After almost a decade of maintaining it underneath wraps, Olympic medalist Katie Ledecky has shared her POTS prognosis with the world.
The athlete, who has gained 14 Olympic medals for swimming, probably the most of any feminine Olympian, mentioned she has POTS (postural orthostatic tachycardia syndrome).
In “Simply Add Water: My Swimming Life,” Ledecky’s new memoir, which was printed by Simon & Schuster in June, she wrote that the illness could cause “dizziness, fainting and exhaustion.”
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This is extra.
What’s POTS?
POTS is a disturbance within the autonomic nervous system, which controls among the regular regulatory capabilities of the physique, in keeping with Dr. Blair Grubb, a heart specialist and professional on POTS at The College of Toledo School of Medication and Life Sciences.
Katie Ledecky competes within the swimming 400m Freestyle Ladies Heats throughout the Paris 2024 Olympic Video games at La Protection Area on July 27, 2024. After almost a decade of maintaining it underneath wraps, Ledecky has shared her POTS prognosis with the world. (Getty Photos)
“When the individual stands, gravity will attempt to displace downward roughly 20% to 30% of the physique’s blood quantity,” he instructed Fox Information Digital.
In response to this displacement, the mind tells the coronary heart to beat quicker and extra forcibly, and tells the blood vessels within the decrease half of the physique to tighten, or constrict, to 3 instances the extent they have been beforehand, the physician mentioned.
“This permits for accumulation of far more blood than regular within the decrease half of the physique,” Grubb mentioned.
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As extra blood is displaced downward, the mind will get much less and fewer oxygen.
Ledecky mentioned this impact in her ebook. She wrote, “I pool blood within the vessels beneath my coronary heart after I stand. My physique then releases further norepinephrine or epinephrine, which provides further stressors on my coronary heart, making it beat quicker.”
What causes the situation?
People with a genetic trait known as Ehlers-Danlos syndrome (also called joint hypermobility syndrome) look like extra prone to growing this situation, in keeping with Grubb.
“Nevertheless, POTS is continuously triggered by a viral an infection, similar to Epstein-Barr virus or COVID-19,” he instructed Fox Information Digital.
Katie Ledecky reacts after competing within the swimming 400m Freestyle Ladies Heats throughout the Paris 2024 Olympic Video games at La Protection Area on July 27, 2024. (Getty Photos)
Considered one of these infections can set off an autoimmune response, during which the physique’s immune system assaults itself and produces antibodies that intervene with the power of blood vessels to tighten, the physician mentioned.
POTS can even happen by itself, with none apparent triggers.
Signs of POTS
A POTS affected person’s signs will depend upon how a lot blood is displaced downward, specialists say.
“It could possibly differ from delicate instances the place your coronary heart races and also you get somewhat dizzy upon standing, all the best way to presenting as a disabling situation, disallowing sufferers from being upright,” Valerie Iovine, PT, a bodily therapist at Try Bodily Remedy in Philadelphia, instructed Fox Information Digital.
“It could possibly additionally change over the course of life, however can even change each day or week to week.”
“When the individual stands, gravity will attempt to displace downward roughly 20% to 30% of the physique’s blood quantity.”
The dysfunction’s identify — postural orthostatic tachycardia syndrome — actually interprets to “once you turn into extra upright, your coronary heart races,” famous Iovine, who treats many sufferers with POTS and likewise has the dysfunction herself.
“The center will flutter in an try and correctly oxygenate the mind,” she mentioned.
Signs can embrace “disabling fatigue, train intolerance, warmth intolerance, palpitations, lightheadedness, dizziness, fainting and mind fog,” a physician mentioned. (iStock)
“However along with the dizziness, complications, passing out or close to passing out, many with this dysfunction do not understand that it will probably account for different points, like temperature dysregulation, blood strain dysregulation and GI dysfunction.”
In additional excessive instances, sufferers might have issue pondering, concentrating or remembering — typically known as mind fog, in keeping with Grubb.
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Individuals might also expertise blurred imaginative and prescient, black spots of their visible discipline, tunnel imaginative and prescient and headache.
“Even higher displacement of blood could cause the person to lose consciousness,” Grubb mentioned.
