Living with Vasovagal Syncope

 

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Does anyone ever wake up in an instance to see their vision in an array of tiny black pixels formulating in obscure random patterns? Or a sick crumbling feeling in their stomach accompanied by an impending tingling wave of nausea moving up their chests with a ringing in your ear and you lose your balance?

If so, you’re in luck because well, you’re not alone.

For the past 15 years I’ve experienced a health condition called Vasovagal Syncope which is basically getting dizzy more than often or fainting. Now I have had this condition long enough that I know the different stages and how severe my symptoms are at the time. My symptoms can range from just a quick dizzy spell and be back to normal all the way to fainting for 5+ minutes and every thing in between.

I’ve adjusted my life to help control my Vasovagal Syncope. For example, when I workout, I cannot do real squats. I must do sumo squats (legs apart) so that way, I have enough balance and lower my chances of fainting. I must carry a water bottle every where I go.

Vasovagal syncope is a fancy medical way of saying that a person had a change in their body that caused them to faint. The change is not caused by a disease or disorder – instead, it happens because of an extreme feeling like shock, fear, or pain. It also happens in certain other situations (e.g., seeing blood). People with vasovagal syncope often describe sweating, feeling dizzy or nauseous, or having clammy hands or skin before they faint. They will usually regain consciousness after lying flat for a few minutes. A doctor will ask you about the situation surrounding your loss of consciousness to identify vasovagal syncope. Treatment usually involves avoiding the type of situation that caused the fainting spell – if this is not possible, there are other behavioural and medical treatments that a doctor could prescribe for you.

The first fainting spell I got was when I was 6 at a toy department store with my parents. A toy box fell on my hand and left a cut on my fingers. It was a moment of intense panic and I slowly find myself collapsing on the ground with my lips as pale as paper. My parents held me down in the car measuring my pulse. It was intense for a child my age, and I thought I was going to die.

When you have a syncopal episode, you have something akin to a very vivid dream, and when you regain consciousness, you can’t remember it apart from the fact that you thought you were dreaming. (Perhaps, that was the leading factor that got me interested in stuff like astral projection, out of body experiences, etc.)

The second time that happened was also the first time I got my menstrual period. I was in a train and I felt like I was losing a lot of blood. I passed out and terrified every passenger in the cabin. Thankfully, to the kindness of strangers and train coordinators, they helped me out with water and a kind lady with paramedic license massaged my temples.

At least once a year, a pattern of thoughts turns into a series of chemical reactions, and I lose consciousness, crash into something, have rapid muscle spasms that look for all the world like an epileptic seizure, and then I lie limp and unresponsive for a while with dangerously low blood pressure, a weak, sluggish heartbeat, and a thready pulse. A series of heart palpitations ensues. It scares the hell out of everyone. As for me, I’ve done it so many times and under so many circumstances that it’s mostly just humiliating. I have a refrain for these post-faint moments, and I’m usually saying it as I come to: “I’m sorry, I’m sorry, I’m sorry.”

Sometimes what I am thinking causes me to freak out so badly that my vagus nerve is triggered and all the blood leaves my brain, with the effect that short portions are edited out of my life.

It was definitely terrifying to experience this from time to time, but the interesting fact is that is biologically justified. Specific triggers induce an overactive “fight or flight” response that then leads to vasovagal syncope. It’s different for everyone. Some people experience it when they hear particularly shocking or overwhelming news. Others pass out at the sight of blood, or at graphic descriptions of injuries, or in situations in which they themselves are superficially injured or are undergoing a procedure involving needles.

Distress signals from the brain cause a wave of adrenaline to crash through the body, which in turn kicks the heart into high gear, narrows the blood vessels, raises blood pressure, and floods the heart and lungs with blood. These are the body’s “oh shit!” responses, developed over the ages to prepare humans to recognise and flee from predators or fight for their lives. A true state of panic, however, one where the brain and body react as though the threat were genuinely lethal, can only be sustained for so long.

