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erik

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Everything posted by erik

  1. I think it's hard to know if/how eating Mg of one form or another will interact with POTS but there are ample things one can speculate on. I got interested in Mg from bumping in to this CFS related article, but if you explore the referenced web site further and do other related Mg searching you can find ample studies and theories in most all matters of health. Many of the conditions & symptoms are right up our alley too, so maybe Mg is a key player in our woes: http://www.mgwater.com/clmd.shtml The "hardest" link that sticks in my mind is that sympathetic nervous system activity & activity of catecholamines is said to deplete Mg. Folks with POTS are said to have a lot of sympathetic nervous system activity, especially at certain times and probably chronically (and some constantly). Perhaps when we push ourselves, the chance of transient Mg depletion is quite realistic or even inevitable. It is interesting that this study indicates Mg shortage and some observable responses can be so quick (on the order of days): http://www.ncbi.nlm.nih.gov/pubmed/1384353?dopt=Abstract Also some of the "players" mentioned even in just this brief abstract are catchy... kinin related increase in histamine activity via substance-p induced mast cell activity. I forgot what Raj/Vandy substance-P research might have turned up, or if it is still ongoing. Whether or not it found a smoking gun for some folks, perhaps Mg depletion can be a potential link one way or another to some/many of our symptoms.
  2. Another way things can happen is that certain substances can be "used up quicker" when they are involved in processes related to a condition (or activity). Just another reason for a shortage, or "competitive shortage" where one process eats up a precursor and might even throw a symptom elsewhere that seems totally unrelated. The only thing I've bumped into in that regard personally is magnesium, which was said in an old CFS article/research to get used up from sympathetic overstimulation (which we tend to have, or have bouts of). Could well be others, known and unknown.
  3. Overall I can just recommend keeping whatever you can to a minimum and prioritizing so that you can get through what you want to get through. In general, anything stressful will aggravate a dysautonomia so that is our Achilles heel. If you have other things that you can identify that affect you then keep tabs on them too. In short, you'll need to insulate yourself & give up on certain things or risk putting everything in jeopardy. You have a great advantage in knowing that you have a condition and despite the mystery and lack of definitive treatment, you have things you can do to help at least somewhat. The problems may subside or become more manageable too. The dynakids site has good tips on college stuff. Some meds might be helpful... ironically either the stimulants or depressants can help in some cases. In any event, it will require compromise of some sort and extent, but it can be done. If you respond well to rest. Find a way to ensure enough of that. Can be quite a challenge. Figure out if nutrition is a factor for you. College students are notorious for pushing the limits in nutrition, sleep, stress, etc... all the things that tend to make us worse. So you'll probably need to tread a cautious (and reasonably separate) path. If you look closely, there are many other folks in school that likely feel similar to you, and folks are rarely truly aloneg in that regard. Also, many expectations are based upon myth. Myths about college, myths about the opposite sex, myths about marriage, work, etc. "Dropping expectations" can initially feel like a loss, but may ironically put you more in tune with real life than other folks... and at an advantage.
  4. Yeah. I only have the classic fog or memory trouble on rare occasion. Usually I have a different style, brain drains out and tires every 10 or 15 minutes repeatedly if I'm doing something "real" and I have to micro-nap or just give up. Plus the classic "inattention". Caffeine works for "doing stuff", but "learning" or "contemplating" is another matter and usually just doesn't work.
  5. Oh man. My prayers for a speedy fix & recovery.
  6. Research points toward a strong hormonal component to SSAD (Sports Season Affective Disorder). I've seen it strike some guys very hard. Unfortunate regression to prior developmental stages and habits, such as yardwork or chores, has been known to occur (but is thankfully quite rare). Irritability and withdrawal into excessive PS2/XBox use or compulsive automobile tinkering is common. Others swing to an outward extreme, a manic flurry of dating to fill the empty void inside... temporarily losing grasp of their strong innate monogamistic base. If lucky, "bright light therapy" can offer some relief... so long as the bright light is shining on the latest Sports Illustrated Swimsuit Edition. For treatment resistant cases though, co-administration of a malt liquor may be required (40oz q.i.d + ad. lib.) is standard. Some folks swear by intense amnesiatic sedation via rapid J?germeister lavage, so long as a little temporary psychosis is tolerable (or desired). I've had a number of friends that found it necessary to resort to all of these techniques on a regular basis, simply to regain normalcy in their life. It can rob a man of his essence. Tragic indeed. But cycles & seasons are a fact of life and we must all cope in our own manner.
