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What Is The Difference Between Oi And Pots?


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:( Can anyone tell me the difference between OI and POTS? I can't quite make the distinction!
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OI tends to be a blanket term for any illness that causes a person to be unable to stand. Examples of conditions that cause OI are POTS, NCS/NMH. OI simply means, in plain english,"the inablity to stand".

POTS is defined as a heartrate increase of >30 bpm upon standing, with or without a signifigant drop in blood pressure (>20mmHg). POTS can cause OI in some, but others have POTS and have no real trouble standing.

I hope that makes sense!

-Lauren

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Yes Lauren, that does make sense,thanks. I did not know that some POTS patients do not have trouble with standing, that is one my main complaints. Thanks again, Pat

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dont you have to have symptoms of orthostatic stress WITH the 30 beat or more raise in HR to be diagnosed with pots? i have read that and also been told that..........doesnt make much sense to me though. i guess it kinda does if someones rates are like 60 supine and only go to 90 standing (30 beat or more) because generally i dont think symptoms would occur with normal heart rates (60-100) and if they did, i would think they'd only be minimal. tachycardia alone can be enough to make one symptomatic and so if someone isnt necessarily "tachycardic" (over 100 BPM), i could see why they wouldnt be symptomatic, cuz sometimes the tachy is actually the main reason symptoms are brought on... i know if i'm under 100 BPM i feel fine, if i'm over 150, i dont feel well at all and if i am at 210, i am very sick. my heart rates tend to reflect where i'm at or how i feel symptom-wise.........not sure if it works like that for the rest of you..........

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The terms are used interchangeably between the specialists. It's mostly just doctor preference. The bottom line is if you have POTS, you typically have problems being upright, so you have OI too. I think I saw on the conference tapes, about 13 names that the docs all agreed could be used for these conditions.

A paper by David Robertson stated that more and more doctors are just using OI, as the primary term, because it pretty much encompasses everything. I will try and find that particular paper again, but who knows if i will. I think I may have been looking at baroreflex at the time.....anyway, as i said, before I commenced my rambling spree, a lot of it is doctor's preference....

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I think "Orthostatic" means upright posture. OI means difficulty being in an upright posture. POTS means tachycardia in an upright posture, and it is a subset of OI. Other forms of OI include NCS, PAF and Shy-Drager. Most people with OI have either POTS or NCS. Some people feel strongly about distinguishing between these conditions. There are subtle differences, but I personally think of POTS and NCS as pretty much the same thing. The Dinet main page and NDRF Handbook have good explanations of all of this.

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Here's my take on it. Folks here are generally correct in saying that OI is used as a broad, overarching term, encompassing all the syndromes that have intolerance of being upright within them. In fact, NDRF (another dysauonomia organization), has a good general definiation with the heading "orthostatic intolerance syndromes" here:

http://www.ndrf.org/orthostat.htm

From our website (DINET), here's the overview of POTS.

http://www.dinet.org/pots_an_overview.htm

So, while some doctors may use the general term OI, POTS is the specific name given to the set of symptoms

Postural orthostatic tachycardia syndrome (POTS) is a disorder characterized by orthostatic intolerance.

Postural orthostatic tachycardia syndrome is defined by excessive heart rate increments upon upright posture. A person with POTS will experience heart rates that increase 30 beats or more per minute upon standing and/or increase to 120 beats or more per minute upon standing (Grubb, 2000). These exaggerated heart rate increases usually occur within 10 minutes of rising.

While the hallmark of this disorder is an excessive heart rate increment upon standing, patients often exhibit numerous symptoms of autonomic nervous system dysregulation. It is the autonomic nervous system (ANS) that regulates the needed adjustments in vascular tone, heart rate and blood pressure upon standing. The ANS is also responsible for regulating a multitude of other organs and functions throughout the body. Some of these functions include temperature, pupil dilation and constriction, salivation and the digestive tract. A patient experiencing ANS dysregulation may experience abnormalities in the many organs and functions the ANS regulates.

Just to really muddy up the issue... some docs think you can't have POTS and also have NCS--others believe they can and do coexist in some patients (er, uh :lol::lol::) , DUH! I'm one of them).

http://www.dinet.org/NCS/ncs.htm

Neurocardiogenic syncope is a temporary loss of consciousness associated with a drop in arterial blood pressure, quickly followed by a slowed heart rate (Grubb & McMann, 2001, p. 133).

Nina :lol:

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Hi, Jennifer:

To respond to your thought on OI, I think you may be confusing OI with OH (orthostatic hypotension). OH is characterized by a drop in blood pressure within 3 minutes (if I recall correctly) of standing of at least (again trying to recall... :)) 20 systolic or 10 diastolic. And hey, since we're getting everyone completely confused, you can have hypotension (low blood pressure - 90/60 or lower, I think?) without having orthostatic hypotension. You can also have something called Neurally Mediated Hypotension (often used interchangably with Neuro Cardiogenic Syncope/Hypotension), which means that after extended standing there is a sudden drop in blood pressure and heart rate caused by a miscommunication of the vagal nerve in response to already dropping blood pressure that causes presyncope (blacking/greying out, nausea, dizzyness) or syncope (fainting).

