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Two weeks ago, I ended up in the ER due to 2 fainting episodes. I got up at 3am to go to the bathroom & fainted, slamming my head against the floor causing a 2" gash in my head. My husband helped me up and while I was standing in front of the bathroom sink rinsing the blood out of my hair to check the gash, I fainted again. The first one I kind of felt myself going down, but the second one I didn't even know I had fainted. I just knew one minute I'm standing at the sink & the next I was on the floor looking up at my husband calling my name. I went to the ER & spent 2 days there undergoing CT exams (head & carotid arteries, abdomen), blood work, EKGs, echocardiogram. The only thing the dr's could find was pancreatitis (lipase elevated 3x the normal), dehydration, and an inflamed pouch. Heart is ok - very strong, in the dr.s opinion. They did contact Dr. Shen to touch base with him on what was going on & he advised Cipro & Flagyl for 14 days.

Returned home with no problems until 2 days ago. My husband & I were on our daily 4 mile walk and I fainted again! One minute I'm standing there petting some neighbor dogs & the next I'm waking up on the ground. This time I face planted....busted lip, hit forehead, bruised nose & slight black eye. I have no idea what is going on! The dr's told me usually if you feel yourself fainting (as the first episode) it's usually heart related. If you don't feel yourself fainting it's usually neuro related. As they ruled out any problems with my heart, I'm concerned it might be nuero.

With all that being said, I do have a stricture in the opening of the pouch & an abd fistula that actually opens on the abdomen. Dr. Remzi & Dr. Shen have been working very hard with me to fix these issues w/o surgery. I have had numerous bowel obstructions with the most recent this past July. I still don't want surgery but am now concerned these could be issues causing the fainting episodes. Is that possible? Am I way off base - should I be seeing a nuero or back to Dr. Shen?

Any advice would be greatly appreciated!!

Thanks

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When J-pouchers faint it's frequently just simple dehydration. Sometimes another illness leads to the dehydration, and sometimes it's just not paying enough attention to your fluid needs. Since the ER noted that you were dehydrated, I'd guess that's more likely than a neuro cause. If you can pay attention to how your urine looks, a light color is good and a dark color is bad.

I haven't fainted in years but used to get what I called 'my angels' when I was little...I would litterally see stars...usually when forcing or if I had had IBS problems...I would get dizzy spells that rarely ended up as a full out faint but would have me sliding down the wall and sitting like a rag-doll on the floor for a few  moments  or longer (water and something sweet or salty usually helped) When it got severe and more frequent they did a full out nuro work-up....turns out that I am epileptic...left temporal...something in there has been atrophied; probably since birth (kind of explains those angels when I was a kid).

I don't have grand-mal sezieurs but petit mal...dizzies, feeling faint, feeling like I have a hangover...

They put me on meds and after figuring out that I can't take LP (coated time released) meds, they got me on Tegretol and I am fine...

Hope that whatever it is its an easy fix.

I have no problem with my pouch and the meds.

Sharon

That happened to me one night also, but I think it might have been stomach flu. I woke up in the night to go to the bathroom and very watery stool just gushed out of me, then I felt like I was going to throw up so stood up so I could at least get it in the sink and then passed out, hitting my head on the counter and coming to on the floor.  Went to the ER and they did a CT and didn't find anything.  Nothing like that had ever happened to me before so I think it was a combination of being sick with a j pouch.

Thanks for all the responses. I do drink constantly. I have a glass of water by my side at all times. I don't drink sodas at all. It's either water or Crystal light. I haven't had any other episodes but I do get a little dizzy when sitting to standing. I have a dr appointment on Monday. Not sure what she will be able to do since it's been several days since it happened, but my sister is a nurse & she says it's doesn't matter when it happened, it happened. So, hopefully someone will be able to figure it out.

I just have a fear that I'll be walking alone or driving a car & pass out. I will be flying the end of the month (alone) & fear that I may faint in the airport in between getting from one terminal to the other. So, I'm really hoping I can get an answer.  Again, thanks for all your responses!! ;o)

I'll try this again: drinking constantly doesn't guarantee adequate hydration for all of us. If you haven't verified that your urine is light colored then you just don't know. You know you've tried but you can't know if you succeeded. Some (not all) people need more aggressive hydration methods, but from what you've written I can't tell if you need them.

