What is POTS?

Postural Orthostatic Tachycardia Syndrome (POTS) is an autonomic nervous system disorder that affects 1 in 100 teens and 1 to 3 million people in the United States. Eighty to 85 percent of these patients are women of childbearing age. POTS can affect patients in different ways but some of the most common symptoms are: fatigue, dizziness, inability to exercise, lightheadedness, fainting, fast heart rate, nausea, anxiety and blurred vision. When experiencing these symptoms, it can be hard for those with POTS to regularly attend work, school and to perform other activities. According to Dysautonomia International, 25 percent of POTS patients are too disabled to make it to work or school.

The disabilities POTS patients face have been compared to those of Chronic Obstructive Pulmonary Disease (COPD) and congestive heart failure. Not only do people with POTS experience decreased ability to consistently attend work or school, they often face setbacks in their social lives as well. Because symptoms can come and go, friends sometimes do not understand the complex health issues someone living with POTS faces.

POTS patients are known to become increasingly hopeless when first experiencing symptoms; this is largely due to the lack of awareness within the medical community. Dysautonomia International reports the average time before receiving a POTS diagnosis is a lengthy five years and 11 months. In the United States, Dysautonomia International has merely 126 documented dysautonomia specialists. Waitlists to have an evaluation by these specialists are scheduled anywhere from six months to one year from the initial referral.

Testing to make a diagnosis can put additional stress on the patients. One of the criteria for diagnosis is increased heart rate by more than 30 beats per minute upon standing. The most widely used test when a practitioner is seeking a diagnosis for a patient is the Tilt Table Test. This test is performed in a quiet, dimly lit and temperature controlled room.

During this test, the patient’s heart rate and blood pressure are being constantly monitored, and the doctor is watching for a spike in beats per minute or drop in blood pressure. The test starts with the patient lying horizontally on the exam table for about 20 minutes, with straps securing them down. The patient is then tilted up to a 60-70 degree angle and stays there for anywhere from 10- 45 minutes. The test ends either with blood pressure becoming too low, satisfactory results being obtained, or the patient experiences symptoms such as dizziness or nausea that cause the test to end. An added stress on the patient is the exclusion of their support system for the duration of the test. The only people in the room are the patient, doctor and assisting nurse.

Treatment for POTS can vary from patient to patient and practitioner to practitioner. Courses of treatment often include frequent Intravenous (IV) hydration, increased salt intake, and various medications from beta blockers, blood pressure regulators, to medications designed to treat anxiety. Though there is no cure for POTS, there is hope that patients may grow out of the syndrome in a matter of five years.

POTS affects many people with varying degrees, severity and longevity. Having an understanding of symptoms and treatment options can help a person suffering to maintain hope that at some point they will have their health under control and can maintain a healthier life.

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