Cory Webb
POTS Website
Health Com 4250
Professor Thompson
October 30, 2013
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Postural Orthostatic Tachycardia Syndrome, or POTS, is an autonomic nervous system
disorder that is characterized by what its name stands for: orthostatic tachycardia intolerance in
regards to posture. According to Mayo Clinic, Orthostatic tachycardia intolerance is when
someone’s heart rate, upon standing, goes considerably higher than a normal person, often
beyond 30 to 50 beat per minute more than that of an average heart. Often times, according to
Mayo Clinic, such prolonged heart conditions can cause fatigue, headaches, digestive problems,
and nausea. By researching into this syndrome, I hope to gain more of an understanding with my
wife’s condition with it, why it affects her the way it does, and some possible ways to help the
syndrome gain recognition for grants, research, and local help. In researching this topic, three
themes began to emerge as a means to generating my end goals.
For starters, the first way to gain traction with informing others of POTS is to help others
understand what the syndrome, how it affects the human body, and include how it relates with
other well-known diseases and syndromes. By doing so, the audience can begin to assess and
empathize with those who are afflicted with the syndrome. I will also be discussing how one gets
diagnosed with POTS since it requires one test to determine if one has the syndrome. Sadly, it’s
not as simple as getting blood drawn and waiting a week for results.
Secondly, the treatment for some that have POTS, because it is so wide ranging, is
another theme that should be touched on. By listing and detailing some of the treatments, and
how relatable some of the treatments are with certain conditions like Diabetes, I believe this will
help bring in the final theme.
Lastly, POTS awareness in the world and why it has taken so long to only now start
gaining headway. This section will focus on the efforts some with POTS have taken to get the
condition, along with dysautonomia, noticed and in the public eye.
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By setting up the themes in this order, I believe that the audience will be informed in
POTS as well as its treatments and other relatable illnesses, as well as understanding and
possibly helping out with broadening the scope of POTS in raising awareness. POTS is a
dysautonomic dysfunction that has no cure at the moment, and by raising awareness, those
afflicted with POTS can hope for a possible cure or at gain better treatment to help them as they
age.
The Following authors provide information related to how POTS affects someone and the
process with how one is diagnosed with the syndrome:
Raj, S. R. (2006). The postural tachycardia syndrome (pots): Pathophysiology, diagnosis &
management. Indian Pacing Electrophysiology Journal, 6 (2), 84 – 99.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1501099/#!po=3.12500
Dr. Satish Raj is an assistant professor of medicine and pharmacology at Vanderbilt
University Medical Center that also holds a private practice at Vanderbilt Heart in Tennessee.
Dr. Raj has written and co-written over 100 articles, most of which include POTS, as early as
1996. This article specifically demonstrates what POTS is, a brief history, how it affects the
human condition, and the process for which how one is diagnosed with the syndrome. The
article also includes pharmacological treatments of POTS as well as non-pharmacological
treatments. Dr. Raj has collaborated with others in researching this topic and is working with
others to increase the amount of information for better understanding of the condition.
Grubb, B. P. (2007). The fainting phenomenon: Understanding why people faint and what to do
about it (2nd ed.). Hoboken, NJ: Wiley-Blackwell.
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Dr. Blair Grubb is a board certified Cardiologist at the University of Toledo Medical
Center that researches and treats patients with POTS. Having received his M. D. at Universidad
Central del Este, Dr. Grubb performs treatments and tests on patients with POTS in hopes to
gather more information and give the information to the public. He is a well-respected member
of the POTS culture and many refer to him as an incredible doctor. In this book, Grubb gives
some more insight into the why and how people with POTS faint. He claims in the book that
although POTS itself is not deadly, it can cause death due to fainting at the wrong place at the
wrong time; sometimes due to head trauma. Grubb also gives some insight into how to properly
treat oneself with POTS, using some non-medication treatment, who to visit, and what sort of
changes to make in one’s everyday activities.
The following authors provide information on the treatment related to POTS:
Grubb, B. P., Karabin, B. (2008) Postural tachycardia syndrome: Perspectives for patients.
