Dear Amy, I was reading some of your past posts an am concerned your docs have missed something. With your history of facial numbness, joint pain, fatigue, rashes, etc, etc. I think you may have Lyme disease. Yes, they do have Lyme in Iowa contrary to what non-Lyme knowledgeable doctors think. Most doctors in Iowa are not aware of Lyme and co-infections, so most Lyme patients in Iowa see Lyme specialists out of state. Joint pain is NOT caused by POTS and Lyme DOES cause joint inflammation and POTS. Serious infection from Lyme that has not been treated can cause damage to the nervous system and heart. Chronic headache, stiff neck, muscle and joint pains, fatigue, numbess or twiching on one side of body, vision issues (floaters) and brain fog are ALL huge red flags for Lyme. PLEASE, PLEASE send me a PM. I want to help you and know first hand (personal experience) about Lyme causing POTS. I can refer you to a real Lyme doctor who knows about testing and treatment. Lyme is treatable, even at the chronic stage. PS. Mayo knows nothing about Lyme. Been there, done that.