I have been counting down the days until we meet Dr. Boris for an evaluation. My daughter has many of the symptoms of POTS and I have done a considerable amount of online research. What if she is having a "good day" when we see you four days from now? Can you still make an accurate diagnosis without the tilt table, norepinephrine and blood volume levels? If she does have POTS, can she still do gymnastics? She loves milk; would she have to stop drinking it? Thank you in advance.
Even if she is having a "good" day, the history associated with postural orthostatic tachycardia syndrome (POTS) is often a reasonable giveaway. Also, these patients still typically have a jump of at least 30 beats per minute in their heart rate from lying down to standing up, even if they're feeling well. I typically do not perform tilt table testing or laboratory studies to confirm the diagnosis.
For physical activity, many of the recommendations are dependent upon how the patient is doing after therapy has been started. I have had patients return to sports without problems. I have had others who will feel good, exercise on one day, and be wiped out for the next 3 days. Everyone responds differently, and it is not easy to predict.
Regarding what to drink with POTS, as you may know, it is helpful for these patients to drink 60 to 80 ounces of fluid per day. That can be water, milk, or juice. I have had a few patients improve some of their symptoms after elimination of dairy products, but most do not demonstrate a difference.
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