I’m the weirdo who faints and has 20 minute non-epileptic seizures from time to time.  I swear I don’t do it on purpose, and not that often.  My version’s triggers are sudden unexpected pain, menstrual cramps, prolonged standing in the hot summer sun, that one IUD insertion, and any injection containing epinephrine as a component.  My best guess as to the cause is some kind of beta receptor supersensitivity.  I can’t do caffeine, I can’t do Sudafed, and to stop anaphylaxis, one puff of albuterol will work.  To drop my resting heart rate from 150 down to 75 during pregnancy, half of the lowest possible dose of atenolol was used.

I’m also an athlete.  I’m training for a half-ironman triathlon this summer.  I’m better than the average person at body awareness.  Having spells of presyncope while standing in line at the grocery store, or standing around at my kids’ soccer games, is just something I’ve been dealing with for over 20 years now, and I thought it was normal!

To prevent fainting, I will often choose to sit instead of standing.  I will lean against a wall if it is available.  I will shift my weight from foot to foot, or gradually clench and unclench my leg muscles on a continuous and automatic basis.  I’ve been doing it so long, I don’t even think about it.  I consume more salt than the average person, but not an excessive amount.  In my reading, I’ve discovered that I needed to add potassium to my salt, so I did.  Training and races go better for me if I’ve got sufficient electrolytes.  I’m not the hypovolemic type, I just don’t want to ever be dehydrated.  I also can not stop a hard interval suddenly.  I’ll always keep moving after a hard training effort because abrupt heart rate drops suck.

I got a fitness tracker, and started watching my heart rate.  I knew it was more variable than the average person from my earlier heart rate monitor use, but I had no idea about the volatility I was experiencing.  My heart rate, just sitting at a computer, can be as low as 44 or as high as 134.  No particular reason.  A dizzy spell standing in my kitchen was caused by an abrupt drop in heart rate from 106 to 49, followed by a slow rise back up.

Unfortunately, beta-blockers are a banned substance in the races I seek to participate in.  I can see why, because they slow the response time just enough to be dangerous.  Also, my history of food allergies, asthma, and Reynaud’s phenomenon make them less than a desirable choice on a daily basis.  I did, however, manage to secure a small supply of a 24 hour version and a 3 hour version for particular high risk situations.  They really work.  I didn’t know that you’re supposed to stand up out of a chair or on the pool deck without dizziness.  They’re terrific for performance anxiety, and to keep me from trembling whenever I watch exciting TV.  Oh yeah, that’s not normal either, but I’ve been doing it for years.

I’m still not on any full-time medication, because the risks outweighed the benefits, but as I get older, that could change.  I wonder how people dealt with this 5000 years ago?  They probably didn’t do anything other than lie down when they needed to.  I’m still driving, because it never happens when I’m driving, and even if it ever did, I have sufficient warning time.  However, sympathetic nervous system hyperactivity is a risk factor for osteoporosis and heart disease.  I can see why.  It takes me longer to heal or recover from my athletic training than the average person because my sleep is sometimes interrupted by adrenaline surges.

Meditation helps a lot.  It can prevent adrenaline surges from being as big as they were in the past, and that can keep the heart rate drops from being as large, which reduces cerebral hypoperfusion issues.  Breathwork also helps a lot, although I can’t do the full Wim Hof method, because I’m not interested in raising my heart rate up to the 150s through simple hyperventilation, and then shivering for minutes afterward.  I can do a very abbreviated version.  There are more kinds of breathwork than that.  There’s the slow version, breathing in for 7 seconds and out for 11 seconds.  There’s the square breath version, breathing in, pausing, breathing out, and pausing for the same amount of time each.  There’s also breathing fire, breathing Earth, and more energy flow stuff that I don’t want to get into.

Does lightheadedness while standing around affect my life, even if I faint on average less than once a year?  Of course it does!  I can’t do the standing around thing on a regular basis, so I would never get a job involving standing on my feet all day.  No teaching, no cashiering, no acting, no military (asthma already got me out of that one), no factory assembly lines, and no baggage handling, because weightlifting is dangerous with a wonky autonomic nervous system.  I can’t think very well on my feet, because if I’m standing, I’m automatically in a low level state of lightheadedness.  Courtroom lawyer work is not my cup of tea, nor is singing in the choir, although I do love singing.  If I ever needed to do these things, I would insist on a daily beta-blocker of half the lowest possible dose, or I’d suck it up and accept fainting as a part of getting the job done.

I vastly prefer lifestyle changes to drugs.  Sometimes drugs work better, but if I can live without them, I will.