Fainting

WHEN TO SEE YOUR DOCTOR

* You've suffered a recent injury to your head.

* You have two or more fainting spells within 24 hours.

* You faint without warning symptoms, such as light-headedness.

* You have a previous history of heart disease, stroke or seizures.

* You have a memory lapse or lose control of your bowels.

* You're taking medication.

* You work around machinery or in a high-risk occupation and your fainting could endanger you or your co-workers.

What Your Symptom Is Telling You

There is no diplomatic way to faint. Former President George Bush found that out the hard way when he collapsed at a formal dinner in Japan a couple of years ago. Unlike Bush, most of us don't have TV cameras pointing at us when we faint. But fainting can still be an embarrassment. It's also a cause for concern.

Fainting (it's also called swooning, passing out or blacking out) occurs when the heart isn't pumping efficiently enough to maintain adequate blood flow to the brain. As a result, you lose consciousness and faint, says Gerald Rogan, M.D., a family practice physician in Walnut Creek, California.

Just before fainting, a person might feel weak, nauseated, dizzy or light-headed; experience blurred vision or sweat profusely.

Among the many causes of fainting are poor blood circulation, pain, stress, the sight of blood, drug or alcohol use, dehydration, sleep deprivation, head injury, seizure, heart disease and stroke. Excessive dieting or mineral deficiencies, particularly of potassium, can make a person black out. And there are a number of medications that can cause fainting as a side effect.

In some rare instances, urination, vomiting and intense coughing or laughing can cause fainting by stimulating the vagus nerve, one of the main nerves in the body that relays instructions from the brain to the heart, says Eric G. Anderson, M.D., a family practice physician in La Jolla, California. When the vagus nerve is stimulated, the brain senses that the heart is beating too fast and orders it to slow down. Normally, that's good. But when some people have a severe coughing spell, for example, the vagus nerve erroneously signals the brain that the heart is working too hard. As a result, the heart slows down when it doesn't have to, blood flow to the brain is reduced and the person faints.

Symptom Relief

Although dramatic, most faints last only 10 to 15 seconds and usually aren't a sign of a serious illness. Still, you should let your doctor know about any fainting spell. In most cases, fainting can be prevented or relieved with commonsense remedies, doctors say. Here are a few that may help you fight off fainting.

Make gravity work for you. The worse thing you can do is to remain seated or standing when you start feeling faint, Dr. Rogan says. "You need to lie down and elevate your legs to stimulate blood flow to the brain," he says. "If you do that, there's a good chance you won't faint."

Don't search for the perfect spot. If you feel faint, drop to the ground right where you are, even if it is in middle of a crowded restaurant. "You have about five seconds between the time you start to feel faint and actually do," Dr. Rogan says. "A lot of people will try to make it to someplace soft or inconspicuous before they pass out, but they seldom make it. My advice is to lie down right where you are and put your feet up. Then after a minute or two, try to slowly get up and get to the bed or wherever else you were going."

Breathe deep. Take 10 to 12 deep breaths a minute until you stop feeling faint, Dr. Rogan suggests. Deep breathing helps draw blood in your arms and legs back to your heart. But take no more than 1 deep breath every five seconds, because overbreathing can cause hyperventilation.

Eyeball your drugs. Some prescription drugs, particularly diuretics, sedatives and blood pressure medications, can cause fainting. Ask your doctor or pharmacist if the drugs you're taking may be contributing to your problem and if you should stop using them.

Make time for snoozing. Lack of sleep can contribute to fainting, so be sure to get at least six to eight hours of sleep each day, says Dr. Rogan. (For some good tips to assure that you get an adequate night's sleep, see Insomnia on page 274.)

Walk away from it. Exercise helps strengthen blood vessels and maintain adequate blood flow, says Dr. Anderson. Walking briskly for about 20 minutes three times a week may be all you need to do to lower your risk of fainting.

Get your minerals. "In almost all cases, you're much better off eating a well-balanced diet," says Dr. Rogan. "If you're on some kind of unusual diet, like an all-liquid diet, you could create a mineral imbalance in your body that could cause fainting.

Don't forget the water. Dehydration may make you feel faint. Drinking at least eight eight-ounce glasses of water a day will prevent that, Dr. Rogan says. If you do feel dehydrated, avoid alcohol, because drinking alcohol will only make you more dehydrated. Instead, try quenching your thirst with a sports drink that will replenish your body's supply of important minerals, including potassium and magnesium.

Be a good detective. "Medicine is a lot like detective work," says Dr. Anderson, "and guess who the best detective is? You. So if you faint more than once, it would be worthwhile for you to begin keeping a diary. Where were you when you fainted? What was your body position? Were you sitting, standing or bending over? This sort of detective work may help your doctor determine the underlying cause."