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  1. 1. Dysautonomia By Dani Fisher and Emily Block
  2. 2. Activity <ul><li>Daily Activities </li></ul><ul><ul><li>Eat Breakfast (1) </li></ul></ul><ul><ul><li>Get ready for school (2) </li></ul></ul><ul><ul><li>Go to school (1 per hour: 4 hours is 4 sticks) </li></ul></ul><ul><ul><li>Eat Lunch (1) </li></ul></ul><ul><ul><li>Exercise (4) </li></ul></ul><ul><ul><li>Go to work (1 per hour: 3 hours is 3 sticks) </li></ul></ul><ul><ul><li>Hang out with friends (2) </li></ul></ul><ul><ul><li>Dinner (2) </li></ul></ul><ul><ul><li>Grocery shopping (2) </li></ul></ul><ul><ul><li>Household chores (2) </li></ul></ul><ul><ul><li>Get Ready for Bed (1) </li></ul></ul>
  3. 3. What does dysautonomia mean? <ul><li>Break it down </li></ul><ul><ul><li>Dys : referring to dysfunction </li></ul></ul><ul><ul><li>Autonomia : referring to the autonomic nervous system </li></ul></ul><ul><li>The autonomic nervous system controls all processes in your body that you don’t have to think about (like digestion, blood pressure, heart rate and wake/sleep cycle) </li></ul><ul><li>With DYSautonomia the autonomic nervous system does not work correctly </li></ul>
  4. 5. Sub Types <ul><li>There are many kinds of dysautonomia, but the information in this presentation is based on the most common type: </li></ul><ul><ul><li>Postural Orthostatic Tachycardia Syndrome (POTS) </li></ul></ul><ul><ul><ul><li>Also called orthostatic hypotension </li></ul></ul></ul>
  5. 6. What does it feel like (Symptoms) <ul><li>Nausea/Vomiting </li></ul><ul><li>Joint pain </li></ul><ul><li>Flu like symptoms (including fever, chills, and body aches) </li></ul><ul><li>Sleep disorders </li></ul><ul><li>Anxiety </li></ul><ul><li>Heat/cold intolerance </li></ul><ul><li>Easily over stimulated </li></ul><ul><li>Lightheadedness </li></ul><ul><li>Fainting or almost fainting (black outs) </li></ul><ul><li>Exercise intolerance </li></ul><ul><li>Abnormal heart rate </li></ul><ul><li>Abnormal blood pressure </li></ul><ul><li>Weakness </li></ul><ul><li>Slow or dysfunctional digestive system </li></ul>
  6. 7. What does it feel like? (Symptoms) <ul><li>Sometimes when you get up too fast, you may feel light headed or even have you vision dim. This is what low blood pressure feels like. </li></ul><ul><li>The high heart rate would feel like you are jogging or sprinting when you are just sitting or walking. </li></ul><ul><li>The other symptoms come together to feel like a mild to moderate case of the flu. </li></ul><ul><li>Everyone has felt what it feels like to have dysautonomia, but only for brief periods of time. </li></ul>
  7. 8. Symptoms may vary
  8. 9. Other Effects 21 Hours per week
  9. 10. Other Effects <ul><li>21 hours a week to </li></ul><ul><ul><li>Cook </li></ul></ul><ul><ul><li>Clean </li></ul></ul><ul><ul><li>Office hours, meet with faculty, meet with advisor </li></ul></ul><ul><ul><li>Homework that can’t be done laying in bed </li></ul></ul><ul><ul><li>Contact doctors </li></ul></ul><ul><ul><li>Grocery shop </li></ul></ul><ul><ul><li>Club meetings </li></ul></ul><ul><ul><li>Hygiene (shower, laundry, picking out clothes, styling hair) </li></ul></ul><ul><ul><li>Foster relationships </li></ul></ul><ul><ul><li>Exercise </li></ul></ul><ul><ul><li>Have fun </li></ul></ul>
  10. 11. Other Effects <ul><li>Isolation </li></ul><ul><li>Facing misconceptions about the cause or validity of symptoms </li></ul><ul><li>Being unable to go to school or work </li></ul><ul><li>Missing out on landmark events like Prom, getting a driver’s license, or drinking to celebrate turning 21 </li></ul><ul><li>Reduction in access to physical activity </li></ul>
  11. 12. What causes dysautonomia? <ul><li>Can have multiple and/or unknown causes </li></ul><ul><li>Onset of dysautonomia may follow a </li></ul><ul><ul><li>Bacterial or viral infection </li></ul></ul><ul><ul><li>Serious injury </li></ul></ul><ul><ul><li>Period of extreme physical or emotional stress </li></ul></ul><ul><ul><li>Surgery (particularly with stronger anesthesia) </li></ul></ul><ul><ul><li>Beginning of puberty or a growth spurt </li></ul></ul><ul><ul><li>Pregnancy </li></ul></ul><ul><li>And may be related to other conditions such as </li></ul><ul><ul><li>Lime Disease </li></ul></ul><ul><ul><li>Ehlers-Danlos Syndrome (hyper-mobility) </li></ul></ul><ul><ul><li>Diabetes </li></ul></ul><ul><ul><li>May be autoimmune, genetic, and/or developmental (Grubb) </li></ul></ul>
