Ever trained anyone who faints when the room temp changes?
My housemate (female 23yo 5'2" 48kg) has been struggling with vasovagal syncope for the best part of 8 years now. It would not be uncommon for her to faint once or more times a week. Temperature changes, high stress events, stimulants and rapid change in exertion all result in nap time.
It goes without saying doctors have advised avoiding strenuous exercise at all costs. She runs, squats and deadlifts nonetheless, not dead yet. They have also proposed a pacemaker may be her only out.
It seems logical to me that a stronger heart could only do good things. Thought it worth seeking a professional opinion, maybe someone on here could help her find a path to a more functional life.
A pacemaker? For vasovagal syncope????
You can have a cardio depressive version of vasovagal syncope, where the heart rate drops out....but it’s pretty darn uncommon. Unless they’ve documented it on a tilt table test (or cardiac monitoring of SOME sort), she doesn’t have that and doesn’t need one.
I guess if she has had an event recorder demonstrate genuine bradycardias associated with the loss of consciousness and it is happening as frequently as you mention then there may be no other choice. However, why this means no strenuous exercise is beyond me.
“A pacemaker? For vasovagal syncope????”
Yeah. That's exactly my response. Something else is going on.
Yeah, we're talking in a vacuum here. "Vasovagal" is a wastebasket term. It basically means the syncope is neurocardiogenic....like most syncopes. But sometimes it's because of a malignant arrhythmia. As Simon intimates, she needs a tilt-table test and probably a holter and an echo. IOW, she needs to see cardiology. If she came to me, I wouldn't train her until I had that workup in hand.
I knew this girl once, a lab tech, with a similar presentation, which did not get worked up beyond the "oh it's just vasovagal syncope now go away" phase. Turns out she had a Brugada variant. Sudden cardiac death in the lab one day while working at the bench. Fortunately across the street from our ED. Resuscitated in less than 15 minutes with a fair neuro outcome, and got an ICD. Happy ending. Could have been...worse.
Remember: syncope is a condition in which your brain temporarily stops working for some reason. Respect that, and get to the bottom of the "some reason" part. That's the role of a doctor who gives a shit and doesn't just slap a "vasovagal" diagnosis on a young person with recurrent syncope.
I really need to stop being imprecise in my replies.
Syncope is loss of blood pressure to the head, for whatever reason, that lasts long enough for you not to be able to stay conscious (or at least upright). If. I remember right, it will happen to about 10% of us during the course of our lifetimes. Most of the time, we never figure out what it was, and it goes away.
There are red flags to watch out for, but one noteworthy thing about your friend is that she hasn’t died from any of these multiple episodes. That all but rules out most of the more terrifying causes. I’d be interested to know what they know about her syncope, before they start putting hardware into her.
If nobody has documented a pause in her heart rate of more than 3 seconds, or SOME sort of bradycardia at the time she passes out, then they shouldn’t even bring up the word pacemaker.
She has been diagnosed with cardiodepressive vasovagal syncope. She was diagnosed via the tilt table test. She does see a cardiologist. No arrhythmia.
During an episode her heartrate ramps up to +140ish before dropping to 40bpm and thus inducing the faint. At least that is what was recorded on the table. Her resting bpm is usually around 70.
In that scenario I suspect she does need a pacemaker. I’m no expert in cardiology but I can’t think of another way to prevent the profound bradycardias she is getting and frequent fainting would be quite an unpleasant symptom to suffer I hope she gets somewhere.
Ah, then that’s simple. Pacemaker. It will greatly improve her quality of life.
I mean, there’s other stuff (making sure she’s hydrated, etc), but if she’s failed that, then this is a no-brainer.
The vast majority of the time, the pacemaker will just sit there and watch the world go by. It will only leap into action if she goes low.
Yes, this should definitely be worked up and characterized before putting in a device, but I would just add that dying from the syncope itself is not the only concern. Regardless of the cause, sudden loss of consciousness can be a big problem if you are driving, swimming, holding a baby, rock climbing, etc. Not to mention it's a bummer to have an ambulance called on you unnecessarily every time you drop in the grocery store or mall. Fainting 2/week puts a huge crimp in your lifestyle. So even if it's "benign," it needs treatment. Whether a pacer is needed is another story. Pacers are pretty darn expensive, so I would assume that at the very least the insurance company is insisting on proper eval and perhaps trial of other treatment first, even if the doctor is a pacer-happy cowboy who drives a Bentley with a "MEDTRONIC" vanity plate. But maybe I shouldn't assume these things...
We've been training in our newly outfitted garage at home for about a month and got our first noise complaint from a neighbor this weekend. I was doing cleans and dropping them with my newly acquired bumpers on my newly constructed platform. We like our neighbors and have good relationships with them, including the guy who complained and so don't want to be belligerent about it. The bumpers we have were bought second hand and are way to the hard side of the continuum. If buying more expensive, softer bumpers would help dampen the noise then we'd bite the bullet and do that, but I don't want to spend several hundred dollars more on additional new equipment if it isn't going to meaningfully change the situation.
The "softness" of bumper plates does not vary to any significant degree, since it would affect their bounce, which must be controlled. The noise is the result of the weight hitting the platform. I guess your HOA needs to pass an amendment to their CC&Rs prohibiting the Olympic lifts in the neighborhood.
Where’s your platform? Can you soundproof the room?
Those of us who do not like neighbors having input into our affairs have chosen not to have neighbors.
That is the dream, but it is increasingly difficult when your country's population has almost doubled in 50 years, placing you in the third most populous country in the world. Or when you live in China. Or India. Or Britain, which keeps trying to grow its population through immigration despite constant environmental claims that the island has already far exceeded its population capacity.
Wow! That escalated fast. From bumper plates to world population growth. Congrats to you Mark for presiding over one "big picture" forum!
Acoustic insulation is the only thing that might work. But dropped plates make noise.
Deeds of Arms –Nick Delgadillo and John Valentine
Coaching Tip for the Start of The Press –Nick Delgadillo
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