September 1, 2024 • 27 mins
09/01/24
The Healthy Matters Podcast
S03_E21 - The Dizzying World of POTS
Lightheaded? Short of breath? Heart racing for no good reason? POTS is one of the more mysterious subjects in medicine in recent years, and although it's been around for quite some time, it has really come to the fore since the COVID pandemic. But what is it exactly? What causes it? How is it diagnosed, and more importantly, how is it treated?
The multitude of symptoms around pots are enough to make your head spin (if it wasn't already) and it turns out that physical therapy(!), of all things is one of the more effective methods for treating this all-too-common condition. We'll find out why on the next episode of the show, when we break down POTS with Dr. Miranda Langford, PT, DPT at Hennepin Healthcare. She's an expert on POTS and we'll talk about who's at risk, how it's diagnosed, and how people living with POTS are finding effective treatments for this condition that seems more prevalent every day. Join us!
If you, or someone you know might be suffering from POTS, or have these symptoms, have your primary care doctor refer you in for physical therapy at Hennepin Healthcare. To make an appointment, call 612-873-6963.
Got a question for the doc or a comment on the show?
Email - healthymatters@hcmed.org
Call - 612-873-TALK (8255)
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Find out more at www.healthymatters.org
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:01):
Welcome to the Healthy Matters podcast with
Dr. David Hilden , primary carephysician and acute care
hospitalist at HennepinHealthcare in downtown
Minneapolis, where we cover thelatest in health healthcare and
what matters to you. And nowhere's our host, Dr. David
Hilden.
Speaker 2 (00:18):
Hey everybody, it's Dr. David Hilden , your host of
the Healthy Matters podcast andwelcome to episode 21. Today we
are gonna talk about somethingthat you may or may not have
heard of Pot syndrome. What isthat? Well , we're about to
find out And what is itsrelation to long COVID . Tell
me out. I've invited MirandaLankford . She is a doctor of
physical therapy at HennepinHealthcare and an expert in not
(00:41):
only long covid but pots, whichstands for Postural Orthostatic
Tachycardia Syndrome. Miranda,thanks for being on the show.
Thanks
Speaker 3 (00:49):
For having me.
Speaker 2 (00:50):
First of all, what the heck is pots?
Speaker 3 (00:52):
So as you said, POTS stands for postural orthostatic
Tachycardia syndrome, whichmeans high heart rate with
standing or positional changes.
But broader scope, what it is,is it's a type of dysautonomia
, so a nervous system relateddisorder, specifically when the
autonomic nervous systembecomes out of balance.
Speaker 2 (01:14):
What's the autonomic nervous system?
Speaker 3 (01:17):
The autonomic nervous system is the part of
our body that tells the otherbody systems what to do and
when. So it controls thecardiovascular system,
respiratory system, digestion,thermal regulation, all of
these other systems. And withpots it becomes out of balance
(01:38):
and that's when people canstart to get a wide variety of
Speaker 2 (01:42):
Symptoms. Now I started off by saying there
might be some connection tolong covid OVID . Now POTS has
been around since before Covid. So could you explore that
relationship with me? Is itcaused by long covid? Do people
with long covid get pots? Saymore about that if you could.
Speaker 3 (01:58):
Yes. So POTS has been around before covid. It
can be caused by a traumaticbrain injury or a concussion
that can trigger POTS inpeople. But yes, it can also be
triggered virally. So Lyme'sdisease, norovirus, other
viruses have been known totrigger pots. But with COVID it
(02:19):
has become much more talkedabout um, because a lot of
people have been getting potsfrom Covid .
Speaker 2 (02:24):
Yeah, yeah . And there's so much about long COD
, which is not a precise term,it just is symptoms that happen
long after your infection'scleared. But we're , we are
seeing people with all kinds ofweird stuff, after they
get covid . Do you find in yourpractice that the majority of
people that have POTS also hadcovid in long covid symptoms?
Speaker 3 (02:47):
Yes, it can vary. So some people have onset from
childhood, that's very commonas well. But I would say
certainly in the last fewyears, most people are coming
in with some sort of post viralsyndrome from Covid
Speaker 2 (03:02):
And we do tons of brain injury as well. We do. So
what about that? Do people withbrain injury also get it?
Speaker 3 (03:08):
They do, yes. So repeated concussions can
definitely trigger pots just'cause autonomic nervous system
starts in the brain and if youhave injury to the brain that
tissue can become compromisedand throw off the autonomic
nervous system.
Speaker 2 (03:24):
So I watched eight zillion hours of the Olympics
in Paris. I do that. I waswatching sports I never even
heard of, but probably the onethat is most interesting to me.
I watched every single secondof of swimming and they were
talking about Katie Ledecky,who's like the greatest athlete
ever to walk the planet justabout. And she has pots. Had
you heard that?
Speaker 3 (03:45):
Yes, yes. She did come out of , on her journey
about having pots
Speaker 2 (03:48):
And she had that before COVID and all that. So
famous people who win goldmedals have pots. So clearly
the reason I say that, clearlythere is lots of room for
optimism and for doing great inyour life if you have pots. So
let's now get down to the nittygritty of what are the
symptoms? Mm-Hmm.what what? How do I know if I
(04:10):
have this thing? Yes,
Speaker 3 (04:11):
There are so many symptoms that can come with
pods because it covers so manybody systems. The wide range of
symptoms definitely can occur.
So typically people have a veryhigh heart rate with standing
or activity, they'll feel dizzyor lightheaded. They might even
feel like they're going to passout. They might even pass out.
(04:34):
Headaches and migraines arevery common as well. GI
disruption, brain fog andalways people have fatigue,
very debilitating fatigue.
Speaker 2 (04:44):
So the first thing you said, and that's the tea in
pots tachycardia. How do , dothey know they have that? Do
they feel their heart racing?
Speaker 3 (04:52):
Yes, most of the time people will feel their
heart beating very fast. Theycan also have kind of a chest
pressure with it or chesttightness with it as well and
feel very short of breath withdoing things that they normally
would not get short of breathfrom.
Speaker 2 (05:06):
Does it come on suddenly or is it kind of
something that sneaks up on you?
Speaker 3 (05:10):
It can come up suddenly. It can also be a
little sneaky. So sometimespeople will get the heart rate
racing with activities, butsometimes it could be when they
are just sitting down watchingtv. So it doesn't necessarily
have to be associated with anactivity which makes it
complicated.
