It’s such a benign question, and probably something you hear several times a week… “how are you?”  The standard and somewhat expected answer is “I’m fine.”  But when you live with a a form of dysautonomia or any chronic illness, you may dread answering this question.

If you answer truthfully, revealing the litany of symptoms you are dealing with at that moment, some people may interpret this as whining or being negative.  “I’m so lightheaded I can’t stand up without losing my vision to a field of grey, I’ve puked twice today, I’ve had a migraine for four days and the pharmacy ran out of my beta-blocker so my heart rate is hovering around 135.”  Speaking the truth about how you are really feeling rarely goes over well, unless you have very understanding friends and family.

If you give the standard “I’m fine” response, this creates expectations that you may not be able to live up to.  Maybe you can’t go Vegas with your college friends this weekend, because you really aren’t “fine.”  If you say “I’m fine,” people may assume you’ve recovered from your illness, because they haven’t grasped the concept of “chronic” illness.

Given how complicated this simple question can be, we asked patients how they deal with the “how are you?” question. Humor and vagueness seem to be popular choices.

“Hanging in there.”
“I’m not dead yet!” in your best Monty Python voice.
“Cured! Just kidding.”
“Meh.”
“No comment.”
“Today is a good day.”
“Good days, bad days.”
“Some days are better than others.”
“The same, but staying positive.”
“Do you want the real answer, or the polite answer?”
“Don’t ask, don’t tell.”
“Same —-, different day!”
“Blessed to be here, but I still feel like —-.”
Ignore the question and ask them how they are doing.
Say “how you doing?” like Joey from friends.  Crack a joke and avoid answering!

However you chose to respond, just be thankful that someone cares enough to ask you!

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Dysautonomia International asked our community to give us their best tips for college students with dysautonomia.  Here are the top 10 tips.

“We’ve learned for my daughter with POTS, no early morning classes to give her time to “get going.” We also met with Student Disability Services at her college– they were so helpful! She’s been able to use a Live Scribe pen that records the lectures as she writes to be able to reference back to the class at the times “brain fog” kicked-in. Her classes are also spaced apart so she doesn’t have to rush so much from one class to another. She’s also able to have water and Gatorade with her in class. We’ve learned a lot together through it all!” -Caryn Williams

 “Talking to your teachers at the beginning of the quarter/semester is a must in my opinion. I always showed up in their office the first week of classes. I would made copies of my doctors’ notes for them and offer it to them. Some took it, and some didn’t. I would briefly explain my condition and allow them to ask questions if they wanted. If I was having trouble finishing a paper on time due to brain fog or a bad flare up I would email my teachers and let them know before the paper was due. 95% of the time the teachers would volunteer to let me turn in it late, or make some other arrangements for me. It’s also really helpful if you can make friends in each class and exchange info that way they can let you know what you missed if you aren’t able to be there.” -Heather Applebury

“I found that if I study whenever I could and never crammed. I could always get enough sleep. I graduated Magna Cum Laude in Physics. Brain fog isn’t impossible!” -Lorin Bales

“Let go of expectations. It’s impossible to do all of the things people expect of you and all of the things you expect of yourself without becoming completely exhausted. Going through college with POTS is hard, and it’s ok if you can’t do everything. Don’t feel bad if you need to miss class, can’t go out with friends, or even have to take some time off. Chances are, you’re still doing a great job.” -Rachel Leeds

 “Always carry a giant water bottle and salty snacks with you.” -Emily Coday

“I start all my assignments super early. That means even opening a word document and typing the header for a paper if I’m feeling absolutely terrible. It helps me gauge how much I have to do.” -Zack Orban

“Be careful about drinking alcohol — IF you have your mind made up that you are going to, drink at least 8oz of water for every alcoholic beverage.” -Maggie Clore

“Use a roll-around backpack for those heavy books and fluids.” -Lorin Bales

“Seek support from your school’s counseling center. Navigating college with chronic illness can be quite draining at times, and it is very important to take care of your mental health. Access to the counseling center is included in your tuition, so it cannot hurt to check it out! Sometimes having someone to talk to can make all the difference.” -Cassidy Celeste

“Before the school year begins or as soon as the semester begins, meet with the campus health clinic staff to talk to them about dysautonomia or POTS. Let them know you may not need their help managing your dysautonomia or POTS, but if you do, you want to be sure they are familiar with the condition and comfortable providing the assistance you need. Give them contact info for your good dysautonomia doctor, if you have one, and give them some journal articles from Dysautonomia International’s website about your condition.” -Micha Freeland

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Seven years ago this week, I woke up sick with acute dysautonomia symptoms. I had no idea what was going on with my body and it was rather terrifying. Life’s challenges teach us the greatest lessons, so I decided to write my 2010 self a letter sharing some of what I have learned so far.  -Lauren Stiles

Dear January 2, 2010 Me,

You went to sleep last night after a thrilling day of skiing and dancing until the wee hours of the morning, laughing to the point of exhaustion with good friends and loved ones. You had a nearly perfect day. But something terrible is about to happen. It won’t make sense to you at first, but the snowboarding concussion you sustained two days ago is about to wreak havoc on your whole body for years to come.

