doctorguest

lol, Nina, what I am supposed to say?! That I don't think he gets it? Just trying to be PC... and give him the benefit of a doubt. I also wonder what his reasoning is? Perhaps, it's having to deal with patients with hypertension, diabetes and kidney problems every day in his practice. In all fairness, he's probably a good cardiologist, just not too familiar with autonomic problems.

Angela, I am glad Baclofen is working for you for gastroparesis. This is very interesting. How much are you taking? Baclofen is an old drug that is used primarily for spasticity. It mimics one of the neurotransmitters that suppresses the neuronal activity. I am not sure why it would work for gastroparesis, except to consider that it may somehow relax the muscles of the stomach and allow it to pass the food down easier.

Sounds like the cardiologist is giving with one hand and taking with another . I think he's too cautious, and I wonder what his reasons are. Fluid and salt loading are not harmful, even if you're drinking 3 L/day and even if your 24-hr urine sodium is just above the upper limits of normal. If your kidney function is normal, your body would excrete the extra water and sodium to keep the balance. If you were someone with hypertension or kidney disease, I'd understand being cautious, but otherwise, these non-pharmacologic measures should not be used for just 3 months, but continuously, as long as you have the symtpoms. Hope you're feeling better today.

Lois, are you seriously eating that much garlic or are you kidding??? If you're not kidding, and that much garlic never caused problems for you, there is no reason to stop enjoying your garlic evening snacks. I am personally not a big fan of garlic - the less the better for me, same with black pepper, by the way

"Normal tests" are always a good thing; even though it may not explain the situation, it certainly helps to exclude "known" causes and conditions. Sweat test is not a measure or a correlate of one's ability to withstand heat, but rather a marker of function of one component of the autonomic nervous system, called sudomotor system. In those with abnormal sweat test, there may be evidence of partial autonomic neuropathy as the cause of POTS. Hope this info helps you!

It's may be worth checking for Sjogren's with certain antibodies and a rheumatology consultation. Since you seem to have several autoimmune issues going on (like psoriasis and antithyroid antibodies), it would be a good idea to explore this and other autoimmune conditions. POTS can be of autoimmune origin in some patients - there is a specific antibody present in 10-14% of POTS patients, but conversely, dry mouth and dry eyes can also be a feature of "just" POTS.

Garlic has some vasodilating properties and thus lowers blood pressure. I am not sure how much garlic one has to eat per day or week to have that effect, but I think if you have some garlic flavoring in your meals, it should not have an effect on POTS. I think it's like niacin situation - it causes flushing and vasodilation in large amounts, but in small amounts, it's a necessary vitamin B3. If you like garlic, there is probably no reason to give it up due to POTS, but also you may want to use it in moderation to avoid vasodilation.

Sounds like costochondritis - inflammation of the ligaments between the ribs. It's usually self-limiting, but you can take Motrin or Naproxyn for pain and inflammation. It's a common cause of chest, rib or breast pain in young adults. Of course, your doctor is the one who would give a definitive diagnosis after performing a physical exam (just a disclaimer ).

Good luck with surgery, Nina!

As correctly pointed out by Lukkychrm, the hallmark of a seizure is loss of consciousness or awareness. If you're shaking and twiching with both arms or legs and is awake and wondering whether you're having a seizure, you are NOT having a seizure. Shaking and trembling can be part of syncope or presyncope.

Chiropractic training is absolutely not similar to medical training. Chiropractors, like all health care providers, do take basic courses in science and physiology, but aside from that, they get no training in general medicine or patient care. Furthermore, having worked in 2 states, I have never met a chiropractor who was board certified in any of the medical subspecialties that you mentioned because qualification to become board certified in a subspecialty requires one to become board eligible first by completing a residency. You may be thinking about D.O. - doctor of osteopathic medicine - completely different from chiropractors - and in the case of DOs, they do go through medical training as MDs, and subsequently qualify for board certification/eligibility of all medical subspecialties. Having said that, I personally do not believe that chiropractors are quacks, though some of my colleagues think otherwise. However, I do think that those who offer expensive and outrageous treatments (not covered by health insurance, by the way) that have no scientific basis, whether it's a chiropractor, MD, DO, etc., are taking advantage of people in order to make profit.

Emily, the hyperbaric treatment is a very legitimate treatment that has been used for decades - for carbon monoxide poisoning and hypoxia, among other things - but unfortunately, it can also be exploited. The one mine survivor was the youngest of the rest and had a collapsed lung, which, as speculated by some, actually protected him against inhaling the poisonous gases. He did undergo the hyperbaric treatment which likely improved his brain oxygenation and perfusion.

Just want to point out that an astute physician, who knows something about the autonomic nervous system, would or should be able to separate the depressed or anxious patient from a patient with an autonomic dysfunction. Yes, some symptoms/signs are similar to many conditions - including those with hyperthyroidism, cardiac arrhythmia, like SVT, etc. - but this is why we go through medical training , to be able to discern what's what. Unfortunately, autonomic disorders is a relatively new field, so misconceptions and lack of knowledge persist in the medical community.

