POTS Diagnosis & Treatment

At Biio, we understand that POTS manifests differently in each person and often coexists with other conditions such as Ehlers-Danlos Syndrome, Mast Cell Activation Syndrome, and post-viral syndromes. This complexity requires a thoughtful, personalised approach to treatment.

Our care model combines three essential pillars of treatment:

1. ‍Medical Management
   Working with the body's physiological needs, we address dysautonomia through careful medication trials, fluid and electrolyte balance, and targeted interventions for underlying conditions.
2. ‍Integrative Physiotherapy
   Our approach focuses on reconditioning the cardiovascular system and improving orthostatic tolerance through carefully structured exercise programs and postural management strategies.
3. ‍Autonomic Nervous System Intervention
   We employ evidence-based techniques to regulate the nervous system, including Transcutaneous Vagus Nerve Stimulation, Safe & Sound Protocol, breathing work, Stellate Ganglion Block procedures and specialised psychology protocols designed to restore autonomic balance.

How It Works

1. Integrative Care Assessment
   During this initial appointment, our expert physiotherapist and integrative health practitioner, Caitlin McPhee, will conduct a detailed assessment of your symptoms and their impact on your life. This comprehensive evaluation includes:
   • Autonomic function testing
   • Orthostatic blood pressure testing
   • Malmö POTS assessment
   • Movement and postural analysis
   • Breathing pattern assessment
   • Lifestyle and nutritional evaluation
     
2. Medical Management
   Following your initial assessment, you'll work with our POTS-focused Integrative Nurse Practitioner, Caitlin Smith for medical management of your POTS. This may include:
   • Medication management
   • In-house cardiac investigations
   • Referrals to trusted specialists when needed
   • Treatment of underlying conditions like Mast Cell Activation Syndrome, Ehlers Danlos Syndrome, and Post-Viral Fatigue
3. Integrative Physiotherapy
   ‍Integrating her skills as a physiotherapist and integrative health coach, Caitlin McPhee will guide you through a comprehensive physical rehabilitation and lifestyle management program.
   Her approach combines graduated exercise programming, postural control training, and cardiovascular reconditioning. Special attention is given to movement patterns, core stability, and breathing normalisation to support your overall recovery. You'll also learn strategies for mobilising effectively and optimising blood flow to and from extremities (to prevent blood pooling or Raynaud's in hands and feet).
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4. Nervous System Regulation Therapies
   ‍With over 15 years' experience, our Senior Clinical Psychologist Valentina Dragicevic specialises in treating autonomic nervous system dysregulation. Her work focuses on stimulating the vagus nerve to calm autonomic dysfunction and downregulate hypervigilance in the nervous and immune systems through evidence-based approaches.
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5. Transcutaneous Vagus Nerve Stimulation (tVNS)
   An innovative, non-invasive therapy for dysautonomia and POTS that works by stimulating the vagus nerve and parasympathetic nervous system response. Our evidence-based program includes a personalised protocol and take-home device, allowing you to complete daily treatments comfortably at home. Clinical research shows tVNS can significantly improve autonomic function, reduce orthostatic symptoms, and enhance quality of life. Regular check-ins with our team ensure your treatment remains optimised for the best results.
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6. Stellate Ganglion Block Procedures
   For patients who haven't achieved sufficient progress with frontline strategies, stellate ganglion blocks may be considered. This procedure involves carefully injecting local anaesthetic around the stellate ganglion, a collection of sympathetic nerves in the neck. The injection temporarily blocks these nerves, which can help reset the autonomic nervous system's function.
   
   SGBs work by interrupting the "fight or flight" response that's often overactive in POTS patients. This brief interruption can help restore normal autonomic balance and reduce symptoms. The procedure typically takes about 30 minutes, is performed under ultrasound guidance, and may provide relief lasting several months.
   

Expected Outcomes

While POTS is a persistent condition, our integrated approach typically yields significant improvements in orthostatic tolerance, fatigue levels, and exercise capacity. Patients often report enhanced nervous system regulation, better quality of life, and improved physical resilience, leading to better daily function.

Next Steps

Treatment begins with a comprehensive initial consultation with our practitioners to develop your personalised treatment strategy. We'll work together to create an approach that addresses all aspects of your condition, from physical symptoms to nervous system regulation.