By the end of this week, you won’t be able to stand up without fainting. You will have trouble breathing, stabbing chest pains, and your GI tract will essentially stop working. Don’t be afraid. You will be OK, eventually, but you are about to begin a difficult journey. Dig deep into your soul to find your strength and resilience, because you’re going to need it.

Over the next two years, you will get to know the ceiling tiles in the local Emergency Room quite well. You will go to many doctors asking for help, but most of them will not help. Some won’t know how to help you, despite their best efforts. Others will cast doubt on you, suggesting that your symptoms are “all in your head.” Do not waste your limited energy being angry with them or trying to change their minds. This is a reflection of their ignorance. You deserve better. Keep searching until you find doctors who believe you, who want to help you, and who have the expertise needed to help you. You will find them, eventually. Do not give up searching for answers, even when you are told to do so.

Trust your gut instincts. After being told over and over again that you are wrong, you will have feelings of self-doubt, but do not let anyone take away your self-confidence. Everything that you feel in your gut turns out to be correct. Remember than no one knows your body better than you do. You’ve lived in it for 31 years.

As weeks turn into months, you will go from a curvy size 12 to a barely size 2. At first, you won’t mind having to borrow trendy clothes from your younger, skinnier sister. But soon you will realize this is not a healthy weight loss. Your GI tract will not properly absorb nutrients or fats. Always a hearty eater, you will enjoy increasing your caloric intake to 4,000 nutrient dense calories per day – loading up on beans, peanut butter, almonds, meat, protein shakes – it doesn’t matter, you will keep losing weight. Your doctor will assume you have an eating disorder, even though you are doing everything humanly possible to gain weight. Your hair will start falling out, but you will get it back, eventually.

As the months wear on, you will find out who is a true friend and who is merely window dressing.  While it is certainly unpleasant to learn that you do not really matter in the lives of some people you thought you mattered to, consider this a blessing. In your life, version 2.0, you will be able to focus on relationships that bring you as much joy as you put into them.

Your love of science will play an important role on this journey. Ignore those who tell you to stop reading medical journals, and those who insinuate that you are not intelligent enough to understand what you are reading. Not only will your insatiable curiosity lead to you figuring out your own diagnosis, it will lead to you conducting medical research and publishing journal articles. You won’t believe this right now, but you’re going to lecture at Harvard Medical School someday. Keep reading. Keep asking questions. Do not be afraid to venture into the intellectual unknown.

Since it will be hard for you to sit upright or walk, your body will become very deconditioned, and this will make you feel much worse. Reversing this will be one of the hardest things you’ve ever had to do, and it will be a constant battle to prevent it from returning. The sooner you get started, the better. People will tell you to push yourself, and you will get very annoyed at them, because you think they don’t understand. They may not understand, but I do, and I’m telling you they are correct. You will never get where you want to be if you don’t push yourself with every ounce of your being. After you get your strength back, you will have to learn when to push and when to rest. It is not something that can be taught, at least not to you, because you are stubborn like your grandmother.

You will feel as though your world is falling apart, and it will. This illness will place tremendous burdens on your health, your marriage, your family, your career, your finances, and your social life. Life as you know it will be shattered, and you will have to work very hard to put the pieces back together again. Every piece of your life you reclaim will feel like a little victory. This will teach you to appreciate every blessing in your life; every moment will feel like a gift. You will rejoice at simple things that once seemed like a chore. The first time you are able to go food shopping by yourself again, you will find yourself crying tears of joy in the produce aisle. You will learn to appreciate the ants crawling in the grass on a sunny day. Sitting in your garden will preserve your sanity when you can do little else.

Your dog will be your most loyal friend during this whole ordeal. She will lay by your side day and night, giving extra kisses and snuggles when you are blue. She will keep you company when you need it. You will feel very alone at times, but you will eventually meet many new people along your journey. You will find a second family of people just like you.

