Saturday, December 29, 2007

You've gotta laugh

Sometimes having POTS and using certain adaptive tools to help me through the day (cane, compression tights, etc.) gets me certain stares or outright questions/comments from random folks.

This especially happens when I use my cane. I used it far more often in the summer than I do now, but I still use it. I get funny looks because I'm 20. You don't very often see someone my age on a cane. I get some "WTF?" looks on the street, but not too many since Pittsburgh is a mecca for medical freaks like me (The University of Pittsburgh Medical System can treat just about anything that ails you). The most interesting ones I get are from older folks on the bus. It almost seems as though they're thinking to themselves "Eh, it could be worse." At least, that's what I imagine they're thinking.

But a lot of what I get is people who knew me before I started using the cane and I can't say I really blame them. Usually they think something horrific has happened to me. No no. You know that thing I have? No, not that one, the other thing? Yeah, it got worse. I'm usually nice enough to explain what's up to those with good intentions, but sometimes I neither have the time nor the energy to explain. That's when I have to reach into the snappy comeback file.

The best one I've been able to come up with so far is "I'm a pimp." It makes them laugh and I can make my getaway before they say "No, seriously..."

Then there's the compression tights. Those are flesh toned and actually pretty discrete. Even when I'm in shorts or a skirt they aren't the noticeable. The only way you can really tell is if you're either a) within a foot of my leg or b) witnessing me pull at the tights. That's when I get, "What's up with the tights?" That's when I say, "I'm a superhero. Shhhh."

Yeah, those aren't the best comebacks in the world. But you work with what you've got.

Wednesday, December 26, 2007

A POTS Patient's Holiday Wishlist

Well, I hope everyone out there had a good time today. I know I did. Three houses opening presents, a meal to die for and I'm spent. I got a lot of neat stuff, but there are medical things I want/need that I was too embarrassed to ask for. I don't know why. However, I got a sizable money loot with which I will hopefully procure these items. So here are the few things on my POTS patient wish list.

This adorable cane
Isn't this cane a beauty? I've been eying it since I bought my first cane in August. It's a but pricey, but it folds up and is oh so gorgeous.

Ice friendly Cane Tip
I live in Pittsburgh. It gets icy and sometimes not that easy to navigate.

Compression Tights
You can NEVER have too many of these... especially if you're as lazy as I am about doing laundry. I use compression level 30-40, which is what's recommended for POTS. I tried 20-30 and it helped a little, but not as much as I was hoping for. 30-40 is a beast to get on in the mornings (I didn't even wear them today) but quite worth it. They're also pricier and harder to find than the other varieties. I recommend this company for compression tights. They're less expensive than the leading brands, good selection and they're pretty good quality.

Med Tee's POTS Tee
When I found this site the other day I doubted they'd have anything POTS or dysautonomia related, but I was pleasantly surprised when I found this shirt. A POTS shirt! How awesome is that? It's under heart disease instead of neurological, but oh well.

Monday, December 24, 2007

Survey Meme

I got tagged by Lindsay over at Living With Fibromyalgia to do this survey (Hurray, people actually read this!)

For readers new to the meme challenge, here are the rules:

1-Link to your tagger and post these rules on your blog
2-Share 7 facts about yourself on your blog, some random, some weird
3-Tag 6 people at the end of your post by leaving their names as well as links to their blogs
4- Let them know they are TAGGED by leaving a comment on their blog


1. I've played clarinet and guitar since I was 11.
2. I'm a pagan.
3. I'm a vegetarian.
4. Harper is actually my middle name. Emily is my first. There are too many Emilys, so I'm starting to go by Harper.
5. I have a tattoo of a kokopelli on my hip and a ghecko on my back.
6. I plan on moving to the southwest eventually.
7. I've dyed my hair with funny colors more time that I can count (It's currently black on the bottom and blonde up top).

In other news, I've been pretty clear on the symptom front. Except for a flare yesterday. I was at church having choir practice after the service (Yes, I just said I'm pagan. I go because the church people are nice and my mom needed another alto). Episcopalian church services are the absolute worst for a POTS patient. Stand up, sing, sit down, kneel, lather, rinse, repeat. It's gotten to the point where I don't do most of the standing anymore. Everyone there's pretty understanding though, so I'm not looked at scornfully when I sit when the bulliten says stand. Anyhow, after the service the church was greened up for Christmas eve and the choir looked over the music we're singing for our performance before the service. This involved a lot of idle standing, also not a friend of the POTS patient. I had to sit down to sing the last number.

I hope everyone has a good holiday. I just got back from a Christmas eve party with my family. Tomorrow I will be opening presents at my mom's, dad's, and then at the bed and breakfast where my extended family is staying. My dad remarried in September and I have a stepbrother and stepsister. This will be their first Christmas with my family. Hopefully we won't scar them too badly.

Medical Tests

I've decided I'd like to document my medical tests. I've had several... some for POTS, some not for POTS. For the purpose of this, I'll only talk about the POTS related tests.

