EarthMother

I had another holter test done in 08 and decided I would keep a DETAILED diary on a separate sheet(s!) of paper to attach to my record. I made sure to do EVERYTHING during that 24 hours that I wanted data on like situps or other floor work , walking up stairs, using the loo, taking a shower and yes Sex too! I even glanced at the clock after organism so I could make a detailed note after cuddling in the afterglow. For me, it gave me the piece of mind I wanted ... and i'm sure a lot of funny jokes for the lab techs who read my holter diary! We all seem to be different in this regard. For me, yes it is possible to have amazing sex in the midst of POTS. Now "amazing" may well look different now in my late 40's than it did in my early 20's. I don't do it standing in the shower or like I am in a triathalon any more. For me and my husband it is a VERY SLOW pas de deux. If I don't have the energy to spend an hour laying in bed with gentle touches and graceful waves of movement ... then I'll make better plans for another night to secure that time. I don't feel any better worse the next day by way of POTS after a night of love making ... but when my body is at its worst and the pain and agitation are high sexual touching provides an amazing contrast to how good I can feel inside of this dysfunctional body. For me, its also an important bonding time with my spouse. Most days I feel completely worthless with very little value added to his life ... so the fact that I am still able to rock his world warms my heart. Intimacy and sexual expression contain a wide range of possibility. If POTS has taught us anything it is creative adaptation.

If I recall premature gray is also linked to auto-immune thyroid disorder. I had my first silver hair at 18 and now at 47 I am mostly silver/white. In my family pre-mature gray was the norm and I grew up looking forward to my silver strands. Still do. Love my hair color! As for hair loss? Yes ... for me I loose up to a third of my hair about three months after any major illness or POTS crisis. Did this after each of my pregnancies, chickenpox (at 28), and whenever my POTS kept me bedridden for weeks on end. Bioton helps. And for me it grows back fine. Fortunately I have a ton of hair so losing even a third is not devastating.

Wow. When did I get so old? I had to look back at my registered date and apparently it's been six years here for me. Amazing. I remember when I was first diagnosed with POTS shortly after joining the boards. I was out on yet another round of short term disability from my work and when I got the official diagnosis from my cardiologist after the TTT at the hospital ... I wrote to my boss and told him 'GOOD NEWS I have a diagnosis, i'm sure that i'll be able to treat this now that I know what it is.' I lasted another four years working full-time ... which eventually worked it's way into most of the time from home ... until I could no longer continue to push myself beyond what my body was capable and in 2007 I was left no choice but to abandon my career. Even in 2007, I was telling myself ... 'if you just rest, you'll finally be able to recover.' But as the other 'old timers' here know ... autonomic dysfunction doesn't always auto-magically go away. It does wax and wane for some of us, it does blossom into new adventures from time to time but for many it is a life limiting illness that may last a life time. Of course we never know what the future may bring. Here's to new research and new possiblitites in the New Year!

There's been a slew of research that indicates that during periods of great stress the blood brain barrier is more permeable. Makes me wonder if some of our common drug "sensitivities" aren't related to the fact we metabolize drugs differently than "normal" people. But for whatever reason, I am VERY sensitive to drugs (as well as foods, herbal meds, environmental toxins etc.) My Doctor recognizes this and we try to stay within a circle of meds that my body has demonstrated it can tolerate and at a dose (usually pediatric) that doesn't cause a problem. For instance, I can handle penicillian at pediatric doses ... so sometimes we'll try something like amoxicillian at 250m 3x a day even if there is another "preferred" antibiotic for a particular infection. If the penicillian doesn't work after a few days we'd move on to a new drug. I also do well with zithromax -- again at lower doses than adult prescribed. I am always up front with my Doctor and let him know if I need to stop a drug that has been recommended and for what reason. We add notes in my chart so we can avoid those in the future if possible. I do recall years back he prescribed something for what we thought was BV ... he did a culture and told me to start the prescription that day. Well I had a horrid reaction and by day 2 needed to call him and say it was a no-go with the new med. Turned out the culture came back and it wasn't BV. Live and learn. Sometimes we have to take new meds. I have on occasion asked my husband to read up on side effects on my behalf so that I would not become overly concerned, and he could more objectively assess if any reactions were attributed to the new drug or a byproduct of the illness/infection they were treating. I also as the Doctor if I can break the pill and try half or a quarter dose for the first day to help gauge my body's response to the new chemical. Some of the peeps on boards have had formal drug metabolization testing which affirms they are not genetically structured to process certain lines of pharmaceuticals. I wish I could recall off hand who had done these but brain fog this morning is drawing a blank. Be gentle with yourself. Trust your inner wisdom -- which is not always the same as your google-armed-mind. Breathe slow and deep and assure yourself that the answers will come. You WILL know what to do and you will be able to do it. Deep bow to your courage. Good luck on your healing journey.

