SeattleRain

July/August - getting up to shower, feed my dogs and myself was torture - especially going up and down stairs. Now, I can force myself to be more active but since standing up is so uncomfortable I tend to avoid it. Today I went to the mall and walked around for an hour (a lot of walking) and was able to pull it off without any major attacks - but my HR went up to at least 150 a couple times just standing there. It's amazing how some of you have to use a wheelchair. I guess I should be thankful for not having it that bad...

A supplement that most don't know about is Piracetam. I took Piracetam several years ago for a short duration of time for other purposes and it worked out great. I don't know why I stopped and now that this has been brought up I should consider taking it again. I took 1600mg twice a day but Wikipedia cites: "Many people take a dosage of 800 mg twice per day to improve cognition." I also took mine with Choline Bitartrate (Maybe citrate, can't remember) to reduce any negative effect it may have caused: - if you take a lower dose you probably wouldn't need to do this.If you end up taking it, please let us know how it works out for you - I'd be very interested in seeing how it may have helped...

I would have to agree that the ER is not a good place to get a diagnosis. They'll check your vitals and send you home if you're not dying. It's helped me mentally feel better, knowing the chances of death were slim being in the ER. Past that it costs an arm and a leg and the discharge diagnosis was more annoying than helpful - with recommendation to follow up with my Cardiologist. It sounds like you've had another Cardiologist and have at least been to the ER once in the past before the first told you that? I hope you can find out what's going on! Find a new doctor if they're not willing to work with you...

I'm like you - I hate the thought of taking any type of medication. My ex took it regularly and a friend of mine was on it before he went on an SSRI. I was just talking to him about it earlier today - saying he started out on a .25mg (notice the decimal place) dose. What dosage are you taking? Check out the Adverse Reactions: http://en.wikipedia.org/wiki/Alprazolam#Adverse_effects If you have an allergic reaction it could cause "respiratory depression" but other than that it doesn't look like it really causes blood pressure issues. Maybe you can start on a lower dose just to see how it feels (cut the pills into halves or thirds?). You could see if your doctor disputes that idea... Either way, I hope it helps you! Good luck, and let us know the response you have...

After my initial "episode"/symptoms ran me over in July, I've started thinking about some health related problems in the past and they seem to make more sense now. Has anyone else thought about a health problem in the past, that seems to make more sense now? A few years ago I thought I had developed a severe case of social phobia. I'm a people person, so this was hard for me to understand. It started when I was at office max checking out buying a chair and out of NOWHERE, BAM, I was about to pass out. I brushed it off, but then it started happening over and over again whenever I was out somewhere in public. This lead to anxiety which lead to me thinking that the anxiety was causing it, and that I have "social phobia". Looking back, it seems more likely I was just experiencing severe Presyncope. I also started having really bad anxiety attacks during this time (really, really bad). I had no idea why - I had no real complaints about my life and no work/family/relationship stresses that could trigger it. Now, I feel like those were Adrenaline surges or something causing me to panic. Never considered going to the doctor because I hated the doctor's office more than anything (never enjoyed hospitals) and if I did have anxiety, I wouldn't have been willing to go on medication anyways - so I just toughed it out. Then as fast as the onset came on, it went away about a year ago. No social phobia, no more anxiety. Overnight - poof! Anyways, to my mind it seems like I'm connecting the dots more or less with past issues that seem related in some way to what I'm experiencing now...

When I talked with my GP regarding adrenaline levels he said there's two ways to treat them: Beta blockers and SSRI's. What I said in another thread: I've gone through this for a while - and in the past year it got really bad. Every night felt like the more tired I got, the more the feeling of impending doom. Anyways, might be something to talk to your doctor about if you're not already on/haven't tried an SSRI. Hope you get some relief soon!

My cardiologist's explanation for everything is "I don't know..." and "I don't know what you want me to do about it?" My GP did a wonderful job at explaining the intricacies of heart function - I'll try to reiterate what he said but I'm sure it wont' sound too accurate. Basically, there's a nerve that controls both the top and bottom contractions. There's also a separate nerve for the bottom chamber. Palpitations occur when that bottom nerve fires when it's not told to. How that relates to the beats we're experiencing - prolonged conractions, longer than normal pauses - I really don't know. Personally, I agree with you when you say " I was thinking maybe my heart was just overfilling or something when I sit down due to the change in bp?" I think it has more to do with blood flow (and/or BP) than it does with nerves firing incorrectly. I see a new cardiologist on the 27th. If I can work this question in, I certainly will.