When you can no longer practice law as you once did, you will feel as though you have lost your identify. You will always be a lawyer, but this identify crisis will help you figure out who you really are. At first, without the hustle and bustle of your former life, you will feel like nothing. But everyone is something, and that something is entirely up to you.

You will learn another hard lesson – that improving your health is largely in your own hands, even when you have the best doctors and best medicine available. This is an intimidating and at times frightening responsibility to accept, but the sooner you embrace it, the sooner you will realize how empowering it is.

You may not believe me for some time, but I promise this gets easier. Let go of the past, because you can’t get it back. Look towards the future and create new goals for yourself. Be thankful for the good things in your life, and no matter what happens, just keep swimming.

Love,
January 2, 2017 Me

PS – Don’t eat your mother’s meatloaf on August 14, 2012. Trust me.

PPS – At the risk of creating a galaxy destroying paradox in the space-time continuum (which we learned about in Back to the Future), I’m going to save you from two years of misdiagnosis hell and let you know that your concussion caused POTS and Sjogren’s. Find an autonomic neurologist named Kamal to get a proper diagnosis, and learn to love salt.

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We all know that Santa Claus visits millions of children around the world on Christmas. But what about his health? How is he doing?

Santa’s medical chart says he’s a 1,746 year-old married male with a jolly disposition.

He consumes an excessive amount of cookies and milk at least one night per year, but his big black belt with a few extra notches suggests he’s probably a cookie fiend all year long. While Santa’s big belly is part of his lovable charm, his extra weight puts him at risk of hypertension and diabetes. 25% of all diabetics develop autonomic neuropathy, especially people who have had diabetes for a long time (like 1700 years…).

Santa may be of Scandanavian descent, which puts him at higher risk of developing celiac disease. If Santa has celiac disease, those cookies will turn him into a jolly old ball of inflammation that can lead to autonomic neuropathy.

Santa’s red flushed face may be simply due to the cold wind he encounters while flying around the globe at high speeds. However, it could also be mast cell activation syndrome, which can occur with some forms of dysautonomia. We think he needs an appointment with Dr. Lawrence Afrin, and in the meanwhile, he may want avoid MCAS triggers (especially reindeer poop!).

Santa was a smoker for the first 1700 years of his life. He quit in the 1980s. Before this, he was often seen with a pipe. Smoking increases the risk of hypertension, stroke and heart disease – all of which involve some element of autonomic dysfunction. His friend Frosty the Snowman still smokes sometimes, exposing Santa to second hand smoke. And let’s not forget the exposure to chimney soot that Santa breathes in every year! Dr. Svetlana Blitshteyn suggests that Santa see his doctor to get screened for lung cancer, given his 1700 year history of smoking and chimney soot exposure. She notes that in rare cases, some forms of lung cancer can cause paraneoplastic syndrome, which can cause dysautonomia.

Santa says his heartbeat feels like jingle bells. Since the heart rhythm is set by the autonomic nervous system, this may be a form of dysautonomia. Santa’s cardiologist ordered a 24-hour Holter monitor to keep an eye on things as he delivers presents this Christmas, but Santa’s insurance company denied coverage for the test. We know who’s going on the naughty list this year!

When Mrs. Claus came down with the same jingling heart condition, the doctor at Snowy Hills Hospital emergency room told her there was nothing wrong and it was all in her head.

Prancer wanted to leave a special present on that doctor’s windshield in honor of Mrs. Claus and all of the female elves who have been treated the same way at Snowy Hills Hospital, but Rudolph convinced him that hosting a physician education course with Dysautonomia International at Snowy Hills Hospital was a better way to educate doctors about jingle heart syndrome and other forms of dysautonomia. Dr. Blair Grubb, being the first to discover jingle heart syndrome when he was four years old, will travel to the North Pole next year to teach the doctors at Snowy Hills Hospital about this complicated and often misdiagnosed condition.

While Santa’s tests results are always normal and everyone says “he looks fine,” he has several risk factors for developing dysautonomia.

You can do your part to keep Santa healthy! Skip the cookies and milk this year, and leave him organic locally-grown free-range kale chips and freshly pressed home-grown almond milk. #KeepSantaHealthy #KaleNotCookies

Happy holidays from all of us at Dysautonomia International! We wish you and your family a joyful holiday season and a happy, healthier new year!

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When a respiratory virus turned into a mystery illness, 16-year-old Hannah Aspden found herself dealing with debilitating symptoms. Daily tasks became difficult, and her normal routines started to fall apart. Three months later, she was diagnosed with Postural Orthostatic Tachycardia Syndrome (POTS).

