Latest news with #POTS
The Hindu
a day ago
- Health
- The Hindu
Integrating modern medicine with ancient wisdom
There has always been a gulf, and perceived incompatibility, between modern medicine and integrative medicine. While modern medicine is focused largely on abnormalities and finding cures for them, integrative medicine is focused on the entire continuum of human healthcare engagement: prevention, maintenance and cure, or to put it more specifically in medical treatment terms, rejuvenation, restoration and rehabilitation. Ancient medical systems such as ayurveda, yoga, acupuncture and tai chi have great potential for the human body, brain and mind, as many research papers have revealed. It has been pointed out too, that we may be erroneous in calling these older systems complementary, as they not only preceded much of modern medicine as we know it but have stood the test of time. Integrative medicine sits well within the philosophy that healthcare must be pluralistic, inclusive and adopt complementary approaches that restore equilibrium (the healthy condition) in an individual. The National Center for Complementary and Integrative Health, United States, emphasises that integrative medicine is a holistic approach to health and well-being, using a coordinated and conjoint but optimal use of allopathy and complementary medicines. Integrative medicine may be defined as a 'single-window' healthcare service that adopts an evidence-based blend of traditional and modern medicines, with optimal use as either a combination or as monotherapy. Here we present one client's healing journey from a plethora of long COVID symptoms, to a state of well-being, with an approach that combines the best of modern science and the wisdom of ancient medical traditions. Mr. S and his healing journey Mr. S, a 52-year-old businessman, consulted us, burdened as he was by a complex web of physical and psychological challenges. Following a COVID-19 infection two years ago, he had begun experiencing persistent cognitive lapses, fluctuating moods ranging from irritability to agitation, muscular stiffness, low back pain, and a host of gastrointestinal issues including bloating and acid reflux. Compounding these problems were fatigue, palpitations, dizziness, sleep disturbances, and increased sensitivity to noise and light — symptoms that, taken together, seriously eroded his capacity to function both at work and at home. A comprehensive multidisciplinary evaluation conducted by our team of a physician, a psychologist, a physical therapist, and an electrophysiologist uncovered several key findings. Although Mr. S's EEG and ECG were normal, precision tests revealed significant autonomic dysfunction detected as Postural Orthostatic Tachycardia Syndrome (POTS). POTS is diagnosed through a significant increase in heart rate on changing postures (usually 30 beats or more when one progresses from lying to standing) accompanied as well in some cases by a drop in blood pressure (systolic > 20 mmHG and diastolic > 10 mmHG) on standing up. Mr. S also suffered from marked anxiety, moderate depressive symptoms, and mild cognitive impairment. His score of 17 out of 30 on our comprehensive autonomic symptom checklist highlighted the extent of his dysautonomia. In light of these findings, the care team decided on an integrated treatment strategy, merging established modern medical practices with ancient healing wisdom to holistically address both his physical and psychological ailments. Central to his modern medical management was the judicious use of pharmacotherapy to stabilise autonomic imbalances, manage mood-related symptoms, and alleviate discomfort. The autonomic nervous system takes its origins in our limbic (emotional) brain, and the use of drugs that stabilise brain activity is, therefore, both logical and necessary. Augmenting this approach was a cutting-edge novel intervention Transcutaneous Auricular Vagus Nerve Stimulation (taVNS). Vagus nerve stimulation has long been studied for its role in modulating the balance between the body's sympathetic ('fight or flight') and parasympathetic ('rest and digest') systems. In taVNS, a small electrode stimulates the auricular branch of the vagus nerve near the ear. These sessions, administered four times weekly for 20 minutes each, are designed to prompt a parasympathetic response, helping to calm hyperactive stress circuits in the body. Research increasingly indicates that taVNS can reduce heart rate variability issues, lower inflammation, and alleviate mental health symptoms — making it particularly relevant for managing complex dysautonomia. Neuromodulation of this kind 'paces' the nervous system, like the cardiac pacemaker. Mr. S's psychological care included 10 hours of Cognitive Behavioral Therapy (CBT) to mitigate severe anxiety and moderate depression including cognitive retraining exercises to help his neurocognitive symptoms. It is well known that neurocognitive dysfunction that is perceived but not detected in formal