The stigma of seizures and black-outs

[Lazuli]

Hi all,

I will try and keep the narrative brief.

For the past couple of weeks I have been training hard and performing regular static breath holds. Last Friday night I held my breath for a couple of mins in bed and again the following morning (when nice and relaxed). Anyhow, I got up to make the coffee and felt quite strange, somewhat carsick, and experienced what seemed like tunnel vision for brief flashes of time. Needless to say it took me rather longer to make the coffee and I told my housemates how s**t I was feeling (with the usual replies of "don't we all" etc!)

Next thing I know I am regaining consciousness with two paramedics in attendance. Everyone is telling me that I have had a seizure. They described me letting out a cry followed by a loud crash when I fell to the floor. I was on the floor convulsing with my back cramped upwards like a taught bow. I smacked my head on the wall and bit my tongue in two places. This all happened about 9am. I passed out again in the ambulance on the way into hospital.

At the accident and emergency I had every test they could throw at me and nothing odd came up. However, in the absence of any immediate explanation I could tell that the consultants and doctors were looking at me and suspecting an underlying neurological disorder (namely epilepsy) regardless of the fact that I had been telling them about my breath-holding and freediving. I know I am not epileptic as I had a seizure like this 8 years ago when trekking in the Himalayas at high altitude (whilst unacclimatised at 17000ft) and the manner in which I convulsed was not as violent as Grand Mal epilepsy. I have no headaches and my vision (which was tested last week) needs no prescription. My GP is also not convinced that the consultants at the hospital disgnosed me properly.

I went to see my osteopath to sort out my back pain following the incident, and I told him all about my freediving and breath-holding. This guy knows a thing or two about physiology, cardiovascular and lots more. From what I described to him he was adamant that I had not had an epileptic episode (as the doctors at the hospital implied) but something called a "Vasovagal attack" or "vasovagal convulsive syncope". Something to do with the heart not getting enough blood to the brain as a result of fatigue, low blood pressure, low sugar and salt levels, plus the added factor of O2 experimentation. He reckoned that the carsickness and tunnel vision I experienced was the "prodromal phase" building up to the seizure or blackout, and the similarities with my black-out at high altitude are no mere coincidence.

My reason for posting this is threefold:

1) If you have a seizure that lands you in casualty, be prepared to fight for the correct diagnosis as the subtleties of breath-holding and Apnea appear lost on the provincial medical profession in the UK (and you will more than likely have to surrender your driving licence as a suspected epileptic.)

2) Black-out is no joke: I was switched-off in a split second, well before I hit the deck. And this was DRY!

3) I have a question for clubs and AIDA instructors: Will I ever be able to do a course now that I have a seizure on my medical records and my GP is paranoid?

Its all quite depressing really!:crutch

Cheers

Laz

 

[ILDiver]

Wow, this sucks. You mentioned "Something to do with the heart not getting enough blood to the brain as a result of fatigue, low blood pressure, low sugar and salt levels, plus the added factor of O2 experimentation." Does your diet effect your reaction? Do the symptoms happen every time you try the breath holds?

I'm not a pro, just curious if you are able to control and counter this?

 

[Lazuli]

I am convinced diet has an impact on my susceptibility as the only times I have ever blacked-out have been first thing in the morning on an empty stomach

1) after a night spent at high altitude
2) after a 2 min breath hold done before getting out of bed

I often feel faint when I have a low sugar intake, and my diet is rather saltfree (no pun intended!). I have upped my sugar and salt intake since the seizure and try to get a good breakfast in as I am quite prone to skipping food first thing in the morning. However, I have never experienced prodromal (pre-black out) symptoms from breath-holding before, only when run-down and low on water, sugar and salt.

I was also having amazing success with lowering my heart rate as part of my dry static routine. This may have aggravated the black-out as well.

