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Genevieve Anna Tyrrell is a visual artist and creative writer based in the Orlando area. Please reach out if you have any questions regarding her work, if you'd like to commission a piece, or if you're looking for prints.


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BLOG: Pregnant Zombie Love

Filtering by Tag: POTS

Crazy Versus Breast Milk

Genevieve Tyrrell

I’m at a crossroads. Take my anti-depressant/ anti-anxiety medication or make enough breast milk to satisfy my baby. Both can’t be accomplished. It’s one or the other.

I’ve tried maybe five or six breast milk supplements. Fennel with thistle and nettle pills, marshmallow root tea, ginger, shatavari root extract, fennel seed drink mix, and so on. I’ve spent a lot of dough trying to find the right supplement.

The fact of the matter is Wellbutrin ups dopamine levels, and dopamine lowers prolactin levels. You need prolactin to make milk. =

SSRIs, which effect serotonin, have never helped. My issue has always been a dopamine issue.

It’s tough. She smiles when I give her the mere ONE OUNCE I can pump out PER DAY. She loves booby milk. And it seems to lessen her nasal congestion and it could help her eczema. There’s also a bunch of nutrients in breast milk that aren’t found in formula—even the expensive fancy formula I have.

But how crazy can I let myself be? How depressed can I stand? How awful can I be around my significant other?

Yet, I’m down about not being able to give her breast milk. I want to be able to do that for her. I feel like Why should she have to suffer just because I’ve got a chemical imbalance?

But stopping Wellbutrin could also make my Postural Orthostatic Tachycardia Syndrome worse too.

It’s so unfair. I know, I know. Life’s not fair. But seriously, this is terribly unfair.

Childbirth Plan for POTS Patients & Catch Twenty-Two

Genevieve Tyrrell

I needed rest. I took the medical leave. I have dizzy spells at home frequently and I don't drive much these days. But overall, I'm feeling better because I can lie down whenever I need to. My anxiety and depression have improved considerably.

But while I’ve been feeling better by taking medical leave from my work prior to the birth of the baby, I haven’t been able to get a straight answer regarding my “birth plan.”

A birth plan is how you plan to give birth. It considers at-home birth, c-section, vaginal delivery, what types of anesthetic you’ll use, and so forth.

Given my POTS, and given my history of blacking out and pre-syncopal episodes (pre-syncopal or pre-syncope means pre-full-black out. This is when the room starts to go black around the sides, but I’m able to stay awake if I quickly lie down and raise my feet), and given my rare genetic condition concerning choline, I have stated several times now that I feel it might be best to have a c-section. I truly believe I’d black out during labor. I nearly blacked out during my last papsmear for God’s sake.

It’s not a squeamish thing. In layman’s terms, it’s the vagus nerve (which runs from the neck down to the pelvis) getting improperly stimulated, causing the body to black out. Even a bowel movement can create a situation where I’m pre-syncopal.

The problem is I haven’t completely, fully blacked out in years. How is this a problem and not a good thing? Because then doctors use this as an their excuse that I’m doing “great.” Nevermind all the pre-syncopal episodes I still suffer during the year.

It's a catch-twenty-two.

In short, I’ve learned what will cause a black out and I’ve learned earlier signals (like extreme fatigue), and so I’ve prevented black outs by not doing activity—often basic activity—and just lying the hell down. But because I’ve become so great at preventing black outs, that comes across as my health problem isn’t that bad. And often pre-syncope seems to be taken either with a grain of salt or as an exaggeration. Unless I lose consciousness it’s not considered serious enough. This was the problem that made it difficult to get diagnosed in the first place for so many years.

So my OBGYN referred me to a cardiologist for testing and consult to figure out my birth plan of action. He’s been under the opinion that if I have a c-section, he’s considering it “elective,” which then means my insurance company will not cover two thousand dollars worth of the surgery.  It will be an out of pocket cost because the doctor has not deemed it necessary.

I had hoped the cardiologist would be able to offer her opinion that a c-section would be best. Instead, I got put through the lousy holter monitor that didn’t always work, and an echocardiogram (which is where I caught that terrible virus with bronchitis back in August – a fluke disaster). I’ve had many of both. But whatever. I went along with the basic tests as a formality.

Her 15 minute follow up appointment she stated, “I don’t want to get into trouble,” meaning sued, for recommending a c-section, “just in case something goes wrong with the c-section.” She said, “There just isn’t the language to state to the insurance company that would recommend c-section for POTS. We don’t have the research to back it up as necessary. Other women have done fine.”

