TMH Helped FSU Athlete Find Diagnosis When No One Else Could

As an athlete, sometimes you need the smallest chance, the slightest break or the tiniest bit of luck to go your way. Almost all sports are games of inches and what-ifs.

For Tiana England, a basketball player at Florida State University (FSU), that little bit of luck didn’t come on the court, it came off it at Tallahassee Memorial HealthCare (TMH).

For much of her life Tiana had struggled with life-altering symptoms such as lightheadedness, vision problems and even losing consciousness, but these conditions were always chalked up to something simple, like needing to eat, getting some rest or drinking more water. As a child she fractured her jaw from passing out and was told she was dehydrated.

“No one could seem to put their finger on it my entire life,” she says.

Tiana worked through these issues to have a successful college basketball career at St. John’s University in Queens, N.Y. She was an All-Big East Honorable Mention selection in 2019 and led the Big East in minutes per game that same season — all while playing through her symptoms.

Tiana’s decision to come to Tallahassee as a graduate transfer at FSU would ultimately lead her to TMH and to the help she needed to finally get some relief.

Upon her arrival in Tallahassee, her symptoms worsened. When an EKG came back abnormal before the start of her first season with FSU, it made sense because Tiana said she hadn’t felt well enough to perform on the court lately.

Neurologists and cardiologists struggled to find much wrong with Tiana, but everything began to change when an ear, nose and throat specialist referred her to Neuro Outpatient Rehabilitation at the Tallahassee Memorial Rehabilitation Center (TMRC) to receive therapy related to headaches, dizziness and balance issues.

While receiving therapy, Tiana’s chance encounter with Melissa Urrutia, PT, DPT, a physical therapist at TMRC, was exactly the break she needed to figure out what was going on.

“Physical therapy helped my headaches, but my lightheadedness was still there, and a bunch of my other symptoms,” Tiana says. “I was talking to my therapist when Melissa walked by and heard me explaining what was going on. Melissa said, ‘Wait a minute, can you repeat that?’ So, I told her my symptoms and that I felt like I was going to pass out and she said, ‘I really think I can help you; it sounds like something called POTS.’ ”

Postural orthostatic tachycardia syndrome, or POTS, is a dysautonomia condition that causes an error or abnormality in the autonomic nervous system, which oversees involuntary body functions such as digestion, breathing, heart rate and blood pressure. POTS often causes lightheadedness, fatigue, blurry vision, increased heart rate and headache when standing upright from a sitting or lying position.

While she couldn’t diagnose Tiana with POTS, Melissa also suffers from a dysautonomia condition and recommended Tiana check out a specialist at Vanderbilt University in Nashville, Tenn. Melissa also became a natural fit to work as Tiana’s physical therapist.

“I recognized the symptoms from myself, so I talked through everything with her, and we did a few simple clinical tests,” Melissa says. “I had her stand up and sit down a few times to see what her heart rate and blood pressure did and said, ‘I think I know what’s going on with you, but it’s outside of my scope of practice to diagnose you, so you need to see someone who specializes in this.”

What Melissa could do is help to educate Tiana on how to manage her symptoms, such as staying hydrated or wearing compression socks to help manage her blood pressure. She also worked with Tiana on gravity-eliminated exercises, meaning Tiana’s body wouldn’t have to work to hold herself up at the same time as it was working to exercise. The primary goal was to teach Tiana’s body to change positions without having such a drastic response to the change.

“I also did a lot of listening to her because sometimes people just don’t feel like they’re heard,” Melissa says. “As physical therapists, we’re lucky because we have a lot of time with people, so we can listen.”

It took just one appointment, and through her conversation with her doctor and some testing, Tiana was diagnosed with POTS. Knowing that she had a diagnosis was a huge relief.

“I feel like Melissa just walking by that day literally saved my life because no one else could really help me. She was able to direct me to this doctor who, in just one day, told me this is what you have,” Tiana says. “This is something I’ve dealt with all my life.”

Tiana has since finished her physical therapy, but she stays in contact with Melissa. When FSU coach Sue Semrau let Tiana check into a game on senior night, Melissa was there. Melissa has also sent encouraging messages and tips to help Tiana even after therapy ended.

Tiana says she’s grateful to have the chance to finish her final season of college eligibility and help spread awareness about her condition.

“As much as I can spread awareness about this is great,” Tiana says. “After my team posted [onto social media] about it, so many people have messaged me, thanking me. Dysautonomia International has reached out to me to see if I would be willing to share my story with them, because people think this is something that happens with white women. To have someone of color, and an athlete at that, to raise awareness about this goes such a long away.”

Learn more about Rehabilitation Services at TMH.