Episode Transcript
[00:00:00] Speaker A: Welcome to the Heart Rate Variability Podcast. Each week we talk about heart rate variability and how it can be used to improve your overall health and wellness.
Please consider the information in this podcast for your informational use and not medical advice. Please see your medical provider to apply any of the strategies outlined in this episode. Heart Rate Variability Podcast is a production of Optimal LLC and Optimal HRV. Check us out at optimalhrv.com Please enjoy the show.
Welcome, friends, to the Heart Rate Variability Podcast. I am Matt Bennett here with a very special guest today, Dr. Diane Droscoll. Hopefully pronouncing that right and really excited to. To learn about Dr. Druscoll's work, Autonomic Health POTS, which has been a reoccurring theme throughout our podcast and our shared passion for autonomic health. So, Diana, you. You have such a great story that I would just love to give an introduction of yourself for our audience. And I can't wait to explore your. Your research, your work, and I think it all is framed in where your passion comes from. So I'd love to start us out there with your sort of journey to autonomic health.
[00:01:24] Speaker B: Oh, boy. It was quite the journey, Matt. And thank you for having me. I'm excited for this. It's.
It's near and dear to my heart because you spent years and continue to, you know, study the autonomic nervous system. And most people, certainly doctors, don't really don't have an interest in that. It's so minute. It seems like we can't touch it, feel it, you know, so, yeah, but I had to get there.
[00:01:47] Speaker A: I'm with you.
[00:01:48] Speaker B: Yeah. So I got thrown into this, honestly. I an optometrist by education, but I'm now clinical director at POTS care, the president of TJ Nutrition, and the president of Genetic Disease Investigators, which now I'm honored to have five patents involving the autonomic nervous system. Congratulations. So, again, had to go deep into it, but I started as I was a patient. I developed pots. My kids ultimately got sick, and it wasn't a subtle condition. And for those who may not know, POTS is postural orthostatic tachycardia syndrome, where your heart starts racing when you stand up. But it was so much more than that. I was completely disabled, my son became completely disabled, and no one was helping us, which was just the strangest journey for me.
So that's when I set up genetic disease investigators and thought, well, if we have any chance of getting answers, you know, it might have to be here. And went deep on it. Absolutely went deep.
[00:02:54] Speaker A: So I would love to like, you know, coming, you know, into your own healthcare journey and then obviously creating, you know, some incredible work around that piece.
I'm just curious, did you know about the vagus nerve before?
You know, trying to find your own health solutions? I'm just, as somebody who is in the medical field, not specifically on autonomic health, but in the medical field, I'm just sort of curious about your learning curve and, you know, just by everything I've learned about you, something struck a passion probably both around how your health and your family's health. But just love to kind of get a little bit of background on what kind of sparked this. When did you first learn about things like heart rate variability in your own journey?
[00:03:49] Speaker B: Yes. And I feel like in some ways, Matt, I was set up for this, you know, as an optometrist. Yes, we do have the medical education and oddly, I remembered the lecture in optometry school about the vagus nerve and remember details of it that no one else seemed to remember. So it's just an odd thing.
[00:04:11] Speaker A: I'm sort of impressed you had that lecture, even not. Not knowing much about your, your, your field of expertise there.
[00:04:19] Speaker B: Yeah, well, in optometry, eyes are kind of a window to systemic health. So you do learn systemic health. And I remembered sitting in this lecture on cranial nerves and covering even the vagus nerve. And there was a phrase that I remembered exactly in this lecture. And this was decades ago, Matt, what the heck, right? But it was. The vagus nerve is actually two parts. There's the long preganglionic nerve that goes from the brain into the chest and abdomen. There's a synapse or gap, and then there's a tiny postganglionic vagus nerve. And I remembered the, the instructor saying that postganglionic vagus nerve is so small, it's almost a part of the organ itself. And that ended up being critical with what I was looking into.
But as you said, my passion for this just be. Came because I was disabled by it. That when I got hit with POTS and it was post viral, I couldn't even see my next two patients. It just stopped me in my tracks. I couldn't breathe, I was shaking. I. I ended up. I couldn't stand up. I would bend over a tremulous trying to get oxygen.
Um, it feel. It felt like I lost the ability to control my body and ultimately my mind, which was terrifying. And then my son got sick a couple years later, also post viral. He was so sick, he ended up again being Bedridden. But sometimes he couldn't even sit up without fainting.