Circulation, 118, e61 – e62. http://circ.ahajournals.org/content/118/3/e61.full#cited-by
This article, by Dr. Grubb, has a figure that gives basic details on how to treat POTS
patients through drug therapy, psychological support, educational & job support, and
conservative therapy. Conservative therapy, where one makes lifelong choices in one’s own
health, includes fluid intake, exercising to keep the muscles from going into atrophy, increasing
salt intake, how to properly bathe oneself, and using “cooling vests.” Drug therapies are
restricted to a personalized basis, but generally include controlling blood pressure, fatigue, and
headaches. Psychological support includes getting one’s family to try and cope with the
diagnosis as well as getting oneself to cope with the diagnosis as well. Overall, Grubb says that
by sticking with certain treatments as well as exercise, one may be able to curb and improve
his/her condition over time. In other cases, where one is “severely limited” by the disorder,
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Grubb says to stick with their treatments as prescribed by their doctors. The journal this article
was printed in, Circulation, is peer-reviewed.
Raj, S. R., & Levine, B. D. (2013) Postural tachycardia syndrome diagnosis and treatment:
Basics and new developments. Retrieved from http://crm.cardiosource.org/Learn-fromthe-Experts/2013/02/POTS-Diagnosis-and-Treatment.aspx
This article is about some of the treatments involved with POTS as tested through Dr. Raj
and Dr. Levine. The treatments support Grubb’s treatments as well which include rehydration
through salt intake and drinking water more often and exercise to reverse or prevent muscle
atrophy. Both articles, Grubb’s and Raj’s & Levine’s posit that exercise is a good tool to keep
the body fit and will help with long term prognosis, but will not completely reverse or disengage
POTS in patients. Raj backs up his exercise treatment with another article by Dr. Qi Fu, a
Cardiologist and Associate Professor at the University of Texas Southwestern Medical Center,
that gave a 3 month exercise regimen to 19 POTS patients that mostly included “aerobic
cardiovascular training” and some resistance training involving the leg muscles. The exercise
regimen had the patients sitting for their exercises, to avoid gravitational problems, and included
a rowing exercise, swimming, and recumbent cycling. All were effective and helped to improve
the quality of life in POTS patients, claiming a 73% cure rate. Raj then goes to explain
Pharmacological treatments that back up Grubb’s previous article as well: to use drugs that
reduces heart rate and controls blood pressure.
The following authors provide information on the awareness of POTS as well as raising
awareness:
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Stiles, L., Rhum, J.,Yardanova, C., & Kessler, E. J. (2013). Dysautonomia International.
Retrieved from http://www.dysautonomiainternational.org
Dysautonomia International is a website that promotes awareness, advocacy, and
advancement for dysautonomia. Dysautonomia, as the website puts it, is an “umbrella term used
to describe various conditions that cause a malfunction of the autonomic nervous system. Such
syndromes include POTS, Neurocardiogenic Syncope, Diabetes, Rheumatoid Artheritis, and
Parkinson Disease. Dysautonomia International is run by Lauren Stiles, a person with POTS that
collaborates with various doctors for their information and articles. The website gives a
multitude of information, backed by scientific journal articles, on dysautonomia and POTS, how
to host a fundraiser for proceeds to go to research, what research is being down, and how to get
recruited for such research.
Rhum, J. E. (2011). POTS - together we stand: Riding the waves of dysautonomia. S. Blitshteyn
(Ed.). Lexington, KY: CreateSpace Independent Publishing Platform.
This book provides a lot of key features involved with POTS from the first hand account
of the author, Jodi Rhum. Edited by Dr. Svetlana Blitshteyn, a board-certified neurologist that
specializes in POTS and other autonomic disorders according to the book. Blitshteyn also
completed her residency at Mayo Clinic and is currently a Clinical Assistant Professor at Buffalo
School of Medicine and Biomedical Sciences. This book goes into detail about the everyday life
of someone afflicted with POTS, others' accounts with the syndrome, while also providing
helpful hints and tips with everyday living and professional medical help. One chapter that stuck
out was how to spread awareness for the POTS cause, as well as some information on which
venues to approach for local awareness help as well, such as radio, news stations, and
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newspapers. Another section that stuck out was the frequently asked questions chapter where
Jodi explains possible and medical reasons for various questions people with the syndrome have.