 

[jay cluskey]

i am so shocked and sorry to hear this
i hope you will be ok
it does just go to show you though doctors are only able diagnose from symptoms
good luck mate

 

[Lazuli]

Cheers Jay.
I'll be fine. What worries me is that I may have a lot of trouble getting medical clearance to do a freediving course or join a club even though I have NOT been diagnosed with anything. I just cant see my GP being that liberal-minded. Its the stigma of the seizure as a recorded event that worries me. :head

 

[ILDiver]

Find a doctor that dives. My GP Doc dives and has studied physiology of diving from his own interests (I got lucky and stumbled upon him though). Maybe contact the AIDA for some guidance to a doctor or someone who can help??

I have not done any searches, but I assume your case is fairly rare?

 

[svetliy]

m8,this is really scary stuff.maybe it has to do something with your blood sugar levels?once after the heavy day of freediving without any lunch running just on the glass of coke I had to do some heavy and intensive anaerobic exercises-I almost fainted afterwards. I felt so impossibly weak,that I fell asleep straight away. Was almost fainting. And also had tunnel vision and "tunnel" hearing, if i can say so. After few hours of sleep everything was gone. Next time I was in the same situation a glass of juice made me feel much better in an instant. So I do think I had very low levels of sugar.

 

[jay cluskey]

Cheers Jay.
I'll be fine. What worries me is that I may have a lot of trouble getting medical clearance to do a freediving course or join a club even though I have NOT been diagnosed with anything. I just cant see my GP being that liberal-minded. Its the stigma of the seizure as a recorded event that worries me. :head

lazuli if you apply for a course with deeper blue , at the sett or vobster quay , prior to the course you can download a student pack wich gives doctors details for all of the country i know murrayfield on the wirral near liverpool has a hyperbaric chamber and does medicals for divers so im guessing that they will be well versed in the physiology of freediving and will assess your fittness for freediving so try going on to the courses link of this site and then download the pack
hope this is of some help

 

[apnea queen]

Sorry to hear about your "accident". I must recommend that you consult D A N/Divers Alert Network,they have a battery of excellent of doc's to help.Also STOP DRINKING
COFFEE.coffee not only speeds up your heart rate,but it constricts blood flow to the brain,
and it raises your blood ph and an acidic body is a hotbed for illness but it also makes your body eat up O2 like crazy,no O2 to the brain+working on O2 deprivation+possible
dehydration= BIG TROUBLE I used to see it on the liveaboard I worked on.Dont think that because your not thirsty that your not dehydrated.1 Gallon a day keeps the trouble away(I won't go into all the partics but suffice it to say.HYDRATE,HYDRATE,AND HYDRATE. I wish you resolution with you dilema and hope you are able to dive DeeDee

 

[efattah]

I have had periods where I could black out from just taking a deep breath.

Adrenaline controls constriction of the abdominal vessels to push up BP in the brain as soon as you stand up. When sitting or laying for long periods, the adrenals shut off and can be delayed when standing up, causing a near BO or BO.

Raw food diets, vegetarian or low salt diets are a disaster for blackouts. The first thing I tell new divers is to get plenty of salt and stay hydrated. Low carb is also a big factor since low glycogen = low hydration.

Stress affects the adrenals, which affects your adrenaline and vagus nerve. The condition of the vagus nerve is important. During times of bad adrenal & vagus function, I could not do an inhale static without blackout out around 1'10" from vasovagal miscommunication.

Another lower probability could be something like sickle cell anemia.

 

[samdive]

hi Laz

replied by PM

Sam

 

[Lazuli]

Thanks Sam, Eric and everyone else for the advice. Apnea Queen... I take on board what you say about coffee - a definite no no from now on. I have done some research (including pestering my housemates for a second-by-second account of what happened complete with actions!) and it seems like I had a convulsive syncope. They are relatively common from what I have read.

 

[billieball]

Eric(k),
What do you mean "vegetarians" are at a risk of these issues? I can understand low salt or dehydration...but am a bit clueless as to why vegetarianism would possibly contribute to these probs. I am recently a convert to vegetarianism, though I do use protein powder and spirulina a couple times a day (exceeding my recommended daily intake of protein). What gives?
Thanks for any advice!

