Coping with Upright Posture

When humans stood upright for the first time s/he faced physical challenges four legged animals did not have to deal with. Assuming an upright posture resulted in positioning of the heart much higher than the legs and the brain even higher. This upright posture presented the circulatory system with new physiological challenges. The circulatory system had to figure out how to move blood from the legs against gravity all the way up to the all-important brain. When the body is upright, both during standing and walking, the circulatory system is most stressed. How can the body move blood up the legs against gravity? Returning blood from the legs back to the heart is a challenge even among normal individuals. Returning blood from the legs back to the brain is an even greater challenge.

Rather than having diseased organs, POTS represents autonomic dysfunction, failure of several of the automatic bodily functions that are responsible for maintaining upward circulation of blood while upright. POTS can best be compared to an adolescent with a newly acquired body (tall structure) that has grown quickly … but, the building’s electrical wiring system (automatic functions) has not yet matured fully and is not functioning properly. Normal complex biologic processes (automatic bodily functions) have the responsibility to return blood from the lower body to critical organs like the heart and brain. When not functioning properly, as occurs in POTS patients, excessive blood accumulates in the lower abdomen and lower limbs rather than immediately returning to the heart to recirculate. What’s required is a reliable nervous system that is able to automatically and immediately respond to this relative volume shift – step-in and initiate mechanisms to increase heart rate, vascular tone and ultimately cardiac output.

POTS is characterized by rapid heartbeat when standing upright. The primary symptom complex consists of orthostatic (standing upright) intolerance, the body’s difficulty adjusting to the upright position. Rapid heart rate occurs upon assuming an up-right posture or standing position and reverses slowly when sitting or reclining. Additional criteria required to establish the diagnosis of POTS include the presence of symptoms related to gravitational shifting of blood to the lower body, decreased cardiac output and sympathetic nervous over-reactivity. Practically all of the bizarre symptoms experienced by patients with POTS are directly related to this diminished blood supply to the heart and brain. Among the most common symptoms are fatigue, headaches, light-headedness, eye and abdominal disturbances. Symptoms may be constant or fluctuate from day to day or week to week. To establish this diagnosis, symptoms usually occur daily and need to have been present for at least 6 months.

Dr. Scheldon Kress is a specialist in Internal Medicine with over 30 years of clinical experience caring for patients and pioneering behavioral management strategies to help patients make healthy lifestyle changes with respect to weight loss, stress management, diabetes management and smoking cessation. Passionate about helping patients manage difficult to diagnose medical conditions, he became interested in POTS when several family members and friends struggled with the symptoms, proper diagnosis and effective management of POTS.

Observing the challenges of POTS first-hand, he began to provide POTS patients and their families with a better understanding of causes and potential treatments, while at the same time teaching them how to utilize an effective behavioral change program to manage their POTS symptoms. This self-directed program is a must-read for patients and families dealing with POTS to empower them to take back their lives and achieve POWER over POTS.

Five Star Reviews

Extremely helpful and informative

My daughter has been suffering these symptoms for months. She, like many others, has been misdiagnosed with neurological diseases and mental illness. Even with her heart rate being 30 beats different and multitude of symptoms, doctor was still skeptical because of her blood pressure not changing. Doctors are not educated on this syndrome and it’s extremely hard to find one that is. This has brought a lot of stress to our family, however, as her mom, I persevered, held my own and kept on researching. I came across POTS, educated myself and now we know what’s wrong and how to fix it. This book was one of the books to help us get there. Thank you for publishing this extremely helpful information!

- Praha2014, Amazon

I would like to thank Dr. Kress for writing this book and bringing much needed attention to this illness. POTS is something I have struggled with for many years and I appreciate how thorough and descriptive the book is. The first part of the book expertly describes the ins and outs of finding a diagnosis and how to recognize POTS in a patient. The second section of the book is perfect for families trying to navigate the lifestyle changes that a patient and the rest of the family go through in order to make recovery easier. The book covers all the bases for someone who is looking for more information about POTS. I will most definitely be sharing this book with friends and family and continue spreading the word of this most amazing book.

- Mary Beth, Amazon

The Best POTS Book Available!

This book was extremely helpful in helping my family understand and navigate POTS. The medical information is outstanding and the explanations for the behavioral changes necessary to improve POTS symptoms are easy to understand. I would recommend this book to anyone who is interested in learning more about POTS or wants to lessen their POTS symptoms to feel better. It really is a fantastic book and I like that it is written by a medical doctor who really understands how POTS affects every aspect of a patient's life.

- Angelina, Amazon

This book was incredibly helpful in educating me and helping me manage my child's difficult medical condition.

- Karen, Goodreads

Additional Information

I hope you find my book to provide helpful information on the subjects discussed. The book is not meant to be used, nor should it be used, to diagnose or treat any medical condition. For diagnosis or treatment of any medical problem, consult your own physician. The publisher and author are not responsible for any specific health needs that may require medical supervision and are not liable for any damages or negative consequences from any treatment, action, application or preparation, to any person reading or following the information in this book. References are provided for informational purposes only and do not constitute endorsement of any websites or other sources. Readers should be aware that the websites listed in this book may change. The author is no longer in private practice and not in a position to respond to any medical inquiries.