A Question For Those Of You Who Have Fainted

[Simmy]

I have classic hypo POTS with near-syncope, but have never actually passed out. On good days I'm able to drive my wife to the ferry that takes her to work, about 10 minutes from my house, and make it home OK. On rare, great days I feel well enough to drive her all the way into Manhattan, about a 45 minute commute, but that's my limit and I then park and lie down in the car for awhile before returning home. I've found that reclining the back of the seat to near 45 degrees while driving allows me more time behind the wheel... and I'm sure I look real rad and hip.

Anyway, today I woke up and felt as though it was a 'great day', so we got in the car and off we went. Only about two minutes later I said "Sorry honey, I'm taking you to the ferry, I'm feeling yuck." My chest felt heavy, I was having trouble finding the pulse in my neck which is usually obvious, but once I did it was fast, feet felt heavy and tingling, both hands got numb, an instant headache got very bad, along with near-pukopy.

All of these symptoms are normal for me when I stand or sit for too long, or from over-exertion, but what happened next was disturbing. Within another minute or two I realized I wasn't going to make it to even the ferry so I was looking for a place to pull off the road when my entire left arm started numbing, I became very dizzy, and this buzzing sound and feeling in my head got louder and louder, like a beehive in my brain. I pulled into a driveway, put it into park, opened the driver's door and literally spilled out onto the pavement. In less than 10 seconds it all went away (except the headache, but that got better with time). My wife drove me home.

How close was I to disaster?

[potsgirl]

What an awful experience. I'm sorry you had to go through that...I'm a fainter, with very low BP (OI), but thought I've felt very sick in the car before, I've never passed out. I think it's pretty uncommon to pass out in your car, although I know some people do. I normally pass out when I get up too quickly, or bend over and straighten up too fast. Most of the time I just get a second's notice and then I'm down. I may have spots before my eyes, a headache, a rushing sound in my ears, but usually I just hit the floor before I know what's happening. I'm usually not out long, but feel pretty woozy for awhile afterwards.

I don't think anyone can tell you (but your doctor, if they're good) how 'close you were', but your symptoms sound more like a "POTS" flare to me. That's just in MHO. If you feel that poorly in the car, however, perhaps you shouldn't be driving for now? I rarely drive, which is a pain but I don't want to hurt others just in case something would happen. Also, what is your BP and HR during a TTT or a poor man's tilt at home? In the car? These numbers would really help give you answers.

Take care and be safe!

Jana

[Noreen]

Becoming a pavement inspector sort of counts as a faint.

It seems that you had plenty of warning. It sounded scary as all get out, though. Next time, god forbid there is a next time, you would not even push it that far.

Since this is new for you, you should give your doc a call - as I remember you actually have a good one.

[issie]

Sounds like an episode!! Pretty scarry, isn't it. I agree, since it is new for you--call your doctor. The numbness should probably be looked at. Were you gripping the wheel tightly, and did you have your arms up higher than normal? You possibly could have brought it on by the position of your arms. I can't do anything with my arms too high, it will bring on symptoms for me. Just trying to think of what could have brought it on.

[lissy]

I've actually had many moments like this in which I thought of just selling my car because I rarely drive. But I have been in situations where I had to keep driving I would put the window down or a/c on , sip water and if its too bad pull over get out of the car and stand up and get if off my mind.

I think it has something to do with simulation and concentration and some chemical that is rushed into our systems. I have discussed w/ doctors and haven't gotten a response one suggested maybe its anxiety.

Have you had this problem while not driving?

Lissy

[Tammy]

Did you by chance get going a bit too fast this morning... like were you rushing to get out the door, etc. Sometimes if I don't give my body enough time to adjust to being up for the day, a short time later, I crash and burn so to speak. Maybe you were more stressed out today or yesterday, as sometimes we get delayed effects it seems.

[Simmy]

I know what you mean by "getting up too quickly..." I get my worst dizziness at those times from the quick drop of blood, but this was different. I felt pretty good doing my morning routine (which is very limited) before we left, but over the next five minutes or so I went straight downhill.

