New Doctor Appt And Need A Little Advice...

[Sleepbree]

I am so nervous about seeing a new doctor. I feel like I need fresh perspective, however, which has given me reason to seek out someone new. Currently, i take 100mg of metaprolol per day and it isn't really having a huge effect on my POTS symptoms. I still average a jump between 30-40 bpm upon position change, lightheadedness, and extreme fatigue due to either the POTS and/or the meds. I had an ablation for right atrial tachycardia in Nov and it seems that afterwards, I went through a period where I wondered often whether my new symptoms were a result of the ablation or just temporary aftereffects. Either way, my doctor's answer for everything was to raise the dosage on the beta blocker and now I am to the point where I am so tired I can barely function. He says I must exercise and push through it, and for the few weeks that i have done so i have felt no change in my energy levels. the other issue that arose after the ablation was that I was having very sharp chest pains that my doc at first said was pleurisy, but then after it persisted, he did and echo and found a small amount of fluid had collected around my heart, likely due to the ablation. He prescribed an anti-inflammatory for a week and mentioned re-checking for fluid at 4 weeks later. 2 appointments have passed and he doesn't feel it's necessary to check right now. i still have chest pains and shortness of breath. I feel like i am losing my mind.

I want to talk to this new doctor about flourinef but I am concerned, because to further complicate things i have Chiari-1 malformation and I am concerned that flourinef can increase cranial pressure, something i don't need. I already suffer with migraines and worry about the side effects, that it can cause bad headaches.

I just really want to have my head on level when I see the new guy because largely, with my current doctor, I feel that he has come to the end of the line with my care and opted for quick fix answers like exercise and more beta blocker when maybe those aren't the answer. At least, maybe not MY answers.

Any advice is welcome, and maybe I am being too harsh because things aren't moving fast enough for me, I just have to go with my gut on this one. It is daunting, though, to have to explain everything to someone new.

[JenniferInOhio]

A new doctor can be scary, but sounds like it is what you need right now. I thought ablation was contraindicated in POTS patients because it can make pots symptoms worse. That might be the cause of some of your symptoms.

Your beta blocker dosage sounds like a lot! No wonder you are exhausted. I take 10 mg of nadolol per day. I also still have an increase of heart rate by 20-30 bpm, but it lowers the overall heart rate in all positions.

I think you are right to go with your gut. I would insist on a recheck of the fluid.

[Katybug]

If I had chest pain and an echo showed fluid around my heart and the doc (the same one who originally said the echo should be repeated), I would have no problem getting a second opinion or leaving the original doc completely. Please trust your instincts and know that you are not being too harsh.

[griffism]

I have also heard that node ablation was contraindicated in POTS patients because I was interested in the procedure when I was first diagnosed. As far as fludrocortisone is concerned, I think it helps me some, but I can say that the biggest improvement that I have had with regard to quality of life is the addition of midodrine. I have so much more energy! It also helps with my high heart rate, which is much more stable at this point. While I am not a doctor, I would definitely say that midodrine is something you should do some research on to see if it is right for you. I am not sure if it affects Chiari-1 malformation, but it is always worth asking your doctor about! Hope this helps