Ms. E is a 31 year-old female. She has a history of anxiety and of bulging discs in the cervical region. She reported dizziness and increased heart rate beginning in 2011. She collapsed at work in November 2012. She gained 30 pounds between 2011 and 2013. She was diagnosed with Postural Orthostatic Tachycardia Syndrome (POTS) in March 2013 after a Tilt Table Test. Her POTS symptoms included syncope and and pre-syncope, dizziness, sensitivity to stimuli, brain fog, tachycardia, drops in blood pressure, shaking, chest tightness, shortness of breath, blurry vision, headaches, insomnia, excessive thirst, increased urination, and occasional inability to walk. About twice a week she reported being unable to get out of bed. She was unable to walk more than a few yards at a time. She used a wheelchair and had stopped working and driving. Her mother moved in with her to help her with her daughter and activities of daily living.
She began treatment at the POTS Treatment Center in Dallas, Texas in May 2013 for an intensive two week treatment program. Treatment consisted of sessions 5 days a week averaging 3 hours per session. Training included diaphragmatic breathing, Heart Rate Variability Training, EMG biofeedback, peripheral hand temperature biofeedback, EDR biofeedback, standing and exercise techniques, nutrition supplements, and other health and behavior interventions. She reported feeling an initial improvement in symptoms after 2 days of treatment, and at that time felt she did not need her wheelchair as much. She was not using it at the end of the 2 weeks of treatment. She also reported an overall decrease in POTS symptoms by the end of the 2 weeks.
Her Beck Anxiety Inventory (BAI) score pre-treatment was 49, indicating severe symptoms of anxiety. Upon completion of the 2 week POTS treatment program, her BAI score was 14, indicating mild symptoms of anxiety. Her Beck Depression Inventory-II (BDI-II) score pre-treatment was 17, indicating moderate symptoms of depression. Post-treatment, her BDI-II score was 7, indicating normal levels of depression.
One month after her POTS treatment, she reported losing 15 pounds. At both one and two months after the finishing the treatment program she reported that she had not used her wheel chair and had not passed out.
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