Theories??: Flat Vs. Uphill Exercise Make Huge Diff. In Symptoms?

[Katybug]

So, I've tried this twice with the exact same results each time because I don't feel like my response to exercise makes sense. While at the park (which has hiking trails through the woods) I can run for 1/4 mile on the flat portion of the trail with no ill effects. I'm not out of breathe, my heart rate only increases 5-7 bpm, I don't sweat, no feeling dizzy, etc. I do feel the effect when I stop from blood pooling and can feel the blood return to my legs which is not surprising. I can't go too much further than this at a run because of my joint pain and swelling. BUT, to get off of the trail, I have to climb a hill that is pretty steep (I would estimate a 50-60 degree incline) and the duration of the climb is probably about 150 ft. from the beginning of any incline to the top of the hill (100 ft of which is at the steep incline). I do this at a walk and am a hot mess when I get to the top. Out of breathe with serious chest pressure, heart racing, blood thumping in my ears, sweating, dizzy, drunken feeling...the whole nine yards POTS usually has to offer. I don't get it!? I also have a bad time with steps. What is it about going uphill that is such a problem and so different from other exercise for me? I can do strength training exercises at home as long as they are at one "level"...you know, if I start the exercise lying down, I need to stay that way like leg lifts are ok but standing and doing lunges is not. The change in orthostatics is not ok. But going uphill isn't an orthostatic change. Any ideas on what causes this?

[Katybug]

Wow...no one has any ideas about why this happens?

[kmichaelson]

Hi Katie, I'm sorry can't offer anything on why this happens, but I just wanted to say that I've experienced the same thing. It seems that any sort of incline or stairs have a much more extreme effect than they should. Like you described, I can increase the difficulty of my exercise and not have such a bad reaction on a level surface, but even taking it pretty easy on an incline brings on the POTS symptoms really badly.

[HopeSprings]

I dunno - I asked a similar question and people agreed that inclines and steps are a problem. Don't think anyone said why though.

http://forums.dinet.org/index.php?/topic/19353-pots-or-deconditioning/page__hl__%20pots%20%20or%20%20deconditioning

[anna]

Professor Grahame explanes some POTs issues are like those found in COPD.

Autonomic Disorders occur in 78% of patients and include Vasodepressor Syncope and Postural Orthostatic Tachycardia Syndrome (PoTS - increased pulse rate on standing or prolonged sitting can result in reduced blood supply to the brain and compensatory high adrenaline levels. Symptoms include fainting, dizziness, fatigue, poor concentration and memory problems, headaches, palpitations, tremor, sense of anxiety, nausea, sweats and visual problems. PoTS can produce functional impairment similar to that found in COPD and heart failure).

RODNEY GRAHAME CBE, MD, FRCP, FACP Emeritus Professor of Rheumatology, University College Hospital, LONDON.

[issie]

katybug,

I asked my husband who is really pretty good with understanding how the body works and exercise. He said that it requires more blood to the legs and activates more lower body muscles than just running on a flat ground. Sounds good to me!

Issie

[Lemons2lemonade]

I feel like this has to do with muscle use and metabolism. I think its not only our brains lacking in oxygen, but also our muscle tissue, which is why we may feel so weak most of the time. Going uphill requires more muscle strength, and there just doesn't seem to be any behind it, does there? Also, another component to consider is that the whole activity of going uphill makes the body have to work a lot harder in general. And, to a certain extent, it is kind of like a tilt, wonder if this is behaving like a mild ttt. It happens to me to though. I've found its actually easier for me to run up a hill, then it is for me to walk up one.

[Katybug]

issie/lemons - I don't have any muscle fatigue in my legs when I get to the top..no feeling of lactic acid build up. I went back to my physiology and human biomechanics textbooks from college (I'm a science geek and kept them) because I thought that was the issue. It is really weird. It really feels like, well...like I imagine COPD to feel (like anna posted). And, what's even weirder is that also get a similar feeling while sitting/laying down.

I think I am noticing it more now that the wonderful effects of the prednisone is wearing off. I didn't realize how much I feel like an elephant is sitting on my chest. I think I was used to it prior to the prednisone but now I can compare it to what I felt like for the 2 wks on the steroids. Thanks to all that responded.

[yogini]

Going uphill is hard for many healthy people, but we with POTS have an especially hard time. Your heart is beating harder to try and get enough blood to your brain while exercising. Your heart may not be strong enough or your body may otherwise be unable to maintain enough BP. If you read through old posts, you see many people have trouble just walking up stairs -- in fact, many people without POTS have trouble with this too and get out of breath. Running up stairs or uphill would be way worse.

I think it is great that you are able to run on flat ground and feel OK. I am mostly recovered from POTS but still have a lot of trouble with cardio. Feeling like there is an elephant on your chest doesn't sound good. I would try to skip the hill part if you can!

[jenniferlynne76]

I'm not 100% sure, but I do know one of the first things my doctor told me was to stay on a flat surface while exercising. His advice was to avoid hills and stairs b/c climbing them causes your blood to pump harder (combination of gravity, greater use of muscles, etc.). So, if nothing else, I think we can all be confident that we're not imagining this! :-)

[Joann]

This is one of my biggest problems and so far no doctor has addressed it. They just say for now avoid stairs. I live in a bungalow! So a huge part of my house is unaccessible to me. I cannot go up or down stairs and avoid inclines as well. I haven't tried jogging, but I have been walking quickly,, and I hit tennis balls back and forth with my daughter for about 20 minutes (I wasn't running all over but still) and that seems to be fine.

It justs seems crazy to me that 15 months ago, I went up and down stairs, even running up them with no problem. Now I cannot even go down 13 steps without awful results.

I don't get out of breath, and sometimes my reaction is not right after, but an hour of more later. But it will trigger symptoms for days!

If I ever get an answer, I will post it.

Once I did try just going up and down 6 or 7 steps hoping I could do his for a few weeks and keep increasing the amount of steps, but I did this for 3 days and later that night had the sympotoms begin and last for about a week, so I stopped that experiement. I am ok going up 2 or 3 steps, so I can get in and out the door okay. LOL

Could our body get that "deconditioned" that quickly, (i hate that term) that we can't do stairs. Can't lift heavy things either, that causes problems too.