I keep collapsing

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03/11/2007 at 19:37

I keep collapsing. The first time it happened was about an hour after medium exercise; I felt nauseous, sweaty, blurry vision and, if I hadn't sat down, I felt that I would have blacked out. I recovered in minutes. There was no pain or shortness of breath. This is now happening every other day (always at rest)!

I'm a standard 54 year old male. I feel fit and healthy, train 5-10 hours a week and have achieved personal records of 39 minute 10k, 3,220m 12-minute Cooper test and a 3.20 marathon in 2007.

My stress ECG was normal achieving a comfortable 16 minutes on Bruce protocol and echocardiogram showed nothing. Blood tests were normal and I've not had a heart attack.

Doctors think I might have a high vagal tone. I'm booked in for a tilt table test.

What will this do to my running? Will I be able to carry on?

I'd be very grateful for any ideas as I'd never heard of this condition before.

03/11/2007 at 19:50
ime a standard 54 year old runner and ive never  had anything like that douglas,ime thinking could it be stress perhaps,not heard of anything like this before, from one 54 year old runner to another good luck and be careful ...
03/11/2007 at 20:04

Hi Douglas, firstly you've done the right thing in going to see your doc. Whenever I have had dizzy spells and blackouts it's either because I haven't had enough/any sleep or I haven't drank or/and eaten enough. I usually come over very hot just before I go. My attacks usually occur in the bathroom, probably down to the heat of the steam. I would suggest taking it a bit easier and make sure you drink plenty. Good luck!!

03/11/2007 at 20:07

How horrible for you

the only other thing i can think of is blood sugar being low??

03/11/2007 at 21:12

My stepdad had a similar problem last year. His doc didn't tell him to stop driving and he ended up blacking out at the wheel and crashing his wagon (he was a HGV driver)

 Luckily noone was serisously injured in the crash but it could have been much much worse.

I don't mean to scare you - but you need to be realy careful about the situations you put yourself if.

 He had all the tests - ECG, MRI, CAT scan, you name it. But they couldn't find anything wrong. Obviously he had to quit his job and now hasn't had an attack for 6 months. With hindsight we think it was brought on by stress associated with his job. He has to be free from symptoms for a year before he gets his driving liscence back.

 Good luck getting a diagnosis, i wish you all the best.

03/11/2007 at 22:47

Thanks for all your replies, folks.

My doctor was quite specific that I can drive and, having looked at the DVLA website, I'm OK at the moment.

I'm actually getting quite good at detecting when something's going to happen before it actually happens despite all this only starting last week.

I don't think it's stress, because I have a really easy, laid back life. However, I do train quite hard and google suggests that fit people are more prone to this vasovagal problem.

I see a cardiologist specializing in tilt table stuff next week. I meet a lot of runners and no one has ever heard of this problem.

03/11/2007 at 22:53

If you know when it goi ng to happen, in enough time-then yeah you can drive

Tilt table stuff, well, I am doing a spell in elderly care at the mo, and one of my colleagues does tilt table stuff

ill ask him next week for you

04/11/2007 at 05:27
I used to get spasms of temporal lobe epilepsy which were a little similar. I would know it was coming, mainly from a feeling of deja vu (often associated with temporal lobe epilepsy which I think is in the memory area of the brain). It would only happen occasionally, sometimes a couple of days apart, other times months. Sometimes I would just get a bit dizzy and become pale, other times I would completely pass out. To me, it has a very characteristic feel prior to starting but I doubt if it is the same to everyone and I'm not sure I used to recognise it the first few times. It also has the characteristic of happening on similar occasions, like maybe the same place in a run or when carrying out a particular task.Might be completely on the wrong track but it could be worth considering.
04/11/2007 at 09:28

Thanks for your help and comments.

Plodding Hippo, you're the first person that I've communicated with who's ever heard of the tilt table test. I'd be grateful for more information, if you'd be kind enough to ask your friend. Google makes the test sound rather alarming and unpleasant.  I gather that there's only one tilt table in the whole of London; it's not exactly a common problem. 

Out of curiousity and noting your comment about caring for the elderly, are you doing tilt table stuff on old people? It sounds rather drastic to strap an old person to a table and turn them upside down.

Michael Davis 4, my cousin had epilepsy for a while, but then she grew out of it. She was off driving for a period, but is now 100% clear. All very strange how these things come and go.

