Should I Quit my Active Job?

[Neomorph]

Hello everyone, I am new here. I was just officially diagnosed with POTS two days ago, 5/9/2023. Apologies in advance for the long post. A little bit of background, I am 23 years old and have been experiencing POTS symptoms since I was about 12. I only became aware of POTS and Dysautonomia about 6 months ago. I realized maybe the symptoms I have been living with were not normal, and I brought them up to my PCP, and he referred me to a cardiologist. They confirmed the POTS diagnosis. The symptoms I experience are: Dizziness on standing, frequent near-fainting (only actually fainted once), tachycardia, fatigue, aches/pains, headaches, heat intolerance, exercise intolerance, shortness of breath, and IBS symptoms. Mornings/waking up are difficult for me.

I hear that it takes many POTS/Dysautonomia patients years to receive a diagnosis, so I am grateful that my PCP quickly took me seriously and got me checked out. However, it took me so long to realize that what I was feeling was not normal.

Now that I have an official diagnosis and am learning a bit more about POTS, I am finding myself in a bit of a dilemma. 6 months ago, I started a job as a veterinary assistant. As you may imagine, it is a very active job. I walk 10,000+ steps a day and lift heavy animals and equipment. I find that restraining animals on the ground for long periods of time (such as during treatments) and then standing causes dizzy spells 9/10 times. Sometimes I see stars, or my vision blacks out. I often sit or squat until it passes. In some ways, I feel that this job has improved my fitness. In others, I feel like it is exhausting me. Some days, I work and deal with clients while feeling groggy and like a zombie. Every night I come home drained and sore. My shifts are 10-11 hours. Tonight, as I’m writing this, I am getting over a pounding headache that started in the last hours of my shift.

I feel like my body should be acclimated to this job after 6 months, but it just isn’t. I’m tired of being exhausted by work and in pain nearly every night. I think I am suffering from burnout due to how I feel physically. For the last couple of months, I have fantasized about quitting this job and taking time for myself. I have a marketing degree and have started a business, but I can’t afford to quit my “day job” yet. I want to spend what energy I do have working on my business ventures. My friends and family don’t seem to understand the physical and mental toll my vet job has on me. I wear a smartwatch to work, and sometimes my heart rate reaches up to 200 BPM, especially when I am dealing with a lot of hard cases. I am starting to feel like this job isn’t worth it. I am craving peace, rest, and time to improve myself.

When I was diagnosed the other day, my cardiologist made it sound like staying active was of the utmost importance. I figured my job should be enough activity, as I come home wiped out every night. My cardiologist wants me to fit in even more exercise and stressed that I couldn’t become sedentary. I just feel like I can’t do it all. I am so tired.

So, I am asking for some advice. How have you all in the community dealt with work? How do you manage active jobs? I’m considering looking for a remote job to hopefully make mornings/work days easier, but I understand that would make me more sedentary, which is not great. I’m not sure what move to make here. All I know is that I am not currently happy/feeling good.

For anyone curious, these are the lifestyle changes I was told to make: Have up to 10,000mg of Sodium daily, take magnesium supplements, drink 3+ liters of water daily, wear compression garments, stay active, stay cool, and take my Propranolol as needed. The only thing I’m not doing yet is wearing compression garments; I plan on ordering some asap. Any other suggestions? (I know I should run everything by my doctor). Thank you so much for any advice, and I wish you all well on your own dysautonomia journeys.

[MomtoGiuliana]

Welcome to the forum.  

Staying active is important but it can be a delicate balance bc many of us can feel a whole lot worse after over doing activity.  Are you able to stay well hydrated including increased salt (as your dr recommends) while working?  A 10-11 hour shift as a vet assistant sounds like it would be exhausting for most people frankly!  Since the economy seems to be strong still maybe another less active job that pays as well is possible, giving you more energy to work towards your other goals?

I am able to work full time, but I have had some very bad relapses/flare ups preventing me from working.  My job is a mix but mostly a lot of sitting.  That has allowed me to work even when not feeling great.  There is no way I could do the work you are describing even if in a mild flare up.  

For exercise most days, I walk and do yoga.  

Compression garments can be very helpful.  Hope you can try that soon and see how you feel with them.

[Neomorph]

Thank you for the reply! I think I am doing pretty well with staying hydrated. I've been drinking 2-4 Liquid IV drinks daily at work, and I feel better after having them. I also salt pretty much all of my food now. I definitely could drink even more fluids. I've read that people with Dysautonomia really benefit from jobs that are flexible and allow for frequent breaks. Unfortunately, that is not possible with my current job. We are supposed to have two 10-minute breaks during the day, and that doesn't even happen because we are so slammed. I also feel bad calling out on the days I'm not feeling well because we are so short-staffed. It's sounding like being a vet assistant isn't sustainable for me anymore! 

Yoga sounds like a good exercise option. Do you experience dizziness while doing yoga? Are there certain poses you avoid?

[Pistol]

@Neomorph I was diagnosed with HPOTS many many years ago. At that time I was working 12 hour shifts as a RN in a hospital; I tried to keep my job and pushed through the shifts, despite passing out and dealing with all of the other symptoms for two years. then I had to stop working all together. I am disabled today, but I can honestly say that I know now that continouing to work made my illness so much worse. Exercise is definitely an must, but being on our feet and not being able to respond to our symptoms is a nono! Today I am able to walk and do mild housework and when I could not do that I used a rowing machine. But I HAVE to be able to sit or lie down and rest when things become too much, or I become really bad. Only by balancing rest with activity and being able to take things slow on bad days have I been able to regain some quality of life ( in addition to meds, treamtnets and IV fluids weekly ). 

