phew!

Despite my body kindly reminding me on a minute by minute basis that I do in fact have PoTS, it’s been a good week, so here’s my favourite view of Sheffield (from Meersbrook park if you’re interested).

Drumroll please ……… after over a months break I’ve finally got back on the exercise bike!!! This is partly because after struggling on for a while I finally rang the specialist nurses who let me increase my second dose of the day of Ivabradine, which has so far helped give me a bit of a boost. I’m hoping eventually they’ll let me try some other combinations of medications as I’m a long long way off feeling vaguely ‘normal’, whatever that ends up being. For now, though, I managed 5 whole minutes on the bike. Those 5 minutes where the hardest minutes of exercise I’ve ever done (yes, even including cross country in year 9, or the dreaded bleep test in PE). I was on such a high afterwards I may as well have run a marathon.

I’ve been to my first PoTS support group meeting and it was lovely to meet other people with PoTS who understand what you are going through, and what a mad mad thing PoTS really is.

Without a doubt, the best thing that happened this week was when I went in to my GP for yet another sick note. We’ve had a system where I ring up the receptionist who then lets a GP know that I need a new note. So I haven’t actually been in contact with a GP since before my actual diagnosis and I thought I’d go in to see them in person for this one. Best decision I could have made! Before I’d even sat down in the consulting room this lovely GP who I’d never seen before was saying what I tough time I must have had lately and asking how I really was. Those ten minutes were probably the best GP appointment I’ve ever had even though I only needed a sick note. We talked about my diagnosis journey and how uncontrolled my symptoms where, how long it might take to recover enough to regain a decent quality of life, what my career options might be, how I was mentally coping, if my family were supportive, what my manager was doing to help me regarding work…. I could go on! I’d like to add that he didn’t claim to know much about PoTS, but he had at least heard of it and knew enough to know how dehabilitating it can be.

I came out feeling quite emotional, it made me realise how damaging it was to have had bad experiences in the past because it made me feel that it was a constant battle to be believed by health professionals. My whole past experience means I can doubt myself or not want to bother GPs or even the PoTS specialists that I’m under as I worry about the reaction I might get. A tiny irrational part of me worries before each appointment that I will have a repeat of the past and be told I’m just an anxious young adult with nothing wrong. Which is silly I know but I think it is a natural reaction to have. It’s hard to undo the 10+ years of being told nothing is wrong when you know deep down something is in fact very wrong.

In other news, I’m waiting for the outcome of my work capability assessment questionnaire and after many phone calls and confusing letters my oh-so-generous Employment Support Allowance payments have begun. Let me put it this way, I’m really grateful for once that it’s my parents I owe rent to!

The hot weather recently has been tough, tougher than I imagined, so I’m enjoying the torrential rain and downpours at the moment. Also, more often than not I’ve been waking up feeling as if I’ve been hit by a bus. I’m sure it would be much more painful to actually be hit by a bus, but it’s the only way I can think to describe it. Everything aches so it’s taking superhuman effort to get up, but most days I manage! I feel so relieved I’ve made it through the last week or so and am still smiling and (relatively) sane*.

*to be fair that is debatable!!!

pacing

Although I know I have moments when I feel much better I also have days when I feel worse again. I think it’s probably due to the fact that thanks to Ivabradine I can stand more so I over-do things and end up feeling worse.
I’m really frustrated at myself today because I had a really busy weekend, but I’ve spoilt it today by having a bath this morning. I’m having to recover all day in bed which is a shame as it’s a lovely day outside. Oh well, tomorrow is another day!

Pacing is something I need to get used to, and to help me I have a few ‘cheats’ to get me through each day.

  • Commode. Or as I like to think of it, my en-suite. I use it overnight, and as my Granny said, in her day everyone used chamber pots and it’s not too different to that!
  • Shower chair. This piece of equipment has been life changing!! I’m so excited by the fact I can now have showers.
  • Wheelchair. I was apprehensive about using a wheelchair especially if people see me getting out to go to the loo, or if I’m well enough to walk for a bit. The thought was much worse than the reality though, as it means I can go out even on not so good days, and for longer periods of time. My family are going to be so fit by the time I’ve finished with it!
  • I’ve also got a seat in the kitchen, I don’t really have the energy at moment to cook but it’s useful waiting for the kettle to boil!

how many spoons?

