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isa5

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  1. After I failed a trial of Florinef (it had bad mood effects for me), my doctor switched me to desmopressin, and I find it quite helpful. I take 0.1mg at night, and retain fluid much better as a result. In the AM I also start with a liter of oral rehydration salts (initially these tasted disgusting, but I've adjusted), which wards off any of the worries about hyponatremia that sometimes come up with the desmopressin. Together they've worked well for me.
  2. Miraclemaker11--just a quick note to say that I also run through midodrine very quickly (I can feel it wear off after 3h) and I take 10mg every 3hours, for a total of 50mg/day (or 60mg, if crossing time zones). Midodrine is metabolized in the liver and apparently there's some variation among people in how fast we process it--I'm a fast processor, so it wears off quickly for me, so much so that my face changes color in the space of about ten minutes when it's "done." Some docs are hesitant to go with a dose as high as mine, but there is precedent, and it has helped me a great deal with the fati
  3. I was maintained for many years on bisoprolol and found it the least sedating / cognitively limiting of the beta blockers I tried. (Metoprolol and propranolol both gave me terrible nightmares). Switched back to metoprolol after a sustained relapse, which gave better control of heart rate but with additional sleep disruptions and fatigue. I'm now taking ivabradine and find it preferable to beta blockers because it doesn't seem to cause fatigue--I'm still tired from the POTs flares, but much less so than I was on metoprolol. Good luck to you.
  4. I take midodrine 10mg 5x/day (every three hours)--while the tests that led to FDA approval tested the 3x/daily dose, my cardiologist tells me most POTS doctors think 60mg/day is the max reasonable dose. Another cardiologist at a national center I just consulted with said the same thing. Something to consider--if cardio is really committed to no Florinef, then maybe a closer midodrine dose would be an option.
  5. Totally agree that you need to see someone with a better understanding of things. Salt and water are important but not the only solution, and someone needs to listen to your IC concerns and adjust treatment plans accordingly. For what it's worth, if Florinef doesn't work for you, you might have some success with Desmopressin (DDAVP), which reduces the amount of water your kidneys take out of your bloodstream. I take it at night to keep fluid in (I was getting up frequently to pee in the night). You need occasional blood tests while on it to monitor sodium levels, but someone knowledgeable
  6. p8d, I see Dr. Greer and he's great. Empathetic, thoughtful, up on the recent treatment protocols. He and his staff will take good care of you if you come our way.
  7. bombsh3ll, I was worried about the water restriction but it's actually been fine so far. I take the DDAVP at night and then don't drink fluids overnight (maybe a little if I wake up thirsty, but not a ton), then have water as usual during the day. I am less thirsty than before and need to use the loo less frequently, but all seems in order. Docs are checking sodium at next visit, but nothing too aggressive in terms of supervision. I think at the lower doses it is less likely to cause problems with the water/sodium balance. (I also have a history of UTIs and was worried about consuming less wat
  8. I take 0.1 mg once a day, the tablets--the smallest dose, I think. It's worked very well. I would not have commented on this to a doctor before, but I was noticing that I was just running through fluid no matter how much salt I ate--as in, I was joking to my husband that I was a human water filter--to the point where I'd wake up in the middle of the night to have to pee, and then get terrible adrenaline surges from standing up. I still have some problems with adrenaline at night, but the DDAVP makes it more likely that I can sleep 8h at a stretch. I'm grateful my doctor pushed on the volume th
  9. Totally recommend midodrine. I am several months in to a substantial relapse and it's been a lifesaver. (Like you, I'd been controlled for years on a low dose beta blocker only. Midodrine made it so I could stand up again, though I run through it really quickly and have to be very rigid about taking it every 3 1/2h or so). While I had never thought I needed volume expansion--my diagnosis was hyperPOTS, hence the beta blocker--adding that has also made a substantial difference, especially in the summer heat. I couldn't manage the side effects from Florinef and am now taking a low dose of DDAVP,
  10. Have you perhaps tried any of the vitamin supplements that are used as preventatives? I've had good luck with riboflavin (vitamin B2; 400 mg daily) and magnesium (I take magnesium malate, as it's easier on the stomach, also 400mg daily). Others use coQ10 for the same purpose. There's some research supporting all of them, though it's not perfect and they are not perfectly effective--for me, they keep me down to one or two migraines a month, along with my abortives used to interrupt migraines when they come (I take Migranal). The plus is that the B2 and magnesium haven't given me any unpleasant
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