How to Cope When a Family Member is in Hospice

Posted on March 19, 2025 by Patrick Hercules

Hospice care or end-of-life care is specialized care that provides physical comfort alongside emotional, social, and spiritual support for people nearing the end of life.

The grief we experience while coping with a dying loved one is different than what we experience after someone has died.

Here are some strategies to help both the patient and their loved ones during hospice care:

Understand your grief

Anticipatory grief is the deep sadness felt during the last days of life. It can be felt by both the patient and their loved ones.

Feeling grief while your loved one is still alive doesn’t mean you are abandoning your loved one or giving up. Instead, anticipatory grief can give you a chance to gain meaning and closure you might not have had otherwise.

You may feel like you are somewhere between holding on and letting go. Some people find this very painful. They may feel like they are betraying their loved one if they lean towards letting go. The truth is that it is possible to live with both holding on and letting go simultaneously. You don’t have to choose.

Let yourself feel and grieve

Everyone grieves and responds differently to news about a terminal diagnosis. Anticipatory grief can begin as soon as you’re told a loved one may die soon. You could also experience a delay as you process the information about your loved one’s diagnosis.

Let yourself feel the pain. This helps you to be honest and true with yourself.

Anticipatory grief is not just grief for the coming death of a loved one. It is also grief for other losses that go along with death, such as:

The loss of a companion
The loss of shared memories
The loss of dreams for the future

Sometimes, grief from the past can resurface during this time.

Denying the pain you are feeling can prolong the grief you feel later on. Grief serves a purpose, whether it occurs before or after death.

Researchers have identified four phases and tasks of grief. They include:

Accepting the impending loss
Working through the pain
Adjusting to a new reality where your loved one is absent
Connecting to your departed loved one differently as you move forward

Implementing these tasks doesn’t mean you should give up on your loved one or forget them. Instead, these tasks will help you hold onto the joy and love you once shared. They can also help temper the deep sadness that may make remembering painful.

Don’t go it alone: Express your pain

Trying to stay strong when a parent or loved one is dying can be challenging. Always give yourself permission to feel sad or ask for support from other people in your life.

It is important to let yourself feel your pain. However, many people find it hard to express grief before death. They may feel they are being unsupportive of their loved one. Talking to a trusted friend is a good way to cope with these feelings.

One huge difference between anticipatory grief and the grief you feel after someone dies is that there is often more anger in anticipatory grief. You may also find it more difficult to control your emotions.

Find a friend who doesn’t judge and will let you express anger. This person should be a good listener and should not try to “fix things” or tell you how you should feel.

There is no easy fix for your emotions. However, a good listener can help you feel less alone.

Spend time with your dying loved one

People sometimes talk about how difficult it is to spend time with a dying loved one because they may not want to remember them as they were dying. They may want to remember how the person was before instead.

Spending time with a dying loved one is important for many people. This isn’t just true for the person who is dying, but also for their close loved ones. If you decide not to visit your loved one, you may regret it later.

Find meaningful ways to spend time together. Share old photographs or keepsakes. If possible, ask your loved one to share stories about themselves, family heirlooms, and other possessions. You may find reminiscing to be healing.

Try journaling

Keeping a journal can be healing. It can help you express things you wouldn’t feel comfortable sharing with a friend. A journal can be a place to record thoughts you had around the time of your loved one’s death.

You can also try writing letters. A letter to your dying loved one may also help you say all the things you’ve been wanting to say.

Take advantage of holistic methods of coping

A holistic approach may be helpful for both the person dying and their loved ones. “Holistic” means treating the whole person, including their mental and emotional health. Some of these therapies have been found to help with emotions like anxiety.

A holistic approach can help bring hope and healing to those grieving. Some examples include:

Guided imagery
Meditation
Art therapy
Massage therapy
Qigong, a Chinese practice of meditation and breathing
Music therapy

Nurture your spirituality

Spirituality is important for those who are dying and for their caregivers. Spirituality can take many forms, including:

Organized religion and prayer
Meditation
Communing with nature
Listening to music that is meaningful to you

Studies have shown that people have a better quality of life in their last days if they have an active spiritual life. Caregivers may also experience less depression if their dying loved one has an active spiritual life.

