Healthcare worker Cognitive Impairment and POTS

[Smile6205]

I was finally diagnosed with POTS 6/2017 after many years of symptoms.  Over the last 4 years my memory, ability to prioritize, comprehend and focus as a health care worker has changed dramatically. People talk to me and I forget it if I don't immediately write it down, then I lose my paper. I am very easily overwhelmed anymore and constantly stay late to work. The stress at work exacerbates my symptoms. My family jokes and says I have early onset dementia (not funny I'm 33). I've been on Florinef 3 weeks and just started midodrine. I have severe pooling in dependent extremities, esp with heat.

Will the brain fog get better as I find medications that work? Will I need to go on disability? I used to be an avid reader and dropped out of grad school because I just can't comprehend what I read. I'm so confused as what to do. I tried a desk job in past but my symptoms were terrible and getting up walking around and compression stocking have not given me improvement. I only work PRN not more than once a week. I am going to have a serious conversation with my Dr. next week about my ability to safely perform my job. 

Experience, stregnth and hope please. 

[Guest KiminOrlando]

I was a stock broker. I had to go on disability because of risk and liability issues. I no longer read because I can't remember what I am reading or realize I have been on the same page for 10 minutes.

I wish I could give you more hope for brain fog. When the stakes are high, the idea that you can cause serious damage is terrifying. 

I hope you find your experience is different.

Kim 

[BuffRockChick]

I experienced similar when my POTS is worse, although I also have ADHD diagnosis.  My ADHD testing was pretty moderate, while my questionnaires were pretty extreme.  I've noticed my worst ADHD symptoms are related to upright position.  Interesting, for sure!  MY PCP encouraged me to "consider" that I have ADHD + POTS.

When I was on methylphenidate for ADHD, my POTS symptoms disappeared.  Now, this was before I knew about POTS and I was not aware of tachycardia yet. BUT when I was on methylphenidate was the only time I've ever been able to be on my feet all day without severe consequences. Methylphenidate has been researched in POTS patients, 77% effective among refractive POTS patients.

If you're not getting relief, it may be worth asking your doctor about.  You may also want to explore taking a medical leave of absence while you get treatment sorted out.  You haven't exhausted treatment options, there is hope.  (((Hugs)))

 

[Zebro]

On 7/10/2017 at 0:02 AM, BuffRockChick said:

When I was on methylphenidate for ADHD, my POTS symptoms disappeared.  Now, this was before I knew about POTS and I was not aware of tachycardia yet. BUT when I was on methylphenidate was the only time I've ever been able to be on my feet all day without severe consequences. Methylphenidate has been researched in POTS patients, 77% effective among refractive POTS patients.

 

So methylphenidate works better than examphetamine based meds?  (ie. Ritalin vs. adderal? ).  

I have EDS but was told that I do not have POTS.  But brain fog is pretty bad.  Similar issues with memory but not as severe as above posters.  I started on a med that is called vyvanse but so far it seems to cause mild headaches and minimal improvement in focus.  Energy levels are better though. Still, the mild headache with it kind of leaves me underwhelmed overall.  Now I am wondering if methylphenidate should be considered.  

[BuffRockChick]

My sister does not have POTS.  She has similar symptoms without tachycardia.  We suspect she has neurocardiogenic hypotension/syncope.  Interestingly, she also has ADHD diagnosis.  She's hesitating to seek diagnosis for her blood pooling, dizziness, headache, fatigue, brain fog, symptoms because she has never fallen or fainted, so she is considering getting switched to a stimulant medication for ADHD to give her relief from her OI symptoms.

[vemee]

I can understand how you feel.  I was a firefighter/emt and had the same problem and still do.  Adderal helps a little but I still have the problem several of you have mentioned; reading is like forcing information through a brick wall.  As far as work goes the Adrenalin surge of an emergency situation helped a lot and kept me out of trouble.  I finally had to retire and go on disability when  I could not keep my blood pressure from dropping  after being upright for an hour or two or under heavy physical stress.

[Debbie Rose]

I am on disability-long term from my job-going thru the SSDI stuff with Neurocardiogenic syncope. I think there is a hyperadrenergic thing too during stress at work. My brain fog was so bad by May 2015, I could not do my job well and was fearful of making that mistake that would end my job. I can't read unless I can read the book in a day or 2-still once I put the book away I completely forget what I read. I am lucky, my sister enjoys reading to me and will remind me of characters and plots as we go along. But I have all my bills on auto-pay since I can't trust my memory and my sister helps alot-lives with me.  I tried to use post-its but I would forget to read them after I posted them-LOL!!! what a mess. I was on provigil for years to help with focus and concentration since I didn't want (was fearful of) amphetimine type meds. But I started to get severe headaches as I came off the med in the evenings so I stopped it.

We can only do the best we can with what we have

Debbie

[Lily]

I used to think that there was a portion of ADHD that did not respond to medications, but now I think it was the POTS.  I have found that brain fog is better with the right medications, probably because they increase blood flow to the brain.  I think brain fog is caused by insufficient blood flow to the brain?

[Bendy_Clutz]

I have narcolepsy in addition to POTS and EDS.  As pretty much all of the above can lead to brain fog, I have a hard time knowing what's acting up at any given time sometimes. But I was on adderall for 5 years and now on Concerta and Ritalin for the last 8 months. The adderall specifically helped my pots at times, even used it sometimes to help my tachycardia (mostly I saw benefit with the XR adderall, less benefit with the IR). I don't know if I could have stayed working without it for the pots symptoms alone( never mind that I can't stay awake or alert enough without them due to the Narcolepsy). Oh and I'm also on provigil which probably does more for other non-narcolepsy folks than it does me but it helps some with the fog as well. 

Until I had the meds I do and wore the compression regularly and made sure I drank enough through any given shift, and tried hard to put my feet up while charting (I'm a nurse), I struggled like crazy with the anxiety/can't think straight/overwhelmed too easily..  and I have days for sure that I feel like I'm back to square one but thankfully they don't happen all the time and I've educated my coworkers a bit so they'll help me out when they can if I'm extra potsy (and remind me to drink if I've been too busy lol). 

im also on florinef and propranolol for my pots and wear 20-30 or 30-40 compression depending on the day and what's clean. 

[Debbie Rose]

Hi Bendy,

   I was a telephonic health coach first at a health center, then from home. And then they decided we all needed to be case managers with all its requirements. The level of anxiety was what brought my potsy NCS to become intolerable. On the phone with a client is no time to get tachy, short of breath,dizzy and forget all the questions you have to get answers for. And the harder I tried the worse it got. No longer able to work now....glad to hear you are still hanging in there

Debbie