The advice you have received is blessed, I could add nothing of value to practical next steps. What I can share with you is some philosophical spin stories which may help ease the "personal" pain and confusion you are grappling with. Each of us in our journey seem to walk a path that feels at times very alone and confusing. However sometimes when we are lucky we get to see the larger tapestry that is being woven and how our one small thread fits in perfectly into the overall design of the masterpiece. A little while back I had an "unfortunate" run in with a highly esteemed medical specialist -- we'll call him Dr Ego. Like you, I could not imagine why Dr. Ego spoke to me in the tone he did. The effort it had taken for me to even get to his office that day was herioc and as I tried to fathom -- why? why did this happen to me? I was able to look back and see some of the pieces that were not evident to me in my own exaserbation. While I was there and flaring badly ... two of the nurses had brought me back to a room to see if they could help. This was a big conglomerate office with lots of different nurses assigned to different Doctors. One nurse said to the other ... "Do you want to check her blood pressure?" then she seemed to catch herself and followed quickly with ... "Oh, I forgot! You are Dr. Ego's nurse, he doesn't let ANYONE take blood pressure on his patients." Then she laughed and cuffed me with the blood pressure device on the wall herself. Dr. Ego's nurse wasn't laughing. I waited a full on hour before the doctor came in to see me -- even though I had been through a horrendous POTS episode in his waiting room and the nurse had said he'd be right in. I'm not sure he even checked my vitals before writing me a script for a beta-blocker (which my cardiologist wouldn't have approved of) and sent me on my way. I was just happy to be released out back to my GP who I could trust to handle things in a professional and thorough manner, and my cardiologist who later helped me better understand the hyperadrenergic aspects of the POTS flair. But as I 'dashed' out of there ... Dr. Ego's nurse followed me into the parking lot. She wanted to know what he said to me, she wanted to know how I was treated. I could tell in her eyes that she was questioning her own choices and if serving the most prestigious specialist in town was in line with her own values. I'll never know ofcourse how my experience impacted her life choices ... but I did walk away knowing it wasn't about ME. I was just one piece of a jigsaw puzzle that brought certain people and circumstances together in order to complete one small section of the board. We can't always see how the other actors and stage hands in this big story of our life seem to fit together ... but when we get a sense that they always do ... we can take a deep breath of relief in knowing there was nothing 'personal' about a particular encounter. Good luck on your next step of your adventure. I do hope this story has a happy ending.

In the -- TRY EVERYTHING -- mode, you may want to consider changing your diet a bit <ok alot> while you are moving through this healing crisis. When I crash like that everything goes awry and my blood sugar gets fickle and my food sensitivities become intense. Think small simple meals every couple of hours -- protein based. I'd take out all sugar, even things like juice until your body is more settled into 'normal' for you. Likewise no white flours or refined foods. Eat as close to source as possible ... eggs, whole fat non-aged cheese, nuts, lentils etc. And whatever meats you include in your diet. I do better when I do a diet that curbs "free glutamates" -- it works like MSG in the body. MsgMyth.com -- Good luck finding something that helps during this difficult time. p.s. I just remembered (darn morning amnesia) ... for my hot flushes and tachy spells I've been taking a tincture of Motherwort. Its a wonderful balancing herb for perimenapause and helps with the earthquake hot flashes in POTS as well for me.

I had a doctor years and years ago also tell me to curb my water in lieu of gatorade because it replaced my electolytes better. So I did like 32-64 ounces it daily for well over a year. Ended up with systemic candida from all that sugar! Never touched the stuff since. My body can't handle even juice these days because the sugar content would cause reactive hypoglycimia. I don't water load any more because it just makes me pee and unless I'm packing DDAVP (anti-diuretic) it won't do me any good. I've also made my own POTStail by mixing water with a touch of salt and just a couple spoonfuls of orange juice which adds the balance of potasium to balance the salt. Good luck finding things that work for you.

