Almost Fainted in the OR Twice!!

[gymnut]

This is long but, I need some advice so hang in there with me!

So as a few of you may recall I am enrolled in a surgical technologist program through my hospital. I absolutely LOVE it and am doing great academically. We have started doing our clinicals, well, we are scrubbed to observe for right now but in January is when we officially start setting up, handing off the instruments etc.

The second time we went to clinicals we were just going to observe and not get scrubbed in but, my scrub tech was very enthusiastic about teaching so my instructor let me scrub in. About 20 minutes into the case I felt the heat begin to creep up my body and my vision start to go. The circulator nurse helped me out of my gown and gloves and sat me on the floor until my instructor came and took me to the lounge were I had orange juice. After that I just went back to observe and was fine. I know I can pinpoint why I almost fainted and that was because it was very hot (The heating cooling system was going haywire that day and it was almost 80 in the room) and I was so excited to watch the surgery that I pretty much forgot to breath and along with locked knees and a crap breakfast (a Poptart while running out the door) is a recipe for hitting the floor.

So today I promised I would not make those same mistakes. I got a good nights sleep, had a ginormous muffin and coffee for breakfast, put on my compression stockings (I don't have any vascular problems they just make my legs feel good after being on them for so long) and remembered to breath in through my nose and out through my mouth and shuffle my feet every so often. Everything was going great and I was really enjoying myself and learning a lot when about an hour into the second case I felt that old familiar heat start again. I tried walking around to the back table figuring it would get my blood moving and started taking deep breathes to get more oxygen but I couldn't make it. I let the tech know and again the circulator got me out of my scrubs and before I knew it I was in the hallway and these guys had one arm under each of mine and kept telling me to keep talking as they walked me to the lounge were again I drank orange juice and had a nurse hold my legs up while I laid down. They said I turned a greyish green color and my eyes were rolling the back of my head.

The funny thing is, is that both times I fainted all the nurses and techs began telling me stories of them fainting, doctors fainting in the middle of surgeries, nurses, PAs, and pretty much all who enter the OR. One guy jokingly said that that's the OR welcome mat! So while I'm still embarrassed I don't feel abnormal.

The thing is I have to figure what's wrong. I think I can pinpoint it to my eating a garbage sugar filled breakfast (Poptarts? Giant muffin? What was I thinking?!?!) all washed down with coffee filled with even more sugar and creamer. I know when I felt it today I was thirsty and starting to get hungry. I'm guessing my blood sugar dropped really low and down I went. I was also wearing those sketcher shape up shoes so I don't know if that was messing with my posture as well. They may be great for walking but maybe not for standing. I also made an appointment this Thursday with my doctor to get some blood work done.

The strange thing is when I worked in a factory I worked in hotter conditions will long sleeved heavy scrubs, gloves, gown and mask and many time I would have to stand in one spot and pack or fold and I never fainted. However we did have 3 breaks for snack and lunch. I know when I'm a PCA on the floor I often miss lunch but I still am able to jam a graham cracker or piece of bread into me to keep some fuel in my body. I know I'm not fainting over blood, organs or smells because they don't bother me at all. In fact the more I see the better!!

The thing I'm terrified of is I won't be able to stop the fainting spells. My one friend had to quit the program because if she stood still for too long her BP would drop really low and she's pass out. I want to be a surg tech with all my heart so I don't know what I would do if I couldn't

So any advice would be great right now because I feel like a schmuck :heartbeat

[42pines]

Get a glucometer and take some readings throughout the day. A normal, healthy human will not become hypoglycemic even if she goes without eating for two days--even without eating any sugars/carbs for a week! (the body will create sugar from fat through neoglycogenesis) Hypoglycemia is often used as a cause for odd symptoms when it is not. Take a day, and have no sugar or carbs for breakfast and then take a few readings. If you show below 70 then you have a problem, but if you show in the mid-80's hypoglycemia is not the cause.

Try standing for several hours and check your blood pressure every half hour. See if low blood pressure is an issue--rule that out.

If none of the above shows positive then consider that you may be experiencing an anxiety/panic attack. It may not feel that way, but sometimes even an unknown trigger sets off a reaction, which leads to fainting. Feeling lightheaded and fainting is common in anxiety/panic attacks (anxiety is less than three symptoms; panic is generally thought of as 3 or more symptoms). See: http://en.wikipedia.org/wiki/Panic_attack

Anxiety/panic is very strange sometimes and though your body is reacting in a fight or flight reaction, your mind may not be in agreement, so it may not feel like anxiety. If this is a possibility I'd suggest, after ruling out the two prior causes, asking your practitioner about the advisability of a few Klonapin 0.5mg tablets. Take one, or even half a one (with permission of the practitioner, of course) two hours before a session (Klonapin has a long half-life). If this is the cause I would expect the fainting spells to disappear. After a time, when very comfortable in your surroundings reduce and then stop them.