Swimming has always been a large part of Hannah’s life. Having been born without her left leg, Hannah began swimming at age four. After swimming for twelve years, Hannah has worked her way to the Paralympics. However, keeping up with a rigorous practice schedule in addition to attending school became difficult after her POTS diagnosis.

“In the beginning, I had extreme exercise intolerance which made it impossible to keep up with my usual training schedule,” Hannah said. “Each day can be very different from the one before it. Pushing through the aches and pains and “uncontrollables” has been difficult, but to me, it is worth it.”

Like many POTS patients, it took time for Hannah to adjust to her new normal. As she dealt with her new diagnosis, she tried to focus on both her school work and swimming. Many POTS patients find school difficult, especially the early mornings when symptoms are often worse. For Hannah, her symptoms included difficulty with concentrating and memorizing facts. However, according to Hannah, her symptoms are “definitely a lot better now” than they were when she was first diagnosed.

A regime of medication, increasing salt and fluid intake, and exercise has improved Hannah’s symptoms. Throughout it all, she remained determined to continue swimming.

After countless hours of practicing, Hannah made it to the Paralympic trials, which determine which athletes will compete in Rio this summer. When she was at the trials, Hannah said she repeated the phrase ‘Just keep swimming…just keep swimming…what do we do? We swim’ from Finding Nemo to remind herself to keep going even when things were difficult.

“I tried to set an example and encourage those newer swimmers to just follow their hearts and have fun with all of it,” Hannah said. “And of course, I was really hoping to swim well enough to make the team for Rio.”

In Rio, Hannah will get the chance to meet with athletes around the globe. In addition to representing the United States at Rio, Hannah is excited to represent parathletes.

“The experience of being there with Team USA and getting the incredible opportunity to represent my country on such a large stage is what I am most excited for,” Hannah said. “Spending time with my teammates and coaches, racing, and learning as much as I can will be so much fun! Helping progress the Paralympic Movement here in the U.S. is truly something I am blessed to be a part of.”

Throughout everything she has experienced, Hannah’s perseverance has pushed her forward. Her love for swimming and acknowledgement of the support she has encouraged her to ‘just keep swimming.’

“Knowing that my passion for swimming hasn’t faded through the years is such a motivation to keep going,” Hannah said. “I’ve been given a very rare and wonderful opportunity in life, and it gives me the chance to represent my country, my team, and all that we stand for. It is something that I could never take for granted. Knowing that I have teammates, coaches, family, friends, and others I may never have even met that support me unconditionally really means the world.”

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13-year-old Will Kenney and his mother Sandy Kenney recently reached out to Dysautonomia International with a unique proposal. They wanted their third annual “Will’s Carnival for a Cause” at Chick Berry Farms in Laurel, Delaware scheduled for August 6, 2016 to benefit Dysautonomia International. We caught up with Will recently to learn about Will’s inspiring efforts.

Q: How did you come up with the concept for Will’s Carnival for a Cause?
A: In January 2014, I decided that I wanted to do something productive with my summer break instead of watching TV and playing video games. My mom was sharing Facebook posts about a two-year old girl, Stella, who has Sturge Weber Syndrome. Stella and her family donated the book “Sam’s Birthmark” to local schools and libraries and super hero capes to children at A.I. Dupont Hospital. Stella and her family inspired me to want to help raise awareness and funds for the Sturge Weber Foundation. I also wanted to organize an event that Stella could enjoy. That’s how I decided to host the first Carnival.

Q: How long have you been organizing this event?
A: This year’s Carnival is my third event. Planning for the Carnival takes approximately six to nine months.

Q: What made you want to add Dysautonomia International as a cause you wanted to support this year?
A: The Carnival has been a huge success for the past two years, raising over $15,000 to benefit the Sturge Weber Foundation and raising much needed awareness.  I have a friend, Rita Chandler, who helped with the Carnival last year, who has postural orthostatic tachycardia syndrome (POTS). One of my mom’s cheerleaders, Crystal Caldwell, also has POTS. I had never heard of POTS before, so I reached out to Dysautonomia International to learn more.  After learning about POTS, I decided to include Dysautonomia International as one of the organization’s we’re raising money for this year.

Q: What kind of attractions do you have at the Carnival?
A: The Carnival features games, a petting zoo, a hayride, pony rides, a duck train, a DJ, a bounce house, a dunking booth, food, face-painting, and a silent auction. The first Carnival had 16 games and the second Carnival had 23 games. I am planning on expanding this year’s Carnival to include seven new games, more entertainment, and rides. I am working on making the Carnival bigger and better to support the causes that are important to me.