I'm not stopping the milk and nuts ... just making sure I am being more vigilant. During the last year that my blood sugar stabalized ... I became more laxed and sometimes went longer without eating particularly in the afternoons. As I said for me I think my thyroid is playing a piece in the puzzle (as well as some colder weather and a visit from my Dad this week.) I changed the timing of my thyroid med today, and so far my blood sugar has stayed good. Wow, you had 3 courtcases, a hospital stay, 6 doctor appointments scans,and just bought your apartment in the last two weeks!!!!!?????? My goodness you don't need a babysitter you deserve a royal court of attendants to cater to your every need and whim!!! Way to go for even being coherent after all that stress. Now think bubble bath, gentle healing massage, pedicure and facial -- you deserve it!!

1. when you are symptomatic have a look at your pupils - LARGE 2. When you lean forward does your head feel -- FLUID, PRESSURE 3. Lye flat on a bed and hang your hand down and keep still for five minutes. Have a look at your hand. Is it ...- I IMAGINE IT MIGHT BE DIFFERENT IF I WAS UP/AWAKE AND THEN WENT TO LAY DOWN. BUT MY HAND DID NOTHING THIS MORNING ON WAKING, NOT EVEN THE NORMAL PUFFY VEINS IF I JUST KEEP MY ARMS AT THEIR SIDES. NOT ANY COLDER OR WARMER THAN MY OTHER HAND. AS I SAID THOUGH ITS MORNING AND I'M GUESSING I HAVE NO BLOOD FLOW ANYWHERE AT THE MOMENT.

My concern is that we only have a single lab doing the testing. How is that in some cases webneed YEARS of research and replication before we can ANNOUNCE a new test/procudure/cure? And these folks have a viral campaign (small pun intended) that is sweeping the media? For myself, I've decided not to be an early adopter. When my medicare will pay for the testing and there are actually some drugs to correct the xmrv then I'll get in line. Seems to me like this group at wpinstitute is actually just doing their second data collection to test their theory. But instead of having "participants" the have "paying customers". Not cool IMHO to break the bank with chronically ill people who have life limiting illnesses. Ok ... i'm stepping down off my retro-soapbox.

{{{hugs}}} I can tell you are really worked up about this. Its only because you are in a crash right now and your whole body feels upside down. YOU are the one who has reassured ME that as these physical symptoms settle back down, I will not need to rely on my husband 24/7. When our bodies are in such a tailspin, our minds begin to think outside-of-the-box-on-overtime searching, judging, worrying. Rest assured this is just your mind keeping busy with all the extra adrenaline. I know you have been in this place before ... and I know you have come through it. When we are very sick, we need someone in the same room. As we begin to breath better and use the loo on our own, we are comfortable having someone at the house. When our symptoms become predictable, we are good to go if we have a cell phone to call someone. And i'm certain if we recovered we'd be piloting our own hot air balloon around the world in 80's days. Right now, your blood sugar is creating all sorts of body chemistry inconsistencies. When your mind begins to question your own sanity ... tell it that you are making an agreement with yourself to put that thought on a shelf UNTIL your blood sugar stabalizes and your POTS symptoms become more predictable once again. This week, after writing several threads to you about hypoglycimia and how it's been a year for me since I had wicked lows ... my own blood sugar dropped out on Wednesday morning!! It was so strange ... I had eaten everything like I normally do. My blood sugar was fine on waking, I ate every couple of hours like always. But I did notice that I was more cold than usual. I was also more tired, and my head hurt which is not common for me. By 11 am I was full on trembling, terribly nausea,and very dizzy. The symptoms were so familiar. I had just eaten some nuts and whole milk etc. 30 minutes before but I took my blood sugar anyway. Any other morning it would have been 95 or 105 etc. after eating like I had been. But Tuesday! when the crash started it was 70!!! I was devestated to think I was going into another unpredictable pattern. My body was shaking and there was nothing I could do to comfort my mind ... it took me a couple of hours before my blood sugar was a bit more reasonable and my mind could consider more reasonable possiblitites. Turns out I crashed again yesterday. This time again in the morning around 11 after having eaten high protein twice already that day. Bottom line ... its scary when we don't know what's going on... what's going to happen next. Far be it for ME to reassure you that you are not crazy because i'm sure most people are certain that I AM!! But, I know what you are going through, and I trust this hypervigilance by way of being with people will pass once your physical symptoms stabalize. As for my own blood sugar oddities this week ... I did a bit of google searching and it seems that hypothyroid can cause wicked blood sugar lows. Seems the lack of thyroid hormone on the liver causes an insulin dump into the blood stream. By no coincidence, I just started a new thyroid presciption last week. I know it makes NO SENSE since I went from .88 to 1.00 (i increased the dose). It would be really strange to think I could be TOO LOW on a higher dose. But given the wide fluctuations in my Hashimoto thyroiditis, I 'm guessing my auto-immune system is not playing nice with my new dosing. I'll give it another few weeks, tweek my diet a bit more in the meantime, and see where this all lands after the holidays. Main thing is to eliminate as much stress as possible right now. Do whatever you can to find comfort and rebuild your body's balance. As always ... my thoughts are with you. ~EM

