Vasovagal Response/Syncope - Sudden Onset?

[TwoDreamRides]

Last year while dealing with a herniated disc, I “vagalled out” twice. Once unprovoked while pumping gas, once after getting knocked over by a horse while clipping (we figure it jarred that herniation/nerve).

Prior to those two epsiodes, I had only “vagalled out” once twenty years prior while having a thorn removed from under my fingernail.

Yesterday, I got kicked/stepped on/tossed to the ground while clipping and almost vagalled out again. Luckily, a nurse was onhand and got my head between my knees fast enough. I was in a coldsweat, lost/tunnel vision, couldn’t form sentences and lips were blue.

My grandfather does suffer from POTS and I do have a low heart rate (50bpm) and my blood pressure does tend to be on the low (albeit healthy) side.

I guess I’m just surprised that this is suddenly happening to me as a pain response, when it did not used to happen. Any thoughts? Doctor wants to run a catscan to rule out brain tumor. I think she’s crazy as these have all been pain responses.

[Bluey]

I would let the Dr do his thing, never hurts to check you out.

I was having serious double vision and the eye doctor also first sent me for a brain scan, to rule any tumor out.

I think that is the smart thing to do with those symptoms.

Maybe, like my bran scan, will only show hot air in there, no tumors to worry with.
Just don’t tease to your Dr about that.
Mine was very serious, didn’t think possible tumors were a funny matter.

[Simkie]

Are you on any meds?

I started doing what you describe when I was on gabapentin.

[TwoDreamRides]

No meds, just the pill - all three episodes.

[MustangSavvy]

I have POTS. You could do the poor man’s tilt table test - you basically need to take your HR laying down, sitting up and standing. It doesn’t really sound like POTS to me though. There are lots of different forms of Dysautonomia. I would get the CT for sure.

[downen]

Another thing to look at would be your adrenal function. Low cortisol can lead to low sodium and aldestrone levels which regulate our blood pressure. Low or no adrenal function can cause POTS symptoms (ask me how I know). Adrenal issues are one of the most overlooked by doctors. A low fasting blood serum cortisol test could be an indicator, and it would need to be followed up with an ACTH Stim test to diagnose adrenal failure.

I hope you get some answers and feel better soon!

[MustangSavvy]

[QUOTE=downen;8916292]
Another thing to look at would be your adrenal function. Low cortisol can lead to low sodium and aldestrone levels which regulate our blood pressure. Low or no adrenal function can cause POTS symptoms (ask me how I know). Adrenal issues are one of the most overlooked by doctors. A low fasting blood serum cortisol test could be an indicator, and it would need to be followed up with an ACTH Stim test to diagnose adrenal failure.

I hope you get some answers and feel better soon![/QUOTE]

This is a great point! My adrenals were checked while I was in the hospital before getting diagnosed.

[BigMama1]

[QUOTE=TwoDreamRides;8916085]
Last year while dealing with a herniated disc, I “vagalled out” twice. Once unprovoked while pumping gas, once after getting knocked over by a horse while clipping (we figure it jarred that herniation/nerve).

Prior to those two epsiodes, I had only “vagalled out” once twenty years prior while having a thorn removed from under my fingernail.

Yesterday, I got kicked/stepped on/tossed to the ground while clipping and almost vagalled out again. Luckily, a nurse was onhand and got my head between my knees fast enough. I was in a coldsweat, lost/tunnel vision, couldn’t form sentences and lips were blue.

My grandfather does suffer from POTS and I do have a low heart rate (50bpm) and my blood pressure does tend to be on the low (albeit healthy) side.

I guess I’m just surprised that this is suddenly happening to me as a pain response, when it did not used to happen. Any thoughts? Doctor wants to run a catscan to rule out brain tumor. I think she’s crazy as these have all been pain responses.[/QUOTE]

I would investigate if it’s something new for you. However what you’re describing is always my response to intense pain and even sometimes overexertion.

[AKB]

You might get a cardiology workup. Most episodes of dizziness are not a big deal, but it is good to get a workup before deciding it is just a simple vasovagal dizziness.

[AKB]

Also, get a CBC blood count to be sure you aren’t anemic.

[allons-y]

Nothing cogent to add to all the excellent responses above, but as a nurse, I have to say

I LOVE YOU GUYS

Where else can a nurse go on a horse forum and read such educated health - related discussions? If only my patients were as well versed in their own health.

[allons-y]

And PS, I vagal down to pain too, with every horse-related injury. I’d sweat, puke, faint , “OK i’m alright now”, but the MD’s always wanted to chase that red herring.

[red_mares]

[QUOTE=TwoDreamRides;8916234]
No meds, just the pill - all three episodes.[/QUOTE]

“just the pill” gave my sister a stroke before she hit 40. They are drugs and and should be respected as such. Just sayin’

–off soapbox

[TwoDreamRides]

Thanks guys!

Good reminder that “just the pill” is still meds. It is actually part of why dr wants the scan. She mentioned that the pill can exacerbate brain tumors and had wanted to pull me off of it until I agreed to a scan. I’d just like to start with the less expensive investigations before we go that way.