testing, also called subjective cognitive dysfunction, is a common outcome of depression and anxiety. Under the guidance of a clinical psychologist, he learned to identify distorted thought patterns, improve stress management skills, and adopt healthier coping strategies. Muscle relaxation techniques further supported this process, helping him gain mastery over the physiological manifestations of anxiety — such as muscle tension and shallow breathing. His practice of cognitive retraining also helped in his gaining confidence about his cognitive performance. Physical therapy formed another pivotal dimension of his treatment. Through manual therapy, electrotherapy, and graduated exercise regimens, Mr. S found relief from muscle spasms, built endurance, and improved both gait and coordination. Meanwhile, complementary approaches from naturopathy and ayurveda provided a well-rounded, integrative model of care. Treatments such as acupressure, reflexology, and abdominal mud packs helped stabilise his digestive system and offered a soothing counterpoint to the physical and psychological stresses he had been enduring. Shiroabhyangam—a gentle ayurvedic head massage with warm kshirabala oil — further enhanced relaxation, improved sleep initiation, and encouraged a sense of inner calm. A structured yoga regimen completed his mind-body therapeutic journey. Incorporating pranayama (breathing exercises), sukshma vyayama (gentle stretches), chanting, and yoga nidra (deep relaxation), the programme empowered Mr. S to calm his overactive sympathetic drive and strengthen his parasympathetic tone. In tandem with a balanced, gut-friendly dietary approach, his digestive issues were addressed by reducing acid reflux triggers, incorporating probiotics to support healthy gut flora, and adopting smaller, more frequent meals to alleviate bloating. After five weeks, Mr. S reported markedly reduced dizziness, numbness, and muscular pain; substantial improvement in mood and sleep; and greater overall resilience. With his autonomic dysfunction significantly mitigated, he returned to a more productive and satisfying daily routine, bolstered by sensible nutrition, regular exercise, and continued yoga practice. Integrative medicine & the McDonald's paradigm Comprehensive and integrated care, including but not restricted to yoga, tai chi, qigong, acupuncture and other mind-body practices, are recommended as add-on interventions in mainstream care and such an approach is rapidly gaining application globally for persons with chronic diseases. In a large study of people with chronic neuropsychiatric symptoms in the U.S., it was found that 43.8% of U.S. adults with at least one neuropsychiatric symptom, used at least one Complementary and Alternative Medicine (CAM) therapy. The multiplicity of symptoms appeared to be an important predictor of integrative medicine being considered. Other important considerations were the duration and chronicity of the complaints and the recommendation of the conventional care provider to consider CAM. Twenty per cent of patients used CAM because standard treatments were either too expensive or ineffective, while 25% used CAM because it was recommended by a conventional health care provider. Adults with at least one neuropsychiatric symptom were more likely to disclose the use of CAM to a conventional healthcare provider (47.9%). Our experience with Mr. S, one of over 15,000 people with chronic disease that we have treated using integrative medical therapy, indicates that such an approach holds promise for individuals experiencing dysautonomia as part of long COVID, and indeed a plethora of other chronic symptoms and diseases, especially in our experience, those affecting the brain and mind. Emerging data globally indicates that post-viral syndromes can involve persistent autonomic disruptions — symptoms such as palpitations, fatigue, and orthostatic intolerance often linger, long after the acute infection has remitted. Combining modern techniques such as taVNS, targeted medications, and structured rehabilitation with holistic therapies — yoga, meditation, acupuncture, and evidence-based traditional remedies — can help recalibrate the autonomic nervous system and foster a meaningful recovery. Reviewing the available research data including discussions at expert forums such as the World Congress of Neurorehabilitation (Vancouver, Canada, May 2024), where Buddhi Clinic had the opportunity to present a full symposium on integrative approaches to neurorehabilitation, the consensus appears to be that integrative medicine is the need of the hour, in an ageing world burdened by chronic disease. Bringing complementary and alternative treatments into the mainstream and seamlessly integrating them with modern (allopathic) medicine and treatments is therefore not just desirable, but essential. Integrative medical practice is criticised in some quarters. These criticisms arise from safety concerns, lack of well-designed efficacy studies, limited knowledge about