Water (and Salt)Your P.O.T.S.
I am not referring to watering your garden, which of course you should do for the plants to grow. I am talking about Postural Orthostatic Tachycardia Syndrome (POTS), one of the diagnoses I have been learning to live with over the years. Normally an individual’s heart rate remains steady varying 10-20 beats per minute (bpm) when standing up. With POTS an individual’s heart rate increases by 30 bpm or more within the first 10 minutes of standing[1]. Dysautonomia International, which is an excellent source of information on POTS, points out that the increase in heart rate occurs in the absence of orthostatic hypotension [2] which is form of low blood pressure that happens when standing up from sitting or lying down causing dizziness and lightheadedness [3].
POTS symptoms vary between individuals and can include racing heart rate, chest pain, lightheadedness especially with standing up, prolonged standing in one position, or long walks, fainting or near-fainting, fatigue, abdominal pain and bloating, nausea, temperature deregulation, nervous or jittery feeling, brain fog, blurred vision, headaches, body pain/aches (flu-like), neck pain, insomnia and frequent awakenings from sleep, chest pain and racing heart rate during sleep, excessive or lack of sweating, tremors especially with adrenaline surges, discoloration of feet and hands, exercise intolerance, diarrhea and/or constipation [4].
Needless to say, learning to navigate my life having POTS has been challenging and full of “what’s next” moments. It has taught me how important it is to be aware of my environment and how I’m feeling and to stay on top of my water and salt intake throughout the day. With POTS, the recommendation for fluid intake is around 2 liters and typically 3 to 5 grams of salt per day [5].
To help others understand the importance of being well hydrated with POTS to manage my symptoms, I like to use the analogy of a potted plant. To thrive, I need to be aware of the environmental conditions, and the balance of water and electrolytes like sodium, potassium, chloride, and magnesium in my "soil."
If I start drying up due to lack of water or hot conditions, I wilt both physically and mentally, and change colors. My posture slumps. I feel weak and lightheaded, bend over with abdominal pain, and can't think straight. My "plant" feet change to reddish purple. Watering my “soil” and adding electrolytes, I can revive myself. At times, I need “Miracle Grow” in the form of intravenous saline hydration. Having “stake support” to stay standing tall using compression stockings or abdominal compression garments is helpful. My POTS sometimes requires me to be relocated to a less hot, sunny environment and repositioned with my feet up.
It's taken research and patience to find the right gardeners and "fertilizer" blend of medications. The process of learning how to care for my POTS and the approach has needed to be reassessed and changed over time, and different expert gardeners consulted. Quite a few storms in the form of burnout, sustained mental and physical stressors, surgeries, and viruses have knocked me down and set back my growth.
It's difficult at times still to admit to myself and others when "I'm wilting" and need to stop and take time to rest. I've learned to check in with myself daily, see if I need watering or salting, and be mindful of stressful weather, cracks, and signs I need to tend my POTS. I am able to revive myself and flourish, standing tall again.
I can look back and see that the challenging storms and droughts I have weathered and POTS care I've mastered show my resilient spirit. I'm waiting for the beautiful flower to bloom.
What challenges have you faced in caring for your POTS ?
References:
Kavi, Lesley, et al. “Postural Tachycardia Syndrome: Multiple Symptoms But Easily Missed.” British Journal of General Practice.2012 Jun; 62(599): 286–287. doi: 10.3399/bjgp12X648963 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3361090/