Maintain a sense of humor

There isn’t much room for humor when someone is dying. However, in the right setting, humor can sometimes be healing. One review found a strong benefit of humor in the end-of-life setting. Humor can benefit the person dying and their loved ones.

Practice forgiveness

Forgiveness can be healing. Learning to forgive yourself is just as important as forgiving others.

The time before death is very emotional. There may be anger and resentment among family members. However, it is also a time to resolve differences.

Listening is an important first step toward forgiveness. Sometimes, two people can say the same things, but in different ways. At other times, you may continue to disagree with what your loved one is saying even after talking it through. When this happens, ask yourself this question: “Is it more important to love or to be right?”

Letting go of resentment and pain from the past can be freeing. Give yourself the gift of forgiveness.

Give your loved one permission to die

Sometimes a dying person can live until a specific moment. Some people seem to wait until after a loved one says goodbye. This goodbye can act as permission to die. This can be helpful for the dying person and their loved ones. A goodbye can be a beautiful gift.

Anticipatory grief is a common experience. There are many ways to cope with anticipatory grief, but everyone grieves differently. It is important to allow yourself to grieve.

All content of this newsletter is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions on this page. You must never disregard professional medical advice or delay seeking medical treatment based upon any content of this newsletter. PROMPTLY CONSULT YOUR PHYSICIAN OR CALL 911 IF YOU BELIEVE YOU HAVE A MEDICAL EMERGENCY.

Signs of High Stress

Posted on March 12, 2025 by Patrick Hercules

Stress is a natural human reaction that happens to everyone. Your body is built to react to stress in ways meant to protect you against threats from predators and other aggressors. These threats are rare today, however, that doesn’t mean that life is free of stress.

Stress responses help your body adjust to new situations. Stress can be positive by keeping you alert, motivated, and ready to avoid danger. However, stress becomes a problem when stressors continue without relief or periods of relaxation.

Stressors can be positive and negative; getting a new job or losing a job can cause stress. Other causes of stress include:

An illness or death of a loved one
Marriage, separation, or divorce
Financial issues
Moving into a new house
Going on vacation
Having a baby
Retiring

There are three main types of stress: acute, episodic acute, and chronic.

Acute stress- is a short-term stress that comes and goes quickly. It can be positive or negative. It is the feeling you get when you ride a rollercoaster or have a fight with a significant other. Everyone experiences acute stress from time to time.
Episodic acute stress- is when you experience acute stress regularly. With this type of stress, you don’t get the time you need to return to a calm, relaxed state. Episodic stress frequently affects people working in certain professions, such as healthcare providers.
Chronic stress- is long-term stress that can last for weeks or months. It can be caused by troubles in your marriage, issues at work, or financial problems. It is important to find ways to manage chronic stress because it can lead to health issues.

The body’s autonomic nervous system controls the heart rate, breathing, vision changes, and more. It also triggers the body’s “flight-or-fight” response as a way to react to stressful situations.

Having a continuous activation of this stress response can cause wear and tear on the body. It can cause you to develop stress symptoms that are physical, psychological, or behavioral.

Physical stress symptoms can include:

Aches and pains
Chest pain or the feeling of your heart racing
Exhaustion or insomnia
Headaches, dizziness, or shaking
High blood pressure
Muscle tension or jaw clenching
Stomach or digestive problems
Trouble having sex
A weakened immune system

Psychological stress symptoms can include:

Anxiety or irritability
Depression
Panic attacks
Sadness

Chronic stress can lead to several long-term issues that affect your immune, digestive, cardiovascular, and reproductive systems.

People with chronic stress try different things to cope. Some of these things can become habit-forming and can impact your health. Behavioral stress symptoms can include:

Alcohol use disorder
Gambling disorder
Overeating or developing an eating disorder
Participating compulsively in sex, shopping, or internet browsing
Smoking
Substance abuse disorder

It can be difficult to diagnose stress due to its subjectivity. It isn’t measurable with tests because only the person experiencing it can determine whether it is present and how severe it feels. A healthcare provider may use questionnaires to understand your stress and how it affects your life.

If you have chronic stress, your healthcare provider can evaluate symptoms that result from stress, such as diagnosing and treating high blood pressure.