And he developed severe osteoporosis. He stopped growing. He broke his arm just throwing a ball, just putting on his coat. And no one was helping us. I went to probably 50 doctors. I am not exaggerating over the years I was in clinical trials for POTS because I was a flaming case of pots. And the doctors conclusions at the end of these three years was we think POTS patients are perfectly normal. They're just more aware of their own bodies.
You have got to be kidding me. Said that's when I decided if we were going to get answers, we're going to have to go it alone. And started looking in the eyes.
[00:06:44] Speaker A: I'm curious about your experience because you're not, you know, the first conversation we've had about POTS and the frustration of these autonomic disorders in mainstream medicine.
You're coming in, you're a doctor. You know. You know, and I'm just curious, like with. With. That had to be incredibly frustrating.
[00:07:10] Speaker B: It was.
[00:07:10] Speaker A: I was frustrated hearing about the story. So kidding. I can't even imagine knowing family members going through this too.
[00:07:17] Speaker B: Oh yeah.
[00:07:18] Speaker A: You know, do you do. Now that you're got a foot solidly in this, 2ft solidly in this world, are we just failing to educate providers? Are we doing like with polyvagal theory and other things coming to more prominent. Are you seeing any sort of shift in this? Because the fact that POTS patients are still going through what you went through if they can afford what you went through, because some of them are stuck getting worse feedback, I've heard without having the opportunity to see 50 doctors or whatever.
[00:07:56] Speaker B: So.
[00:07:56] Speaker A: So I'm just curious, where are we failing so miserably with these patients?
[00:08:02] Speaker B: And I do have some insight to that because I was on the other side too. Right. I wasn't just a frustrated patient. And the lack of validation for that much suffering is horrible. So it's one reason I'm so passionate still about helping people today. That journey was so, so difficult for us. It was 10 years after I abandoned the. The traditional help and win it alone to get all the answers. I mean it's just terribly difficult and understand that no one was getting it. They. They didn't understand how every system of the body was affected, how we could be so disabled. And we looked okay. You know, I think I looked better when I was sick.
So as a practitioner, I was there where. If you don't learn about this sort of thing in school.
Yeah. How are you supposed to understand Right. Most of what I discovered was brand new and that's how you know I have five patents. It was brand new science.
So when I look back on my journey, Matt, it would be very easy to be bitter and angry at so many doctors who are unable to help. But I, I come to understand that they did the best they could with the knowledge that they had. And it's what we learned in school.
So although we learned, for example, the basics of the autonomic nervous system, it wasn't deeply understood. A lot of what I found out was brand new. They didn't have that insight.
So it allowed me to kind of forgive and move on and instead just try to help people push along the research faster.
And as an independent researcher, I can move fast.
The bigger institutions were kind of sluggish. It takes years to get grant money, then you have to get consensus and. Oh, you got to be kidding me. So instead I just moved fast, as fast as I could. And that helped.
[00:10:05] Speaker A: I love that. So we kind of, we hit the part of the, your hero's journey in the dark spot of getting what I really feel is horrible, horrible conclusions.
It's like, yeah, your self awareness is causing your, that just.
And your family is affected as well. So I'm curious, as you're in this dark place, you're getting B.S. i think medical conclusions drawn.
I'm just curious of. Okay, now you didn't get anything from the systems that should have been able to at least understand a little bit better than they did.
I'm curious how you took, you know, the, the horrific situation that you were in medically and your family was experiencing and what, what turned that into your, your journey out of that dark spot into becoming a leader in, in this arena?
[00:11:08] Speaker B: Yeah, see, it was my hard headedness, I guess. I knew it was medical.
Yeah, I knew something happened. Right. I mean, I was 46 years old and I got sick. I got a virus and the virus passed within a couple weeks. And then bam. I was hit with all of these symptoms and I had a spreadsheet of symptoms. Sometimes it was like 80 symptoms. It involved every aspect of the body and it was, it was frustration with the system, comfort with my own knowledge. I've always been somewhat of an independent thinker and it still took years to figure out each layer.
[00:11:51] Speaker A: Yeah.
[00:11:52] Speaker B: So what, what I ended up with at the end of the journey, one was full POTS recovery, which is absolutely the goal with every patient. POTS is not a disease, of course, it's a presentation.
Something is always causing it. And that's Very important to remember. Don't try to live with pots. Right.