  7. I had a phase of myoclonic jerks for a while... usually while dozing at night but especially in the day. Was also having sever excessive daytime sleepiness and these jerks & mini-zaps were stronger when sleep would "grab me" suddenly in daytime. I kind of kicked a girlfriend a little once due to it (no it wasn't a subconscious motivation, it was neurological During the worst of that period I had a couple real brain zaps (mild) and they're freaky but not a regular thing for me. Wasn't on any meds but it is said that antidepressants are one common cause of the zaps. I think my electrolytes, sugars, or other "regulatory" thing was off kilter and in hyper-sensitive mode. Was also having seizure or pseudoseizure-like stuff roughly around that period (which I've had months long phases of several times over many years). Have only had myoclonic phase a couple times and not lasting all that long (weeks). Myoclonic jerks while dozing off are considered medically harmless & normal... but I took mine as a subtle clue that something more was afoul since they timed with some other similar stuff.
  8. Fainting & uptick in cognitive challenges were high school... several months after a solid but mild head injury (had prior milder ones... they're kinda my thing . Were plenty of other symptoms which could easily be considered "post-concussive syndrome" as it is now known. Could even be autonomic stuff like damage to pituitary, hypothalamus, brain-trunk or just the theoretical "dispersive damage" that makes brain function burdensome & fatiguing, but not broken. My cognitive stuff often fits that style more than the "brain fog", though I've had my bouts of heavy fog too... and classic "inattention" (the non-hyper sort). Some memory blips, but mostly I'm burdened by too much memory, if you know what I mean. Maybe norepinephrine surges do that... some theories say it amplifies memory traces. Prior, at 12 yrs or so, I reported dizzy, spacey, detached, tired, headaches, couldn't read, mild nausea, etc. There are other symptoms recollected now but unmentioned then, since I couldn't articulate. All tie in with various things quite tidily, as I now know today. This is start of more anxiety/dissociative style stuff, but also exercise intolerance and the like. I can pin this on trauma, emerging POTS, an delirium inducing infection, or a couple mild head injuries. I can pick & choose symptoms & causes. I'm am my own special blend of manure... specially fertilized to sprout a magical tree or just a resilient fungus. Well, I'm that nice ghostly moss that grows high up there on the trees in the mist. The blocked saliva glands seems loosely like a Sjogren's thing. Some folks here have had things point that way and I know someone on another forum for whom that is the confirmed tie in with POTS and such. Might be worth looking at, but like many things it is hard to pin down. Some folks say just the overactive "sympathetic" system of POTS can make for stuff like that (since saliva is on the opposite "parasympathetic" side and can get diminished in the balance). Worth a mention to a doc at least if you haven't already.
  9. After an initial couple days bad reaction when starting, I've stopped, started and adjusted my dose pretty much as I please without undue effect. I will get expected things at high dose (0.35mg) like water bloat, headache, beginnings of edema if also pushing salt & water. I go hypertensive at moderate (0.1 - 0.2 doses, or even 0.05) which I use to my advantage. At worst, when stopping I just have a return to the symptoms that I had prior to ever taking it. My OH tendencies respond like the folks in this study: http://www.curehunter.com/public/pubmed10750642.do It also blunts the extent of my POTS HR increase somewhat to feel super-volemic and be hypertensive (but doesn't extinguish it or solve symptoms all that much). Others of us have different stuff going on underneath so we will respond differently to all this and other meds might give more noticeable results. If your doc is continuing a hunt for things and trying other stuff out, then this could be fine for you overall and maybe you'll just return to fludro if it did provide some relief. If your doc is saying, "I don't measure anything wrong, I will not prescribe anything whatsoever"... then should probably push for the typical "symptomatic treatment approach" with POTS... which means trial & error of meds looking for nominal/mixed improvement in a patient that basically tests normal for everything (as opposed to using meds to "correct" a known issue).