Stress is something that can’t be avoided. However, you can prevent it from becoming overwhelming by practicing daily stress relief strategies, including the following:

Eating a healthy diet and getting regular exercise and sleep
Doing relaxation exercises such as yoga, deep breathing, massages, or meditation
Keeping a gratitude journal
Taking time for hobbies
Fostering healthy relationships and talking with your friends and family
Finding ways to include humor and laughter in your life
Volunteering in your community
Organizing and focusing on what you need to get done at home and work and removing unneeded tasks
Seeking professional counseling

Embracing mindfulness and learning to manage stress can reward you with peace of mind, fewer stressors and less anxiety, and a better quality of life. If you need the assistance and support of a mental health professional at Jamaica Hospital Medical Center, please call 718-206-5575 to schedule an appointment.

COPD Myths

Posted on March 7, 2025 by Patrick Hercules

Chronic obstructive pulmonary disease, or COPD, is a group of health conditions, such as chronic bronchitis and emphysema, that limit airflow in the lungs.

Many myths and misconceptions exist about COPD. Here are some misconceptions surrounding COPD:

Myth #1: Only people who smoke get COPD

COPD is often associated with smoking, as smoking cigarettes and other tobacco products is the most common cause of the damage done to the lungs and airways. However, nearly 30% of people with COPD have never smoked a cigarette. Nonsmoking causes of COPD include:

Long-term exposure to polluted air, such as smog in an urban area or dust and fumes at a workplace
Genetics plays a role, specifically a condition called Alpha-1 antitrypsin deficiency (Alpha-1)
Asthma that’s active or even inactive. Researchers have found that 29% of people with asthma eventually receive a COPD diagnosis
Childhood respiratory illnesses, such as pneumonia

Myth #2: COPD is rare

According to estimates from the Centers for Disease Control and Prevention (CDC), over six in 100 adults in the U.S. had a COPD diagnosis in 2022.

That means millions of adults across the country have received a diagnosis of COPD. The actual proportion of adults with COPD may be higher due to delays in obtaining a diagnosis.

Myth #3: Exercise is too hard if you have COPD

Shortness of breath, wheezing, a chronic cough, and fatigue can all be a part of COPD. Any one of these symptoms can make exercising challenging.

Moderate exercise may not affect your lungs. In some cases, exercise can minimize the symptoms of COPD while strengthening the heart and helping reduce stress.

Try to build up to 20 to 30 minutes of exercise three to four times a week. Combine safe cardiovascular activities such as walking or biking with stretching and strength-building. It won’t be easy to start exercising. Speak with your healthcare provider about building an exercise plan that works for you. They may be able to connect you with a respiratory therapist for breathing techniques and exercises you can do. It is recommended that you speak to your doctor about your health before starting a new exercise regimen.

Myth #4: Only older people develop COPD

COPD is more common in people 65 or older. However, younger people can also develop this condition.

A 2023 study found that COPD affected more than 1.6% of adults ages 20 to 50 in the U.S. Adults aged 35 to 50 had a higher risk of COPD than those under the age of 35.

A history of smoking or secondhand smoke exposure significantly increases the risk of COPD in young adults.

Myth #5: COPD is a man’s disease

The Centers for Disease Control (CDC) reports that women are more likely to develop COPD than men in the U.S.

More women than men have also died from COPD since 2000 in the U.S.

Exposure to tobacco smoke and other pollutants raises the risk of COPD for anyone; however, women can experience more harmful effects than men from these pollutants.

Women with COPD also tend to get a diagnosis later than men, after the disease has progressed and treatment is less effective. This may contribute to reduced survival in women with COPD.

Myth #6: Nothing can be done to treat COPD

COPD treatments are available to help limit symptoms and potentially slow the progression of COPD.

Your treatment plan can include lifestyle changes like quitting smoking (if you smoke), as well as one or more of the following:

Vaccinations
Medications
Pulmonary rehabilitation
Supplemental oxygen
Lung transplant
Surgery

Talk with your healthcare provider to learn more about your treatment options.

Myth #7: There’s no point in quitting smoking after you develop COPD

Avoiding tobacco smoke is one of the most important things you can do to manage COPD.

If you smoke, cutting back and quitting can help limit symptoms and slow the progression of COPD.

