#7: POTS & COVID-19 Long Haulers with Emily Rich (CE Course)

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Full Course Details: Public course page
Learn more about our guest: Emily Rich, OTR/L

Supplemental Materials

Read the article and discussion upon which this podcast is based.
See the documentation example, which features an example eval with a POTS patient submitted by Emily Rich.

Resources Mentioned in the Episode

Course Description

Released February 1, 2021 from Aurora, NE

The struggles of COVID-19 long haulers have caught the attention of the medical community. In many cases, symptoms seem to correlate with a little-known condition called postural orthostatic tachycardia syndrome (POTS). But, even before the pandemic called attention to POTS, research and advancements in treatment were taking place in the background. Unfortunately, while the research is out there, POTS is not always understood by health providers, and proper diagnosis can take years.

Occupational therapy has a potentially significant role to play in the lives of both POTS patients and COVID-19 long haulers.

In this monthā€™s hour-long podcast episode, we are lucky enough to talk to POTS researcher and practicing clinician, Emily Rich. We discuss what we do and donā€™t know about POTS, as well as the strategies you can use to help these patients get the most out of life.

Primary Research Explored

When you log in, be sure to check out the OT Potential Clubā€™s written breakdown of the following research article, then share your questions and thoughts with fellow practitioners.

Emily M. Rich, Asha Vas, Valerie Boyette & Carol Hollingsworth (2020) Daily Life Experiences: Challenges, Strategies, and Implications for Therapy in Postural Tachycardia Syndrome (POTS), Occupational Therapy In Health Care, DOI: 10.1080/07380577.2020.1824303

Secondary Research

  1. Exercise and non-pharmacological treatment of POTS
  2. 6-month consequences of COVID-19 in patients discharged from hospital: a cohort study
  3. Management of post-acute covid-19 in primary care

Learning Objectives

  1. You will be able to recall 5 areas of difficulty for many POTS patients.
  2. You will be able to summarize 5 categories of treatment strategies used by POTS patients.

Agenda

Intro (5 minutes)

Breakdown and analysis of journal article (10 minutes)

  • What is POTS?
  • What was the purpose of this study?
  • What are the common difficulties reported by POTS patients?
  • What are the common management strategies used by POTS patients?
  • What were the clinical implications of the study?
  • What else was discussed?

Discussion on practical implications for OTs (with guest Emily Rich) (45 minutes)

  • How do you define POTS when speaking with a patient?
  • What information do you typically seek to gather in an eval with a patient with POTS?
  • What are common strategies you use with your patients?
  • How do you coordinate your care with the larger healthcare team?

COVID and POTS

  • As a researcher, what are you seeing as the connection between COVID-19 and POTS?
  • Can you tell us what OTs in the clinic are seeing in COVID-19 long haulers?
  • Should their care look different than a POTS patient who has not had COVID-19?
  • What resources would you recommend for listeners who are interested in diving deeper into this topic?

Contact Hours

1 hour (0.1 AOTA CEUs)

Target Audience/Educational Level

Occupational therapy practitioners who work with patients who have POTS. The educational level is introductory.

Instructional Methods/Registration/Special Needs Requests/Cancellation Policy

This course is an independent/self-study course delivered via podcast on iTunes, Spotify, Google Play, and Stitcher. Explore your listening options on the OT Potential Podcast page.

If you need accommodations to take this course, please contact us and we will address your needs on an individual basis.

If this course were to be canceled, please see our cancellation policy on our terms page.

Course Completion Requirements

In order to receive a certificate for this course, you must first listen to the podcast in its entirety. Then, you will need to take the test (found at the top of this page) and earn 75% or higher. If you pass, a certificate will be automatically generated and sent to your email.

Speakers

Emily Rich, OTR/L:

Emily is an occupational therapist serving adolescents and adults in a medical outpatient therapy setting at Tucson Medical Center in Tucson, Arizona.

She specializes in treating individuals with chronic conditions, including forms of dysautonomia such as postural orthostatic tachycardia syndrome (POTS), Ehlers-Danlos syndrome and hypermobility, persistent pain, and Parkinsonā€™s Disease. She places a high value on patient-partnered, evidenced-based treatment.

Emily is currently pursuing her Ph.D. in occupational therapy at Texas Womanā€™s University. Her research centers around POTS and rehabilitation therapy, specifically exploring treatment options for cognitive rehabilitation.

Sarah Lyon, OTR/L:

Sarahā€™s passion is helping fellow OT practitioners translate evidence into daily practice. Sarah earned her BA in religion from St. Olaf College, then earned her masterā€™s degree in occupational therapy from New York University in 2011. Since then, sheā€™s worked in numerous facilities, including a critical access hospital, an acute trauma hospital, and a state inpatient psychiatric hospital.

In 2011, Sarah launched OT Potential because she realized we needed a reliable source of quality occupational therapy-related content and resources. She has also had the opportunity to create content for brands like WebPT, MedBridge, Saebo, and NeuroLutions.

