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Jill Brook: Hello fellow POTS patients, and fabulous people who care about POTS patients. I'm Jill Brook, your horizontal host, and today we are interviewing Dr. Jacquie Baker about her research and findings on hyperventilation in POTS. She has done some really impressive studies looking into this and how it affects

POTS and how it is affected by POTS. Dr. Baker is a postdoctoral associate working with Dr. Satish Raj at the University of Calgary in the Department of Cardiac Sciences in the Cumming School of Medicine. Her research focuses on patients with autonomic failure and dysautonomia, and she has done a ton of great research in the dysautonomia space.

I think some of our best science is coming from projects that Dr. Baker has helped to make possible. Dr. Baker, thank you so much for being here today.

Dr. Jacquie Baker: Jill, thank you so much for having me. I'm really looking forward to the next hour.

Jill Brook: I'm so excited to get to talk to you 'cause I feel like your name is on so many [00:01:00] important papers, but maybe you've like, I don't know, we haven't heard from you that often. And so do you mind just like telling us a bit about your background and your research interests and how did you get interested in problems of the autonomic nervous system?

Dr. Jacquie Baker: Yeah, definitely. I mean, I think I have to sort of say that I, I hear it all the time and now I'm getting to a point in my career where I'm gonna start saying it, but I honestly am like standing on the shoulders of giants. Like the fact that you just said that my name is popping up on so many things and I thought, is it? I feel like I'm still just a baby in this field.

So, I guess like a little bit of my background. I love telling the story that I finished my master's and I actually was like, I don't think research is for me. Research wasn't that like exciting. And so instead of pursuing more research, I actually started working in an autonomic clinic [00:02:00] and that was my very first exposure

to actually the, the patient facing, patient focused clinical research. And honestly, it was that experience. So I worked there for about five years, and it was that experience that truly like opened my eyes to just the wide range of disorders that that can affect the autonomic nervous system.

And then sort of like the debilitating, disabling outcome for patients and their quality of life when this part of their nervous system, like truly like the automatic nervous system, fails or becomes dysregulated. And it was just, it was really striking again to see how devastating that was for patients.

Jill Brook: So you were like, these people just need some more research.

Dr. Jacquie Baker: Well, yeah, like things that people, we take for granted. We truly take for granted. Like I say it to people all the time, our heart beating, our lungs, breathing our blood pressure. Like we take it for granted truly [00:03:00] until they stop working. And you know, I was, I was a young woman working in the clinic and so one of the things that was especially shocking was seeing so many other predominantly young women

dealing with such like disabling symptoms. Like we typically think about, you don't think about young people getting sick, right? And so this was just really eye-opening to have patients that my age, younger, maybe a little older, but basically looking in a mirror and just seeing how how much this could really like, disrupt an individual's ability to work, to go to school, participate in daily life engage with families, friends, you know, all of that stuff.

And you know, I think like with so many research focused around the autonomic nervous system, there's just, there's not a lot of it. You know, we've got our big hitters, when we think about autonomic research, we think about Vanderbilt. We think about [00:04:00] Mayo Clinic. So many others, I can't, I can't list them.

But really in like the grand scheme of things, we're not talking like hypertension, we're not talking, you know, stroke research. And so in the grand scheme, I think I just saw how little research was behind it and, and how little we kind of understood and how few, I guess, effective treatments that we could offer for patients.

And, and it was really at that point that, at that point I had worked, only worked in the clinic for two years, and my supervisor was really encouraging me to do a PhD, and I thought, okay, yeah, let's do it. So then I worked in the clinic through the whole time I was doing my PhD which accumulated to the full, like the five years in the clinic while focusing specifically on disorders of orthostatic intolerance.

So that being a, a combination of both POTS, orthostatic hypotension, things like that. So yeah, that was my journey.

Jill Brook: Wow. That's great. We're [00:05:00] so lucky to have you. So have you changed your mind? Do you think research is more exciting now?