Although more research is necessary, it may also be helpful to avoid e-cigarettes and other vaping products.

Avoiding smoking and vaping altogether is likely your healthiest option. Talk with a healthcare provider to learn about smoking cessation counseling, medication, or other resources that can help you cut back and quit smoking or vaping.

Jamaica Hospital’s Medical Home Department has partnered with the American Lung Association to bring you Freedom from Smoking, a comprehensive and successful group-based smoking cessation program. For more information or to register, call: 718-206-8494

Trauma Department- Pedestrian Safety

Posted on February 20, 2025 by Patrick Hercules

Pedestrian safety is critical whether you are driving or walking on the sidewalk. We each have a responsibility to keep each other safe. Here are some safety tips for drivers that will keep themselves and pedestrians safe:

Look out for pedestrians everywhere at all times
Use extra caution when driving in hard-to-see conditions, such as nighttime or bad weather
Slow down and be prepared to stop when turning or otherwise entering a crosswalk
Yield to pedestrians in crosswalks and stop well back from the crosswalk to allow other vehicles to see the crossing pedestrians so they can stop too
Never pass vehicles stopped at a crosswalk. There may be people crossing where you can’t see
Never drive under the influence of alcohol and/or drugs
Follow the speed limit, especially around people on the street, in schools, and in neighborhoods where children are present
Be extra cautious when backing up and look for pedestrians

Here are some safety tips for pedestrians:

Follow the rules of the road and obey signs and signals
Walk on sidewalks whenever they are available
If there is no sidewalk, walk facing traffic and as far from traffic as possible
Cross streets at crosswalks or intersections. Look for cars in all directions, including those turning left or right
If a crosswalk or intersection is not available, locate a well-lit area where you have the best view of traffic. Wait for a gap in traffic that allows enough time to cross safely and continue watching for traffic as you cross
Watch for cars entering or exiting driveways, or backing up in parking lots
Avoid alcohol and drugs when walking as they impair your abilities and your judgment

Taking the proper precautions whether you are a driver or pedestrian is for your safety and the safety of others.

If you or anyone you know is injured due to a car accident, make sure to call 911 right away. Each day Jamaica Hospital Medical Center’s Level 1 Trauma Center treats a high volume of motor vehicle collision injuries in New York City. To learn more, please call (718) 206-6000.

Robotics: Appendectomy

Posted on February 19, 2025 by Patrick Hercules

An appendectomy is a surgical procedure to remove an inflamed or infected appendix. An inflamed or infected appendix is the result of appendicitis.

Appendicitis occurs when your appendix, the finger-shaped pouch that sticks out from the colon on the lower right side of the abdomen gets clogged, infected, and inflamed. It can cause acute pain in your lower abdomen, however, for most people, pain begins around the belly button and then moves. As inflammation worsens, appendicitis pain typically increases and eventually becomes serious.

Symptoms of appendicitis include:

Sudden pain that begins on the right side of the lower belly
Sudden pain that begins around the belly button and often shifts to the lower right belly
Pain that worsens with coughing, walking, or making other jarring movements
Nausea and vomiting
Loss of appetite
Low-grade fever that may rise as the illness worsens
Constipation or diarrhea
Belly bloating
Gas

Additional symptoms that may develop later in some people can include:

Malaise
Urinary symptoms- needing to go more frequently or more urgently
Bowel paralysis

The size and location of the appendix make it easy for it to become clogged and infected. Your large intestine is home to many bacteria. If they become trapped in your appendix, they overgrow and cause an infection. The bacteria then multiplies quickly causing the appendix to become inflamed and filled with pus. If it is not treated right away, the appendix may burst or break open.

Some common causes of inflammation, swelling, obstruction, and infection in your appendix include:

Hardened poop (appendix stones)
Lymphoid hyperplasia
Colitis

Other factors that could block the opening of your appendix can include:

Tumors
Parasites
Cystic fibrosis

Risk factors for appendicitis include:

Age – anyone can develop appendicitis, but it most often happens in people between the ages of 10 and 30
Your sex – men have a slightly higher risk of appendicitis than women

To help diagnose appendicitis, a healthcare provider will likely take a history of symptoms and examine the abdomen. Tests used to diagnose appendicitis can include:

A physical exam
Blood tests
Urine tests
Imaging tests

Appendicitis may spontaneously resolve if the cause suddenly goes away on its own. This might happen if an obstruction in your appendix gets unblocked and passes through the intestines, or if an infection causing lymphoid hyperplasia in your appendix suddenly improves. However, you shouldn’t assume this will happen or that it has happened, even if your pain has reduced.

