3 Questions

[ramakentesh]

Hi'sorry to bother you guys again, just have three quick questions for you:

1. when you are symptomatic have a look at your pupils - do they seem unusually large, normal or unusually small?

2. When you lean forward does your head feel normal, or does it feel like its filling up like a balloon with blood or liquid?

3. Lye flat on a bed and hang your hand down and keep still for five minutes. Have a look at your hand. Is it normal, blue and cold or hot and swollen?

thanks guys!!!

[Maisie87]

1. Mine are unusually large during an episode and sometimes slightly different sizes.

2. Head feels terrible when I lean forward- throbbing/pulsating/dizzy

3. hands are white and cold after being in that position for 5 min.

[summer]

1. My husband has often told me that my pupils get small when I am not feeling well.

2. Leaning forward makes me feel like my head is filling up. I can get a headache from doing this.

3. Hands are blue and very cold after 5 minutes.

[potsgirl]

Hi R~

1. when you are symptomatic have a look at your pupils - do they seem unusually large, normal or unusually small?

They're usually large.

2. When you lean forward does your head feel normal, or does it feel like its filling up like a balloon with blood or liquid?

My head feels horrible when I lean forward, heavy and liquid-filled feeling.

3. Lye flat on a bed and hang your hand down and keep still for five minutes. Have a look at your hand. Is it normal, blue and cold or hot and swollen?

My hands get hot but not really swollen, and I have large veins that pop out (lovely).

thanks guys!!!

You're welcome!

[firewatcher]

1. when you are symptomatic have a look at your pupils - do they seem unusually large, normal or unusually small?

Huge, almost no iris showing at all.

2. When you lean forward does your head feel normal, or does it feel like its filling up like a balloon with blood or liquid?

Filling up to the point where hearing is difficult and my eyeballs feel like they could pop out.

3. Lye flat on a bed and hang your hand down and keep still for five minutes. Have a look at your hand. Is it normal, blue and cold or hot and swollen?

White, cold and both are absolutely sweaty.

[EarthMother]

1. when you are symptomatic have a look at your pupils -

LARGE

2. When you lean forward does your head feel --

FLUID, PRESSURE

3. Lye flat on a bed and hang your hand down and keep still for five minutes. Have a look at your hand. Is it ...-

I IMAGINE IT MIGHT BE DIFFERENT IF I WAS UP/AWAKE AND THEN WENT TO LAY DOWN. BUT MY HAND DID NOTHING THIS MORNING ON WAKING, NOT EVEN THE NORMAL PUFFY VEINS IF I JUST KEEP MY ARMS AT THEIR SIDES. NOT ANY COLDER OR WARMER THAN MY OTHER HAND. AS I SAID THOUGH ITS MORNING AND I'M GUESSING I HAVE NO BLOOD FLOW ANYWHERE AT THE MOMENT.

[brownsea]

hi

1. ive never noticed the pupils, so i dont know.

2. the head thing, im glad others have the same thing. for my whole life if i look down and forward, my head is heavy and i get extremely nauseous. i can never put a newspaper on the table and look down and read it.

3. my head feel uncomfortable, cold, and the veins usually stick out.

good bunch of questions.

x

[MommytoSJEA]

1. I have never looked at my pupils or have anyone notice anything.....might be worth checking out.

2. If I lean forward my head pounds and my pulse races

3. I know that in the morning when I wake up my hands are swollen really bad. Lately its so bad that I had to take my wedding rings off.

~Kelli

[fighting4health]

1. Sometimes my pupils stay the same and sometimes they constrict. I've never noticed them dilating when I'm symptomatic.

2. I get a little dizzy and pressure in my head, but I hardly even notice it.

3. My hand felt electrical pulses from the second I put it over the bed. When I pulled my hand up it was numb and white with no notice of temperature change.

[Maisie87]

! O I misread the #3 about the hand**

my hand definitely turns blue and cold-bulging veins

[dakota]

On behalf of my daughter (age 15) who is the one in the family with POTS:

1. Very large pupils, almost no iris showing

2. Feels like there is a lot of pressure in her head

3. Hand is darker and mottled, slightly colder and tingling

[daisy]

1. pupils get larger

2. strangely enough, I can dry my hair upside down and feel better...I think it's the same concept of putting your head between your legs when you feel faint - gets the blood to the brain. But, if I just slightly lean forward, I feel dizzy and spinny

3. hand turns bluish/purple within a minute or so and gets very cold...

[toddm1960]

1) Pupils get larger

2) My head fills up bad if I lean over, it happens even when I lay on a flat surface.