 

[efattah]

Eric(k),
What do you mean "vegetarians" are at a risk of these issues? I can understand low salt or dehydration...but am a bit clueless as to why vegetarianism would possibly contribute to these probs. I am recently a convert to vegetarianism, though I do use protein powder and spirulina a couple times a day (exceeding my recommended daily intake of protein). What gives?
Thanks for any advice!

Vegetarians have lower blood pressure than meat eaters, and are often deficient in carnosine, carnitine, arachidonic acid, omegas, and other nutrients. Some of those must have an effect. Vegetarians often can do longer static apneas, but are often more prone to blackouts.

 

[naiad]

Lazuli, thanks for sharing. I hope you get the problem sorted and find a doctor who is understanding.

Eric, that is interesting, I used to be vegetarian and I think my health has improved a lot since stopping being vegetarian.

 

[billieball]

Thanks all! You learn something new every single day!

 

[Lazuli]

Lazuli, thanks for sharing. I hope you get the problem sorted and find a doctor who is understanding.

Well... I'm working on it but expect to have something of an uphill struggle. This is because I need to establish that it was a provoked seizure and not an unprovoked/unexplained loss of consciousness or epilepsy. If I can find a doctor/consultant who understands the stress I put my body under, I will stand a better chance of avoiding a misdiagnosis and the horrors that come with it. When I passed out I also took a blow to the head which I feel aggravated the convulsions and possibly added concussion into the mix - hence why I passed out in the ambulance on the way to casualty.

 

[ILDiver]

Good god man! Do we have to pitch in and buy you a helmet! Someone already mentioned it but, if you haven't already, give D.A.N. a look. They are good coverage to have and could very well advise you on this and possibly give you the name of a good doctor.

 

[RogueCanadian]

Hey Lazuli,

although new to the forum I'm not new to Seizures as A close relative of mine suffers from a seizure disorder (not epylepsy) and they can be triggered but almost anything. She actually played hockey and had her first grand mal triggered by the flourescent lights in the rink. this was in her late teens. What you described sounds exactly like a grand mal. With that being said, there are a hundred other possibilities to consider. Have you been tested for diabetes? A good griend of mine developed it in his mid 20's and had similar sympoms right before he was hospitalized. You did however mention that your vision is fine so who knows.

I'm with the rest of the gang here by saying, find a doctor that dives. These kinds of medical mysteries only lead to a fast and often premature diagnosis of something completely wrong in the hands of a doctor who thinks they have it figured out and are mentally checked out thinking the case is solved and closed.

You definitely want to be able to dive and you certainly want you driving record and any possible job in the future to be view as "clean bill of health"

Find a doctor who knows where your coming from and will help you get back to diving confidently

One thing I would reccomend however is that if you do have a steady dive buddy and you are nervous about this happening again, make sure you instruct them on how to deal with a seizure (as a percaution), especially a grand mal, if one actually happens. On land the best thing to do is support the victim's head to protect it from banging into the ground, lay them on their side as best as possible and clear the way of their legs so they dont injure temselves by kicking anything. never put anything in their mouth to stop them from swallowing their tounge. That is a wives tail. if they are on their side it won't happen.

You may also want to read up on how to deal with a vicim of siezure in the water. just in case...it's better to know what to do and never have to use it than have no idea and be caught out. I think we can all safely agree that freediving is a sport based on lots of preparation

Anyway mate - that was a long post on my part - I just hate hearing stories of people being limited from their passions by an uncontrollable aspect of their life.

Good luck, keep us posted.

Rogue

 

[wes]

Just a not staying hydrated and on the horrors of caffeine and/or sugar (like in coffee or soda) is tha t I have read that in military camps for desert acclimation where they train troops to deal with heat and stress they OUTLAW soda any where on the base as it has been implicated in so many incidents and I believe only let the troops drink water only (I am not sure about coffee).

Cheers Wes