 deducting 7 each time.
Deep breathing - I had to take a deep breath in for 5 seconds and then blow into a tube for 15 seconds. The tech had to do this test 3 times as my result came out "rare abnormal" with "square waves" whatever that means
She had to go and get another tech in to look at the results as she had never seen the response I had before.
Panting - I had to hyperventilate for as long as possible. This I found hard and it brought on my symptoms of dizziness and pressure feelings in my head quite quickly.
Reaction to cold - this I think was the worst test for me as my right wrist was wrapped in a cold "thing" (as I was lying down flat I couldn't really see what it was) that had been kept in the freezer. I had to take off my wrist support for the test and the icy coldness soon brought out the arthritic pain in my wrist. I found this excrutiating and the tech had to stop the test sooner than normal as she could see from the ECG that I was in cardiovascular distress. Normally they keep this on you for 3 minutes (I think
that is what she said).
There is also normally an Isometric Test where you have to squeeze something in your hand repeatedly, but they did not do that test on me because of my wrist problems, but said they could get a good idea of my autonomic function without needing to do that test.
The last part of the test involved taking readings after you have got up from the bed and stood up for 5 minutes.
The tech said she will report on the results and send a copy to Prof Grahame/Dr Hakim. She warned me that it will take a while as they are short of admin staff at the moment but that it should be ready in time for my follow up appointment at UCH at the end of March
I mentioned that my local Neurologist is keen to see the results before deciding on a course of treatment and she said I will need to get him to request a copy of the results.
I did not need to take away the 24hr holter monitor as she said she had got enough info from the tests on the day.
Oh yeah, one last thing, the tech asked me what meds I was on and when I mentioned Venlafaxine, she siad that could explain some of the results she was getting
. I wasn't asked to stop taking any meds prior to the tests, but then as I had a short notice cancellation perhaps they forget to advise me. I hope this will not have interfered with the results
Anyway guys, I hope that this information will be of use to all of you waiting to have these tests. On the whole the tests were all quite straight forward and I think I only had problems with the "cold" test because of the problems with my wrist.
Take care all