@RookTheFanatic and
@pensacola - POTS is another one of those conditions that can be a side effect (maybe you are taking drugs that lower your BP or raise your heartbeat), a symptom of another illness (multi system atrophy, peripheral neuropathy), and it can be dx’d as a syndrome on its own. Like chronic fatigue, which can be a real problem for people undergoing chemotherapy, or with heart disease or autoimmune disease, but can also be a side effect of depression or a consequence of poor lifestyle factors.
POTS at its most basic is an observable phenomenon with clear parameters (unlike fatigue which is subjective) - in certain situations (postural) when moving from standing to sitting (orthostatic) your heart rate increases by more than 30 bpm (tachycardia). This can be accompanied by low blood pressure, which can cause people to faint, and this on its own (without the tachycardia) is orthostatic hypotension.
Whether a dx in its own right or a side effect or symptom, it is highly treatable. You can lower the heart rate with beta blockers, and you can raise the blood pressure with drugs like Florinef or midodrine. Drinking more electrolytes is also number one advice - ideally 3 litres a day of oral fluid.
Now, the waifs with their saline and ports are something we don’t see on my side of the fence and I’m kind of amazed it is so prevalent in the US. Unless you have intestinal failure, or a high-output stoma, or another type of dysautonomia that impacts your body’s ability to balance fluid, you don’t need saline.
Even with these conditions, the first line of treatment is to exhaust other options like increased oral intake and medication. You pretty much need to be at risk of kidney failure, or hypovolemic shock, to get regular access. It is rare, but it does happen and in these situations a port and regular IV hydration is needed but it is supportive, not curative.
As for needing a wheelchair, that is just insane. No legit doctor would recommend it. All it will do is decondition them further - the Levine Protocol is a highly recommended exercise program for POTS that builds muscle in the legs so they can better pump blood when standing. Claiming they need a wheelchair for safety is also BS, as they would only get faint when moving positions and you get pre-syncope. The first time someone faints it might take them by surprise, but after that people learn the signs, and get low while blood pressure restores.
So, yeah, tldr, POTS as a side effect / symptom / syndrome is a real thing but it is highly treatable with minimally invasive methods. There are instances where saline is needed but this is due to serious dysautonomia or intestinal function compromise.
Thank you for coming to my Ted Talk
@poopinmy_line 
LOL at being allergic to saline and not realising Hartmann’s is saline based. She is comedy gold!
I remember she ended up on an SSRI because she started getting anxious about the unpredictability of the episodes because it was embarrassing for her. She still did sport, went to uni, etc though. None of this wheelchair shit.
