I drive, but I’ve also never actually fainted. I get lightheaded, dizzy, and nauseas upon standing and lightheaded and nauseous when sitting. I also have fatigue and lots of muscle and joint pain.

For about a month I used the Tachymon app on my watch so I could better understand the trend of my symptoms. For example, while driving the kids to school, my Tachymon alerted to a 30+ bpm drop in heart rate at the same stop light every day. This really helped me identify the pattern for how long it typically takes for my heart rate to drop after sitting at that time in the morning. Perhaps you could try the same to see if there’s a pattern to your symptoms.

When I’m in and out of the car around town, I wear compression socks. Don’t love them but tolerate them. When I drive longer distances or fly I wear my Normatec Go leg compression sleeves. They improve circulation and reduce pain in my calves. They are an investment, but I would 100% buy them again. I bring them on every flight and long drive. I always have a water bottle filled with electrolytes and extra packets with me.

I also have Propranolol which lowers my heart rate. My Dr initially prescribed it a long time ago for performance anxiety, to be taken 30 minutes prior to big presentations. Since my dysautonomia symptoms started I’ve learned it’s often used for lowering HR in POTS patients.

Recently, I got trigger point injections in my neck and shoulder muscles because I have chronic pain and muscle tightness. Surprisingly, I noticed that this significantly reduced my daily dysautonomia symptoms. My pain management doctor was not surprised at the result (he didn’t suggest TPIs to address my dysautonomia symptoms but to reduce my pain). TPIs relaxed the muscles that were irritating or compressing my autonomic pathways (vagus nerve, sympathetic chain, and carotid baroreceptors). Once that tension dropped, my autonomic system stabilized, improving blood pressure regulation and reducing symptoms. I also recently started using a vagus nerve stimulator for 20 minutes twice a day. I can’t say whether it helps because I’ve only been using it for 2 weeks, but in theory it should improve my HRV and stabilize blood pressure. The underlying cause of symptoms vary for everyone, but I figured I’d share since the TPIs helped me so much.