The standard treatment includes medicine such as antibiotics and surgery to remove the appendix. Appendicitis is considered an emergency, so it is treated in the emergency room.

An appendectomy can be performed open, laparoscopically, or robot-assisted.

Through the acquisition of the Da Vinci robot surgical platform, Jamaica Hospital Medical Center can now perform minimally invasive robotic surgical procedures.

There are many potential advantages of robotic-assisted surgery over other types of surgery, including:

Robot-assisted surgery provides the surgeon with 3D images inside the abdomen and pelvis that create a clearer picture to reference as they operate.
Under the surgeon’s direction, the robot can move more freely and with more versatility than a human hand
You’ll have a few tiny scars.
You’re more likely to experience less pain and less bleeding after surgery compared to open surgery.
A shorter hospital stay.

For more information about robotic surgery or to learn more about other surgical options at Jamaica Hospital Medical Center’s Department of Surgery, please call (718) 206-7001 to make an appointment.

Podiatry: What Your Feet Can Tell You about Your Health

Posted on February 5, 2025 by Patrick Hercules

Our bodies present many signs and symptoms to show us that we are sick, such as a runny nose, fever, and body aches. However, your feet can tell us a lot about our health, including:

Dry, flaking, itchy, or peeling skin may be signs of a thyroid condition or a fungal infection.
Foot numbness may be a sign of circulation problems such as peripheral artery disease (PAD), peripheral neuropathy associated with type 2 diabetes, other neurological problems, arthritis, or long-standing alcoholism.
A foot sore that won’t heal may be a sign of diabetes or peripheral vascular disease. In addition to causing nerve damage, high blood sugar might also damage the blood vessels that supply nerves, causing circulation problems that prevent healing.
Swollen ankles and feet may be signs of heart failure, kidney disease, liver disease, or a blood clot. Painless swelling in the feet is gravity in action. If your heart, liver, or kidneys aren’t working properly, you will have excess fluid in the body that leaks into your tissues and drains down to the feet.
A suddenly, intensely painful, and swollen big toe may be a sign of gout, inflammation caused by a buildup of uric acid that forms crystals in the joints.
Pain in the foot when walking or exercising that goes away when resting may be a sign of a stress fracture or osteoporosis.
Sore toe joints in both feet may be a sign of rheumatoid arthritis.
Frequent foot cramping may be a sign of dehydration and nutritional deficiencies.
Heel pain may be a sign of plantar fasciitis, the strain of the ligament that supports the arch in your foot.
Yellow toenails may be a sign of a fungal infection, such as athlete’s foot.
Balding or hairless feet and toes may be a sign of circulation problems, such as peripheral artery disease.
Foot or heel pain upon standing or rising in the morning may be a sign of arthritis or plantar fasciitis.
Frequently cold feet may be a sign of hypothyroidism, peripheral artery disease, or Raynaud’s disease, a condition where blood vessels spasm and constrict when experiencing cold temperatures.

Some ways you can care for your feet include:

Wash and examine your feet daily
Keep the skin on your feet moisturized
Treat any callouses and corns
Trim toenails weekly or as needed
Wear protective clothing on your feet
Maintain blood flow to the feet

If you are experiencing any of these foot ailments, contact Jamaica Hospital Medical Center’s Queens Podiatry Center at (718) 206-6713-6712 to make an appointment.

What is Induration?

Posted on January 29, 2025 by Patrick Hercules

Induration is a deep, thickening of the skin from edema, inflammation, or infiltration, including cancer.

Signs of indurated skin include:

Skin that feels firmer to the touch than the surrounding skin
Skin that appears thick
Skin that looks smooth and shiny

The indurated areas commonly appear on the hands and face, but can also be found on the chest, back, abdomen, breast, or buttocks.

The primary underlying causes of skin induration include:

Specific types of skin infection
Cutaneous metastatic cancers
Panniculitis
Hives

The precise physiological process that results in many conditions that cause skin induration includes inflammation and infiltration of the skin by certain types of cancer cells.