Dr. Jacquie Baker: It, it is. Yeah. I mean, I'm in the wrong business if I answered anything different. Yeah, no, I still, I still love it, but I, I often think about it and I think if you took the patients out of it, I don't know if I would love it as much. So, like, for me, it's, it's like research is like a means to the end, to trying to make someone's life just a little bit better, right?

It, it truly was the patient perspective that, that put me on this career path. So I don't regret it at all. I love it, but if you took the patience out of it, I would have to maybe rethink my career path.

Jill Brook: Well, I'm so glad 'cause I'll just say it again that the research that I see your name on, it just looks so impressive, so well thought out, so high tech. Like not the easy stuff to do, not the low [00:06:00] hanging fruit. And and so I guess that kind of brings us to the study we wanted to talk about today, which is about hyperventilation in POTS patients.

Can you talk about what made you wanna study that?

Dr. Jacquie Baker: Yeah, definitely. It was actually brought about by, well, a couple papers that started to come out that were proposing that POTS was primarily respiratory or breathing disorder, driven by abnormal breathing patterns, including hyperventilation. And the primary authors of this work, they sort of suggested

that the reason why POTS was a respiratory disorder is because it was related to carotid body. So the carotid body, just quickly, it's a key sensor in the neck for blood oxygen and blood carbon dioxide levels. So when these levels either get too high or too low, it's the sensor that can kind of detect it, and it will send signals to the [00:07:00] brain to change our breathing patterns to

regain a homeostasis or a balance. And it was thought that perhaps this little sensor, this carotid body was actually overly sensitive or exaggerated in patients with POTS and that that was leading to all of the symptoms that we see. So, excessive breathing, tachycardia, increase in sympathetic nervous system activity, which

makes, would make perfect sense when the carotid body becomes active, we do see all of those things, increased heart rate, increased breathing, increased sympathetic nervous system activity. And so I thought that's a very plausible thought, but I was reading this and I remember saying like, well, let's, let's test it.

Like, let's stop wondering. And like, we have everything here, let's just do it. So it's really like reading the other papers that were coming out that actually gave me the idea. 'cause I thought like, well, like I said, [00:08:00] let's, let's just go to the lab. Let's just test this idea. So, that's kind of where the work work began.

Jill Brook: That's great. And you know, from my perspective, it's interesting that you thought to kind of double check that assumption, because I have heard from a lot of patients who are told by their doctors, well, you have POTS because you're breathing wrong, you get too anxious, and then you over breathe and that's your problem.

You just need to retrain yourself to breathe more slowly or less. And I know that for myself, I went through that thought process and thought, oh my gosh, at my age how am I gonna retrain myself on how to breathe? That sounds really hard. Am I really causing all these problems by just breathing wrong?

Dr. Jacquie Baker: Not to mention though, breathing is supposed to be automatic. Right? That's, that's why it's part of the autonomic nervous system. You know, we don't, that's one of the things that I, I remember learning in grade five. It was like one of those physiology questions, [00:09:00] is breathing controlled by the autonomic nervous system?

I remember a lot of people got that question wrong because they were like, yeah, I can hold my breath. I control my breathing. Well, no you don't. 'cause you don't sit there and go, breathe, breathe, breathe. Right? So yeah, that's a big, big misconception.

Jill Brook: That's great. Okay. Well, and I know of people who spent hours and hours and hours, you know, for months trying to train themselves to bring, to breathe differently. Sort of never, never questioning that, you know, something else could be going on. So, so can you talk about what you did in the lab to look at all of this?

Dr. Jacquie Baker: Definitely. I guess, I guess I'll start with the basics. Every single one of our studies, you know, we always start with lots of fun research equipment, and a ton of amazing collaborators as well as all of the amazing, I have to throw it out to the, the patients. You know, always circles back to the patients that are constantly like, willing to be participants.

So, you know, wouldn't be able to do what we do [00:10:00] without good people and willing participants. So really I'll start there. Then of course we always have our, our standard things. We have our beat to beat blood pressure, heart rate, transcranial doppler for sort of brain blood flow, blood velocity measurements.

