I’ll open with the most important news: I’m feeling fine. I didn’t start out that way this morning, and that led to a one heckuva an adventure which I will describe for you now. Pull up a chair and pop some popcorn. I had a wild ride.
I was up late last night working (again) and had settled into bed for a little night time reading around midnight. I’m working my way through a book on US tax policy and its various permutations and political ramifications. You’ll just have to trust me when I say that it’s much more interesting than it sounds. Anyway, after about an hour of that, I grow weary, turn off the light, and go to sleep.
At about five o’clock, I wake up with a full bladder and an urge to relieve it. So I swing myself out of bed, head to the bathroom, and start doing my duty. In the midst of this, I begin to feel…very…unwell. Having relieved myself, I start washing my hands, whoa, this doesn’t feel right…not good…I put my head down against the towel on the counter. I feel light-headed…worse, I’m looking at myself in the mirror, and I’m thinking, “This is wrong. I shouldn’t be feeling this way. I have a problem.” It’s dawning on me that it’s a problem I can’t solve.
Erin tells me now that I bumped into the bathroom door (I remember the sound of hitting a door) and banged my head against the bedroom door as I attempted to right myself. Erin says I opened the door, said I was sick, staggered a bit toward the dining room, and went down like a sack of bricks -thump- backward on to the bathroom tile floor. I have no personal recollection of any of this other than the sound of hitting a door. I just remember waking up on the bathroom tile floor.
Apparently I was only passed out for a minute down there, but obviously I have no recollection or sense of time passage. I remember Erin talking to 911 and holding my hand which she described as “clammy.” I remember feeling cold. Erin told me to stay put, a somewhat redundant command since I wasn’t planning on getting up, she wouldn’t have let me, and I was physically incapable of it regardless. I remember looking into her eyes—she has marvelously expressive eyes—and seeing fear. I felt badly for worrying her.
The paramedics arrived a few minutes later. I was in relatively good spirits by then, which is to say that I felt terrible but not as terrible as I had before. They moved me into Erin’s office chair and rolled me out to the dining area. That didn’t feel so great, but it was tolerable. They got a very weak pulse. They were unable to get a blood pressure reading. Simply put, that is never a good thing. After a couple minutes, they had me try standing up. Very quickly that turned out to be bad news. I seem to remember that they again got a weak pulse, but my feelings of impending sickness and doom returned. They again couldn’t get a BP, so they sat me right back down, and told me I was headed to the hospital. I had no complaints with that whatsoever. I felt terrible.
Next the EMTs rolled me to the doorway, lifted me out in the office chair, and transferred me to a gurney. Laying in a stretcher and being wheeled out in an ambulance was almost surrealistic. I wasn’t thinking that at the time, though. I was actually very buoyant—thrilled to be laying down and feeling so much better than I had standing up or sitting down. I remember thinking briefly about death—having trained medical professionals not be able to get a blood pressure on you does that, I guess—but it wasn’t with a sensation of panic or fear. In fact, if anything I remained chatty, thankful, and jokey throughout the ride to Salem Hospital. How to tell when I’m in pain: I make jokes and lots of them. If I’m going, I’m going with a smile. I’m sure it was a relatively amusing trip for the paramedics.
The EMT was a fellow named Chris from Newberg. He and another EMT guy took turns trying to stick an IV drip into the veins on top of my hands. Apparently, I’m thick skinned. Who knew? After a couple failed attempts (ouch), they got the saline solution going and took some vitals and drove down to the hospital. Erin, who had already called my parents, rode in the front seat.
They wheeled me into station 12 and did some blood pressure checks. Pretty low. I’m normally a 110/70 type of guy (120/80 being average range), and I think upon admittance I was something like 70/whatever, where “whatever” equals a number they don’t care about because the systolic pressure (when the heart is pumping) is already too low for them to care about the diastolic. They put me on a IV pump and started dumping another liter of saline into me.
Somewhere in here my parents show up and of course still Erin’s hanging around. I’m on an automatic blood pressure cuff—that’s a sphygomomanometer to you folks who, like me, were forced to learn the technical term back in high school Advanced Health—that takes my blood pressure every 15 minutes. I’m also on a pulse monitor. Erin has fun watching the pulse meter move when she tells me jokes and pats me on the head. I swear the Davison clan is a goofy lot.
Eventually, a doctor came by, heard my story, and checked me out. The doctor spoke a lot of big words, none of which I understood, so I had him write down his diagnosis: “vasovagal syncope/postmicturitional syncope.” The Merck Manual medical definition of syncope is “a sudden brief loss of consciousness, with loss of postural tone.” That’s a fancy way of saying I blacked out and collapsed to the floor. “Loss of postural tone….” That still cracks me up.
Interestingly, unless you really clock yourself on a night stand or something on the way down to the floor, the condition is usually self-correcting. Laying down equalizes the blood pressure, and less than a minute later consciousness generally returns. My friend Sue likened this to an airplane stall; the airplane stalls, falls, picks up airspeed so that it doesn’t stall again. Good analogy, Sue.
The “postmicturitional syncope” is pretty funny too. It basically means you went to the bathroom and blacked out. That seems to fit the bill pretty well in my case. Of course when I talked to Bret, he claimed I was just experiencing morning sickness and that it would pass after the first trimester. I swear I’m in a family of comedians.
Ultimately, we think a confluence of factors caused my problem this morning. First, I got up quickly out of bed giving my body relatively little time to activate the autonomic reflex that is supposed to equalize the blood pressure. (See orthostatic hypotension.) Moving from a relatively warm environment (the bed) to a relatively cold one (the bathroom) didn’t help matters. But what probably did me in was these factors combined with the urge to urinate. The neuro pathways for these signals somehow got crossed and the BP never got equalized. -Thud- like a sack o’ potatoes.
The statistics I’ve read on syncope are interesting if less than thrilling: According to a 1985 study, about 3% of the population have syncope at some point in life. Annually, it accounts for 3 percent of all ER visits and 6 percent of all hospital visits. About 30 percent of people with one syncopal episode have a recurrence. The mortality stats around syncopal episodes are sobering, but since these problems mostly occur in the elderly population, statistics likely don’t apply to my situation. (Nice epitaph, that: “Statistics don’t apply to my situation.”)
As I said at the outset, I’m feeling fine. It wasn’t exactly how I planned to spend my Friday, but all’s well that ends well. Doctor appointment scheduled for 11 AM on Monday. I’ll keep you posted.