Fainting spells

I’m a third-year medical student. During a recent rotation in the ICU, I almost passed out—thankfully, I managed to step out of the room before actually collapsing. I’m assuming it was vasovagal, mostly because what I was looking at in that moment was pretty gruesome: a patient in their final moments. Then today, during clinicals again, I felt this sudden wave of weakness while the attending was going over a patient's history. This has never happened to me before. I’ve looked at cadavers without any issues or discomfort, so it’s honestly terrifying that this is starting to happen now (with living patients!!!). Please, if anyone can help, give me some advice or even just some self-suggestion techniques. How on earth am I supposed to become a doctor if this keeps happening? I’m convinced it’s some kind of psychological hurdle. That said, I have noticed my vision has been a bit off lately (I’ve worn contacts for years), especially when I have to focus intently. Maybe the dizziness is related to that? I’ll go see an ophthalmologist, but in the meantime, please help me—how can I get through this?
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gentlemason62 said:I'm a third-year medical student. During a recent rotation in the ICU, I nearly fainted—I managed to step out of the room before actually collapsing. I assume it was vasovagal, mostly because what I was looking at was pretty grim: a patient in their final moments. Today, during rounds, I felt that wave of weakness again while the attending was taking a patient's history. This has never happened to me before; I've handled cadaver labs without blinking. It’s terrifying that this is happening now, especially with living patients. Please help me—any tips for mental conditioning? How can I become a doctor if I can't handle this? I'm convinced it's psychological. Though, my vision has been a bit off lately (I've worn contacts for years), and I wonder if eye strain could be causing the dizziness. I'll see an ophthalmologist, but please, how can I fix this?
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Hey.

First things first, and likely the most important point: as a medical student, you shouldn't assume these symptoms are purely psychological or related to your vision.
Before jumping to conclusions, rule out organic causes. I'd suggest seeing your primary care physician for a standard workup.
Psychological support is great, obviously, but it won't make a physical syncopal episode just vanish.

A basic workup would include blood work, an EKG, and blood pressure monitoring. Depending on those results, you might need more specialized testing.

Good luck!

Thanks for getting back to me... but everything else seems fine. I feel okay overall, but these dizzy spells and bouts of nausea started happening right when I began visiting the wards and seeing and hearing things that aren't exactly everyday occurrences. I haven't felt faint once in any other situation, so I've ruled out anything physical or medical. How then do you explain that vasovagal syncope some people get just from seeing blood? I feel like what I'm going through is completely analogous to that...

gentlemason62 said:Thanks for the reply... but everything else checks out. I feel fine otherwise. These dizzy spells and nausea only started once I began visiting the wards and witnessing things that aren't exactly "everyday." I haven't felt lightheaded in any other context, so I’ve ruled out anything organic. How else would you explain a vasovagal response when someone sees blood? I think what I'm experiencing is pretty much analogous to that...

Hopefully the mods don't kick us out or lock this thread. :-)

I've had something similar happen twice in my life, though it was during extremely high-stress emotional moments—like having a sick family member. Usually, I'm pretty much bulletproof.

Since you mentioned everything else is fine, could you walk me through your testing? Did you really cover all the bases? Also, did an actual professional confirm it's vasovagal?

Hmm, I haven't actually been diagnosed yet. Personally, my best guess is that it’s just vasovagal syncope. Other than that, I feel fine—I don't have any other issues. Well, hopefully it's just that... otherwise, I'd just be waiting for a brain tumor to pop up next. That would really be the icing on the cake. Anyway, I'll make sure to head to the doctor as soon as I can... thanks for the advice!!

gentlemason62 said:Hmm, I haven't been tested yet. My gut feeling is it's just vasovagal. I feel fine otherwise—no other issues. Well, hopefully it's just that... wouldn't mind adding a brain tumor to the mix, right? That would really be the icing on the cake. Anyway, I'll head to the doctor ASAP... thanks!

Check your PMs.

Sorry if this topic already exists, please move it if it does.

So, my cat woke me up around 3 AM, and I got up to feed him.
The second I hit the kitchen, I felt this insane wave of weakness and nausea before just blacking out completely. When I finally came to, I had a bruise on my forehead, a split lip, and a banged-up knee.
What actually causes someone to just pass out like that? Is it blood sugar? Blood pressure? Something else entirely? What kind of tests should I be looking into? Honestly, I'm freaking out. 🕺

Angela Murphy74 said:Sorry if there's already a thread about this, please move it if I'm wrong.

So, my cat woke me up around 3 AM, and I got up to feed him.
The second I hit the kitchen, I felt this wave of horrible weakness and nausea, and then everything just went black. When I finally came to, I had a bruise on my forehead, a cut lip, and a banged-up knee.
What causes someone to just pass out like that? Blood sugar? Blood pressure? Something else entirely? What kind of tests should I be asking for? Honestly, I'm pretty freaked out. 🕺

Just go see a doctor.

They'll run some panels—check your glucose, check your blood pressure to see if it's spiking or bottoming out, and a whole bunch of other stuff... You can sit here and speculate and spiral into a panic attack all you want, but it won't help.

It doesn't necessarily mean it's something catastrophic, but you really need to get checked out ASAP so you can deal with whatever it is before it gets worse.

I headed to bed early this past Sunday because I had a 5:00 AM start at work on Monday. Around midnight or so, I got up to use the bathroom—standard stuff—but once I finished, everything just went black. I collapsed and lost consciousness for a few seconds. Luckily, I didn't hit my head on anything. For about half an hour afterward, I felt incredibly weak, but then my energy just snapped back to normal as if nothing had happened.

The doctor suggested it was likely micturition syncope, but she's still sending me to see an internist and a neurologist just to be safe.

I’m honestly confused. I’m generally in good health, aside from having Hashimoto, though currently it’s just elevated antibodies with zero symptoms. I'm not even on any medication.

Your doctor is almost certainly right on this one. Honestly, you really need to sit down and wrap your head around what urinary (and orthostatic) syncope actually entails—once you grasp the mechanics of it, everything will finally click. Hashimoto’s has absolutely nothing to do with this.