Vitals refer to our vital signs, which include measurements we deem “vital” and can include our blood pressure, heart rate, oxygen saturation, respiratory rate, and even bodily temperature. Often when navigating illnesses like POTS, we rely on these measurements. Providers rely on these measurements to gauge how we are doing overall. These objective measurements can be extremely useful for us to monitor and track regularly, but it is also important that we are taking measurements in the most advisable and accurate way. We will say that recommendations specific to how often you should be checking your vitals and documenting your vitals will vary, but we still hope some of this information is helpful and can be used as a guide you can then personalize while in direct collaboration with your medical teams.

Heart Rate

• Fitness trackers (Apple Watch as an example) can give us very helpful insight into heart rate trends throughout the day.

• It can be helpful to record your heart rate at different points throughout the day.

• It can be helpful to record your heart rate before and after exercising.

• Heart rate is most accurate when measured for a full 60 seconds (Bickley et al., 2021).

• It can be helpful when recording to also record your activity level and position (lying, sitting, or standing).

Blood Pressure (using automated cuffs)

• Need to ensure you have the proper cuff size, as a cuff that is too large may give you a falsely lower reading, and a cuff that is too small may give you a falsely higher reading (Bickley et al., 2021).

• Proper positioning is very important and can have an impact on the reading’s accuracy. Arm positioning that is lower than your heart can lead to a falsely higher reading, an unsupported arm can lead to a falsely higher reading, talking during the measurement can lead to a falsely higher reading, and crossing your legs can lead to a falsely higher reading (Bickley et al., 2021).

• Ideally, if possible, you should be seated comfortably with both legs touching the floor, uncrossed, with your back supported. It can be best to rest for a few minutes prior to taking the reading (Bickley et al., 2021). This does not apply to emergency situations or situations where you are very symptomatic and need to lie down. Always speak with your medical team to determine what is best to ensure you are following all recommendations.

• Blood pressure readings may vary based on the time of day, so it is always helpful to record the time it was taken, any symptoms you may be having, any stressors, and what you were doing prior to taking your blood pressure (Bickley et al., 2021).

Respiratory Rate

• It is most accurate to measure your respiratory rate by counting for a full 60 seconds (Bickley et al., 2021).

• It may be helpful to record the time of day, how you are feeling, symptoms you are having, and any recent stressors or contributing factors.

Pulse Oximeter

• It is important to make sure your hands are not too cold as this can impact the reading. This may be difficult for individuals in our community who may struggle with their peripheral circulation (circulation to hands and feet), so we recommend discussing various recommendations with your medical team.

Temperature

• When taking your temperature using an oral thermometer, it is important to note that drinking hot or cold liquids may alter the reading’s accuracy. It can be helpful to delay taking your temperature by 15 minutes after drinking hot or cold liquids (Bickley et al., 2021).

• Make sure the thermometer is placed underneath the tongue, as far back as you can comfortably do so, close both lips, and wait for the reading (Bickley et al., 2021).

Frequency

• Checking our vital signs and being familiar with what is normal for us is very important. Some providers may recommend checking them at regular intervals throughout the day, and possibly more often when more symptomatic (worse symptom day) or before or after taking certain medications. This being said, some in our community may find that the development of health-related anxiety (which is completely understandable given everything many in our community have experienced), leads them to check readings more often than is recommended. If you notice that you are checking your heart rate or blood pressure more often than is recommended, please discuss this with your medical team because we don’t want this to cause you added stress- that is the last thing you need!

Source:

Bickley, L. S., Szilagyi, P. G., Hoffman, R. M., & Soriano, R. P. (2021). Bates' Guide to Physical Examination and history taking. Wolters Kluwer.