  10. I've been thought to be drunk in public (when not drinking or on meds)... if that counts as a "balance" trouble! Shopping (and plenty of other things) can bring anything from a tolerable experience, to constant nagging discomfort and "gotta get out of here" feeling, to migraine/seizure aura-like "light/sound oversensitivity and very freaky feelings", to physical "overt near-fainting" and staggering. The faintness after standing still for a while stuff is most like NMH tied with POTS in my opinion. The NMH/NCS thing is the vulnerability to have brain flow go fishy at inopportune moment (usually stress triggered). Then the POTS sets up a steady progression of physiological stress signals that culminates in NMH (the sudden crash). It might be an eventual depletion or adjustment though... some docs figure it is inevitable to happen for anyone, just unusual to have it hit within a few minutes. I fit that profile too and can often trigger it on demand with a long duration poor mans tilt test. But at other times, I get the immediate OH stuff... where thing hit immediate & hard rather than "building". I've had nausea tie in with things, but am spared most bad gastro things. I'm non-IBS and non-Fibro, more CFS style... with emphasis on cerebral/cognitive disruptions since I can push through physical fatigue often ought... but when cognitive fatigue and/or inattention are strong, there's no brute force fix. Some folks seem to be born with these autonomic challenges, as far as I've read. One obvious case of that is EDS related POTS or OI, plus the more rare DBH and NET deficiencies that researchers have identified. Other than that, it seems to remain very fuzzy even for "experts" in the field. If not born with the "full condition", there are more genetic traits being documented that can modify specific body responses. Every now and then people study those & look for correlations with conditions like ours. Some of these have to do with known genetic influences on how specific neural receptors respond and adapt. Each of those individual traits need not result in a noticeable condition by itself. If you happen to have a magic (unfortunate) combination of them, then certain body responses might become more likely to happen under various circumstances. They also might make malfunction more apparent after something specific has come along and "broken" or altered something elsewhere in the body (like some viral damage, a neuropathy, etc.). I'll never know. 4 of the "speculative causes" were early in my life so I can just take my pick! Otherwise, I can pretend that I had 1 rare disease back then, then another rare disease, then now the semi-rare POTS stuff... and that all 3 rare conditions happen to have very similar symptoms & possibilities! I think it most likely that the condition that I now have documented "by expert" was just present "all along" or at least to early adolescence. Makes more sense than having to presume 2 or 3 rare conditions that happen to have similar symptoms!
  11. There are vertical MRI's but wouldn't expect access to one or a radiologist that will go out on a limb interpreting anthing with a non-standard technique. Not in our modern lawsuit and "by the regs" era. May or may not be any more accurate than compression MRI. Doubt anybody knows: http://verticalplusmri.com/ I seem to recall a "mystery diagnosis" episode about CFS leak too. Might be this one but I could be mistaken: Season 5, Ep. 10: The Woman with a Knife in Her Head They have an index of diseases as well as an episode guide. I guess they can be watched on demand in iTunes for $2 an episode (or some can be found in non-legal sources too I suppose). "Woman Who Kept Falling Down" is Season 5, Episode 4. If you end up with an episode of your own, what will you title it??? Perhaps, "The Woman with the Jerk Ex-Boyfriend... and trembling collapse upon standing?" If they need an actor to play the jerky ex in the episode... I am not a trained actor but reportedly I can act like a jerk pretty well and I could use the income.
  12. Unchecking the "[ ] Enable emoticons?" checkbox should prevent the D) and such from being turned into an image. If you do a "full edit" on the first post it should re-offer that option.
  13. Human barometer. Perhaps there is a steady employment opportunity for me yet!!! I guess there are a few circulatory barometric sensors... you can apparently do some weird stuff with "suction" on the carotid (more than just a hickie, that is). There might be pressure sensing of different "cavities" of the body... not sure about that but no reason "stretch" receptors all over can't form an indirect measure here. There are indirect effects of pressure (and so called "partial pressures") on any gas exchange going on, which is probably in a few places. Not sure exactly how/where it is "exposed" to external realms, but internal CNS pressure is said to be fundamental to central autonomic calibration.
