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Katie Ledecky, the renowned Olympic swimmer, has publicly revealed her struggle with postural orthostatic tachycardia syndrome (POTS), a condition she had kept private for nearly ten years.
With an impressive collection of 14 Olympic medals to her name, Ledecky shared her diagnosis in her memoir, “Just Add Water: My Swimming Life,” published by Simon & Schuster in June. In her book, she described the debilitating symptoms of POTS, which include “dizziness, fainting and exhaustion.”
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Here’s what you need to know.
Understanding POTS
POTS is characterized as a disorder of the autonomic nervous system, which plays a critical role in regulating bodily functions. According to Dr. Blair Grubb, a cardiologist specializing in POTS at The University of Toledo College of Medicine and Life Sciences, this condition manifests when blood flow is improperly regulated upon standing. As a result, the brain perceives reduced blood volume reaching it, prompting the heart to react by increasing its rate and strength.
“Gravity displaces approximately 20% to 30% of blood volume downward when a person stands,” Dr. Grubb explained to Fox News Digital. To counter this, the brain signals the heart to pump faster and constricts blood vessels in the lower body to compensate.
As Ledecky noted in her memoir, her body compensates by pooling blood when she stands, leading to further complications and increased stress on her heart.
Causes of POTS
While the presence of Ehlers-Danlos syndrome, a genetic connective tissue disorder, can increase susceptibility to POTS, various triggers can instigate its onset. Dr. Grubb pointed out that viral infections, such as Epstein-Barr virus or COVID-19, are common precursors for developing POTS. Infections may provoke autoimmune responses where the body’s immune system mistakenly targets its own tissues, impairing blood vessel constriction.
In some instances, POTS may arise without any identifiable cause.
Recognizing Symptoms
Symptoms of POTS can vary significantly among individuals, depending on the severity of blood displacement upon standing. According to Valerie Iovine, a physical therapist at Strive Physical Therapy in Philadelphia, manifestations can range from minor dizziness to debilitating conditions that prevent patients from maintaining an upright position. She emphasized that symptoms might also fluctuate over time, impacting daily living.
Iovine explained that the disorder’s name—postural orthostatic tachycardia syndrome—reflects its essence: upon standing, the heart rate accelerates. Symptoms commonly reported include severe fatigue, exercise intolerance, headaches, dizziness, fainting, and cognitive difficulties often referred to as brain fog.
Additionally, more severe blood displacement could lead to loss of consciousness.
Treatment and Management
Increasing water and salt intake is the cornerstone of managing POTS, as per Dr. Grubb. Patients are also encouraged to engage in targeted exercise to strengthen their lower extremities. Medications such as midodrine and droxidopa, which help tighten blood vessels, may be beneficial, along with others aimed at enhancing blood volume.
Iovine highlighted that appropriately prescribed exercise is crucial. Ledecky herself mentioned that swimming serves as an effective therapeutic avenue, promoting both aerobic fitness and core strength.
“For many patients, movement is medicine,” said Iovine, underlining the importance of physical activity in managing POTS symptoms.
Collaboration with healthcare professionals, including cardiologists and physical therapists, is vital to effectively managing the condition. Proper hydration, electrolyte balance, and staying cool can also alleviate some symptoms associated with POTS.
The Impact on Athletes
POTS presents distinct challenges for athletes, including elite competitors like Ledecky. Iovine explained that the condition can cause adverse reactions through exercise, leading to increased symptoms or new issues arising from physical exertion. This dynamic can affect training regimens and performance.
“POTS causes a ‘dynamic disability’,” noted Iovine, explaining that on some days, affected individuals may compete at peak levels, while on others, they might struggle with basic activities.
Recognizing POTS as a Valid Condition
Experts assert that POTS is a legitimate health issue worthy of recognition. Grubb emphasized that previously active individuals can encounter debilitating limitations due to this illness. Iovine added that the “invisibility” of the disease often leads to misinterpretation as purely mental health issues, with patients facing skepticism from medical professionals.
“POTS is a very real condition, and fortunately, there are effective management strategies available,” she noted.
Despite the absence of a cure, many individuals can manage their symptoms with appropriate care and support. Iovine encouraged building a supportive healthcare team and advocating for one’s health to navigate the complexities of POTS effectively.
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