Not-fainting?

July 8, 2005 1:37 PM

Fainting spells: health concern or potential parlor trick? [more on the floor]
posted by ellanea to Health & Fitness (17 answers total)

Response by poster: A few weeks ago after a routine physical and blood test, I felt very tired and sat down to rest in the lobby. I awoke covered in vomit, surrounded by medical staff: I’d passed out. I’m young, healthy, average height & weight, and I’ve never been squeamish about blood or needles (or anything aside from slugs and mayonnaise, really). But since this incident, I’ve been semi-freaked out about fainting, even falling to the floor a few times (no injuries, just ice everywhere). Just reading about multiple blood draws makes me sweaty and dizzy.

Asking around, I’ve found that fainting after blood donation is somewhat common; the general advice seems to be drink water before, lie down after. And, with most of the people I’ve asked, just avoid donating blood. But I’ve been wondering: how psychosomatic can fainting be? Am I more likely to faint because I’m worried about it? Are the tales of Victorian maidens being able to drop like flies at the slightest unpleasantness true? (Will I need smelling salts?)

Does anyone have any first-hand experience with uh, not-fainting? Anyone who’s fainted in the past (due to low blood pressure or anxiety), yet been able to overcome it on subsequent occasions? I have a follow-up exam tomorrow: any hints (medical, psychological, spiritual) would be helpful.
posted by ellanea at 1:39 PM on July 8, 2005

I have an acquaintance who passes out from the discussion of medical acts. Literally, he looks fine, seems fine, then blam, on the floor. So it sounds like what precipitated your event is now being coupled with anxiety about the consequences of future events. Youch.

You are not more likely to faint just because you're worried about doing so. A couple things:

1. Talk to the doctor and the medical staff beforehand. Tell them about the event. Tell them anything and everything. Just go ahead and blab. That's to vent the anxiety, and to prepare them to take care of you.

2. Be hydrated. Be fed, unless your doctor asked you not to eat. Breathe. And you can use a number of anxiety tricks: put a rubber band around your wrist and snap it to bring you back to the present. And, if you can, bring a friend.

Also? I think you'll be just fine. I'm not worried about you.
posted by RJ Reynolds at 2:03 PM on July 8, 2005

Yes, fainting can be psychosomatic, but it's still fainting. To not faint, when you start feeling "tired" or dizzy, sit down and put your head between your legs. This will increase blood flow to your brain and prevent you from passing out. Stay down until you feel better, breathing slowly and regularly, and sit up gradually.

Talk to your doctor about it, and I think RJ Reynolds has some good advice.

Incidentally, in the Victorian era, it was fashionable for young delicate ladies to faint/feign "the mimsies", but it was also popular to take belladona (toxic and faint-inducing, but it dilates your eyes so they look big and shiny and makes your skin fashionably pale), restrictive clothing, and virtually no physical activity.
posted by Specklet at 2:23 PM on July 8, 2005

Please ignore my poor grammar, there was a big time gap between when I started that post and when I got back to my desk to finish it.
posted by Specklet at 2:24 PM on July 8, 2005

After my first experience with fainting (one morning after a day of sun exposure and not having had dinner), like you I was really nervous about it happening again. I felt really vulnerable, because the fainting had been so unexpected! Eventually, though, the anxiety did fade. To cope, I reminded myself to pay attention to any warning signs (signs which, prior to my first fainting, didn't mean anything threatening to me). So, any time I feel light-headed or that particular kind of nauseous, I sit right down on the floor and lower my head. In the 10 years since the first fainting, it's only happened one other time (later in the day after a minor but stressful skin procedure on my eyelid), but I totally felt it coming, and was already kneeling on the bathroom floor with my mate behind me ready to catch me (in hindsight -- could have prevented that one by going slower, particularly in moving from horizontal to vertical, but I really had to pee!).
posted by xo at 2:30 PM on July 8, 2005

I am just curious--did the medical staff examine/reassure you re: any medical problems--are you pregnant--has this ever happened before--if all is OK it is very unlikely you will spontaneously faint--the advice to be candid in the future with medical personnel is very accurate--good luck
posted by rmhsinc at 2:31 PM on July 8, 2005

I used to have real problems with this in college. Go in for a checkup, get blood drawn, wake up to smelling salts and stares. For me it was almost totally in my head; I had a needle phobia and aversion to the sight of my own blood. Not a good combination.

I'm not going to second guess the other posters. The advice above, especially about staying hydrated and informing your docs, is very sound. However, the way I overcame it is the opposite of the advice of most of the people you've asked; donate blood. It may not work for you, but I have only passed out once after a blood draw since I started donating regularly six years ago, and that was due to my own stupidity (not drinking enough water the day of and donating on an empty stomach). Actively facing your fear (even if you don't consciously fear it) may the best thing to do.

Good luck.
posted by cog_nate at 3:00 PM on July 8, 2005

For years my wife would pass out at the mere mention of anything medical. A colleague of mine was an authority on the physiology of fainting and my wife was filled with the same concerns you have. She asked Peter to talk about some medical procedure and then observe her response. As predicted she passed out in about 1 minute.

Peter concluded that her reaction was not the traditional "syncope" or fainting. Rather, it resembled a sort of convulsion but without the violent spasms. He concluded that it was an extremely strong mental device to escape the object or subject of her attention. (Your vomiting during the episode would indicate something similar and it sometimes happened to her.)

My wife cured herself of this phobia by deciding to watch medical programs on TV. The fact that it was on the tube and therefore remote and controllable meant that she had more confidence in the situation. She could flip to another channel and thereby change the subject the instant she felt uneasy. It only took a matter of months before she was comfortable watching programs on open heart surgery.