[00:12:11] Speaker A: Can I ask you to elaborate on that?
What you just said was incredibly powerful. So, yeah, that. It's. If I heard, it's not a disease, It's a process. Can. Can you go into that a little bit more? That. That's fascinating.
[00:12:24] Speaker B: Absolutely. When I was sick, the doctors would try to treat me traditionally by covering up the symptoms, like give me medicine to slow the heart rate, because my heart was just racing, you know, even at rest, it was 123. I remember one time, much less when I stood up, it was really high.
And I said, but shouldn't we know what. Why the heart is going so fast? He said, yeah, we don't know that. I go, well, could you give me a list of things that I should check out that would drive an abnormally fast heart rate like that? It's. Structurally, the heart's fine.
And he said, no, we don't really know that. And I thought, why don't we know this? This sounds just as crazy to me. So. Had to start with dealing with what causes the heart to react in that way. Like getting the flu, for example. We get tachycardia. The heart is reacting to the inflammatory components of that virus.
So I thought we had to start at the very beginning of that.
Right.
And to this day, the traditional treatment is to try to cover up symptoms, which gets us nowhere. So incredibly frustrating. And if it had just been me, at some point, I probably just would have exited, you know, stage left. But my kids were so sick.
[00:13:46] Speaker A: Yeah.
[00:13:46] Speaker B: And my son's life had stopped. My daughter was able to stay in school. It was somewhat of a struggle, but my son couldn't. His life stopped for three years, and that continued to motivate me to. To get answers.
[00:14:00] Speaker A: Well, now you're in the caretaker parent role while dealing with your own as well. I can. I can imagine that had to be, I mean, incredibly motivating, obviously, but just incredibly difficult with. With all the questions, you know, that you were facing, too.
[00:14:20] Speaker B: I wouldn't wish this on anyone, but I think the journey my family went through was not atypical, which is so frustrating. Right. Yeah.
[00:14:31] Speaker A: And I would. I would reinforce that with my. My conversations, but both with the medical side and the side with folks around, this issue is just.
There's a psychological cost to not knowing and not having good answers while you're experiencing all these symptoms that make life incredibly difficult.
And then as physicians and medical providers, not necessarily knowing what to do as. As well. And there's just so much kind of frustration, I think, you know, and helplessness, which obviously didn't translation far into your journey because of where you ended up. But it's just one of those things that I would say the range of autonomic disorders out there, that, that they're just such a lack of knowledge on this that it's devastating psychologically as well as physically. For so many folks, it absolutely is.
[00:15:33] Speaker B: And for families, for loved one friends, they can't understand what the patient's going through. And eventually they start to wonder, well, the doctors are saying everything looks fine, you know.
[00:15:46] Speaker A: Yeah.
[00:15:47] Speaker B: Is this person actually losing their mind?
If I hadn't been an established, healthy doctor, you know.
[00:15:56] Speaker A: Right.
[00:15:56] Speaker B: If I was a 13 year old girl or something.
[00:15:59] Speaker A: Yeah.
[00:15:59] Speaker B: Would I have wondered if I was just going crazy? Because it didn't just affect the body, it started to affect the, the mind pretty dramatically. But again, I knew all along, Matt, this was a medical issue. I was triggered by a virus. Likely it involved the immune system. Let's dig for answers. Let's not try to just cover up the symptoms. That wasn't working. I was getting worse continually and that was the only way out.
So with patients, although it's extraordinarily difficult, I love a medical puzzle. I love getting those answers. And we start with the commonalities among patients. Where do we we start? We always measure the heart rate variability and it always sucks. I mean, it's horrible. That sympathetic nervous system is way up here and the parasympathetic is way in the dumper.
And we can look for objective improvement with that, but we always look for complete recovery. POTS is just a presentation.
Right. The underlying issue that's driving it needs to be identified, treated. The patient has a full chance of recovery.
[00:17:08] Speaker A: So, so I'm curious because I'm assuming this probably brings in autonomic and HRV and sort of these, these topics.
If it's a, if POTS is a presentation, I'm assuming we're autonomic.
I mean, inflammation as far as I understand, is very high. You talk about sympathetic, you know, is, you know, we're not getting the vagal break where we need it to be.
I'm just kind of curious if it's a presentation and if my question is ignorant, please help me ask a better one. A presentation of, of what per se?
