I've had autonomic issues at a disabling level for almost 2 decades now - secondary to a hypermobility syndrome/connective tissue disorder.
Last week I caught COVID for the first time. Given that any infection messes with my autonomic issues and COVID can itself cause autonomic issues, my symptoms are, shall we say, a little more enthusiastic that I'd like.
So I'm writing my management techniques, in no particular order, as a reminder to myself, and sharing it in case it helps anyone else. (and no, it won't be superbly worded with perfect spelling and grammar - I have COVID.)
(Note: These are what works for me. They may help other people too but they won't always work for everyone. Always check with your medical professional before making changes)
1. Compression of abdomen and legs when upright and concentrating. Sports compression wear (like Skins) and an abdominal binder style back support work for me. Sit with feet up as standard sitting position.
2. Eat frequent small meals. If I eat enough to feel full I can guarantee a big symptom increase as my body struggles to digest it. Don't skip meals though - that makes me feel sick.
3. Eat easy-digest food. Yesterdays omelette with vegetable mash was perfect.
4. Cough horizontally where possible. I mean when lying horizontal - it reduces the autonomic strain. Same with sneezing.
5. No talking while standing. Avoid if possible when sitting. Converse lying down wherever possible. (Yes, talking is a legit Postural Tachycardia Syndrome/autonomic dysfunction symptom trigger - it changes the breathing pattern. If I talk as well as do something else that is autonomically challenging, it's a disaster recipe. A few words when standing can literally wipe out my energy for an hour)
6. Pace. Rest breaks whenever I start struggling to concentrate/think or coordinate. Numb face = BIG REST NOW. (This is my personal 'red flag' symptom that means if I don't manage symptoms there and then, symptoms are going to get really really bad.)
7. Rest only counts if it's horizontal. Head at or below heart level. Lying back on propped up on pillows does not allow me to recharge from PoTS symptoms - and will infact slowly worsen them. It's OK to do it, but I must remember that although it rests my joints, it does not recharge/rest my autonomic system.
8. Move. slow and strength based works best for me. e.g. slowly flexing my ankles and tensing my calves as much as I can (calves? Calfs? is the plural of anatomical calves the same as baby cows?)
9. Forget upright exercise. If standing and breathing is a challenging, adding in exercise isn't going to work. It's amazing how much can be done horizontally with an exercise band - I even have my own horizontal with exercise band version of squats (albeit a bit gentler) - in just a few reps it makes my muscles feel exercised with minimal autonomic strain.
10. If feeling well enough to try to exercise, try 2 reps of something my body usually likes and see if it makes me feel good or zonked. If zonked, back to rest and do not attempt again today. Or at least for several hours.
11. Hydrate. With liquids plus salts. Current favourites: fruit juice with table salt, or water with 'five Zero' sports rehydration tabs added. Little and often - not whole glasses in one go (that just makes me feel sick - esp if lying down)
12. Beware the battle between wanting to feel cosy, and overheating. Heat can be a major symptom trigger - and feeling poorly means I want to wear a fluffy jumper and snuggle under the duvet. But doing that will worsen symptoms: So turn heating down, and open window to keep the room cool enough for some snuggling to be managed, and wear a soft but thin jumper. Double check whether have overheated several times a day - unsnuggle and see if the cooler air revives or does nothing. If it revives, reduce snuggle coverage (maybe a blanket instead of duvet, and long sleeved shirt instead of jumper). Also remember that overheating much more likely after food, so eat meals outside of the nest.
13. wriggle/stretch before standing. Going from horizontal and relaxed to standing and using muscles is a big autonomic challenge - ease the body in to it by slowly stretching, flexing calves, generally tensing then relaxing muscles, taking a deep breath - and then moving into upright.
(I may add to this if I think of more, but it's enough for now!)