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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 17 of 17. This is the beginning of the thread.
Posted by Deneb on August 14, 2009, at 11:37:31
I was just looking around at the Q&A's on this medical forum and learning about the heart among other things and it seems like getting faint with exercise is not normal.
I submitted a question to see if it is normal though, maybe my circumstances are different, since I've had trouble exercising my whole life.
Anyways, I've been to the doctor for this and they all say I just need to ease into exercise. They don't examine me in any way or ask questions really.
Being the anxious person that I am, I'm starting to worry again. I hope they answer my question and let me know I am just worrying myself.
Does anyone else here almost faint (start losing vision and hearing and feeling lightheaded, nauseous and sometimes vomiting) with strenuous exercise sometimes?
I've searched for this and it happens to some people. Most think feeling nauseous is a gastrointestinal problem or a blood sugar thing, but how does that explain the vision loss?
Should I just trust my doctor and pdoc about this in thinking I am just out of shape?
Posted by Deneb on August 14, 2009, at 11:58:08
In reply to From concern of Dr. Bob to myself, posted by Deneb on August 14, 2009, at 11:37:31
Has to do with histamine
http://www.sciencedaily.com/releases/2006/10/061012185827.htm
Posted by SLS on August 14, 2009, at 12:58:28
In reply to Re: Found a beign cause, posted by Deneb on August 14, 2009, at 11:58:08
Risperdal?
Propranalol?Each drug causes blood pressure to decrease. Taking the two together can be synergistic.
- Scott
Posted by Deneb on August 14, 2009, at 13:10:48
In reply to Re: Found a beign cause, posted by SLS on August 14, 2009, at 12:58:28
The only problem with that theory is that I remember these symptoms happening when I wasn't on any meds at all. That was a long time ago. I was probably 14 or so. I was walking through the snow fast to catch a bus. As I got to the bus, my vision was dimmed, I almost blacked out, my hearing was muffled and I felt extremely nauseous.
I'm thinking is is some sort of hypotension, but I don't seem to have hypotension at the doctors.
Posted by Phillipa on August 14, 2009, at 13:27:25
In reply to Re: Found a bneign cause » SLS, posted by Deneb on August 14, 2009, at 13:10:48
Deneb if you're worried call your doc maybe wear a holter monitor for 24 hours. Then you will be reassured. Love Phillipa
Posted by Deneb on August 14, 2009, at 13:45:14
In reply to Re: Found a bneign cause » Deneb, posted by Phillipa on August 14, 2009, at 13:27:25
My doctor and my pdoc don't think it is anything to worry about. I'm reading all sorts of scary stuff about this though, like sudden death. I remember I had the Holter monitoring as a kid, I don't know the results, but I assume they were good. Can things get worse over the years?
I think I'm going to wait for an answer to my question to see if I need to worry about this.
Posted by Deneb on August 14, 2009, at 14:01:40
In reply to Re: Found a benign cause » Phillipa, posted by Deneb on August 14, 2009, at 13:45:14
I'm going to run as hard as I can and see if I faint. brb
Posted by Deneb on August 14, 2009, at 14:37:01
In reply to I think I'm going to run, posted by Deneb on August 14, 2009, at 14:01:40
OK, I didn't faint or feel faint. It's so hot today! I'm sweating buckets. LOL
Posted by Phillipa on August 14, 2009, at 20:29:05
In reply to Re: I think I'm going to run, posted by Deneb on August 14, 2009, at 14:37:01
Deneb now drink fluids. Feel better now? Love Phillipa
Posted by Larry Hoover on August 14, 2009, at 20:35:11
In reply to From concern of Dr. Bob to myself, posted by Deneb on August 14, 2009, at 11:37:31
> I was just looking around at the Q&A's on this medical forum and learning about the heart among other things and it seems like getting faint with exercise is not normal.
When you last raised the subject in December, you were blowing it off, and I was the one that was concerned. You said then that you saw a doctor about it, I believe.
http://www.dr-bob.org/babble/social/20081222/msgs/872760.html
Lar
Posted by Deneb on August 14, 2009, at 20:51:21
In reply to Re: From concern of Dr. Bob to myself » Deneb, posted by Larry Hoover on August 14, 2009, at 20:35:11
Yeah, I saw my family doctor. She said I was just out of shape, but she didn't do any tests or examine me in any way. She was much more concerned with my eczema.
Then when it happened again, I told my pdoc about it and she said I was probably dehydrated.
I asked about this on this forum. I'm going to see what they say.
Posted by Deneb on August 15, 2009, at 16:49:14
In reply to Re: From concern of Dr. Bob to myself » Larry Hoover, posted by Deneb on August 14, 2009, at 20:51:21
Hmmm...the health forum seems to be temporarily not answering questions. I was able to do more research. I am pretty sure my pre-syncope is not serious. It was probably neurocardiogenic, or in other words, a simple faint, which is not serious.
It might have been that histamine reaction that triggered the hypotension. I am pretty sure it was hypotension. Sometimes I get orthostatic hypotension. I'm just going to trust my doctors.
I worry too much about things.
There are no sudden deaths in my family. I highly doubt it is long QT syndrome.
Besides, I got like an echocardiogram or something when I was a teen, that plus the Holter monitoring and obviously there was no concern. Long QT syndrome would have shown on the Holter probably.