In people with a history of vasovagal syncope, the “fight or flight” response seems especially prone to overheating and then triggering a response from the body’s emergency pressure valve, the vagus nerve. From its privileged position close to the brain, this nerve sends up a message authorizing the release of massive amounts of the neurotransmitter acetylcholine, adrenaline’s opposite. Blood volume plunges and pools in the legs, leaving the brain with too little circulation to keep functioning. Musculoskeletal control is lost and the body collapses.

It is the brain’s last-ditch effort to reclaim the blood it needs—if the heart is suddenly too weak or slow to pump blood upwards, the body must be brought down.

And here the response usually ends. Sometimes it even looks graceful, more accurately fitting the word “swoon”—wrist to forehead, a gentle crumbling perhaps brought on by a too-tight corset. There were even special couches for this purpose in the Victorian age, “fainting sofas,” on which one could elegantly recline while smelling salts were held beneath the nose. But in an even smaller subset of the already small percentage of the population prone to vasovagal syncope, an exclusive club to which I and a few members of the population belong, the fun continues with a sudden, violent stiffness in the limbs or uncontrolled shaking that resembles, but is not, a seizure.

In other words, anyone without a spear in the Paleolithic Era learned pretty quickly how to tell when things were going south for their side in a conflict. Better, if the raid is heading more towards a massacre, to go ahead and appear dead. Keep in mind that humans at this point were pre-verbal, and had no means of communicating through sounds or symbols.

A convincing appearance of death was truly the only way of saying, “Fuck, please stop stabbing me.”

I find it fascinating that a non-lethal trigger, something as tiny as a needle’s prick, the sight of someone else’s blood, a convincing or elaborate description of gore, or even a strong emotion, can cause an uncontrolled, if brief, shut down of the brain and the superficial appearance of death in the body. The situation is not “fight or flight,” not a confrontation between predator and prey, but my imagination, my emotions, my mental pictures of split bones, pierced veins, and swelling, empty tooth sockets that have convinced my brain that the stakes are life and death. The stress of lost control plays a huge part as well, the knowledge that whether or not I approve, painful and invasive things either must be done or have already happened to my body.

In a case of a syncope episode, it is important to not freak out. I’ve complied some effective ways of managing it, to protect yourself from your environment. These are from my personal experiences. I am in no way a certified cardiologist, but I have been recently diagnosed and I really hope they could come in handy one day.

Self-Management tips for Vasovagal Syncope

1. If you are able to be aware of the oncoming signs, sitting down, lying down, would be an immediate response. There’s the old head between the knees method. But avoiding them completely, well, the only thing to do would be to avoid what causes it, and sometimes we just don’t know what the trigger is.

But once you do learn then treating the symptom as something to avoid if you can, and generally taking things slower and easier to allow the body time to adjust.

2. It is important to lie down flat immediately when you sense heart palpitations and loss of vision because you never know what can happen if you fall and knock your head, breaking your skull, neck or spine which can cause instant death.

3. Lying down helps to regulate your blood flow instead of gushing it down to your lower body, delaying the flow to your brain which needs it most for oxygen.

4. It is also especially helpful to drink water as taking gulps helps to regulate breathing and take in long timed breaths.

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All in all, it is not a lethal condition, but something biologically engrained. Perhaps, that adds as a relief knowing that is something just to be aware and cautioned about, and not to fear any onset potential health threats. I, and some others, just have a more sensitive nerve, which sometimes malfunctions and starts a fight with my brain, all for the better of my safety.

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The Narrative Error

 

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I recently sat in on a talk for a leadership class for young people as part of my friend’s university programme. The premise of the talk went something like this: “In order to bring change to your community, it’s important to know your own story. You should reflect on your life in order to create a narrative that you can bring to the table when you go out into the world.”

We were asked to fill out a large number of questions about our pasts, our families, our aspirations, and how all of those things fit together to form our personal story. In a certain sense, we were constructing psychological profiles for ourselves, not unlike a Freudian psychoanalysis.