It's also amazing the kindness and help that is available on forums such as this. My faith in human nature is reinforced on a daily basis.

04/11/2007 at 09:33

Douglas

 One of the commonest problems in the elderly is falls and giddiness

so yes, they do get tilt tested-then a diagnosis and treatment plan can be formulated

yes these forums are great

04/11/2007 at 09:50

OK, understood. I guess that I'd never really thought of it before.

Anyway in a short while I'll probably be my running club's expert on tilt tables in the unlikely event of anyone else having the same problem.

Get your thrills on a tilt table; it's better than any Alton Tower's ride!

04/11/2007 at 19:21

I have epilepsy. Personally don't think the sweaty blurry vision and nausea is typical....... but epilepsy presents in many ways.

Forum great for support but glad you're under the docs!  Good luck with your thrill seeking tilt table test

04/11/2007 at 22:41

Douglas - the tilt table test is only a way of trying to induce the problem, so your docs can see it in action - don't worry, it's only going to feel like another 'do'.

Did you have a 24hr (or longer) ECG (or 'event monitor')? - your symptoms might be explained by a slowing down of your heart so you effectively faint (in a fit man in his 50s the commonest reason is the 'sick sinus syndrome'). There is at least one V60 on these forums who has a pacemaker in for this problem and regularly whups my ass in marathons - some thanks - I got the thing put in for him!

You'll find a lot of the terminology sounds very scary when it comes to cardiovascular problems - don't panic. Pretty much all of these rhythm problems are sortable and don't reflect any disease likely to cause you harm - they are a nuisance and nothing more.

04/11/2007 at 23:30
Mrs Pig and DJ. Temporal lobe epilepsy can appear very different from the general sort of epilepsy (though I'm absolutely no expert on that and have only the typical TV watchers idea of how that appears). Because it's restricted to a small part of the brain which doesn't control movement there is no shaking or whatever (not with me anyway). I used to frequently have a mild attack when running and apart from slight dizzyness and a loss of performance it didn't usualy stop me. If I passed out which I did a few times (not when running) there was some queasyness after the typical sort of fainting symptoms. Without the internet I would never have known it was any sort of epilepsy.
05/11/2007 at 01:31

It's definitely some form of brachycardia; whilst in hospital I was on a holter monitor, but there were no events so it showed nothing.

I've taken to wearing my heart rate monitor (Garmin Forerunner) during the day and on all but the last attacks my heart rate dropped to around 35 (normally resting HR is about 55 upwards). 

On the last attacks (I've just had three in an hour) my heart rate was a steady 55 and then rose to around 65 during the attack before returning to 55. I now feel right as rain and they occurred under an hour ago.

Is sick sinus syndrome curable?

I'm hoping that I'm not due a pacemaker.

Thanks for your comforting words about "nuisance and nothing more". I see the cardiologist (Chris Baker) at Charing Cross Hospital on Wednesday.

05/11/2007 at 04:26

Douglas

you need a five day event recorder--the trouble with holter minitors is that they are usually only on for 24 hours, and you can bet your bottom dollar a symptom wont appear while you have got them on

And i know Chris Baker a little----------well, I did when he was a registrar(his dad was one of my bosses years ago at Barts)

he wont remember me!

hes good

05/11/2007 at 08:35

Once again many thanks for all your help, folks. It's much appreciated.

I guess that I'll have to be patient until Wednesday and beyond. It's all good character building this "how to deal with a crisis" lark. Anyway glad that I'm unlikely to snuff it quite yet.

05/11/2007 at 20:21

Well funny you should say about the bradycardia....that is how my epilepsy was first suspected.....also detected on a heart monitor thingy

I have complex partial (temporal lobe) and you can get all sorts of funny symptoms. Deja vu/taste/smell or sudden sensation of fear/terror. Let us know

05/11/2007 at 20:26

evening dear

I asked my mate

he said you wont be turned upside down, just to 60 or 70 degrees

they wil monitor your blood pressure with a finger probe usually

sometinmes they may put a drip in to administer drugs to dilate the venous system-but this is rarely done

if you drop your BP with posture, , treatment is difficult in a fit person your age, but depneds on the individual circs

leting yourself get unfit would help(I know, not an option)

You might need to increase dietary salt

if the postural drop is really bad there are drugs-but its a bit hit and miss

05/11/2007 at 20:44
if it's high vagal tone you will be given appropriate medication, don't worry
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