Therapies and therapies
The first therapy for POTS is rising water and salt consumption, Grubb mentioned.
“Additionally it is vital to recondition the affected person by means of train, constructing the energy of their decrease extremities,” he mentioned.
Some drugs, similar to midodrine and droxidopa — often known as vasoconstrictors — can work to tighten blood vessels and enhance blood return to the guts, in keeping with Grubb.
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Nonetheless different medication, similar to fludrocortisone or desmopressin, work by rising the quantity of fluids obtainable for the guts to pump.
“Medicines similar to pyridostigmine facilitate nerve transmission and assist the nervous system work extra successfully to keep up regular vascular operate,” Grubb added.
The illness can typically trigger a flu-like feeling after train, one thing known as post-exertional malaise/post-exertional symptom exacerbation (PEM/PESE). (iStock)
Many typically use the time period “train intolerance” when describing signs of POTS, however Iovine mentioned that “poorly prescribed and dosed train” is the issue.
“Exercise is the most effective administration for POTS,” she mentioned.
“I’d argue that for these sufferers, motion is medication.”
In her ebook, Ledecky famous that swimming may be an efficient therapy for POTS, writing that “reclined cardio train, similar to swimming, and strengthening your core, can present aid.”
“For these sufferers, motion is medication.”
Searching for care from a heart specialist and a bodily therapist is crucial, in keeping with Iovine.
The heart specialist can assist to get important indicators like coronary heart fee and blood strain underneath management, she mentioned, whereas a educated bodily therapist can assist to handle signs and enhance upright tolerance.
“Issues like correct hydration, further electrolytes, and with the ability to maintain cool can even assist handle signs,” an professional suggested. (iStock)
“Issues like correct hydration, further electrolytes, and with the ability to maintain cool can even assist handle signs,” Iovine suggested.
“The warmth will make the blood vessels develop, making it more durable to get the blood up the top towards gravity,” she mentioned.
How POTS impacts athletes
“POTS generally is a problem for anybody — from folks with sophisticated pre-existing circumstances, all the best way to the highest athletes, like Katie Ledecky,” Iovine instructed Fox Information Digital.
The illness can typically trigger a flu-like feeling after train, one thing known as post-exertional malaise/post-exertional symptom exacerbation (PEM/PESE).
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“That is when the autonomic nervous system can have a reflexive response to stress or train, both making present signs worse or creating a brand new host of points in folks with POTS,” Iovine mentioned.
“This could pose a difficulty within the sense of rigorous train for an Olympic athlete — or in different instances, exertion could also be so simple as getting off the bed and strolling to the kitchen.”
Whereas there isn’t any treatment for POTS, many sufferers are capable of handle their signs and return to their each day actions with the assistance of a care group. (iStock)
POTS causes a “dynamic incapacity,” Iovine famous.
“In the future, it might assist you to swim like an Olympic athlete, and different days, [it will] have you ever caught in mattress and even in a wheelchair.”
POTS is especially difficult in athletic actions that contain frequent “begin and cease” actions, similar to basketball, volleyball, soccer and discipline hockey, added Grubb.
‘An actual sickness’
Each specialists emphasised that POTS is a “actual sickness.”
“Individuals who have been beforehand fairly wholesome develop extreme limitations and disabilities,” Grubb mentioned.
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“They’ll expertise disabling fatigue, train intolerance, warmth intolerance, palpitations, lightheadedness, dizziness, fainting and mind fog.”
Iovine mentioned that as a result of “invisibility” of the illness mixed with the excessive coronary heart fee and variability of shows, it’s typically dismissed as a operate of psychological well being.
“In the future, it might assist you to swim like an Olympic athlete, and different days, have you ever caught in mattress and even in a wheelchair.”
“Sufferers are sometimes turned away from correct care, made to consider it’s all of their heads,” she mentioned.
“POTS is a really actual situation, and the excellent news is that there are very actual administration methods as nicely,” Iovine went on.
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Whereas there isn’t any treatment for POTS, many sufferers are capable of handle their signs and return to their each day actions.
Added Iovine, “Construct up your care group and your confidence to advocate in your well being and maintain to your regimented routines for administration.”
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