For the past five years, I felt like I was going to lose consciousness any time I was walking or standing. After a year of not passing out, I just tried to ignore the feelings of death and sit whenever possible.
I never strongly pursued autonomic testing, because I hadn’t heard of any appealing dysautonomia treatment options. While beta blockers can lower heart rate and blood pressure, they also can increase mast cell activation. IV fluids always lessen my overall symptoms, but my veins are difficult to stick and react very painfully to IVs. (Drinking water is not as effective.) My symptoms never outweighed the risks of a port or PICC line, a convenient way to deliver fluids and medications.
After autonomic testing, my new MCAS specialist recommended fludrocortisone, a medication that helps control the sodium and fluids, to address my “heavy” feeling, which I was beginning to recognize throughout the day thanks to the tilt table. On the internet, I read that fludrocortisone can raise your blood pressure. My blood pressure spikes when I stand, so I worried the medication would only make it worse. I decided to try it anyway.
My first agility competition on fludrocortisone seemed unremarkable at first. I sleepily walked the course and warmed up my poodle. When it was our turn, we crushed it, winning first place. Maybe a coincidence, I thought. I celebrated with my friends, but something felt off.
I COULD FEEL MY LEGS.
Remember how I didn’t know my legs were numb from the tilt table until I laid back down? I didn’t know I’d been running agility on numb legs until I took the fludrocortisone. My legs didn’t throb and swell afterwards. I leisurely visited with my friends. I took my first picture holding my dog while standing.
And then I realized Quixote and I had just qualified for the AKC National Agility Championship!
BUT WAIT, SO THIS WHOLE TIME I DIDN’T HAVE BLOOD IN MY LEGS?!
I squeezed my 11-year-old pup and fed him some extra chicken. Then I continued to fume.
SOOOO EVERYONE HAS BLOOD IN THEIR LEGS?! AND NOBODY TOLD ME WHAT IT FEELS LIKE! WHAT ELSE AM I MISSING?
Turns out, all organs like blood and oxygen. I had never considered low blood volume might be my problem. My blood pressure actually decreased, probably because my body had been overcompensating from hypovolemia. Over the next few weeks, I felt like I was learning to operate a new body. I really underestimated the impact of dysautonomia on my poop tube. My muscles still brace for pain when I go to the grocery store and I have to remind myself my strength has improved.
AND OH YEAH, TEAM QUIXOTE IS GOING TO THE AKC NATIONAL AGILITY CHAMPIONSHIP IN TULSA ON THURSDAY!
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May 2021 Update: MCAS remission eliminated my dysautonomia symptoms completely. Dr. Weinstock estimates MCAS accounts for 1/3 of POTS cases. MCAS can increase vasodilation and blood vessel permeability. While fludrocortisone was helpful, addressing MCAS was the key improving my circulation, reducing my heart rate, and lowering my blood pressure.