Advice

Before I even start, let me remind you that I'm not a doctor. I don't even play a doctor on television. This is just a compilation of things that were recommended to me by doctors and that have worked for me individually or for others that I have met. Please, please, please talk to your primary care physician before starting any medications or making any changes to your diet.

Everyone always assumes that medication is the primary source of help when your body is freaking out. It's true, proper medication can make a major difference in the life of a "potsy," but there are other changes that can make even bigger impacts. These are the three major non-prescription components of treating POTS. 

1.)     Hydration. Not just your “recommended 8 glasses a day,” either. The more water/liquid you take in, the higher your blood volume, the easier the workload will be on your heart to pump blood to your head. This also means staying away from diuretics like caffeine and alcohol, too. When you’re working out (i.e. sweating for any reason) you should be especially conscious of liquid intake to replace the fluids you’re losing. Contrary to the line from Remember the Titans, water doesn’t make you weak when you’re running. It’s your friend. It might take a while to figure out just how much your specific body will need, but I promise you it will need a lot. If you don’t have to go the bathroom every hour, and if it’s not coming out clear, you’re probably not drinking enough. The rule of thumb for a regular person is to divide your body weight in half and drink that number in ounces of water. For me personally, I need about my body weight in ounces of water to stay hydrated. Find your number and, more importantly, make sure you drink it! Also, I’m in a rare situation where I can have IV’s through the athletic department, but I would suggest talking to your general practitioner about the possibility of weekly IV treatments. They’ve helped in incredible ways both for me and for other people that I know. 

2.)     Sodium. Find yourself a salt shaker. Sodium helps your body retain water, and water is your friend because it increases blood volume. This is also where it gets important to talk to your doctor, especially if you're already at risk for high blood pressure. The Mayo Clinic recommends 5,000 mg a day as a minimum (I’d recommend that, too, but the Mayo Clinic has much more authority than I do!) This doesn’t have to be through just dumping salt on everything, either. I use Gatorlytes, by Gatorade, as well as “The Right Stuff,” and I’m not sure who makes that one but it was developed by NASA. They both make your Gatorade taste like the Gulf of Mexico with a hint of lemon, but they work wonders and don’t have the fat and calories that come with just eating salty food. I used to drink shots of pickle juice and use Pickle Juice Sport (yeah, that’s a real item), but they killed my stomach and I just couldn’t take it anymore.

3.)     Exercise. This can sometimes be the most challenging aspect, especially when you just don’t feel like doing it (which will be almost every day to begin with, unfortunately). But this is crucial. The better shape your cardiovascular system is in, the more efficiently your heart can pump. If running is too hard at the beginning, or when you’re having a physically bad day, it’s ok. You’ll get there again, I promise. Recumbent bikes can be great for those situations because you’re not fully upright but you still work the cardio system. The more muscle mass your legs have, the better those muscles can constrict the blood vessels to keep blood from pooling and squeeze it back up into your upper body. This means things like squats, leg presses, calf raises, etc. are great. It will be a struggle at first, and you’ll find that some days your body simply doesn’t function as well as it should, and I would suggest (from experience) NOT overdoing it. I know that goes against everything you’ll probably want to do, but oftentimes if you push too hard on a “bad” day it will set you back farther and take you longer to recover. It’s going to be like a game of chutes and ladders…some days you take great strides forward just to get knocked back the next day. But that’s ok. It’s a slow process, and over time you will get better. When I first was diagnosed, I could hardly jog on a treadmill for a few minutes. This year, I made it through preseason two-a-days and am in better shape than I’ve ever been.

These three changes will help tremendously, but there are also some other little things that you may be interested in trying. Compression stockings (like the ones they sell for airplane travel) will help artificially constrict the blood vessels of your lower legs and keep blood from pooling. Ice baths after exercise have helped me to recover more quickly. Like compression stockings, they also help force blood out of your legs...just make sure if you're ice tubbing you're only doing it for the recommended amount of time and in the recommended temperature of water. Along these same lines, there are many places and web sites that sell light weight cooling vests. These are great for hot days when your body temperature may not be able to adjust well to the heat and can help prevent further dehydration caused through sweating. Finally, if you're like me and suffer from head pressure or "coat hanger soreness" (neck and trap pain), I've found that pressing into the pressure points at the base of the skull, the nasal bridge, and the temple area can reduce the pain.