The class, of course, had the best of intentions, but I left with a bit of a sour taste in my mouth. I don’t know if this is a characteristically modern way of approaching life, but there seems to be an obsession in this society with personal and cultural narratives. Life should, apparently, follow the same format as a novel. Every detail has meaning and effects subsequent events, with a few themes running across the years to tie our lives together. We reach a series of climaxes that resolve our psychological, emotional, and spiritual journeys. We are supposed to strive for continuity, so that if we were to sit down with a pen and the instructions to write a memoir, the narrative would come easily.

I don’t personally believe in the narrative structure of a life. The reason why novels have such a definite, thematic narrative is because the author is in charge. There is no serendipity or random chance in a novel; events are planned and edited according to a predestined narrative arc. Our fiction follows a neat, congruous storyline because novels are written to produce a sense of closure and resolution at the end. They give us morals, themes, and characters with beginnings and ends. I love novels, but they are not accurate depictions of the real progression of human life.

The problem is, we don’t live towards resolutions. Every event in my past isn’t culminating in this very moment, leading me towards a climax and closure. My life isn’t a collection of a few themes that pop up over and over again, evolving over time. My very memory isn’t really continuous, and my psyche doesn’t evolve linearly like a character in a book. Cause and effect are so messy in real life, and much of our identity and memory is made up, misremembered, or imagined after the fact. Memories change, identities evolve in strange ways, and we all abide by a certain degree of randomness and chance.

I believe that trying to turn life into a narrative is dangerous. It makes us crave resolution and a definitive causal structure for our entire lives. We feel the need to box up our experiences and explain them based on grander themes and ideas, when some events just happen for no narrative reason. Our decisions are supposed to follow a progression, and our memories are supposed to accurately portray our pasts and inform our futures.

There is so much pressure and disappointment to be felt when trying to turn life into a novel. We have to be finding meaning and arc in every action, every experience, every thought and feeling. We have to be constantly justifying our choices, our aspirations, our desires and fears, our very selves on some decades-old story that started at birth. When things end without total resolution, we feel that we’ve failed to finish the story, and we get trapped in an endless need to find closure. We limit ourselves to a few identifying themes and become paralyzed, because abandoning our labels and themes is abandoning our story.

In order to grow and fully appreciate the serendipitous quality of life, we must be willing to let go of the narrative that holds our story together. We are not stories; we are a present consciousness. We are the atoms that make us up in this very moment, which are forever changing and reacting to an infinitely complicated universe. We can never ascribe a narrative to our lives because the world and the brain are too utterly complex to box up in a story.

Being human and free means being able to shift in any direction, to take the reins and reinvent ourselves, to let go of old memories and identities and move into new domains as we evolve. Abandoning old narratives and self-stories is accepting the transitory, momentary quality of human life. It is denying the ego its power of storytelling and justifying, accusing and blaming the past for our present suffering. Stories restrict us, and blank pages are our freedom.

I have told myself so many stories about myself, which become habitual loops of thinking about my own identity. I now realize how pernicious this cycle is. I don’t want to be limited by my old identifiers and memories. I am grateful to be a human because being human is being free. I would hate to shackle myself to a sensical novel that I have to strive to write every day.

What stories do you tell yourself about your past, present, and future? Do stories comfort or restrict you? How have you given up narratives in favour of present Being?

Me or Us?

 

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Every person on earth has trillions of bacteria living on them and within them. Your nose and belly button each have their own unique bacterial colonies, while pale in comparison to the veritable universe inhabiting your gut. We each carry pounds of bacteria around in our bodies, who outnumber our own body cells by several magnitudes of ten. As a life form, I am no more a single “me” than Earth is a single “me.” We each contain multitudes. These bacteria are critical for digestion, immune health, and may even regulate our moods and fluctuations in weight. Little do we know, trillions of creatures inside of us are making our own lives possible.