Speaker 2 (05:28):
That does make it complicated. 'cause all of our
heart rates go up at times. Myheart rate went up when I'm
watching Katie Ledecky swim,much less being the one who's
swimming. So it must bekinda hard to diagnose. And you
said they all have fatigue andI, I'd say 80 90% of my
patients come to me and say,yeah , I've got fatigue. So
that also is common. When theyget to you, you're in physical
(05:51):
therapy, have they typicallyalready been diagnosed or are
you sort of teasing it out withthem? Them,
Speaker 3 (05:57):
They typically have already been diagnosed and if
they don't have the officialdiagnosis, they're usually
awaiting the autonomic testing,but they usually have an idea
of what's going on and we canassume some sort of
dysautonomia is present justbecause the symptoms line up
very well with that. Usually.
And even if somebody does nothave the official POS diagnosis
(06:18):
or they do the autonomictesting and they don't meet the
criteria for pos in the rehabprogram that we're doing, we do
a symptoms based approach. Soit doesn't necessarily like
they don't need to have the POSdiagnosis to be in our program.
Speaker 2 (06:33):
Yeah, I think that that's kind of key because it's
a clinical diagnosis that youand patients would do with
their, whoever they see fortheir healthcare . They could
be their primary care doctor .
Some people see cardiologists,I think others might have seen
a neurologist. And the patientsI've seen have seen a lot of
people.
Speaker 3 (06:50):
Absolutely.
Speaker 2 (06:51):
Do you find that to be the case is like by the time
they get to you, they've beento 13 other people trying to
come up with what do I have?
Speaker 3 (06:57):
Yes, absolutely. So on average it takes six years
from onset of symptoms togetting an official diagnosis.
Speaker 2 (07:05):
Good grief. Six years, that's a long one .
Speaker 3 (07:06):
Six years. It's sometimes for people it's even
more than that, but within thattime period, people are seeing
a lot of different specialties,cardiology, gi, rheumatology,
before they even get to aneurologist and get the tilt
table test done. So that's avery common experience for
(07:27):
people to see many, manyspecialties before actually
landing on the diagnosis.
Speaker 2 (07:31):
Can you tell people what tilt table testing is?
Speaker 3 (07:35):
Yes. So it's the official testing for POTS and
dysautonomia . So you will layon this table and you will be
hooked up to all of thesedifferent machines that are
testing
Speaker 2 (07:46):
Yours .
Speaker 3 (07:46):
Yes, absolutely.
. And you go from beingsupine and the table will
slowly tilt people upright andduring that time and after they
will be testing to see whatyour vitals are doing. So for
pots, they wanna see more thana 30 beat per minute raise from
(08:06):
baseline. And they're trackingother things too, like sweating
and what your blood pressure isdoing as well. And your
symptoms are tracking your
Speaker 2 (08:13):
Symptoms. Yeah. So you've you've described it
marvelously. I've seen it. I ,uh, loads of times . So yes,
you are strapped to a table andit puts you on a line down
position into a standing upposition. And no folks, it's
not like some medieval torturedevice or it isn't like Dr.
Frankenstein and all that. It ,it's a medical device that
simply measures your vitalsigns when you're in different
(08:36):
body positions. So don't beafraid of the tilt table
testing everybody if ,if somebody suggests you get it
done, because that's really theobjective way to do it. Right.
Because otherwise it's hard toknow. Yeah, I'm tired. How do
you, how do you diagnose that?
But before I get into , um, thelong covid connection, you also
said that everybody hasfatigue, literally everybody. I
(08:56):
mean it it , why do you thinkthat is? Mm-Hmm.
do we know?
Speaker 3 (09:00):
Yeah, almost everyone does have fatigue and
it's all on a spectrum. Butyes, I would say when the
autonomic nervous system is outof balance, it's functioning in
a way that it's not normallysupposed to function at least
chronically. And that takes alot of energy for all these
different body systems to beworking at a rate that they're
(09:23):
not made for. So that can causefatigue because all of the
energy is going towards thosesystems trying to be in a
balance and being taken awayfrom people's ability to do
daily things.
Speaker 2 (09:37):
So this condition that has has existed and been
described for some years nowseems to be making a lot of
headlines 'cause of covid . Andwe're now four, five years out
from the first diagnosis ofcovid and we're learning a
little bit more about some ofthe lingering for months or
years, the lingering symptoms.
This maybe is one of them. Helpme out to, to define what that
(10:00):
relationship is. Do we know howmany people get POTS as a
result of covid? Is there anydata yet or is it still too
early in in our understandingof it?
Speaker 3 (10:10):
There's a few numbers out there. So the
estimate of people with longcovid is about 10 to 30% of the
population of people that havegotten covid of those people,
how many of them have pots? Notsure, but the symptoms
certainly align in overlap inmany ways where you can say
(10:34):
that long covid presents like adysautonomia .
Speaker 2 (10:37):
I tell people all the time , um, who dismiss
covid ? I said, yes, it hasbecome a less severe acute
illness for most people. Notall, but for most. And I
remember very well when it was, uh, life-threatening all the
time. And yes, it's gottenmild, but long covid OVID is
something you really don'twant. Um, 10 to 30%. I've heard
(10:59):
those numbers as well. We'renot sure. 'cause not all of it
gets reported. There's not arobust data collection. But if
one in four people who getcovid get long covid symptoms,
that's a lot. And, and some ofthose might get this condition.
How in your practice do you seepots, whether or not it was
related to long covid, how doyou see it affecting people's
(11:21):
lives, physically, emotionally,mentally, psychologically, all
that?
Speaker 3 (11:25):
Yeah, it can affect every aspect of somebody's
life. Even just the dailyactivities that we need to do
in order to go to work, go toschool, care for the family,
all of these different rolesthat people have in their lives
can become significantlydisrupted from pots. Even like
(11:46):
getting ready in the morningcan feel truly like a marathon
to people because even justgetting out of bed in the
morning, the blood pooling thathappens overnight when they sit
up, they can start to feeldizzy, lightheaded, nauseous,
and then to go on and get readyand stand up and do all of the
tasks that you need to do inthe morning to get out the door
(12:10):
or even just have breakfast andget dressed. That raises the
heart rate. And that can causea flare in symptoms. This
Speaker 2 (12:19):
Is all before you've left for the
Speaker 3 (12:20):
Day, all before, sometimes you've even gotten
out of your bedroom. We do workwith patients that are
considered to be bedbound andwe'll do video visits with 'em
and we'll work with reallyslowly increasing their
activity tolerance and gettingback some of that muscle mass
so that they can expand theirworld a little more. Again,
Speaker 2 (12:40):
You that could affect even your social
circles, your family, andespecially since nobody really
knows what you have, you know,and it's hard to describe, but
I bet I bet that's challengingas well.
Speaker 3 (12:49):
Very challenging.
