For too long, Postural Orthostatic Tachycardia Syndrome (POTS) has been minimized with a dismissive phrase: “It’s just feeling dizzy.” But for those living with it — and those treating it, like Dr. Sarah Diekman, who’s both a physician and a POTS patient — the reality is far more complex, often life-altering, and deeply misunderstood.
This blog will cut through the myths, break down the science, and explain why POTS is a serious medical condition that requires compassionate, informed care — not eye rolls and generic advice.
What Is POTS, Really?
POTS stands for Postural Orthostatic Tachycardia Syndrome, a form of dysautonomia — a dysfunction of the autonomic nervous system (ANS). The ANS controls things your body does automatically: heart rate, blood pressure, digestion, temperature regulation, and more.
In people with POTS, there’s a sustained increase in heart rate of at least 30 bpm in adults (40 bpm in adolescents) within 10 minutes of standing, in the absence of orthostatic hypotension, often accompanied by a slew of debilitating symptoms.
But the condition goes far beyond that single metric.
The Misconception: “Just Dizzy”
Yes, dizziness is one of the hallmark symptoms of POTS. But it’s just the tip of the iceberg. Here’s why that oversimplification is harmful:
- It invalidates the patient experience
- It delays diagnosis and treatment
- It prevents deeper investigation into coexisting conditions
- It ignores the science behind the syndrome
At the clinic led by Dr. Sarah Diekman, the mission is to understand each patient’s full picture — not just the surface symptoms. Why? Because she’s been there.
What’s Really Happening in the Body?
POTS is rooted in dysfunction of blood flow and nerve regulation. Here’s what’s going wrong beneath the surface:
Brain Blood Flow Disruption
When you stand, gravity pulls blood toward your legs. In a healthy system, the body narrows blood vessels and increases heart rate just enough to maintain blood flow to the brain. In POTS, this regulation fails. As blood pools in the lower body, the brain doesn’t get enough oxygen-rich blood, resulting in:
- Lightheadedness
- Brain fog
- Fatigue
- Vision disturbances
Autonomic Nervous System Malfunction
The sympathetic nervous system (the “fight or flight” branch) often overreacts in POTS. This causes a rapid heart rate but ineffective circulation, leaving patients feeling exhausted, shaky, and unwell.
Underlying Mechanisms
POTS isn’t one-size-fits-all. Multiple biological processes can contribute, including:
- Hypovolemia: Low blood volume
- Hyperadrenergic states: Elevated norepinephrine levels
- Small fiber neuropathy: Damage to small autonomic nerves
- Mast Cell Activation Syndrome (MCAS): Allergic-like reactions causing vascular instability
- Ehlers-Danlos Syndrome (EDS): A connective tissue disorder often comorbid with POTS
More Than a Cardiovascular Issue
POTS impacts multiple organ systems, leading to a wide range of symptoms that often get misdiagnosed or dismissed.
Common (and often misunderstood) symptoms:
- Fatigue that’s not relieved by rest
- Gastrointestinal issues (nausea, bloating, constipation)
- Shortness of breath, often described as a sensation of not getting enough air
- Temperature regulation issues (cold hands, heat intolerance)
- Chest discomfort or palpitations
- Brain fog (difficulty focusing, word-finding problems)
- Sleep disturbances
- Exercise intolerance
- Anxiety-like symptoms (but not always psychiatric in origin)
At Dr. Sarah Diekman’s clinic, these symptoms aren’t brushed off. They’re seen for what they are — neurologically and physiologically real.
Why Diagnosis Is Often Delayed
Many POTS patients go years without a diagnosis. The reasons are frustratingly familiar:
- Normal EKGs and lab work
- Misdiagnosis with anxiety or panic disorder
- Lack of awareness among general practitioners
- Gender bias (POTS predominantly affects women of childbearing age)
Dr. Sarah Diekman’s own story mirrors many of her patients’. While in medical school, she faced unexplained symptoms and mounting medical bills — without answers. It wasn’t until she took charge, researched her own symptoms, and found a specialist that she received a proper diagnosis.
This lived experience is part of what makes her approach so different. She listens deeply, validates experience, and builds care plans that reflect the full complexity of POTS.
Treatment Is Complex — But Possible
There is no cure for POTS, but treatment can dramatically improve quality of life. At Dr. Sarah Diekman’s clinic, care is personalized and multidisciplinary, often including:
Lifestyle Changes:
- Increasing fluid and salt intake
- Compression garments
- Elevated head of the bed
- Recumbent or seated exercise (e.g., rowing, recumbent biking)
Medications:
- Beta blockers (e.g., propranolol) to manage heart rate
- Fludrocortisone to increase blood volume
- Midodrine to improve vascular tone
- Ivabradine for selective heart rate control
Environmental & Occupational Medicine:
With expertise in Occupational and Environmental Medicine, Dr. Sarah Diekman helps patients reintegrate into work or school with tailored accommodations and sustainable routines.
The Emotional Toll: Real and Valid
Living with a chronic, invisible illness takes a mental toll. The frustration of not being believed, the fear of losing independence, the guilt of feeling like a burden — it all adds up.
That’s why empathy and validation are core to the care provided by Dr. Sarah Diekman. When she says, “I understand what you’re going through,” it’s not a cliché — it’s lived truth.
What Patients Need (And Deserve)
- Doctors who listen and understand
- Early and accurate diagnosis
- Science-backed, individualized treatment
- Support systems for navigating daily life
- Hope grounded in real progress
That’s the kind of care Dr. Sarah Diekman is building — a medical home for people who’ve been overlooked and underserved for too long.
Final Thoughts
POTS is not “just dizziness.” It’s a full-body condition rooted in dysregulation of one of the most important systems in the body. And while it’s invisible to most, it’s very real to those who live with it.
With the right care, understanding, and science-driven support, life with POTS can improve. At Dr. Sarah Diekman’s clinic, that journey starts by being heard, believed, and treated by someone who truly gets it.
Ready to Take the Next Step?
Schedule a new patient appointment and start building a care plan that’s designed for your life, your symptoms, and your goals.
