Monday, August 15, 2011

The Heart of the Matter

This is my are-we-having-fun-yet face.  That walkman-sized thing on my shoulder?  The receiver for the Holter monitor I'm wearing today.  You want to be hooked up to stuff?  Don't have to go to the hospital to do it!
It is already well established that I am a sensitive gal.  I've been called worse.  Nurses say I'm "reactive", often experiencing the rarest (and even some undocumented) side effects of medications, known by many friends, family and co-workers as an easy cry, prone to unravel while even reading such stories as Old Yeller, Where the Red Fern Grows, Charlotte's Web or The Keeping Quilt.  Even ask my students.  I have always been an emotional person, raised to express myself, never one to keep my opinions to myself (even ask Dan).  What can I say?  My heart has always been open.   

I have been taking a beta blocker for over a month now - it was a little touch and go in the beginning with some itching (anxiety, much?) - but it seemed to do the trick and my heart rate upon examination in the cardiologist's office is a respectable 82.  Still, this BB did not seem to do much to relieve my fatigue (in fact, as this type of medication is made to slow your system down, it definitely worsened the exhaustion in the beginning) or my tendency towards feeling lightheaded, especially when I stand up.

This initial diagnosis of inappropriate sinus tachycardia (basically means that my heart is racing for no detectable reason) of course led to some interweb searching.  I stumbled upon some autonomic function disorders, but I didn't seem to fit in any of those categories.  Last week, my mom accompanied me to get a second opinion from a cardiologist at Pennsylvania Hospital.  After taking a good look at my most recent echocardiogram (ultrasound of the heart) and my other records and reports, he decided I have P.O.T.S. 

Hmm.  Pots, you say?  Yes, POTS.  Postural Orthostatic Tachycardia Syndrome.  Ooooh, first I get a malignant disease, then some inflammation, and now, now I get to have a syndrome, too?  It's too good to be true.

POTS is a member of the autonomic disorder family, which would seem to fall under the umbrella of neurology, since it's all about your brain's job of sending and receiving messages.  However, since this particular condition seems to be ruled by the heart, cardiologists are the primary treating doctors. 

I'm still not entirely convinced that I have this syndrome, as it's primary characteristic is that upon standing, heart rate jumps and blood pressure drops - both dramatically.  My problem is that my heart races and blood pressure is low even at rest (last night, after laying in bed for a few hours, my pulse was 92 - and that's with medication to keep it low).  I never got the "tilt table" test, which many websites indicate is vital to a diagnosis, so I don't consider this the final word on my situation.

Either way, the beta blocker does not eliminate all of the symptoms of this syndrome, it merely aids in the tachycardia portion.  The poopy part is that because the job of a BB is to slow down your system, it also lowers your blood pressure.  Mine was already at the low end of normal to begin with (94/64).  Now it is down to 80/50, maybe 88/60 if I'm having a good day.  Low blood pressure is the leading cause of lightheadedness.

The biggest obstacle in the treatment of this POTS business for me is that little chemical sensitiviy thing I have going.  I will surely get whatever crazy annoying side effects there are to whatever drugs I use to rectify the situation.  Like Dr. Henry says, "there's no free lunch."  Which really stinks, cause I like lunch, and definitely free stuff.


I still have not made any concrete decisions about returning to work this year.  Certainly, my main goal is to feel good.  And if feeling good = return to work, then so be it.  In the meantime, I am afraid to

a) lose my position at my school and never be able to return there in the future
b) overexert myself and bring back that pesky cancer
c) be bored at home and drive myself crazy with anxiety with no work to keep me mentally occupied

While last year at this time, I was perpetually requesting a fast forward button, this August finds me searching out pause.  I would actually like to freeze frame the next month and give myself a chance to find my equlibrium, be it with salt pills and lots of all-natural gatorade or the potentially dangerous/miraculous chemical concoctions. 

Is there any chance of finding that universal remote (or, as it's known in our house, "the mote control") from the Adam Sandler movie Click?  C'mon Hollywood people, I know you're out there.



  1. I'm facing a similar predicament but for a totally different reason. I'd planned to stay home with Leah, especially since my private school job was gone in the blink of an eye. Well, my job is all the sudden available and I have 2 weeks to decide whether to go back and find daycare for Leah. If you find a pause button, I hope you'll share.
    I hope you feel better with each passing day!

  2. Just do what is best for you and your family. You are wonderful and being sensitive is one of your gifts!

  3. If you decide to go back, don't forget about FMLA for days you are feeling poopy.