  14. I know Dr. House would do a lumbar puncture... the kind that measures the "escape pressure", not just contents. They do a lumbar puncture to almost every patient on that show it seems! I had runny nose thing for a while, and it tasted odd (not like a normal runny nose). Made me investigate the CSF leaks and such, but they didn't end up matching me as far as I know. CSF pressure variations create inherent dysautonomia because that pressure is like the "calibration" of the whole brain trunk, hypothalmus and such... which is the "heart" of the ANS. If it is floating around or out of range then "everything" else in your ANS floats around (a.k.a dysautonomia). Overpressure gets noticed pretty quickly, but I think underpressure can squeak by (IIRC). I think I read a report of a patient with crazy low pressure that nobody thought to check and then when they did, the docs were like "how was this person still getting around"!?!?! The CSF is constantly regenerating, so if the body keeps up it can go less noticed... if the body falters in that process, symptoms get severe (temporarily). This was to do with the nasal area leak stuff, but I suppose it happens elsewhere? If things are leaning this way, I suppose a (neuro???) expert would know what other supporting signs to look for and see if LP or focused spine or nasal imaging is merited. Symptom wise, I think most of it falls in to the pit of "nonspecific stuff" that we all have... so I don't know if something will jump out without specific expert investigation. Don't worry about the darn ex-boyfriend! Guys are all jerks. (Oops, did I just say that??? +++ There was someone on this forum that had the sinus leak situation I think... perhaps they are still around to comment. Hope so +++
  15. I had not heard of an insurance company issuing a specific generic... thought they just dealt with $ caps & such and reimbursement to a pharmacy for whatever they stocked. Seem to be new twists every day. Midodrine generics don't seem much cheaper than non-generics when I look them up. Did Upsher-Smith make a breakthrough or price-war or something? Quite true that generics are pushed more and more. Sometimes a pharmacy is required to substitute generics (varies by state). Cutting costs is very "en vogue" it seems. Making a case for exception to your plan's policy will likely be challenging when "official government certification" defines "medical equivalency" and when state laws & momentum are biased toward generics. How does one then argue subtleties with these bureaucracies? Not really my cup of tea. Dysautonomia & related conditions are a wee-bit out of the mainstream . I personally don't expect much if things shift even further toward bureaucracy than they already are. Boy, it took a life struggle and dumb luck to get 2 people to believe me that something was legitimately fishy. I finally did that and now I might have to convince an entire government bureaucracy? Too big a fight. I opt out! I'll just cop to a beefy psych diagnosis and ask to be gently "zoned out".
  16. Regardless of how well outside people understand the condition... she has family that does, and that is an incredible blessing. The advice throughout the http://dynakids.org/ site seem like great stuff, especially for high school and college. There are some good articles there, as you likely know. Even as an adult, the advice translates well and seems good for helping other folks get a more solid perspective.
  17. True. There are some docs that do "physiological doses" of various things... meaning simply supplying an exogenous (and usually a steady) supply of something. They just aim for normal (or "top of normal") range. Mostly heard of that for thyroid. Also heard of super low dose cortisol in some experiments for CFS (and low enough doses are thought to avoid adrenal fatigue). That's similar to certain "hormone therapy" for ladies. I'm not talking about replacing known deficits (since in most dysautonomia cases there aren't any obvious ones), nor augmenting to supra-normal values (except like with fludro that can be a possibility)... but just the simple notion of "going exogenous" with a few things, rather than trusting the dysregulated endogenous production & feedback. That can be my book title: "Going Exogenistic: A Dysautonomic American Life".... how I faced medical oppression as a male minority in a female dominated disease, and triumphed. Even if I don't end up having Low-T, overt Addison's, hypopituitarism, hypothyroid, et. al. (like most with dysautonomia that "test normal" for most everything)... a modest trickle of some hormones might do something, good or bad. The testicular shrinkage from exogenous testosterone would be a bummer, but then that leaves less to hurt during the heating/cooling treatment process! I'm not too worried about growing excess breast tissue... a reduction surgery can handle that. But my deepest fear is that I might develop "feelings" and all that "sensitivity" junk. That could be the worst potential side effect and blow to my manhood. Now that I think of it, this is all a bit too risky.