[00:17:52] Speaker B: Yes, it's POTS is. We're kind of lucky, I guess, if you will, having an invisible illness like pots, because there's some objective testing.
[00:18:01] Speaker A: Yeah.
[00:18:01] Speaker B: Right. Okay. So the objectivity is checking heart rate. When someone is vertical and the heart rate change a certain amount. So that's the presentation.
But the underlying issue is the true problem, right? So I feel very bad for patients with other invisible illnesses like chronic fatigue syndrome or whatever, with these subjective, loose diagnostic criteria. At least with pause, we have something objective we can look at, and that's a place to start. Something is always causing that. The fast heart rate is not the problem.
We can live with a fast heart rate. The problem is whatever is causing the heart to react in that way, and that is causing damage elsewhere.
So although very tricky with each patient, all patients are complex. There are commonalities among them, and we can start with that.
[00:19:01] Speaker A: So I'm curious, as you look to help assess the reason behind the presentation, again, correct any of my language if I am, if I'm off at all. But. But I'm curious. I mean, we talked about higher heart rate, you know, the, the standing test things that a lot of our audience members are probably some somewhat familiar with less parasympathetic activation.
Are you sort of on an investigative journey then, to figure out what is causing those pieces? Because I, I mean, I'm wondering is, did they have a virus at some point in their life? Are they experiencing severe burnout at work? Are they in. Is it childhood trauma?
You know, I mean, there's things that would pop into my mind as where if I bring my expertise on why that vagal break isn't as strong as we'd want it to be.
However, I'm curious, like what, you know, some of those underlining causes might, might, might be that you're. You're assessing for.
[00:20:06] Speaker B: And ultimately, this was again, such a journey, right? Looking for the causes. Both of my kids were sick. Ultimately, I was sick. My husband at the time was fine.
So I thought, what are the chances there's no genetic component.
Right. So this is when I set up genetic disease investigators. So one of my goals is ultimately to release some of these genes that set people up for this tendency of an abnormal inflammatory reaction to a trigger, something we call inflammatory. Pots put that word, that phrase out there years ago.
So if we think in terms of a propensity to develop this abnormal response, the trigger itself is not as important, right? A lot of things can cause an inflammatory response.
Injury, psychological stress, physical problems, illnesses, you know, viruses, what have you. Many things cause an inflammatory response. But if genetically we're set up where we can't regulate certain forms of inflammation, well, that inflammation starts to do damage.
And ironically, that damage causes more inflammation, and patients get caught in this Cycle. And no fault of their own. They can't break out of it. Right. So they just start spiraling downhill. We've got to identify what's happening, start to treat it, allow them to. To return to health. We ultimately will normalize that. That autonomic nervous system response, and that'll be measurable. Yeah.
[00:21:50] Speaker A: Excellent. So, I mean, are there. Have you or. Or has science identified the specific gene or genes involved in the POTS presentation? Is it different genes for different people?
You know, what are we looking at from a genetic perspective?
[00:22:12] Speaker B: And I think it's important to note patients do not have to know their genes in order to recover.
[00:22:19] Speaker A: Okay.
[00:22:19] Speaker B: So we will be releasing that. That. And that is my ultimate goal. It doesn't have to be the patient's goal. Right. Instead, identifying the inflammation and the fallout from it is enough to pull them out of it. So I put out a book. Gosh, Matt, this has been almost 15 years ago, called the Driscoll theory, and I'm happy to provide that to you.
[00:22:41] Speaker A: We'll put a link in the show notes for sure.
[00:22:42] Speaker B: I'm happy to share that. But put out the commonalities among patients, and this is where they can start. Like, there's a propensity to develop high intracranial pressure.
Why that is missed, how that is treated, and that can cause some dramatic relief. As you mentioned, the change to the autonomic nervous system, which, interestingly, although it started with the vagus nerve, it didn't stop at the vagus nerve. It was a bigger problem than that. And I had to step back and see what looked like a vagus nerve problem and say, is this a vagus nerve problem, or is it a parasympathetic nervous system problem, or is it a neurotransmitter problem? It was a neurotransmitter problem, all right. Contributed to problems with the autonomic nervous system, but also the peripheral nervous system and the central nervous system, the brain, all of those were involved. So it was actually a bigger problem than that. Yeah. Which was, again, quite the journey. And then the cardiovascular response, where patients do show the tachycardia, they also showed vascular problems. We saw veins were terrible, Arteries weren't great either. And we could start to see that by looking at the blood vessels in the eyes. But it was a systemic problem.