And POTS is an invisibleillness. You look at most
people with pots in , you wouldnever guess that they have this
disorder and it's significantlyaffecting their lives.
Speaker 2 (13:02):
And that's something that I'm hoping that we can at
least , uh, enlighten ourlisteners about this condition
that probably many haven't evenheard of. And that if you have
somebody or know somebody inyour life , uh, maybe they're
not just being a slacker,
Speaker 3 (13:15):
Right?
Speaker 2 (13:17):
Yes . There's gotta be some stigma to the fact that
you , you know , what's wrongwith you? I can't you , you
suck it up. You know, get out,do your day.
Speaker 3 (13:24):
Yeah. Sadly, a lot of people with POTS and even
people in their lives mightthink that they are lazy or
unmotivated, but it is trulythere's physiologic changes
that are happening that arecausing all of these things.
Speaker 2 (13:37):
We've been talking with Miranda Langford. She is a
doctor of physical therapy atHennepin Healthcare with me
right here in downtownMinneapolis. She specializes in
treating patients with pots. Soif you're suffering from
symptoms that we've just beendiscussing or know someone who
is, and you haven't beendiagnosed, there's hope. We're
gonna talk about the role thatphysical therapy can play in
(13:57):
managing symptoms and thedifference that Miranda and her
colleagues are making in theirpatients' lives right after
this short break. So stickaround. We'll be right back
Speaker 4 (14:08):
When Hennepin Healthcare says we are here for
life. They mean here for you,your life and all that it
brings. Hennepin Healthcare hasa hospital HCMC and a network
of clinics both downtown andacross the West Metro. They
provide all the primary careand specialty care you would
expect to find, but did youknow they also have services
like acupuncture andchiropractic care available at
(14:30):
many of their primary careclinics and at their
integrative health clinic indowntown Minneapolis? Learn
more@hennepinhealthcare.org.
Hennepin Healthcare is here foryou and here for life.
Speaker 2 (14:46):
And we're back talking with Miranda Langford.
She is a doctor of physicaltherapy at Hennepin Healthcare
and a specialist in POTSpostural orthostatic
tachycardia syndrome. SoMiranda, you've already told us
about what the symptoms are andwe've talked about the long
covid connection. Now let'stalk about physical therapy and
what you can do. Before I dothat though, it occurred to me
(15:06):
who gets this? Does it affecteverybody equally?
Speaker 3 (15:09):
It can affect everyone, but it is most common
in female born people. About75%, actually
Speaker 2 (15:17):
75% of your patients
Speaker 3 (15:19):
In general pots in general pots diagnosed
patients.
Speaker 2 (15:22):
Yep . Do we know why that is?
Speaker 3 (15:23):
Um, there's probably a lot of factors leading into
that. Um, I'm sure there'sstudies being done on it as
well. But age range wise , it'sabout 15 years to 25 years of
age for onset of symptoms.
Speaker 2 (15:37):
Adolescents, teenagers, young adults. Yes.
Do we know why that is? Wedon't like young . That's
young.
Speaker 3 (15:42):
That is very young.
Yes . I mean, there's a lot ofhormonal changes happening.
There's a lot of bodily changeshappening at that time, so it's
hard to say exactly. They can'treally pinpoint it to one thing
that would be triggering
Speaker 2 (15:56):
It. So that makes sense with, with our Olympian ,
um, Katie Ledecky and, and forlisteners, we only talk about
public figures, medical issueswhen, when they've been talking
about it themselves oninternational television. So,
but that's, she's a young womanand , um, a highly conditioned
athlete. Mm-Hmm.. So that it may break some
stereotypes of who might begetting this. Yes . Thanks for
(16:18):
that. So let's talk about whatyou do and your colleagues in
the POTS program in physicaltherapy. So when somebody comes
into you for the first time,what do you do?
Speaker 3 (16:28):
We spend a lot of time right off the bat, really
just going through all of theirsymptoms. What are all your
symptoms? What are theactivities that you're really
having a hard time with? Andbreaking that down. So then we
have a good idea of kind ofwhere to start, where are they
at baseline with their activitylevels and what are their goals
for physical therapy and beingable to do and get back to some
(16:52):
of those things that have beenchallenging for so long.
Speaker 2 (16:54):
You're a physical therapist by training. When
people think of physicaltherapy, at least I think they
do you think of Well , yeah, Ihurt my arm. I have a rotator
cuff problem. I strained myquad. You work with me on my
musculoskeletal system. Thisseems to be more complicated
than that.
Speaker 3 (17:11):
This is, yeah, this is very complex. It's working
with the nervous system. Soit's like neuro neurological
physical therapy. So it is, itlooks very different. It still
includes the same things in theaspects that like ortho
physical therapy would in termsof like exercise and cardio and
strengthening. But there's somany other aspects to it that
(17:33):
need to be addressed sometimeseven before we get to that part
of pt.
Speaker 2 (17:38):
So you, you do a , a , a history, you talk about
symptoms, you talk about goals.
Mm-Hmm. . What dothe treatment plans look like
then?
Speaker 3 (17:45):
So I would say in the beginning we would work
really on education. So we needto make sure that before we hop
into activity that theyunderstand what's going on with
their body. So we'll do a lotof nervous system education and
we'll start to build theirtoolbox of what they can do to
help manage symptoms that canstart with the basics of making
(18:08):
sure they're hydrated, makingsure they have electrolytes ,
um, they're taking their saltto help with those have been
prescribed and compression tohelp with some of the blood
circulation issues that cancome about with pots. And then
also giving them nervous systemregulating techniques. So we'll
do breathing exercises withpeople to help with the blood
flow, to help withreregulating, their nervous
(18:32):
system. And we'll also do avariety of other nervous system
related techniques as well,like use of weight to help
regulate the proprioception andthe nervous system. There's
Speaker 2 (18:43):
A lot in there. I want to ask you more about you
. So you talked about salttablets and electrolytes and
fluids, diet and hydration. Howmuch role does that
Speaker 3 (18:52):
Play? That can play a big role in people's
symptoms. So low blood volumecan be an aspect of pots and a
tendency for the blood to bepooling hips down, which causes
a lot of symptoms if you're notgetting adequate blood flow in
your trunk, in your head area.
So we'll work on building bloodvolume. So salt and hydration,
(19:15):
electrolytes and hydration,build blood volume in the body
and can help people feelsignificantly better sometimes.