I get it. It’s her livelihood. I wouldn’t want to be sued either. But I really feel like she only spent two 15 minute appointments with me and barely knew my health history, yet charged hundreds of dollars for these consults. And I really feel like she has no understanding of the varying degrees of POTS severity. Some women ARE indeed fine with vaginal birth. Some women don’t have POTS severely. I, on the other hand, have had POTS severely. She’s definitely by no means anywhere close to being an expert. She told me she had done “some reading.”

I told her, “I gave you the NIH documentation stating that I have an abnormal baroreflex response. All of child birth is the baroreflex.”

The baroreflex is the bearing down reflex you use for a bowel movement and for child labor.

“There’s just nothing to back up needing a c-section.”

“Can’t we retest the baroreflex then?” It’s a simple, fairly painless test where you bear down on a device in your mouth, but something tells me Winnie Palmer probably doesn’t even have that test on hand.

She couldn’t answer this and adjusted her notes.

I started to cry and said, “So, okay, I need to know: if I have the vaginal birth and I black out during labor, what is the protocol?”

She got strangely hesitant about answering this.

I said, “If I black out—which is most likely going to happen—will the baby be cut out in an emergency c-section?”

Mind you, an emergency c-section can be worse than a planned one. The incision can be bigger and also sometimes sliced at a different angle (up and down the abdomen/ pelvis as opposed to a smaller incision across the lower pelvis). It can be harder to recover from.

I never got an answer out of the cardiologist. She deferred to my OBGYN and changed the subject to how she’d confer with an electrophysiologist about c-section and POTS.  An electrophysiologist has nothing to do with the baroreflex or testing this and I said that. She agreed but said he might have ideas about whether the c-section could be deemed necessary. Whatever that means.

Here I come to find out, there IS NO protocol if a woman blacks out during childbirth. In fact there’s not much protocol for a lot of emergencies during childbirth for the entire United States.

Check this out:




Prenatal or Antenatal Depression & Anxiety

Genevieve Tyrrell

The face of depression. This is a painting I did during a depression a couple of years ago. 

So much of chronic illness for POTS patients is the unseen. 

Pregnant women are supposed to be elated and actually I do feel excited about my baby. I didn’t really in the first trimester so much, but I do now. And yet, that doesn’t stop the depression and anxiety. 7 to 20 percent of pregnant women experience prenatal or antenatal depression. It's often a precursor to postpartum depression if not treated properly.

POTS patients already have a tendency towards anxiety disorders to begin with. There’s multiple reasons why. For some it may be a thyroid issue or some other imbalance that will never quite be resolved even with medication. Perhaps we all had a lot of stressful childhoods. Or it may be that having an autonomic nervous system that’s so easily stimulated or on overdrive day in and day out lends itself to anxiety. Maybe trauma of previous bad experiences relating to Dysautonomia/ POTS triggers underlying anxiety.

The thing is—it’s very real and exhausting. It can also create a cycle of feeling sick.

Before pregnancy, I had suffered at least four severe periods of depressions in my adult life, and also daily issues with anxiety. SSRIs usually made me sicker. Wellbutrin was a relief. However, it also increases heart rate. So the treatments for depression and anxiety can often exacerbate POTS symptoms like heart rate and blood pressure instability.

At this point in the pregnancy—almost 28 weeks—almost third trimester—it’s difficult not to worry about finances. I think that’s my biggest worry. On top of worrying about how to care for the baby and also maintaining a loving, romantic relationship with my fiancé.  I still take 150mg of Wellbutrin XL, but often it’s just not enough. I really need a higher dose and perhaps a combination of a medication I’ve taken during depressions— Brintellix.  But really, it’s better for the baby if I don’t do these things.

With depression and anxiety, my POTS and overall health deteriorates, which in turn gives me more depression and anxiety. And if I get upset enough I can feel it stressing out the baby, which is unhealthy for the baby, which in turn makes me feel awful. If only I could put her in a safe bubble outside of my chaotic body.

I have to make the difficult decision to go along with my doctor’s recommendation of disability leave, which will leave me without pay for two weeks definitely, and then potentially I could get 60 percent my old pay if my insurance doesn’t deny the claim. IF. IF. IF slides down my body in a wave of heat and shorter breaths. The thing that first gave me relief in the doctor’s office days ago—a way out—a way to get more rest and relax—have less work obligations—gives me stress just thinking about the financial repercussions.

I can’t win.