She launched the OT Potential Club in 2019 to marry her love of simplifying complex topics with her desire to help therapists access the most important OT-related research released each year.

Sarah is a prairie girl at heart, which is why she returned to her hometown to raise her children in Aurora, Nebraska (home of the strobe light).

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Please share any other feedback below! Including, ideas for future programming, and most importantly, how you feel this podcast will impact your practice!

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Thank you for this timely article on POTS and also implications in the post Covid population. We have been seeing post-Covid patients in inpatient rehab, and now I have a game plan if they present with POTS symptoms.

6 Likes
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This was a great listen! I wasnā€™t able to read all the comments from last weekā€™s discussion yet but plan to go back and see what other knowledge was shared. So needed, especially now!

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This was a great podcast! Iā€™d never heard of POTS before OT potential, through school or 4 years in SNF. This was very informative and included practical strategies to meet our clients needs. I havenā€™t worked since COVID started, but hopefully keeping up to date with the current research will help my confidence when I do re-enter the field.

6 Likes
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Iā€™d like to add to my original comment. I just met someone at my gym, whoā€™s wife (70s) has recovered from COVID, and is suffering from Long Haulers. I was able to have a conversation with him and contribute some suggestions thanks to this podcast! :grin:

4 Likes
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Awww! I love this @leah4! This to me is a testament to how people are actively looking for help, but there arenā€™t clear places to meet their needs!

I also just got a message this morning from a hospital classmate who was diagnosed with POTS last year, and has found it to be such a lonely process- and worst of all has been made to feel like it is ā€œin her head.ā€ Which is all so unfortunate, because there are such concrete management strategies these patients can be trying! Iā€™m so glad you were able to share some strategies while at the gym!!! :slight_smile:

2 Likes
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@emily12, I wanted to piggy back on @gretchenā€™s comment and ask if you know of any additional resources for people who are seeing these issues in inpatient rehab? (Or even if they are at home, and just a few weeks or month removed from COVID.) Based on our convo, I would make sure the right specialists are ruling out things like a PE, and probably use the bouncing back PDF. Anything else?

Iā€™m also curious, is part of a POTS diagnosis that theyā€™ve been having symptoms for 3 months?

1 Like
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Topic very thoroughly discussed with good, reasonable treatment strategies in the context of Occ Therapy.
And yes Sarah-itā€™s a very OT condition/diagnosis.
Would love to treat one of them and take the person to their max potential. Coordination with other disciplines would certainly make it more effective

Thanks much to both of you.

2 Likes
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I canā€™t think of any resources right now, Sarah, but Iā€™ll come back here and post if I come up with any! I think the primary care resource linked has a helpful visual as well. Re: 3 months. Many would say yes - I think generally speaking itā€™s hard to determine a diagnosis if symptoms are more recent than that. Iā€™m not positive if this is a universal diagnostic criterion, though.

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Thank you both for this timely and much-needed information on POTS and long-haulers of COVID. I am excited to share this information with my OT counterparts in acute and inpatient rehab and my students who will soon be in Fieldwork.

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I am an OTR/L with POTS and ME/CFS. I was very impressed with the podcast. Everything was spot on with my experience and those of many of my POTS friends. I was impressed that you recognized the unique challenges that need to be addressed with you add the ME/CFS dx. with POTS. This is a huge concern to many PwPOTS and ME, as so many clinicians due not realize the dangers of PEM. I had to laugh at the image in grading exercise based on how many houses. SO TRUE. It is a good day for a POTS/ME when they can get a shower. That is how many rate their day. Thank you for a true to life discussion and keep up the education of POTS and how OT can assist in quality of life.

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Thank you for such a good overview of how to treat Long-haulers after Covid and for including so many good resources.
This will help steer my practice and help me catch those who need help but havenā€™t found it yet. It will also help transform treatment when my ppts develop POTS.

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Wow, @donna9! That is the best feedback we can have- is to hear from someone with the condition who is also an OT. Iā€™m really interested to keep learning more about OT and ME/CFS- if this doesnā€™t come up naturally in the research we review, we may need to see out some research about it!

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Thank you for the wonderful podcast and for spreading information about this increasingly known syndrome, thanks to people like you! I encourage those who work in settings that require vitals to be taken to take the vitals not only in the sitting position but as well after the person has stood for a couple of minutes to ensure that ā€˜equilibriumā€™ has taken place (HR, O2, BP, etc.). POTS is often missed because vitals are always taken in the sitting position when they have no symptoms present. It is not till they stand do their symptoms present.

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Yes!! It is such a simple step to take vitals in different positions if you suspect any difficulties with autonomic regulation!

Welcome to the OT Potential Club, @zachary1!

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18

Love this podcast. A wealth of information. Thank you so much

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Great knowledge dispersed. Love to get this info and now can assist patients that have this

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Iā€™m glad you liked this @kimberly23! I still think about this episode all of the time! I hope the info sticks with you, like it has for me!

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