Internal Medicine, Cardiology, and Neurology--Oh My!

I have low blood pressure. That is usually a good thing. But, it causes me to get lightheaded EVERY time I stand up. For the past year it has gotten worse. I passed out in front of Josh last summer, and quite often I'll take a few steps, then just drop to the floor because everything goes dark and my legs give out. I've mentioned this to my Endocrinologist a few times, and she decided we should find out if it was something more serious.

 So, she referred me to Internal Medicine. They couldn't explain it, so they referred me to Cardiology and Neurology.

 I met with the Cardiologist last week, and she did blood pressure/pulse readings with me lying down, sitting up, then standing. My blood pressure readings were 104 lying down, 102 sitting up, and 98 standing. What was interesting, though, was that my pulse rate jumped from 76 to 104 when I stood up. The cardiologist said this is why I black out so easily--my blood pressure drops when I stand, and my heart starts racing trying to compensate for the drop in pressure. She diagnosed me with Orthostatic Hypotension. She said there are medications they can prescribe, but she prefers to just recommend lifestyle changes. She told me to always drink plenty of fluids, but not just water. She said I should drink Gateraid daily. She also told me (more than once), that I do NOT need to limit salt. She said the more salt I eat, the better. And if I can't get enough salt in my diet, she can give me salt tablets to take.  I was so relieved to find out that it wasn't anything serious, just an inconvenience that I can continue to deal with.  But, she wanted me to still meet with Neurology, since I already had an appointment set up with them.  (I also got to have an echo that day, just to make sure my heart looked good.  It looked perfect.)

So this week I met with the neurologist.  He did a complete exam of all my nerves and reflexes, and I was perfectly fine.  He agreed with the cardiologist's diagnosis, but went a step further, and said he  thought I had POTS (Postural Orthostatic Tachycardia Syndrome).  The most telling symptom of that is a jump in pulse rate of at least 30 beats per minute when changing postural positions.  He said treatment for that is just what the cardiologist recommended--fluids and salt.  

I came home and read more about it, and everything fits my symptoms.  I found this especially interesting, "POTS patients use about three times more energy to stand than a healthy person. It is as if these patients are running in place all the time."  I think this explains why I've struggled with fatigue so much.  I kept thinking that my thyroid must be causing it still, but my thyroid levels have been where they needed to be for years now (with medication).  It also explains why I can run for 5 miles at a time, but get tired just going up the stairs in my house.  The article I read also said, "People generally develop POTS after becoming sick with a virus, giving birth, or being exposed to great bodily stressors".  This all seemed to start when I was barely pregnant with Owen.  I had just miscarried before I got pregnant with Owen, and that might have been enough of a "bodily stressor" to cause it.

So now I know what's wrong with me.  It's not anything serious, which is a huge relief.  It's also something that can't really be fixed, but just has to be tolerated.  I will just have to stand up very slowly for the rest of my life.