Stress and Symptoms

[MeganMN]

At work on Sunday I had a very stressful confrontation at work and ended up crying, getting all splotchy and flushed,  and.spent the next TWO days fighting the fallout. I had a horrible headache, super dizzy, almost passed out in the kitchen, exhausted, felt horrible. Is there anything I can go to shorten the recovery time or mitigate this reaction? It was.horrible, and obviously stress cannot be completely avoided!

[Pistol]

Rest!!!! Avoid being on your feet too long, call of work and stay home, drink fluids, eat salty snacks, be kind to yourself! I too cannot handle stress - whether it is physical activity, temperature changes, emotional upset … even though I am controlled on meds and follow my limitations - stressful events will trigger symptoms. In my case over the years the one thing that helps me to cut a flare short is IV fluids. In the past my PCP would admit me for fluids or order them to be given over 8 hours and it was no-fail treatment every time. But I understand that not every doctor is open to this. In my case my PCP gave me a standing order and I could get the fluids at an infusion center. Now I have  a port and get them at home. There are studies about the effectiveness of IV fluid therapy in the treatment of POTS - so talk to your doc about it ( you can PM me for a link to the studies ). I bet you would be surprised how much they help for these - unfortunate - flares. And I am sorry you had this confrontation at work - as I said: be kind to yourself and take care of yourself!!!!

[MeganMN]

Thanks!  It took me by surprise for certain. I had a pretty terrible week and even had a pretty rough time through Wed. And then yesterday and today have been much better! No dizziness at all! Yay!  Am optimistic that I might have some sort of plan after my appointment this week with the EP. Hope he is a good one. 

[Pistol]

@MeganMN -when you go to the EP go prepared: write a list of all of your symptoms and BP or HR readings when you feel bad. Tell him what triggers your flares and what makes you feel better. If he dismisses any of your symptoms than he is not a good one! EP's often are trained to just concentrate on the heart itself, especially the electrical system of it. They sometimes forget that the heart is ONE part of the cardio-vascular system and is regulated by many other influences. That is the nature of the ANS's cardiac branch. Also - tachycadia, palpitaitons and syncope are only ONE part of POTS: fatigue, weakness, exercise intolerance, GI problems etc are also important symtpoms that need to be addressed b/c they affect our quality of life. An EP most likely will concentrate on any cardiac symptoms - and that is his area of expertise, so it is a good starting point. --- I had 5 cardiologist before I found my current one and also my specialist. They as well as my PCP are all wonderful and understand that POTS affects the whole body and person, so they address ALL of my symptoms. THAT is what you hope to find in a good EP capable to treat POTS. But having said that  - it takes a village!!! Most of us have several docs so do not expect a miracle. But there should be some treatment recommendation to give you relief!!! Best of luck - please keep us posted how the appointment went!!!

[p8d]

Stress is one of my worst triggers.  I agree with @Pistol.  I like my cardiologist but he only deals with BP/HR.  My neurologist deals with everything else.  I adore her. 

[MeganMN]

@Pistol So I wrote a big, long reply last night and it looks like it never sent!  Eek!  Essentially, I said that I am trying to keep a running tab on my symptoms, but I am really struggling with the triggers because other than a few random things, I have been unable to really sort out WHAT makes things better or worse.  Sudafed seems to make symptoms better, but fluid intake, compression, salt, etc do not seem to make much difference.  Stress definitely makes it worse!  I am wondering what I should be thinking about in terms of other testing.  I feel like i should probably get a Holter/Event monitor but am guessing that i would have to be off the Propranolol for that?  I am also wondering about Norepi levels, other Cathecholamine testing, etc.  I have also wondered about ENT and/or Neuro because of the awful lingering dizziness/head pressure that remains in spite of everything.  Any suggestions on what else I should ask the EP?  Nervous about the idea of stopping the Beta Blocker for testing.  I am always so tachy in the morning and then at night it is the opposite- I get unconducted bigeminal ectopy with rates in the 40's!  

[Pistol]

Hi @MeganMN - yes, a halter monitor would be good but you do not need to stop the BB ( unless your EP wants you to ). Depending on your symptoms he/she may want catecholamines but that is only of you have symptoms of hyper-POTS. The usual tests ordered are TTT, basic labs, EKG, Echo, sometimes stress-echo, rule out pheochromocytoma ( labs and urine ). If you experience a lot of palpitations many cardiologists or PCP's will order a halter monitor to check for arrhythmias. My specialist also checked renin/aldosterone levels at my first appointment. Good for you that you are trying to prepare yourself - best thing you can do because until you find that one-in-a-million doc you  have to advocate for yourself. But this forum is always here if you need us!!!!