#visible

PoTS

PoTS, or Postural Tachycardia Syndrome. The silent and invisible illness that is one of the most diagnosed conditions in the world today. 

For someone who has Pots, every day is a struggle and a battle. When you stand up, your body is unable to adjust to gravity, so rather than your blood continuing to pump around your body to reach your brain, all the blood drops to your legs (or pools) and not enough blood is able to reach your brain. 

It can be fixed by laying down, either voluntarily or by your brain 'cutting out' to make you collapse. 

Headaches, fatigue, palpatations (thudding heart), sweating, nausea, dizziness and fainting are all a part of the condition. 

When the blood pools to your legs and feet, your heart jumps into gear to try and pump it back up, causing an elevation in heart rate. From sitting to standing, the heart beats an extra 30 beats a minute- even more sometimes!- and rather than adjusting back to normal as 'normal' people experience, it continues to beat abnormally fast for more than 10 minutes (if you haven't fainted!)

So who is affected? 

The main group of people affected are teenage girls, (though boys can have it too!) between 12-14, with worsening symptoms until the age of 16. By the age of 19 to 24, about 80% of individuals will have no symptoms. But this is definitely not always the case! 

Chronic conditions such as Hypermobile Ehlers Danlos Syndrome, Chronic fatigue, Mast Cell Activation Disorder, Inappropriate Sinus Tachycardia, Lyme Disease and other autoimmune conditions can ALL result in the development of PoTS, and as these are all life-long condition, being cured of it is impossible. 

There are ways in which someone with PoTS can live a low/ symptom free lifestyle, though it is important to note that there is a huge spectrum of disability when it comes to this condition. With a mix of medication, stress free living, healthy eating and exercise it is possible to limit the symptoms. 

So how is it diagnosed and managed? 

There are many ways, as it is different for everyone who goes through this, so I will tell you about what I went through. To be diagnosed,  I undertook something called the Tilt Table Test! 

I am also on a strict tablet regime- (I missed one tablet last weekend and was violently ill and collapsed.) I have 5 tablets a day for my heart, one of them is to lower my heart rate, which i take 2 times a day, and the other 1 I take 3 times a day are to give me higher blood pressure, as a racing heart and pooling blood leads to low blood pressure. 

Swimming is also a great exercise, as the pressure of the water and the horizontal nature of the body means the blood goes where it is supposed to! Though due to the fatigue, it is something I can only manage once a week for half an hour. 

So how can you create a character with it?

As just about anyone can have Pots, you aren't limited to who your character can be. For the sake of this, let's say you are writing a school drama, and one of your characters is a 14 year old school girl. The symptoms of PoTs can- and are!- often mistaken for 'normal' teenage behaviour. Want to sleep, being 'lazy', not wanting to eat much food... imagine what sort of conflict you could create between this character and her friends/ teachers/ parents. Often people with Pots aren't believed, told they are faking it or that they just need to get out and exercise more. 

So you have created a character that can lead a fairly normal life, but with the added dimension of this unknown fatigue around them. People worrying that they are collapsing, unexplained hospital visits (remember, once you lie down it's all good! So a hospital bed would make things 'normal' on all the equipment!) 

Perhaps you need a character that is a good friend, but you don't want in the foreground? Someone with Pots may have to cancel plans last minute, only feel well enough to go to a party for an hour, and also miss school because they simply couldn't wake up. 

PoTS is so common, but so undiagnosed, that I bet you have met someone with it, whether they knew it or not, so that should be reflected in the characters we write!