Thanks for the link. It's one we all should keep on file. I am going to have to re-read when I have less brain fog ... but at first blush I see the breakdown for us chronic potters etilogy as some form of either: global hypovolemia, disturbances in the renin-angiotensin-aldosterone system, excessive adrenergic activation (hyperadrenergic POTS) or this new theory parasympathetic withdrawal. Yet, wheras the other paths get discussed in more detail (even things like EDS defined) ... I don't see any further mention of the mechanics of what parasympathetic withdrawal would look like. My undergraduate thesis (some 25+ years ago) was on a physiologic paradigm for the condition known as 'learned helplessness' and established in my study to be based on parasympathetic rebound. In this case the parasympathetic branch over-shoots after a stress event and the participant simply can't get it up for the next stressor (lower than baseline pulse). But parasympathetic withdrawal sounds like it might be saying that the parasympathetic branch is actually NOT kicking in and we are left with unabated sympathetic arousal (high baseline pulse on standing). Yet that wouldn't account for how the ANS cranks way down again on supine. What have you gleened is this new parasympathetic withdrawal theory?

I don't notice nuts to be "addicting" for me UNLESS they are salted! ;-) And even then, I figure it just means that I need the salt!! When I was crashing back then it was hard to eat and I was loosing weight. So I ate anything I could and as often and as much a I could tolerate. All that extra adrenaline was burning up the calories quickly. I'd say eat now ... count calories later when your body feels better. If you can handle a quarter cup of nuts every couple of hours with a half slice of whole grain bread then go for it!

Juice use to spike on me (i actually still can't handle it) ... for me the easiest thing is four ounces of whole milk. In part because the fat helps keep my blood sugar stable longer ... also because there seems to be something in reduced fat milks that trips my glutamate action (hidden msg). I learned a lot from the msgmyth.com website and found for me when I eliminated those foods too I did much better. If even four ounces a day seems too much for your cholserol, you can try whole nuts instead of nut butters which can be hard to find. I actually grind my own nutbutters in my food processor -- walnuts, almonds, hazelnut or brazil being my favorites. Unsweetened soynut butter works for me too --- but that can be hard to find. I've had my cholesterol checked twice since adding the butter and whole fat milk but cutting out all the sugars and my triglycerides came way down and my other values are better too. Even my 'bad cho steral' was only like 140. I think its a genetic thing. My Dad has really high cholesteral and eats this really low fat diet. But he still eats plenty of refined carbs (white pasta) and simple sugars. I think there's a link there. Where I live we can buy a little disposable blood glucose meter ... like 25 or 50 strips with the meter built right in to the cap on the vile. If you can pick one up, you can do some experiments yourself one weekend. I was testing and charting particular foods every 15 minutes or so to watch the spike and gradual or most cases RAPID drop off in my blood sugar as a result. I kept detailed notes and would repeat the ones that seemed strange (like bananas or even a quarter of a potato which became no-nos for me back then) and I could come up with a set of dependable foods that worked for me at the time. It might be that a small piece of chicken (or tofu) works well for you at work when you feel a crash coming on. Good luck sweetie, I know how hard these symptoms are and i'm sending you good thoughts that your body finds it way back to an easier time soon!

Carina -- do you know WHICH of your cholesterol levels went high on your last screening? When I was in the blood sugar spikes it was my tri-glycerides that went high. These are a direct result of the sugars and carbs that were throwing me out of whack.

