Brief Answer: Need clarification.... Detailed Answer: Hello, Your query is slightly ambiguous to me. You reported that you have symptoms of POTS, did you mean Postural Orthostatic Tachycardia Syndrome or spinal tuberculosis (also referred to as POTS spine). If it is the former, can you also clarify what problem you have with the spine. Awaiting your reply... Regards

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Brief Answer: It could be two different things Detailed Answer: Hello Thanks for the clarification. POTS is certainly very disabling and I understand what you are going through. The cause for the POTS is not still clear and it can also be initiated with the trauma that you had. Further to this your complains of ringing in ears and imbalance further suggest that the cause is in the inner ear. Your heart rate of 150 can never be explained by ear pathology and hence I feel that they both are from a different etiology. For POTS may different therapies are suggested but of them the most effective for my patients has been taking excess of drinking water and therapy with propranolol. For ear causes it would be wise to get your ear examined and also to get an hearing test to look for any ear pathology. For the thoracic spine problem you will have to maintain a proper posture and will have to have a regular physiotherapy sessions for backache. The shakes and weakness of your left side of the body is difficult to explain but it could be due to some compressikn of intervertebral nerve and this can be confirmed by doing a whole spine MRI. This can be useful for evaluating the thoracic spine problems as well. Basically all these symptoms are probably not related to each other. Hope that was helpful, Thanks and regards Dr. Srikanth Reddy MD

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Brief Answer: Metoprolol also helps Detailed Answer: Hello Thanks for the follow up question. Metoprolol and propranolol are two drug of the same class and even metoprolol is very effective. These drugs may take some time but symptoms are brought down quite effectively. It is one of the successful drugs. Adding of salt to the water may not help. The use of taking water is maintaining a more than normal volume of blood. Adding salt may not help. Pots patients do recover. Like the onset of the illness, even the cure is paroxysmal and it suddenly disappears with treatment. All the exercises which improve the leg strength and core muscles will increase the blood supply and improve the symptoms of POTS. It may be walking, running or swimming what ever suits you. You need to start slow so that you dont over exert yourself. And then gradually increase the exercise duration. Hope I am able to answer your concerns. If you have any further query, I would be glad to help you. If not, you may close the discussion and if possible you may rate the answer for me, so that I get a good feedback. In future if you wish to contact me directly, you can use the below mentioned link: bit.ly/dr-srikanth-reddy Wish you good health, Kind regards Dr. Srikanth Reddy M.D.

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