She might have overdone it, however. Her last 2 visits to the dentist required serious drilling and filling and she insisted that she would not require any local anaesthetic. The dentist was most uncomfortable at this, but she came away each time saying that she felt absolutely no pain.
posted by RMALCOLM at 3:20 PM on July 8, 2005

I have a friend who passes out whenever he sees - in a movie or what have you - an eye about to be injured.
posted by Clay201 at 3:30 PM on July 8, 2005

what specklet said about restrictive clothing. You have seen GWTW with Scarlett insisting that Mammy lace her tighter and tighter? Tight lacing is a good reason why corseted Victorian women fainted when their bodies tried to react to stress in a perfectly normal way, but were hindered by the constriction. You might want to ask in advance of your next appointment if there is anything you can do to pre-empt the reaction.
posted by Cranberry at 4:44 PM on July 8, 2005

I used to faint a fair bit, and get serious dizzy spells and blackouts even more. I believe the family history of low blood pressure was the cause. What worked for me was really just learning to eat well. Or at least, regularly. Perhaps I'm just increasing my blood pressure as I get older, but eating properly was the thing that I could consciously do which helped.

I'd probably avoid giving blood (yes, I know that's evil to say... donate blood if you can people!), but for me, I always got turned away anyway.
posted by pompomtom at 5:51 PM on July 8, 2005

After both my heart attacks, I fainted about six months later. After the second one, my cardiologist recommended that I be tested to get a defibrillator implanted, and a second opinion concurred. The electrophysiology test indicated a possible problem but the fainting was the deciding factor.

If I faint or have a heart attack during sex, whew, will she ever get a jolt! heheh
posted by mischief at 7:06 PM on July 8, 2005

BREATHE. Remember to breathe.

I went to nursing school (decided it was not a career for me, for reasons such as not having enough time to spend with my patients) and the only time I almost fainted was when I was watching a circumcision. Mind you, this was after I'd witnessed open-heart surgery in person. The problem was I had skipped breakfast, and I was in a tiny room smashed up against the wall where I couldn't move. I had to be extremely careful to not contaminate the doctor's sterile field, and I was probably holding my breath a little.

One of my doctors pointed out to me that when I'm anticipating pain, I tend to hold my breath. Indeed, the only other time I came close to fainting was when I had stitches removed from my finger - very painful, and I was again holding my breath.

When I go for a blood draw, I find it helpful to tell the person sticking me to keep me talking. This involves having them ask me an open-ended question just before the stick. I try to elaborate and ramble on about whatever they ask, whether it's about work or my hobbies or whatever. Having to talk ensures you will keep breathing.
posted by IndigoRain at 9:32 PM on July 8, 2005

Check your blood pressure. I'm willing to bet that it is on the low side, normally. It was simply a reaction of waiting and anticipating the blood draw. If this isn't true, I'll buy you a beer.

By the way, I'm guessing you are under age 27, female, and of below or "average" weight. How close am I?

Also, do you normally eat breakfast?
posted by kamikazegopher at 11:35 PM on July 8, 2005

I concur with the advice about eating and breathing. It sounds like you weren't squeamish about needles or losing blood when you first fainted, so you were probably reacting to a physiological cause like a drop in blood sugar or blood pressure after your blood draw.

I went through a phase when I got a lot of stress-inducing piercings (which is similar to a blood draw, but with more pain and less blood loss). A good piercer won't perform a piercing if you haven't eaten in the last four hours, and they will guide you through deep breathing as they prepare and perform the piercing. Although I'm prone to lightheadedness from adrenaline bursts, the eating and breathing really helped me. I eventually found that I could feel when I was becoming faint and I could head it off by concentrating on my deep breaths.

Talk to your doctor about this the next time you have a blood draw. Eat 1 to 4 hours before if you can, deep breathe during and after, and don't stand up for a few minutes until you're sure you're back to normal. Have a bit of sugar before standing up, too, as that will address any momentary blood sugar dips you might experience.
posted by rhiannon at 12:39 AM on July 9, 2005

Response by poster: Like xo mentioned, it's the unexpectedness that's got to me - at least I have warning signs to watch for now. Specklet: head between the knees! Exactly the kind of practical advice I forget when I'm freaked out. And I like cog_nate's face-your-fears strategy. Rhiannon's probably right about low blood sugar contributing to this, and although I can't eat before, I'll be way hydrated, concentrate on breathing, and eat right after. Thanks all.
posted by ellanea at 8:33 AM on July 9, 2005

I was going to say exactly what jamikazegopher said-- I fainted a few times in college. My doctor said that fainting is fairly common in young women with low blood pressure. If I know I'm going to have to stand for a while (like if I'm a bridesmaid in a wedding) my doctor recommended support pantyhose. It sounds silly, but it keeps the blood from pooling in my legs and keeps me from feeling faint.

That said, I've known several people who faint at the sight of their own blood/faint at discussion of medical procedures. A few years ago I took a 40 hr First Responder course. There was this tall, brawny young guy in my class. He was an experienced wilderness traveller and a certified EMT. One day the doctor who was teaching the class asked this guy to come up to the front of the class and be a model for us so we could learn about orthopedic injuries. For about five minutes the teacher discussed shoulder dislocations while pointing to this guy's shoulder, moving his arm around to demonstrate, etc. Then, out of nowhere, the guy fainted and dropped to the floor. We were all shocked, but the doctor merely leaned over and put his fingers on the guy's pulse, said something calmly about how that happens sometimes when you talk about medical subjects, and continued with the lecture like nothing had happened.
posted by bonheur at 8:45 AM on July 9, 2005 [1 favorite]