My BP - I don't know what it was when this happened, but based on previous episodes (never quite this severe) my systolic drops and diastolic rises to 96/84 as one example, so I suffer from low pulse pressure, but that's usually when I'm standing or sitting upright for awhile, and in the car I'm reclined like on the couch... except the feet, they're on the ground! I hate them, but I may have to wear my compression hose again. And yes, it's hard to admit it may be time to hang up the keys. It would have been quite a sight, had an officer been present, me trying to walk a straight line at the scene

"Pavement Inspector" Classic! Thanks for the laugh. I should make another shirt. Yes, I did have a few minutes of warning and I should know better by now, it's just that I've never felt that bad before out of the blue while driving. I'm seeing my PotsDoc in two weeks anyway, so we'll see what he says.

I should have clarified, I've had the numb left arm before, when all of this first started about two years ago, before I knew what I had, and my doc and I understand it to be caused by the lack of blood flow to the extremities when I'm standing, like the tingles only more, but again, I've never felt it that severe while driving. And the way my seat is reclined I can only reach the bottom of the wheel so my arms were actually resting on my legs.

"Get out of the car and stand up"? Whoa, that's the very last thing my body needed and I doubt I could have stood up if I tried. Didn't you mean lie down, lissy?

I think you got it Tammy. We did leave 20 minutes early this morning and I now realize that my morning meds were in me for only a few minutes, instead of the normal half hour or so before we usually leave.

It was that buzzing sound and feeling in my head that I've never experienced before so profoundly, that scared the crap out of me and I was wondering if you always "hear" this before the lights go out.

Thanks guys.

[pat57]

its very possible to be out and not know it. If you were laying down you would not get the obivous confirmation of the fall. You can be out very briefly. I know because, I go out during TTT and don't know it. I'm strapped in, I don't fall, and I recover as soon as the table is down. The Drs tell me afrerward.

And I would say also, the med timing could be a major factor too.

[juliegee]

Wow, Simmy...When I first read your post the BUZZING in the ears is what stood out for me most. I hesitated to post as I don't want to convolute your interpretation of things . I have had episodes like you describe before I was consistently treated for MCAD. My doctors and I think I was having anaphylaxis at the time. I get really severe tachy out of the blue, my chest gets heavy, my extremities turn blue, I have a feeling of impending doom, and the freaky buzzing in my ears starts. During several of these episodes, I have actually used my epi-pen (wrong thing to do for tachy!!!) and all of my symptoms stop.

What many hear call "episodes" or "spells", I call anaphylaxis . The symptoms seem the same, but mine responds to epinepheine...

Many lose consciousness during anaphylaxis. Perhaps that's what was happening to me with the buzzing. Maybe everyone hears that prior to a faint. My Mayo allergist thought the buzzing was classic for anaphylaxis???

Julie

[lissy]

No, I really would stand up I really don't know why it helps me I guess my increase in HR maybe increases my BP at the time . I never had my BP cuff to check while traveling.

During my eposides of feeling faint it always felt like my BP was dropping and my body just had to do try anything in a state of panic to regulate it.

I read something about the ear buzzing noises - I've always had this since I could remember it was like hearing electricity it comes at random, its happens often while at the doctors office while waiting it gets so loud its hard to concentrate . It only lasts 15 minutes at the most so I have never mentioned it, I thought it was an inner ear problem or something with the ANS ...

I wish we had a better idea of how to handle these issues theres just so many.

Lissy

[ramakentesh]

i think its a bit of a stretch to suggest its anaphylaxis - it all sounds pretty postie to me

[juliegee]

i think its a bit of a stretch to suggest its anaphylaxis - it all sounds pretty postie to me

I agree . That's why I hesitated to post...just couldn't help but note some similarities, most noticeably the buzzing in the ears. My anaphylaxis IS pretty "potsie." The symptoms are identical to what many here call "pots attacks", "episodes," or "spells." The symptom I am most aware of before using the epi-pen is the tachy, ear buzzing, impending doom.

