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My daughters episodes changed dramatically as well. Yes, right at first it was just a black out. She was awake almost as soon as she was out. After a while they manifest themselves into longer periods of unconciousness, the next change was that her chest (heart area) started to hurt, she would scream out, then it seemed to turn to a more seizure type response, now she says when she wakes up she can't feel her legs from her knees down.
It is not much comfort, but the doctors tell us that she is having a type of anxiety attack after she has the fainting spell now. She is reacting to being so worried about the vaso vagal. All of these other hurts and conditions are NOT real in the sense that they are physical conditions. They are real because they do hurt and are happening, but they are brought on by anxiety or panic.
My daughter seems to come around faster when I am there to help coax her into breathing and focusing on getting better and realizing that she WILL be ok. I usually rub her legs to get the circulation back. I talk to her calmly and tell her all is gonna be ok.
Just recently her psychologist suggested that we try FREEZE FRAMER. It is some type of biofeed back that will perhaps help her learn to control her reaction to her vaso vagal nerve stimulations. If she can reverse the process or over come the fainting sensation, things will start to improve. We have been told that pilots are very motivated to get over this without using prescription Rx's. They do Tilt training as well as Biofeed back.
I am not an expert on this condition, only a mom who has worked with her child suffering from this condition for a few years. We have been to many specialist and read and listened to many suggestions. It is not an easy thing to live with, but have been reassured that there is hope.
email me if you have any other questions: firstname.lastname@example.org Yvonnie