dysautonomia vs ME

Doctors

What is Dysautonomia?

Dysautonomia is a terrifying array of symptoms which can affect every system in the body, including blood-pressure, heart-rate, breathing, sleep, digestion, balance, vision, memory, temperature, pain centers, emotions, and more. In short, dysautonomia prevents the body from operating as designed.

DEFINITIONS

Breaking down the word DYSAUTONOMIA:

dys – from the Greek, meaning badabnormalimperfect

auto – from the Greek, “autos,” meaning self

nomia – from the Greek, “nomos,” meaning lawgovernmentsystemregulation

A nominal definition of the term “dysautonomia” is that the body’s ability to regulate itself has become abnormal. The medical definition is that the Autonomic Nervous System [ANS] has become dysfunctional.

WHAT ACTUALLY HAPPENS?

The unconscious management of & between the two halves of the ANS, the Sympathetic Nervous System [SNS] & the Parasympathetic Nervous System [PNS] has broken down. The systems are out of sync individually & with each other.

(Click here for a beautifully illustrated, easy to understand overview of the two major players of the Autonomic Nervous System.)

As this discord causesblood-pressure to falltheheart-rate risesto compensate, resulting in fainting. There can be an inability to perspire, vertigo, nausea, frequent UTIs, headaches akin to spinal fluid leak headaches, brain fog, painful fibromyalgia, & inappropriate anxiety that could eventually turn into emotional instability. If not arrested by appropriate treatment the process will continue wreaking havoc. It may start slowing motility in the stomach causing gastroparesis, which can lead to extreme weight loss & malnutrition.

Further problems arise with the kidneys. Unable to hold onto sodium, the sodium/fluid ratio becomes unbalanced & blood volume is decreased (except during pregnancy, a time when many women with dysautonomia feel much better). As a result of the imbalance blood-pressure can drop precipitously on change of position, most commonly during the simple act of standing. Instead of rising to where it’s now needed, the heart & the brain, the blood remains pooled in the legs. What happens automatically for everyone else doesn’t happen at all for dysautonomia patients. As this failure begins to be discerned one gets down to the floor fast or one will faint & fall to the floor. It happens to men & women both.

No matter how much fluid is consumed, including Gatorade & other electrolyte drinks, it cannot fully compensate for the imbalance. The drinks help but are not a cure. Proper treatment is what’s needed or the outlook is grim. And because there are different forms of dysautonomia treatment is not one size fits all. Some folks with dysautonomia have high blood-pressure, so Gatorade would NOT be good for them.

HOW TO NOT PASS OUT (as per Dr. M)

While I slowly titrate my way up to the therapeutic dose of a new medication to treat the dysautonomia (off-label use), I’ve had to go back on Gatorade. It’s helping a lot. Although this site does not give medical advice, I will share one piece of common sense advice that came to me from the doctor who saved my life & my father’s life, Dr. M. This advice is for those of us with low blood-pressure/POTS type dysautonomia. Dr. M advised Dad & me never to stand still if we were waiting on a line or looking at something on a shelf in a store. He said, “Make sure you jiggle your legs, or keep alternating your weight from one leg to the other. It gets the blood moving & can give you more time to do what you’re doing.” Dr. M also had me wear anti-embolism stockings. Dad was already wearing compression hose due to Peripheral Artery Disease. Even so, if we were out somewhere & forced to stand for awhile – like waiting on line at the doctor’s office to sign in – I had to remind my father ALL THE TIME: “Dad! Jiggle your legs!” He’d roll his eyes but start jiggling – because he knew that was better than suddenly “getting the feeling” & passing out. So people, NEVER stand still. JIGGLE YOUR LEGS!

BEDTIME & DYSAUTONOMIA

Bedtime is a wakeful nightmare for most dysautonomia patients. The PNS is supposed to be taking the hand-off, as it were, from the SNS. Unfortunately, the parasympathetic system cannot overcome the always on sympathetic system, thereby preventing sleep, which leads to a myriad of other difficulties. The SNS is constantly sending its owner adrenaline to prepare for fight or flight, neither of which can he do since he’s either too exhausted to move or already passed out.

SHODDY TREATMENT OF PATIENTS

Another aspect of this condition bears mentioning. Undiagnosed dysautonomia patients endure (sometimes for years) demoralizing experiences at doctors’ offices. The patient comes in feeling faint yet the physician detects “normal” BP at the brachial artery – the inner elbow. At this “normal” finding some doctors become dismissive of the situation, mentally marking the patient as a hypochondriac or liar.

Uninformed MDs fail to realize that in this instance the BP drop is occurring in blood vessels in the brain, bringing the patient to near or actual syncope. Most of the time low BP will reflect in the arm as well, but not all the time. For susceptible individuals being in the sun, even being next to a light, can dilate superficial vessels enough to affect a drop in blood-pressure. Showers are practically a no-no. You gotta get out fast & the water can’t be too hot. Even then you might pass out. Proximity to heat from the stove or oven can also bring on fainting, as can hot water from the sink, folding hot clothes straight from the dryer, ironing with steam & blow-drying your hair. I trust it’s understood that summer is the worst time of year for low BP dysautonomiacs. (Have I just coined a new word?)

So many medical practitioners entirely discount dysautonomia patients symptoms & offer no help. Let’s remember they’re not gods they’re people practicing what they were taught a long time ago. Scores of these people were taught nothing about dysautonomia. Unable to feign concern, a significant percentage of the untaught respond with condescension. Time to get rid of the hypochondriac & move to the next name on the list. You can hear them thinking it. How about doing a little research, doctor, to help these suffering patients? That this is still happening to people is unbelievable & unacceptable. Of course not all doctors behave this way, just too many.

HOW DYSAUTONOMIA AFFECTS FAMILIES

As challenging as it can be to “live” with this disorder (if it can be considered living), it is almost as difficult for the patient’s family to watch. They don’t know what to do, where to turn, or how to help. Imagine seeing a bus about to run over your spouse or child, while you stand there like a statue, unable to stop the bus or warn your loved one. And imagine it happening all day every day. Over time the feeling of impotence becomes corrosive to mind & soul.

Some family members manage very well. Later though you might find them crying in bathroom to release their stress. In worst case scenarios husbands or wives must assume all the duties of their now disabled spouses. It takes incredible fortitude to bear this overwhelming new life. Those without that inner strength may abandon the family, leaving devastation in their wake.

Children are perhaps the greatest casualties of dysautonomia. Mom or Dad has suddenly become incapacitated & is no longer able to care for them as before, which is bad enough. Even worse, one of the parents may have cut & run. Is it becoming clear just how dire the fallout of dysautonomia can be?

Ongoing research must continue if a cure is to be found. If you’re able please consider donating to Dysautonomia International.


Photo by Image Point Fr

Dysautonomia Is All In Your Head Dear

“Your blood-pressure is normal,” said the tech.

“There’s nothing wrong with you,” said the MD.

“It’s all in your head, dear,” said the nurse.


“You’re darn right it is!”the patient screamed to herself. “Don’t you understand it’s the blood-pressure in my head that’s low, not my arm!”

Haven’t most dysautonomians lived this scenario? In my case it was 20 years ago when 99% of doctors had never heard of dysautonomia, nor could they pronounce it. Even today, 2021, most don’t understand about BP in the brain causing near or actual syncopes.

It’s OK. It’s changed now because WE MADE IT CHANGE!

Tilt Table Test Terrors!

In a tilt table test, you lie on a table that adjusts your body position from horizontal to vertical to simulate standing up. The test can tell your doctor if faulty brain signals are causing low blood pressure.

Above illustration & TTT description used with permission of Mayo Foundation for Medical Education and Research, all rights reserved.

Does every fainter need to take a tilt table test? That depends.

MY FATHER

Sometime in his mid-50s Dad was diagnosed with high blood-pressure. (We’re talking 1970s here.) For a few years, they said it was “white coat syndrome.” No, it was high blood-pressure. (He wasn’t nervous around doctors. His father & older brother had high BP too.) But for quite some time “white coat syndrome” was what the doctors swore he had. Finally, FINALLY, they decided he actually did have high BP & put him (I think) on a beta-blocker. Right before he turned 60 he started passing out on a regular basis. (Part of the problem was the medication. Because of dysautonomia it was dropping his BP too low. But we didn’t know any of this back then.) It was horrifying to witness him collapse. The first time he was walking to the bathroom. BOOM! Half of him was lying on the tile floor, half of him in the hallway. My sister was in nursing school & did all the things she was supposed to do. Dad came around & wanted nothing to do with going to a hospital.

LATENT DYSAUTONOMIA

The passing out became chronic. And every time it happened the cardiologist gave him a Tilt Table Test. It was the defacto procedure after every syncope. The problem is the test was kept going until he passed all the way out. EVERY TIME. After the third or fourth repeat of this experiment there was no medical need to do it that way. The reason I can say that is because after making my father pass out on the tilt table over & over again nothing was ever done for him. No diagnosis, no drug changes, no referral to a specialist. Besides, his heart rate/BP readings were clearly showing discrepancies as the table was going up. Dad could feel it so they had to see it. But they wouldn’t stop that test until he was unconscious. Dad finally refused to ever take the test again as there was clearly no purpose other than to cause unconsciousness. He wasn’t properly diagnosed with dysautonomia till 2001 – without the Tilt Table Test. Some meds were changed, others adjusted & then the intervals between pass outs grew much longer.

Another view of the dreaded Tilt Table Test.

INTERVIEW WITH MAYO DR HERE.

Many thanks to the Mayo Clinic for the use of their copyrighted materials. | Additional TTT Image by rumruay

Is Your Doctor Confused?

“At least it’s the enemy I know.”  

That is no reason to stay with a doctor who can’t figure out what’s wrong with you. Yes, it’s hard to go from doctor to doctor. It’s expensive. It’s tiring. The worst part is getting your hopes up then getting them dashed again. It’s painful. It’s dispiriting when they give you “the look” & express their ignorant erroneous conclusion, i.e., that they don’t believe there IS anything wrong with you. But for the sake of your family, for the sake of your life, you have to keep searching for the doctor who will figure it out.

Ha! I should talk! I don’t have a treating doctor. My doctor moved nearly 1653 miles away about 10 years ago. It had taken 4 years to find him & I almost died making my way through about a million other doctors who HAD NO IDEA what was wrong with me. After he saved my life (and my father’s) & started me on treatment I did fairly well. I maintained even off medications for several years. Until three surgeries in four years, one of which removed all my reproductive organs thus taking away my essential hormones. Being the caretaker of both my parents in their last years, and getting allergy shots for four years while already in a relapse, has brought me to the brink of catastrophe once again.

ALL DOCTORS ARE NOT CREATED EQUAL

I’ve gone to many doctors who claimed to treat dysautonomia. Here’s a story you may not hear every day. While I was in the office of one particular doctor, an old woman sitting across from me in a very crowded waiting room – at least 50 people – waiting her turn to be called in DIED in her seat. The patient sitting next to her, also waiting her turn, happened to be a nurse. The poor old woman’s head fell slightly sideways onto the shoulder of the nurse, who looked over at the old lady and said, matter-of-factly, “She passed away.” The nurse felt for a pulse. There was none. “She’s dead,” the nurse confirmed to one and all. Loudly. The doctor heard all this commotion and rushed into the waiting room.

All other patients were asked to leave as the doctor and my sister who’s an RN, performed CPR on the woman until an ambulance came. (The nurse who pronounced the woman dead wanted nothing to do with the CPR & she was out of there.) I was sitting on the side of the room in the wheelchair I’d come in until my sister had done her duty for the poor old woman who died waiting to see her doctor.

That was of course a one-in -a-million very unfortunate occurrence but it certainly put me off going back to that office. Other doctors I went to over many years were completely ignorant of dysautonomia & POTS even though they advertised as treating the condition. It was maddening.

At the moment I’m mentally stuck. I can’t handle going through again what I went through 20 years ago: going from doctor to doctor getting no help as all – that’s if I was lucky. Most of them said I was making up my symptoms, called me a liar to my face, and worse, and it is just not something I deign to put up with at this time.

What is happening is two wonderful non-dysautonomia doctors I’ve know 40 years who I trust implicitly are doing their best to help me. I can feel time is not on my side so I pray to God they come upon the right treatment that will arrest the progress of my current deterioration, before it’s too late.

If you find yourself in the same situation take a look at Dysautonomia International.org‘s worldwide list of treating doctors. You’ll find many other helpful websites on my LINKS page. If you want to read more about my luck with doctors & dysautonomia, take a look at my story, Journeying Through Hell & Back – AGAIN!

Photo credit Imgflip.com

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