This might seem like a really weird piece of content for us to make but it isn’t the first one like this. Oh no, back in 2020 I covered another medical condition, hEDS, and after a barrage of symptoms from PoTS recently, I wanted to make this video for a few reasons. The first one is that I’ve been affected by PoTS more severely than ever in the past few months and the second is that when I was first diagnosed, I searched for information on real people with the condition and found practically nothing, so hopefully this can help someone, somewhere.

Here’s the video, there’s a blog post with bits mentioned underneath:

If you have PoTS and already know what it is, skip to the sections lower down. If not, please just watch this video as your one good deed of the day because you might be able to spot the warning signs in someone you know and signpost them to get checked out, so they don’t spend 20 years thinking they’re weird as hell – knowledge is power, it helps to find solutions.

Let’s start simple:

What is PoTS

Postural Tachycardia Syndrome or PoTS is an abnormality of the functioning of the autonomic (involuntary) nervous system. The ANS is the system responsible for keeping the body in its happy place, making silent decisions instantly on things like blood pressure, heart rate, blood flow, digestion, temperature regulation and so on.

In a normal body, when someone sitting on the floor stands up, blood vessels narrow, and the heart rate increases slightly to maintain the blood supply to the heart and brain. Seems pretty basic, right?

Unfortunately, in a PoTS body, we lucky folks get an excessive rise in heart rate, increased norepinephrine in the blood and altered blood flow to the brain resulting in heart palpitations, extreme dizziness and occasionally (or usually, depending on the severity person to person) we straight up just pass out. 

You can read about the main bits of the condition plus the diagnostic stuff here.

Because the ANS is woo-woo, PoTS also affects digestion and temperature regulation, amongst other things. It’s also worth noting that 50% of people who have hypermobility, or hEDS, like me, also have PoTS. They go hand in hand like old irritating friends. 

PoTS, like a lot of medical conditions, including hEDS which has been mentioned a couple of times already, exists on a spectrum of severity in that one person with the diagnosis can lead a relatively normal life, yet another may be able to do very little.

If you were wondering where I sit, I’m at the milder end when it comes to PoTS itself – I can manage my days to pace well physically unless I’m away teaching on multi-day workshops and incidences of fainting from standing up happen around 2-3 times per year. If I cannot pace for scheduling reasons, I have to take additional precautions, ensure I over-hydrate and also schedule rest weeks immediately after travel. Usually, exertion/exercise and heat are enough to start a severe episode in summer months.

But how is this relevant to photography? Well…

How PoTS impacts photography

As a portrait photographer who regularly photographs children and dogs, I’m usually at their eye level or below. Knowing all of the above, can you see the problem yet? The condition is exaggerated in high or low temperatures. Summer is worse for spinnies and passing out, but winter can be awful too. As it’s winter here in the UK, I can cover the specific situations I’ve had in the past few weeks and hopefully shed light on them for others.

  1. Firstly, the main PoTS symptom of going from sitting or lying to standing. I spend most of my shoots sat cross-legged or lying flat on the floor. Standing up, or specifically standing and trying to move straight away, will usually result in a dangerous situation. In summer, this is much more extreme, where bending down to pick something up, like a lens or a dog lead, and then standing again will cause a pass-out event.
  2. Secondly, shooting outside in -5 with no sunshine and a windchill for 3 hrs whilst getting up and down out of the hard frost in not enough layers is going to probably result in a thermo-backlash from your body. For me, I was absolutely fine shooting, cold with numb fingers and toes, but ok. The thermal shock of blasting the heat in the car on the way home started a mini spiral that ended 3hrs later with deep shivers and Raynauds coming to the party with no blood, or feeling, in most of my toes. It took another 3 hours to actually warm up, by which point bed is the only answer. 12 hrs after that, the yoyo begins of being WAY too hot and then absolutely shivering freezing cold as your body tries to work out where on earth normal is. Eventually things calm down but you’ve lost at least a day of work and set up brand new negative feedback loops for shooting outside in winter, which will make you less likely to so again, and…
  3. Finally, physical exertion is harder with PoTS so if you’re lugging 15kg camera bags around forests or mountains, or setting up a full pro studio kit solo in a time crunch, you need to prep yourself for potential disaster. 

That’s it in a teeny nutshell, but if this is you, how do you cope? Is it all really doom and gloom? Should you hang up your camera for good? I can’t tell you what to do, but I haven’t stopped shooting or working, but it is a good idea to set up some precautions.

Management to make PoTS easier to cope with as a photographer

I can only speak for myself here, so make sure you speak to your health professional too, but as a working photographer with PoTS, these are my tips:

  • Drink a lot more than you think you need to. Hydration is the number one protector so always take a water bottle or a sippy cup to every photoshoot or location scouting. Ensure you have another spare in your vehicle and drink both before and after the session
  • Bring a packet of crisps (chips for our North American friends) for a salt boost. Don’t go crazy, but you’re going to need a little more salt than normal bodies (please check with your healthcare professional on this one!)
  • Always aim to get up slowly when you’re shooting. Explaining this in words is hard but I usually roll and sit, or move to my knees, and then slowly unfold upwards pausing at times to just give myself a second
  • If you get the spinnies (head spin) then lie down if possible. If it isn’t safe to do so, just stop and breathe and bend over if you can. Lots of people do recommend clenching muscles in your legs, buttocks and abs where possible and it does make a difference
  • Wear tight clothing on your bottom half. Leggings, compression tights, or even super-tight skinny jeans all help me 
  • Dress in layers if you can so that you can add and remove them as needed for temperature regulation. In winter, prepare properly with mountain thermals, hats, scarves and invest in a good pair of gloves
  • If you get way too cold like I did in the little example list above, run half a lukewarm bath and get in. Slowly add more water until you return to normal temperature – do not blast yourself back to warmth, it seems to make things much worse
  • In super hot weather, try to find a cold tap or water source and put your hands and feet into it for a few minutes – I just use the sinks inside but always keep to the shade outside. Luckily when it’s too hot for me it’s also too hot for my subjects, so we both get the welfare call which really helps!
  • Only carry as much as you need to, especially in summer. For me I don’t even take a camera bag because it’s just asking for problems and the heat on my back makes everything worse. I just take one camera and lens and make it work. 

So that’s that, if you have any additional tips for the topic we’ve covered today please put them in the comments!

See you soon!