So we addressed the cardiovascular problem, the systemic inflammatory problem, the autonomic nervous system problem, the intracranial pressure problem, and patients can recover.
[00:24:17] Speaker A: That's amazing.
[00:24:19] Speaker B: So they don't have to yet know their genes, but ultimately, I would Love to be able to give patients that validation.
[00:24:26] Speaker A: Yeah, Right.
[00:24:27] Speaker B: Here's the objective issue here. And now this will be reflected in the blood work. Oh, there it is. You know, and tie it up with a little bow and give it a label based on the true underlying problem. Not pots. But POTS is working against us as a label. It's implying there's a heart problem. And doctors who are out of the field think pots. Orthostatic tachycardia. Oh, yeah, that goes to a cardiologist. Cardiologists don't know what to do with this, so that's not the problem. And that label has held us back in getting the care we need now.
[00:25:02] Speaker A: And I'm curious as you.
Your use of heart rate variability in this process. Do you. Are there things that.
I mean, I'm assuming maybe there's conversations about nutrition, you know, sleep quality. I mean, there may be other things. I'd love to get that. And, you know, is HRV something you're looking for as sort of an outcome, measure of improvement over time? Is that the goal even of addressing this? I. I'm curious kind of how you see that as folks kind of progress in their. Their work with you.
[00:25:38] Speaker B: Yes. Well, as you know, one reason doctors hate the autonomic nervous system is basically invisible. And not having much to measure is very frustrating.
So HRV is very important to us. Our goal for the patients is POTS goes away.
They know what happened and they can manage this propensity for whatever type of inflammation they deal with. So. So well that they're not sick again, that's great. So that's the ultimate goal. But with the work, trying to figure out, for example, if it was a vagus nerve problem, a neurotransmitter problem, parasympathetic problem.
Being an eye doctor was a unique approach to this, like starting in the eyes.
What I noticed was that patients invariably had large pupils. They were light sensitive.
And that is not vagus nerve driven.
Right. The pupils are not under control of the vagus nerve. That's a different type of receptor controlling the pupils. It's a muscarinic receptor where the vagus nerve is a nicotinic receptor. And then with the brain fog, the inability to focus, make a to do list. I got so bad, Matt, I couldn't even stay awake, much less, you know, be make a to do list of things to do. That right. I just. And I told the neurologist, I feel like I'm running out of something.
He thought it was some neurodegenerative condition. But he just couldn't label.
Was very clear that this was a bigger problem than the vagus nerve problem. And when that was identified, not only did the vagus nerve respond immediately, we could measure that with a bowel movement. Basically, the pupils got smaller.
[00:27:29] Speaker A: Interesting.
[00:27:31] Speaker B: Immediately. I mean, pretty immediately, I could stay awake and actually start to think again.
So if we limited ourselves to it's just a vagus nerve problem, we would have limited recovery.
[00:27:46] Speaker A: Well, let's dive in a little bit about to the neurotransmitters, because I'm sure that's interacting with the autonomic nervous system, if, you know. So I'm curious what your findings are in. In that. That arena, if that kind of held the. The golden ticket, so to speak, to understanding pots in a different way. Like, what. What. What were some of your findings there?
[00:28:11] Speaker B: Yes. And this is where me being a total nerd really helped. Right.
I just was refusing to accept that I was, yes, sick for the rest of my life.
I developed ultimately just complete gastroparesis. It wasn't just constipation. My gallbladder stopped working, wanted to remove it. And I. I remember telling the doctor, well, okay, is the gallbladder filled with gallstones? And said, no. Okay, Is it. Is it stuck? Like, is the opening stuck closed? Is that's why it can't eject? And it said, no, the opening's fine. Oh, okay. Is it inflamed or infected, like an appendix or something about blow? And they said, no, no, it looks fine. I.
Okay, first, why would I want to remove this organ if it's quiet and appears healthy?
[00:29:01] Speaker A: You got to love western medical science, right?
[00:29:03] Speaker B: I just. I'm trying to make sense of it. Everything has to make sense to me. And then I said, it sounds neurological to me.
It sounds like that organ is just sitting there quietly, you know, let me know if you need me. I'm ready.
And that was indeed objective for me to be able to figure out. Unfortunately, I still have my gallbladder. It works great, you know.