Q: How many people attend the Carnival?
A: The first Carnival had 150 guests, and the second Carnival had 300 guests. During both years, I had about 50 volunteers helping with the event.  We hope even more people will come this year!

Q: Do you have any advice for other teens who want to start a fundraiser for Dysautonomia International?
A: Organizing and planning a fundraiser for an organization gives you a rewarding feeling because it gives you a chance to help and make a difference for so many people in need. I recommend thinking about an event that the community would enjoy and also one that would be fun to plan. I have a notebook that I use to continuously jot down ideas until I am ready to approach each one of them individually. Also, remember to get your community involved. Last year, we invited Miss Delaware, Brooke Mitchell, to join us at the Carnival. She was excited to be a part of it, meet the attendees, sign autographs. My local Councilman, Rob Arlett, volunteered to get in the dunking booth. I also recruited my football team and coaches to help. The football players especially loved it because they were helping move a great cause forward. My coaches also got in the dunking booth which was doubly fun. The Carnival has been so much fun to plan and it was a great way to meet a lot of wonderful people.

Q: If someone wants to donate prizes or volunteer during this year’s event, how can they contact you?
A: You can make a silent auction donation or a prize donation for the children’s games by contacting me via my Facebook page, Will’s Carnival for a Cause. You can also email me at skenney86@yahoo.com. I am looking for rides and entertainment such as clowns, magicians, jugglers, etc. I welcome all your ideas and help!

Q: How can people attend the event? Do they buy tickets in advance and/or on site? How can we learn more about or get involved with Will’s Carnival for a Cause?
A: To learn more about Will’s Carnival for a Cause, like and follow my Facebook page. I am very excited about this year’s Carnival. The Carnival is scheduled for August 6th, 2016 from 4pm-7pm. It will be held at Chick Berry Farm in Laurel, Delaware. Wristbands are $10 each which covers children’s games, rides, and activities or tickets are $.50 each. Wristbands and tickets can be purchased on site at the Carnival.

As my friend Ruth Ann Marvel said, “Raising money is great, but raising awareness is priceless.” And, as I have learned, one person can’t move a mountain, but a village can. So, come be a part of my village.

We love this kid. Thanks Will, we’ll see you on August 6th!

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Last month we introduced you to the 2016 Dysautonomia International Summer Research Interns.  This month we’re pleased to announce that Ms. Emily Deaton will be interning with Dysautonomia International’s Board of Directors this summer, helping with writing projects, educational programs, web development, conference planning, and more.

Q: Tell us a little bit about yourself.
A: My name is Emily Deaton and I’m majoring in English with a minor in nonprofit studies at James Madison University in Harrisonburg, Virginia. I’m 20 years old and have lived in Virginia for most of my life. I love writing, editing, and spending time with my family (and pets).

Q: What motivated you to get involved with Dysautonomia International?
I’ve had POTS for four years, and Dysautonomia International was one of the first resources I came across when I got diagnosed a year after getting sick. Ever since then, I’ve tried to learn as much as I can about POTS and have worked to advocate for myself and for others with POTS and other chronic illnesses.

Q: How do you balance your school and work activities with your health?
A: It’s difficult! I’ve had to learn when I can push myself and when I need to take a step back to skip out on a social event to ensure I can go to class the next day. There will still be days where I push myself too hard and have to pay for it the next day (or three). Having a supportive network of friends and family has made all of this much easier, however, and I’ve also been lucky to have professors who have accommodated me.

Q: What are your plans after college?
A: I want to continue to advocate for those with chronic illnesses. I’d love be a copy writer at a nonprofit in order to educate others about how to be as well as possible while living with life-altering conditions.

Q: What do you hope to get out of the Dysautonomia International Internship?
A: I’m looking forward to learning the ins and outs of a nonprofit, and I’m also hoping to learn how to better reach people who are in need of resources to better deal with their condition(s). I want to be able to use my communication skills to connect with patients and educate people who are unaware of what dysautonomia is.

Q: If you could give one bit of advice to a newly diagnosed patient, what would you want them to know?
A: Know you’re not alone. There will be good days and bad days, but you will learn to live a new normal. Seek support from doctors, friends, and family; you know your body best, so trust your intuition. If you need to rest, know it’s okay, and you can still live a meaningful and happy life.

