Syncope

I am about to go under the knife. I first started writing in this blog (which was originally set up as a photoblog for the Theo Progress Reports) as a way of getting through the one and only other surgery that has touched my life.  Last August, Little Man had his tonsils and adenoids removed in what after the fact proved to be a very wise decision, though it certainly didn't feel like that in the midst of recovery. The positive results of his breathing were immediate. The healing from the procedure, THAT was difficult. And yet, if under the same circumstances someone were to ask my recommendation on the procedure, I'd definitely say yes. Easy to say in hindsight and I'm thankful for being there. While in it, I channeled my feelings towards documentation and story telling. The only way I'd like to ever re-live those moments is by going back and reading my posts of the time. Otherwise, I hope to never have to see my son through any such experience.

Now it's my time. My turn. I've written of my knee problems before. More with the hope of avoiding any sort of invasive procedure. With the somewhat comical twist of my spiritual shaman sister's new age techniques of transatlantically healing me with the power of her focused mind. Yes, I'm a bit of a skeptic to this realm, but I love my sister and was and always am happy to open myself up to giving her a chance. I had nothing to loose. In her mental travels of visualizing the internal workings of my torn meniscus, she was led to see a monkey jumping out from within my knee. I know, I know. A monkey? Yes, a monkey that claimed to be my inspiration. He had been trapped in my knee and was now out and free. You'll just have to look far enough back in my writing and seek the corresponding post to satisfy your curiosity should the itch need be scratched. And still, do so with an open mind. The bottom line of this inspiration monkey turned out to be quite a prolific period of my artistic flow. Thus, inspiration came freely and led to more and more writing, woodworking, and the ever-continuing polaroiding and life of art in all it’s formats. Inspiration continues as the words find their way to this page and the stories I tell find their way to your eyes. So for that, I thank my sister (and the monkey).

Unfortunately, the pain in my bad, left knee has persisted and gradually worsened. My right knee, which has no tear, over compensates for the other's shortcomings and is heading in the degenerative path, occasionally acting up. So, I have finally taken the step (intended pun) to do something about it. All of you millions of people (wishful thinking of my readership) out there that have had arthroscopic knee surgery have been telling me of how simple and common this procedure is. It has been perfected over 30+ years as the technologies advanced. Should calm my nerves and make me feel at ease. But regardless of how small the incision may be, the idea of having anything protrude through my skin and beyond makes me nervous. Not for the obvious reason. Unlike a tattoo where the needles quickly go in and out of the top layers of the dermis, just beneath the epidermis, and more like a consistent scratching beyond one certain spot, injections and surgeries (both of which I am not a fan of) go further, deeper in. And more disturbingly, stay in longer.

My zero hour of May 24th is nearing faster than anticipated and the nerves are beginning to make their way into my consciousness. Less of the actual surgery itself. More from the two upcoming needle occurrences that are to happen prior to the deed. Routine pre-op blood work to determine my body as surgically fit a week before the procedure, followed by the anesthesia on the day of. It may seem odd that those are the two things I fear most. More than the actual procedure and its recovery.

You see, I recently found out the name to a condition that I've suffered from since childhood. Vaso Vagal Syncope. It's not rare. It’s actually quite common. Maybe one of you live with it too. It's not anything I've ever been ashamed of, even prior to now in discovering it's name. Basically, I'm a fainter. Not for nothing.  My trigger is needles. Those that go in deep and stay in for a period. I've had no control over it in my life thus far and have learned to live with it, through it and despite it. Luckily, I don't have to face a needle too often. Or maybe not. Maybe regularly facing it is the answer to overcoming. At this point, I'd rather find another way.

It doesn't always happen at every instance, which has made it more difficult to identify over the years.  The path of symptoms, though are always the same when it does. Through my numerous experiences I learned to recognize them and prepare for all they bring. To make sure I'm lying down and make it be known as a possibility. When it does happen, it's not the physical act of the faint that scares me. The sudden hot flash, sweats, paleness, loss of vision and the tingling sensation as the black out begins to set in. The loss of speech and hearing followed lastly by the dark void. Dreams. Then on the other side, a slow, disorienting return to consciousness that starts with hearing while the eyes still see black. Fuzzy vision slowly refocuses to normalcy. I'm used to it. I recognize the feeling as it's about to happen, during and after. If this were the only part of the whole process I'd be a relatively happy camper. It's the side affects thereafter that hit me hard.

Just as I make my way back into this realm and finish assuring whoever it is, lucky enough to be in my presence, that I'm ok, it happens, it's happened and I'll be fine... that's when my body takes me on the wild ride along it's painfully familiar way of dealing with the next phase of the now dreaded process. Like a 24hr bug, I'm stricken with immobilizing nausea and vomiting. And just like a 24hr bug, it's gone at the end of its cycle. But in the midst of that day and night, I'm as miserable as I could possible be. Utter helplessness. The current healthy mind doesn't let me formulate the words to describe my hatred for that moment. Bottom line is it just absolutely sucks. And it's this post-faint period more than anything else, I fear and wish to avoid. Which may perpetuate the anxiety deep within the mind that causes the trigger in the first place.

Over the years, this fear of the after life of my meetings with a needle, have much surpassed the actual fear of the needle itself. It's not the physical prick or conscious pain. It's not at all about pain. My threshold for that is high in all other realms. As I've been told over and over again, it's all in the head. When that needle is in for long enough for the mind to decide if today is the day, somewhere in my psyche, the emotional trigger kick starts what's called the Vaso Vagal response. The part of the nervous system that regulates heart rate and blood pressure malfunctions. A message is sent by the brain for the heart rate to slow and the blood vessels in the legs to widen, allowing blood to pool down there. Which in turn lowers blood pressure suddenly. Blood flow to the brain quickly diminishes and thus we have syncope, or in layman's terms, the faint. In most cases, such as mine, the most dangerous part of this condition can occur from physically falling and injuring the head or other body parts during the faint. Thus, the lying down. Otherwise, there are no other health implications. It just happens. Shit happens.

Finally now, at 39, armed with a definition and knowledge of the condition, I may just be able to find a way of not just recognizing and living with it, as it’s been, but actually avoiding it. There are techniques that can be applied to try to avoid the response. I used to think simply lying down, turning away and trying to distract myself was all I could do. I know now that's not enough in my case. Raising the legs allows gravity to discourage the misguided message the ventricular system receives from the mind. If the darkness begins to creep in still, a critical window of 2 to 3 seconds exists as the symptoms leading into the black out take hold. Rhythmically flexing or pumping the leg muscles can help the blood push back upwards (actually downwards, when the legs are up) and return the flow back to the brain. Simple techniques that theoretically make perfect sense. Seems almost too simple. They’ll soon be tested. But it obviously took my lifetime of experience in recognizing my body's way of coping to get to this understanding.

Simplicity, I hope will win over my little battle with the condition. I will take my new techniques with me and utilize them this week at the next needle face off. And I will overcome. No fainting means no followed misery, and thus a personal victory.

Oh yeah, and the knee surgery. It's almost a secondary thing. I'm certain that will go smoothly. And all I've heard and read will ring true as recovery speeds along and the pain will be a memory of past. I look forward to that day when I can say to Little Man - "YES let's do that, cause my knee DOESN'T hurt."