[00:29:25] Speaker A: Right.
[00:29:25] Speaker B: But the gastroparesis got so bad, and that's when I was just kind of on my own and started to think, is this a vagus nerve problem? Is it compressed at the neck? When I was considering, thought about that lecture that I told you about where the doctor said that that postganglionic vagus nerve is so small, it's almost a part of the organ itself, thought, can I stimulate that?
And then thought through the anatomy and the neurotransmitters, and ultimately thought, if I can Put that neurotransmitter in. Could it land on the receptors of either that postganglionic vagus nerve or on the organ itself and stimulate a bowel movement? And indeed I I used nicotine because that's the agonist for acetylcholine, the neurotransmitter. It worked beautifully.
I was able to walk away from that little test with one. You can't use nicotine consistently because it's so inflammatory. It was horrible.
But the receptors were working just fine. The neurotransmitter wasn't getting released. And then look toward the receptors then. And controlling the pupil size and tear production. Different type of receptor. Let's just assume those are okay. And is this also involving the cell central nervous system? So replacement of that. I just sat in my kitchen and I thought could I come up with some oral supplementation where I mix the ingredients a certain way cover for any genetic problems with the pathway of making the acetylcholine. I didn't know if that was involved. Could it cross the blood brain barrier to help the central nervous system? Could I see a bowel movement knowing then that vagus nerve was triggered and with the pupils get smaller reflecting the more systemic approach and and put it together and just gave it to my kids and I this blend. It's now called Parasymp plus. Gave it to my son and I my daughter consistently and had no plans of ever putting it out in the public. I didn't want to be in the supplement business.
But one day I was in the hospital and they gave me an antibiotic that activates inflammatory cells that almost killed me. And I went home with pancreatitis.
And you can't miss pancreatitis when it's happening. I thought is there any chance that Paris and plus could be enough to help me? I mean it gets the vagus nerve working. I knew that there were bowel movements. That's your anti inflammatory nerve. And pancreas is somewhat controlled by the vagus nerve. And it's an inflammatory condition. And indeed within days it started to resolve. And that's when I thought I probably need to get this out to the public.
[00:32:22] Speaker A: Awesome.
[00:32:23] Speaker B: And I I think this is unique.
I think I could apply for a patent. And did. And it was unique. So all new, all necessary and all me, you know, nerds sitting in my kitchen trying to use my ancient organic chemistry knowledge. My new knowledge of genetics involved in that pathway and putting together something that would trigger that parasympathetic nervous system.
[00:32:50] Speaker A: Excellent. And is that you Know, just, just out of curiosity, because I think a lot of times, you know, it in the fields that I travel through, anywhere from the elite performers to things talking about POTS and other health conditions, that there, there seems to be a mix of some sort of strategic, you know, intervention like the, the supplement you mentioned. Do you also talk about other anti inflammatory lifestyle habits?
You know, I'm just kind of curious. What, what, what other things go. What, what, what other, what, what else do you give to your patients as they're, they're managing again, that, that the symptoms and of this, if, if you get the neurotransmitter issue under control, does that just fix everything magically?
I'm curious what the treatment looks like beyond the supplementation specifically.
[00:33:46] Speaker B: Absolutely. I mean, because it certainly goes beyond that. Pots. Think of POTS as an extreme example, right? As an extremely bad inflammatory state.
Patients oftentimes exist with it for years. I had a patient recently who was sick 37 years.
That inflammation has continued to do damage. So they're an extreme example. The cardiovascular system is dramatically affected. Intracranial pressure is affected 95% of the time. The oxidation from the inflammation can be bad, there can be damage from it. Right. So think of those people as extreme examples. And it certainly takes more than, you know, just getting the, the parasympathetic nervous system working, although that is usually a necessary step.
I don't know that I've seen anyone recover without that. But if you take a step back and think what we learn from that extreme example of PODS and this extreme inflammation. What about patients who are more mildly affected, you know, the athletes for example, where just extreme athletics can cause inflammation, the autoimmune patients, menopause, what have you. Is their autonomic nervous system affected? Perhaps less so, but it's kind of the same thing. And they might feel sluggish, their digestion isn't great, they might just get tired, brain foggy, what have you. Can we be more proactive to help those people on that? Certainly a goal now.
So think in terms of.