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When I was twelve years old, I became sick with the H1N1 flu virus, walking pneumonia, and mononucleosis all within three weeks of each other. Because of this, my body stopped being able to regulate my autonomic nervous system and I was diagnosed with Postural Orthostatic Tachycardia Syndrome (POTS). Subsequently, doctors found that I also had Ehlers-Danlos Syndrome (EDS) and mitochondrial disease, which I had from birth, but had gone undiagnosed. I was told these illnesses are chronic, and I will have them for the rest of my life. Coping with this was very difficult, especially because I was too sick to go back to school. If I never had these experiences, I would have never become the strong person I am today, and this is why I want to share my story.

I was bedridden for three years, and during this time, I was barely able to do any schoolwork, let alone go out and be with my friends. This was the most difficult time of my life, not just physically, but emotionally. When I first got sick, I received get-well-soon notes from my entire grade, and people would visit on the weekly basis. But as time went on, people moved on, which now looking back on it, makes sense. But at the time, it was utterly heart-breaking. I still am so grateful for those that were thoughtful enough to stay in contact with me, and I no longer hold any ill-will towards those that I considered my best friends, who seemed to just stop caring one day.

Back then, I thought it was all their fault, and if my friends really cared about me, they would stop by, or at least text.  Now, I realize I wasn’t helping the situation either. I was so depressed that I would never initiate the conversation. I would never send a message on Facebook to my best friend of six years and say, “Hey! How are you doing?” Or call them up just to see what the latest gossip was in middle school. I was so paranoid (because of so many doctors telling me that I was “faking it” and that “I wasn’t really sick”) that I had it stuck in my mind that the reason my best friend “abandoned me” was because her parents were doctors and they told her that I wasn’t really sick.

Needless to say, that friendship faded, along with many others. And because of this, most of my interactions with other people were all medically based, whether that be with doctors, therapists, or community groups. After a while, I forgot what it meant to be human, and all I knew was my illness ⎼⎼ I was my illness. I could name the latest and greatest of what was happening in the medical world, which doctors were becoming more or less popular, and which medications “were looking promising for individuals that experience certain POTS symptoms.” I don’t think I need to even say that after three years of this, if you put me in a room with healthy teens my age, I would be completely lost.

Finally, that day did come, and it was on my first day of high school. I went into my first day freshman year thinking I was the coolest person ever, and that I would rule the place. I thought I would have an advantage over the rest of my class because I had already done 9th grade once, and I would be older and much wiser than everyone else. This was not the case, in either aspect.

My family and I wanted to find a high school that would be fit to all of my needs ⎼⎼ small class sizes, understanding teachers, and NO STAIRS ⎼⎼ and The Nora School fit perfectly. They were nice, accommodating, and I fell in love. I thought the transition would be a breeze. To a certain extent, I was right. I got along with all of my teachers splendidly, and the administration loved me. The students, well… that took some work. Now let me get this straight, The Nora School is a family, and I never got a sense of anything different, but making friends can be hard, especially when you have been out of practice for a while.

Like I said earlier, I had lost contact with most of my friends when I was 12, and at this point, I was 15, so not only did I not know how to talk to teenagers, but I was crippled by the fear of being abandoned by them when I eventually told them of my illness. So with this in mind, I did my best to “act normal” in my first few days of school. This did not work out well. Not only did I not know how to “act normal”, but I also was completely unsure of what “normal” was for a teenage girl.

I was annoying, bossy, and a kiss-up my first few weeks of school, according to my now friends. Yes! Did you hear that!? I made friends! It took a while, and the fact that I never saw anyone from school outside of school made it take longer, but I made friends! Honestly it took a few years to build up these friendships to the point where I can say that I will be close with these people far after we graduate high school.

After the first few days of freshman year, when I saw that my humor, and all around good charm of acting like a middle schooler wasn’t cutting it, I started to observe. I wanted to understand the beast that we call “a teenage girl” before I committed to spending time with it. The main thing I observed was that they always are complaining about things, that to me at the time, really seemed like luxuries. In my first week, I specifically remember a classmate talking about how she was “soooo bummed” because she broke her nail and she was having guy troubles. In my mind, I was furious. How could someone like that think that they are having the worst day ever when I was in about ten minutes going to have to go into the bathroom stall and change the padding around my G/J tube because it constantly leaked this smelly, gross, liquid. I couldn’t find myself able to relate at all to what they were saying.