Speaker 2 (19:21):
Yeah. You know, that's what one of the primary
causes of dizziness andlightheadedness is not enough
blood to the brain. And we havegravity working against us,
don't we? Yes. You know , itpulls down in your legs . So,
so hydration matters. You thentalked about proprioception and
kind of regulating your, yourneurologic system and you
talked about breathing. I findthat fascinating because this
(19:43):
is two episodes in a row wheremy guest has talked about
breathing as a way to regulatesomething. Now , um, Dr. Mitch
Radden talked about it in ourlast episode when we were
talking about trauma-informedcare and how you can regulate
your heart rate by deepbreathing. Now you're talking
about regulating the nervoussystem by breathing. How does
that work? What do you tellpeople to do? Mm-Hmm.
Speaker 3 (20:03):
We'll work on diaphragmatic breathing to
start off with. So the conceptof breathing into your lower
stomach, into your diaphragm,there's a lot of nerves that we
have in that area and if we canbreathe into that spot, it can
activate the parasympatheticnervous system, which is the
branch of the nervous systemthat's rest and digest. So a
(20:25):
lot of times people can beliving more in that sympathetic
nervous system of like fight orflight and stress mode and we
need to switch that. 'cause ifyou're living in fight or
flight, that's only supposed tobe for very short periods of
time. And we want to be able toswitch them out of that and get
(20:46):
them more into a balanced stateof their nervous system and
breathing can directly do that.
Speaker 2 (20:52):
That was a great explanation. You know, we all
or most of us know about thefight or flight systems in our
body. That's the sympatheticnervous system, but what many
people probably haven't thoughtabout quite as much is what you
just said, the rest and digestportion of your nervous system,
the parasympathetic system. Andyou can regulate that by
intentional breathing. We allthink we know how to breathe.
(21:13):
Turns out we don't. . If you, if you
haven't learned anything onthis podcast, you should learn
that breathing is important andbeing intentional about it and
doing it deeply and using yourdiaphragm. I really, I really
like that. Okay, so thenyou've, you've talked about
that stuff. You've talked aboutthe neuro system , you've
talked about hydration and allthat. What then do you do
Speaker 3 (21:34):
Then? We'll work on really what specific activities
are difficult for them.
Sometimes what we find is thatpeople are overdoing it.
They'll do multiple things in arow, they'll feel pretty
terrible doing it and thenthey'll crash for the rest of
the day or the next days. Andso we'll really kind of address
that with the concept of pacingand like energy conservation.
(21:59):
Like, okay, maybe you can do 10minutes on the bike, but let's
not do it at level seven. Let'smaybe do it at level one or
two. Let's have a reallygradual warm up and cool down
and have you take a breakhalfway through. And when you
take the break, can you do someof the nervous system
regulating techniques, whetherthat's the diaphragmatic
(22:19):
breathing or any of the othertechniques to help signal and
cue to your body that it'ssafe. You don't need to be
having a really high heartrate, you don't need to be
getting dizzy or lightheaded.
So to help regulate the wholesystem. And then usually people
can find that they can dothings. They just had to modify
it with breaks , pacing andnervous system regulation.
Speaker 2 (22:42):
That's brilliant.
Listeners, if you don't knowthere , there's no more goal
directed specialty thanphysical therapy. We , we
always, I , you know, I readphysical therapy plans
endlessly and it always isgoals. I'd like that 'cause you
talk to people about what areyour goals and how are we gonna
get there and what progress arewe making toward that. I like
that, especially in what you'vejust said, it's very specific
(23:03):
for some people, you know, youhave to modify and pacing. I
really, really like that. Whatother things do you tell people
or are there other things thatyou tell people that they need
to avoid in their life or thatthey should be doing more of in
their life?
Speaker 3 (23:16):
So on the other end, so there's the end of where
people are doing too manythings and then they're
crashing on the other end wouldbe where activity is super
hard. They've kind of gotten tointo this cycle of
deconditioning and so they havebecome a little avoidant of
activity because hard and itdoesn't feel good and it flares
them a lot. So on that end wewould work on can you do small
(23:41):
bouts of more movement? So evensomeone that is , um, a bed
bound patient, for example, wewould have them start to do
small reps of ankle pumps orheel slides in bed. Just a few,
however many they can tolerateat that time without overdoing
it and slowly build on thatover time. And then really it's
(24:04):
like, well then can you besitting up in bed for more
hours of the day than layingdown? And then transitioning
from there into sitting up inthe living room and sitting up
in the kitchen and then havingand going on short little walks
around the house. It kind ofdepends on where the patient is
at with their activity in termsof how we would guide them to
(24:28):
either like do more or kind ofmodify what they're already
doing and tone it down.
Speaker 2 (24:32):
It sounds like people, it's sort of a daily
fact of, of their lives and
Speaker 3 (24:38):
It can also be on and off. Symptoms can be very
present one day and verylimiting in that day and then
maybe not in the next day. Andthey feel almost essentially
normal, which can be tricky toplan things. can be
tricky to explain to otherpeople and really even just to
make sense of it on your owntoo, because it's hard to track
(25:01):
and they , there sometimes isno pattern. So it can have an
on and off nature to
Speaker 2 (25:06):
It. So listeners, if you have symptoms that you're
not too sure about, you'redizzy, you're fatigued, your
heart's racing and you don'tknow what it is, there is help
available. I would encourageyou to, wherever you get your
healthcare, talk to yourdoctor, your advanced practice
provider, talk to yourneurologist about whether you
might be suffering from pots.
(25:28):
And if so, we have resources tohelp you. We'd love to help you
here at Hennepin Healthcarewith both Miranda Langford and
Megan Meyer . They are ourspecialists in the physical
therapy department on pots.
We'll put some contactinformation for you on how to
get care at Hennepin Healthcarein our show notes. Miranda,
what would you like to leavewith our listeners?
Speaker 3 (25:48):
Yeah, so the experience and the feeling of
having pods can be veryoverwhelming, but I would like
people to understand that thereis hope, there are real things
that we can do to help withsymptoms and slowly gain back
that bandwidth so that you canget back to the things that you
enjoy doing in life. And it'sall possible and it's a slow
(26:10):
process, but it is a verydoable one. I
Speaker 2 (26:13):
Love that help is available. Miranda Langford,
doctor of Physical Therapy atHennepin Healthcare. Thanks for
being on the show. Miranda.
Thanks
Speaker 3 (26:20):
For
Speaker 2 (26:20):
Having me.
Listeners, POTS is a conditionyou maybe hadn't heard of until
today, but I hope you'velearned something today. And if
you think you might be havingsome of these symptoms, I hope
you can seek attention becausethere is help available for
you. I hope you enjoyed theshow and that you'll join us in
two weeks time for our nextepisode. And in the meantime,
be healthy and be well.