But really the, at the core of this, I have to sort of, I'll tie it back to that carotid body, that sensor in our neck. So one of the ways that the sensor becomes activated is if there's too little oxygen in the body, so something we call sort of a hypoxic state, and it makes sense that if this little sensor detects the oxygen levels in the body to be too low, it's gonna send signals to the brain to engage breathing.

To increase breathing, right? We wanna start bringing in more oxygen to, to normalize that. And so one of the cool things is that what turns the sensor on is low oxygen. That also means [00:11:00] that if we want to turn the sensor off, we give the opposite. We have an individual breathe high amounts of oxygen, and in that sense, we can turn the sensor off.

And so the thought was if indeed this sensor is exaggerated in its activity, it's overly sensitive and it's triggering all of these symptoms essentially leading to you know, what we see in patients. Well, then if we could shut it off, all of those other things should normalize, right? Like their breathing should calm down,

their sympathetic nervous system should calm down, their heart rate should calm down. And so that's, that's basically what we did. So we had patients put on a, a breathing mask and hook them up to a super fancy machine that could like precisely control their oxygen and their carbon dioxide levels. And we gave them sort of a period of in the lying down position first we looked at their breathing under normal conditions, not just their breathing, [00:12:00] sorry, breathing, sympathetic nervous system activity,

heart rate, everything, stroke, volume, cardiac output, you name it. And we looked at all those parameters with normal oxygen levels, and then we started giving them little bouts or little hits of high oxygen, and we saw how all of the things changed. Then we basically repeated that exact same thing, but with patients in the upright position.

So we had little bouts of normal oxygen interspersed with the bouts of really high oxygen to see again, if we, if we could normalize all of these things. And one of the key components of this study too was the fact that we did not just recruit patients with POTS. We also recruited individuals, healthy controls without POTS.

And the reason why that was super key was because while we did see in patients that breathing the higher amount of oxygen did actually reduce their sympathetic nervous system activity, it did reduce their [00:13:00] breathing, and it did reduce their heart rate a bit, that change, that reduction was no different than individuals without POTS.

In other words, what we were able to draw from that conclusion was that this little sensor wasn't overly activated. It wasn't exaggerated in its activity because if it were, we should have seen much larger reductions in all of those variables in our patients compared to patients without POTS. So, you know, if we didn't have the control group as it comparator in that we may have

come to the, like a, a misconception or, or a mistake in the conclusion that this actually was hyperactive. But yeah, so that was the ultimate that was the first part of the study, I guess, was just looking at that carotid body activity.

Jill Brook: And so, okay, so if I can just see if I can summarize this and make sure I got it. So basically you had patients and then you had regular healthy controls and you had them hooked up to all kinds of stuff. So you said beat to beat blood pressure, heart [00:14:00] rate, I think you said trans cranial doppler ultrasound to measure blood brain flow.

Dr. Jacquie Baker: Yep.

And then we also had an expert in muscle sympathetic nerve activity or micro neurography, so Dr. Anthony Incognito, who's been trained in that for over a decade. He was actually able to use the tiny micro electrode to get direct measures of direct recordings of muscle sympathetic nerve activity.

Jill Brook: And so for this part of the study, basically what you're saying is that the patients and the controls look the same when you added the hits of extra oxygen.

Dr. Jacquie Baker: You got it. Yeah.

Jill Brook: Okay. So it was not the little chemo receptors that you're talking about.

Dr. Jacquie Baker: That's right. That's right.

Jill Brook: Those other papers, their hypothesis, was not supported by your findings.

Dr. Jacquie Baker: I mean, I think it was a very valid hypothesis given, like I said, that when this little body carotid body becomes activated, we do [00:15:00] see that sort of physiological phenotype. You know, but at the end of the day, a hypothesis is only good until you test it.

Jill Brook: Okay. Super impressive. What next?

