Wednesday, 28 August 2013

Tilt Table Tests

For many reasons, I really admire Chris Hadfield, the Canadian astronaut who tweeted from the ISS the most spectacular images of earth from space, life on board ISS, and his rehabilitation. As a family, we caught up on his tweets each day over dinner. Then his posted this tweet....

Tilt table tests are the main part of a POTS diagnosis and any future investigations. Aside from our family jokes about which was a quicker way to get a tilt table test - sit on the waiting lists at Queens Square or qualify as a astronaut and spend six months in space.... Chris Hadfield became even more of a hero! 

My tilt table tests were to test the effectiveness of a potential new medication. I had to be "starved" as they put it from midnight the night before, so I enjoyed a bit of a carb fest for supper the night before! I personally prefer the word "fasting" or simply "not eating", but I guess "starving" is fitting with the torturous nature of the rest of the tests!
The next morning I arrived and was given all the usual admission paraphernalia - MRSA swabs, penicillin allergy ID wrist band and several forms. I had thought the hospital already knew my address - they did post the letter about these tests to me after all! When you haven't had breakfast and have blurry vision, filling out that basic information all over again when you know they already have it is somewhat irksome.

But the staff were all very welcoming and smiling - my glass of water came quicker than any waiter would have got it for me. They were jolly and friendly. 

I was most impressed with the technician who was doing my tilt table tests - she sees two patients a day, and I had seen her two years ago - she recognised me! She was just as jolly, lovely and explained everything. The tests involved something resembling a medieval torture technique... the tilt involved being strapped to a table and tilted up to almost vertical swirled up to various things to measure my blood pressure and heart rates and how they react to the 'orthostatic challenge' of standing up. I fainted whilst titled on the table!

The second tilt is done following a 'meal' which consists of full fat milk, 20g of glucose and a protein shake powder - yum yum! One of the unfortunate side effects of drinking this pint of gloop through a straw while lying horizontally is that all rearranges itself inside you when you are titled to vertical - queue really loud embarrassing burps!!!!

Day units are odd places, with armchairs and bedside tables for each patient - a very busy environment but quite sociable. It was nice to share stories and coping strategies with other patients, and I am very grateful to the true expert patient next to me, who showed me how to make my chair recline!

After coming in and out of the room several times, the doctor finally came in and called my name - he had said it was just to say hello and have a quick chat - little did he know how complex I was!!! After a few minutes of asking me a few things and taking notes, he moved his chair away from the desk to look at me, leaning forward - I knew he was really listening! What impressed me more, was how he said he would ask if his more senior colleagues could see me. I returned to my designated arm chair and expected to never see him again, but within 5 minutes he had checked and told me the arrangements to see them tomorrow. I really rate people who say they are going to do something and actually do it! 

The first day ended on a bad note, confusion over lunch being delivered and delays and undercooked jacket potato - which was a shame and didn't reflect how good everything had been in the morning. I resented spending an extra two hours in when I knew the following day would involve a lot of waiting!

The second day of tests saw again more wonderful staff - a porter who knew I was fasting for my tests choose a route that didn't take me past the wonderful smell of cooked breakfasts at the cafe, a friendly technician and lovely nurse both who explained things clearly and gave me plenty of opportunities to ask questions. The injection was far from pleasant but these things never are! The 40 mins or so I had with her afterwards were very precious - she understood the reality that POTS patients face daily, and had the brilliant skill to suggest talking therapies and counselling without me wanted to accuse her of thinking it was all in the mind - she approached that difficult topic very well. 

This being the NHS in 2013, I was asked the infamous friends and family test each day! On the first day, a nurse thrust an iPad into my lap. Interestingly, the nurses attitude was brilliant and enthusiastic all day, apart from when she gave me the iPad. I wonder how much buy in there is from staff on the wards towards patient feedback, or is it something imposed on them from above. Her attitude was very 'tick-box' and as if this feedback was not something she considered to be important. Her attitude was is stark contrast to the nurse on the second day who was very anxious not to inconvenience me by asking me to fill out the survey - I know 'feedback fatigue' is a big issue but I was surprised how apologetic they were about it! Perhaps patients in the past had been very negative when approached about their feedback? Education about the value of patient feedback really needs to be for patients and professionals, so they are both aware of its value. 
The other irony of the first question, "would I recommend this unit to friends and family if they needed similar care?" was amusing - this is the only unit of its kind in the country! 

Overall, I was impressed by how wonderful staff were. When looking back, the poor admin of admissions/overnight stays/repetitive forms/lunch doesn't reflect how brilliant the nurses working on the unit were. Thank you to all them all! 
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  1. Really interesting Blog entry Anya. Your insight regarding how interested each member of staff was to your personal issues and you as a person was fascinating. I will be directing my new students to your blog as soon as they arrive!

    1. Many thanks Trevor! As a brilliant educator, I am really flattered you see educational value in my blog - thank you!

  2. Very funny Anya. (I assume you are joking!). Your blog is a goldmine of learning for students! (Thanks for the complement, by the way). My blog is going live in a few weeks and your expert view would be appreciated! Its called 'The Experts by Experience blog'.

    1. I wasn't joking! And I'm not joking when I say I really look forward to reading your blog! : )

  3. Yes, tilt table test clears the doubts raised by the patients where we can get complete scan report of the body. It is compulsory to have a check and follow the diet tips to keep your health fit and healthy.........