  18. Since fludro "amplifies" the effect of salt & water intake, just keep conscious of all three... and maybe be steady or moderate with them at first. I just observe these key things and get a feel for my body's responses... now I can "play with them" a little. Some folks need lots of all, some folks need a little. It's an individual thing though. Building up working blood volume is said to happen slowly (probably 3 days is a guideline), whereas "simple hydration" can jump up/down in hours. Using a weight scale is actually a way to confirm your own "feeling" about how hydrated you are. Water gets tucked into tissues too, not just blood stream (but ladies already know all about that My initial prescription was for 0.1mg once per day. I think I started at half that for like 4 days or something, then full dose. Some people go even lighter & slower. Some can jump right in at high doses without issue. I personally had no reaction from any specific dose... more it was the timing as my body adjusted slowly. After a week or two I got several days of side effects, and just as I was about to give up, they passed. My doc did followup "electrolyte" panels when I started, since fludro can push potassium low. Especially with your prior low K history it sounds like you should insist on this. Might end up needing extra K, like a "slow K" if a doc advises. Might even be good to sample your electrolytes before starting the fludro if haven't done so recently??? Maybe your doc would be up for that given your history? One can ask. Might not be necessary. Mostly I'm after "consistency" since my BP isn't way low (it just drops out suddenly at times). Other folks have chronically low BP too, so their picture is different. I still always show POTS response and I will near-faint if I stand upright & still. Your situation may be similar and might not be "fixed", only improved. That's not uncommon. I can take my pick of "years-ago markers" where suitable symptoms existed or escalated in "coincidence" with various things. 5, 12, 20, 25 or 30 (I'm about 40 now). Trauma, infection w/delirious fever, adolescent/growth-spurt escalation, head injury w/amnesia, possible toxin exposure, chest/abdominal injury, anesthesia, bout of odd respiratory/sinus stuff (unusual for me), rapid weight loss period. Each of those was at a different time and from what I've read, any of them can be a suspected cause for folks. Frankly, my gut tells me I just have the "born with" dysautonomia, and each experience intensified/morphed the existing condition along the way, so no "cause" or "onset" other than birth & some "luck deficiency" that we all can get. I don't think mine will go away but I do expect problems to stay mild especially now that I have a handle on what "it" probably is... finally.
  19. True, if you had been married to me I imagine you'd opt for the "Implanon" option even if it is more expensive! I can only think of unpleasant options in that regard. I did pass a "Low-T" test at one point in the past (without even studying)... but things can change and it is almost fraudulent to consider "moment in time serum sample" of anything hormonal to have much meaning. Yet that's medicine and it's 10,000 times better than nothing and much to be thankful for. I do look forward to the science fiction days when a little chip-on-chip like device can help digest some of these complex things. A couple folks are researching artificial baroreflex devices... that's at least a start for some sci-fi autonomic stuff! Mack's Mom, in terms of "those w-i-l-d-l-y flucuating hormones" I did have an odd thing for a few days when I first started fludro. I felt horrible & volatile for a while... but it was "literally the exact same" horrible state that I felt during many of my teen years (also after head injury, which might tie in). It was like a "return to youth" for a bit (a negative one, but youthful still). Was similar with a panic-attack-like phase after a round of hydrocortisone. Was awake... yet also messed up of course. Made me hopeful that something could be corrected. Of course, since it's dysautonomia rather than overt Addison's or other constant shortage or excess... nothing tests out of whack and no simple fix. Just band-aid stuff. "Keep you from fainting", "Keep heart from exploding", "Blunt some feelings of one sort or another". Aww... it is probably just my PCOS acting up again and I'm singing the dysautonomia blues.
  20. I'm sure there are multiple possibilities but do keep in mind that taking corticosteroids makes the body produce less of them itself. Perhaps your symptoms are from adrenal fatigue due to the steroid treatment??? The general steroid rule is that short term use does not induce adrenal fatigue. Not sure, but I think that means durations like "a month" or so... but an expert might pin that down better. You are clearly beyond "short term". For fludrocortisone by itself, "the literature" that I came across is that short or long term use below 0.4mg daily "has not been found" to induce adrenal fatigue. This is perhaps why a doc wouldn't tend to worry here... since research indicates not to worry in this way about stopping fludro. Fludrocortisone is synthetic steroid with potent glucocorticoid as well as mineralcorticoid properties. We tend to use it for it's mineralcorticoid (salt/water retention) effect... but the other factor is there too (just minimal because of the low doses). I don't know, but maybe the concurrent use of the other steroid changes the whole picture. It seems like it might. One simple way to look at this is that you might have "drug induced Addison's" at this point which is part of the game, with medical steroid use. If that is the case (and I don't know how to know for sure or what else might be better explanation)... then slow weaning off is involved (meaning up to years).
