Mytwogirlsrox

http://en.wikipedia.org/wiki/VO2_max Did you have this test?

I think there are things like ejection fraction and oxygen consumption during exercise stress tests which indicate deconditioning

There is a journal article somewhere, that says people who have had gastric bypass can become afflicted with Dysautonomia, might take some searching around to find it. But I vaguely remember it saying something about the change in fluid volume and weightloss. I became ill with pots/ OH after two large pregnancies, I gained and lost hundreds of pounds in two years! I was first diagnosed POTS, but now Dr thinks its OH.

Kelly -- I agree with what your saying. I wish there was a strict diagnosis criteria. However many people would be excluded, I had very significant changes in HR, but little to no noticeable orthostatic symptoms. I had no idea I was tachy upon standing, I just became Pre-syncopal walking through a store and my dr placed my EKG on wrong so I had inverted twaves which was reason to send me to a cardiologist. I suspect many people who don't have substantial changes, but more orthostatic symptoms would be excluded from diagnosis -- and like you said for insurance and darn peace of mind, a diagnosis is a very necessary thing for your psyche. Interesting side note, some definitions of POTS don't include the word sustained so technically my itial surge would be considered pots.. But in the absence of symptoms what does that really mean? For me, I feel fine, I'm productive, happy and have no limits on my activities. Ive never had any symptoms besides anxiety which is very much under control now, so the only change has been HR reduction. Yogi-- I guess what I meant to say, is that I have some sort of anxiety related reflex fainting. I don't have any documented orthostatic hypotension other than after the nitro which is a questionable practice that gives many false positives. My Dr just said OH because of my symptoms of occasional graying out and a "surge" in hr upon standing-- which he equated with a BP fall. But he also stressed to me, that this is a very normal occurrence in healthy people.. There are many reasons : dehydration, medications, age etc...

Your symptomatic though right? I was wondering if I take my results to a POTs expert will he see pots? I feel like if you go looking for a zebra, you'll find a zebra. So I was hesitant at first to do so, I consulted a EP, 2 general cardiologists and then a pots expert and all but the EP who diagnosed me in the first place said no pots. I truly did have PoTs in feb 2012, and much of the year. My tilt I shot up to 140-150. At home I would walk around at 120-130, I do see why I received the diagnosis. My Hr was high.. Abnormally high. Anyways I'm bantering.. I keep trying to work through this...

Yes, that's what he was saying. Just keep up with the fluid and salt. I have NCS also (which luckily I have never fainted unless it was an high anxiety situation) My primary reason for seeing him was to get his opinion on whether or not my pots is improving or this is something different. It's been 2-3 months now I've been self-checking to see what's going on, and it's pretty consistent ... But the hazy diagnosis criteria made me wonder what was really going on. Regardless, un-diagnosing me or changing the diagnosis means a lot to me. Im just not sure if I'm ready to accept it, I still have this lingering suspicion that there is something insidious lurking within me.

That's why I wanted to consult my DR. My HR no stays between 80-85 even though I get a 20-30 Bpm "surge" in the first seconds of standing up. I was under the impression that since its not above 100 it's not tachycardia anymore.. and my Dr really thought it wasnt pots but mild Orthostatic hypotension (a dip in blood pressure upon standing) however on my original 45 min tilt my BP didn't change until I was given nitro @ 40mins and passed out. My BP still doesn't change when standing.. But I do get that grayish vision when standing up too fast or after I have lied down for a long time--maybe once a day. My BP has always been low 90/60, which he said puts you in. High risk of OH. So I guess for me couple the low BP, anemia, low RBC/ hematocrit yaddah and low blood volume most likely. I get orthostatic easy. He was really under the impression that pots is more than just numbers.. More symptoms.. OH is transient

I guess my numbers are normal enough. Dr really thinks pots is a lot more than just a 30bpm increase. I get a compensatory "surge" from the blood volume shift, then my hr slows down to 80-85. I'm never over 100 anymore, so I guess it's not considered tachycardia? I don't have other symptoms besides anxiety (no GI or brain fog, any of the related potsy symptoms).. So it's not like I was disabled then recovered.. I don't know, I'm just glad to be unlabeled. The OH to me makes sense, Ive always been 90/60, I had a huge volume shift after I stopped breast feeding & then hormone shifts. Then being anemic from pregnancy and massive bleeding during 2 c/s. I don't know, I still have to work through all this in my head... Anxiety makes things hard to cope with. Plus I'm so pessimistic I just hope my pots days are in the past and I will continue to "normalize" to whatever norm that may be.

