The following is a guest opinion article from Doc Martyn.
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The following is a guest opinion article from Doc Martyn. His opinions and advice are entirely his own and may not necessarily be those of The Pattaya News Company Limited. His contact information can be found at the end of the article.
Syncope is the medical term for fainting. It involves a rapid loss of consciousness and muscle function, both of which recover rapidly.
Loss of consciousness after eleventeen pints of beer is not syncope. Inebriation may result in a rapid loss of consciousness and physical capacity, but from which there is no rapid resolution of consciousness, muscle function or coordination, all of which remain impaired, see photos 1 & 2.
There are 3 broad categories of syncope: Syncope caused by the Heart, Neural Syncope caused by nerve dysfunction (vasovagal) and Syncope caused by Orthostatic (postural) Hypotension.
For the purposes of this Byte, I will confine my comments to egestion syncope and micturition syncope.
Egestion syncope occurs during egestion, the process of eliminating faeces from the bowel. As patients age this type of syncope becomes more commonplace. If you have experienced syncope whilst on the toilet, your heart and your blood pressure should be investigated to eliminate underlying pathology.
Similarly, recent onset of micturition (urination) syncope should also be thoroughly investigated to exclude underlying pathology.
Further, depending on the circumstances, the involuntary loss of consciousness and muscle tone during syncope can have serious consequences and may even be fatal.
During my recent incursion to Ubon, Supakit, the senior Monk from the local Watt, sought my opinion. He had several issues about which he had consulted the local Thai doctors.
I responded to his different issues, which included spinal manipulation for his lumbar pain. He then told me about his main concern; that he would collapse when urinating. I explained that he was suffering from micturition syncope. He had endured this illness for many years, as had his brother and father. His diagnosis: familial micturition (vasovagal) syncope, a condition that I have never seen before. I asked the monk some very personal questions including was he scared of dying. He was not. I then suggested several ways to avoid the syncope, which included sitting on the squat toilets and applying the Valsalva manoeuvre, the technique scuba divers use to equalise pressure.
A couple of days later the Monk commented about me on Facebook. He complimented me on my ability and stated that ‘I talk true’. He also stated that he was happy to die ‘because now the people had a good doctor’, humbling praise from such a spiritual man. A couple of days later the Monk experienced another micturition syncope episode during which he suffered injury. Such are the ravages of syncope.
Addendum: Over the past 6 years, as a retired medic living in Buriram I offered second opinions on any medical issue. I recently moved to Pattaya. As in this case, if you reside outside of Pattaya, telephone consultations are provided. For assistance; please contact me, Doc Martyn, on Facebook or call Dao on 095 414 8145.