It's certainly not being dealt with optimally. Lack of treatment is definitely dangerous as well; I suppose from a legal perspective, a doctor is covered by referring you outside and not claiming you as the patient. additionally, there are big crackdowns on narcotics, so I know there's increasing fear among healthcare providers to even give those out for the chronic pain you're experiencing - not to mention the acute episodes.

I actually thought about a couple of those other medication classes you mentioned. In your case it's a difficult combination because, for instance, a beta blocker would be long-acting when instead your episodes have a brief, acute trigger (not to mention the contraindication of asthma). Even using other classes to control heart heart and blood pressure is not ideal because your issue is orthostatic in nature. If this ones flies over cardiologists' heads, it's in another galaxy for me lol.

I'm not sure where you live, but maybe in your case you could benefit from living in a nursing home? I know it's not an ideal solution in itself, given how liable they are to screw things up - I've seen plenty of that in my few years of training - but this way you could also have more assistance in daily tasks, medication administration, and even in setting up appointments plus transportation. In my state, there are a good number of patients even without insurance who are able to get into nursing homes when sent from the hospital.