The Encroaching Blackness aka Syncope

The first time in my life that I ever passed out completely was during a choir concert in high school. We were dressed in the red polyester choir robes, packed onto risers like sardines into a can, made to stand there under the hot spotlights on the stage and sing, At some point, the blood drained from my head and darkness crept from the sides of my vision until my sight was filled with blackness, and I sunk down onto the riser for a short nap. I woke up a little while later confused and disoriented, wondering why I was napping - dreaming even- in the middle of a choir concert.

Six or seven years later, I was pregnant with my first child, but not far enough along to show. I was kneeling in worship, and once again I felt the darkness come creeping in. I tried to stave it off, shifting my weight, concentrating on breathing, but nothing helped. Again, I fell into an unexpected sleep, and awoke in another room, with no memory of having been carried there.

About five or six years ago, at a time when we had no health insurance and I didn't have a car during the day, I was home alone, sitting at the computer, when I had a very strange experience. I began to remember a dream that I'd had a long time before. This memory sucked me in, and I felt the need to take a nap - right then. I laid my head down on the desk, and was instantly asleep. I woke some time later, remembering that I had been dreaming, but no longer able to remember the dream. I was a little dazed and confused, but soon began to wonder if I should do something about the event. By that time, I felt perfectly fine, and the idea of calling an ambulance or even a friend to take me to the emergency room seemed stupid. I hadn't talked to a doctor about the other two times I passed out - although the reasons for passing out those times were more understandable, and during those I had experienced the encroaching blackness, while this time I did not... but it was easier to try to forget the entire experience, so I did.

Maybe nine months or a year later, it happened again. I was at home alone again. I was sitting at the computer again. (I tended to spend a lot of time on the computer.) Once again, the memory of the dream invaded my mind, and I took an unexpected nap. This time when I awoke the computer was shutting down. Somehow, I had managed to push the button on the computer tower to tell it to turn off - while I was unconscious. This event scared me a little more than the one before. My sister had been suffering from seizures. Was this a seizure? I did some looking around on WebMD and other sites, and even tried to casually ask my sister what it felt like to have a seizure, but in the end, I did nothing.

Two years ago, I was playing wiffle ball with the family in the front yard on a Monday evening. I honestly don't know if that was another "passing out" event but it is a real possibility. One minute I was chasing after the ball, and then the sidewalk was coming towards me, and the next thing I knew, Steven was at my side and my shoulder was in a world of pain. Talking to Steven later, it sounded like I had tripped, and it wasn't until I didn't get up immediately that he came to my side to see if I was okay. As we went to the emergency room to have my dislocated shoulder put back in place, through my pain I remember wondering, "Should I tell them that I might have passed out?" I didn't. At this point, it kind of felt like a deep, dark secret that I should have told a long time ago, and since I hadn't, it was now too late.

Some time later, I was visiting with a couple friends. We were sitting in chairs around a table in a dimly lit room. One friend was talking - telling a long story about something I don't remember now. Once again, I felt the dream take over my mind. This time, however, I didn't even put my head down. When I awoke, I was still sitting in the same position, my friend was still talking, and no one in the room had noticed a thing. This confused me even more, and I pondered it as I drove home from my friend's house a short while later. My sister wasn't allowed to drive because of her seizures. Should I be driving? Was it a seizure? I hadn't been shaking or moving enough for anyone to notice. Was it real? Or was I just imagining it?

Monday, February 13th was a busy day for me. I exercised. I washed laundry. I went grocery shopping. I cleaned house. I did Relief Society stuff. That night I was sitting at the dinner table with the family, telling Steven about something that had happened that day, when I was distracted with memories of  "the dream". Unable to push the thoughts away, I succumbed to it, resting my head on the table (luckily not in my half-eaten dinner.) Steven says I was out for about 30 seconds, during which I was unresponsive. Someone got me a drink. I awoke and tried to continue the tale I had been telling before, but I was confused and disoriented. I remained in that "cloudy" state the rest of the evening, and I had a headache. It was during a discussion with Steven that night that I decided I would *finally* see a doctor about it.

You should understand, I hate going to the doctor. I don't have a regular family doctor. I went to my OB/GYN during the years I was having babies, but only 3-4 times since then for birth control purposes and the like. This didn't seem like something an OB would know much about.