Several types of skin infections with symptoms of skin induration include:

An abscess
An inflamed cyst
Insect bites that become infected

The diagnosis of skin induration is made by palpation or the feeling of the area, assessing whether the raised area feels hard and resistant.

Treatment of skin induration varies depending on the underlying cause. Treatment options include:

For an abscess, the treatment option may be antibiotics, incision, or drainage
For inflammatory disorders, such as scleroderma or lichen sclerosus, immunosuppressants or steroid creams can be used.

Supportive care for skin induration conditions can vary greatly, depending on the underlying cause. Examples of supportive care for skin conditions can include:

Warm compresses
Analgesia
Elevation of the affected extremity to help reduce swelling

If you are experiencing any signs of skin induration, you can schedule an appointment with a doctor at Jamaica Hospital Medical Center’s Ambulatory Care Center, please call (718) 206-7001.

Winter Dehydration

Posted on January 24, 2025 by Patrick Hercules

Dehydration in the winter may seem less likely than in the summertime, but it is still a risk. According to the U.S. National Academies of Sciences, Engineering, and Medicine, the recommended amount of daily fluid intake is around 15.5 cups for men and 11.5 for women. For many of us, it might be harder to reach these quantities during the winter months.

Some causes of winter dehydration include:

Indoor heat
Bundling up in too many layers
Lack of thirst
Fluid loss from respiration
More frequent urination

There are many signs of dehydration, including:

The color of your urine
Constipation
Fatigue
Dry mouth and chapped lips
Dry skin
Headaches
Difficulty concentrating
Irritability
Feeling faint or dizzy
A rapid heart rate

Here are some tips for staying hydrated in the winter:

Drink warm fluids if it is too difficult to drink cold water when it’s cold outside.
Infuse plain water with flavor, by adding flavorings such as a wedge of lemon or lime, other pieces of fruit, or unsweetened water enhancers.
Carry a reusable water bottle with you to encourage daily hydration.
Eat homemade soups and water-rich fruits and vegetables to help increase fluid intake
Avoid drinking caffeine as it can contribute to dehydration.
Swap drinking an alcoholic beverage for a mocktail.
Make hydration a routine by drinking a certain amount of water daily.

If you have symptoms of dehydration, consult a physician immediately. Severe cases can lead to complications and potentially death. For less severe cases, you can schedule an appointment with a physician at Jamaica Hospital Medical Center’s Ambulatory Care Center, by calling (718) 206-7001. If you are experiencing an emergency, call 911.

Integrative Health Month

Posted on January 23, 2025 by Patrick Hercules

January is Integrative Health Month. It raises awareness of the need for collaborative care among various disciplines to treat the whole person instead of a symptom-only approach.

Integrative health uses an evidence-based approach to treating a patient’s mind, body, and soul. Because physical, emotional, mental, and spiritual needs are all involved, integrative health combines these therapies.

The relationships between you and your healthcare providers are important in integrative health. You are equal partners in your healing process, as integrative health aims for well-coordinated care among different providers and specialists.

A variety of healthcare providers delivers care through integrative health, including:

Physicians
Chiropractic doctors
Holistic mind-body psychotherapists
Acupuncturists
Chinese herbal therapists
Tai chi practitioners
Yoga practitioners
Massage therapists
Nutritionists
Chefs (culinary medicine)

Integrative health physicians don’t replace your primary care provider or specialist. They work with all members of your healthcare team to heal your mind, body, and spirit. Their expertise lies in preventing and managing chronic diseases not in treating acute medical problems. You should see your primary care or emergency medicine physician for acute and medical emergencies.

Many people can benefit from integrative health including those who are healthy. People with chronic or complex conditions may especially find the approach helpful. Integrative health can help you find relief for many medical conditions, including:

Autoimmune diseases
Acute and chronic pain
Breathing disorders
Headaches and migraines
Cancer and cancer-related side effects
Chronic fatigue
Cold/flu symptoms
Digestive disorders
Infertility
Menopausal symptoms
Menstrual issues
Mental and emotional health issues
Obesity
High blood pressure
Sleep issues

Integrative health techniques support the body’s natural ability to heal. They help reduce stress and promote a state of relaxation that leads to better health. Integrative health can help you achieve optimal health when you engage in your own healing and feel empowered to make lifestyle changes. Adding integrative health to your healthcare routine can help you regain control of your well-being.