Speaker 1 (26:39):
Thanks for listening to the Healthy Matters podcast
with Dr. David Hilden . To findout more about the Healthy
Matters podcast or browse thearchive, visit healthy
matters.org. Got a question ora comment for the show, email
us at Healthy matters@hcme.orgor call 6 1 2 8 7 3 talk.
There's also a link in the shownotes. The Healthy Matters
(27:01):
Podcast is made possible byHennepin Healthcare in
Minneapolis, Minnesota, andengineered and produced by John
Lucas At Highball ExecutiveProducers are Jonathan , CTO
and Christine Hill . Pleaseremember, we can only give
general medical advice duringthis program and every case is
unique. We urge you to consultwith your physician if you have
a more serious or pressinghealth concern. Until next time
(27:23):
, be healthy and be well .
Welcome to the Healthy Matters podcast with
Dr. David Hilden , primary carephysician and acute care
hospitalist at HennepinHealthcare in downtown
Minneapolis, where we cover thelatest in health healthcare and
what matters to you. And nowhere's our host, Dr. David
Hilden.
Speaker 2 (00:18):
Hey everybody, it's Dr. David Hilden , your host of
the Healthy Matters podcast andwelcome to episode 21. Today we
are gonna talk about somethingthat you may or may not have
heard of Pot syndrome. What isthat? Well , we're about to
find out And what is itsrelation to long COVID . Tell
me out. I've invited MirandaLankford . She is a doctor of
physical therapy at HennepinHealthcare and an expert in not
(00:41):
only long covid but pots, whichstands for Postural Orthostatic
Tachycardia Syndrome. Miranda,thanks for being on the show.
Thanks
Speaker 3 (00:49):
For having me.
Speaker 2 (00:50):
First of all, what the heck is pots?
Speaker 3 (00:52):
So as you said, POTS stands for postural orthostatic
Tachycardia syndrome, whichmeans high heart rate with
standing or positional changes.
But broader scope, what it is,is it's a type of dysautonomia
, so a nervous system relateddisorder, specifically when the
autonomic nervous systembecomes out of balance.
Speaker 2 (01:14):
What's the autonomic nervous system?
Speaker 3 (01:17):
The autonomic nervous system is the part of
our body that tells the otherbody systems what to do and
when. So it controls thecardiovascular system,
respiratory system, digestion,thermal regulation, all of
these other systems. And withpots it becomes out of balance
(01:38):
and that's when people canstart to get a wide variety of
Speaker 2 (01:42):
Symptoms. Now I started off by saying there
might be some connection tolong covid OVID . Now POTS has
been around since before Covid. So could you explore that
relationship with me? Is itcaused by long covid? Do people
with long covid get pots? Saymore about that if you could.
Speaker 3 (01:58):
Yes. So POTS has been around before covid. It
can be caused by a traumaticbrain injury or a concussion
that can trigger POTS inpeople. But yes, it can also be
triggered virally. So Lyme'sdisease, norovirus, other
viruses have been known totrigger pots. But with COVID it
(02:19):
has become much more talkedabout um, because a lot of
people have been getting potsfrom Covid .
Speaker 2 (02:24):
Yeah, yeah . And there's so much about long COD
, which is not a precise term,it just is symptoms that happen
long after your infection'scleared. But we're , we are
seeing people with all kinds ofweird stuff,
get covid . Do you find in yourpractice that the majority of
people that have POTS also hadcovid in long covid symptoms?
Speaker 3 (02:47):
Yes, it can vary. So some people have onset from
childhood, that's very commonas well. But I would say
certainly in the last fewyears, most people are coming
in with some sort of post viralsyndrome from Covid
Speaker 2 (03:02):
And we do tons of brain injury as well. We do. So
what about that? Do people withbrain injury also get it?
Speaker 3 (03:08):
They do, yes. So repeated concussions can
definitely trigger pots just'cause autonomic nervous system
starts in the brain and if youhave injury to the brain that
tissue can become compromisedand throw off the autonomic
nervous system.
Speaker 2 (03:24):
So I watched eight zillion hours of the Olympics
in Paris. I do that. I waswatching sports I never even
heard of, but probably the onethat is most interesting to me.
I watched every single secondof of swimming and they were
talking about Katie Ledecky,who's like the greatest athlete
ever to walk the planet justabout. And she has pots. Had
you heard that?
Speaker 3 (03:45):
Yes, yes. She did come out of , on her journey
about having pots
Speaker 2 (03:48):
And she had that before COVID and all that. So
famous people who win goldmedals have pots. So clearly
the reason I say that, clearlythere is lots of room for
optimism and for doing great inyour life if you have pots. So
let's now get down to the nittygritty of what are the
symptoms? Mm-Hmm.
(04:10):
have this thing? Yes,
Speaker 3 (04:11):
There are so many symptoms that can come with
pods because it covers so manybody systems. The wide range of
symptoms definitely can occur.
So typically people have a veryhigh heart rate with standing
or activity, they'll feel dizzyor lightheaded. They might even
feel like they're going to passout. They might even pass out.
(04:34):
Headaches and migraines arevery common as well. GI
disruption, brain fog andalways people have fatigue,
very debilitating fatigue.
Speaker 2 (04:44):
So the first thing you said, and that's the tea in
pots tachycardia. How do , dothey know they have that? Do
they feel their heart racing?
Speaker 3 (04:52):
Yes, most of the time people will feel their
heart beating very fast. Theycan also have kind of a chest
pressure with it or chesttightness with it as well and
feel very short of breath withdoing things that they normally
would not get short of breathfrom.
Speaker 2 (05:06):
Does it come on suddenly or is it kind of
something that sneaks up on you?
Speaker 3 (05:10):
It can come up suddenly. It can also be a
little sneaky. So sometimespeople will get the heart rate
racing with activities, butsometimes it could be when they
are just sitting down watchingtv. So it doesn't necessarily
have to be associated with anactivity which makes it
complicated.
Speaker 2 (05:28):
That does make it complicated. 'cause all of our
heart rates go up at times. Myheart rate went up when I'm
watching Katie Ledecky swim,much less being the one who's
swimming
said they all have fatigue andI, I'd say 80 90% of my
patients come to me and say,yeah , I've got fatigue. So
that also is common. When theyget to you, you're in physical
(05:51):
therapy, have they typicallyalready been diagnosed or are
you sort of teasing it out withthem? Them,
Speaker 3 (05:57):
They typically have already been diagnosed and if
they don't have the officialdiagnosis, they're usually
awaiting the autonomic testing,but they usually have an idea
of what's going on and we canassume some sort of
dysautonomia is present justbecause the symptoms line up
very well with that. Usually.