Although POTS is very complex, there are some things in their control, as you mentioned, food, exercise, what have you. It's such an extreme illness that the traditional ways of dealing with low levels of inflammation with food, you know, exercise, etc, are not sufficient to get them there. When I got sick, Harry was dramatically sick. Nutrition was a hobby of mine. I ate great athletics, I was very regular with that. I taught aerobics classes, you know, so I wasn't, I wasn't going to be able to respond to the doctors who said, okay, Diana, to recover this, you need to exercise and eat. Right. It's like, well, already doing that, you know?
[00:36:10] Speaker A: Yeah.
[00:36:10] Speaker B: But that's not enough. But it puts the blame on the patient.
[00:36:14] Speaker A: Yeah.
[00:36:15] Speaker B: Which I think is inappropriate.
[00:36:17] Speaker A: That's a great point.
[00:36:18] Speaker B: Yeah. Do we need to look at that? Absolutely. First, help with the medical condition.
Right. And then if they need help with, you know, eating better, exercising, that sort of thing. Absolutely. Help them with that. But the cause of the illness is not driven by the patient.
Right. It's driven by this genetic, whatever it is, inflammatory state that they are unable to control.
I remember one doctor in my journey said, diana, maybe. Maybe you just need to meditate.
And I said, okay, that is a teaspoon of help against an ocean. I just got hit with some tsunami. I don't know what that is. I said, if you help me with that ocean, I will do my part with the teaspoon. Okay. Yeah.
[00:37:06] Speaker A: Yeah.
[00:37:07] Speaker B: Right now I'm so incredibly ill.
Most patients we see have been sick for a while, ultimately end up deconditioned. They're eating kind of crap because they're just looking for comfort food. I get it. You know, but when they start to feel better, they. They want to get back to being healthier. Right.
So it. We are very careful not to blame the patient. Yes. We need to pay attention to that. But POTS is a dramatic illness.
Yeah. So.
[00:37:35] Speaker A: So I'm curious with the folks that you. You work with, is it.
Are.
I guess, what's the outcome? And I know that varies per patient and per individual, but are we talking about, like, someone with severe pots, like, not having those symptoms any any longer? I mean, I'm curious because the folks I've talked to that have struggled with this, it seems like a lifetime journey in many ways, unfortunately, which is an exciting conversation to have. I'm just kind of curious about what are the realistic medical outcomes where we're getting the neurotransmitter issue addressed.
Working on other things specific as well. I'm just kind of curious. Is it a lifelong. That all I got to do is take a supplement once or twice a day, or is it a longer journey with. With folks?
[00:38:38] Speaker B: Yeah, it tends to be a longer journey. We tell most patients we see at POTS care, and at POTS Care, we don't see the easy, you know.
Yeah, these are people who are pretty sick for a while.
[00:38:50] Speaker A: Yes.
[00:38:50] Speaker B: But give it a year, and you'll be at, like, 90%.
[00:38:55] Speaker A: Oh, that's great.
[00:38:56] Speaker B: But most patients I know, I'm probably typical. My kids are Typical. We have a genetic setup that makes us more prone to inflammation. We have to learn to manage that well so that we don't get sick. I do not have pots. I am not sick. I think I have the highest energy level of anyone I know of any age. You know?
[00:39:18] Speaker A: Yes.
[00:39:18] Speaker B: Oh, my kids. But I'm proactive and stay on top of some things. And if I got a virus, you know, Covid or what have you, I'm ready to jump on the consequences that can occur in my body that might not, you know, happen to you, for example, but my body reacts in a very inflammatory way, so I have to jump on that. So ultimately, patients understand why them, you know, why are they coming to this? What can they do to stay proactive so that they're not sick? We never think of POTS as except acceptable.
If you're having that fast heart rate, your inflammation is out of control. Don't let that happen. Right. And get to the point where they can manage it and everybody is different. I. I have seen a pattern where the younger we get a patient, the soonest we get them, once they've. They've developed this illness, the easier it is for them to re f. Right. Yes. And whether or not they need any meds, you know, down the road or what have you is a very individual thing because there's so many different reasons for it and response.
Part of what I did, once I had gotten all my answers, my kids had recovered, was took a step back and looked at what else could other people be dealing with? You know, it isn't all about me.
And what sort of things could make this presentation worse? We can't just look at one underlying cause. There's multiple things happening here, and that was complex.
But in order to set up POTS care, we had to be ready to see. See it. All right.
[00:40:57] Speaker A: Yeah.
