if at first you don’t succeed….please fill in the form

Today I attempted to apply for benefits. After 60 minutes listening to a loop of 8 bars of Handel’s water music the last thing I wanted to hear when I got through was ‘>sigh< hmmmf >sigh< good morning my name’s …… this call will take 60 further minutes of your time do you still want to continue’. 10 mins in and they’ve given up on me and decided to send my forms in the post (they read out a paragraph of info I was required to listen to about postal forms, but so fast it sounded like when they read out small print at the end of an advert. The gist of it was if I now try and ring up to apply for benefits rather than fill in the form I will be fed to ravenous lions by Theresa May or something, it got a bit confusing at the end).

It turns out I got my security questions wrong because I moved house before christmas and the system still hasn’t updated yet. So I was given the choice of ringing up again and being on hold for 60 mins and then lying (I mean giving different answers) when asked my security questions (?!) Wow. Not wanting to spend another 2 hours on the phone giving ‘alternative facts’ to the department of work and pensions I chose a form instead. Which I imagine is going to be great fun and I’m really looking forward to it coming next week (they’re sending it 2nd class to really prolong my enjoyment and anticipation!).

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on yer bike

I’ve not written in a while because the last fortnight has passed in a blur. I woke up the day after my last blog post and madly decided to take the next step: exercise! I have seen research that claims exercise is the single best thing you can do to manage PoTS symptoms, but knew this would be impossible to start without the help of drugs to allow me to tolerate exercise.

As I was now on medication I decided the time was right and it felt good to unpack all my old running gear (yes I still hadn’t unpacked them from when we moved house!).  I’ve started on an exercise bike because I can sit down and go as slow as I want. I’m not going to see the benefits for months yet, so it will be worth it in the long term, although realistically in the short term it’s leaving me worse off. 5 mins on the exercise bike is leaving me in bed for the rest of the day!

My eventual aim to to be able to run again but the eight month plan I downloaded from the dysautonomia international website for PoTS patients advises to wait until month 5 at least before starting upright exercise.  It feels good to have something to work towards though, and it feels like I’m achieving something positive.

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 hours.

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.