Tired Teens: Understanding and Conquering Chronic Fatigue and POTS.: Understanding and conquering chronic fatigue and POTS

by Philip R. Fischer M.D.

What happens when a perfectly healthy teen suddenly becomes tired and lethargic? In Tired Teens , Dr. Philip R. Fischer draws upon decades of experience as a pediatrician to pinpoint causes of chronic fatigue in teens and explains how teens and parents can help combat these debilitating conditions.

Preparing for college applications, keeping up with schoolwork, and balancing a variety of extracurricular activities, all while maintaining a social life, is causing modern-day teens to become overworked and under-rested. While some students manage to keep up with this packed schedule, many teens go from being A+ students to barely being able to get out of bed in the morning.

Some causes of excessive tiredness, like lack of sleep and improper sleep hygiene, can be easy to remedy. However, other causes, like digestive problems, hormonal changes, and postural orthostatic tachycardia syndrome (POTS), may require more serious care.

In Tired Teens , Dr. Fischer explains how to identify the warning signs and symptoms of chronic fatigue in teens, helping you determine if your teen’s excessive tiredness is simply a symptom of a busy schedule, or the result of an unexpected disorder, like autonomic dysfunction and POTS.

Finally, the book provides expert advice on receiving an evaluation and diagnosis for adolescent fatigue, and outlines different treatment plans available to those diagnosed with this invisible illness. By simplifying these issues in a clear and digestible way, Dr. Fischer makes it easy for teens and parents to learn how to manage and treat persistent tiredness.

Whether you’re a teen experiencing chronic fatigue or the parent of one, Tired Teens offers hope and guidance about how to overcome chronic fatigue and POTS for good.

Genres: Nonfiction

208 pages, Paperback

Published July 19, 2021

Reviews

[Kylie Percival · Rating 5 out of 5]

This is an excellent resource for teenagers with POTS and their parents. I wish I had read it when my daughter was first diagnosed as it would have been both encouraging and helpful. Fischer's description of POTS recovery has certainly been borne out by our experience; the turning point to improvement was absolutely an incremental exercise regime with the right medication.

[Sara Geiger · Rating 4 out of 5]

As a teen with POTS, I would’ve loved something like this to help educate myself and explain to others. I appreciate that the book makes treatment interventions more accessible.

BUT, as a teen with POTS and an eating disorder (and a current eating disorder dietitian), I am disappointed by the obvious weight-centric focus of this book. So many of my clients have POTS co-occurring with their ED. While I know first-hand how important movement is for POTS, I also know that excessive and compulsive exercise is damaging to anyone. The language of “pity party” and “Debbie downer club” is a bit too emotionally toxic in my opinion. It’s possible to be recovery-oriented and forward-thinking while still being validated by friends, family, and even yourself! Giving yourself credit for all that you go through is a necessary part of your growth. If I were to recommend feedback for a second edition, I would highly recommend having a healthcare professional who is eating disorder-informed have an edit. It’s wild to me how a book advocating for teen girls didn’t consider that, but then again, not surprising.

[Randy Astle · Rating 5 out of 5]

I'm the father of a fifteen-year-old girl who's struggled with chronic pain and fatigue for at least three years now; we initially thought it was a rheumatological condition, which is why I read Managing Your Child's Chronic Pain a while ago. That's a good book for parents with kids in pain and no explanation, so I do recommend it, but if you have a diagnosis—or even a suspicion—of POTS, this is obviously the book to go to. One thing I appreciate about Dr. Fischer's approach here is that he writes to teenagers themselves; I think reading the whole book would be daunting for my daughter, but I am going to ask her to read certain parts, especially Chapter 11 on recovery. A second thing I appreciated is his broad approach to all types of chronic fatigue. After several evaluations my daughter didn't get an official POTS diagnosis, but her symptoms are close enough that the approach he outlines here still applies to us—we'll still cure it the same way.

The first ten chapters are full of background information about the anatomic nervous system, causes of fatigue, POTS' psychological/emotional effect, and so forth. This can help, as in our case, when a cardiologist doesn't give a formal diagnosis of POTS, or you're still trying to reach a diagnosis in the first place. He emphasizes that POTS and fatigue manifest differently in every individual, so some people will experience some symptoms and some people others, but just because you don't have a worst-case-scenario diagnosis with blood pooling in the legs (that turn blue) or fainting if you hold still for a few minutes, it doesn't mean you don't have some form of abnormality with your circulatory or nervous systems. So, like I mentioned, definitely still read this regardless of whether you have an official diagnosis or not; with so many pages describing different ways POTS manifests it can help you drill down into what aspects of the condition you're dealing with—I asked my daughter about several symptoms he describes, because she doesn't always think to mention something, or even necessarily know that something is abnormal (she was amazed to learn that it's not normal to get light-headed with blurry vision when you stand up).