To learn more about Jamaica Hospital Medical Center’s integrative health services, events, or classes, or to schedule an appointment, please call us at (718) 206-5675.

POTS (Postural Orthostatic Tachycardia Syndrome)

Posted on January 22, 2025 by Patrick Hercules

Postural orthostatic tachycardia syndrome (POTS) is a condition that causes your heart to beat faster than normal when you transition from sitting or lying down to standing up.

Each word of “postural orthostatic tachycardia syndrome” has a meaning:

Postural – related to the position of your body
Orthostatic – related to standing upright
Tachycardia – a heart rate over 100 beats per minute
Syndrome – A group of symptoms that happen together

Your autonomic nervous system normally balances your heart rate and blood pressure to keep your blood flowing at a healthy pace, despite your body’s positioning. However, if you have POTS, your body can’t coordinate the balancing act of blood vessel constriction and heart rate response, meaning your body can’t keep your blood pressure steady and stable. This causes a variety of symptoms, including:

Dizziness or lightheadedness, especially when standing up, during prolonged standing in one position, or on long walks
Fainting or near fainting
Forgetfulness and trouble focusing (brain fog)
Heart palpitations or a racing heart rate
Exhaustion/fatigue
Feeling nervous or anxious
Shakiness and excessive sweating
Shortness of breath
Chest pain
Headaches
Nausea
Bloating
A pale face and purple discoloration of your hands and feet if they’re lower than the level of your heart
Disrupted sleep from chest pain, a racing heart rate, or excessive sweating during sleep

POTS symptoms often get worse in the following situations:

Being in warm environments, such as in a hot bath or shower, or on a hot day
Standing frequently, such as when you’re waiting in line or shopping
Participating in strenuous exercise
When you are sick from a cold or an infection
Having your period

You can develop POTS suddenly or it can develop gradually. Symptoms vary from person to person. They may happen immediately or a few minutes after sitting up or standing. Lying down may relieve some of the symptoms.

Researchers aren’t sure what causes POTS. They currently believe there are multiple causes, which have been put into different subtypes of POTS, including:

Neuropathic POTS – this happens when peripheral denervation (loss of nerve supply) leads to poor blood vessel muscles, especially in your legs and abdomen
Hyperadrenergic POTS – this happens when your sympathetic nervous system is overactive
Hypovolemic POTS – reduced blood volume can lead to POTS. Low blood volume can cause similar symptoms that may overlap with neuropathic and hyperadrenergic POTS

There is also growing evidence that suggests POTS might be an autoimmune disease, meaning the immune system attacks healthy tissue for unknown reasons.

POTS can be difficult for healthcare providers to diagnose due to the many symptoms that can occur over time. People with POTS may have symptoms for months or years before they are finally diagnosed with the condition.

To confirm a POTS diagnosis or rule out other possible causes for your symptoms, your healthcare provider will ask questions about symptoms, medications, and medical history, and they will also perform a series of tests.

A tilt table test is the main way providers diagnose POTS, as it measures your heart rate and blood pressure as you change your posture and position. A healthcare provider may order other tests to help determine a diagnosis, including:

Blood and urine tests for causes of POTS and conditions that mimic POTS
QSART (a test that measures the autonomic nerves that control sweating)
Autonomic breathing test (a test that measures your blood rate and pressure response during exercise
Skin nerve biopsy

Unfortunately, there is no cure for POTS. However, healthcare providers use strategies to manage the symptoms. Treatment is highly individualized based on your symptoms and what works best for you. The main forms of treatment include:

Exercise and physical activity
Diet and nutrition

There is nothing you can do to prevent developing POTS. But there are steps you can take to try to prevent flare-ups by knowing what your triggers are, including:

Maintaining a consistent temperature
Avoiding prolonged standing
Avoiding alcohol

If you are experiencing any POTS-related symptoms, you can schedule an appointment at Jamaica Hospital Medical Center’s Cardiology Department by calling (718) 206-7100. If you are experiencing an emergency, please call 911 right away.