I looked up our health insurance website to find a list of primary care physicians that took our insurance. I selected one that wasn't too far away that said it was accepting new patients, and gave them a call. The soonest they could see me was in three or four weeks. Surely someone could see me earlier than that! Maybe? I didn't bother making an appointment.

There is an urgent care up the street that we occasionally go to for physicals for scout camp, strep throat, or stitches, and they take walk-ins. I decided to go there. I'd ask them to do a physical, and just see if there was anything generally wrong. I arrived and signed in, and then the receptionist asked what reason brought me there. I casually mentioned I had passed out the evening before, and after consulting with the doctor on duty, she told me to go to the emergency room within the hour. They wouldn't see me at the urgent care.

Seriously? The emergency room? For passing out over 12 hours before? How is my insurance going to like that?

I returned home and called the insurance's nurse hotline. When I told her what was going on, she confirmed what I had been told by the urgent care. I should go to the emergency room. Ugh. So, feeling quite a bit foolish, I climbed in the car and drove myself to the emergency room.

Two hours later, I had provided them with a urine sample, they had listened to my heart, taken my blood pressure, and stuck a clip on my finger that measures oxygen levels.They had attached several stickers to my chest and attached wires to them and watched a bunch of lines jump around on a computer monitor. They had taken chest x-rays. They had taken samples of my blood. Finally a doctor came in with their final diagnosis. I have syncope. (AKA fainting... I could have told them that...) He told me that all the tests they had done had come back negative/ normal and they sent me home with a referral to a cardiologist and an injunction to find myself a primary care doctor.

Back at home, I found a doctor who could see me in just one week, and I visited him on President's Day. This doctor is about 80 years old, a bit hard of hearing, and his big, black Labrador followed him into the examination room. He has little to no appreciation for emergency rooms. ("They don't know anything, and I just have to fix people up after they've been there...") but he does have some respect for the cardiologist I had been referred to. He explained to me that syncope is difficult because it is hard for doctors to know what is going on unless they "catch it in the act". Considering I only experience it once a year or so, the chance of that happening is very slim. They would probably give me some sort of monitor. He took a drop of blood to make sure I'm not diabetic (I'm not), listened to my heart a bit, and sent me on my way.

Two days ago I met with the cardiologist. He asked for my entire history of fainting - from the very first time. It seemed strange to me because in my mind the first two times were "normal" fainting while the more recent times were not the typical "black outs." But he's the doctor. Again, it was explained how they have to catch it in the act to find out what is causing the fainting spells. He told me (I think he was joking... but it was hard to tell) that they could put me in the hospital for the next year or two so they could keep me on the monitor just in case it happened again. Or, they had different gadgets that could keep track of my heart rate for varying amounts of time - from a big thing I'd have to attach to my chest for 24 hours, to a tiny one that could be surgically implanted over my heart and last for three years. He said they could also do a series of tests that would attempt to "cause" a fainting spell: a tilt table, an exercise stress test, and some others, as well as an EEG that would determine (for sure) whether I'm fainting or having seizures. I told him I'd rather do the easy tests before I have anything surgically implanted, so I'm scheduled to do the tilt table and stress test in a couple weeks. They are still working on scheduling the other tests. While I was there on Monday, they took more blood to check my cholesterol levels. They also took my blood pressure (which was quite a bit higher than normal, but some of that could be from the stress of being in a doctor's office) and listened to my heart.

Part of my is relieved that I've gotten this condition into the open and that I have people with experience helping me figure out what it is. The other part of me is stressed about the expense and everything that is going to be involved in figuring this out, and wondering if it is really worth it. I asked the cardiologist as much when I talked with him on Monday.

"How dangerous is it that I pass out randomly once a year or so? I mean, is this serious, or can I just ignore it?"

The answer I got was, "I treated a woman a couple weeks ago who had a similar condition, and when she passed out, her heart stopped for six seconds. That is serious."

I gathered that there is a possibility that it could be something very serious, even life threatening. On the other hand, it could be harmless. It might happen some day while I'm driving (and I'm driving more these days than ever before in my life due to my current church responsibilities) and that could be devastating not only to me but to others as well. So yeah, I'm going through with it, and hoping they figure out what is causing it.

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