When I saw my GP the other day he asked if this happened to me, and said patients with panic disorder and other autonomic dysfunctions will wake up in the middle of the night sweating and in the middle of a panic attack. When you say NE - does that mean Norepinephrine? I think that's what he called it - but it might have been just "adrenaline" surges - I can't remember. If I remember right, he said that the brain will produce the adrenaline/NE in the middle of the night for no apparent reason - and that he treats these patients with a low dose SSRI. Not to treat depression - but because an SSRI directly effects some fancy schmancy nerve or node in the brain I can't remember the name of - that effects how your brain releases the NE/Adrenaline. Ugh, I do a bad job at explaining things. I should start recording my doctor visits!

Not sure if we're talking about the same thing but when I stand up, it sounds like I experience something similar. This is what I wrote up for my cardiologist: This sometimes happen from standing to laying down, but not nearly as often or severe as from laying down to standing. Another thing: When I'm moderately active and go straight to laying down (especially on my right side) - my heart beat slows prematurely and I start having "funny" beats. Much different than the normal palpitations I get. It's like there's random pauses between the top and bottom chamber contracting, and the duration of the contraction also seems to vary. So for example: My top chamber takes longer to contract, there's a longer than normal pause, then the bottom chamber contracts at normal duration. Then, maybe a longer than normal pause after that beat, then the top chamber contracts normally, longer than normal pause, then the bottom chamber takes longer to contract than the last beat. If a normal beat looks like: THU-thump, THU-thump, THU-thump. (THU is top chamber, thump is bottom, -- is brief pause between) The "funny" beats look more like: Thhhuuu---------thump, Thhuu---thhuuummmppp.............. thuuuuu-thumppppp. I hope that makes sense - don't know any other way to describe it. Is that what you experience, too?

The Atenolol was a no go. After an hour I started having breathing problems, extremely painful palpitations while standing (never have had standing palps much before) and the feeling like my heart was about to drop/fall out of place... (and oh, dry mouth like crazy). It did, strangely enough, reduce the symptoms of standing up. Wasn't very worth it - my pulse got as low as 32. At least I know it's definitely a blood flow problem (I think?).

The diagnosis (if you can even call it that) for being deconditioned would come with a basic analysis of your level of activity. Being deconditioned revolves entirely around lack of activity and the effect that has on your muscle mass and other bodily processes. You can't have a high level activity and be considered deconditioned (unless you're an Astronaut - since zero-gravity is void of any physical demand), since being deconditioned revolves around a severely low level of activity. This is different than your ability to exercise, how tired you are when you walk up a flight of stairs or how well your heart muscles are pumping as shown in a stress echocardiogram.

I think it's more of a formal term for being "out of shape" (for whatever reason). I don't think there's any tests that could really tell you this - would be more of an analysis of your level of activity - I'm sure your doctor could tell you right away.

I got back from my GP today and after going over my ultrasound results (came back normal) he brought up autonomic dysfunction (he deserves a cookie just for that). He said I could be having an adrenaline problem, and that one way to go from here is to try a low dose SSRI or low dose beta blocker - both which have an effect on the ANS. It was up to me so I went with the beta blocker as I know this to be what helps with most POTS patients. So, he has me on 25mg of Atenolol (daily) for 10 - 14 days, and to stop if I get dizzy or fatigued. I'm curious to know what you guys are on and what your dosage is (for beta blockers specifically). He also mentioned that beta blockers can cause a drop in blood pressure which is why he has me on the lowest dose possible (25mg - 250mg range). Given that I hear a lot of about low blood pressure among POTS patients - is this why the increased salt intake is necessary? To not only combat the low BP, but on top of taking a BB? Lastly, he deserves another cookie for saying "You're learning a great lesson in medicine. Doctors do a great job at telling you everything that's not wrong with you." Coming from a doctor, that was music to my ears.

WOW. That is CRAZY! Enough to make you nauseous!

Being computer savvy is the important part - you'll understand things better and learn faster. The "Stylin' With CSS" Volume 3 book I referenced is where I would recommend starting. I wouldn't recommend taking any classes. Most are outdated, overpriced, slow-paced and not put together very well. I think you'll find after reading the above book (or Kindle version/ebook) you won't need additional training per say - and from that point on it's just getting experience under your belt. There's CSS/HTML forums like there are for everything else - and they're good resources for if you have questions/get stuck on something.

