What are the disabling symptoms of Postural Orthostatic Tachycardia Syndrome?
Orthostatic Tachycardia is the medical term for a spiking heart rate when sitting or standing up. Overall, those living with this syndrome deal with a variety of different symptoms. Many of these can be debilitating or disabling. Symptoms include:
- Chronic fatigue
- Chest pain
- Low Blood Pressure
- Heart palpitations
- Shortness of breath
- Difficulty sleeping
- Difficulty focusing
Generally, symptom occurrence and severity can vary case by case. In many cases, the spike in heart rate when sitting or standing can be 30-40 beats per minute extra.
Why Does Heart Rate Increase So Much with POTS?
Generally, standing up or sitting down causes gravity to affect our blood a little differently. While standing up, gravity pulls down more on your blood. Your body naturally releases hormones such as epinephrine and norepinephrine in response. These hormones tighten blood vessels and minimally increase your heart rate to compensate, and continue efficient blood flow. Unfortunately, for those living with POTS, lower blood pressure makes these effects more severe. Blood pools more in the lower half of your body, and cannot efficiently return to the heart and brain. This results in lightheadedness, fatigue, and dizziness.
Different Types Of Postural Orthostatic Tachycardia Syndrome
There are 4 different classifications of POTS. While the origins of this condition are not fully understood, the type you have may give you a better understanding of how it affects your body.
- Neuropathic POTS is generally associated with small fiber nerve damage. This is related to small-fiber neuropathy. Usually, these nerves regulate your body’s ability to constrict or relax the blood vessels in your body.
- Hyperadrenergic POTS refers to elevated levels of the stress hormone norepinephrine. Norepinephrine, along with adrenaline, increases your heart rate. With more of it being produced and released by your body, your heart rate tends to spike more often.
- Hypovolemic POTS describes a form of this condition caused by lower overall blood levels. With less blood than average in your body, it becomes harder for blood to flow effectively throughout your body.
- Secondary POTS is a form of this condition that is generally caused by another condition that affects the nervous system. This may include Diabetes, Lyme Disease, Lupus, or Sjögren’s Syndrome.
Is Postural Orthostatic Tachycardia Syndrome Fatal?
While POTS can be a life-altering condition, it is generally non-fatal. The biggest risk for those with the condition is falling from fainting. However, not everyone living with this condition will experience fainting. If you know that you have POTS, you may want to take precautions against trauma from falls.
How Do I Prove POTS as a Disability?
Most people living with this condition find that the best position to be in to reduce symptoms is a reclined posture. Generally, this is not something you can do in the vast majority of work environments. Overall, it may be difficult to properly perform your work duties when living with POTS. When you file a long-term disability claim for POTS, you will need to provide proof of your diagnosis and symptoms. Your insurance company will need documents proving your claim. You will need to provide medical evidence of how your symptoms limit your ability to work.
Getting a Diagnosis for POTS
Firstly, you will need to have a proper diagnosis of your condition. Generally, a POTS diagnosis is found through a variety of tests. The most common test for this condition is the Tilt Table Test. A Tilt Table Test is where the patient is harnessed to a special table that can be tilted back and forth. Your doctor will monitor your heart rate as the table moves you from a prone to a standing position. This recreates the motion of standing. Changes in blood pressure and heart rate during the test may determine a proper diagnosis. Abnormalities during this test may also indicate other conditions. Additionally, a physician may have you stand up from a sitting position and record your heart rate and blood pressure before and after. However, a Tilt Table Test offers a more objective diagnostic report, so it may be more effective in proving your case.
Medical Evidence of POTS Symptoms
Having a medical diagnosis of this condition isn’t technically enough evidence to prove it as a disability. Rather, you also need medical evidence that your POTS symptoms affect your ability to perform work tasks. These symptoms must be documented and verified through objective means. This can be somewhat difficult, as some symptoms can be subjective. Subjective symptoms can include things such as fatigue and lightheadedness. Generally, symptoms such as those are self-reported. Insurance companies are often skeptical of subjective self-reporting of symptoms. They may assume you are exaggerating claims of how you feel.
However, you can work with your doctor to bolster your claim by providing more concrete evidence. Look for a supportive doctor who understands the symptoms and potential work restrictions of your condition. Due to the varying symptoms of POTS, you may need to see multiple doctors of different specialties to best handle your condition. Cardiologists are often the most equipped to diagnose and report on your condition. Your primary care physician may also be able to help you obtain the records you need. Evidence from a neurologist may also be useful in building your case.
Medical Records of Your Condition
Proper medical records that show your limitations due to your condition are vital to building a POTS long-term disability case. Whenever you visit a doctor’s office, the details of your visit are recorded in the visit notes. These records are often essential to creating a strong foundation for your case.
When visiting your doctors regarding your POTS symptoms, be sure to tell them of all of the symptoms you are experiencing, even if it is not the reason for your visit.