I Flew Again! Initial Tachycardia Still A Problem - Any Suggestions.

[E246]

I am so pleased to have got this under my belt as I can now go on holiday. But...

The flight was only 1 hour and I HR climbed to145 when the plane pressurised before take off, then dropped after maybe a minute. Coped with this.

On the return flight I was very tired and as soon as it pressurised and took off my hr climbed up to 150, then it jumped really fast for maybe 1 minute - probably around 200bpm. (This can happen normally if I move to quickly but have been told it is sinus rhythm.) Its not pleasant and afterwards I am cold and shakey. I recovered and was ok for the rest of the flight.

So - any suggestions for minimising this.

I had on tights and I drank lots of water.

I assume the pressure change dilated the vessels in my legs / stomach and drops the volume of blood to my heart - so my HR increases. I assume my blood pressure drops. Normally its a little high. I take 1/2 tablet Fludrocortosone. Can't think what else to do to try and avoid this.

Any other suggestions.

[firewatcher]

I asked a former Air Force Instructor now airline pilot about this less than five minutes ago.

He said: "There is generally very little (1.125 psi) or no pressure difference at take-off, and cruising altitude is about 8,000 ft atmosphere (8 psi.) There are only about 1.1 G's pulled at altitude during take-off. So there should be no physiological difference for the people on the plane."

BUT...we don't respond to "normal" circumstances (like standing) like "normal" people do, so there is a possibility of hypoxia due to the slight increase in pressure. He suggested that you speak to your doctor and get a prescription for oxygen to take with you and use it as needed. The airlines will provide oxygen or you can bring it with you if you coordinate it with the Airline and your doctor before the trip. (I don't know the TSA regulations.)

I have found that compression and hydration works for me, but I have not tried O2. I still have several hours of increased symptoms after flying, so something is going on up there.

[E246]

Hey - thanks - that is really helpful.

I had the same reaction on euro star as soon as it pressurised and we were only just out of London.

It does seems the slight change in pressure just sets of a tachy episode.

I took 5mg valium to keep down any anxiety - don't know if that drops BP and contributes. It's hard to know what's best.

I have bought oxygen as an aerosol and doctor's fit to flight letter suggests this could help. I have wondered if that was it too. I lost my oximeter that I was going to try on the flight in the taxi. I will have another for the flight on Wed.

I just want to understand what it is that causes it.

I am just so pleased with myself for facing it. I felt very trapped by being too afraid to travel.

Sorry you have a bad time after flying - I can understand that and a few others have said the same.

Cheers for your help.

[Katybug]

I haven't flown since my official diagnosis (just because I haven't had any place to go) but when I had symptoms and was flying for work and had no dx, I used to practice meditative breathing during pressurization and take off, as well as landing. It did not prevent changes/symptoms from happening, but, it did minimize the whole thing. At the time, I thought I was having anxiety attacks but also thought it was odd since I don't fear flying...now I know it was POTS.

I asked my POTS neuro about that a few months ago and he said that it has been proven that meditative breathing does help slow the heart rate (can even reverse the effects of some heart failure) and that I should keep it up. I actually find there are times when I breathe very slowly subconsciously and he said it is probably a learned counter-maneuver just like fidgeting. A good and easy book to learn how to do this in everyday situations is, "Where Ever You Go, There You Are", by Jon Kabat-Zinn.

[yogini]

If you can get an extra seat or two lie down at takeoff. Airlines let you do this as long as your seatbelt is on.having your body's/head as flat as possible may help

[puppylove]

Emma246- that was so brave of you to face your fears and fly! Good for you for not letting POTS hold you back.

[E246]

Thanks Puppylove - It has taken 14 months to dare to do it but I feel empowered by it. It's probably taken this long to get a grip on all the pots symptoms and how they hang together.

Katybug - Yes I have been doing meditation but also saw a psychologist and followed her instruction of moving eye and physical focus from one side to the other by tapping alternative thighs with left and right hand. I am not afraid of flying - this has happened twice before take off - but I am anxious about the high tachys.

Yogini - I always lay down as soon as I can but don't want the stress of trying to persuade the staff to let me lie during take off - I assumed they would not let you.

Thanks for replies - I am feeling stronger about flying on wed.

[corina]

Emma, the only thing I could think of was an abdominal binder might be of additional use. I have the same porblems flying. I know it doesn't kill me but it does make me quite sick. I'm happy you've overcome your fear and hope you'll have the best summer holiday ever!!!

[issie]

I think you have to be seated upright on take off and landing. I've flown quite a bit and it is a little nervey. I have issues with low oxygen too. There is an herb that helps with altitude called Suma that has a lot of germanium in it. I use it at high altitude. It helps to increase oxygen. There are also medicines that you can get for altitude. When I recently went to CO - where we stayed was at 7,000 feet. I had a hard time being at that altitude. The herb and oxygen helped. We were only there for 3 nights and by the 3rd night I was getting a little better - but, was still not great. If the airplane is pressurized at 8,000 feet - then that explains the issue with flying. I can go up to about 5,000 feet before I have issues - any higher and it becomes a problem. But, I don't let that stop me ---I just know I'll feel bad for at least a day after flying and do it any way. It's worth getting to go somewhere and see something different. I lived at this altitude and never really adjusted to being that high up. My POTS was a whole lot worse when I lived that high. Now that we are lower down - I feel much better.

Issie

[E246]

Thanks Issie/ Corina - You can see I am watching the responses as this has been such an issue for me. It has all been really helpful.

Would anyone suggest a beta blocker - I always assume the heart goes fast to compensate so I have worried it is not good to stop this.

What do you think?

[corina]

Emma, my cardio advized me a bb when in the mountains (I get in trouble as soon as I'm above 800 meters), so it might be an option (to keep hr in control) while flying too. Please talk to your cardio about this s/he's the one to know!

I started flying again last year when we went to Rome (I'm in The Netherlands) and got sick again on the plain. Like Issie, I'm very determined to go on flying (unless I'm in danger of course) and enjoying all the places that are on my list!!!!

Have a great time Emma!

[yogini]

Not sure where you are, but in the US as long as you have your seatbelt on you are fine. I only do it when there is an empty seat next o me. They are pretty good about letting you move to an empty row once everyone has boarded. Everyone does this - you dont need to mention POTS

[Katybug]

Emma,

Keep in mind that it is the meditative breathing that is specifically helpful to us (not meditation in general) because your respiratory rate has a direct impact on your heart rate. Not that general mediation isn't good for us, but the controlled breathing has a very specific benefit for those of us with heart issues.