When I'm upright for about 12 minutes, I have neurally mediated hypotension (in addition to POTS). My blood pressure cuff can't even read my vitals at that point, and if I don't lie down, my body will take care of that for me, lol. :lol:

Interesting discussion!

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Deucy, you and I are peas in a pod with the sudden loss of bp and slowing heart rate--mine takes about 15 minutes too if I'm unmedicated. With my daily regimen, I can get out to almost a half hour standing in one place--but I rarely do that! Moving around helps my blood get back north to my head and heart and keeps me from fainting.

Nina

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So, people with 'just hypotension' without the word orthostatic in front of it...that means that they are asymptomatic whereas someone with orthostatic hypotension is symptomatic of OI? Am I getting that right?

i.e. I have two friends with very low bp who show no signs of problems--only time it bothers them is if, say, they try to get out of bed and go for a run in the morning or if they have surgery or something. Otherwise, they function normally--my one friend could run marathons around most anyone with her energy level.

Okay, as for the OI...I look at it as an overarching/umbrella term also.

I have Neurally Mediated Hypotension AND POTS, like Duecykub.

I had the increase in HR and the sudden drop in BP on my TTT, which according to my ANS doc means I have BOTH conditions.

This is one thing that I was thinking about for the video too...how do we explain all these things? It's so confusing. I hope doctors start to use the over-arching term of dysautonmia or Autonomic Nervous System dysfunction....THEN, recognize that there are sub groups within that.

hmmmmmmmmmmmmmmmmmmmmmmmm......food for thought.

Emily

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Thanks everyone for your replies. I think I get it. Ok, so I have POTS, I think that means I have OI, right?, I guess it really does not mattter, Just trying to understand. I thought maybe if I had another name such as OI, it might help, since so many docs. are not familiar with POTS. Thanks, Pat

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Many of us with POTS or other illness grouped under the OI category choose to say we have either Dysautonomia or Autonomic Nervous System Dysfunction when we go to the ER or a new doctor.

I have Dysautonomia on my MedicAlert bracelet b/c really they just need to know NOTHING is regulated properly!!!!!!!!! So, the need to focus on that!

Emily

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Em, My medicalert bracelet says "Drug Allergies, Dysautonomia, Asthma"--like you, I want them to know I'm unregulated with my hr/bp/gi functions/bladder function--but I put "Drug Allergies" first because that's the most likely reason I'd be in an ER or unconscious--and also the most dangerous to me if they treated me w/ something I'm already known to react to, like nearly all antibiotics, a few pain killers, two anitnausea meds, etc.

Nina

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Wow, Nina, we really are two peas in a pod. We share asthma, GERD, and scoliosis, too. Count me out on Hypermobility though... I'm the stiffest, least flexible person I know (well, physically, at least!). :lol:

Well, Mom always said it was nice to share, but I'm not sure that's the case here. :) At least we can empathize, right? :)

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Hi again,just wondering where you girls got your bracelets? I think it is time ,I need one

Thanks, Pat

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Pat,

www.medicalert.org

Also, if you do a search for 'medicl bracelets' or 'medic alert' or just 'bracelets' in the topic title you will get TONS of hits--this is a popular topic. It will help you choose what you want to put on your bracelet as well as learn about how to get 'pretty beaded bracelets' like many of us have done with our original medic alert one.

Emily

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I get HYPERtensive before I pass out, and have a run of tachycardia. Medical people always say I'm not going to pass out because my bp is too high to pass out. But the higher it goes, the faster i drop. Few people in the medical field can grasp fainting with a rise in bp as opposed to a drop, so I will almost always hit the floor.

They say there is no explainable mechanism for that scenario ( ie...faking it nutball) so i tell them to look up baroreflex failure....then ask the sarcastically, if they can spell it, or should I? I'm sure my tone doesn't help, but I'm the black and blue one supposed to be loving it......in my tilt, I went from 140/80 to 220/110. I didn't pass out then. I didn't pass out for awhile after this started. The cardio said negative, my pcp said positive. I go with my pcp....

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morgan

I have a tendency to the same problem...I feel faint when my bp spikes. I was treated like a nutball post-partum b/c of this--literally. When I was finally admitted to the hospital they put me in the room reserved for psychiatric patients.

I've been told I have POTS -- under the "umbrella" of OI. But increasingly my specialist refers to it as autonomic dysfunction.

Katherine

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  • 3 weeks later...

Hi everyone,

I have OI but do not have POTS--my heart rate only rises one or two beats when I stand instead of the "normal" 10 or so, but my BP drops and keeps slowly dropping till it goes into a sudden crash. I know the rise in heart rate in POTS patients seems to be an attempt to get the BP to stop falling. Does anyone know what kind of strange compensation the body makes to try to stop the BP falling, if you don't have POTS?

Thanks.

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lol, it is cornfusing.

I have NCS and dysautomia. I "don't" get tachy. I put it in quotes because this past month a had a heart in the throat and jumping sensation that lasted about 5 seconds. Don't know what that was, but it was related to working extra hours. I'm done that! :angry:

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