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I told my ANS doctor that this past summer when I was in a cool pool of water up to neck I felt normal. As I expected he said that this was from the vasoconstrictive effect of the water. He said that it had nothing to do with the temperature of the water but the effect of the water pressure on my veins and suggested pool walking as an exercise to train the "muscles" in my veins to constrict.He suggested 40 minutes 4-6 times a week. I believed that the positive experience in the water came from the cool water,not necessarily the water pressure, as I also noticed that being outside when there is a cool breeze also makes me feel better.

Well, I went in a heated pool yesterday, (I'm in Pennsylvania) so there is no outside swimming this time of year and indoor pools are very warm. I did not have the same positive experience as I had in the cool pool and felt just as Potsy in the water as out. Never the less, following his instructions I did walk in the pool for twenty minutes. I am very achy after this and could not possibly have walked for the forty minutes. I can only do about 15 minutes outside on dry ground.

I'm interested in anyone with pool exercise experience chiming in, particularly about the vasoconstrictive effect of water and my doctor's "training" philosophy.

Lynne

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Hi Lynne,

My POTS Dr told me on no uncertain terms not to do hydrotherapy. Firstly due to the heat and secondly due to the fact being in the water would make me want to urinate more. I have problems with frequent urination and only have to hear a tap drip and I'm off! If cool water works go for it!

Rach

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We have had two different doctors give us two opinions on the matter. The first doctor prescribed water jogging for my son to get him in shape and the water helps with the circulation. So my son did that over the summer when he was able.

The second doctor, at the Mayo, said no water jogging. He wanted my sons body to be able to work against the gravity on its own, without the help of the water. The doctor at the Mayo also said no recumbant bike, he wanted an upright exercise bike used. Again the reasoning was for the body to fight the gravity.

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Yet another cardiac specialist in dysautonomia who I saw this fall explained to me with my purple and swollen feet (and having EDS) that the vessels and muscles are very very lax from the EDS problems and the hypotonia from the so many days of temperatures above 90 degrees this summer. He told me no hot tubs or hot showers. I had all the glutteal muscles/tendons ripped off my hip bone when I got hit by a car, and fearing to do my treadmil lest the legs collapse under me without warning, he wrote a Rx for me to take to pool or to physical therapy. I chose PT since there is only one public hotel here that will 'rent' you a monthly rate to use (rather high). The YMCA here keeps it's water temp conducive for competetive swimming. I need heat for the fibro and arthritis and the therapist and I were both really cautious in how we began. I did aquaciser treadmil with water almost shoulder high with a safety belt attached at my waist and the therapist holding on to the other end of the gait belt in case I were to go out. I only went 2 days/week--never back to back. The water temp was at about 92-93 degrees and after a while of 'jogging' sometimes it would begin to feel like a sauna. Sweat would pour from me--yet other times I felt invigorated but after I would get home, I was crashed for the rest of the day and sometimes the next. I always checked my BP before going. Days I felt puney and wondered how things would go, might have gone well. I could never know. One day after I was trying to shower and dress (I'd been cramping so bad from the Mestinon), I was puking/hugging the commode while trying to manage to get clothed and stagger to cot to get down before I went down. I would drink big cup ice water before going in and when coming out. I had 3 episodes where I got faint during the 2 months of therapy and my last session I 'walked' 70 min. (he forgot about me in the aquaciser) going 1.9 miles in water and against the jets. He told me that was an all time record and i was 'physically fit' 'could run a marathon' (so I guess he doesn't get it--good days, bad days). And as the sessions got to around the 50 min. mark, my skin started breaking out/itching horribly (despite showering right out of the aquaciser and again at home). I know it was from the chemicals of the pool being infused into the skin. I had PCP give me Diflucan and coupled 3 days of that with 50 mg Benadryl to calm this stuff. After 2 pills of Diflucan, this is the best (and still itches/hivey and rashy) I've been in about 3 weeks. I didn't want to say anything to the therapist as I was afraid he wouldn't let me in the aquaciser and I didn't want to drag this out through the end of the year. I just wanted it behind me.

I got in outdoor motel pool (cold) this summer and it just made my joints hurt so bad. Therapists told me I should drive to this other county (over icey/snowy winter roads) to YMCA senior center a couple of times/week that have temp around 88 degrees to do exercise program. If I was exercising that would probably be okay for me after the initial surge of pain going into the water. I am not 'senior' by it's criteria but am disabled.

The therapists said that if your doctor writes a Rx for water exercises and that you can show some form of disability (may or may not be needed), they would let you into their classes (another thing I think they don't get--I have osteopenia and should I slip/fall in snow/ice, I'd break a bone. I can't get out to bend over and lift shovelfuls of snow to clear walk/drive. I spend so many days going to doctor appointments not close to home by any means which I pay for dearly with riding being so painful to me with the injuries from the car injury. Those riding days will have me down another day or two.

I used to bike 10 miles every day, too, but this spring when the legs were like lead weights and I didn't understand what was happening to me and I got syncopal I suppose from leaning forward or getting too warm, I got a portable stationary bike til they figured things out. This cardiac specialist in dysautonomia tells me no bike for me--only a recumbent stationary bike. He told me that falls are the 4th leading cause of death in elderly and people with this (plus I have the osteopenia and am a bleeder).

Maybe start out again doing less time. I think my first session they had me in about 12 minutes (hardly worth the shower before and after), and by the end of 2 mos., up to 70 min (therapist had forgotten about me and only intended me to go 60 min). He had me set at 1.4 miles/hour which felt like a jog but I let the water help me with the ups and downs and he told me 1.9 miles in 70 minutes was great?

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While warm water has therapeutic effects for some things, it is not a friend of dysautonomia as it causes dilation of the veins. Both of my POTSy kids feel probably their best in a cool pool. However a hot tub will bring on a crash. My son loves warm water and finally gave in to the temptation to go in a hot tub again last year when at a motel. He enjoyed it so much but collapsed from exhaustion. He was lying on the cement beside the pool for a while before he could even get the energy to get up and walk shakily back to the room. Certainly everyone is different, as is clear from the many discussions in forums such as this one, but I think it's correct to say that generally speaking cooler water is better for dysautonomia patients than warm water. I do think it is vasoconstrictive effects of the water pressure that is the helpful factor but the warm water also has dilation effects according to my understanding and thus apparently overrides the good effects of the water pressure?? Seems to make sense in light of our own experience.

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