Dr. Jacquie Baker: Well then, so then we, well, we had a bit of a null study on our hands, and so we, we dug into the data that we had because like I said, we were measuring all of these extra things and one of the, key findings that we did find in this was the fact that, of course, like we, we know it's sort of been in the literature that patients with POTS in the upright position will experience a more profound reduction in stroke volume compared to healthy controls, individuals without POTS.

And we started to see some very strong relationships with, that drop in stroke volume, particularly what we saw was that the individuals that had larger drops in stroke volume had a larger drop in the brain or cerebral perfusion, and [00:16:00] they had a larger increase in their ventilation. So it was sort of

pretty cool, because we felt like we were starting to be able to like put these pieces together. Like, okay, someone stands up, stroke volume drops. So that's like the amount of blood that's being pumped from the heart. And if the heart isn't pumping enough blood to key organs, primarily the brain, right,

you get a reduction in stroke volume, which reduces perfusion to the brain. And that's where we have our respiratory centers, our breathing centers. So could this potentially be triggering those respiratory centers to say, hey, like we're not getting enough blood, we're not getting enough oxygen. We need to do something about it.

And so within our, within our patients, we, we recognize that this like really strong relationship. But in true research form, you know, we like to say that correlation doesn't equal [00:17:00] causation, right? And so we, we want to test this further and we obviously can't go digging around in the brains of patients, you know, ethics committees

we won't allow for it. Patients probably won't sign on for it. And so that's when we turned to our, our animal models. And so using this, this animal model, we're actually able to specifically manipulate blood flow going to the brainstem. So that's where we have sort of these key respiratory centers.

And so we were able to manipulate blood flow and perfusion to the brainstem while directly measuring activity from the phrenic nerve which is the nerve, sort of, is largely involved in breathing as well as a sympathetic nerve. So we really wanted to mimic kind of what we were seeing in the patients.

We wanted to have a direct measure of the sympathetic nerve activity and we wanted to measure breathing. And that was, this study was really incredible and really great because it was able, [00:18:00] we were actually able, like I said, to manipulate specifically blood flow and perfusion going to the brainstem.

And what we found was that when we dropped it, that like, phrenic nerve or that breathing activity coming from the nerve, it huge increased, bam, bam, bam, bam, bam inactivity. Same with the sympathetic nerve activity. And, and if you increased perfusion to the brain. Everything came down and it was quiet.

And so we were able to actually like, manipulate this over and over and over again where we had increased perfusion, decreased perfusion, increase, and every single time we reduced perfusion to the brainstem, just massive amounts of like nerve firing from, for, for ventilation and for sympathetic nerve activity.

So that was, that was really like the, the topper for this study, being able to see something in patients and then bring it back and really test it in an animal model.

Jill Brook: So it sounds like what you're saying is you can trigger hyperventilation whenever you want [00:19:00] by reducing brain perfusion.

Dr. Jacquie Baker: That was how we did it. Yeah. So we, I wouldn't call it hyperventilation so much in an animal. But we could, 'cause we were specifically measuring, just that nerve activity.

Jill Brook: Got it. Got it. Okay. So, if I can just maybe summarize again to make sure that everybody's up to speed. So you were able to, in the POTS patients watch that when they went from, from supine to upright that their heart or their stroke volume went down. So the heart pumped less blood to the brain.

And then after that, you were seeing more breathing activity

or hyperventilation in the patients. And then in an animal model, you were able to see the exact same thing by directly controlling the amount of perfusion to the brainstem.

Dr. Jacquie Baker: You got it. Yeah.

Jill Brook: Wow. Okay, so, so what does this [00:20:00] mean in the big picture of things?

Dr. Jacquie Baker: Oh, it means we have a lot more work to do. Right. Like, I think that it, I think that it means that while we've been able to identify a potential mechanism, how can we take that information and turn it into a potential, like a, a treatment or, or something there, like, you know what I mean? The first step is identifying the mechanism, but then what's next?