CBCs were done earlier this year, as I have always felt like I might be anemic. I get very cold hands/nose, go through periods of lethargy, and I don’t regularly eat red meat. Going on an iron supplement did seem to help the symptoms, but bloodwork (while not on supplement) showed no indication of anemia.

Adrenal function looks like something I should ask about. I am always craving salty foods. I did lose weight last year (40lbs) but done healthily through workout and diet modification (with a small dose of heartbreak to speed things along lol).

And I like the idea of the poor man’s tilt test!

[Simkie]

How’s your B12? Iron levels (not just RBCs!)? Vit D? Thyroid? ALL things to ask about.

[Bluey]

[QUOTE=TwoDreamRides;8916832]
Thanks guys!

Good reminder that “just the pill” is still meds. It is actually part of why dr wants the scan. She mentioned that the pill can exacerbate brain tumors and had wanted to pull me off of it until I agreed to a scan. I’d just like to start with the less expensive investigations before we go that way.

CBCs were done earlier this year, as I have always felt like I might be anemic. I get very cold hands/nose, go through periods of lethargy, and I don’t regularly eat red meat. Going on an iron supplement did seem to help the symptoms, but bloodwork (while not on supplement) showed no indication of anemia.

Adrenal function looks like something I should ask about. I am always craving salty foods. I did lose weight last year (40lbs) but done healthily through workout and diet modification (with a small dose of heartbreak to speed things along lol).

And I like the idea of the poor man’s tilt test![/QUOTE]

If you eat very little red meat, as I do, you can be mildly anemic, as I tend to get.
Then cold extremities is one of the symptoms.
That is caught at times in CBCs, but not always.
The regular dr didn’t catch it, the cardiologist did and the solution before supplements was to at least eat some red meat once a week, so it is not so hard.
It doesn’t take much, but a little red meat goes a long way.
Also, as others have mentioned, you may be short on B12 and/or zinc.

That is just one of many possibly problems you may have, so let your Dr check you over well, generally, if it is some metabolic problem, things like low iron or such may just be a symptom, they need to find what is behind it all.

It does feel funny when you are warm but your nose is freezing.

[downen]

[QUOTE=TwoDreamRides;8916832]
Adrenal function looks like something I should ask about. I am always craving salty foods. I did lose weight last year (40lbs) but done healthily through workout and diet modification (with a small dose of heartbreak to speed things along lol).

And I like the idea of the poor man’s tilt test![/QUOTE]

If you are thinking adrenals I would recommend doing LOTS of research so that you can direct your doctors, as most will not be at all versed in the area and won’t normally order the right tests without pushing. I had to fire three doctors before I found one that would order the test that diagnosed my Addison’s disease (Primary Adrenal Insufficiency or PAI). I also helped a friend get her diagnosis when she was bedridden and very close to dying about a year ago.

Many of your symptoms do fit, such as B12 deficiency, syncope and craving salt. In fact, your salt cravings indicate you are likely low in sodium, which will cause low blood pressure and dizziness, something common with PAI (one of our medications is Flourinef to aid in salt retention). I most likely consume 10X the recommended amount of salt on a daily basis, lol. Despite this, my sodium blood levels always in the low/normal range.

PAI often is accompanied by other diseases such as Hashimoto’s, Pernicious Anemia (B12) deficiency, and Type 1 Diabetes, which is why it can be challenging to diagnose. I also received a diagnosis of probable MS before I got my Addison’s diagnosed. Doctors probably receive one day of training in the area because it is fairly rare. That being said, there is an entire community of us who have connected online and through Facebook with the goal of helping each other and staying educated on our disease.

If you would like more information or to be directed to places you can find information, don’t hesitate to PM me.

[downen]

[QUOTE=Bluey;8916963]
If you eat very little red meat, as I do, you can be mildly anemic, as I tend to get.
Then cold extremities is one of the symptoms.
That is caught at times in CBCs, but not always.
The regular dr didn’t catch it, the cardiologist did and the solution before supplements was to at least eat some red meat once a week, so it is not so hard.
It doesn’t take much, but a little red meat goes a long way.
Also, as others have mentioned, you may be short on B12 and/or zinc.

That is just one of many possibly problems you may have, so let your Dr check you over well, generally, if it is some metabolic problem, things like low iron or such may just be a symptom, they need to find what is behind it all.

It does feel funny when you are warm but your nose is freezing.;)[/QUOTE]

I just want to make the point that it is important to pinpoint the CAUSE of the Pernicious Anemia. Some cases can be corrected with diet, but some people (like me) lack Intrinsic Factor so we cannot obtain our B12 through diet, and must receive it either sublingually, intra-nasal, or via injection.

[GoldDustWoman]

Ugh this has happened to me twice in my so far 3.75 YEAR taper off of Benzos . I have fainted OFF of 2 horses in the past 18 months . Once was during a class when I had been called out second , talk about EMBARRASSING . Especially when the rest of the class is 20 -30 years younger . Second time was a favorite older mare and I woke up staring at the rafters of the arena with this great mare sniffing my face , I still have about 2 more years to safely taper ,it’s done alot of neurological damage , plus my vagus nerve was actually nicked during emergency gall bladder surgery 12 years ago . I see white and only the tips of their ears and try to just stop .