What I did was I find something that we could have in common. Many of you may have heard of the show, Supernatural. It’s great, if you haven’t watched it, like me at the time. The majority of the girls in my class loved the show, so over the course of about three weekends, I binge watched the entire show on Netflix and when I went to school the next day, I had something to talk about with my classmates. This gave me an immediate connection with them that I couldn’t find before. Now, I would take this with a grain of salt, and I am not asking you to go out and do what everyone else at your school does because that could take you into dangerous territory. But, instead of looking at the big picture of a person, and the things you don’t have in common, focus on what you do, and expand upon that. I used Supernatural as my way in, and once I was able to establish a rapore with my fellow classmates, it then became easy to see who I would be able to have that natural friendship with.

It is sometimes difficult to decide when or who to disclose your medical problems to, if at all. Personally, I live by the philosophy of not talking about it unless someone asks. If they do ask, I will be completely honest with them about my experiences. For example, in my first week of high school, I didn’t tell any of my classmates about my condition until one day when we were all supposed to go on a hike as a bonding experience and I had to sit out for medical reasons. My future best friend asked why I wasn’t going on the hike, and I first said, “Well, I have some medical problems that make it hard for me to do physical activity.” Of course, she asked (in a very nice way) what I had, and I told her, and the rest is history.

I found that it is important to always give people a way out of that conversation. You never know what that person may be going though and they might not want to hear your story at that time, and that is totally okay! They may ask if they could talk to you about it later, or maybe they won’t say anything because your brief description is all they needed/wanted to know at that time. Don’t take it personally if they don’t seem interested.

Also, if you don’t feel comfortable talking to someone about your personal medical issues, remember that they are called personal for a reason. We all get so used to going to the doctors and telling them everything. If someone (that is not your doctor) starts to poke around in your business, maybe you should remind them that it is your business. Plus it has always been fun for me to be able to walk down my hallway at school and think, “No one knows. They are the only people in my life that don’t know about my medical conditions and they treat me like a normal person.” It can give you a great confidence boost to be able to get to know people and have people get to know you, not the POTS. All of this being said, if you are going to be in a situation where you might pass out or something, a little heads up to the person you are with is always a nice thing to do.

Going back to school can be very difficult, and the anxiety can be completely crippling. But if you go everyday that you can, you will find that it gets easier and easier, until that fear finally all together goes away without you even noticing it; and in its place friends, learning and fun can become your normal.

Katie Herbert is an 18-year-old POTS/EDS/Mitochondrial Disease patient who was diagnosed at age 12. After being home-bound for three years, she returned to classes full-time for high school and will graduate in June. Katie volunteers for Dysautonomia International and will begin her freshman year at Grinnell College in the fall. 

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Dysautonomia International is pleased to announce our first two summer research internships for college and graduate level students interested in studying POTS.  A talented pool of individuals from across the US and Canada applied for the 2016 Dysautonomia International Research Internship.  After a careful deliberation, two interns were selected – Erin and Julia. Erin and Julia will get to work with one of the top experts in the field this spring and summer, Dr. Hasan Abdallah, Director of The Children’s Heart Institute.  They’ll be working on two very exciting POTS research projects – a long term follow-up study on pediatric POTS patients and study on peripheral vascular resistance in pediatric POTS patients.

In addition to conducting POTS research that is needed right now, we hope this annual research internship program will have other benefits too.  By supporting young scientists and nurturing their interest in POTS research, over the long term we hope to attract more medical professionals and scientists to focus on POTS clinical care and research throughout their careers.  Please consider making a donation to Dysautonomia International so that we can fund additional research interns in the future.

Q: Tell us a little bit about yourself
Erin: I am majoring in neuroscience and biology at Carthage College in Kenosha, Wisconsin. I am 19 years old and lived in Connecticut until I was five. I then grew up in Pewaukee, Wisconsin until I graduated from Pewaukee High School. I have a health and nutrition business and I enjoy teaching classes and sharing better health with others.

Julia: I’m from Scotch Plains, New Jersey. I’m 21 years old and graduating from the University of Miami this May. I majored in Marine Science and Biology and minored in Chemistry and Math.

Q: What motivated you to get involved with POTS research?
Erin: For the past 4.5 years, I have had first-hand experience with POTS. During this time I have attended many doctors appointments and have continuously sought out more information to improve my health. I believe that knowledge is power, and research is one form of knowledge that can have a truly powerful impact. My experiences have led me to develop my own theories as to causes or of underlying mechanisms of POTS which I plan to further research in my future. I am personally invested in and motivated to do research in relation to POTS to better understand myself, but more so to help all of us dealing with this condition or related conditions.