I went to elaborate lengths to hide my illness for years. I found it exhausting. When I finally got a formal POTS diagnosis, I felt better about trying to explain my situation to people at work. That was a help. For the last few years that I was able to work folks were great about having committee meetings in easy access locations, having warm and cold beverages on hand and even couches for me to recline as helpful. In the last year of my career we even did several video meetings or teleconferences to try and keep me in the saddle for as long as I could. But even that became too much and by 2007 I had to leave my job. After that I decided I wasn't going to hide any of it any longer. The POTS, the panic surges, the extent to which my life has impacted my family ... I'm up front with everyone. Sure ... I lost some folks along the way. Not the least of which was my own mother who simply withdrew completely from my life a year ago. There are friends who understand, friends who don't understand, people who gossip and make up their own stories and some strange folks who find my blog an inspiration -- LOL Bottom line ... I can't control what any one thinks, believes or assumes either with or without accurate information. But for me, I feel as if I am in integrity with my situation and my word if I at least put it out there and say honestly ... "No, I can't go to lunch with you, I'm having a darn hard time getting out at all these days because the dysautonomia is a real challenge on my body." As I said, for me that's the path of least resistence. I feel GOOD when I'm up front and out of the closet. I think doing things to reduce our stress is crucial in our healing. So if it is HARDER for some to share that information then it would be counter-productive -- whatever works for you. Whatever makes your life easier to handle in the moment and down the line.

This is where the glucose meter helped me in 2008 when my blood sugar was all over the map. It was easy to see what I could or could not eat because I was testing all the time. For instance I saw that even a half of a banana was a no-no for me. Same with 'no sugar' granonola -- still waaay to much natural sugar/carb. I know how hard it is to eat when this blood sugar instability is raging. Small meals are fine but you probably need to change what you are eating and make sure you are getting all three <a protein, a little complex carb and a fat> in each mini-meal. My system when wacked out back then, couldn't handle even fruit and absolutely NO CANDY not even a single lifesavor that I was using to boost my wicked hypoglycimic lows. Sure, I felt better because it pumped me up a bit but it was making the problem worse down the line. Think a protein, a little complex carb and a fat, for every bite. Also what stabalizes me when I am already surging is four ounces of whole fat milk. I used to drink soymilk only, but reading my glucose levels I realized this did very little to help my rollercoaster ride. Whole milk gets my blood sugar up and the high fat content keeps it stable no spikes or dips. Other foods that helped: 1 slice of whole milk non-aged cheese with a Half or even quarter slice whole grain bread. <I have histime reactions too so chedder or swiss etc is OUT but whole milk mozzerella is fine> 1 TBL almond butter <no sugar added> with a tiny bit of bread. Or even a handful of walnuts or brazil nuts. <not pecans they have too much carb and way too little protein> I also used real butter on my small morsels of bread because again the fat helps spread out the sugar load over time. Carbs <noodle soup, chocolate> convert to sugar quickly, proteins <meat, tofu, cheese> take a little longer and FATS convert to sugar at the longest decay. It took me many months adhering to a strict reactive hypoglycimic diet before I felt better -- there's no quick fix. But you must stop eating things that are keeping the cycle going for your unique body chemistry. For me I had to cut out all simple carbs, no white pasta, breads, rice etc. NO fruits, no sugar, no potatoes. I had to limit even my complex carbs. I could have a TINY bit of brown rice IF I was eating twice that of protein. I also needed to eat more animal fat -- as a vegetarian that meant real butter,whole fat milk and whole fat simple cheese like mozzerella. Hang in there Hun. I'm holding a good thought for you. ~EM