I am perpetually puzzled as to why the epi-pen STOPS my symptoms if it isn't anaphylaxis...

Take my musings with a grain of salt (or several ), Simmy. Just putting it on the table.

Julie

[Guest tearose]

It sounds like you were very symptomatic.

If you are that way, you shouldn't be doing anything like driving. You were wise to pull off the road. I hope you tweaked your management plan.

[potsgirl]

Simmy~ I also get 'numb' arms/hands/legs, and my neuro told me that it can be a lack of blood to the brain, too.

[potsgirl]

I agree with Julie and Rama ~ when I get anaphylaxis, I can hardly breathe and my chest feels like there's an elephant sitting on it. I get these reactions to Morphine and Iodine Dye Contrast. The symptoms still sound like POTS to me, albeit a scary episode!

[Stace915]

I am not exactly how to describe it but before I faint or when I have a bad episode and I am able to prevent fainting my ears don't buzz, everything around me just started to sound garbled, almost like in the snoopy cartoon, like womp, womp, womp... I can still hear but it sounds like this weird language that I can't quiet understand...almost like slow motion mumble. I also get REALLY hot, I mean I all of the sudden start sweating profusely and my vision blurs, my hands and sometimes the lower half of my face get numb/tingly oh and this is a weird one but I start to yawn like crazy out of no where. The whole thing is such an awful feeling and scary, no matter how many times I go through it I hate feeling so out of control of my own body. The first time I fainted I was 12, and my mom was standing next to me, I grabbed onto her arm because I was so terrified, I had no idea what was happening and I honestly thought I was dying. 17 years later it is a much much more common occurrence for me to deal with these episodes but still scary even though I know what is happening.

[flop]

Hugs Simmy, what a horrible experience.

Your symptoms all sound to me like they are due to lack of bloodflow. When body tissues become hypoxic (lack of oxygen usually due to lack of adequate blood flow) they send out "distress signals". These signals are often abnormal sensations that you can learn to identify as warning symptoms. Sometimes you get distress signals for only a second or two before fainting, other times you can have the signals for quite a long time and maybe not actually faint.

Some classic "distress signals" are:

eyes - vision going black & white, visual fields closing in (like a tunnel), spots, flashing lights, blurred vision, curtain coming down.

Ears - muffled hearing, voices seem distant, going deaf, ringing noises, buzzing noises.

Muscles/skin - heaviness, numbness, tingling, unable to move.

Other symptoms that can happen before a faint are due to the surge of activity in the autonomic nervous system:

tachycardia, bradycardia, palpitations, feeling hot, flushing, going pale, sweating, nausea, and many more.

Re ear buzzing and anaphylaxis. The full name for a life-threatening allergic reaction is "anaphylactic shock". The medical use of "shock" means lack of oxygen to the brain, usually due to low blood pressure. In anaphylaxis the histamine released into the body causes the blood vessels to dilate and fluid to leak into tissues - this causes a big drop in BP and if untreated can lead to unconsciousness.

Because both POTS and anaphylactic shock cause low BP they both cause a lot of the same "distress signals". Often the clues pointing towards anaphylaxis would include: contact will an allergen, difficulty breathing, wheezing, coughing, heaviness in chest, hives, swelling. If you think someone might be having an anaphylactic reaction you should get emergency medical help.

Flop

[Simmy]

I don't think I was completely out, but it's possible I blanked for a second when I hit the floor. I guess I just needed to reboot.

I looked up MCAD and, after first learning about the Massachusetts Commission Against Discrimination, I found what you were referring to and no, I think it was only POTS, just more severe than I've had before. The buzzing, I'm assuming, is an effect of blood loss and therefore some oxygen deprivation to the brain, which causes crazy sensory reactions.

I cannot say I was feeling any impending doom as this was occurring, more like everything was falling, or drooping, and I became very weak as I pulled into the driveway. And yes, thanks for reminding me, I was sweating and yawning quite a bit leading up to the event.