[00:40:58] Speaker B: So become a complex thing.
[00:41:01] Speaker A: Very cool. So I. I'm curious, you know, as just getting to know you. I'm assuming you're not done, so. So I would love to see it. Sounds one. I need an update on the kids. It's. I got a few hints that they're doing well.
So I just. I like to round that story up for the happy ending, but also just sort of where you see the next questions that you want to tackle.
Where do you see the field going? So just kind of looking into the future with your own work and our understanding of this condition. Just sort of where we're going. But let's start with a quick update on how your kids are doing.
[00:41:39] Speaker B: Fortunately, we have a Happy ending.
And not everybody does, I'll tell you. It can be such an incredibly difficult journey for most.
But we're doing fine. The kids are doing fine. Went on to lead completely normal lives.
But I am instilled with this passion to change this, because it shouldn't be this hard. It should have never happened to us. When I look back on that journey we were on, why. Why could no one else have figured it out? Why would it have taken an optometrist from Texas start picking this apart? It just did. I had that personal involvement. But we've got to change this. We've got to change the labels.
We've got to change the evaluation, the treatment protocol, and then some important goals for me. Because you're right, I'm never finished. Right. There's always another layer to this.
I'm an optometrist, and once I got answers for the autonomic nervous system, I saw the pupils respond, the dry eyes respond. I started to think, could this be a more global problem with the patients who have lower levels of inflammation? They don't necessarily have pots, but they have this chronic dry eye that we as doctors can't seem to help them with. We can help them sustain, you know, their symptoms of it, et cetera, but we're not really getting to the root problem. Could they be dealing with some systemic inflammation that's driving that change in the autonomic nervous system? Yeah. And then take a step back and look at aging or inflammaging, as we say. As we get older, we get more inflammation. Is that inflammation affecting the neurotransmitter? Is that why we as a population are more prone to these old age, old age illnesses? You know, sluggish digestion, the brain fog. Can we be more proactive there? And then something else I really want to change is the hypermobile patient population. I don't know if you hear much about them. I was told, for example, I had Ehlers Danlos syndrome, which is a genetic problem with connective tissue.
And that's why I develop pods. My kids were hypermobile, and that was all wrong.
They couldn't point to the genes of it. And I said, how do you know it's a genetic problem with connective tissue then? If you can't tell me the genes involved, could it be a genetic problem in the inflammatory cascade that's ultimately affecting the connective tissue? Or could it be bow and really set us up for a problem? But what we can't ignore is the treatable aspect of that.
Right.
So so much of what I want to change is that label is also harming patients and it's a dead end for them where there's a treatable aspect to it. So work continues.
[00:44:42] Speaker A: Awesome. Well, this has been an amazing conversation. I want to celebrate you and your journey. Journey.
Anything else about your work that, that we didn't cover. We'll put your website and other resources in the show notes for sure in case anybody wants to reach out.
But just anything else before we, we wrap up that, that, that, that I may not have asked that that we, we want to cover before we wrap up here.
[00:45:09] Speaker B: You know, if, if nothing else, I would say anyone who's listening, who's struggling with getting the best heart rate variability possible, right. As a reflection of autonomical to look at all of it and never give up. It would be so easy in these especially the, the chronic illnesses to think this is just something I'm going to have to learn to live with, which is horrible. But no, never, never give up. Get in the weeds if you have to, but understand what is happening in your body the best you can and be very proactive with it and the HRV will respond to that. Absolutely. It's measurable. And look at the pupils too.
[00:45:49] Speaker A: I love that. I love look in the mirror right now. I don't get too close to the zoom camera, but I'm going to go check it out. So thank you so much for your work. It's been a pleasure to get to know you. I'm excited to follow what those next steps with you will look like. And again, we'll put all the links, get your book in there, get your website in there.
I believe people who are interested can schedule virtually as well as in person.
[00:46:20] Speaker B: We do everything virtually.
[00:46:23] Speaker A: Awesome. I know that's going to be answer a big question for some of our listeners. So we'll put those links in the show notes as well. So Diana, thank you so much. And yeah, I hope somewhere along the line maybe there's like a sixth and seventh patent that we can have you back on the show to talk about.
[00:46:42] Speaker B: I can't seem to stop it.
Thank you.
[00:46:46] Speaker A: Well, as always, thanks everybody for joining us on the heart rate variability podcast and we will see you soon. Thank you so much.