And even if somebody does nothave the official POS diagnosis
(06:18):
or they do the autonomictesting and they don't meet the
criteria for pos in the rehabprogram that we're doing, we do
a symptoms based approach. Soit doesn't necessarily like
they don't need to have the POSdiagnosis to be in our program.
Speaker 2 (06:33):
Yeah, I think that that's kind of key because it's
a clinical diagnosis that youand patients would do with
their, whoever they see fortheir healthcare . They could
be their primary care doctor .
Some people see cardiologists,I think others might have seen
a neurologist. And the patientsI've seen have seen a lot of
people.
Speaker 3 (06:50):
Absolutely.
Speaker 2 (06:51):
Do you find that to be the case is like by the time
they get to you, they've beento 13 other people trying to
come up with what do I have?
Speaker 3 (06:57):
Yes, absolutely. So on average it takes six years
from onset of symptoms togetting an official diagnosis.
Speaker 2 (07:05):
Good grief. Six years, that's a long one .
Speaker 3 (07:06):
Six years. It's sometimes for people it's even
more than that, but within thattime period, people are seeing
a lot of different specialties,cardiology, gi, rheumatology,
before they even get to aneurologist and get the tilt
table test done. So that's avery common experience for
(07:27):
people to see many, manyspecialties before actually
landing on the diagnosis.
Speaker 2 (07:31):
Can you tell people what tilt table testing is?
Speaker 3 (07:35):
Yes. So it's the official testing for POTS and
dysautonomia . So you will layon this table and you will be
hooked up to all of thesedifferent machines that are
Speaker 2 (07:46):
Yours .
Speaker 3 (07:46):
Yes, absolutely.
slowly tilt people upright andduring that time and after they
will be testing to see whatyour vitals are doing. So for
pots, they wanna see more thana 30 beat per minute raise from
(08:06):
baseline. And they're trackingother things too, like sweating
and what your blood pressure isdoing as well. And your
symptoms are tracking your
Speaker 2 (08:13):
Symptoms. Yeah. So you've you've described it
marvelously. I've seen it. I ,uh, loads of times . So yes,
you are strapped to a table andit puts you on a line down
position into a standing upposition. And no folks, it's
not like some medieval torturedevice or it isn't like Dr.
Frankenstein and all that. It ,it's a medical device that
simply measures your vitalsigns when you're in different
(08:36):
body positions. So don't beafraid of the tilt table
testing everybody
done, because that's really theobjective way to do it. Right.
Because otherwise it's hard toknow. Yeah, I'm tired. How do
you, how do you diagnose that?
But before I get into , um, thelong covid connection, you also
said that everybody hasfatigue, literally everybody. I
(08:56):
mean it it , why do you thinkthat is? Mm-Hmm.
do we know?
Speaker 3 (09:00):
Yeah, almost everyone does have fatigue and
it's all on a spectrum. Butyes, I would say when the
autonomic nervous system is outof balance, it's functioning in
a way that it's not normallysupposed to function at least
chronically. And that takes alot of energy for all these
different body systems to beworking at a rate that they're
(09:23):
not made for. So that can causefatigue because all of the
energy is going towards thosesystems trying to be in a
balance and being taken awayfrom people's ability to do
daily things.
Speaker 2 (09:37):
So this condition that has has existed and been
described for some years nowseems to be making a lot of
headlines 'cause of covid . Andwe're now four, five years out
from the first diagnosis ofcovid and we're learning a
little bit more about some ofthe lingering for months or
years, the lingering symptoms.
This maybe is one of them. Helpme out to, to define what that
(10:00):
relationship is. Do we know howmany people get POTS as a
result of covid? Is there anydata yet or is it still too
early in in our understandingof it?
Speaker 3 (10:10):
There's a few numbers out there. So the
estimate of people with longcovid is about 10 to 30% of the
population of people that havegotten covid of those people,
how many of them have pots? Notsure, but the symptoms
certainly align in overlap inmany ways where you can say
(10:34):
that long covid presents like adysautonomia .
Speaker 2 (10:37):
I tell people all the time , um, who dismiss
covid ? I said, yes, it hasbecome a less severe acute
illness for most people. Notall, but for most. And I
remember very well when it was, uh, life-threatening all the
time. And yes, it's gottenmild, but long covid OVID is
something you really don'twant. Um, 10 to 30%. I've heard
(10:59):
those numbers as well. We'renot sure. 'cause not all of it
gets reported. There's not arobust data collection. But if
one in four people who getcovid get long covid symptoms,
that's a lot. And, and some ofthose might get this condition.
How in your practice do you seepots, whether or not it was
related to long covid, how doyou see it affecting people's
(11:21):
lives, physically, emotionally,mentally, psychologically, all
that?
Speaker 3 (11:25):
Yeah, it can affect every aspect of somebody's
life. Even just the dailyactivities that we need to do
in order to go to work, go toschool, care for the family,
all of these different rolesthat people have in their lives
can become significantlydisrupted from pots. Even like
(11:46):
getting ready in the morningcan feel truly like a marathon
to people because even justgetting out of bed in the
morning, the blood pooling thathappens overnight when they sit
up, they can start to feeldizzy, lightheaded, nauseous,
and then to go on and get readyand stand up and do all of the
tasks that you need to do inthe morning to get out the door
(12:10):
or even just have breakfast andget dressed. That raises the
heart rate. And that can causea flare in symptoms. This
Speaker 2 (12:19):
Is all before you've left for the
Speaker 3 (12:20):
Day, all before, sometimes you've even gotten
out of your bedroom. We do workwith patients that are
considered to be bedbound andwe'll do video visits with 'em
and we'll work with reallyslowly increasing their
activity tolerance and gettingback some of that muscle mass
so that they can expand theirworld a little more. Again,
Speaker 2 (12:40):
You that could affect even your social
circles, your family, andespecially since nobody really
knows what you have, you know,and it's hard to describe, but
I bet I bet that's challengingas well.
Speaker 3 (12:49):
Very challenging.
And POTS is an invisibleillness. You look at most
people with pots in , you wouldnever guess that they have this
disorder and it's significantlyaffecting their lives.
Speaker 2 (13:02):
And that's something that I'm hoping that we can at
least , uh, enlighten ourlisteners about this condition
that probably many haven't evenheard of. And that if you have
somebody or know somebody inyour life , uh, maybe they're
not just being a slacker
Speaker 3 (13:15):
Right?
Speaker 2 (13:17):
Yes . There's gotta be some stigma to the fact that
you , you know , what's wrongwith you? I can't you , you
suck it up. You know, get out,do your day.