This thought struck me, not only for its biological wonder, but also as yet another example of the mysterious interdependence of the universe and the planet. It made me balk in wonder at the sheer complexity of each living organism, and how much each of us is influenced by other forms of life. We learn about symbiosis in biology class, but why don’t we learn that we ourselves are symbiotic creatures, providing a home to trillions of bacteria who in turn keep us healthy and safe?

It also made me realize a completely new dimension of the sacredness of the human body. It is so easy to get caught up in the flaws of our physical beings, in a culture that views the body as an object of physical prowess and beauty. We are taught to see our bodies mere proof of our self-control, habits, and dedication to improvement, in the form of diet and exercise. We are taught that our bodies belong to us alone, and will be used as tools to judge our character and dedication to the self. Our culture dictates that our body is an extension of our ego, a physical sense of self and value.

But, knowing that we each contain multitudes, we can look at the body in a sacred and selfless way. No matter what our bodies look like or how they perform in strength and endurance, they are home to trillions of organisms. We are, each of us, a world for trillions of living things. The human body is a universe, not only of microbes, but also of each individual cell that spends its whole life working to keep us healthy and alive. The idea of “me” as a singular entity, from a biological perspective, does not truly describe the human body. I am countless, infinite life forms, all working together to produce the being that my eyes perceive as singular.

This perspective on the human body has made me feel a new sense of love and responsibility to my physical form. If I wouldn’t want to harm others, how could I harm myself? How could I discount the body that holds so much life, so many beautiful creatures conspiring every day to keep me alive? How could I look at my own skin with anything but wonder, knowing what I see is really a vast fabric of cells and bacteria pulsing with life?

I hope that when you look at your own body, when you feed it and wash it and move it, you too can see a bit of the wonder of your own inner multitudes.

Patagonia

 

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I was watching a documentary about a chef who lives in Patagonia and he said something that really struck a chord with me, “I seldom invite people to have lunch and dinner with me, but they are really chosen. Because I can’t spend time with people anymore that I don’t enjoy. I make choices and that’s the beautiful thing about growing up, learning to say no. In a nice way, but you say no.”

I think that’s something that took a long time for me to realise. There are a lot of people who I have wonderful memories with, who I still love a whole lot, but they don’t necessarily fit in my life anymore because we’ve simply grown apart. And it’s nice to be able to acknowledge that they had a big impact on me while also knowing it’s okay to say goodbye.

There are certain people from my past that I’ll always carry with me. And it’s really hard for someone to leave that kind of impact on me; it’s more of a downfall, but I’m very good at moving on. At forgetting.

But there are a few whose presence hit me so hard that they are permanently engrained into the person I am today. The type of person who influenced me so much that I’ll see something specific and think of them and only them. Or I’ll say a word that only exists in my vocabulary because they used to say it all the time. Or on a deeper level, who inspire the way I live simply by the way they live.

And for me, nearly all of those people are no longer around me. And I never know who they are until they are gone. But I look back and sort of view them as teachers, in a weird way. Because I am undoubtedly an amalgamation of those few voices mixed with my own strong sense of self. I don’t know, I just think it’s interesting that some people we once knew we would barely recognize in a grocery store but others, others burn so brightly, so constantly at the center of who we are that no amount of time could make us forget them.

Humans

 

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Humans. The first creature on Earth able to lie and delude, have emotions such as self-loathing, and survive using intelligence over strength. While they are the smartest beings on the biosphere, humans fear the things they do not understand. Such as other humans.

We, the cleverest of species, are also the most ignorant. We have spent years putting ourselves back into the caveman ages by banning a kind of love and by degrading the feminine gender and by frowning at a certain ethnicity. We push people so far back into the closet that their eyes dilate to freedom and we start unknowingly labeling them as the monsters. And then we raise our kids to think they should fear the things that live in their own room and in their own world. And the TV tells them it’s okay to shoot and kill any of the monsters that happen to get free. Maybe the story books were never about a giant, furry, red-eyed creature — maybe it was just the fear of power, a different color, a flash of a camera.