Right? Well, you know, how can we prevent this? And so that's actually some work that we we're actually currently working on just because hyperventilation in and of itself, it, it actually is comprised of, of three things. Well, actually postural hyperventilation has three components to it. We have posture, of course.

But then with hyperventilation, we see a change in breathing. And when we breathe deeper or faster, we actually are blowing off the carbon dioxide or the CO2 in our body. [00:21:00] And that is something that we've been investigating more to better understand. Okay, what is actually causing patients to feel bad to have all these symptoms?

Is it the posture? Is it the fact that they're breathing deeper or is it the low CO2 that happens when we do breathe it off? And so that's something that we're currently working on to kind of like unravel or untangle each of those components because once we understand which one is making patients feel like, which one is leading to this sort of adverse outcome, then we can target that.

Jill Brook: Okay, so that's so interesting, and when you talk about how hyperventilation makes people blow off more carbon dioxide. Before I had read up on this, I kind of thought, well, who cares? Isn't carbon dioxide just a waste product? Why wouldn't you wanna just get rid of all of it? But it's actually kind of important for the oxygen exchange, right?

Dr. Jacquie Baker: Well, I mean, [00:22:00] first off, you're absolutely right. It is, it is a waste product. But like everything, our body needs to be maintained in sort of a homeostasis or a good balance. Too much or too little of anything is not good. But one of the things I'm sort of spoiling some of our PhD work that is gonna be coming out in probably the next month or two, but what we actually did find was that CO2

and posture are sort of the primary culprits. So what we see, of course, you know, we, we stand up and we have all of these normal physiological changes that occur with just standing. But if patients sort of become hypocapnic, this sort of shifts their hemodynamics into a state of almost like instability

'cause what we actually see is that, that makes, the drop in stroke volume even worse. It makes their tachycardia worse. It causes their [00:23:00] blood pressure to drop. And so we think that because like then because blood pressure is dropped, stroke volume is dropped, that's causing the heart rate to go up even more to try to compensate and maintain.

And the other critical component to this is that low CO2 for the brain causes the blood vessels in the brain to constrict or get smaller. So we're actually like further reducing the amount of blood flow going to the brain. So now we're talking about like all of those symptoms, the lightheadedness, the blurred vision, all of those more cerebral symptoms that we see because of the CO2.

So it's not just its relationship with oxygen, it's the fact that it in and of itself can lead to this like profound shift towards hemodynamic instability and symptoms, which I think together encompass that sort of idea of orthostatic intolerance.

Jill Brook: Wow. So this sounds like a mess.

So it sounds like kind of a vicious cycle.

Dr. Jacquie Baker: Yeah, yeah, absolutely. [00:24:00] Because I think like, like normal physiology when we stand up if we do have that big drop in stroke volume we believe that it's actually sort of a normal response that we do increase our breathing a little bit when we stand up because we, it actually engages a little bit of that respiratory pump.

It, it works almost to like help improve the amount of blood flow coming back to the heart. So in that sense, you think the change in breathing is good. This is a positive, very adaptive response. But if you are breathing too much such that you start to reduce your CO2 in your body, that that's where we see this complete shift towards adaptive response to maladaptive response.

And it really is a very profound change, like in the hemodynamics that we see. So that that's the culprit there.

Jill Brook: Wow. Okay. And so I guess first of all, I, I've had so many patients ask this, that, that I just have to make sure I ask this question. For [00:25:00] patients with hyperventilation, are they, you know, quote unquote just anxious or just breathing wrong?

Dr. Jacquie Baker: Yeah. I think the most direct way, direct answer for you is, is no. Straight up. You know, I think that this is a big, big misconception and unfortunately I think that this misconception was further amplified or sort of brought about by a very highly debated paper in Brain, you know, that tried to say exactly that, that this is just patient sort of being,

this is just the product of anxiety, which is really like tough to read as a researcher. And it's also like tough to hear as a patient, right? Because it kind of discounts like, oh wow, like this is in my head. Like, this is a psychological issue. This isn't a physiological issue. And that's not the case at all, right?