Posted by Phillipa on August 15, 2009, at 21:41:30
In reply to question still not answered, posted by Deneb on August 15, 2009, at 16:49:14
Deneb to be on the safe side call your doc you're now in late 20's much older than a teen. Long time since testing done. Love Phillipa
Posted by Deneb on August 16, 2009, at 21:49:04
In reply to Re: question still not answered » Deneb, posted by Phillipa on August 15, 2009, at 21:41:30
It's been more than a week and my question hasn't even been posted yet on that forum. Oh well, it's OK, I found another place to ask my question, AllExperts. It is much better there. I should get an answer within 3 days.
I'll let you know what the expert says I should do, that is whether or not I should go to the doctor.
Posted by Deneb on August 16, 2009, at 22:18:19
In reply to Re: question still not answered, posted by Deneb on August 16, 2009, at 21:49:04
I posted my question as soon as the expert was available again and I got an answer back after an hour.
He recommended I stop the Risperdal, but it really helps me. I think I can live with my presyncope.
Anyways, here is my question and the answer I got:
Hello, thanks in advance for answering my question.
I'm a 27 yo female with a BMI in the high end of normal. I am wondering whether or not I need to go to the doctor and get tests done.
Ever since I could remember as a child, I've had problems with strenuous exercise. I remember I would get nauseous or vomit nearly every time I ran. It didn't have to be a long run, even short sprints would often make me nauseous.
As a result of this, I never grew to like exercise and for the most part I avoid it.
As a teen I remember one time I walked through the snow fast to catch a bus and I got nauseous and vomited. I also lost my vision, had a ringing in my ears and felt I was going to faint. This pre-syncope following exercise has happened several times, mostly following short and intense (for me) exercise. The last time was a few months ago. I decided to jog slowly. I jogged extremely slowly for half a kilometer before I had to stop. I started losing my vision and felt lightheaded. I almost fainted. I had to actually sit down in the middle of the walking path for 10 mins before I could walk back home again.
I've done some research on this and discovered that feeling faint with exercise is not normal, but I also found benign causes of pre-syncope following exercise. I read about this histamine reaction that occurs in some people that cause low blood pressure following exercise. I've also read about neurocardiogenic syncope. I guess that would have to be confirmed with tilt-table testing.
I've gone to the doctor about this and my doctor just told me I was out of shape and to start more slowly. She didn't order any tests or examine me in any way. She seemed more concerned about my eczema.
As a teen I got some testing done. While getting my blood pressure taken I held my breath because I was nervous and thought holding my breath would calm me down (stupid I know lol). My doctor found my BP to be high and my BP was different on either arm. I think she also said I had a slight heart murmur, I don't remember exactly. I think I got an echocardiogram and Holter monitoring but I can't be sure what tests they were.. I am guessing they were all normal, but didn't get any details.
My BP is normal and I don't know what kind of blood tests I've had, but I assume they were normal since the doctor never got back to me.
I am thinking my exercise induced pre-syncope is the result of over reactive histamine receptors or is neurocardiogenic in nature since I get postural hypotension often. My psychiatrist tells me it is just dehydration. She also warned me not to take propranolol before exercising. It isn't the propranolol that is causing my pre-syncope because I didn't take any on the days it happened. Should I just trust my doctors and stop worrying about things or do I need tests done?
There is also no history of sudden deaths in my family so I doubt it is long QT syndrome. There is a history of nausea and vomiting with exercise in my family. My Mom told me she used to get lightheaded with exercise.
Oh I almost forgot, about 5 years ago I was hospitalized for an deliberate ASA overdose. My heart was monitored for about a day. Would I be correct to assume nothing is wrong with my heart?
Here are the meds I am taking:
40 mg Celexa
40 mg Prozac
0.75 mg Risperdal
40 mg propranolol PRN (for tremors, heart weirdness caused by anxiety)
AnswerDear *****,Neurocardiogenic syncope only occurs when you're standing quietly, especially after exercise, but not while you're exercising. Exercise-induced presyncope is more likely for you, I think. Risperdal particularly makes orthostatic hypotension worse and can even lower sitting BP a lot. Must you take it? Celexa and Prozac may cause orthostatic hypotension. tho they are less likely than Risperdal. Yes, the monitor for a day would have showed arrhythmia, but nothing else about your heart. A normal EKG would rule out long QT, as would a normal Holter.
I recommend an EKG and an echo to be sure your heart's structure and function are normal, and that you consult a cardiologist, the latter after you've stopped Risperdal for at least a week.
Please write back if this note doesn't answer all your questions.
David Richardson
--------------------------
I guess I should see the doctor or something, but how do I get my doctor to order these tests? She just thinks I am out of shape.
Posted by Phillipa on August 17, 2009, at 20:29:31
In reply to Re: Wow, that was a fast answer!, posted by Deneb on August 16, 2009, at 22:18:19
Deneb definitely get tested and please continue the resperidol til you see the doc. Even that doc recommended the testing be done. Phillipa
Posted by glydin 00 on August 18, 2009, at 7:46:22
In reply to Re: Wow, that was a fast answer!, posted by Deneb on August 16, 2009, at 22:18:19
Maybe look into blood sugar regulation stuff also... just a thought.
This is the end of the thread.
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