  12. 13. How is Dysautonomia Diagnosed <ul><li>Tilt table test </li></ul><ul><ul><li>Heart Rate increases by at least 30 bpm </li></ul></ul><ul><li>Orthostatic blood pressure and heart rate reading </li></ul><ul><li>Patient history </li></ul><ul><li>Sweat test </li></ul><ul><li>24 hour urine test </li></ul><ul><li>Many other tests as well </li></ul>
  13. 14. What is the prognosis? <ul><ul><li>POTS is usually not fatal but there isn’t a cure </li></ul></ul><ul><ul><ul><li>Post viral usually resolves in 2-5 years </li></ul></ul></ul><ul><ul><ul><li>Developmental usually resolves by around ages 21-24 </li></ul></ul></ul><ul><ul><ul><li>Some will have symptoms for life </li></ul></ul></ul><ul><ul><ul><li>Most will experience at least some improvement in symptoms from treatment </li></ul></ul></ul>
  14. 15. How is dysautonomia treated/managed? <ul><li>Medications can help </li></ul><ul><li>IV Saline Hydration </li></ul><ul><li>Lifestyle changes </li></ul><ul><li>Exercise </li></ul>
  15. 16. Aides to improve quality of life <ul><li>Cooling vests </li></ul><ul><li>Compression stockings </li></ul><ul><li>Wheelchairs </li></ul><ul><li>Canes </li></ul><ul><li>Service dogs </li></ul><ul><li>Shower/kitchen stools </li></ul>
  16. 17. Exercise <ul><li>Why does it pose such a challenge? </li></ul><ul><ul><ul><li>Low endurance </li></ul></ul></ul><ul><ul><ul><li>Expectations </li></ul></ul></ul><ul><ul><ul><li>Lack of motivation </li></ul></ul></ul>
  17. 18. Tips for Physical Activity <ul><li>Control environmental temperature </li></ul><ul><li>Make sure environment is not stuffy or humid </li></ul><ul><li>Concentrate on strengthening legs and abdominal muscles </li></ul><ul><ul><li>Tone in these muscles improves blood circulation </li></ul></ul><ul><li>Carefully monitor heart rate and blood pressure </li></ul><ul><li>Frequent breaks </li></ul><ul><li>Avoid long periods of standing </li></ul><ul><li>Hydration is important before, during, and after exercise </li></ul><ul><li>Should expect frequent steps backwards in progress and may need to give extra encouragement </li></ul>
  18. 19. Exercise for fun (For Moderate or Severe Cases) <ul><li>Art </li></ul><ul><li>Wii </li></ul><ul><li>Swimming </li></ul><ul><li>Hippotherapy </li></ul><ul><li>Swinging </li></ul><ul><li>Skiing (outriggers) </li></ul>
  19. 20. Exercises for fun (For mild cases) <ul><li>Skating </li></ul><ul><li>Jump rope </li></ul><ul><li>Trampoline </li></ul><ul><li>Bike riding </li></ul><ul><li>Hiking </li></ul><ul><li>Scooter </li></ul><ul><li>Sometimes even more demanding sports like soccer, basketball, or dance are tolerated well </li></ul>
  20. 21. Sources <ul><li>Grubb, Blair P., DANIEL J. KOSINSKI, and YOUSUF KANJWAL. &quot;The Postural Tachycardia Syndrome: A Concise Guide to Diagnosis and Management.&quot; TECHNIQUES AND TECHNOLOGY . The Medical University of Ohio, Toledo. Web. 22 Feb. 2010. . </li></ul><ul><li>Blair. Postural Tachycardia Syndrome:POTS [Internet]. Version 18. Knol. 2008 Oct 26. Available from: . </li></ul><ul><li>Edwards, Laurie. Life Disrupted: Getting Real about Chronic Illness in Your Twenties and Thirties. New York: Walker & Company, 2008. Print. </li></ul><ul><li>Low, Phillip, Paola Sandroni, Michael Joyner, and Win-Kuang Shen. &quot;Postural Tachycardia Syndrome (POTS): Management.&quot; (2009). MedScape: Medical Students . Web. 22 Feb. 2010. . </li></ul><ul><li>Miserandino, Christine. &quot;The Spoon Theory.&quot; Weblog post. But You Don't Look SIck. 2003. Web. 20 Feb. 2010. . </li></ul><ul><li>Raj, Satish. &quot;The Postural Tachycardia Syndrome (POTS): Pathophysiology, Diagnosis & Management.&quot; Indian Pacing and Electrophysiology Journal (2006). Pub Med . National Institute of Health, 1 Apr. 2006. Web. 22 Feb. 2010. . </li></ul>