Like, I think that it was, we, we actually had a really nice study. We didn't. Others had a really nice study. I think it was Julian Stewart, who actually, he looked [00:26:00] at the breathing patterns in patients with POTS versus patients like with anxiety disorders. And they found key differences. So, for example, the patients with anxiety, when they hyperventilated, they tended to increase their breathing through a change in the rate or how fast they were breathing.

So they weren't breathing deeper, but they were breathing faster. And this was very different from how the patients were breathing. So patients with POTS, yes, they were breathing, they had a larger ventilatory response as well, but they were changing how deep they were breathing. So that paper was showing that like, that like actual patterns of breathing are distinctly different between patients with anxiety disorders and patients with POTS.

And so just that paper, like, like alone, like to me is like, no, these patients are not anxiously breathing. And like I said, sort of alluded to before, when we actually breathe [00:27:00] deeper. I think that's like the, the body's physiological response to try to actually like suck blood back to the heart. So through that respiratory pump, right, it's, it's supposed to be adaptive.

And when you have a drop in stroke volume, that's the adaptive part. Like I sort of said before, alluded to before though, it, if you then become hypocapnic, you know, that's again where we see that shift from adaptive to maladaptive. So, no, there, there's my, there's my straight up answer. Are patients just anxious?

No.

Jill Brook: Oh my gosh. That's so fascinating. That is such good information. And I guess, does this have any practical implications for what patients could or should do if they notice that they have a problem with hyperventilation?

Dr. Jacquie Baker: Well, I mean, at the end of the day, we're, we can't ask patients to just lie down for the rest of their lives, right? Not exactly practical. And so one of the things that like [00:28:00] we as a lab are trying to move towards next is trying to figure out a way, this isn't on the patients, this is on us as the researchers. Try to find a way to maybe feed some of that CO2 back or,

so we are looking at like CO2 manipulation techniques to try to see if that makes patients feel a little bit better, for patients that do become, like severely, like hypocapnic or, or low CO2. The benefits to that is that, you know, earlier I said how low CO2 in the, in the brain causes vasoconstriction or those blood vessels to tighten, get smaller, I should say.

High CO2 does a complete opposite. We see this very robust increase in brain blood flow. So we're thinking that even like that perspective alone could potentially, like in small doses, potentially make individuals feel better, you know? And if patients are feeling you know, we know what CO2 can [00:29:00] act on the blood vessels of the heart to cause the same constriction.

Some patients experience things like chest pain, right? So we're wondering if, if we can manipulate the CO2 and maybe start to feed a little bit of that CO2 back, if that would help make patients feel a little bit better. So to target the hypocapnia, to target the low CO2. Yeah, from, so that's on, that's on us, that's on the researchers, you know, to make those next steps. For the patients,

you know, I get this all the time, like, just control your breathing. Why can't they just hold their breath? Like, I don't, that's just not practical. Yeah. Just hold your breath, you know, you feel like you're gonna pass out a faint, just start holding your breath, you know, it's the same thing. Just stop breathing like that.

It's like, okay, you know, come on. So it's tough for, it is tough for patients. I think the easiest thing for them to recognize is if they are starting to really breathe like that, just having the awareness that they are blowing off their CO2 and that could like internally make them feel worse, a lot more presyncopal,

it could be changing [00:30:00] their hemodynamics. And so I know it's probably just they don't wanna hear this anymore, but sit back down, lie back down, let things sort of settle out.

Jill Brook: And can I ask you, you mentioned that you had looked at, you know, the stroke volume and the brain blood perfusion in all of these patients, and it sounds like not all of the patients maybe necessarily had it so bad. Like could you, could you try to address your hyperventilation problem by, I guess maybe just like backing up a few steps and just doubling down on all the normal POTS stuff that we do to try to get more blood up to the head in the first place.

Like be really good about your compression stockings and

like all that good stuff.

