pre-syncopal symptoms during surgery

[vet_wanna_be]

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Ive wanted to becom a veterinarian ever since I was in high school. But last week I attended my first surgery where we spayed and nutered two dogs and not three minutes into it I started having 'pre-syncopal' symtoms and had to leave four times during the procedure. This is devestating to my career, and I dont want to give up, is there anything to stop this from happening? I've never been woozy or grossed out by blood or guts it just happened. 🙁 😕

P.S. I know most of you are going to be MDs not DVMs but I din't know where else to post this 👍

 

[Telemachus]

Desensitize by repeat exposure. But that's just a guess, because I have no experience with such symptoms myself.

 

[erin682]

Its hardly devastating. Lots of people have that type of reaction seeing surgery. I've even heard of people who worked in lots of surgery before being in med-school w/o problems but when they got into med school and had to stand back and watch would get sick. Don't worry about it b/c stress will only make it worse.

 

[robotsonic]

I'm with Telemachus. Just keep going in and watching these procedures. Maybe that will work. (But this hasn't happened to me so I can't say that for sure.)

What was it about the operations that made you sick? Was it the smell, the sight of blood, something else? Perhaps if you can identify specifically what made you sick, you can try to desensitize yourself to that.

 

[vet_wanna_be]

I'm with Telemachus. Just keep going in and watching these procedures. Maybe that will work. (But this hasn't happened to me so I can't say that for sure.)

What was it about the operations that made you sick? Was it the smell, the sight of blood, something else? Perhaps if you can identify specifically what made you sick, you can try to desensitize yourself to that.

see thats the problem I wasn't gaggy or anything the vet said it could be the smell of fresh blood. which is funny because i cant even smell it

 

[MrDreamWeaver]

Fortunately, i was able to observe the traumas in the specific hospital which i volunteered at. I still clearly remember one specific incident: an elderly gentlemen. He was driving on the freeway with left hand outside of the window when his car collided with the center divide and went into a tumble roll. I'm sure you can imagine what this guy's arm looked like! it was almost completely severed. keep in mind this guy was fully awake at the time w/o any pain killers! After 10 mins of him yelling and pleading for pain killers, i decided to leave the room because i felt like fainting.

I spoke to a few of the doctors after the incident and they told me it's not unusual for people to faint in the trauma rooms... it just takes some time to become desensitized.

 

[manta]

weird...this was happening to a friend of mine during her OB rotation. she's already done surgery, and had no problems until this point, so it was definitely strange. the problem resolved itself as mysteriously as it occurred - no changes in diet, sleep habits, etc. maybe you have a mild viral infection or something. *shrug*

 

[Telemachus]

see thats the problem I wasn't gaggy or anything the vet said it could be the smell of fresh blood. which is funny because i cant even smell it

Vasovagal responses are often tied in with emotions -- so in a way it is a mind over matter issue (i.e. distract yourself, maybe that will help).

 

[TX515]

Don't forget we are talking about nutering here. What male doesn't get sick when watching that?

 

[Psycho Doctor]

Vasovagal responses are often tied in with emotions -- so in a way it is a mind over matter issue (i.e. distract yourself, maybe that will help).

I absolutely agree. The time I passed out right in the OR was when I was watching a heart transplant on a young girl who reminded me of my gf, who also needed a heart transplant, but never got one.

 

[ExtraCrispy]

Was it the experience itself, or was it standing for long periods of time when you're dehydrated? I once had a pre-syncopal episode while watching a carotid endarterectomy, b/c I hadn't eaten or had anything to drink and was just standing for a long period of time.

Compression stockings may help. I went the cheaper route and wore knee-high trouser socks + two pairs of snug knee-high socks, and I always make sure that I drink some water and have something small to eat before a case. So far, so good.

 

[Gimlet]

I went the cheaper route and wore knee-high trouser socks + two pairs of snug knee-high socks, and I always make sure that I drink some water and have something small to eat before a case. So far, so good.

Be careful if you are going to do this to make sure the elastic on these socks isn't too tight near your knee. They could actually cause the blood to pool more in your legs, which would probably increase your chance of passing out. Also you could get some nasty varicose veins. (We just had a lecture about DVT & varicose veins in anatomy, and the professor made specific mention of girls who wear knee-high stockings with tight elastic bands around the top.)

From what I hear, compression stockings are less than $10 at Walgreens.

 

[velo]

Ive wanted to becom a veterinarian ever since I was in high school. But last week I attended my first surgery where we spayed and nutered two dogs and not three minutes into it I started having 'pre-syncopal' symtoms and had to leave four times during the procedure. This is devestating to my career, and I dont want to give up, is there anything to stop this from happening? I've never been woozy or grossed out by blood or guts it just happened. 🙁 😕

P.S. I know most of you are going to be MDs not DVMs but I din't know where else to post this 👍

Its never happened to me but its happened to plenty of my classmates. Actually, for whatever reason, a fair number of my classmates passed out in the hospital first year when nothing "gross" was really going on.

