Saturday, June 6, 2009

POTSy Turvy

So what's the 411 on POTS? POTS stands for Postural Orthostatic Tachycardia Syndrome. I figured POTS was a great place to start because I am feeling very "potsy" today! POTS is just a suspected diagnosis for me because it requires several tests and a cardiologist to make that diagnosis.

But, here's why the nurse practitioner in NY suspected it:
Right now my heart rate is 68. I'm relaxed, sitting in a chair typing. Now I am going to stand up.... Wait for it... Ok, in about 1 minute my heart rate jumped to 110.... All I did was stand up. No jump-n-jacks, no marathons, just standing up...
I got a little lightheaded, but not much.

SO what is POTS, besides something you put a plant in?

A person with POTS has an irregularity or malfunction in the autonomic nervous system, which is the system that regulates the heart rate, respiratory rate, digestion, etc etc etc.... When a person with POTS changes position from sitting/lying to standing their heart rate increases by insane amounts. In order to be considered POTS it has to be an increase of at least 30 beats per minute. Some people experience a drop in blood pressure to very low levels when they are feeling POTSy, but not everyone.

Hallmark symptoms:
heart rate increase of at least 30 bpm
blood pressure drop
exercise intolerance

You can also see from the dysfunction of the autonomic nervous system:
nausea and other gastrointestinal symptoms
depression (although this may be because of all the doctors who missed the mark by a long shot...)
brain fog (very similar to a brain fart, just a little less stinky...)

Here's another theory that's pretty interesting:
A person with EDS is missing pieces of their connective tissue, and the blood vessels are made up of connective tissue as well. Sooooo, if their vessels are missing connective tissue they are very likely to not pump the blood correctly. When a person with EDS stands for long periods of time the blood may pool in their legs, and the vessels will have a harder time pumping it back to the heart. Therefor the heart must work harder, beat faster to return the blood as quickly as necessary to keep the oxygen levels in the body up.

So what can we do about POTS?
Well, it is suggested that people with POTS eat plenty of salt, unlike everyone else in the world that take in too much salt... The salt keeps the fluid volumes in the body up, and both the extra fluid and the salt itself will raise blood pressure if that is an issue.
There are also certain medications that are effective in treating POTS, but they must be used with caution, as many also lower blood pressure. Corticosteroids are also used to produce the same affect as added salt, but must be used with caution as it raises blood pressure.
Exercise, if tolerated, is suggested to keep muscles strong, thus aiding in the pumping of pooled blood. Also, compression stockings can be used to assist in moving blood back up. It might be nice seeing some of you menly men in stockings for a change! haha

Ok, and finally, it is very easy for doctors to miss POTS because the symptoms vary and mimic many other disorders including some psychological. To test for POTS a cardiologist might order a Tilt Table test, where upon a patient is strapped to a table, monitors are placed and recordings are taken while lying flat and in upright positions to see the hearts response to sitting upright. The person may be asked to wear a Holter Monitor for an extended period of time. Think of it like an ongoing EKG, thats shows the docs how the heart works in everyday conditions.

This post is, by no means, all inclusive, you know like those vacation packages you get that forget to tell you about the fees that cost you a thousand dollars... Yeah, no promises here. So, if you have any questions you can ask and I can research it for you, or you can research it online!

1 comment: