My POTS And Anxiety Play Into Each Other

I have a solid handful of chronic health conditions. Most of these are treated by individual specialists. A cardiologist treats my POTS, a rehabilitation doctor treats my hypermobility, an allergist treats my asthma and allergies, a psychiatrist treats my anxiety and depression, a gastroenterologist treats my IBS, a neurologist treats my migraines, etc… In our current medical system it’s very hard to get any specialists to talk to each other, so I am usually left trying to figure out how all these conditions interact with each other. That has been one of the hardest parts about learning to navigate the healthcare system as a chronically ill person. I am the one coordinating most of my care, but I was given no training on how to do so.

The last couple days have been a good example of my various conditions interacting in interesting and distressing ways. My POTS has been very bad lately. It started 2-3 months ago after a viral infection. Post-infectious POTS is a thing, and I have experienced it before. On Monday I had an experience that significantly raised my anxiety. As a result I overdid it that day cleaning. I also spent a larger portion of the day than I normally would sitting upright, rather than laying horizontally. This was all a direct result of my anxiety.

I woke up Tuesday feeling mostly okay but pretty tired. I took it easy in the morning and then decided to take a shower and do a couple other small things in the afternoon. By evening I was feeling decidedly weird. What had happened was the over exertion had made the POTS worse and all the extra cleaning had caused me to dislocate a rib. It didn’t stay dislocated, usually what happens is it slides out and then back in all in the same motion. But the pain of the muscles in the surrounding area persists for days. At the time I hadn’t put all of this together so what I was experiencing was a frequently racing heart beat with heart palpitations (caused by the POTS), along with occasional chest pain and difficulty taking deep breaths (from the rib). All that was enough to increase my anxiety significantly, which then made the POTS symptoms worse and the interplay just continued from there.

It took all of the next day for me to sort all of that out. I called a nurse, got a same day appointment with a cardiologist, emailed a different doctor, called a physical therapy place to verify they take my insurance and get scheduled for aqua therapy. And I cried a lot. I cried because my anxiety was still high and because I didn’t feel equipped to sort all this out. I cried because I was exhausted and because I dreaded standing up for any reason since that would make my heart rate jump up and then make my anxiety kick in. I cried because there was nothing new wrong with me, which was relieving in some ways but also meant there were no new resources available to help me. And then, since I’d spent so much of the day crying for all those reasons, I started crying whenever my husband or anyone else said something particularly nice to me.

Now here I sit (or rather lay) writing about this day because writing helps me to make sense of things. On some level I’m just considering this day lost to anxiety. I think it’s okay sometimes to accept that today’s a bad day and to focus your hope on tomorrow. There’s a freedom in declaring a day a loss and moving on. I have a plan now. It’s a plan that I have mostly come up with (though I have gotten very important help from several doctors). And eventually I’m confident that I will feel better. But this is going to be a long road and despite having some really wonderful doctors, I am going to have to do most of the navigating for myself.