 

It sounds like your blood pressure is dropping when you stand up, and you are right to be concerned about the risk of fainting again at a terrible time. Dehydration is just one of the possible causes, though it's especially common in J-pouchers. The doctor can measure "orthostatic" blood pressure, which tests what changes when you stand. Good luck!

You need salt and sugar in your fluids so an oral rehydration solution could work well for you.  Drink, drink, drink, drink, drink.  Keep track of your intake and output to tell your doctor when you see that person.  I think you could also benefit from a 24 hour Holter monitor which monitors your heart rate and rhythm for a 24 hour period.  Even though your tests at the hospital turned out well, they would not have captured a "faint" or syncopal episode to see exactly what your body was doing at that time.

When you go from sitting or lying to standing spend at least 2 minutes in that standing position before you move your feet to start walking.  Take some deep breaths.  Clench and release your thigh muscles a few times.   Once you have been standing for 2 minutes then you can begin to move.

I hope you get to the bottom of this so you can have happy, worry free travels.

The fact that you sometimes feel dizzy changing from sitting to standing is an important clue. You may well have orthostatic hypotension, which is a dramatic drop in BP with position changes. Chronic dehydration can be a factor too. Also, if you have infectious processes going on (like the chronic fistula issues), you may have some systemic effects from that.

 

So be sure to mention the dizziness to your doctor and ask about testing for orthostactic hypotension. It is pretty common.

http://www.merckmanuals.com/ho...ess-when-standing-up

 

Jan

 

Once a year  I would ask for an IV because since my J pouch I am constantly dehydrated. Sometimes I knew when I was at my "close to fainting often"  time and try to beat it head on. Many MD's are reluctant to give you, or not paid by insurance.

For myself, it was worth around $200 to get (only if I was at the end point of water not helping). ND's are more apt to assist on this matter and can add extra nutrients

that you dont always get from food. Use to use Gator aid in the beginning until I found out all the bad ingredients....now I drink 1-2 large glasses of Emergen-C,

many yummy flavors and has kept me from getting the IV's.

Was just thinking....sometimes if I had a blockage, (must be that everything clogs for your body to work correctly). I would feel faint, so at that time would go right to liquids only..have learned to practice deep breathing which really helps too. Breathing from one nostril, then another also helps. I found sometimes I held my breath and did not realize I was doing so until I started yoga.

Gosh, here is another P.S.

I also found during my worst fainting periods (either dehydrated, j pouch blocked, AZ heat, exercise -sometimes not even very much)....found that my lymph nodes were

blocked!  Not everyone knows to   or how to manipulate the lymph areas...look up

The Lymphatic Man online..He was a loss why his wife kept getting dizzy - in a shower, or just getting up, many simple things....finally he found it was blocked lymph glands. He is trying to get the word out there. Someone trained in massage of this area is key.  I also found therapeutic massage has been fantastic for my whole system - wish I would have started this years ago. (not just a spa one, a

true therapeutic massage by a trained professional will open up all areas blocked)

This is frightening - I went through a period of this about 15 years ago.  Went to ER twice.  They never could figure it out and called it "vaso-vagal" response - having to do with the vagus nerve (sorry if spelled incorrectly).  Good news - it stopped happening.  Who knows why it did?  I agree with all - drink and yes, some sugar.  I drink propel and G2 along with regular water.  Of course, everyone is different.  I also try to be certain I'm getting enough protein.  That and electrolytes seem to help me.  I didn't drive for awhile - had my husband drive me to work, or carpooled for awhile during that time.  It just feels awful when you faint.  I thought I was dying or something for awhile when it kept happening and they couldn't find an answer. Well...it stopped happening, never did know an answer.  I find this to be more and more common as I age.  Lots of "we don't know why" - your tests all are normal, etc. (I don't mean for me personally - I don't go in for every little thing anymore - can't afford to) - but just as my friends and I get older - lots of "who knows?"  Idiopathic reasons for all kinds of issues - meaning - they don't know.  Or - they don't want to run zillions of tests to figure it out and if you aren't dying, they don't really care.  Docs and nurses - just human and tired  I hope you improve quickly as I did and you will be able resolve this with ease.  All that said, I always listen to Jan Dollars advice on here.  She's the nurse.  Lucky Jan!

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