Common standards is a theme here that works for the couples that are in sync about housekeeping responsiblities. Its probably like spending vs saving money; having pets; or even big things like fidelity ... you BOTH have to have common definitions and agreements to make things easy. Not to say that things don't work if there is not a meeting of the minds, but that's when creative compromises must be reached. Asking someone to clean something beyond their own level of "acceptable" is really difficult to enforce. I say this because I go round-a-bout with my teenagers on this issue all the time. ;-) But while badgering my kids is part of the package deal of being "mom", it would take the wind out of my sails to keep up that level of nagging with my spouse. I'm fortunate my husband and I have both learned to overlook the atomic dust bunnies, cob webs in the vaulted ceilings and routinely step OVER piles of laundry that accumulate by the washer. It works for us for now until we can get a smaller place that is managable. For me, I keep my bedroom tidy. I ask my kids to help me sweep or mop my floor and I wash down my bathroom sink/counters and commode. Those are easy to do because its a small space and that is the extent of my energy. As for the rest of the house, what works best for us is cleaning together ... all of us, one room at one time. Me, my kids and my husband. We can all chit-chat and get things done in much less time. And we don't try and tackle the whole house just one room ... once in a while. When we both worked, I had help with the house cleaning. Not on option any more. But if are thinking along those lines and trying to figure out how to financially swing it ... you may want to consider hiring a neighborhood teen <somewhere there must be a teenager who knows how to clean, right?> There also may be people in your neighborhood who are inbetween jobs, active seniors, or stay-at-home Moms who might be willing to help for less money than a professional agency. If spending cash is simply out of the question ... you might barter a service in exchange for cleaning. I can usually cook (I have my kitchen worked out so I can do things within the limits of my POTS) and I know there are very busy friends who work fulltime who would appreciate a few home-cooked meals to pop in their freezer in exchange for some scrubbing and sweeping in my house. Good luck finding creative solutions that work for you and your DH.

My undergraduate thesis involved an experiment with progressive relaxation techniques, there's a lot of good research that it can help a great deal with stress. My first meditation track I recorded used a varient of Jacobson's Progressive Relaxation: http://coolkarma.com/free-videos.html If its the same time each day, i'd suspect blood sugar instability. When I dropped a lot of weight in a POTS crash last year my blood sugar spikes and crashes were horrid. Once these go out of whack, its not a matter of eating well <every two hours a small meal with protein, whole grain carb and a fat> and then you feel better. It took me SIX MONTHS with a reactive hypoglycimic diet before I stopped flaring before or after meals. For me, I needed to really increase my whole food fats, like real butter and whole milk. I still start my day with four ounces of whole milk because it seems to stabilize my blood sugar better than anything else I tried. Nothing wrong with meds if they work for you. All of us have different body chemistry and we sometimes need to go through several trial and errors before finding something that helps. Good luck to you on your healing journey. ~EM

Nice to see so many other veg-heads!! ;-) I have lots of free recipes on my website for my cookbook: http://www.30dayvegetarian.com/forum/ including some new ones for holiday meals. I've been vegetarian for 10 years and during that time I have done various periods of wheat-free, dairy-free, egg-free etc. as my Doctor and I were addressing food sensitivities. Like you, I asked my Doctors if my diet was adequate for my health issues and each of them over the years (looking at my blood work etc.) said I was doing an amazing job at meeting my nutritional needs and leading a healthy lifestyle. But clearly I'm not a vegetarian for my health! LOL In my case my POTS is not better or worse with or without meat. i.e. it doesn't help ... it doesn't hurt. Though for my particular body, being mindfull of blood sugar issue is very important. I eat a minimal amount of even natural sugars and follow a hypoglycimic meal plan -- which works well for me at this phase of my life. Good luck finding foods that work well for your unique body chemistry ... ~EM

I was getting the burning face pretty bad last year and also the burning mouth syndrome. Most of it subsided as I worked on serious muscle relaxation for my face and particularly with my mouth. Turns out I was tongue bracing without realizing it. Once I was able to release those muscles the burning seemed to subside. Though could have been coincidence because I was also adjusting thyroid meds at the same time too!

Ooo! I'll bring a gluten free chocolate cake! Hang in there sweetie! It sounds like your body is trying to fight this on its own (ala the low grade temp.) Sending good thoughts your way.

I use to take Natural Calm magnesium. It helped some with the palps, but my cardio switched me to Slow-Mag ... its a timed release magnesium supplement, very easy to digest and absorb. Within a couple months my palps had gone down dramatically. Now they are the rare occurrence instead of the norm.

Any standard labs testing this yet, do we know? And is the anti-body xmrv available now or is this still the 'simple' test?

Best I can do is try and dissipate the adrenaline surge once it already enters my bloodstream. And to that extent things that seem to help reduce the duration include; laying down flat with my arms over my head, slow abdominal breathing, and if I am feeling tacky or anxious I take a tincture of Motherwort. I don't know why the Motherwort works, but for me it does better than kava and I never was able to tolerate benzos. I have also practiced zen meditation for 10 years ... can't say it helps in a flare but it helps considerably between the flares so that my entire life is not one big vortex of anticipatory concerns. Good luck finding things that work for you.