A little over a year ago, I was diagnosed with Postural Orthostatic Tachycardia Syndrome following a fall on campus and subsequent hospitalization. I’ve learned a lot about how to manage this condition over the course of a year, and my professors have been very supportive with helping me figure out accommodations for POTS that I could benefit from and how my experience in the physical and digital classroom could be improved. In honor of Postural Orthostatic Tachycardia Syndrome Awareness Day, here are some examples of classroom accommodations that I have used as a college student with POTS, and accommodations that my friends with the condition have used as well.
What is POTS?
Postural Orthostatic Tachycardia Syndrome, also known as POTS, is a disorder that is characterized by blood flow changes that occur when a person changes positions, i.e going from lying down to sitting up. When this happens, a person’s blood pressure will frequently decrease and their heart rate will increase, as the heart beats faster in order to get blood to the brain. POTS commonly co-exists with other chronic illnesses and disorders as well- in my case, my POTS was linked to my Chiari Malformation diagnosis.
According to the NIH Genetic and Rare Diseases Information Center, some of the most common symptoms of POTS include:
- Blurred vision
- Lightheadedness, dizziness, or fainting
- Heart palpitations
- Poor concentration
- Gastrointestinal symptoms (for example, nausea, cramps, bloating, constipation, diarrhea)
- Shortness of breath
- Head, neck, or chest discomfort
- Sleep disorders
- Difficulty exercising
- Coldness or pain in the extremities
People with POTS may not experience all of these symptoms, and all of these symptoms may not necessarily be linked to POTS either. To learn more about the condition, I recommend reading about it from trusted informational sources such as NIH or reaching out to a trusted medical professional.
Limiting movement in the classroom
It can be very disorienting for me to stand up and sit down frequently in a classroom, or otherwise walk around the room. Many people with POTS also use mobility aids such as canes or wheelchairs to help with balance issues and may prefer to sit close to the door or another exit in order to limit movement in the classroom. When my professors would do an activity that involves moving around the room, they would typically have me sit at my own desk and have group members walk up to my desk, or hand me a paper directly instead of having me walk to another area of the classroom to pick it up.
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Permission to have food/drink
It’s very easy to get dehydrated with POTS, and many people eat salty foods throughout the day in order to manage low blood pressure or vertigo. While I almost never eat in class, I did ask for permission to have a water bottle with me so that I could easily stay hydrated, and I have snacks on hand in my backpack or on my desk if I need them as well. Since many of my classes take place in a computer lab, I would make sure to turn away from the computer when drinking from my water bottle to avoid any accidental spills, or I would use a bottle with a built-in straw.
It’s worth noting that I had to get a formal accommodation when I took an online math class at a community college in order to have food or drink during recorded classes or proctored exams, though this was not needed for online classes at my home college.
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Copies of notes and other classroom materials
Another common symptom of POTS is trouble concentrating or trouble with brain fog. Since it can be difficult for some students to focus in class well enough to take notes, requesting copies of notes and other classroom materials can be very beneficial for ensuring that students have access to good quality study materials. I already had this accommodation in place as I have low vision and did not have to request it specifically for POTS, though many of my friends with this condition have this accommodation as well. My professors will typically post a copy of the notes to the class website or send me an email with a more detailed document.
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Recordings of lectures when possible
I’ve found that having access to recorded lectures and class sessions has helped me dramatically with reviewing notes from class as well as working on assignments. However, instead of only having the recordings for myself, my professors will frequently make the recordings from class available for all students, in case there is a student who does not want to disclose a disability or access need. I still have this written as an accommodation though in case I encounter a professor who does not post recordings of the class, and prefer to use the built-in audio recording feature on my phone so that I can easily synchronize the audio file across my other devices.
Taking exams in an alternative location
This is another accommodation I had prior to my POTS diagnosis because I have low vision, but being able to take exams in an alternative location such as the disability testing center or in my room with a secure browser is helpful for a lot of reasons. For one, it’s easier for the proctor or professor to provide needed accommodations such as extended time, stretch breaks, and alternative exam times than it would be for them to do these things in the traditional classroom setting. Another reason is that students can have better control of their environment and not have to worry about having accommodations denied, as all of the accommodations for the testing center or individual exam are approved ahead of time. Students will need to have a disability services file in order to be approved for the disability testing center.
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Permission to sit during presentations
In my major, students do not frequently have to stand up in front of the class and give presentations, but my friend was in a major where this was a much more common occurrence and strongly recommended that I have this accommodation added so that I wouldn’t lose points when presenting a project- something that had actually happened to them. In my previous major, if I had trouble standing for a presentation (such as when I injured my foot), the professor would typically have me sit at their desk in the front of the classroom so that I could still face the audience or have a chair for me to sit in that wasn’t directly facing the projector.
Ability to take classes remotely
By far, one of the most helpful classroom accommodations for POTS that I received was the ability to take classes remotely that were traditionally offered in-person. I was diagnosed with POTS shortly before midterms and was unable to reliably attend my classes in-person, so I worked out a plan with my professors to take classes remotely and stay up-to-date with my coursework. Without the ability to attend classes remotely, I would have failed the entire semester. I have an entire post about how I attended classes remotely linked below.
Summary of classroom accommodations for POTS
- Limit movement in the classroom so that students do not have to stand up/sit down frequently
- Give permission for students to eat/drink in class to maintain blood pressure and avoid dehydration
- Provide copies of notes and classroom materials to help fill in gaps in student notes
- Allow recordings of class lectures so that students can listen later on
- Allow use of the disability testing center or remote proctoring options for exams
- When giving presentations, give students the option to sit so that they don’t have to stand for long periods of time
- If necessary, allow students to take classes remotely/asynchronously instead of in-person