drug interactions, less robust regulatory controls over products, perceived bias against CAM in mainstream medical journals, and conflict between research and clinical practice. Research in complementary and alternative healthcare approaches has increased in recent years, and sufficient data that support the benefits of certain practices in some illnesses are being reported. In addition, work in the field of non-pharmacological care research for conditions like cancer points out that these practices have become 'essential and critical' in providing optimal care and support to elders with this condition. With the support for integrative medicine by the Government of India, the future growth of such research appears bright. In our experience, the service paradigm has to be based on a McDonald's model: combining prescription (the Mac meal) with choice (just fries or a burger as one deems fit). For conditions of health and mild impairment, the choice model may work well, as it encourages patient autonomy; but in conditions of disease, where restoration and rehabilitation are required, a prescription model drawn up by the healthcare team may work better. The core of integrative medicine lies in its unique ability to encourage patient choice and participation in care; to be complementary (combining the modern with the traditional, seamlessly); to support in acute conditions and take the lead in chronic conditions; to focus on symptoms rather than diagnosis; and to take a practical, problem-solving approach to health and wellness. Most importantly, perhaps, combining modern medicine with ancient wisdom, leverages the power of human touch and communication, both powerful tools in the journey to health and well-being. Thus, as Mr. S's journey reveals, the synergy of modern medicine and ancient wisdom offers great hope for individuals confronting chronic diseases including those dealing with the complex aftermath of viral illnesses such as Covid. A truly holistic path to restored health and well-being has been brought to life by bringing together healing traditions, both modern and ancient. (Dr. Ennapadam S Krishnamoorthy is founder and CEO, behavioural neurologist & neuropsychiatrist, Buddhi Clinic, Chennai. Dr. Rema Raghu is co-founder & chief clinical officer, Buddhi Clinic, Chennai.)
Business Insider
3 days ago
- Health
- Business Insider
Living on $3,400 a month: How one couple pays the bills while juggling medical debt and saving for gender-affirming surgery
Last year Alex Mixson and his wife Marley Britt were having a string of medical crises. She was unable to work because of an undiagnosed illness, and he had to have an appendectomy. "We couldn't afford Columbus anymore," Mixson said of the Ohio city where they lived. Multiple emergency medical visits drained their savings and racked up thousands of dollars in debt. Mixson, a trans man who's been transitioning for eight years, put off his top surgery to focus on saving money and helping his wife, who had been suffering from undiagnosed Postural Orthostatic Tachycardia Syndrome — a condition that causes dizziness and lightheadedness that was making it difficult for her to work. "I'd rather take care of my wife than be comfortable in my skin," said Mixson, who is 26. The couple moved back to West Virginia, and both of them are employed, earning about $3,400 a month total. Mixson is building savings to have top surgery in the next few months. Britt and Mixson are part of a cohort of about 91 million Americans who cannot afford or don't have access to quality medical care. A study from the UCLA Williams Institute also found that while transgender people have high rates of enrollment in health insurance, 1 in 3 avoid seeking healthcare because of the cost. "It's a lot to struggle with, and it's hard," Mixon said, of his journey to afford surgery, "but it's so rewarding at the same time to just wake up and not feel so shitty about yourself." Finding community and fundraising for gender-affirming medical care Mixson works as a front desk receptionist, and his wife is a remote IT worker. Since spiraling into debt, the two have had to cut amenities like eating out and have chosen to prioritize rebuilding their emergency savings over paying back their medical bills. The two spend over half of their combined monthly paychecks on rent, transportation, utilities, and food, leaving them with about $100 a month to set aside for savings. "I haven't paid a medical bill. I just kind of let it sit on my credit," Mixson said. Britt was finally diagnosed with POTS this past month and is receiving proper treatment for it while working remotely. The newfound stability has allowed the pair to schedule Mixson's top surgery this summer. Mixson estimates that if insurance doesn't cover his top surgery, he'll be on the hook for another $10,000. He has saved some of that amount and started a GoFundMe to raise an additional $3,500. Mixson said it's been hard to fundraise from the small queer community in his hometown, as he