The spoon theory was devised by Christine Miserandino, as a way of helping her family and friends understand how she lives with chronic illness. She writes about it in her essay ‘The Spoon Theory’ on her website ‘butyoudontlooksick.com’. I would recommend a look as it’s a much better explanation than mine!

Basically, each activity that you might do in a day uses up ‘spoons’. Even little things like boiling a kettle or walking up stairs. You replenish these ‘spoons’ through rest. A ‘spoonie’, or someone with a chronic illness, has to conserve these spoons else they will run out, but someone without a chronic illness pretty much has an unlimited amount of spoons to get them through the day.

If a ‘spoonie’ runs out of spoons they could borrow some from the next day, but this will leave them with less ‘spoons’ to use in the future.

To illustrate, yesterday I was so pleased that I managed to sit up all day without having to nap, and so in the evening I decided to have a shower. However, that meant borrowing a couple of ‘spoons’ from today (climbing the stairs and having the shower took more ‘spoons’ than I had left) so I’m paying the price now. It feels like a backward step as I had been feeling much better yesterday, but it’s a little reminder that it’s going to take baby steps (which is a bit longer than I’d like it to take!).

feeling sluggish

One of the symptoms of PoTS that I’ve struggled with is the constant feeling of being on edge. Because my Autonomic Nervous System has gone a bit haywire, my heart rate is going faster than it should when I change position (see: what is PoTS?). This means my body has panicked and gone into the ‘stress’ response, or ‘fight or flight’ mode in order to try and compensate. This response involves the release of norepinephrine, a type of adrenaline. This helps to maintain a high heart rate and then results in a general feeling of anxiety which is very frustrating especially as the body does not need to ‘fight or flight’. I’m wondering maybe that’s why I was drawn to work in A&E because when you’re constantly ‘wired’ with adrenaline a little bit more doesn’t really register! I’m also able to function with a huge amount of adrenaline in my system and you wouldn’t even notice because I’ll seem so calm. My body also has irrational responses to sudden loud noises like people shouting, the doorbell going or the phone ringing which is really annoying!

Ivabradine is not stopping my heart from jumping when I stand, but my heart rate (for the most part) is not getting high enough to make me feel anxious, and when it does it’s returning to a sensible range much sooner so I’m feeling really chilled out.

Its very strange getting used to my heart slowing down so much, it feels really heavy and sluggish, almost like it’s going slower than the rest of my body, so for the majority of this week I’ve been feeling really drowsy. Lots of napping has taken place!

good things come in small packages

When I took my first Ivabradine it was so small I wasn’t even sure I’d swallowed it! It’s a tiny tablet anyway, but I have to cut them in half which is near impossible. It describes itself on the box as ‘salmon’ coloured. I was wondering if it came in fuchsia or teal but sadly not. Fun fact: pharmaceutical companies don’t like to make drugs a green colour because it’s considered unlucky. See, I have remembered SOMETHING from my nursing degree!

Ivabradine will obviously affect everyone differently, but so far I’ve experience headaches (normal for me), dizziness (normal for me, but occasionally it felt more like vertigo when the wheelchair would feel like it was moving when I had the breaks on; normally my dizziness feels like I’m looking through a haze). I have felt my heart rate slow, occasionally it’s felt really ‘heavy’ and pronounced, even more so than my usual palpitations. It’s a really slow acting drug though, which peaks after 30 mins and wears off after 4.

I’m not looking forward to the most common side effect which is light sensitivity seeing as I’m very light sensitive anyway at the moment and am wearing sunglasses pretty much 24/7 so might have to become a mole or something. Lets hope that’s not a side effect I get (I mean light sensitivity, not turning into a mole. I’m pretty sure I didn’t read that as a side effect in the leaflet!). So far I’ve not felt a reduction in my PoTS symptoms but not sure if that’s because I’m feeling so extremely exhausted and rubbish at the moment anyway. Hopefully I’ll see some improvement in a couple of days when this ‘flare-up’ has settled.

diagnosis: day one

Today’s been a big day. I was up bright and early (well it was early for me anyway, so before midday!) for my second ever appointment with the PoTS nurses. The day I’d find out if I had PoTS or I was a delusional mad woman making all my symptoms up for sh*ts and giggles like some GPs might have thought… It was no surprise at all to find out that yes I do in fact have PoTS. Which is good considering what I’ve called this blog.