Speaker 3 (13:24):
Yeah. Sadly, a lot of people with POTS and even
people in their lives mightthink that they are lazy or
unmotivated, but it is trulythere's physiologic changes
that are happening that arecausing all of these things.
Speaker 2 (13:37):
We've been talking with Miranda Langford. She is a
doctor of physical therapy atHennepin Healthcare with me
right here in downtownMinneapolis. She specializes in
treating patients with pots. Soif you're suffering from
symptoms that we've just beendiscussing or know someone who
is, and you haven't beendiagnosed, there's hope. We're
gonna talk about the role thatphysical therapy can play in
(13:57):
managing symptoms and thedifference that Miranda and her
colleagues are making in theirpatients' lives right after
this short break. So stickaround. We'll be right back
Speaker 4 (14:08):
When Hennepin Healthcare says we are here for
life. They mean here for you,your life and all that it
brings. Hennepin Healthcare hasa hospital HCMC and a network
of clinics both downtown andacross the West Metro. They
provide all the primary careand specialty care you would
expect to find, but did youknow they also have services
like acupuncture andchiropractic care available at
(14:30):
many of their primary careclinics and at their
integrative health clinic indowntown Minneapolis? Learn
more@hennepinhealthcare.org.
Hennepin Healthcare is here foryou and here for life.
Speaker 2 (14:46):
And we're back talking with Miranda Langford.
She is a doctor of physicaltherapy at Hennepin Healthcare
and a specialist in POTSpostural orthostatic
tachycardia syndrome. SoMiranda, you've already told us
about what the symptoms are andwe've talked about the long
covid connection. Now let'stalk about physical therapy and
what you can do. Before I dothat though, it occurred to me
(15:06):
who gets this? Does it affecteverybody equally?
Speaker 3 (15:09):
It can affect everyone, but it is most common
in female born people. About75%, actually
Speaker 2 (15:17):
75% of your patients
Speaker 3 (15:19):
In general pots in general pots diagnosed
patients.
Speaker 2 (15:22):
Yep . Do we know why that is?
Speaker 3 (15:23):
Um, there's probably a lot of factors leading into
that. Um, I'm sure there'sstudies being done on it as
well. But age range wise , it'sabout 15 years to 25 years of
age for onset of symptoms.
Speaker 2 (15:37):
Adolescents, teenagers, young adults. Yes.
Do we know why that is? Wedon't like young . That's
young.
Speaker 3 (15:42):
That is very young.
Yes . I mean, there's a lot ofhormonal changes happening.
There's a lot of bodily changeshappening at that time, so it's
hard to say exactly. They can'treally pinpoint it to one thing
that would be triggering
Speaker 2 (15:56):
It. So that makes sense with, with our Olympian ,
um, Katie Ledecky and, and forlisteners, we only talk about
public figures, medical issueswhen, when they've been talking
about it themselves oninternational television. So,
but that's, she's a young womanand , um, a highly conditioned
athlete. Mm-Hmm.
stereotypes of who might begetting this. Yes . Thanks for
(16:18):
that. So let's talk about whatyou do and your colleagues in
the POTS program in physicaltherapy. So when somebody comes
into you for the first time,what do you do?
Speaker 3 (16:28):
We spend a lot of time right off the bat, really
just going through all of theirsymptoms. What are all your
symptoms? What are theactivities that you're really
having a hard time with? Andbreaking that down. So then we
have a good idea of kind ofwhere to start, where are they
at baseline with their activitylevels and what are their goals
for physical therapy and beingable to do and get back to some
(16:52):
of those things that have beenchallenging for so long.
Speaker 2 (16:54):
You're a physical therapist by training. When
people think of physicaltherapy, at least I think they
do you think of Well , yeah, Ihurt my arm. I have a rotator
cuff problem. I strained myquad. You work with me on my
musculoskeletal system. Thisseems to be more complicated
than that.
Speaker 3 (17:11):
This is, yeah, this is very complex. It's working
with the nervous system. Soit's like neuro neurological
physical therapy. So it is, itlooks very different. It still
includes the same things in theaspects that like ortho
physical therapy would in termsof like exercise and cardio and
strengthening. But there's somany other aspects to it that
(17:33):
need to be addressed sometimeseven before we get to that part
of pt.
Speaker 2 (17:38):
So you, you do a , a , a history, you talk about
symptoms, you talk about goals.
Mm-Hmm.
then?
Speaker 3 (17:45):
So I would say in the beginning we would work
really on education. So we needto make sure that before we hop
into activity that theyunderstand what's going on with
their body. So we'll do a lotof nervous system education and
we'll start to build theirtoolbox of what they can do to
help manage symptoms that canstart with the basics of making
(18:08):
sure they're hydrated, makingsure they have electrolytes ,
um, they're taking their saltto help with those have been
prescribed and compression tohelp with some of the blood
circulation issues that cancome about with pots. And then
also giving them nervous systemregulating techniques. So we'll
do breathing exercises withpeople to help with the blood
flow, to help withreregulating, their nervous
(18:32):
system. And we'll also do avariety of other nervous system
related techniques as well,like use of weight to help
regulate the proprioception andthe nervous system. There's
Speaker 2 (18:43):
A lot in there. I want to ask you more about you
. So you talked about salttablets and electrolytes and
fluids, diet and hydration. Howmuch role does that
Speaker 3 (18:52):
Play? That can play a big role in people's
symptoms. So low blood volumecan be an aspect of pots and a
tendency for the blood to bepooling hips down, which causes
a lot of symptoms if you're notgetting adequate blood flow in
your trunk, in your head area.
So we'll work on building bloodvolume. So salt and hydration,
(19:15):
electrolytes and hydration,build blood volume in the body
and can help people feelsignificantly better sometimes.
Speaker 2 (19:21):
Yeah. You know, that's what one of the primary
causes of dizziness andlightheadedness is not enough
blood to the brain. And we havegravity working against us,
don't we? Yes. You know , itpulls down in your legs . So,
so hydration matters. You thentalked about proprioception and
kind of regulating your, yourneurologic system and you
talked about breathing. I findthat fascinating because this
(19:43):
is two episodes in a row wheremy guest has talked about
breathing as a way to regulatesomething. Now , um, Dr. Mitch
Radden talked about it in ourlast episode when we were
talking about trauma-informedcare and how you can regulate
your heart rate by deepbreathing. Now you're talking
about regulating the nervoussystem by breathing. How does
that work? What do you tellpeople to do? Mm-Hmm.