said most are also struggling to make ends meet. Mixson has been posting to Reddit forums about his fundraiser in an attempt to reach a wider audience online and garner more support. As of March 31, he's only raised $980 toward his goal. He said that his close friends have been pivotal in helping him figure out things like insurance and extending cash in times of need, including $200 when he moved, so he and his wife could buy groceries. For Mixson, top surgery is a matter of safety in being able to pass as a cisgender man. Since starting testosterone, he said, few people recognize him from before his transition, but in the small city, word spreads quickly. There are moments when Mixson is afraid he'll be recognized. He's even more worried since the election, given that the Trump administration has pulled funding from institutions that work on DEI-related projects and purged inclusive language and mention of transgender people on federal websites, saying it promotes "woke" ideology. "I need to do what I need to do, keep my head down and come home," Mixson said. His wife has asked him to carry pepper spray in his car in case he is attacked. Research from the Williams Institute at UCLA in 2021 found that transgender individuals are four times as likely as their cisgender peers to be victims of violent crime. Despite the financial challenges, getting the surgery is important to Mixson. From a young age, he has struggled with body dysmorphia — feeling that his gender identity didn't match the gender he was assigned at birth. Mixson has been taking testosterone for five years and flattens the appearance of his chest using a compressive top, but that has also led to other kinds of discomfort. "I've been binding for years and it's at a point now that my back is almost always hurting," Mixson said, adding that his transition has brought positive changes to his mental health. "I am definitely more outgoing than I used to be. I feel stronger."
Yahoo
5 days ago
- Business
- Yahoo
Benchmark Maintains Buy Rating on Ooma, Cites AirDial as Key Growth Catalyst
On May 28, Benchmark analyst Matt Harrigan reaffirmed his stable Buy rating for Ooma Inc. (NYSE:OOMA) while maintaining a price target of $20. The analyst highlighted the company's robust product line, particularly the AirDial POTS (Plain Old Telephone Service) replacement solution, as a key factor in its continued progress. Harrigan stressed that the AirDial device meets a significant market demand, since more than 20 million POTS lines in North America urgently require an upgrade to prevent cost increases and possible safety hazards. He expects Ooma Inc. (NYSE:OOMA) to continue to experience gains in margins as a result of operational leverage, including lower costs for R&D. Harrigan added that if the current upward trends continue, there may be more potential for the stock. He noted AirDial's impressive performance as a key growth driver and proposed that the company's valuation potential could be improve by exceeding existing estimates for Adjusted EBITDA margins. While we acknowledge the potential of OOMA to grow, our conviction lies in the belief that some AI stocks hold greater promise for delivering higher returns and have limited downside risk. If you are looking for an AI stock that is more promising than OOMA and that has 100x upside potential, check out our report about the cheapest AI stock. Read Next: and Disclosure: None. Error in retrieving data Sign in to access your portfolio Error in retrieving data Error in retrieving data Error in retrieving data Error in retrieving data
Yahoo
5 days ago
- Business
- Yahoo
Benchmark Maintains Buy Rating on Ooma, Cites AirDial as Key Growth Catalyst
On May 28, Benchmark analyst Matt Harrigan reaffirmed his stable Buy rating for Ooma Inc. (NYSE:OOMA) while maintaining a price target of $20. The analyst highlighted the company's robust product line, particularly the AirDial POTS (Plain Old Telephone Service) replacement solution, as a key factor in its continued progress. Harrigan stressed that the AirDial device meets a significant market demand, since more than 20 million POTS lines in North America urgently require an upgrade to prevent cost increases and possible safety hazards. He expects Ooma Inc. (NYSE:OOMA) to continue to experience gains in margins as a result of operational leverage, including lower costs for R&D. Harrigan added that if the current upward trends continue, there may be more potential for the stock. He noted AirDial's impressive performance as a key growth driver and proposed that the company's valuation potential could be improve by exceeding existing estimates for Adjusted EBITDA margins. While we acknowledge the potential of OOMA to grow, our conviction lies in the belief that some AI stocks hold greater promise for delivering higher returns and have limited downside risk. If you are looking for an AI stock that is more promising than OOMA and that has 100x upside potential, check out our report about the cheapest AI stock. Read Next: and Disclosure: None. Error in retrieving data Sign in to access your portfolio Error in retrieving data Error in retrieving data Error in retrieving data Error in retrieving data