Old lady lighthead, Yes, some medical doctors do get training in performing this treatment since it is being used in some hospitals for various reasons, including promoting wound healing and treating the so-called "flesh-eating" bacterial infections. It is also used as a reasearch tool in physiology where both PhDs and MDs work on the IRB-approved protocols - i.e. protocols that have scientific basis and merit. As Pamyla said, these treatments are expensive and provide a great means of supplemental income to "quacks". Chiropractors are trained to manipulate the spine, not provide treatments where knowledge of physiology, medicine and first aid are critical. Ultimately, it is up to the patient to decide whether they want to proceed with any treatment/procedure, whether offered by MD or non-MD, but it is best to research the procedure and the health care provider extensively before proceeding with something that currently has no scientific evidence. doctorguest

You can decide for yourself, but I would not advise my patients to have that type of treatment administered by a chiropractor, who, by training, is not qualified to either administer or make decisions regarding recommending such treatment to a patient.

There are many medications, other than Florinef, that can be used for blood pressure and heart rate control. Midodrine may be one of these.

It saddens me to hear that given the current knowledge and medical training, a physician can still "not believe in POTS", like it's some kind of 'fairy tale' In this case, my advice is for you to print a copy of review articles on POTS by Dr. Low and Dr. Grubb and give these to your PCP in person. Afterward, find another PCP who is open to learning "new material".

You may be extremely sensitive to beta blockers, and many patients with autonomic dysfunction have beta1 receptor hypersensitivity. You probably need to start on very small doses of beta blockers - quarter or less of the smallest dose available - to feel the benefits without experiencing significant side effects. You can discuss with your doctor as to what type of beta blocker to retry, but in my experience, a very small dose of Atenolol - i.e. 1/4 or less of the 25 mg tablet once a day- may be a good option to start with.

A better option to provide calories during labor is getting dextrose solution IV which can provide the needed energy supply. That way if a vaginal labor should be converted to a C-section for whatever reason, there is no risk of aspiration of food from the stomach to the lungs as would be the case with taking in food orally.

I would not worry about "possible" Chiari and the use of Florinef. Additionally, it is not necessary to run a blood volume test in order to start Florinef. A simple measure of your blood volume and sodium status is a 24-hr urine sodium test which is easy and inexpensive. How high does your blood pressure run? If it's above 140/90, I'd discuss the issue of Florinef further with your doctor. If you have tachycardia along with slightly elevated blood pressure, beta blockers or calcium channel blockers may be an excellent choice in your case.

I watched the video and was impressed by the presentation. It was honest and accurate, and Shannon and her mother did a great job in describing the illness and its impact on their lives. Great way to raise awareness and educate the general public and the medical community!

Yes, sympathectomy can cause autonomic dysfunction - not surprising because the procedure is designed to intersect the major peripheral outflow of the autonomic system. I presume that it was done for pain or spausticity control in your son? I would suggest that you contact physicians at the Baker Heart Institute in Melbourne. These doctors do research on autonomic disorders and could possibly refer you to specialists who understand dysautonomia and are able to manage it. Good luck!

First of all, I am proud of you that you are giving SSRIs a try despite your initial reservations, and I hope that it does help you symptomatically. After 2-4 weeks, you should be able to see whether there is any benefit, but the good thing already is that you seem to report no side effects, and that's great! Constipation is not something that is routinely reported with SSRIs, although I suppose it's possible. I think the worsening of constipation is probably from Zofran, however. I've taken this medication a few times myself, and it had this effect on me too. With respect to why you're not feeling the urge to go from having stool in the rectal vault, I would not worry about this too much: it is so easy to "see" things on an X-ray, and that doesn't necessarily translate into "sensing" it. It may be due to smooth muscle relaxation and position of the stool so that it doesn't cause the urge. This may be secondary to the constipation problem. I am fairly certain that once you discontinue Zofran, it will improve. Hopefully, the SSRIs would improve your motility problems.

Just want to add that doctors often joke that "steroids can make the dead feel better" . Hope I didn't offend anyone with this. It's true that many people with various problems feel better while on steroids, but some with autonomic dysfunction feel worse because it, in a way, acts like a stimulant and can affect BP, HR, glucose level, etc., cause insomnia, anxiety and changes in appetite. Has your morning cortisol level been checked? Abnormalities in cortisol level seem not uncommon in dysautonomia because of the alteration in the hypothalamic-pituitary-adrenal axis. If you have low a.m. cortisol, it may warrant further evaluation for adrenal insufficiency.

Sophia, You made me laugh with your comments - you're right, and your comment applies to all research topics in medicine, not only autonomic dysfunction. Hypertension has been studied ad nauseum because it's so prevalent and because it's a known risk factor for cardiovascular disease and stroke, and yet we still don't know its precise cause. Hypotension has been historically overlooked, if not completely dismissed, by mainstream research, so it's not surprising to see studies on supine hypertension vs. supine hypotension. My personal opinion is that when gravity exerts its effects on someone with POTS, etc., the system may overshoot with vasoconstriction and tachycardia to maintain cerebral perfusion. You still may feel pretty bad, but at least the compensatory mechanism keeps you conscious. This is just my hypothesis, so don't quote me on this .