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How to Practice Standing

I was talking to a friend the other day – and by talking, I mean messaging through social media, and by friend I mean a stranger that I’ve come to know online – and she told me that she was going to physical therapy to regain the use of her legs. POTS has made standing and walking a challenge for her. She uses a walker to get around and needs the therapy to strengthen her legs which have become weak over time.  When someone has an orthostatic intolerance, like we do, they feel better laying down. Not only that, but our bodies actually function how they are supposed to when in the supine position. When we “POTSIES” stand up, our autonomic nervous system isn’t working properly: our blood doesn’t flow to the right place at the right time, usually meaning we faint, or feel like we are going to faint – also called syncope and pre-syncope. So this friend has pre-syncope every time she goes to stand up, just like me. I told her: standing is hard. I have to practice. Then came the question: How do you practice standing?

Learning to stand was Lesson Two at The POTS Treatment Center, right after breathing with your diaphragm. Now in order to execute Lesson Two, you must first know how to execute Lesson One. Breathing with your diaphragm sounds easy enough, but in order to truly Belly Breathe, you have to focus. And practice. How are you breathing right now? Hopefully you’ve experienced some yoga or meditation at some point in your life journey because the principles are similar, except here, we are breathing in and out through our nose, and we are breathing with one purpose: to relax. With POTS, our heart rate is out of whack. Think of it this way, we have the body of a sloth, with the heart rate of a hummingbird. So the purpose of the breath is to calm and regulate our heart rate. Inhale. Hold. Exhale. Inhale. Hold. Exhale. Inhale for four counts, hold for two, and exhale for six. Inhale. Hold. Exhale. Place one hand over your belly and one hand over your heart. Inhale. Hold. Exhale. Your belly should be expanding, your chest should not move. Inhale. Hold. Exhale. A relaxed person should take six breaths a minute. Only six. Inhale. Hold. Exhale. Inhale. Hold. Exhale. How are your breathing right now?

So now that you are aware of your breath, how does that help us stand up? Well for starters, you can’t just jump out of your chair and move. That’s wrong. With POTS, you know that’s wrong because the minute you are on your feet, you’re transported into outer space and suddenly there is no floor. When you feel gravity’s pull back to this plane, you realize that you stood up too fast. Again. So sit back down, and let’s try again. Scoot to the edge of your seat and take three deep breaths like we practiced above. Inhale. Hold. Exhale. On your final exhale, use the strength of your arms to push you up from the chair and continue to exhale as you push yourself into standing position. Now stop! Don’t take off walking just yet. Its time to breathe a little bit more before you start rushing forward. Your body is adjusting to being upright. Give it a chance to catch up. Take three more long, full, deep breaths. Inhale. Hold. Exhale. On your third and final exhale, you can take that first step.

If you have POTS, you’ve probably been told by your doctor to not stand up so fast. It made you roll your eyes, right? I know it made me roll mine the first time I was told “Well don’t stand up so fast” after saying I felt like I was going to pass out every time I got up. But the truth is, if the doctors took the minute to explain this method, or maybe used the phrase “give yourself more time to stand up”, maybe we wouldn’t roll our eyes. Maybe we would listen and actually practice standing. If you’re reading this and you don’t have POTS, I hope you got a glimpse of the small, subtle things that we must take our time for when living with this syndrome. Something as simple as standing up is often taken for granted. “Healthy is a crown that only the sick can see.” Be aware of how fortunate you are. And be gentle out in the world with others. You never know what silent wars are waging within them. You never know if that person taking a little longer on the plane has two more breaths to count through before they can stand up. Be patient. Be kind. And be thankful that you don’t have to practice standing.