Ask Nurse Aubrey: Catch Up Post with 8 Questions Answered!

Sorry it has been over a month since I did my last blog post! It's been a crazy few weeks, but I am happy to be back to a more normal schedule:) To catch up for the weeks I missed, I wanted to answer a few "Ask Nurse Aubrey" questions in one post! 

1) Can blood pressure fluctuate between low, normal and high with POTS?

Yes it can! High adrenaline levels can cause high blood pressure, low blood volume can cause low blood pressure and your high heart rate can actually normalize blood pressure! I am going to explain a lot more about this in an upcoming course I am working on:) But the short answer is yes! There are a lot of different reasons that it can be low, high or normal! 

2) What compression do I recommend for POTS? 

I definitely recommend waist high compression because a lot of blood pooling can happen in your abdomen! I feel a LOT better when I do waist high instead of thigh high or knee high:) I really like the stockings material and I have a prescription for the Medi brand, they're great! I have also seen similar ones on Amazon! I also really like compression leggings! I will sometimes wear them by themselves and sometimes wear them with compression stockings too. I like the CompressionZ, and Dragon Fit from Amazon:) I use the 20-30mmHg and that strength works really well for me! 

3) What is the most important intervention to improve symptoms of POTS? 

I honestly feel like this is a tie between salt and compression for me! I notice a substantial difference when I am not drinking electrolyte fluid, taking salt tablets and adding salt to all my food! 10 grams a day is the recommended goal and that's a lot! I also notice a substantial difference when I'm not wearing waist high compression, so I would have a hard time choosing between those 2 interventions! I also know that exercise is one of the best things you can, but I'm not very good at being consistent with that😅

4) Thoughts on getting the new COVID booster if you have POTS & bad palpitations? 

I would definitely recommend asking your doctor about this just in case! But in general, I always recommend vaccines and always get boosters for myself! Unless you've had a severe reaction in the past, or you are severely immunocompromised, most people are normally better off getting it:) POTS patients often have a strong immune response after a vaccine that can include fever, chills, headaches, body aches, fatigue and just feeling crummy for a few days! But I know people who have gotten POTS because they had COVID, so I think it's better to prevent the illness! But again, ask your doctor just in case there are specific factors you need to consider:) 

5) Any tips for a post-virus POTS flare up?

I always try to prioritize extra rest during and after an illness! I try to ease back into physical activity and give my body space and time to heal! I definitely have POTS flare ups with illness, so you are not alone in that! I also normally get IV fluids after to help my body stay hydrated:) I make sure I am eating regularly and drinking more electrolyte fluid than normal! I also make sure I am getting at least 10 grams of salt a day! I take naps and try to take it easy for awhile:) 

6) Is there a link between POTS and PCOS?

Both PCOS and POTS are syndromes, meaning we don't know the underlying cause is! So, I don't know what the specific connection is, but I do know that POTS & PCOS are seen together in some patients! I have both and know there have been several studies that included patients with both:) 

7) I have POTS and think I have PCOS, should I try to see a specific type of doctor? 

Your POTS doctor should be able to also manage and test for PCOS actually! Most Primary Care Providers or General Doctors should know how to treat it! PCOS is pretty common and it's actually a clinical diagnosis. That means that you can do imaging to see if you have ovarian cysts and they can check labs to see if you have elevated hormone levels, but they can also just diagnosis it based off of symptoms in the office without needing more tests:) If you want to see a women's health doctor (gynecologist) or someone who specializes in hormonal conditions (endocrinologist) you definitely can though! 

8) Should POTS patients worry about going on roller coasters?

I would ask your doctor about this just to be safe! But I have gone on roller coasters since getting sick! There are some intense rides that recommend not riding if you have any neck, head or heart problems, so sometimes I avoid those! But I have done a lot of the ones at Disney:) I often feel pretty dizzy and nauseous after, and by the end of the day I normally have a pretty bad headache. But normally my body recovered, so I just spaced them out and took breaks in between:) I don't think you can do any long term damage, I think they can just cause flare ups? But I would double check with your doctor just in case!

These have been great questions, thank you so much! Feel free to ask any follow up questions or any others you might have! I primarily check for questions through the "Ask Nurse Aubrey" Instagram story on Mondays, but you can also email me some at navigatingpots@gmail.com  or by filling out the Contact Me form on this blog! 

Ask Nurse Aubrey: Flying with POTS

This week's blog post will answer an Ask Nurse Aubrey question! The question was: "Can I fly with having POTS? I used to love travel and now it's nerve wracking for me" This is a great question!! So thanks for asking it:) You are definitely not alone because I have had a lot of similar emotions! Traveling has always been one of my very favorite things to do, but it has been a lot more nerve wracking since getting sick! In this blog post I am going to do my best to answer your question by sharing my experience and some tips and tricks that have helped me over the years, I hope it helps! :) 

1) Can you fly with POTS? 