Every time we shiver at the site of a boy and a boy holding hands, and we spat on the women who said no, and we shout at the man of colored skin, we then allow the dehumanization of our own to carry on.

We think that maybe if we keep allowing our words to be venomous and our actions to be cruel then we can make people believe that they are not worth their life and we can then keep stripping them off their human rights.

But it won’t work anymore. Because the numbers are getting stronger and we no longer care if the light stings our eyes a little.

We are asking what exactly makes us monsters.

An Unanswerable Question

Yesterday, my aunt came over to visit and began talking about a seminar she and her husband attended. It was a psychology seminar, focused on self-awareness and understanding one’s own motives and purpose. She explained to us one of the activities, which she says still affects her life today: finding your unanswerable question.

An unanswerable question, she told us, is the question which guides your actions and life decisions. It embodies the way we view our own purpose in life, and how we define success and failure. These questions often lie in childhood psychology, built over years of conditioning, insecurity, and relationships. Her unanswerable question is “Am I good enough?” in reference to her always competing with her three older brothers in childhood, tirelessly trying to get some sort of recognition from my grandparents.

The night after she explained, I tried to find my own unanswerable question. Perhaps I’m more acutely aware of myself and my motives than others, but I found the exercise quite easy. I believe we all know our unanswerable question deep down, seeing as we act on them, but we don’t always acknowledge them consciously.

I believe mine to be: “Am I living up to my full potential?”. As a child, I was consistently told that I am talented and am on track to do amazing, world-changing things with my life. My mother encouraged me to use all my gifts as an adult, telling me it was my duty to grow up and use my full potential to help the planet.

So I grew up fearing failure, fearing that I wouldn’t use up all of my potential in life. That’s why I often strive today to do everything I can, stretching myself too thin. I need to be the best in most situations or I feel like I’m failing to use my full potential. I often embark on projects, books, and artistic ventures that I abandon, trying to use up all of my potetial as soon as I can.

Another manifestation is that I feel the need to show the world my goodness, a tendency to justify, so as not to waste my inherent gift of kindness and my inherent ability to change the lives of others. I am all too aware of my mortality, and try everyday to use all of my potential in case my time on this planet is short. To me, time used unwisely and unproductively is time wasted. My greatest fear is dying before I can surely say I have lived up to my potential and used it to change the world.

I knew these things about myself, but knowing where they all stem from has helped me to understand the way I think, feel, and act. My unanswerable question is completely personal, and so is yours. I encourage you to do some soul-searching, so to speak, for your own question. I’ve so far provided two examples, but I will give a more general list of requirements for a question now. Your unanswerable question must be somewhat general, but specific to you. It doesn’t have to encapsulate all your views and actions, but it often dictates the way you act as a default in everyday life.

For example, if yours was “Am I smart enough?” you might try to surround yourself with smart people, fear that people are talking down to you, force yourself to read difficult material, and have a lack of respect for less intelligent people. Another example, “Am I like my mother?” might be the question of someone who despised their mother in childhood and has it set within them not to follow her example. The question usually focuses on a childhood and adolescent theme.

The possibilities are truly endless, dependent on your own personal past. Finding my unanswerable question has allowed me to reflect on my actions in a new light, seeing how they line up with my inner value of fulfilling my full potential.

It’s also allowed me to see how the way I view the world and act is different from that of other people. Before, I thought everyone was looking to achieve their full potential at the end of the day- I never considered otherwise. Now I know that it’s a specific value, and I no longer judge people based on their ability to fulfil this value. It’s not because they are unmotivated or lazy or too tired; it’s because their unanswerable question is different from mine.

More recently, I’ve been attempting to figure out the unanswerable questions of others, in order to understand why they act the way they do and how to treat them better according to their needs.