3) bluish / purple

[lissy]

#1. Pupils get larger

#2. Head feels lots of full pressure and more dizziness (also painful tightness in neck)

#3. Hand gets cold slightly mottled and very tingly

Lissy

[jump]

1) Pupils oscillate back and forth between more dialated and less dialated. Looks like my pupils are wiggling.

2) No liquid feeling in head, but when symptomatic I can "hear" my blood pulsing in my ears with very little exertion; before POTS and when less symptomatic, this only happens if I am exercising really strenuously

3) Actually, I've experienced both symptoms. But I would say it's more likely that my hands will get swollen and hot; about every fourth time they will get really cold and white. Usually they are very cold and white all the time, and doing something like that - hanging them over the bed - usually helps this symptom.

[janiedelite]

1. Usually my pupils look normal, and I feel more or less symptomatic all the time.

2. I never tried this til today! My face and forehead were flushed and I had a lot of apparent broken blood vessels on my cheeks (I flush often as a part of my POTS), and my head did feel full. But any time I lower my arms or legs below my heart they feel full and burn painfully also, if this matters.

3. My hand was red during the first 2 minutes, but got bluer as time went on until my palm and fingertips were solely blue and the back of my hand was purplish. I tried to discern a temperature change in my skin, which is hard because my hands burn all the time so everything feels hot to me. Nonetheless I couldn't detect much of a change. I made sure the room was warm, otherwise I overconstrict peripherally. I often elevate my arms because they feel engorged and are so painful.

[ramakentesh]

Interesting results - My friend and I noticed that when Im symptomatic my pupils are like pin pricks every time. They nearly disappear! Even if it is at night.

I think there might be something to this.

The hand and head questions were trying to assess the local responses there. Its hard though because even then it doesnt really indicate whether there is an inappropriate pressor response to hanging the limb or whether the adrenaline kicks in to stop pooling. Although as its local (hand only) im thinking its the former.

[Brye]

1. Haven't looked at my pupils ... too busy trying to stay upright.

2. No head sypmtoms when I lean forward!

3. Hands get cold/blue. I'm a fairly cyanotic looking person if I get stressed or cold! My hands are frequently cold and blue!!

Brye

[ramakentesh]

its worth checking out your pupils next time you are symptomatic - there is a point to this LOL. Id never noticed mine until a friend said something.

[summer]

Interesting about the pupil constriction/dilation. Our responses are so different - from very dilated to pinpoint. Ram, what are your thoughts about this?

[dakota]

I wondered if the pupil dilation might have to do with meds. Wikipedia says "Drugs that increase overall serotonin levels in general are capable of causing mydriasis" so I was kind of thinking that my daughter's dilation might be related to the Trazadone she takes for sleep.

[erik]

1. pupils seem normal at all times (though whites are prone to incredible redness when symptomatic)

2. head forward seems normal

3. hand gets purple & veiney

[bjt22]

1. when you are symptomatic have a look at your pupils - do they seem unusually large, normal or unusually small?

on the larger size, but slower to adapt to changes in lighting

2. When you lean forward does your head feel normal, or does it feel like its filling up like a balloon with blood or liquid?

Oh, definitely feels like its filling with something...anytime I move my head or just my body quickly it does this.

3. Lye flat on a bed and hang your hand down and keep still for five minutes. Have a look at your hand. Is it normal, blue and cold or hot and swollen?

Blue, warmish and swollen.

[pat57]

Do you have any idea what that #2 (head pressure )is all about?

I have asked several people (at work) about it, to see if they feel it- they don't.

I find it very uncomfortable.

[ramakentesh]

THANKS for the replies.

I was thinking about it this way:

1. parasympathetic nerves generally regulate pupil constriction - medications that upregulate parasympathetic action result in pinpointed pupils. Pupil dilation on the other hand can be caused by many different mechanisms - parasympathetic withdrawal being one of them perhaps but also increased serotonin, medications, epinephrine release so its probably not as helpful as perhaps pinpointed pupils might be in indicating how the overall sympathetic tone is operating maybe.

2. The head pressure thing appears to be a result of impaired cerebral vasocular regulation. Apparent blunted arterial vasoconstriction. So when you lean forward an unusually large amount of blood runs into your head region.

Cerebral circulatory regulation is implicated in POTS.

3. This can help to suggest whether its local regulatory factors that might be at play in your form of POTS. An overly zealous vasoconstrictor action may make your hand cold and blue and suggest that either through Net deficiency or other factors there is too much vasoconstriction as a response to blood pooling.

overall these observations may be helpful in determinging what is going on in your form of POTS.