I haven't seen any official articles or papers that have talked about not being able to fly with POTS, but that being said it is always best to talk to your doctor/health care provider if you have any questions or concerns! I know that some things that can prevent you from flying are increased Intracranial pressure (I will talk more about this in the future), a blood clot disorder, a recent heart attack, a recent ear drum rupture and other more emergent conditions! You can read the articles below to see if you find them helpful:) So, from what I understand, POTS doesn't necessarily prevent you from flying, but that being said, I would definitely still talk to your doctor about it! 

https://www.fitfortravel.nhs.uk/advice/general-travel-health-advice/air-travel

https://www.who.int/philippines/news/q-a-detail/air-travel-advice

https://www.hopkinsmedicine.org/health/wellness-and-prevention/traveling-with-chronic-conditions

2) My Experiences Flying

I have flown many times since getting diagnosed with POTS! I have been able to do it, but it can be hard at times! I know that higher elevation makes POTS a lot worse and I definitely notice that while flying! I think taking off and landing are the worst for me, I get really dizzy and my head hurts quite a bit, but I haven't ever passed out! I normally try to be watching a movie during that time so I can distract myself😅 Sometimes I like to sit by the window because having something to look at can help ground me, but other times I am on the aisle since I have to pee a lot haha😂 We normally don't plan very much for the day of the flight so I can rest and recover a bit and that seems to help:) And I avoid red eyes because I often feel worse after those! So even though it is hard, I can still do it and I have found ways to make it better, I'll share those with you💙 

3) Tips & Tricks for Flying

• Stay hydrated!!! People avoid drinking water when they are traveling because they don't want to use the bathroom during the flight, but it is worth it to stay hydrated! Dehydration is really common while flying, and that will definitely make your POTS feel worse! Since you can't bring any drinks in, I either pack electrolyte packets and an empty water bottle in my backpack to fill up once I'm past security; or I buy electrolyte drinks from the gift shops before my flight. And I almost always buy a ginger ale to help with nausea 🤢 I notice a big difference when I do this! And keep up on your salt intake! Flying causes fluid shifts and you want to keep as much fluid in your bloodstream as you can🧂💧🩸 

• Pack lots of snacks! Flying can also affect blood sugar! I always feel a lot worse when I haven't eaten in awhile, and my appetite is always a lot lower when traveling because of how sick I feel at times🤢 I have noticed that packing snacks makes a really big difference! I often bring cheerios and other simple carbs to settle my stomach and help with nausea:) And pretzels are a great option because of the salt! 🥨 It can also be helpful to chew on a snack or gum to help your ears pop! And mints can help a lot with nausea 🤢

• Wear compression stockings! This is actually recommended for anyone who is going on a long flight, even if they don't have any health problems! High altitude makes POTS a lot worse, so wearing compression stockings or leggings can make a really big difference with blood flow! 

• Use a wheelchair if you need to! I had never used a wheelchair at the airport before, but there was a time where we had 5 minutes to catch our next flight because the airline switched our flights🙄 Of course we were in the farthest terminal and gate from our next flight, so we had to sprint across the airport! We made it within those 5 minutes, but the plane had already left! 😡 Needless to say I felt SO sick after that sprint! Then the next time we flew, the airline switched our flight again and we had a really short layover! I told my husband that I didn't think I could handle running across the airport again😬 So, when we asked the flight attendant what we should do, she recommended a wheelchair👩🏼‍🦽 I hadn't used one before and I was a little self conscious, but it made a HUGE difference! Not having to walk across all the terminals while wearing my heavy backpack was amazing! And not having to stand in a really long line while we boarded was so helpful! I didn't realize how sick I normally felt before the plane even took off! So, I would highly recommend asking to use a wheelchair! It made a huge difference for me! 

• Talk to your doctor beforehand to ask about anything you can take to help with motion sickness and other symptoms while flying! This has made a really big difference for me! Even if your provider doesn't understand a lot about POTS, they should be able to help with motion sickness or nausea while flying✈️There are over the counter medications that help with those symptoms (meaning you can buy them at the store/you don't need a prescription) so you could even just ask your doctor if they would recommend those or ask if they would have any bad interactions with some of the medications you are on💊 It's always a good idea to ask just in case:) And some of the medications I gotten for nausea have helped a lot!

Here is what I try to have in my carry on/accessible during the flight! 

Ask Nurse Aubrey

I am really excited to announce that today's blog post is all about a new feature I am launching called Ask Nurse Aubrey! Here is what it will look like:

Ask Nurse Aubrey will be on the Navigating POTS Instagram Story on Mondays! There will be a question feature where people can type in a specific question they have and then I will choose one to answer in a future blog post! The goal of the Ask Nurse Aubrey questions and blog posts is to provide more detailed answers to general questions or recommendations, so I hope it can be helpful! There will likely be some weeks where I have a different kind of blog post, so when I announce the weekly Blog Post on Instagram & Facebook, I will specify what kind of post it will be:) 

Since I will only be choosing one question to answer, if yours is not chosen, you can ask it again the next week! While you are able to ask me anything, there are some kinds of questions I might be more likely to choose, so here are some guidelines for that:

• You are more than welcome to ask specific questions about your personal situation, but those kinds of questions will likely be better for upcoming individual consultation appointments, so stay tuned for more information about those:) Once those are up and running, I can reach out to you individually and recommend setting up an appointment if I think your question would be best answered in a 1-on-1 situation!

• Some questions might require a bit more context to understand, and those kinds of questions will likely be answered in future courses! So again, stay tuned for more information about that:) Once they are up and running, I can reach out and recommend a specific course that has that information!

• Some questions might be better suited for your health care provider because my licenses have some legal limitations about what I can and cannot do outside of my state and if you are not my specific patient👩🏽‍⚕️ 

•  Remember the primary purpose of this is to provide general education that will be helpful for a large group of people:) That being said, it doesn't have to be limited to POTS! You can ask questions about any of the comorbidities I have posted or any other chronic health challenges! I will do my best to answer them:) Again, I want this to be helpful for you!