[QUOTE=en bloc;1150160]As for BP, there are some very simple ways to check (yourself) to see if you have any autonomic type dysfunction. The effect on BP is not just a high or low BP, it is the ability of the BP to adjust accordingly for postural changes. So, symptoms would be dizzy/lightheaded when you stand up from a seated position, or after standing still for a few minutes. The best way to check, is to use a BP machine and take your BP while laying down, then sit up (3-5 minutes later) and take it again, then stand and take it again. If the systolic (first number) drops more than 20 points and you get any symptoms, then you probably have some sort of autonomic involvement. You can check this at any time...like if you start to have your symptoms, then immediate go start this process of BP checks to see if your symptoms might be related to BP. Doctors actually use this same technique in the office to determine if you are having any orthostatic hypotension. Your home BP machine will also give an accurate heart rate and can be used to check this whenever you are having symptoms.

The autonomic process on the heart rate does not simply change the rhythm. It too effects the rate during postural changes. POTS (postural orthostatic tachycardia syndrome) is just as the name describes, a high heart rate upon standing or changing your position. This also happens when the BP drops upon standing (as the heart tries to compensate for low BP by trying to beat faster to increase blood flow).

There is also an element of bradycardia (low heart rate) with autonomic dysfunction. You mentioned having a low heart rate at times...how low? Where they able to document this low rate on an EKG? Did they tell you what the arrhythmia was (name)?

I really wonder if your face symptoms might be due to some SVID (small vessel ischemic disease). I have this as well and have had many times of unusual numbness/tingling in the face to include nose and around eye. This is why I asked on another thread (I think I did) whether you had an MRI of the brain yet? You may have answered, but I don't remember. A CT scan won't pick up those small vessels...has to be an MRI.

I have horrible TMJ but no real pain (except rare times). People in the next room can hear my jaw pop when I eat...LOL It's really that bad. But NO dentist or doctor has ever said my face tingling was from TMJ.[/QUOTE

Thanks for this Enbloc - very helpful as usual. Yes I had an MRI of my brain in January and all it revealed small vessel disease which matches my age and stage. No lesions.

The chest heaviness and feeling of weight is worse when I'm sitting or lying down on my back but propped up (as I am right now - to the point where I have to move about to get enough breath). I had assumed this was part of my GORD - which is worse when I'm on NSAIDs or steroids despite Ranitidine. But I'm not asthmatic or coughing with it at all nor very overweight. The chest weighted feeling when I'm rested is hard to cope with - like a huge heavy wave passing slowly over me over and over. It puts me in a very still, fugue like state so I can barely move or speak or do much at all and the pain in my peripheries is immense with it. It has greatly improved since starting steroids though but is returning at the lower dosage. I had assumed this was costochondritis because my ribs are always tender to the touch.

I have a reliable BP machine so will use to check postural changes as you suggest. No one has tried this on me yet. I don't know what type of arrhythmia I have but it can't have been of much concern because the cardiology nurse and GP haven't referred me for further tests. However my GP refused to let me try the Cox 2 family of NSAIDs because he said I had higher cardiovascular risk than the normal person because I have RA and because of my family history and high ESR.

I will discuss autonomic neuropathy with my GP on Friday and see what she thinks.

The special interest dentist (NHS) confirmed from nerve tests on my face this morning that I appear to have small fiber neuropathy here too now. I have posted about this appointment above. Presumably it is progressive because it only started in November and has bascically gathered momentum as my legs and then arms did a over year ago? He called it "Parasthesia affecting the small nerve fibers"

My jaw doesn't click at all although he agreed my mouth is tight and doesn't open fully. I think my other concern is that this could be Scleroderma but I didn't ask him about this as I don't want these medics to get the idea that I'm finding diseases and matching the symptoms accordingly. Is this what you mean by ischemic disease I wonder?