  21. I use Firefox (mostly)... being a geek type and all (which you might have guessed There are also some nurses that I've been enamored of... but we may be speaking of different things here
  22. We definitely sound similar (so sorry for you ... good not to be alone and to be on a more accurate medical path, even though dysautonomia offers few medical certainties. I'm surprised that everybody doesn't get phobia about the situations that trigger our symptoms (or phobia for doctors, friends, parents, strangers that misunderstand)... especially those of us that suffered in mystery or misdiagnosis for so long (having symptoms club us "out of the blue"). Avoidance, anxiety, detachment/dissociation, generalized anxiety, etc. all seem like perfectly appropriate responses to me! Unhealthy and tragic, but appropriate in their own way. I'm half-morose and nervously-comedic about it... but also self-forgiving. The most similar thing to fludro for me, has been high steady dose of salt, steady water and some steady potassium (triggers aldosterone release) plus making sure to not give in to laying down "all the time" despite the challenges and frequent need. There are probably other tricks to OH management... like hunting for any specific triggers like foods or whatever. I just haven't had those things emerge for me. I also "stupidly" push through things and this both backfires & helps... probably a plus overall but can be a big no-no for some folks. ------------------------------------------------------- The "being upright" thing just has to do with your body making more aldosterone. Think of aldosterone as your own natural "fludrocortisone" (or vice versa)! It especially applies to folks that are bedridden and such. Doesn't mean "standing up" will simply fix you... plenty of other complicated things going on... but it's part of the overall picture. It can be part of a "positive feedback" cycle. When one is doing better, one tends to keep doing better... and vice versa. DDAVP, or desmopressin, is like a synthetic vasopressin (a.k.a. anti-diuretic hormone). It is an even more direct signal telling kidneys to "retain water" than fludrocortisone is. This makes it a little more "volatile" in some respects and although it was used very commonly (for bedwetting and such), there were some tragic incidents that make docs way more cautious with it. For that and maybe other reasons, folks start with fludro unless there's observed ADH issue. Exercise is a natural inducer of ADH, since the body is preparing to conserve water... but it's also easy to see the "water dumping" that can follow some well hydrated exercise. NSAIDS are things like ibuprofen (Advil), naproxen (Aleve), and similar prescription stuff (usually stronger arthritis things, I guess). I can't remember if scientists decided whether aspirin is also an NSAID... I think so, but it's kinda separate too. They're reported to adjust signals between kidney & blood vessel walls that, in turn, promote building blood volume. Main risk is burden on the kidneys long term. EPO, or erythropoietin, is a hormone that make you pump out more red blood cells. Since we tend to have symptoms much like those who are anemic (or maybe we are borderline or secretly anemic too) it is sometimes used. It's crazy expensive. Probably not often an option except in research or for a super-athlete When my OH was at it's worst, fludro certainly did the trick. I had some mood effects and headaches after about a week when I first started it, which are the kind of thing to report right away to a doc. I stuck it out and it was a big benefit directly for my OH... my POTS remains. At least I could stand up and walk across the room more consistently, though! And exercise in fact. Got me out of a hole.
  23. I second this consideration. It's worth chatting with a doc about subtle differences in meds and use strategies. Klonopin is a 20hr half-life (people vary of course) so there's a chance it can be used to great effect exactly like McBlonde alludes to. Doesn't mean xanax can't be used that way too... just saying even similar things have an assortment of differences. If relief doesn't come some other way, these more subtle differences provide further possibilities. There's always something to try. Also, stuff like buspar... which some docs lean toward instead of or following the benzo's, especially for longer term use.Personally, me likee the Klonee... tho. I am a paradoxical responder. No sedation, just activation and stabilization. No set rules to any of this, especially for we odd ducks.
  24. A piece of my puzzle fell in to place when it was pointed out that when the brain is wanting more blood flow it can sometimes "rob" it from other regions, like head, neck and such. I figure this ties in with my personal troubles, a longstanding tendency/vulnerability to: muscle tension headache; head/neck/back soreness; lightheadedness; et. al. These go back to my earliest signs of dysautonomic probs... followed a few years later by actual syncope (or really really near-syncope episodes... then followed by more pronounced phases that fit a "POTS crash" perfectly... then followed by phases of "panic like" stuff... then followed by prolonged O.I. issues... and on and on (not sure what's next for me On the other hand. This could well be totally non-POTS or different! Just throwing the idea (and my personal case) out there for consideration.
  25. Since hormonal influences are often so interactive with dysautonomias and such (well, everything really , and a decent number of female patients get improvement with hormonal BCP or other hormone therapies, I figured I'd float the question in the context of men? Does such an approach exist? ...in theory? (I offer this as both a serious and humorous question. Both styles of response are most welcome)
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