This morning in the cath lab, I was standing up talking to one of our techs, who happens to be a personal trainer. I was asking him about how to handle my plantar fasciitis (inflammation of the bottom of the feet, often due to running).
He pushes on the heel of my foot. Owww! That hurt. I definitely have plantar fasciitis, and possibly a bone spur as well, he says. I have to stop running for a while and give it a rest.
I started to get very lightheaded. Owww that really hurt. He keeps talking. I don't hear much of what he's saying, but I'm nodding and acting like I am paying attention, because I don't want to be rude or embarrass myself. But I really need to sit down. I feel my pulse; it's slow and thready. I know I'm getting vasovagal. When he's done talking, I'll go right over here to the break room. I don't know if I'm going to make it..... and I start to slump over.
Next thing I know, I'm lying on the cath lab floor. I feel my eyes fluttering but I can't open them. I hear voices and I know there's a crowd standing around me. "Heather? Heather? Are you okay?" I want to talk, but I can't. Someone takes my wrist.... "I can't feel a pulse."
I open my eyes. "I'm ok, I just got vasovagal." After a minute, I stood up and somehow a barcolounger chair appears. I sit in the chair for a while with my feet propped up, drink some water, and start to feel better.
Wikipedia has a great explanation of vasovagal syncope. Triggers include pain and emotional stimuli. Usually it's a very benign condition. The combination of the pain in my heel when he pressed, along with being told that I should stop running for a while, likely set it off. I've had this happen before, but have never passed out -- in high school when I shadowed a cardiologist and he was pulling out an arterial sheath with lots of blood spurting, in med school when I met my cadaver for the first time, when learning to draw blood. Before this, it was two years ago, standing in the cath lab during a long case, after barely eating breakfast and being upset that George W. Bush had been reelected for four more years (can I say I told you so? I digress...).