Julia: Because of developing POTS last Spring, I decided not to apply to graduate school until after I graduate so that I have a little more time to adjust to my new circumstances and I’m not too overwhelmed with filling out applications in addition to all of my senior year classes. I’ve always been very interested in research and experimentation and I’m planning to continue doing those things in graduate school and beyond. I’v been involved in research since my freshman year of college and I’m always curious to learn more about all aspects of biology, including mine. That’s why POTS research seemed like a really good pursuit for my gap year. 

Q: How do you balance your school and work activities with your health?
Erin: Over the past few years, I have learned the importance of health and that it really must come first to even allow anything else to be possible. With this being said, it is absolutely necessary to hold myself accountable for what I am capable of doing in terms of work and school and to continuously be pushing my boundaries and capabilities, within good reason of course. Dysautonomia has taught me how to be a better worker and student. Making working out a priority, I better myself and those I invite to join working out with me. Although sometimes exhausting, this gives me the blood flow and energy necessary to think and do well on my school work. By putting my limited energy into the things I care about and am passionate about I am able to find balance, but preparation and focusing on these aspects of life is necessary for me to achieve this balance. Additionally, I have found asking for accommodations and help when I need it is essential to success in all of these areas.

Julia: I can’t do all of the things I used to do at school so it’s been important for me to learn to conserve my energy and push myself at the same time (if that makes any sense). I’ve been able to do pretty much everything I want to do, just in moderation. With the exception of some bad days here and there, school hasn’t been as hard as I thought it would be. There isn’t much work that you can’t get done sitting down or from the comfort of your own bed or couch. 

Q: What are your plans after college?
Erin: After undergraduate schooling, I plan to go to an MD/Ph.D. program and become a medical scientist. I believe that better answers can be found more efficiently when doctors, scientists, and patients work together in a collaborative nature. Having training as both a clinical practitioner and scientist will provide me the foundation to help enhance this collaborative environment with those I work with specifically relating to causes and better treatment options for dysautonomia and other neurological conditions.

Julia: I’m planning on working on some of Dr. Abdallah’s research while also applying to grad programs; I’m applying to Ph.D. programs and hope to continue studying something in the field of microbiology, molecular biology, or evolution. I also really want to spend the next year getting back into good shape and exercising regularly again.

Q: What do you hope to get out of the Dysautonomia International Research Internship?
Erin: I am looking forward to expanding my knowledge in dysautonomia research and learning as much as I can from Dr. Abdallah. I envision learning more research techniques, enhancing my technical writing skills and hope to gain a better understanding of the autonomic system. I hope these skills will help me discover patterns and connections that can provide further understanding into this condition and inspire further questions and theories.

Julia: I’m hoping this internship will give me some good experience working on a project that directly involves people. In the past, I’ve worked with algae, sea urchins, anemones, ctenophores, and sea slugs, so this internship will definitely give me a different  perspective on how to conduct research. I also really want to understand more about POTS as it is something I live with and hope that the work we do will help others learn more about their own situations. There isn’t as much data out there on POTS and there aren’t as many research studies being done yet compared to other conditions so I’m glad I can help keep the momentum going on projects like this!

Q: If you could give one bit of advice to a newly diagnosed patient, what would you want them to know?
Erin: Life can get better if you choose life. You have to choose your best life every single day even though sometimes you may not feel the best. It is so easy to become deconditioned, which can have harsh implications, so choose better health and workout. With this in mind, every aspect of health needs to be acknowledged, so also always respect and listen to your body. There are many people working to help you, and even if they may not be directly in your life right now, they exist, but you may have to seek them out. Some things you cannot control right now, but maybe one day you will be able to or you will be able to manage it better. To become better, you must continuously choose life. Just keep looking and choosing to better yourself until you find these things. Yes, sometimes it may seem impossible but you must try. I’m not saying push yourself past what you are capable of so that you fall backwards, but I am saying you must escape your comfort zone and continuously strive to better yourself and your life. Every day holds something good, so focus on the good more than not. Enjoy the process of improvement and discovery and know that you can make a difference for the next person that comes along and needs some understanding in this regard. But remember you and your health must come first to allow for a great life to follow.

Julia: Make sure you find a good doctor that you personally get along with and trust. It is very easy for doctors with little experience in the POTS world to be dismissive or discouraging or tell you a certain treatment will make you feel better and you just end up being disappointed when it doesn’t happen. It’s totally okay to get a second or third opinion, especially if it gives you peace of mind. It can take a long time and many appointments to find a doctor that “gets it” but it will happen eventually.

Follow Dysautonomia International on Facebook and sign up for our email list to find out about next year’s Research Internship application deadline, and for updates on the research Erin and Julia are conducting with Dr. Abdallah.

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