So, based on my experience, I would look for a job that accomodates your needs better than the one you have now. As @MomtoGiuliana said - that job seems very stressful and challenging even for a healthy person! 

Also - when you order compression hose please make sure you take the right measurements to get the correct size! 

[Neomorph]

@Pistol Thank you for sharing your experience! That sounds similar to what I am dealing with at work. I am concerned about pushing myself past a point of no return. I am glad to hear that you could find a balance and treatments to help you start to feel better. Is HPOTS the Hyperadrenergic type? My cardiologist didn't get into specifics, so I'm unsure which form I have. 

[Pistol]

@Neomorph yes, HPOTS means hyperadrenergic POTS. This type of POTS is - different than other types of POTS - caused by excessive vasoconstriction. So commonly prescribed POTS meds will make it worse, because they address vasodilation. The biggest difference in this type - that I have found - is the tachycardia and symptoms are accompanied by high diastolic BP, cold hands and feet, and tremors. 

[Neomorph]

@Pistol I see! Thanks for the information! I am still learning lots. 

[MomtoGiuliana]

For me with yoga, I just pay attention to how I am feeling on any given day.  The thing that is great about yoga is there are many options and poses.  You can move as slowly as you need to, etc.   I feel better when I am at least doing 10 min of yoga daily.

[Sarah Tee]

I guess this is a naive question, but is it legal to have people working such long shifts with only two ten-minute breaks?

In Australia, if you work eight hours, you must have two tea breaks (15 or 20 minutes) and a half-hour meal break. If you work more than eight hours, you must have two meal breaks.

People with POTS are advised to have frequent small meals, as well as rest breaks, and it seems your current job is unlikely to accommodate that.

Could you find a veterinary assistant job with more reasonable hours and proper meal breaks?

P.S. I don’t think your cardiologist appreciated how active your job is. If anything, you should be doing less exercise, and definitely different exercise. People with POTS are usually advised to start with supine exercise, then build up to seated exercise or perhaps swimming if that suits them, and finally upright exercise. There are special exercise programs for POTS that you can access (free PDFs). Definitely not squatting and standing, or holding difficult positions for long periods, or anything that makes you feel faint or start to black out. It’s not so much that fainting is dangerous, although it’s definitely something to be avoided, but the damage you might do to yourself if you faint and fall. Also, feeling faint or fainting is exhausting, so it’s counterproductive. The general idea is to exercise in a way that doesn’t make you feel faint, and to gradually build up, alongside lifestyle measures and often with support from medications.

Here’s some lectures that might be helpful:

https://vimeo.com/672168018

https://vimeo.com/672168018

 

[MikeO]

I hope you work this out. I have experienced the hPOTS (seizures) and sudden tarcardia. Low BP has a hand in this. There is other reasons outside of the general it's dysautonomia blame i just won't go down the road as to what i am finding out.

A good employer should make some accommodations for you (not unreasonable to ask).

Best of luck!    

[Pistol]

57 minutes ago, MikeO said:

A good employer should make some accommodations for you (not unreasonable to ask).

@Neomorph I agree with this statement. My employer exhausted all avenues before we decided I could not work anymore - shorter shifts, less days, desk job, wheelchair, extra breaks ... before they let you go they should see if they can keep you on in a different function. Although the law here in the US states that they do not HAVE to do this if the accommodations are unreasonable. The employee must be able to fit the job description. 

[Neomorph]

@Sarah Tee I looked it up. Technically, the law here is that we should receive "a paid rest period, free from duties, of at least 10 minutes for every 4 hours worked". So I should be getting at least two 10-minute breaks a day. While this is outlined in our employee handbook, this doesn't happen. The closest I get to taking a break is going to our break room to quickly chug some Liquid IV or eat a handful of chips before someone calls me back to help with an animal. However, we do get an hour for lunch because "all workers must receive a meal period of at least 30 minutes for every five hours worked". So I guess my employer isn't holding up their end of the deal with the breaks? I'm not really sure what to do about that. If we aren't getting our state-mandated breaks, I'm unsure how I'll get extra accommodations. I technically am already part-time. I work three 10-11 hour days instead of four days per week. 

And thanks for what you said about exercise! I felt that my cardiologist didn't understand how active I really am at work. I will definitely check out those lectures. 

https://www.lni.wa.gov/workers-rights/agriculture-policies/rest-breaks-and-meal-periods#:~:text=All workers must receive a,of at least 30 minutes.

@Pistol @MikeO My clinic does have reception positions, and they spend most of their time seated. And they don't have to restrain/wrestle the animals like the assistants do. I have thought about asking them to see if I can become a receptionist instead. Part of me wants to go into a completely different career field because it seems that no matter what, working in a vet clinic is stressful. The receptionists often come to the back nearly in tears because phones are ringing off the hook, clients are yelling at them about pricing, or the lobby is full because our doctors are backed up on appointments. It wouldn't be as physically demanding, but I'm not sure it would help my heart rate xD