Lissy - My "buzzing" only lasted about 15 seconds, and grew from a light hum to a volume that drowned out all other sounds before I hit the deck. I can't imagine listening to that noise in my head for as long as you describe, although I imagine yours doesn't remain that loud for the duration.

Thanks, Flop, for clarifying. I'm certain now it was not anaphylaxis. The heavy chest and trouble catching my breath I experienced were identical to those I've had before from overexertion or standing too long. It was not an air problem, like I've witnesses with my brother who is allergic to pomegranate and carries an epi pen. I, on the other hand, have no allergies that I know of.

Thanks again, everyone, for your concerns and explanations. I'm glad y'all are here.

[juliegee]

"Re ear buzzing and anaphylaxis. The full name for a life-threatening allergic reaction is "anaphylactic shock". The medical use of "shock" means lack of oxygen to the brain, usually due to low blood pressure. In anaphylaxis the histamine released into the body causes the blood vessels to dilate and fluid to leak into tissues - this causes a big drop in BP and if untreated can lead to unconsciousness.

Because both POTS and anaphylactic shock cause low BP they both cause a lot of the same "distress signals". Often the clues pointing towards anaphylaxis would include: contact will an allergen, difficulty breathing, wheezing, coughing, heaviness in chest, hives, swelling. If you think someone might be having an anaphylactic reaction you should get emergency medical help."

Flop

I think you're right, Flop re. the buzzing. It can happen with BOTH anaphylaxis & syncope as the same mechanism is essentially causing both.

For clarification, I'm DXed with MCAD and the symptoms you describe in anaphylaxis aren't all necessarily present during an attack. We don't necessarily break out into full body hives and swell up. The Mastocytosis Society is working to educated ER docs about this. I have learned this not only from my experiences, but from many other sufferers of both mastocytosis and mast cell activation syndrome/disorder. I do experience all of those symptoms, but rarely, if ever, all at once. For me, the out-of-control tachy- in which I'm about to lose consciousness is my signal to use my epi-pen. It is frightening as that is the wrong thing to do for tachycardia. Epinepherine will worsen that. Thank goodness, I have instinctively always assessed correctly so far- and the epi has stopped my symptoms.

Sorry to hijack, Simmy- but I think the clarification is important for others to be aware of, especially if you are searching for an underlying cause of your dysautonomia.

[flop]

Julie, I didn't mean that anaphylaxis would have all of the features that I listed - just that having one or more of those symptoms should prompt people to consider anaphylaxis.

I know what you mean about doctors not understanding atypical presentations of things. I remember having a horrific asthma attack and going by ambulance to A&E (ER). My asthma is mostly coughing, I don't wheeze even when my peak-flow is really low. The dr said I have over-dosed myself on my salbutamol inhaler (had also had 3 nebs in the ambulance) and didn't take any notice of the fact that my peak-flow was way below 50% of my normal. Luckily I saw a more clued-up doctor later that day who put me on the prednisolone that I needed to treat the flare up!

Flop

[juliegee]

Julie, I didn't mean that anaphylaxis would have all of the features that I listed - just that having one or more of those symptoms should prompt people to consider anaphylaxis.

I know what you mean about doctors not understanding atypical presentations of things. I remember having a horrific asthma attack and going by ambulance to A&E (ER). My asthma is mostly coughing, I don't wheeze even when my peak-flow is really low. The dr said I have over-dosed myself on my salbutamol inhaler (had also had 3 nebs in the ambulance) and didn't take any notice of the fact that my peak-flow was way below 50% of my normal. Luckily I saw a more clued-up doctor later that day who put me on the prednisolone that I needed to treat the flare up!

Flop

Hey Flop-

I know you knew that a patient experiencing anaphylaxis didn't have to have ALL of those symptoms, but I was afraid that other members wouldn't. It was certainly eye-opening for me for to discover.

Unfortunately, I have a few of those unique presentations in the ER too. It's not only scary, but potentially life threatening when you are dealing with asthma & anaphylaxis. Why can't we have a garden variety ailment. Those folks don't know how lucky they are

Thank you for always sharing so much good medical info with all of us.

Julie