Can POTS symptoms be transient?

[blizzard2014]

I was just wondering if POTS symptoms can be transient. I have been having a really bad week this week with my other non-POTS related illnesses. I had two days in a row where at work my standing HR was 135 constantly. It was almost up to 150 on Saturday. It was affecting me so much that I had to take 2 fifteen minute breaks in 1 hour in order to push through the rest of my work day. I was operating on survival mode. At first, I put the symptoms down to having ate a huge sandwich before work on Saturday, but I did not eat much before work on Sunday and had almost the exact same symptoms. I felt some better on Sunday, but as soon as I got to my home town area after work, it's like someone hit me with a baseball bat and every muscle in my body began to hurt. I then became out of it with a brain fog, almost had a head on collision with someone in the parking lot and I have not had confusion while driving like that in years. I used to get it a lot before I was being treated for thick blood which causes mental confusion. I checked everything, BP, HR, Blood Sugar was 90, usually when this happens it is low blood sugar. All checked out. I will be getting a blood thickness test in a few days to see if my blood is clotting again. Other than that I had full on POTS symptoms. Even on those nights after I got home, my HR was still going to 115 when standing. I could have passed the POTS test two days in a row with 135 HR for ten minutes straight. But I am not always this bad. So, do these symptoms have to be persistent in order to be true POTS. On Saturday it was so bad I was thinking about quitting my part time job. I have never been that sick at work before. I had full on flu-like symptoms and dizziness, shortness of breath, and weakness. I don't know what more I can do to fight this as I take my meds and continue to force myself to work part time to remain active. Tonight is my hard job, so will see how it goes. Too bad I wasn't on a tilt table yesterday. It's crazy how sometimes symptoms can hide when the doc's are around. I knew to check my HR because It felt like my heart was about to pound out of my chest. I could hear it clanking inside my ears and felt it pumping in my neck like a jack-hammer. 

[StayAtHomeMom]

My elevated HR was not a perfect 30 point jump when I was testing everyday before my diagnosis. Even now my garmin shows high of 120 some days and 150 others. It depends on what I am doing, hydration levels, and time of the month. When I did research in the beginning before my diagnosis I remember reading the POTS is known to have symptoms that cycle. I have not had a dizzy spell that lasted longer than a second or two in about a year and a half or so. But when it started I had it constant for about 3 months then it would come and go as it pleased. That is what makes this diagnosis so hard to deal with. It is constantly changing. 

I hope you feel better soon. I know when I feel bad like you described sometimes I have to take a break. A few days of rest and hydration and I feel better. If I keep muscling my way through without the break I just keep getting worse. 

[Pistol]

@blizzard2014 - yes, it is common for POTS symptoms to wax and wean. In my case I get good periods and bad periods ( usually triggered by something ). But in addition to that Over the years I have noted that there also are times when I just start getting bad and even the treatments like infusions or slight med increases are no longer effective. At those times I get reevaluated by my autonomic specialist and often he had to introduce a new med that usually fixed things. It seems that POTS does change over time. I also noted that at times I have more cardio-vascular issues, then at other times more GI problems or wekness and fatigue and brain fog, or bladder problems. All these areas are regulated by the ANS and they flare up at different times. Or even all at the same time - that is D-day!!! -- I can only stress the importance of NOT DRIVING on bad days. I am no longer driving because POTS can lead to seizures and syncope, so my doc does not allow me to drive at all. But even if you feel you can drive when you are well - if you are not you can harm yourself and others. Imagine you crash and kill someone! --- When I used to work and got bad I either had to call in until I was better or I had to leave work immediately to avoid seizures. That ended up so frequently that I was no longer able to keep my job- or even work in any capacity. I am not implying that the same is the case for you but I do want to point out that pushing through anything is contraindicated for us. It will only result on worse symptms. Stop - drop - and plop. That is my emergency routine: stop what you are doing, drop everything and plop on the couch until you are better. ( And drink fluids!!!! ) 

[blizzard2014]

Pistol, you give some great advice. I know at times I should not be driving. The only reason why I continue to drive is because driving is what I do. I have over 2 million miles under my belt from truck driving. Even on a bad day I am still a better driver than most, but a lot of that has to do with dumb luck. If things get bad I will have to opt for an easier job again. I had a job dispatching 50 trucks from home in 2015, but my friends company went under and I lost my job. That was a good for of work because I would just wake up and be right at work. I used to run my own trucking/expedite company in 2011 and 2012 before I got sick. I know trucking from the drivers seat all the way up to being a CEO. I would just start another company right now if I was healthy. I simply can't go back to working 18 hour days. When you own a trucking company, the phone never stops ringing. Even on the weekends, the phone needs to be answered and customers and drivers need to be updated with new delivery times and position updates. There is never any off time and unless you have a huge staff to help you out, or a few good business partners, you will never get any sleep. This is not good for chronically ill peeps. Oh, I know better not to fight. If I would have not taken my breaks on the weekend, I would have probably collapsed right there on the floor. I did better yesterday though. Weird how one can be on survival mode for two days and then have a semi-decent day. I'm paying for it though today. I did extra cleaning that needed to be caught up on from shaming it for the last two weeks and every muscle in my body hurts. I slept 10 hours after work, got up for 6 hours, then went back to bed for 6 more hours and I will be going back to bed again real soon. At least I emptied out my bowels two good times earlier today so I was able to eat a good meal. Any how, I'm trying to hold onto this cleaning job for another year then I will be ahead financially. 

[blizzard2014]

It's just weird how the last two Monday's I was barely able to complete my work. Last Monday I only made it though my shift because someone illegally dumped in the outside dumpster and I could not empty the trash cans. That saved me 30 minutes of heavy lifting which allowed me to complete my work. Last night I felt better and was able to mop the warehouse area two times in order to make up for skipping it for two weeks in a row. Next week, if I am not feeling well, I can skip it again and then make up for it the following week. I will continue to skip certain tasks until the customer complains. Then I will have to decide if I can handle the work or whether or not I need to move on. As for now, the customers are pretty happy and not so picky, so all is good thus far.