Or maybe I can some. Maybe if I have the rest I won’t be on this much of an edge. I don’t know. It’s exhausting even thinking about it. The dread is overwhelming. It can be suffocating. How will there ever be enough money on top of my student loan payments, my car payment, groceries, taxes, medical bills, and on and on and on. I dread being a burden on my partner. I consider myself a strong woman and yet it's all overwhelming.

Hey, You're Fat. You must work here.

Genevieve Tyrrell

So when I was really overweight from the insulin resistance, almost every single time I was in a place like Target or Walmart or sometimes some place else, I’d get mistaken for an employee and asked about products. Almost without fail. Even if I wasn’t wearing the colors of the store. I rarely had it happen to me prior to the weight gain. No one assumed skinny me worked at a store.

When I lost all the weight, things went back to normal. I rarely got assumed to be an employee of any store.

But now I’m pregnant. I’ve gained thirty-five pounds and though all the weight is on my front, particularly belly, my baby bump is not a perfect round shape yet. Angled at just the right way, you might assume I’m just obese.

Today I was at Home Depot and bending down to get something. So at the angle I was at, you might not have been able to see I’m pregnant. Mind you I was wearing black capri pants and a dark turquoise T-shirt with “Zoo York” on it. My cart was full of stuff I was buying. There wasn’t a single bit of orange on me (the Home Depot color). And yet, a woman just presumed I worked there and started asking me questions like I worked there. I stood straight up, rubbed my belly in that maternal way everyone knows, and said, “I don’t work here. I’m pregnant.”

I wasn’t mean about it, but on the inside I was furious. Again?! Seriously?! Why is it assumed that if you’re fat that you’re there to wait on people? Am I the only one that this happens to? It only happens with significant weight gain.

Funny Things to say to a pregnant lady, particularly one with an underlying chronic illness:

Genevieve Tyrrell

1)   “You better sleep now, because you won’t sleep after the baby comes!”

Thanks for this tidbit of helpfulness. I struggled with all kinds of sleep issues including terrible insomnia prior to ever being pregnant. And now that I’m pregnant, of course that got so much easier.

In fact, it’s a looming fear that I won’t be able to function due to lack of sleep after the baby, so make sure to remind me of this fear. It’s absolutely hilarious and you’re giving me real world prepping advice!

2)   Me: “Wow, the baby kicks a lot. It’s kinda cool but weird.”

You: “Just wait until after she’s born and kicking you with shoes on!”

Oh, so you wanted to see my cringe face! No really, you shouldn’t have. You could have just offered me a dirty tissue, bad coffee, or a colon cleanse coupon if you wanted to see my cringe face, but this is a funny substitute.

Actually, I have weak muscle tone from my health issues. If I can physically carry that baby after three months, I’ll be lucky or it’ll be a miracle. And lifting the baby off the floor will be a whole other heart rate sky-rocketing can of worms considering the tachycardia I have.

3)   “Your life is going to be over now.”

Lolololol! I’ve already been through periods of time of being bedridden, hospitalization, needing wheelchair help, unable to maintain a career or romantic relationship, considering suicide when the physical pain got so bad. My life is going to be over NOW? Now you say? *falls off the couch laughing*         

4)   “The second trimester will be much better.”

LMAO.  Ummmm we’re in the second trimester now. Where’s my unicorn?

5)   “You have a doctor for your health issue, right? What does he say?”

*shaking my head*

No, I do not have a specific doctor for my health issue. Actually Dysautonomia specialists are extremely, extremely rare. And even a specialist is playing catch up with the research. Dysautonomia diagnoses “POTS” are syndromes that have not been determined to have a definitive cause. Anything could be the cause. Multiple things could be the cause. There is no fix.

I spend a lot of my medical consults informing the doctors about my health issue.

This quote is similar to "But you have a high risk OBGYN, right?"

I love my OBGYN but he does not understand my health issue specifically.

6)   Me: “I’m upset about how crappy my job maternity leave is.”

You: “Actually, that company is better than most in the states.”


You: “It’s amazing women even get paid for having a baby these days.”

These are funny because they completely undermine my fear of being able to function after the baby because of my chronic illness and being able to support us. I get to feel more inadequate than the average healthy woman having a baby, while feeling guilty that I’m not more grateful.

7)   “Oh yeah I had a lot of fast heart rate when I was pregnant too.”

Unless you’re a POTS or NCS patient, or dealing with a chronic illness that has extremes in heart rate, I find your statement hilariously naïve.

