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Welcome to Gray Matters, where we unpack how medical management is rarely black or white.

And go on deep dyes along the way.

I'm Dr. Nick Falano.

I'm Dr. Shera Chavetti.

And on our last episode on Orthostatic Hypotension, Nick brought a really interesting case to the

Gray Matters table.

It was a 72-year-old male whose hospital

course was complicated by orthostatic hypotension, and we figured out it wasn't dehydration

or some other easily reversible cause. We reviewed some meds. We stopped some isisorbid mononitrate.

Yep. I also gave him an abdominal binder. I told him to eat more, smaller meals throughout the day

instead of just a few big

ones. And I even taught him this cool drink water really quickly trick that we talked about last

episode, if you missed that. And physical therapy taught him some in-bed exercises to keep up his

strength. Yes, Nick, I really want to believe that chugging cold water really fast in the morning

did the trick and he's all cured and ready for discharge.

Same here. I would have felt so cool if that worked. It did help, but unfortunately didn't fix all his problems.

His standing blood pressures did improve, but they were still in the high 80s, systolic when standing.

And his symptoms decreased, but they were still not totally tolerable for him.

And physical therapy thought that he could use a little extra help.

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