I take it as a HR that hits 30bpm and stays there within 10 mins. For me, it shoots up with the positional change then trends downward-- as my dr explained it POTS would continue with an upward trend. Which was true for me months ago, my HR would creep up to over 120 quickly till I reached my max which was usually 125-130 and it woul hang around there until I would shift my weight around. Not sure if that's the case for all us postsy though. I had similar questions, I wanted to know the EXACT definition .. But my Dr was very confident in his interpretation of the definition, and his clinical findings in me. I'm a pessimistic nature so I'm not sure I can just walk away from this very easy...

If you look at Vanderbilts description it says a 30bpm sustained increase or above 120bpm for 10 mins Here is the diagnosis criteria my Dr followed. http://www.mc.vanderbilt.edu/root/vumc.php?site=adc&doc=38932

Shan I wouldn't get a HR monitor, just my advice, but I get kinda obsessed with the numbers. If your not using one, go with how you feel. Listen to your body

Dana-- I stand up it will go up to 95ish within 10-15 seconds then 5-10 seconds it levels off to about 80-85 and hovers around there. Might bounce between 75 and 90 too. Dr was pretty sure that this is NOT pots, but mild OH. He kept saying POTS is sustained And HR trends upward. Mild OH is usually transient upon standing. He was very serious that what is happening is a variance of normal. But he did say my "levels" tend to run low ... Meaning my hematocrit and iron levels are low, and he suspects that had a play in my POTS symptoms. Who knows. I really hope your friend doesnt have POTS

Thanks guys

Cured... Lol I wouldn't say that

I was on florinef for a week, then Celexa for 5 months. Im currently medfree

Thanks song canary... I hope that you have a similar appt in feb

Thanks, yea for the most part.

Ive been asking around lately if my symptoms are still consistent with a pots diagnosis. So yesterday at my appt with my cardiologist, he said I no longer fill the diagnosis criteria. Which I have been suspecting for a little while now, it's always nice to have something validated by an authority though. He did say; however, that I have mild OH instead. That the tachycardia I have (non-sustained, quick 10sec increase after rising), is just an overcompensation to the drop in BP. But my body compensates and returns to a normal-ish baseline HR. So during his poor-mans tilt I went from 69bpm to 95 in 15 seconds then back to 80-85 for 10 minutes. So I guess I still have a bit of a wonky system (mild-OH). He summed up our appt with something Iike.. Don't worry... Your doing great... See you next year.

I don't think your suppose to take you BP in the same arm, twice in a certain amount of time. There is something in the manual that says that... Something like it Will give false readings

http://www.nejm.org/doi/full/10.1056/ENEJMicm010831

Gosh I don't know. Does your Dr think this is just POTS? Seems like you have a whole lot going on.. Have you looked into barcode flex failure? http://www.mc.vanderbilt.edu/root/vumc.php?site=adc&doc=4793

I don't have that problem, ever since pots hit I feel like I'm chronically dehydrated.

I do this, I thought it was pretty normal vaso-vagal response.

No, it's great... I'm really trying to do similar things... Right now I've plateaued, my HR isn't slowing down much any more... Maybe it's gonna be more time than exercise now? Who knows, but Im gonna keep on exercising

There is a study about calcitrol reversing pots in a case http://www.ncbi.nlm.nih.gov/m/pubmed/22891006/?i=9&from=orthostatic%20tachycardia However that seems as though it would be the opposite of your problem