Forbes
5 days ago
- Business
- Forbes
Why States Must Stop Treating Your Smartphone Like A Dumb Rotary Phone
Woman Talking on Telephone (Photo by Library of Congress/Corbis/VCG via Getty Images) Plain old telephone service (POTS) has been dying a slow death in the United States since the turn of the century. The number of POTS lines peaked at 192.5 million in 2000; by June 2024, only 7.6 million residential POTS lines remained. For much of the 20th century, almost every American household used only POTS to make a phone call. Now, only 1.3% of households rely on POTS to do so. What happened? Consumers flocked to mobile and Voice over Internet Protocol (VoIP) – advanced platforms that did not exist during the heyday of POTS's monopoly reign. The total number of mobile telephone lines in the U.S. surpassed POTS in 2004. Today, there are more than 388 million mobile lines in service. The number of VoIP lines passed POTS in 2013. There are now more than 64 million VoIP lines in service. This is not news to the tens of millions of Americans who cut their telephone cord years ago and embraced mobile telephony or VoIP and all the advanced features they offer, like nationwide calling and the go-anywhere convenience of a cellphone. Unfortunately, for some state policymakers, the horse and buggy that is POTS continues to loom large, shaping their misinformed view of the advanced communications sector. Worryingly, some states have not only resisted removing outdated POTS laws from their books; they are actively seeking to extend those rules to new communications technologies, which have thrived in a competitive marketplace governed by a deregulatory framework. By doing so, states will undermine investment in new networks, increase prices, and ultimately harm consumers. None of this is good for America. Backwards-looking, heavy-handed regulation never has been. Go Your Own Way…Or Maybe Not? When it comes to applying old rules to new communications technologies, California has been in the vanguard. It has refused requests to roll back POTS-era rules; sought to regulate VoIP like POTS; and is finalizing rules that would hold competitive offerings like mobile and VoIP to a more punitive version of service quality standards originally devised for Ma Bell. At the same time, though, the Federal Communications Commission (FCC), along with dozens of other states, have been actively engaged in regulatory modernization aimed at removing POTS rules to incentivize and accelerate the deployment of modern networks. California's approach is misguided and fails to put customers first. States sometimes choose to forge their own path on certain issues. This seems to happen more often in California than elsewhere. Indeed, the state has a history of choosing an alternate path on issues like vehicle emissions and data privacy. In many of those instances, however, California framed its actions as necessary to either fill a perceived gap left by federal inaction, as it did when it passed a privacy law after years of failure by Congress to do so, or to go above and beyond existing federal rules, as it has done with vehicle emissions (California's federal waiver allowing it to impose stricter emissions standards is at risk of being revoked). On issues of national importance, outlier approaches create collective action problems, which stifle progress towards achieving a shared federal goal. Assuring an orderly and timely transition away from POTS has been a national imperative since the early 2010s, when the Obama-era FCC began taking steps to relieve POTS providers of monopoly-era obligations so they could invest in modern networks and improve the services that consumers are actually using. Each subsequent FCC, under both Republican and Democratic leadership, has taken additional steps down this path. This reflects and furthers the country's bipartisan light-touch approach to regulating advanced communications platforms at a national level. Consistency and predictability are critical to maximizing investment, innovation, and overall consumer welfare gains. California has lost its way. Its proposed service quality rules illustrate just how far outside the mainstream the state is on these issues and how continued pursuit of its unique – and highly regulatory – agenda for communications services could impede national transition efforts. Welcome To The Hotel California The notion of service quality rules might sound innocuous, but the rules proposed in California are incredibly exacting and could end up harming consumers rather than protecting them. In a nutshell, California seeks to regulate voice service quality by applying standards governing how providers of all ilk – POTS, mobile, and VoIP – address almost every aspect of service, including how quickly they act in response to an installation