Syncope

Or, as I like to call it: synch oh pee. There’s really no delicate way to say this, so forgive my bluntness – last week I peed my pants. There’s some context, as you might imagine, but the precise reason why it occurred remains a mystery. One that, hopefully, next week’s appointment with a new cardiologist will help to solve.

During my life, I’ve passed out at least a dozen times. Trying to discern the common thread between the very first time (at Nathan’s in Coney Island at the expense of my knish) to my most recent episode, hasn’t been easy. While many of the occasions have featured a lot of sun and elevated temperatures (last year’s Palm Springs’s faint), others have been in less extreme situations. Like that time I fainted at the Lion Heart after a few sips of my first pint and bought myself 3 days on the cardiac unit at St. Peter’s. It wasn’t particularly hot or sunny that afternoon.

Over the years, I’ve lost consciousness in the shower (twice), at bars (also twice), at a party, after physical exertion, at a friend’s house and following a long drive. My three most recent instances have each resulted in my landing in an ambulance and being transported to the emergency room for bloodwork, observation and an EKG.

The results have revealed some consistencies. Like many others, I have a heart murmur. I also have low blood pressure and what can sometimes be an extremely low heart rate, like <45 bpm. Beyond these commonalities, there’s some real disparities. Sometimes I vomit after I regain consciousness, usually multiple times. Dehydration seems to be a factor at times, despite the constant presence of my Nalgene bottle. In Palm Springs I took a liter of fluids in the ER, last week it was two liters, along with some meds for nausea. My electrolytes can also be whacky. One time my potassium level was off the charts low, which was how I ended up getting admitted to St. Peter’s.

Generally, I get dizzy, things go black and I go down. When I open my eyes, I usually feel better, albeit tired. This most recent faint was different in a couple of ways, though. First, my bladder released when I went out. I’d like to be able explain that as a situational thing – prior to losing consciousness, I recall thinking that I needed to use the bathroom, but I’ve never experienced incontinence. My friends also observed that my initial speech was a bit “peanut butter mouthy,” although my responses to their questions were appropriate. Lastly, after being released from the ER I continued to feel nauseous to the point that I vomited one more time on the way back to Wellfleet from Hyannis.

Prior to last year’s post desert hike pass out, I hadn’t fainted in more than a decade. I had actually begun to believe it was a phase that I moved beyond. Since this does not seem to be the case, it looks like I’ll be reconnecting with Capital Cardiology for some sort of cardiac work up. If they’re looking to repeat that 30 day study I did 15 years ago, it’s going to have to wait until I’m back from Italy.

And the next time I pee my pants, let’s hope it’s because I’m laughing too hard. Because passing out really isn’t fun – or very funny.