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March 28, 2007
Dear Dr. Herr, Yesterday it was suggested to me from a medical professional that I might have vaso-vagal syndrome. Having never heard of it before, I went home and researched it on the internet where I came upon your forum. I appreciate the interest you have in this and would like to take the opportunity this evening to describe two experiences I have had that may well be explained by this syndrome. The first occurred two years ago in May of 2005. I was traveling alone on the NYS Thruway on my way to visit my son’s family. Just prior to the trip, I had met a friend at a restaurant for lunch. As I got underway, I felt a bit nauseated and stopped to get a large Coke with ice which I sipped for over an hour as I drove west. I was within about 20 minutes of arriving at my destination when I began to feel quite uncomfortable and wondered if I would need to stop at a rest area. I was achy and flushed and nauseated and breathing deeply. Suddenly I knew I had to vomit, and I pulled off onto the shoulder of the Thruway and turned off the engine. I wanted to get out of the car and run around to the grass, but as soon as I opened the car door, I had to lean over and vomit. I also passed out, still hooked into my seat belt. When I began to regain consciousness before I opened my eyes, I had the wonderful sensation of having had a deep, long sleep. Then I heard sounds that frightened me; I opened my eyes and was struck with terror as I began to realize and assess my situation. I was strapped into my car seat and was leaning head down with my face on the pavement, resting in vomit. A mere two or three feet away, traffic was zipping by my open car door. I had no idea of where I was or what had happened. I pulled myself up to a sitting position, unstrapped my belt and got out of the car, wanting to remove myself from the path of danger. I was very frightened. In the meantime, a woman had stopped to assist me and was running toward me, yelling, “Do you need help?” I was in a bit of a swoon, leaning against the front of the car. She was concerned about whether I had turned off the ignition, and so she first ran to the open car door to check that out. As she did so, I passed out again, this time from a standing position. My face hit the pavement and I broke my nose, chipped two teeth, split my lip, scraped up my face and badly bruised my gums. The woman grabbed me around the waist and dragged me out onto the grass as far from traffic as she could get me, in the meantime yelling directions to another man who had stopped to help. She told him to call an ambulance which evidently he did. I remember that the woman sat behind me, supporting my head, and speaking comfortingly to me while asking me questions – my name, where I was going, was there someone she could call. I felt in a fog and my responses seemed slow, yet I was able to accurately answer her questions, even giving her my son’s cell phone number to call. I also remember that the man took some things out of the car for me – he brought a blanket, and my purse and keys. I felt nauseated again and asked to lie down flat, which the woman helped me to do. Soon emergency vehicles and personnel began to arrive. I was strapped onto a stretcher and loaded into an ambulance. Not long after we got underway, I told the attendant that I needed to vomit again; he tilted the stretcher sideways and gave me a basin to use, which I did. I was taken to Geneva General Hospital where my facial injuries were superficially treated and an X-ray was taken to confirm that my nose was broken, but nothing was done to assess why I had passed out. My son and daughter-in-law arrived to take me to their home where I stayed for two days. I had come down with a stomach virus and was unable to travel until I felt better. They kept me supplied with ice packs, and I got lots of rest. But my husband and friends and I always thought it a mystery that I would pass out like that when I was simply sick to my stomach. I was 57 years old with no history of problems with my heart, diabetes, blood sugar, blood pressure, or seizures. Then this week I experienced a similar difficulty. On Monday, March 26, I had a colonoscopy following a day of preparation on Sunday. I was released late in the morning to go home. My husband and I had a light lunch together, and then I took a two hour nap. When I woke up from my nap, I had the sensation that I had diarrhea and hurried to the bathroom. As I sat on the toilet, I became flushed, clammy, light-headed and sick all over. I began to wonder what I would do if I needed to vomit. Then I passed out. When I came to, I was on the bathroom floor; I had vomited and I had bitten my tongue badly enough that it was bleeding. I was moaning and groaning when my husband discovered me in a mess. He considered calling an ambulance, but instead helped me get up in stages as I cleared my mouth and nasal passages and wiped my face with a cool clean cloth and so forth. Again, my verbal and physical responses were slow. After a complete change of clothes, I went to bed and rested, then spent the evening quietly at home. The following morning, I called my doctor to let him know what had transpired. He requested me to go immediately to emergency for an assessment of why I passed out. The doctor on duty had my blood pressure and blood work done, a urine sample and temperature check; he ordered an EKG, chest X-ray and head CT scan. He checked my ability to squeeze his fingers with both my hands; he had me follow his moving hand with my eyes. When all the test results came in, he saw no problems that might explain my close encounter with the bathroom floor on the previous day. He then suggested that I might have vaso-vagal syndrome and explained it to me, instructing me to try to get as close to a lying position as possible whenever I sense that I might need to vomit. I hope that this not-very-pleasant information may be of some help to you in your research, Dr. Herr. Again, I thank you for your interest and hope that you may be able to find ways to help people with this problem. I would prefer not to continue getting a broken nose or a swollen tongue when I am sick to my stomach!
Sincerely, Virginia M. Merritt firstname.lastname@example.org