Speaker 3 (20:03):
We'll work on diaphragmatic breathing to
start off with. So the conceptof breathing into your lower
stomach, into your diaphragm,there's a lot of nerves that we
have in that area and if we canbreathe into that spot, it can
activate the parasympatheticnervous system, which is the
branch of the nervous systemthat's rest and digest. So a
(20:25):
lot of times people can beliving more in that sympathetic
nervous system of like fight orflight and stress mode and we
need to switch that. 'cause ifyou're living in fight or
flight, that's only supposed tobe for very short periods of
time. And we want to be able toswitch them out of that and get
(20:46):
them more into a balanced stateof their nervous system and
breathing can directly do that.
Speaker 2 (20:52):
That was a great explanation. You know, we all
or most of us know about thefight or flight systems in our
body. That's the sympatheticnervous system, but what many
people probably haven't thoughtabout quite as much is what you
just said, the rest and digestportion of your nervous system,
the parasympathetic system. Andyou can regulate that by
intentional breathing. We allthink we know how to breathe.
(21:13):
Turns out we don't.
haven't learned anything onthis podcast, you should learn
that breathing is important andbeing intentional about it and
doing it deeply and using yourdiaphragm. I really, I really
like that. Okay, so thenyou've, you've talked about
that stuff. You've talked aboutthe neuro system , you've
talked about hydration and allthat. What then do you do
Speaker 3 (21:34):
Then? We'll work on really what specific activities
are difficult for them.
Sometimes what we find is thatpeople are overdoing it.
They'll do multiple things in arow, they'll feel pretty
terrible doing it and thenthey'll crash for the rest of
the day or the next days. Andso we'll really kind of address
that with the concept of pacingand like energy conservation.
(21:59):
Like, okay, maybe you can do 10minutes on the bike, but let's
not do it at level seven. Let'smaybe do it at level one or
two. Let's have a reallygradual warm up and cool down
and have you take a breakhalfway through. And when you
take the break, can you do someof the nervous system
regulating techniques, whetherthat's the diaphragmatic
(22:19):
breathing or any of the othertechniques to help signal and
cue to your body that it'ssafe. You don't need to be
having a really high heartrate, you don't need to be
getting dizzy or lightheaded.
So to help regulate the wholesystem. And then usually people
can find that they can dothings. They just had to modify
it with breaks , pacing andnervous system regulation.
Speaker 2 (22:42):
That's brilliant.
Listeners, if you don't knowthere , there's no more goal
directed specialty thanphysical therapy. We , we
always, I , you know, I readphysical therapy plans
endlessly and it always isgoals. I'd like that 'cause you
talk to people about what areyour goals and how are we gonna
get there and what progress arewe making toward that. I like
that, especially in what you'vejust said, it's very specific
(23:03):
for some people, you know, youhave to modify and pacing. I
really, really like that. Whatother things do you tell people
or are there other things thatyou tell people that they need
to avoid in their life or thatthey should be doing more of in
their life?
Speaker 3 (23:16):
So on the other end, so there's the end of where
people are doing too manythings and then they're
crashing on the other end wouldbe where activity is super
hard. They've kind of gotten tointo this cycle of
deconditioning and so they havebecome a little avoidant of
activity because hard and itdoesn't feel good and it flares
them a lot. So on that end wewould work on can you do small
(23:41):
bouts of more movement? So evensomeone that is , um, a bed
bound patient, for example, wewould have them start to do
small reps of ankle pumps orheel slides in bed. Just a few,
however many they can tolerateat that time without overdoing
it and slowly build on thatover time. And then really it's
(24:04):
like, well then can you besitting up in bed for more
hours of the day than layingdown? And then transitioning
from there into sitting up inthe living room and sitting up
in the kitchen and then havingand going on short little walks
around the house. It kind ofdepends on where the patient is
at with their activity in termsof how we would guide them to
(24:28):
either like do more or kind ofmodify what they're already
doing and tone it down.
Speaker 2 (24:32):
It sounds like people, it's sort of a daily
fact of, of their lives and
Speaker 3 (24:38):
It can also be on and off. Symptoms can be very
present one day and verylimiting in that day and then
maybe not in the next day. Andthey feel almost essentially
normal, which can be tricky toplan things.
tricky to explain to otherpeople and really even just to
make sense of it on your owntoo, because it's hard to track
(25:01):
and they , there sometimes isno pattern. So it can have an
on and off nature to
Speaker 2 (25:06):
It. So listeners, if you have symptoms that you're
not too sure about, you'redizzy, you're fatigued, your
heart's racing and you don'tknow what it is, there is help
available. I would encourageyou to, wherever you get your
healthcare, talk to yourdoctor, your advanced practice
provider, talk to yourneurologist about whether you
might be suffering from pots.
(25:28):
And if so, we have resources tohelp you. We'd love to help you
here at Hennepin Healthcarewith both Miranda Langford and
Megan Meyer . They are ourspecialists in the physical
therapy department on pots.
We'll put some contactinformation for you on how to
get care at Hennepin Healthcarein our show notes. Miranda,
what would you like to leavewith our listeners?
Speaker 3 (25:48):
Yeah, so the experience and the feeling of
having pods can be veryoverwhelming, but I would like
people to understand that thereis hope, there are real things
that we can do to help withsymptoms and slowly gain back
that bandwidth so that you canget back to the things that you
enjoy doing in life. And it'sall possible and it's a slow
(26:10):
process, but it is a verydoable one. I
Speaker 2 (26:13):
Love that help is available. Miranda Langford,
doctor of Physical Therapy atHennepin Healthcare. Thanks for
being on the show. Miranda.
Thanks
Speaker 3 (26:20):
For
Speaker 2 (26:20):
Having me.
Listeners, POTS is a conditionyou maybe hadn't heard of until
today, but I hope you'velearned something today. And if
you think you might be havingsome of these symptoms, I hope
you can seek attention becausethere is help available for
you. I hope you enjoyed theshow and that you'll join us in
two weeks time for our nextepisode. And in the meantime,
be healthy and be well.
Speaker 1 (26:39):
Thanks for listening to the Healthy Matters podcast
with Dr. David Hilden . To findout more about the Healthy
Matters podcast or browse thearchive, visit healthy
matters.org. Got a question ora comment for the show, email
us at Healthy matters@hcme.orgor call 6 1 2 8 7 3 talk.
There's also a link in the shownotes. The Healthy Matters
(27:01):
Podcast is made possible byHennepin Healthcare in
Minneapolis, Minnesota, andengineered and produced by John
Lucas At Highball ExecutiveProducers are Jonathan , CTO
and Christine Hill . Pleaseremember, we can only give
general medical advice duringthis program and every case is
unique. We urge you to consultwith your physician if you have
a more serious or pressinghealth concern. Until next time
(27:23):
, be healthy and be well .
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