The ways in which unanswerable questions affect our lives are limitless, and get to the crux of our subconscious decision making. Understanding your own question is central to understanding yourself; and understanding yourself is the key to living a meaningful life that you control.

Unplug and Recharge

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Lately, I’ve been keeping myself busy even though I just ended my final project and I am not too sure if I am okay with that. Maybe, maybe not. There is this funny thing about me where I would keep myself busy and then get exhausted and overwhelmed by daily busy schedules, tasks, to-dos and things to get me going, simply said. I may not enjoy the process of being busy so much but I do enjoy the outcomes of getting things done. It is fulfilling although tiring.

I love being quiet, being able to unplug and recharge and just take days off sitting by the window, drinking a warming cup of sencha and top it off with a wonderful playlist. There is nothing as valuable as some inner peace and tranquility or just getting down and heavy with my favourite films, books, or even getting out for a walk in the park and cycling in the neighbourhoods. It is vital to me, especially an introvert like me, who could spend ample time on my own for a good time of relaxation.

The funny thing I want to point out is that by doing so, every minute, every second I am fully aware that I could be wasting time. It gives me some sort of unexplainable anxiety deep down. And I hate that, I also hate that I can’t stop feeling this way.

I think as far as modern society goes, we have grown so used to being busy, its almost like a cult. A cult of busy—which taking time off makes you feel guilty. Society demands us to achieve, achieve and achieve, I am a victim of that. I have grown so used to this mentality that doing nothing alone, spikes up my feelings of uneasiness and anxiety. You squeeze everything out of every living minute; you’re speed-crazed, time-obsessed, tech-dependent, and a productivity freak. To complicate matters, you’re flooded with time management techniques to help you be more productive every day of your life.

But having some down-time (whatever that means for you) is not a waste, even though you might think it is. Having nothing to do for a while is the ultimate luxury of our modern days.

I do not want to sound like a complaining child because I know people would tell me to embrace this gift. There are a lot of people who are the opposite and find it hard to motivate themselves.

Truth is, I don’t feel that I am incredibly fulfilled and happy even when I am busy and I do not feel okay with being free either. It is a constant tug-o-war of my wants and desires. How do I define what makes me happy, is it being busy and productive or self care and personal needs. Is it too greedy to want both? Maybe that is why I am writing this post in the first place because I am also trying to find out while I recollect my thoughts.

I’m graduating, have nothing much on my mind that needs to be submitted, at least at the moment, no deadlines to fulfil yet I feel this curse of uneasiness. Dammit, I could hear the echo of my friends and family telling me to just let myself loose and I am not supposed to feel guilty about doing nothing all day. Am I?  Do I have to “accomplish” something in order to be worthy?  Why can’t I feel good about myself if I just spend the day doing nothing much at all?  What’s with all the guilt?

Doing nothing is often unfairly labelled as being lazy, but in fact it’s probably the best thing that you could do sometimes. A recent study led by scientists at University College London found that individuals who work over 55 hours a week increase their risk of having a stroke by 33 per cent compared to those who work 35 to 40 hours a week.

And another study spanning over 50 years of research published in the American Journal of Epidemiology, showed that a ten hour or more workday increased the risk of coronary heart risk by 80 per cent.

Basically, science is telling us that we should be resting more, and we’re happy to get on board with that. Most of us spend majority of our time at work, commuting to work and back, or thinking about work. So why do we feel the constant need to always be doing something, rather than having a well deserved rest? What ever happened to being able to relax, without feeling guilty about it?

All in all, I think it is still ultimately important to care for yourself. Perhaps, the resistance of having downtime and an inner critic show up because of fear of failure. The fear of letting myself and others down. It was such a good reminder that between goal setting/achieving, work, exercising etc there’s a thing called life that has to be lived and enjoyed. Letting go of your to-do list and simply just be. Ultimately I want to do the things I do because I enjoy it, not because I have to. And I guess I like to keep it that way.

Rest and best of luck, everyone.