Blood Work
Blood work upon blood work upon blood work. The first time I had blood work (that I remember) I was 15. Three or so vials of blood were taken. I became so pale, clammy, nauseous, and light headed that I was nearly admitted to the emergency room. Since then I haven't had NEAR that reaction. I've had blood taken from me more times than I can count

Hypoglycemia Test
I had this test when I was 17 to determine whether or not I had developed hypoglycemia. You fast the morning of the test and they take some blood when you first get there. Then you drink the most disgustingly sweet thing you can imagine and wait. As I recall during this test I had no symptoms of hypoglycemia, but the test came back positive for it anyhow. Hypoglycemia is when your body produces too much insulin. If you eat a lot of sugar too much insulin is released, thus plummeting your sugar levels, making you cranky and headachy and foggy.

Autonomic Function Test- Take 1
I had this test the first time around when I was 15. I don't remember very much except for the fact that it made me feel like crap and become quite nauseous. In this incarnation of the test I was strapped to a table lying down for 10 minutes and then tilted up for 10 minutes at about a 70 degree angle.

Holter Heart Monitor
This test involved me being hooked up to a portable EKG machine for 24 hours. I had this test in September of this year. It was actually quite easy to conceal: the wires were all under my shirt and the machine was the size of a pager. I had to write down in a little diary when I'd have symptoms and what they were. I also had to make note of when/if I was exercising, drinking caffeine or alcohol, or engaging in sexual activity. Seriously, who does that? I was able to go to class and do what I normally do, except I didn't go to the pep rally that night with the marching band (which I'm an active member of) because remembering pep rallies of years past I knew it was going to be close quarters in the dark. We do horn swings in the band and I didn't want some freshman who hadn't gotten the swing of things yet (yeah, pun intended) to ruin a very expensive machine. My band director was quite understanding. After 24 hours of having the monitor on, I went into the bathroom during a class break and yanked the electrodes off. This left visible marks that didn't go away for a week that I referred to as my alien hickeys. The test showed that at one point my heart was beating so fast that they thought I was exercising, but I wasn't. I was sitting at my desk at my nonphysically tasking office job.

Autonomic Function Test- Take 2
This test was the most recent (December 6) and by far the most interesting. I had to withdraw from my antidepressant (which SUCKED) and my steroid (not much fun either) and abandon my trusty compression tights for that day. Oh, did I mention this was the week before finals? Instead of being just the tilt table that I had when I was 15, it had three more components.

Sweaty
This part was a sweat collection test. How do they make someone sweat who is strapped to a table? By putting 4 receptors and electrodes on select places on your body (forearm, upper calf, lower calf, foot), injecting them with acetylcholine (a neurotransmitter that stimulates, among other things, sweat) and adding an electric current. The result? A mild burning no more uncomfortable that the "oh my god these pants are chafing me" pain. During this test I looked like I was in Frankenstein's Laboratory.

Yoga Breathing
This test involved looking at ascending and descending lights and breathing in as the lights went up and out as the lights went down. Not too bad.

Pressure Breathing
This part involved breathing into a device that kind of mimicked the sensation of attempting to blow up a skinny balloon with your mouth. During this test my face got really red and my heart rate shot WAY up.

Tilt-Table
For this part the doctor in charge of the lab I was in was brought in the room (until now I was dealing with a tech, who was pretty cool). I liked this doc, he really seemed to know what he was doing, which I haven't found a lot of. He also had an appropriate sense of humor, which I really enjoyed. They let me lay there for a few minutes to get a baseline heart and blood pressure reading. I was hooked to electrodes on my back as well as a cuff on my arm which took a reading every 5 minutes, as well as a small cuff on my wrist which did automatic readings and periodically needed to be adjusted. Once the baseline reading had been gathered (HR- 80 bpm, BP- 122/80) I was tilted. I immediately became lightheaded, hot, and slightly nauseous. It was not fun. In order to procure a POTS diagnosis your HR has to go up 30 bpm during the tilt, which lasts for 10 minutes. My heart would jump around from 90 one second to 105 the next. At times it would hit the mandatory 110. At this point the doc called it "Borderline POTS." My incarnation of POTS is not NEAR as serious as some other cases (i.e., I can still go to school, work, and even stand up. Some POTS patients are confined to wheelchairs), so this didn't surprise me. However, with a minute left in the test my HR shot up to 120 and 125. At this point the doc and tech began yelling "Alright, sell!" which I thought was pretty funny. Once I was taken down the doc confirmed the POTS and stated it was mild. However, mild POTS is like a mild hurricane: it could be worse, but it's still going to do some damage.

I go back to the general internal medicine guy I've been seeing in January. The lab doc suggested a low dose beta blocker. What I've read about them seems a bit daunting, but everything you read on the internet about drug therapies is scary. If I do start a beta blocker, I will probably withdraw from my Paxil just to stay on the safe side (I've read about some interactions with antidepressants). I guess we'll find out on January 11.