Dr. Jacquie Baker: Yeah. You got it. So I think you guys probably remember a paper a couple years back by Kate Bourne, now Dr. Kate Bourne, who [00:31:00] specifically looked at the use of compression garments and how that could, improve exactly that, stroke volume. And now we're starting to go back to that data a little bit more and we're looking at the exact same dataset, but we're looking at the the brain blood flow patterns that were also seen in that.

So yeah, absolutely we could double down on on interventions, non-pharmacological interventions to help improve, improve stroke volume and perfusion to the brain. Absolutely.

Jill Brook: Wow. This is so much great information. Is there anything else you wanna tell us about any of this stuff?

Dr. Jacquie Baker: I mean, I think the only thing that's just like best to sort of reiterate is like, is the change in breathing, like it is an adaptive response. It is something that we see even people without POTS. But when we, like I said, when, when that becomes too much, that's where things sort of shift and it's just important for patients to recognize that it's nothing that they're doing [00:32:00] wrong or that they're sort of bringing about themselves.

It's a physiological response. And, you know, we as scientists, researchers, and patient advocate groups, it's something that we're trying to address.

Jill Brook: Thank you for saying that. I know that that makes such a big difference to a lot of people.

And thank you for all the work that you do. I know, I mean, I, I hope, I hope we get to talk to you again. I know you you just do so much incredible science. Thank you for being such a good scientist.

Dr. Jacquie Baker: Thank you Jill. Oh, and I need to say also thank you to Standing Up To POTS, 'cause it was actually that funding that was sort of the, the fuel behind this study, so...

Jill Brook: Well, so we can pass that on and thank the listeners who, who help fund that research. That's so great. Is there anywhere people can go online? Like, we'll post a link to the paper that we've been talking about, but is there anywhere that people can go online to either learn more about your work or your lab?

Dr. Jacquie Baker: Well, the lab [00:33:00] that I am a part of, like, we're always trying to post our papers. Something I like to do is after a paper comes out, I send it to all the patients that actually participated. So when it says, you know, N of blank, they're like, I'm one of those N's. But yeah, that's great if you're gonna post it for a wider patient viewership so everyone can have a read.

Yeah, so like our lab, we always try to post like ongoing studies as the Calgary autonomic research group with Satish Raj. And then of course Standing Up To POTS. You know, you guys are really good about highlighting the work that we do. And I will little, little plug here. I guess for those that like to travel the American Autonomic Society, it's the annual conference that I, I attend every year.

I've been going for probably over a decade. And it's a, it's an amazing very, like it's a small, tight-knit conference that's a meeting up of like researchers and patients. And we're always talking about current and the latest research related to POTS happening all over the world. You know, and [00:34:00] for me, I also get to see some of the same patients there like year after year after year.

And we reconnect 'cause it's like a nice tight, tight knit group. So for anyone that likes to travel or sort of see what's going on, the American Autonomic Society is, is a really great place to connect with researchers and other patients.

Jill Brook: Well, thank

you so much. We'll put a link to your lab in the show notes so people can find that. And Dr. Baker, it's such a pleasure to get to know you a little bit and to learn that you're not just brilliant, but you care. And we're so excited to have you on Team POTS.

Dr. Jacquie Baker: Thank you, Jill. Thanks to yourself. Thanks to the, like I said, Standing Up To POTS, the agency, and thanks to all the patients for listening, and like I said, constantly, constantly giving us their time to be a part of our research. You know, like we have a, we basically have a call list of patients that are like, on your next study, you call me.

And it's, it's amazing. Like I tell, I tell people all the time, [00:35:00] I wouldn't have a job if it weren't for patients willing to participate in our research. So thank you.

Jill Brook: This is great. This just reminds me that nobody really chooses to be in Club Dysautonomia, but once you get here, the people are amazing.

Dr. Jacquie Baker: That's right.

Jill Brook: Thanks a million. Okay, listeners, that's all for today. We'll be back soon with another episode, but until then, thank you for listening, remember, you're not alone, and please join us again soon.