Hello everyone, I've been reading through the archives for a couple weeks and really appreciate all the great information here. I recently received a possible diagnosis of POTS from a primary care physician, who suggested I see a specialist. (He ran all the tests of exclusion, and my heart rate and symptoms fit the criteria, but I haven't had a tilt table test.) If it is POTS it would make a ton of sense, going all the way back to my history of vasovagal syncope as a very young child through my teenage years. I don't faint anymore, because I can recognize the signs to sit/lie down. (Which is occasionally embarrassing: in line at an ice cream shop, suddenly needing to sit and grabbing the only free chair in the place, at a table with a surprised mom and two kids ("sorry... I'll just be a minute") and then realizing it wasn't cutting it and stumbling outside to lie down on the grass in a daze. I don't want to know what everyone thought!) My symptoms were chalked up to depression for the last 15+ years, which is understandable since I have had recurring bouts of severe depression (which respond best to stimulant medications). The past four years have been difficult, though, as the fatigue has never fully gone away even when my mood has improved, which got me a diagnosis of treatment resistant depression and a several-year tour through all the treatments imaginable, including MAOIs, ketamine infusions, and prescription dextromethorphan. It's only recently that we finally teased out that yes, there are probably two kinds of tired at play here, and we've fixed the depression kind. Now I need to find someone to help with the POTS kind. I'm near NYC and have lousy insurance for this type of visit, so as much as possible I'd like to find the right person on the first try. I don't think my POTS (if that's what it is) is extremely severe, at least not compared to much of what I've been reading here. I haven't been able to work full time in several years, but if I manage my schedule just right I can get by with part time hours that are enough to (just) pay the bills. Mostly I need to schedule in alternate days off and a few hours down time in the middle of the day when I can be horizontal and quiet. I've had some success with fluids, salt, and compression socks recently, but not as much as I'd like. I was very active before this became a more pronounced problem in the past several years, and I've put on 40 lbs from a combination of medications and exercise intolerance. I used to run 4-5 miles in the evening several times a week, but now I can only do a mix of walking with 1-2 minutes slow jogging, which puts my HR above 200. (At 31, my supposed max is 189.) I'm worried a doctor might say that I'm deconditioned and that I just need to get in shape, but I've been trying very hard (I've committed to Couch-to-5K several times, but I just can't get past a couple minutes of running, no matter the repetitions over the weeks... which makes sense now that I know my heart rate is in the "workout" zone just lacing up my running sneakers.) I walk and bike as my only means of transportation, so I do have strong leg muscles, but I have blood pooling in my feet regardless. I'm hoping to find a doctor who will realize that deconditioning and weight gain came because of the fatigue, and not the other way around. Since reading this site, I'm curious whether my flushing and allergy symptoms might point at MCAD. I am very sensitive to skin irritants and have allergic reactions to things, but the allergy tests have always come back negative. (They gave me an epi anyway, given the reactions I'd had.) If you'll forgive the ugliness of these photos (and I never really understood the effectiveness of creating anonymity with a rectangle over eyes, but I added it anyway), I wonder if this type of flushing looks familiar to MCAD folks. I turn bright red, sweat excessively, and get a runny nose while exercising, and continue sweating usually for 60-90 min after. The flush gradually goes away by two hours later. It's VERY red when I'm actually exercising, and always splotchy. I also flush after eating sometimes, and when embarrassed or hot. I'm not sure how to tell "normal" flushing from MCAD flushing, though... maybe this is nothing out of the ordinary: 30 min post-exercise: http://smg.photobucket.com/user/porticas/media/30minpostexercise3anon_zps448a7662.png.html 30 min post-exercise:http://smg.photobucket.com/user/porticas/media/30minpostexercise2anon_zpsfdbf36cf.png.html 60 min post-exercise (still sweating): http://smg.photobucket.com/user/porticas/media/60minpostexercise1anon_zps38c6eeaf.png.html 90 min post-exercise (not sweating, almost back to normal color):http://smg.photobucket.com/user/porticas/media/90minpostexerciseanon_zpsa615b771.png.html I have a list of NYC doctors I've culled from the archives and site, but I wonder if anyone has recommendations specific for my situation. I imagine I'm not severe enough to see Dr. Weimer, for example, but I wonder if there's someone who is kind and sympathetic, and knows their stuff about flushing/MCAD, if that seems like it might be related. Thank you for reading! I'm sure I'll have more questions, but this is enough for now. I appreciate any help!