Sunday, December 23, 2007

A Dog is a (Wo)man's Best Friend

One thing I've noticed that really helps me with my symptom management is being around furry animals. In Pittsburgh my landlord doesn't allow pets, so obviously I don't have any. I try to make it down to the animal shelter to walk dogs and play with cats every once in a while. When I go, I notice afterwards it feels as though my stress and symptoms have just melted away. However, part of the struggle is getting to the shelter in the first place. It's a 10 minute bus ride from my place, but the issue is motivating myself to get there, even though I know it'll make it feel better. Sometimes I'm all about the instant gratification and take a nap instead.

Since I've been home for break, I've been surrounded most of my waking hours by wonderful dogs and cats. Some are the sweetest, cuddliest, stupidest animals to live and some are more dignified, but they're all wonderful. The larger of the two dachshunds at my dad's house (Benji) has to constantly be in contact with you. He's a snuggle bug. The smaller dachshund (Kudzu... yes, we named the dog after a forest killing plant) has the biggest eyes that express all the love in the world. The golden retriever (Jake) would have a voice like Patrick Stewart if he were human. He's the kindest, gentlest, noblest dog I've ever met. The cross-eyed tabby cat (Frisky) is a great lap cat... however, he's quite loud and vocal. At my mom's house, the German Shepherd-Chow mix (Scout) makes happy noises when she's glad to see you and demands belly rubs. The blue eyed/brown eyed Australian Shepherd mix (Strudel) is a ball of energy who herds the cars in and out of the driveway and is probably the most intelligent dog I've ever met. Our sweet, stupid, we're-not-quite-sure-he-is dog (Griblet) has been spending a lot of time at the neighbor's house lately but we've been able to get him to come inside for a while. He's a big cuddler. There are two old, cranky cats here as well (Fish and Ting) who belong to my stepdad... they're special in their own way.

I've noticed such a difference from volunteering at the animal shelter and being at home with my babies that I've decided that next year I want to move into a pet friendly apartment. Hopefully this will help in calming me down.

Thursday, December 20, 2007

Shopping? Ugh.

Thanks to POTS I may be one of the rare few of the female kind that doesn't like to shop. I generally don't go out of my way to go shopping in Pittsburgh... I don't have a car and I live in the city. Most of the shopping centers are in the suburbs and not pedestrian friendly. It takes a pretty good chunk of ones afternoon to negotiate a shopping trip... time I don't have.

However, I'm in North Carolina for the holidays and the only thing my friends and I could think of to do was shop. So we loaded up and drove an hour to a mall in Charlotte. I had my energy for a good little while... as long as we kept moving. My one friend got sucked into Wet Seal and with her, once she goes in, fat chance of getting her out for a while. Of course not many of the clothes there interested me, so all there was to do was stand around. Standing around makes me light headed, weak, cranky, and hot. At this point I'm relying on the cane I carry around with me for such events. Luckily by then we had to leave the mall to get back home for an engagement... as opposed to more standing around.

So yeah, that's why it's hardly ever my idea to go shopping. When I go, I feel like crap.

Tuesday, December 18, 2007

Meds

And so now for my second installment of my POTS blog, medicines. Here's my current cocktail:

Paxil CR- 25 mg (anxiety)
Glyset- 25 mg (hypoglycemia... goes along with the POTS)
Florinef 0.1 mg (POTS... it's an oral steroid that ups my sodium count, thus upping my blood volume)
Kariva- baby-go-away pills
OTC allergy meds
Multivitamins

I've considered going off the Paxil, however withdrawal is such a beast that I just don't have the time nor the energy or it. I've run out a couple of times and it was NOT fun. I could withdraw over vacations but spending a vacation feeling like little electric shocks are going through my body? No thanks.

After some recent medical testing, I might be started on a low dose beta-blocker. This suppresses adrenaline... an abundance of adrenaline can cause POTS-y symptoms. From what I've read, this can either be a Godsend or a Devilsend for POTS patients... it really depends on the root cause.

First Post in a New Blog

Hello.

My name is Harper. I'm a 20 year old college student in Pittsburgh. I have Postural Orthostatic Tachycardia Syndrome, or POTS for short. I was initially diagnosed at the age of 15 and rediagnosed at 20. I'm keeping this blog to document my medical journey and to hopefully educate people as to what this condition is.

So what is POTS? POTS is a syndrome that basically means when I stand up, my body can't counteract the forces of gravity very well, thus forcing my heart to beat much quicker than the average person. This anomaly can be caused by any number of factors, but in most people that have it chronically it is believed to be caused by one's autonomic nervous system not working correctly, or dysautonomia. Your autonomic nervous system controls the things in your body that you don't have to worry about consciously, such as heartrate, sweating, breathing, body temperature, blood pressure, digestion, and the like. Due to this I have a whole host of seemingly unrelated symptoms including, but not limited to:

tachycardia (HR over 100 beats per minute)
low blood pressure
digestive problems
difficulty with body temperature regulation
blurring of vision
blood pooling in my legs
weakness
brain fog
feeling overstimulated

Those are just the ones I can think of off the top of my head that I've experienced recently. Anyhow, I plan on writing more in depth soon about medicines, treatments, and medical tests.

Harper