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Help with hyperpots episodes


lamp_girl

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The last few days I've had several scary episodes, one of them took me to the ER, where I suddenly felt like I couldn't breathe/was hyperventilating, face flushed, got dizzy/lightheaded, muscles went limp, heart beat and blood pressure went through the roof, honestly thought I was going to die. In the ER they stopped it by giving me IV ativan. Since then I've been taking ativan regularly to prevent these episodes/stop them when I feel like they're coming on. They are definitely more likely to come on after I've been upright and active for a while, but they don't just go away when I lay down. It's been pretty strange because I haven't had many hyper pots episodes before, though then again my POTS seems to be worsening. When I was in the ER they though it was a panic attack, but I have never had a panic attack before and it feels strange that these come on only after I've been upright for a while.

Is this a standard hyper pots episode? Is it an adrenergic storm? Should I be worried that I actually am going to die when these happen? So far they've only ended after I've taken ativan, I haven't tried to see what happens if I don't.

What do people find helpful for preventing these? Do beta blockers work? I definitely can't keep taking ativan forever and would rather not live my life lying down.

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Hello @lamp_girl - yes, this sounds close to what I experience when I have hyperadrenergic symptoms. In my case I always also get cold hands and feet. At times I can stop them by immediately retreating to a dark, quiet room and lying down. If I am not able to do this then I usually either pass out or have an autonomic seizure. I personally have never taken Ativan for this but was told that Ativan does not work for this. I take 0.5 mg of Ativan at night sometimes for sleep but it has never prevented any episodes, I would still get them during the night sometimes despite taking the Ativan that night. -- It is a good thing if Ativan helps you, that way you have something you can take at the first sign of trouble and hopefully prevent a full episode. Best of luck!!!!!

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In my case yes I have these. They do go away on their own. In my case I think it always feels worse than it is and does mimic a panic attack. I guess panic attack is one way our body can signal us to change what we are doing. I guess I try to limit my time up and activity to where I do and rest do and rest all day long so I never get to that level. It usually takes me 30-45 minutes to feel okay again if an episode starts coming on strong. 

I hope you can find a level of activity that you feel satisfied with that also helps you avoid the episode. 

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It sounds like one.  Have you had your catecholamines checked?  Sitting and standing for ten minutes each?  There’s also a urine test.  Are you seeing a dys specialist?  In my case I had evidence of adregernic involvement when I got tested but it’s definitely worsened over time.  There are drugs to help, clonidine, methyldopa and a few others.  Alpha 2 agonists.  Betas won’t touch the norepinephrine dumps but will help the tachycardia.  

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I don’t know.  Personally I haven’t found anything that helps all the other symptoms of being upright too long except sitting with my legs elevated when I get that I have to sit right now feeling. I do fluid load before trying to be upright anything more than a few minutes and that gives me a few more minutes.  We are all so different, it can be blood pooling, norepinephrine release or something specific to you.

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