Graded Exercise and Pacing in POTS with Dr. Catherine Lewan

In this episode, Dr. Catherine Lewan discusses the complexities of using graded exercise and pacing as treatments for POTS patients, particularly those with hypermobility and related chronic conditions. Drawing from her experiences both as a physical therapist and a patient with POTS, she emphasizes the importance of customization and creativity in exercise approaches. Standard protocols like the Levine protocol may serve as starting points, but Dr. Lewan stresses the need to adapt them to individual patient needs, factoring in symptoms, stressors, and even less obvious influences like time of day and environmental conditions. Her own experiences with CSF leak and recovery highlight the challenges and potential successes of graded exercise, as she shares the process of regaining function after significant setbacks. Dr. Lewan also discusses the overlap and treatment strategies for long COVID patients, noting that understanding and flexibility in treatment plans are key to effectively managing these complex conditions.