On Trying to Be a Better For Her

Genevieve Tyrrell

Like many moms to be I want to be the best mom I can be to my daughter to be. I want her to be able to look up to me as a role model—as a thriving writer and artist—as someone who pursued and continues to pursue being creative because that is who I am to the core.

 This is complicated in a weird way. I was so chronically ill for years that my career fell behind. I often feel like I lost about ten years of my life. I’m playing catch up. And yet, it’s kind of hard to catch up with a baby on the way.

I feel the weight of financial stress—of trying to prep for baby, of trying to save up money for all the impending medical expenses, of trying to save up for a wedding too. There’s that nagging If Only, If Only, If Only . . .

If only I had figured out a stay at home career in my twenties that could’ve supported myself. If only I had even been well enough to begin with. If only I had researched biochemistry earlier to figure out my genetic issues.

 I know. I can only live for the present and hopeful for the future. I can’t dwell on the past. But as a memoirist finishing up a book, I had pretty much forgiven myself for all of these things—for not being “good enough” because I was so sick—for not being as successful as I could’ve been.

 But now with the baby on the way, call it the hormones or whatever, but those feelings are coming back up. Doesn’t everyone re-assess their lives when a baby is on the way? And how do you reconcile that with a life of chronic illness?

Sunday Before Week 20 - Hi

Genevieve Tyrrell

August 21st, 2016

showing off horror flick moves in utero

showing off horror flick moves in utero

I’m starting this blog because while I found a ton of info, articles, and blogs on whether or not I should conceive while chronically ill, I didn’t find a whole lot regarding the in-over-my-head feeling I have now that I am pregnant while chronically ill.


This really came to a boiling point this week, because on Monday, August 22nd, I’ll be twenty weeks pregnant (5 months)—the “half way point” of pregnancy—and I've felt the worst I’ve felt yet, while every pregnancy app out there says stuff like, “You’re probably feeling like you have much more energy now! Most women feel this way in the second trimester.” To top it off I woke up yesterday with a sore throat, headache, and cough, which will mark the fourth time sick while pregnant (I’ve already dealt with Shingles and Epstein Barr reactivations), because when you have a chronic illness, getting a cold is pretty darn easy.


I’m a writer and artist. It’s what I do. I suppose I need this in order to process the isolation at times, but the more I thought about it, the more I realized, If I feel this way, how many other women must too?


So I dedicate this to you, ladies. We are the “high risk” ladies. We are the knocked up chronically ill. We are the invisible illness ladies and the not so invisible illness ladies, working on making a human while trying to function basic tasks. I toast this start off message with a non-alcoholic beverage just for you.


My journey begins as a POTS (Postural Orthostatic Tachycardia Syndrome) patient, co-diagnosed with Fibromyalgia, Chronic Fatigue Syndrome, Insulin-Resistance, Hypothyroidism, and a couple of amino acid or vitamin deficiencies that are the first of their kind documented in the entire world. I was a research patient for about six years. I’ve had more tests done on me than I care to remember. I wanted to make a difference though for other POTS patients. Finally, this research paper was written and published about my cells. (See: ) Hopefully it will help others.


Just before I got pregnant I had the worst bout of Shingles in years and period that lasted a month (they found a polyp and presumed that was the cause). I didn’t anticipate my body was even well enough to conceive, let alone maintain a pregnancy beyond the first trimester. And we weren’t trying to conceive. I simply miscalculated my ovulation because of all the previous bleeding like a total moron and the lousy mathematician I am.  My mother had asked, “How did this happen?”  Well, Mom, the usual way combined with sheer stupidity, really.


In fact I had already decided I wasn’t well enough to try to have a pregnancy. I had set up an appointment with a fertility doctor to discuss getting my eggs taken out. I had filled out forms to receive information about adoption. My significant other hadn’t proposed yet, but I’m thirty-five. I figured it was high time I plan stuff. Frozen eggs and adoption info seemed logical. And terribly responsible. I would have children at forty via adoption or surrogacy if—and only IF—I was well enough then. I was pretty proud of my well-planned genius self.

Here's a snapshot of a dorky thirty-something couple with almost everything figured out during Christmas vacation.

Here's a snapshot of a dorky thirty-something couple with almost everything figured out during Christmas vacation.

But we got pregnant and I figured if out of all the miraculous things that had to come together in order for my body to even conceive, I would help this life the best I could. There are parents out there dying to conceive. Maybe, I thought, this is the lucky gift I get after so many years of suffering a serious chronic illness?