That's a great plan you have! It was a big chunk of change but I'm just glad I have insurance. My Mom bugged the crap out of me to get it and all the while I was saying "Nah, I'm young, I don't need insurance!". Mothers are always right! I got started working from home in 2008 doing "affiliate marketing". Did well, but transitioned into running an online advertising company in 2010 and have been doing that since. Most guides/how-to's for making money online are scams or the information is so outdated that the info is useless. If you're lucky, you could find a company that hires people to work from home (there are some, but they're hard to find). If I were to recommend something, I would highly suggest learning HTML5 & CSS3. It'd take 3 months. 1 month to learn, 2 months of practice. A good web designer with these skills can easily make $10,000 a month. The market is so huge, and the demand so high - most designers are booked with clients. "Stylin' With CSS" Volume 3 by Charles-Wyke Smith is an excellent starting point for a beginner. If my business went down the drain tomorrow, this is exactly what I'd do.

http://circ.ahajourn.../118/3/e61.full This is a bit confusing to me. I'm under the impression a 30bpm increase upon standing is relatively normal, especially for people that are obese, elderly or out of shape. Is she talking about an exponential increase of literally, 30 beats per (each) minute? Update: Hm, well my heart rate in a reclined position in bed was 57. After standing up I checked it 3 times. 77, then 93, then 111, then 91, then I need to lay down - haha. So, that's a 20, 36, 54 bpm increases respectively. I'll have to mention this to my doctor and bring the POTS article as a reference.

Hang in there, you'll make it! Take it one day at a time... Try to pre-occupy yourself with something so you don't think about your symptoms so much. I know it's a lot easier said than done!

From what I've read an increase of 30bpm from sitting to standing is relatively normal. When I was in the ER the first time, I stood up from the hospital bed and watched as my HR increased from 40 to 90. I brought this up with the doctor and he said it was completely normal - and that it'd have to go way up - to 130 or so to become a concern. However, that was from lying down to standing. I'm sure there's a difference between lying down and standing up, and sitting down and standing up.

Read a lot about that - as well as those who develop pots after a viral infection seem to be great candidates for the best prognosis: Source: http://en.wikipedia....drome#Prognosis (It's Wikipedia, so you know it's legit ) I just wish it went away as fast as it comes on.

I pay $125/month for a $2,500 deductible. That's up from $110/month before the Obamacare ruling. It includes a $7,500 co-insurance limit - where I pay $35 appointment co-pays, $150 ER co-pays, some lab work co-pays (like x-rays, etc), and prescription co-pays. I went through the deductible immediately after my first ER visit. Since July I've paid a little over $6,000. My insurance company probably hates me, lol. I've saved a good portion of my income since I turned 19 - so I'm fortunate to not have to have financial stresses on top of medical ones - which I'm sure causes a lot of anxiety for people. I'm even more fortunate to be working from home making my own hours - so when I became practically bed ridden, it didn't have an effect on my income. A friend of mine ended up in the ER with no insurance a few times and owes something like $20,000 to the hospital. He says he just pays a couple hundred dollars a month and they leave him alone (He's in Minnesota). I noticed when I was paying my bills online, each medical center had a section for signing up to a payment plan for people that can't afford their bills.

http://www.mayoclinic.com/health/how-to-measure-blood-pressure/MM00784

That's true: When you eat a meal blood is allocated to your stomach/abdomen. Otherwise, you'd probably get nauseous every time you eat and that'd be worse than feeling tired (in my opinion at least). Another thing is that with most foods we eat, they cause your main artery to spasm and narrow (by about 50% from what I read). You're supposed to eat something like tomato slices, or a multivitamin because the "lycopenes" will cause it to spasm back open. I hope you feel better soon....

As a male, I can vouch for this. I don't even know how I feel myself half of the time.

Wow - 2500 is a lot! Are they painful for you? Mine feel like being shot in the chest with a cross bow - extremely painful and startling. My palps come like clockwork in the morning right after waking up and laying bed. If I have them standing up (not very often) - they feel different. Not as painful but more uncomfortable, like there's a difference in blood flow/volume. I also notice that if I'm walking around and then lie in bed on my right side in a certain position - they're completely predictable - and start happening almost immediately.