Having said that, the book is a slow burn, with a lot of expositional information before Chapter 11 finally gets into treatment. Spoiler: treatment is basically a gradual program of increasingly difficult cardio and strength-training exercise—not just off-the-cuff intentions to try to exercise, but a planned program. As other reviews say, at this point the book can sound like an ad for the Mayo Clinic, where Dr. Fischer works, or at best an advice book for really economically privileged kids, e.g. if you can't schedule a major trip to Minnesota then just hire a personal trainer. So the tone can be a bit out of touch in places, but the intent and the medical principles remain true. If this book had to be boiled down to one word it would be "exercise." Exercise, exercise, exercise. Which I know is the last thing my daughter wants to do, so I'm particularly going to ask her to read the passages that Fischer includes from a past patient named Laura about how exercise helped her. There are also many passages from her parents, for the parents out there, but Laura's segments speak directly to teenagers currently going through POTS' travails. It's nice to instill hope and know you're not the only one going through this.

Beyond all this, the most practical takeaway is STEPS.
S - salt
T - take fluids. drink
E - exercise. the most important
P - prescription medication (there's a whole chapter on this, so you can advocate at the pediatrician's office)
S - school, sleep, social/psychological support

If your child's struggling, this slim 200-page book won't hurt. My daughter's POTS-like symptoms are complicated by a major scoliosis surgery a few months ago, so I'm not yet at a place where I can describe an ultimate recovery, but at worst this will give you and your teen more information and abundantly more hope.

[Dave Schaafsma · Rating 3 out of 5]

A good and useful book we are all reading in my house, as one of us is suffering from POTS, though we also follow podcasts and other medical sites. One of the interesting things about the book for me is that my sister was diagnosed with both chronic fatigue syndrome and fibromyalgia and pediatrician Philip Fisher makes some links between these maladies. And all have been also seen (and by some still) as "hysterical" women and girl problems, "all in yr imagination," reminding me of The Yellow Wallpaper by Charlotte Perkins Gilman and the whole history of doubting women and girls on the sharing of symptoms. Each doctor has suggested psych therapists.

Too much of this book is intro--I ran through at least the first third very quickly--and too much of it is a kind of an ad for the Mayo Clinic and Dr. Fisher's approach (though I know, it is his book, he works there, so it's expected, and the Mayo Clinic is a kind of Gold Standard, but even before this book comes out he admits you have to wait at least a year to get an appt there).

The most helpful parts of course are on diagnosis and treatment, which are helpful, though you can find similar discussions online, too. Though not all the doctors we have seen agree that what she has is POTS, we have felt some confirmation in the reading of this book and online. Fisher's style is informal, sharing aspects of his own physical and mental health in the process, and he works to emphasize that you can't generalize too much about disease and disorders. Each person is different, and though shared symptoms are part of a diagnosis, each person has different symptoms. I liked that. I also like it that he alternates between his medical talk and the testimony of a girl and her mother who survived POTS.

Staying active in spite of the fatigue seems key. Some combo of meds and exercise and fluids and friend/family support are parts of the building blocks, which does not seem like a remarkable set of remedies as I write them out, but I'll read on.

Short audio book read by the author.

[Quirky Shauna · Rating 5 out of 5]

Easy to read with a conversational style. Dr. Fischer gives quite a thorough overview of diagnosing and treating POTS. A plug for Primary Children's Hospital - just opened a new clinic for Autonomic Dysfunction. No need to travel to Mayo!

[Jen (bookscoffeedogs) · Rating 5 out of 5]

Wish I had read it for an overview years ago. It was out in 2021, which could have still been helpful jumping off place! I did not realize how important exercise is as a healing component to the regiment. Not sure why there are two listings for this book on Goodreads, but reviewed on this one.

[Carlena · Rating 3 out of 5]

Pretty much as much information as you can get by seeing a doctor or online.

[audrey wells · Rating 3 out of 5]

i thought it was a good resource but at the same time seemed a little out of touch at times. The urgence to “ignore every physical symptom” in the face of chronic illness seemed a little extreme.

[Kieran Nurmi · Rating 2 out of 5]

It seems insightful at start but it turns around the time they imply that pots is a smart white girls disease. Past that point it's a plug for the mayo clinic and it's treatment plan.