It happens to plenty of people. Don't turn it into a big thing in your head and you'll be fine, I've yet to meet someone who had to abandon a career in medicine because they kept passing out. Just make sure you're well hydrated. good luck.

 

[velo]

the professor made specific mention of girls who wear knee-high stockings with tight elastic bands around the top.)

hot

 

[emack]

I think there's something to be said for visceral (in the colloquial rather than the anatomical sense) responses to some of what we see. Like you mentioned-- blood. Even if, intellectually or even emotionally you don't have a problem with it, blood is something that, by nature and by nurture, we have learned is a sign of something gone wrong. I think I read somewhere that our innate disgust at other people's bodily fluids (not just blood, but even something relatively benign like saliva) is a protection against infection.

There are lots of gross things that I find I react to on a really primitive level (ex. the sight of vomit makes me gag, no matter how much I steel myself). And the first time I saw someone get a digital rectal exam, I almost fainted. I think it was a combination of being tired/dehydrated/hungry and some fundamental horror at something getting shoved in the out hole.

I guess the good news is that all these aversions can be overcome, with practice and especially with good preparation, like many other people here have mentioned.

 

[vet_wanna_be]

Don't forget we are talking about nutering here. What male doesn't get sick when watching that?

hey now lets not get sexist here. I AM a FEMALE 😉

 

[vet_wanna_be]

Was it the experience itself, or was it standing for long periods of time when you're dehydrated? I once had a pre-syncopal episode while watching a carotid endarterectomy, b/c I hadn't eaten or had anything to drink and was just standing for a long period of time.

Compression stockings may help. I went the cheaper route and wore knee-high trouser socks + two pairs of snug knee-high socks, and I always make sure that I drink some water and have something small to eat before a case. So far, so good.

I dont think it was the standing for long periods of time because we were only a few minutes into the surgery; but I do remember not eating because I did not feel very well and had a horrible stomach ache.I guess I never got the memo about eating before hand. 😛

Keep the ideas comeing they are all very helpful so far. 👍

 

[erin682]

Its never happened to me but its happened to plenty of my classmates. Actually, for whatever reason, a fair number of my classmates passed out in the hospital first year when nothing "gross" was really going on.

This happened to me. I didn't pass out but I was quite close. I was examining a newborn, seriously nothing gross there, and stuck my head under the incubator. Next thing I know I'm diaphoretic, nauseated, shaking and according to annother student and my preceptor white as a ghost. It was marvelous.

 

[chef_NU]

Heh, I'm kind of in the same boat. I have no problem watching surgeries or procedures on other people, but when I watch my own blood getting drawn I get faint. I think the best way to get over it is just repetition. Hell, if civil war surgeons can saw people's arms off with no antibiotics, no sedation, and no painkillers, I'm sure after a little experience I can handle whatever gore I might run into.

 

[MattD]

I posted my serious advice reply in the preallo thread on this, so I'll just tell a story now instead🙂

I've never passed out during surgery or anything like that, but I have gotten very light headed before. Never actually during the operation, the thing that gets me the worst is watching an epidural needle go in! I don't know why, maybe it's because it's such a big needle, but that of all things causes the worst reaction for me. Blood draws don't bother me, I can even watch a needle go in my own arm for a blood draw with no problem, but those darn epidurals... LOL Not the smells, sounds, and sights of total joint replacements, but epidurals.

Does anyone find it strange for one particular procedure to cause problems repeatedly, or is that common? maybe I should talk to a shrink about me inner fear of things being jabbed into my spine LOL

 

[kassie]

There you go - you probably answered your own question.

During surgery there was a wave of ppl passing out or presyncopal and the next day I got the worst stomach flu ever, I think I puked for 24h straight. In hindsight, we probably all had it floating around. Give it another try and have some fluids right before.

Oh, and there was the time we were doing prostate exams on a SP and the guy was too excited by the whole thing. That was the first time I almost fainted.

I do remember not eating because I did not feel very well and had a horrible stomach ache.I guess I never got the memo about eating before hand. 😛

 

[run4boston]

I dont think it was the standing for long periods of time because we were only a few minutes into the surgery; but I do remember not eating because I did not feel very well and had a horrible stomach ache.I guess I never got the memo about eating before hand. 😛

Keep the ideas comeing they are all very helpful so far. 👍

maybe how you think about the experience is important too. for instance, when i see blood now, i think of it as just another fluid.

 

[DropkickMurphy]

If it makes you feel better, I puke and pass out every time I deliver a baby (currently at three and counting in 8 years of EMS)