Fainting: cause for alarm?

Fainting, also called syncope (pronounced SIN-ko-pee), is caused by a sudden, but temporary drop in blood pressure. The brain does not get sufficient blood flow and you lose consciousness.

Fainting can be caused by random and isolated events like low blood sugar from hunger, dehydration, or when you experience severe pain. These often are not cause for concern. Still, frequent fainting may be a red flag for a serious medical issue. For instance:

* Heart blockage: A problem with the electrical impulses that control your heart, which makes it beats too slowly and thus cannot pump enough blood to the brain.

* Heart arrhythmia: An irregular rhythm of the heart’s ventricles, the main pumping chambers, which disrupts blood flow. It often feels like a fluttering or racing heartbeat.

* Pulmonary embolism (PE): Fainting after recent air travel could be a sign of PE, a potentially fatal blockage in the lungs, according to a recent study from the American College of Chest Physicians.

Fainting also can signal a medical condition that interferes with parts of the nervous system that regulate blood pressure and heart rate, such as diabetes and malnutrition.

Other possible causes

Fainting may run in the family, according to a study in the journal Neurology. Researchers examined 44 families and found that the ones with the highest number of average fainting episodes across three generations shared a strong linkage to a specific chromosome.

Everyday situations can make people more prone to fainting, too. For instance, you may have a problem with how your body controls blood pressure when you suddenly stand from a lying or sitting position. Called orthostatic hypotension, this type of fainting is common in older people and those with poor muscle tone. Some high blood pressure medication also can contribute, as can thyroid disorders or neurological conditions, like Parkinson’s disease.

Another possible cause is vasovagal syncope. This happens when the vagus nerve–the longest of the cranial nerves, extending from the brainstem to the abdomen–is briefly stimulated and lowers both your heart rate and blood pressure. This often occurs when you strain during a bowel movement (or when urinating, for men).

This is also the main trigger of more familiar fainting incidents, such as the sight of blood, emotional distress like hearing bad news, or even laughing or coughing too hard. When this happens, it is common to feel nauseated or break out in a cold sweat before fainting.

The bottom line is that fainting is not something to take lightly. If it occurs periodically, note the symptoms and circumstances of when you fainted and seek medical advice.

Fish oil supplements… getting active… stress incontinence

Q I’ve heard a lot conflicting advice regarding the health benefits of fish oil supplements. I’m not sure if I should take them. Are they helpful?

A The research findings on fish oil supplements have been inconsistent so it’s no wonder you are confused. Fish oil supplements contain omega-3 fatty acids. It’s important is to distinguish between taking supplements and eating foods rich in omega-3 fatty acids. Most studies focus on the supplements. Omega-3 fatty acids are a group of polyunsaturated fatty acids that are important for a lot of functions including muscle activity, blood clotting, and digestion. A 2015 National Institutes of Health (NIH) research report found that omega-3 supplements did not slow cognitive decline in older persons. NIH findings on fish oil supplements and heart health are also unclear though there is some indication that they can reduce rheumatoid and osteoarthritis joint pain. But when it comes to food, there is evidence that seafood rich in omega-3 fatty acids is beneficial especially for heart health. Fatty fish including salmon, tuna, and trout and shellfish such as crab, mussels and oysters all have high amounts of omega-3. So, it’s ideal to get your omega-3s through food. If you do take omega-3 supplements, talk with your doctor as they can interfere with some medications.

Q I’m 60 and my husband just turned 75. Unfortunately, he’s become quite sedentary and is resisting doctor-recommended exercise. How can I convince him it will make a difference?

A Exercise has many positive benefits but perhaps the one that might be most convincing to your husband is that exercise will help him maintain his physical independence. To be able to reach a cupboard, walk to the mailbox, or drive a car requires coordination, balance, strength and flexibility. For that, we need regular exercise. It can, however, be difficult to get moving after being sedentary. But it’s a good thing he has you because research has shown that married couples that joined a gym together were more likely to workout when their spouses went with them. And it’s never too late to begin. A recent study of adults ages 70 to 89, who were at risk for losing their ability to walk revealed that those who had a modest increase in exercise significantly improved their mobility. As little as 30 minutes a day, five days per week can make a difference. I know gyms and gym equipment can be intimidating, so consider hiring a personal trainer specializing in senior fitness who can help design a program for both of you. There are also community centers that offer Silver Sneakers group exercise classes that are designed especially for seniors. For those older than age 65, Medicare subsidizes the cost.

Q I’ve recently begun to leak a little when I laugh and cough. It’s embarrassing, but I’m also concerned that it could get worse. What should I do?

A Urinary incontinence can happen to anyone but it’s more likely to occur with aging. It is also more common among women than men. There are different types of incontinence, but what you describe is generally due to what’s called “stress incontinence.” Stress, meaning pressure on the bladder, can make urine leak when bladder muscles are too weak. A cough, a sneeze, or lifting a heavy object can be enough pressure to cause a weakened bladder to leak. There are a few self-treatment options that can help correct the problem. They include exercises known as Kegels, which strengthen the pelvic floor (the muscles used to stop the flow or urine], and timed voiding, which involves going to the bathroom at timed intervals to urinate. Losing weight and drinking less caffeine also helps some people. Other causes of urinary incontinence can result from nerve damage, certain medications and diseases. If the issue persists or gets worse, I recommend talking to your doctor to rule out more serious problems.