Just ideas of course...I'm not a medical practioner, merely an RN.... always check with your practitioner be she a ANP, a PA or MD.

[gymnut]

So I went to the doctor today and he diagnosed me with neurocardiogenic syncopy. I almost cried because that's what my friend had and she had to leave the program. However he said that some people have it worse than others and since this only ever happened to me in the OR he feels that my body just has to get use to the new environment and it will pass. He also said that with my schedule being topsy turvy (we start clinicals at 6:45am so that means getting up at 5am which is unheard of for me because I worked middles my whole life) plus not having adequate nutrition or hydration just exacerbates the condition.

So I feel a bit better and just not have to freak myself out the next time I go back in which will be difficult. I'll just have to remain occupied. I also noticed the fainting spells occurred when I wasn't engaged in anything and all I was doing was just standing there watching while when I felt good I was working with the instruments and helping in the field. My doctor also told me to try not get overly excited either because that's also considered stress which is true and will be hard because I love the OR.

Well just thought I'd update because I hate when threads like this get started and then you never hear from the OP again. I'll bump it after my clinical too to let you know how I did.

[xtxrn, ASN, RN]

So I went to the doctor today and he diagnosed me with neurocardiogenic syncopy. I almost cried because that's what my friend had and she had to leave the program. However he said that some people have it worse than others and since this only ever happened to me in the OR he feels that my body just has to get use to the new environment and it will pass. He also said that with my schedule being topsy turvy (we start clinicals at 6:45am so that means getting up at 5am which is unheard of for me because I worked middles my whole life) plus not having adequate nutrition or hydration just exacerbates the condition.

So I feel a bit better and just not have to freak myself out the next time I go back in which will be difficult. I'll just have to remain occupied. I also noticed the fainting spells occurred when I wasn't engaged in anything and all I was doing was just standing there watching while when I felt good I was working with the instruments and helping in the field. My doctor also told me to try not get overly excited either because that's also considered stress which is true and will be hard because I love the OR.

Well just thought I'd update because I hate when threads like this get started and then you never hear from the OP again. I'll bump it after my clinical too to let you know how I did.

This is what I was thinking of with my suggestions about quad squeezes :) Thanks for the update. Are you having any diagnostic tests for this? Seeing an electrophysiologist? Sometimes those can isolate any co-existing arrhythmias that can be treated :) Can you talk to your doc again about this?

[gymnut]

This is what I was thinking of with my suggestions about quad squeezes :) Thanks for the update. Are you having any diagnostic tests for this? Seeing an electrophysiologist? Sometimes those can isolate any co-existing arrhythmias that can be treated :) Can you talk to your doc again about this?

He said normally he would send a person to a cardiologist and have them wear a haltor monitor and a whole bunch of other stuff but feels that in my case it's not needed because I've been going to him for awhile and all my recent blood work and tests (ultrasounds of abdomen and pelvis)have come back great and I'm athletic and not overweight. He often says that if all his patients have my test results he would be out of business.

He did listen to my heart and both him and the PA took my blood pressure (98/60) and he even did orthostatic BPs on me and didn't find anything out of the ordinary. However if things continue then I think he will send me out for some tests. He is a great doctor and I do trust his opinion because he's always found the right diagnosis for myself and my family. So hopefully he's right on this one!

[xtxrn, ASN, RN]

He said normally he would send a person to a cardiologist and have them wear a haltor monitor and a whole bunch of other stuff but feels that in my case it's not needed because I've been going to him for awhile and all my recent blood work and tests (ultrasounds of abdomen and pelvis)have come back great and I'm athletic and not overweight. He often says that if all his patients have my test results he would be out of business.

He did listen to my heart and both him and the PA took my blood pressure (98/60) and he even did orthostatic BPs on me and didn't find anything out of the ordinary. However if things continue then I think he will send me out for some tests. He is a great doctor and I do trust his opinion because he's always found the right diagnosis for myself and my family. So hopefully he's right on this one!

I'm glad you got some answers :)

[gymnut]

Well today is the big day and it's gonna be a long one because we are there until 2:30. I got a solid nights sleep and right now I'm eating a large breakfast of Blueberry pancakes, hashbrowns, sausage and scrambled eggs with Bolthouse Farms Protien plus drink that has 30g of protein in it.

I also went out and got these to put in my bra to keep cool in the suites.

http://www.relaxanddream.com/products/spa-comforts-mommys-kisses

Going to wear different shoes other than my sketchers shape-ups. I have a small feeling that while standing still they were inadvertently locking my knees some how. Also going to put on my compression stockings and wear just a mask with safety eyeglasses instead of that shield. One nurse said that the mask/shield combo could be trapping too much CO2 and I could be re-breathing it. I don't know does that sound right?

Well wish me luck and I'll post back this afternoon to let you know how it went!