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About doctorguest

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  1. Just like with any chronic medical condition, medications may need to be continued throughout pregnancy for women with POTS. What we know after several studies on the subject is that many women remain on beta blockers, Florinef, Middorine and SSRIs, which has no negative impact on their health or the health of the baby. As a rule, the least number of medications, preferably one, and the lowest dose should be used for pregnant women with medical conditions, including POTS. The fact that a woman takes medications before pregnancy should not be a factor against becoming pregnant if pregnancy i
  2. Below is the letter I received today in response to my letter to Shire. Page 1 August 24, 2010 Ref: US10-010211 Subject: ProAmatine Dear Dr.________: Thank you for your recent medical information inquiry regarding ProAmatine. We understand that you have requested information on the discontinuation of ProAamatine. Shire will be discontinuing the sale of the branded drug, ProAmatine effective September 30, 2010. Shire acquired ProAmatine as a part of the acquisition of Roberts Pharma in 1999 and Shire conducted and completed the post marketing trials that the FDA required. The FDA, however, view
  3. Congratulations on becoming a mother! While I don't know the specifics of your C-section/POTS/current status, in general terms, recovery after a C-section for a healthy person is more difficult than recovery after a simple vaginal delivery. Add POTS to the mix and one can expect exacerbation of POTS symptoms. The good news is that blood clots in the lungs have been ruled out - this would be the main concern post-partum after a C-section. Current symptomatic management depends on whether you are breastfeeding or not - i.e. whether you're able to take medications. In any case, my advice is
  4. There is currently a debate about a relationship between POTS and anxiety disorders. As someone here pointed out, the Baker institute researchers contend that these two disorders are on the same spectrum. However, more studies are coming out against it than for it. In fact, it's been shown by other researchers that patients with POTS DO NOT have a higher prevalence of anxiety disorders than the general population and that POTS and panic disorders have different symptoms and can be distinguished. Obviously, some patients have both POTS and panic disorder, in the same way as some patients ha
  5. It's great that you found a doctor who is knowledgeable about ANS disorder. Your concern about testing is valid. Her reason for testing an asymptomatic patient is unfortunately financial. If you or your insurance are paying, the doctor will be ordering. This is not to cast doubt on your doctor; rather, it is the financial predicament that many physicians in private practice find themselves these days. Understand that as a patient, it is ultimately YOUR decision whether to get tested or not. You might want to say to your doctor that you would "prefer" not to get tested right now that you'
  6. Congratulations on making it through pregnancy and becoming a mother! You are right that there is no data available on the topic of POTS and pregnancy, which is why I encourage you and others to participate in a study, currently in progress, addressing POTS and pregnancy. When you're feeling better and have some free time, please consider filling out a questionnaire. If you are interested, e-mail me at doctorguest@gmail.com.
  7. Just trying to resurrect this poll from the past. It would be great to have the 42 women who responded to this poll participate in a research project on POTS and pregnancy and explore this topic further. After this project is completed and results become available to the medical community, it would educate OB/GYNs, primary care doctors, cardiologists, neurologists, nurses and midwives, as well as help other women with POTS who are planning to have children. If you would like to participate in this important project, e-mail me at doctorguest@gmail.com. Thanks!
  8. Hello all, It has been a while since I posted the original message about a potential research project on POTS and pregnancy. I am happy to inform everyone who wanted to participate that we are finally ready to move forward with the project! To those who have replied to me in the past through e-mail - and to the new people who would like to participate in a research project on POTS and pregnancy (see description above) - please, e-mail me your name and address so that we could send you a short questionnaire to be filled out on an anonymous basis. My e-mail address is: doctorguest@gmail.com S
  9. Katherine, I am very sorry for the tragedy that your family is experiencing. Please accept my condolences. As to whether POTS played a role in this tragic outcome, I completely agree with Flop on her statements. It appears, at least anecdotally, that there is no - or should not be - a connection between POTS and pre-eclampsia/eclampsia. However, as you pointed out, this subject has not been studied, and this is exactly why I am now working on getting funding for a research project that addresses POTS and pregnancy. I hope your sister has a speedy physical recovery; the grieving will, undoub
  10. Dear jolinshope, Thank you for sharing your story. I am glad you got help with the diagnosis and treatment at Vanderbilt University. As you stated, the diagnosis made by Dr. Biaggioni was baroreflex failure/hyperadrengergic dysautonomia/hyper-reflexia/SVT. This diagnosis is not the same as "hyperadrenergic POTS". In fact, it refers to a completely different form and type of dysautonomia. Let me assure you and others that there are plenty of people with hyperadrenergic POTS who are greatly helped by either beta blockers, midodrine, florinef, SSRIs or a combination of these. Unfortunately,
  11. Agree with Nina. Sometimes office staff does not directly or immediately notify the doctor that a patient called. Or they notify by a method that is not easily accessible by a doctor, like leaving a written message in their mailbox at an office, where, for example, they only work a few times a week. Many doctors work at various locations, including several offices and/or hospitals, and thus, may not be able to receive non-urgent messages in a timely manner. Of course, if your matter is urgent, then a physician should be immediately accessible to the office staff via pager or cell phone. A
  12. Mack's mom, what you are referring to you is one study from Vanderbilt that showed that some patients have both mast cell disorder and hyperadrenergic POTS. http://www.ncbi.nlm.nih.gov/pubmed/1571078...Pubmed_RVDocSum In this case, because of the mast cell disorder, not hyperadrenergic POTS, the use of beta blockers is not recommended and can actually be dangerous (because beta blockers cause constriction of the airways, and because they also interfere with the effects of the Epi-pen, should there be a need to use one). Otherwise, if you don't have a mast cell disorder, beta blockers are pe
  13. Tearose, on further recall, I remember having a similar debate on SSRI use in the past, where, if I remember correctly, you seemed to have a perception that SSRIs are dangerous medications. In any case, I will not discuss this issue any further because there is nothing to debate about. You seem to want to contradict my statements, first on what I posted about treatment options being the same in patients with various mechanisms or etiology of POTS, and then bringing up the issue of SSRIs which have been widely used in all fields of medicine, including in patients with autonomic disorders, wit
  14. If you read my original post, you will see that I didn't say that treatment is the same for all patients with POTS. What I did say, based on the current research studies, clinical experience of the academic institutions that treat and research POTS and my own training and clinical experience with POTS patients, that treatment options available today are the same for all forms of POTS. In fact, you may be shocked to learn that the same treatment choices are also used in more aggressive forms of the autonomic disorders, like Multiple System Atrophy or Parkinson's Disease. What the term "treat
  15. Just in case anyone is taking SSRIs or SNRIs and have hyperadrenergic POTS and reading this, this is perfectly OK, as these medications ARE NOT contraindicated in hyperadrenergic POTS. Tearose, I don't think you fully understand the issue of neurotransmitters and the use of SSRIs. Those who take SSRIs for POTS or other conditions do not necessarily have high or low serotonin levels, but are greatly helped by SSRIs for all kinds of conditions - from depression/anxiety to pain to GI motility disorders to low blood pressure and others. SSRIs may not have been recommended to you by your doctors
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