Saturday, January 5, 2013

Salt, Salt, Salt... Fluids, Fluids, Fluids: Part 1

What's a POTS blog without a post about our top survival techniques?  Sodium and hydration.  "Salt, salt, salt... fluids, fluids, fluids" has been repeated to me by my EP every visit and has thus become a mantra of mine.

Today let's focus on the fluids side of things.  When I first presented with symptoms, even before I knew dysautonomia existed, I immediately began increasing my fluids.  I was constantly thirsty, and I was so overheated that drinking water was my natural response.  Despite being drawn toward H20 naturally, I had to learn through trial and error the best ways for me to remain hydrated day-to-day.  It can come very naturally some days, but other days I have to pay attention and not let myself fall off the hydration wagon.

Become Water-Accessible

Keeping fluids with you all at times is very important.  I have learned the hard way that even if I think I am just running into the pharmacy for a quick errand, I better still take my water from the car into the store.  I carry a 32-ounce water bottle with me everywhere I go.

I couldn't come up with a creative way to take a picture of a water bottle.
This blog will not be known for its "wow factor".

I found that I would go through 16 ounces way too quickly and would often be left without fluids at inconvenient times, so it quite literally became a go-big-or-go-home scenario.  I also keep some bottled water in my car so I have a refilling station at times when I may not have access to a water fountain.  Personally, my favorite part about my water bottle, aside from its capacity, is the flip-straw top.  I find the straw makes it easier for me to access fluids as I need them especially when doing things like driving.

How Much Should I Drink?

There isn't an exact science to how much you should drink each day as each person with POTS and daily circumstances vary greatly.  I find that as a baseline I need to make sure I have at least 2 liters a day, but most days I have 3 - 4 liters.  My fluids increase with my activity level and when I am in warmer environments, but if I am just having a lazy day around the house then I make sure to have at least 2 liters.  Since this water bottle holds just under a liter, it is a lot easier for me to keep track of the amount of fluids I've consumed in a day.  In addition to making sure you get enough fluids each day, make sure to start as soon as you wake up.  I keep water next to my bed, and I try to drink 8 to 16 ounces the moment I wake up, which helps me to rehydrate from the night and gives my perpetually low blood pressure a boost right off the bat.


Each time I would show up to a doctor's appointment with my water bottle in tow, I would be told, "I see you are keeping hydrated, which is great, but Gatorade or another sports drink would be even better."  Of course they would also suggest I stick to the low sugar and low calorie varieties, but I personally can't handle artificial sweeteners.  For one, I can't stand the taste, and two, I end up with really bad headaches.  As a compromise, I have a 32-ounce bottle of Gatorade a day, and often times mix it 50/50 with water to avoid that heavy sugary-drink feeling in my stomach.  I also keep powdered Gatorade on hand in case I need extra electrolytes during a particularly symptomatic day.

Another way I get extra electrolytes is by drinking coconut water.  Now I am not going to lie, this is definitely an acquired taste and can be pricey, but sometimes I just can't bear one more sip of Gatorade in a day.  You definitely want to drink it really cold.  I prefer the Zico brand based on its sodium content.  Keep an eye out though because the larger cartons that aren't from concentrate have very low sodium content compared to the bottled, from concentrate varieties.  The potassium in the coconut water also helped me relieve leg cramping at night from my beta blocker.  One thing I haven't tried yet, but might help those with an aversion to the taste of coconut water, would be to use the coconut water in a fruit smoothie.