In all seriousness though it was such a relief because there was always that niggling doubt that I’d turn up and they’d say hey, that GP was right, you really should be back at work there’s nothing wrong with you. Or hey, I know you only spent 24 hrs in bed that one time with D&V 6 months ago but you are just DECONDITIONED (I hate that word I’ve heard it far too often!) and there’s nothing wrong with you that a 30 minute run and some abdominal crunches won’t fix.

I won’t bore you with stats but during the tilt table my heart rate increased by quite an impressive amount (you need an increase of at least 30 bpm upon standing to be diagnosed with PoTS and I definitely qualified!!) and in the words of the nurse my bp was ‘all over the place’ despite only spending 15ish minutes upright.

Inevitably I’ve been started on a wonderful drug (well I’m not sure how wonderful it is yet, only had three doses!) called Ivabradine to slow my heart rate, increased my salt intake to 1 teaspoon a day (yuk) and am keeping on with the super tight compression tights and the 3 litres of water that makes me need to pee every 30 mins or so (not easy when you’re wrestling with the compression tights I can tell you!!).

The specialist nurse said today was like ‘day one’. It’s the start of things rather than the end. Now I have my diagnosis things can move forward and symptom wise can only get better. Well I can’t remember exactly what she said (thanks brain fog) but it was something positive and lovely like that!

So I’m feeling pretty good about things (well, symptom wise I’m feeling horrendous but you know what I mean!) …roll on the future!

note: I feel I need to clarify, the huge vast majority of GPs I’ve ever met are absolutely amazing and deserve much more credit than they get. I think part of the problem is the lack of awareness surrounding PoTS which means when people like me come along over a number of years with vague, random symptoms they don’t even understand themselves, it’s so hard to join the dots and get a diagnosis. There are so many health professionals out there who simply don’t know that PoTS even exists.

new wheels

My wheelchair has finally arrived, thanks to Dave the DPD man! You might get a picture later and I’m still thinking of a name for it. So mum and I decided it was time for a trip out. Word of advice, don’t move to a city known for its seven hills if you need a wheelchair. We found this out today the hard way. I do trust my mum in a lot of things, but I have to say I was worried about her taking me down the huge hill by a main road to the centre of town. ‘Don’t worry’, she told me. ‘I used to push you all the time in a pushchair when you were a baby’. I replied that I wasn’t exactly the same weight as I was then. We were half way down the hill when she said ‘You certainly arn’t’. Ouch. Thanks Mum.

So we made it to John Lewis via a few other shops with only minor hiccups (involving kerbs mainly). Luckily I have a seatbelt but I do wonder if I need to invest in a helmet too…

We mooched around for a bit then got to a tiny set of 5 steps, so I got out and helped mum carry the wheelchair down rather than look for a lift. Que horrified shop assistant coming over to let us know there was a lift available if we wanted next time. We found this hilarious, to her it must have looked like mum had made me get out to carry my own wheelchair. I promise you it was a be there moment!

We were both exhausted by this point so went to the cafe for lunch. After, mum headed off whilst I had a lie down. You know it’s a bad day when you’ve been in a wheelchair all day and you still find yourself needing to lie down (laughing emoji, crying emoji). I heard a small child on the next table ask her mother why I was lying down. She said ‘Oh that lady must be very tired’ and I swear the elderly couple next to me (to be fair they were sitting further down on the bench, closest to my feet) tutted. Actually tutted. I wanted to shout ‘Hey, I know I’m wearing sunglasses inside and I haven’t been able to wash my hair in a while and my feet are all sweaty from being rammed inside compression stocking tights but I’m not hungover I promise’. But then I realised that I’d rather go to sleep so I did.

Then it came to my attention that a crowd of people where peering down at me, including members of my extended family and weirdly, Graham Norton and Mary Berry. They were asking what the hell I was doing lying on a bench in the John Lewis cafe in the middle of the afternoon. I told them all to f*** off (which is most unlike me I assure you) and went back to sleep.

We came home on the bus. I was so exhausted and I wasn’t even the one pushing the wheelchair! I’m now collapsed in bed while my poor mum makes tea. I’m feeling really bad about swearing at Mary Berry and wondering why Graham Norton was dressed as Father Christmas at this time of year. Surely the Easter Bunny would have been more appropriate? Think it’s time for another nap!!