DEAR DR. GOTT: My husband (has seizures) throws up and passes out when he has a virus. He gets clammy and feverish, followed by throwing up and passing out on the bathroom floor. He has been doing this for about 20 years. (Of course, it only happens when he has a virus and throws up.)
This has never happened in the car but he is almost 60 years old and is not getting any younger. I’m afraid it will happen when he is driving with me or others in the car and he will hurt us or someone else.
He is very healthy and has high metabolism. He works as a packaging manager for a chicken processing company and then usually works on things around the house when he gets home. He only sleeps 5 hours at night but after work if he sits down, he will fall asleep.
He gets his teeth cleaned twice a year and flosses. He has sinus drainage a lot and has a sinus infection at least once or twice a year. Other than that he is very healthy. He exercises, but not consistently. He is 5’9” tall and weighs about 180 pounds.
Please let me know if there is something we can do at home to help him or if we should call 911 when it happens.
DEAR READER: Based on your description, I don’t believe your husband is having seizures that are causing him to pass out. While loss of consciousness can occur, seizures are more typically associated with rapid eye movement, muscle twitching, or shaking and many times end with sleepiness known as a “post-ictal state”.
That said, I do have an idea of what may be happening. The key is that you indicate it only happens when he vomits. For this reason, I believe your husband is likely passing out from over-stimulation of the vagus nerve. There are two vagus nerves in the body; one on each side. These nerves are very long, extending from the brain stem to the abdomen. They are responsible for regulating heart rate and blood pressure. During times of extreme emotional or physical stress typically caused by an external trigger, the nerve can malfunction, slowing the heart rate and drastically reducing blood flow to the brain, resulting in a faint.
Symptoms that can appear prior to a faint include, lightheadedness, tunnel vision, a feeling of warmth, skin paleness, nausea and a cold, clammy sweat. These are then followed by a brief loss of consciousness.
Common triggers include having one’s blood drawn, the sight of blood, straining (such as from a bowel movement), standing for long periods of time, heat exposure, and fear of bodily injury. Your comment about your husband having a virus and throwing up which causes the fainting may not be entirely correct. It may be that he is exhibiting symptoms of a vasovagal syncopal episode which may resemble a viral infection (fever, chills, sweats, nausea, vomiting, etc.).
In most cases treatment only involves identifying and avoiding triggers. When the sufferer feels a fainting spell coming on, lying down and raising the legs may prevent it. If he can’t lie down, have him sit with his head between his knees until the feeling passes. Beyond that, if episodes occur often enough to interfere with quality of life, medication, to include antidepressants and blood vessel constrictors may be beneficial. For some, pacemaker insertion has been found beneficial.
Other causes of fainting can include certain heart and brain disorders which can be much more serious.
Also, your husband needs to get more sleep at night. Humans need seven to eight hours of sleep in order for the body to function optimally. Clearly your husband is tired if simply sitting down after work causes him to fall asleep. He isn’t doing himself any favors by fighting to stay awake when his body wants, and needs, to sleep.
I urge your husband to speak with his physician about these episodes of passing out. As soon as a cause can be identified, steps to prevent further occurrences can be taken. The next time he exhibits symptoms and feels as if he is going to vomit, have him lie down and raise his legs. If his symptoms subside, great, but be sure to inform his physician. Also, ask him to try to remember what happened immediately prior to the feeling as this may help identify a trigger. If he does vomit and then faint, immediately call for help. Fainting is never normal.