request; reporting on and fixing outages; crediting customers for service disruptions; and how long it takes for a customer service rep to pick up the phone. In many cases, the proposed rules are stricter, and the penalties more punitive, than the rules devised just for POTS, the antiquated technology deployed and governed as a natural monopoly service. Where's the beef? Numerous stakeholders of all sizes have faulted regulators for failing to provide compelling data demonstrating actual negative trends in service outages or degradation in service quality. For example, many have argued that the outage data cited by regulators in support of their rules generally fail to account for the underlying cause of the disruption. Oftentimes, a mobile or VoIP outage is attributable to a loss of electric power, a common occurrence in California that is beyond the control of communications service providers. For these reasons, the FCC has rightfully forged a different approach, one that supports investment in network reliability and encourages collaboration among communications providers and electric utilities to restore service. At the same time, there appears to have been little effort by regulators in California to weigh the compliance costs for providers against the benefits the proposed service quality rules purport to deliver to customers. This is especially relevant in the context of POTS, the user base of which is rapidly shrinking. Per the latest FCC data, there are less than 600,000 residential POTS subscriptions in California (population: 39.4 million). POTS prices will inevitably rise as service providers pass through some portion of their higher compliance costs to a smaller number of customers. Meanwhile, the compliance costs for newly imposed standards on mobile and VoIP providers will also likely be passed through in part to customers, resulting in higher prices for them as well. To the extent some of these costs cannot be recouped, there will be less capital available to service providers to invest in next-generation networks or to invest in the same customer service tools the rules claim to incent. This ultimately harms consumers and frustrates timely realization of an overarching goal to move on from POTS so that new platforms are not burdened, directly or indirectly, by monopoly-era rules. What's Next California is not alone in dragging its feet on the transition away from POTS. Numerous states still have POTS-era rules in effect. Some, following California's lead, are also exploring whether to regulate broadband, VoIP, and mobile like traditional telephone service. Inevitably, these actions will trigger lawsuits, with service providers arguing that federal law limits state authority to regulate non-POTS services. Even in the context of POTS, arguments could be made that state efforts impeding fulfillment of national goals for the POTS transition might also be susceptible to preemption. A sounder approach would be for state policymakers to listen to what consumers are telling them about their communications preferences and react accordingly. In the case of voice communications, consumers have been voting with their feet for years. Unlike 50 or 100 years ago when POTS ruled the world, there is no shortage of options for people to communicate with each other. And now with satellite 'direct to cell' technology rolling out alongside grant funds via the Broadband Equity, Access, and Deployment (BEAD) program, which will facilitate universal broadband availability, there are few parts of the country where some form of non-POTS communications platform is unavailable. In this new environment, providers are aggressively competing on service quality, speed, latency, price, and a host of other service parameters. Regulation is not a bad word, but in the advanced communications arena, the type of regulation being considered by California and others is simply not necessary. If a customer feels let down by one voice or non-voice service, they can easily switch to another. And that is exactly what they are doing. Any action that impedes these dynamics should be flatly rejected because unnecessarily regulating a competitive marketplace will only harm consumers. States might also take a page from the FCC and adopt a 'delete, delete, delete' mindset and begin to actively review and repeal antiquated regulations. Regulators can do their job if they deregulate. There is no requirement that they must regulate just for the sake of regulating. Finally, the spate of recent regulatory actions in California only adds to the urgency for Congress to update federal communications law. This is long overdue and critical now that the Supreme Court has made clear that administrative agencies like the FCC can only act according to specific Congressional delegations of authority. An update that empowers the FCC to facilitate a smooth transition from POTS by allowing it to preempt burdensome and backward-looking regulatory actions like those in California is needed.
