7 weeks ago I had an episode where I fainted on a 4am toilet visit. Got out of bed and within seconds fell backwards on my head heavily. After the fall didn’t know where I was and confused.
Hospital admission to A&E and as a result of the fall heavy concussion and minor brain bleed identified through a lumbar puncture the following day. MRI same day show no bleed and subsequent MRIs, Angiograms showed no abnormalities.
12 days in hospital and all bloodwork, ECG, blood pressure and various other tests came back normal and was released. No real indication of any medical reason why I fainted and this is the first time it has happened.
I am 50, 15 years of riding / racing /training and generally in very good health. Nothing changed in my routine prior to the fall in terms of life stress, diet, sleep or training.
Prior to the fall I was alternating 2/3 high intensity sessions per week.
Obviously my family now think exercise is the reason for the fall and all this training is making me too thin / weak and I should put up weight. I’ve been hovering 4 - 4.5 wkg over the last 3 or 4 years and do gym work also so feel good.
Doctors maintain the high intensity exercise is not likely the cause of the fall but I can’t help thinking it was a contributory factor. When I think about some of the training sessions critically I wonder why I am putting myself through “Very hard” exercise on a regular basis, I’m not getting paid for this and in fact I race very little these days.
Not sure what I am asking but most on this site will put themselves through grueling workouts in the name of gains. Do you ever wonder if this abuse of your body is actually good for you?
Do you think VO2max workouts etc could be a contributory factor in my fall?
I’m so sorry to read this. Glad you are recovering well. I’m sure your family is looking for anything they can to help ensure it doesn’t happen again.
Prior to the incident, did you ever experience orthostatic hypotension, or any form of lightheadedness? I get it sometimes when standing up. I’ve read it’s normal with other athletes, but it always worries my wife. I’m just wondering if it could be something related.
On the topic of “questioning whether all this is worth it”, I’ve moved into the second half of my 50s and I’ve recently been pushing myself to move toward better overall health and not just focusing on being the best cyclist I can be. I’ve mixed in regular running, along with strength and yoga days. I hate watching my CTL and FTP drop, but I figure it’s just a temporary resetting of my brain to change expectation and get mental satisfaction from overall heath rather than just focusing on cycling numbers. It’s not been an easy transition mentally though.
I get light-headed fairly often, when standing up getting out of bed. Originally, it was easily blamed on the betablocker I was taking to reduce high resting heart rate (it pulled my otherwise normal blood pressure pretty low, like 90/58). Now, after 10+ years of cycling, I’ve gotten my resting HR down where it should be, and am off the beta blockers, but still occasionally get light-headed when standing from bed or bending over, or squatting. I don’t have any reason to believe exercise is the cause, except in the middle of (or immediately following) a bike workout, since my cardiologist says that isn’t unexpected since blood flow is being directed to those muscles (e.g., the time I asked the doc about it, I had been riding for awhile in extreme heat, climbed a couple sandy, steep hills, and stopped at the top to do something that I had to bend over for, and when I stood back upright, got real bad spins and stars).
Maybe try sitting up on the edge of the bed for a minute, before standing. And make sure your staying hydrated, and your electrolytes are kept up.
I have fainted twice, both in the middle of the night going to the bathroom after hard hot days on the bike. Not fun and it is scary but diagnosed as a vasovagal fainting due to my low blood pressure and post exercise hypotension. It is benign other than the risk of the fall itself. I busted my face up the second time. I make sure I drink plenty of fluids, increase salt intake, and stand up slowly in the middle of the night.
Possibly orthostatic hypotension? I’ve gotten episodes of it since I was a kid. I tend to get it more when I’ve been doing a lot of hard riding. If I’m lying on the couch reading or otherwise relaxing and stand up, I’ll get dizzy and have to hold onto something. My vision can also start to black out/tunnel. It passes and I’m fine thereafter. I never actually fainted though.
I turn 50 at the end of the year and I have a 19year history of cycling and 9 year history of training. Im also fairly light for my height (175.5cm) at circa 61kg. Im no medical expert but my only history of fainting was way before I started cycling, and in my mind I wouldn’t be here if I hadn’t been fit when the gene genie (cancer) hit.
I get this, always have. I’ve never fallen though, fortunately.
I have a hunch that it happens more frequently during very hard training blocks when energy deficits are happening. I noticed with the highest frequency ever when I was doing high mileage and losing weight at the same time. For example, it doesn’t happen if I’m doing a block of winter base training without a lot of intensity.
I’ve adjusted to always sitting up first, pausing, and then standing up slowly.
My kid gets it to (14 years old - runs XC and track). We had him worked up and they found nothing. Their only suggestion was to drink more fluids with electrolytes. My kid also has issues with fueling. He’s lazy and doesn’t stay on top of nutrition while working out 2 hours per day. We have to nag him to eat an extra meal per day and make a recovery shake after workouts.
Pior to the fall I did have an incident where I took a small tumble due to light headiness on another 4am toilet visit, it was harmless in isolation but in hindsight it was a warning sign.
Over the years I have had some light headed experiences but never resulted in a fall, just getting up too quickly. Relieved to hear I am not on my own in that regard
I think the only constructive thing I can do going forward is take some time sitting on the bed before rising, i have a tendency to bounce out of bed.
Thankfully it was a subdural hematoma and not an internal bleed so a full recovery expected.
Kinda scary in the the weeks after trying to walk on marshmallows to preserve my head. Managed a short leisure spin today so confident I will get back, maybe knock the intense training on the head and enjoy the bike more as I do love just cycling.
It’s not possible to diagnose this over the internet, but there’s also no reason to jump to the conclusion that it’s exercise related. Plenty of people who don’t exercise faint, and plenty of peolle who do exercise don’t faint.
Totally. It could certainly be unrelated to exercise. In my case, orthostatic hypotension is not due to exercise but exacerbated by it. When I’m fit, skinny, and riding/training hard is when it’s most prominent. I will say, it comes on over 3-5 seconds which has always given me time to hold onto something and not keel over. I’ll grab an arm of chair or edge of a table and bend over lowering my head. It passes in another 3-5 seconds.
I’ve had several of these types of occurrences over the last three decades. Doctors all come back with the low resting HR due to being an endurance athlete, as well as possible slight dehydration. Mine usually occur at night when I get up to go to the bathroom. I’ve learned to be conscious of my hydration, especially after a longer or more intense ride that day. I also sit on the edge of the bed for 20-30 seconds to let my BP and pulse respond to the change in position. Seems to help, but not completely fool proof. the resulting concussions are the most irritating part, in addition to a panicked spouse.
This pretty much mirrors my experience. Had issues with it in HS to the point it was an issue one year during swim season and had doctors chasing all sorts of things. Turns out I had (have) really bad allergies but that wasn’t the cause.
It never went away but wasn’t too bad until about 2010 when I started lifting and outside of episodes in the evening I had one doing some floor to ground type lift, yeah not safe so backed off.
That was finally the time when the my Dr was able to do do something and capture my blood pressure dropping out when I stood up quickly.
Its always there in the background but absolutely gets worse as my training picks up. More recently (over 5 years at this point) I had a doctor who showed an interest again (long distance runner himself) and suggested making sure I was getting enough “salt” during long hot workouts. What testing I did at the time didn’t seem to make much difference. Dehydration and/or salt is probably a big part of it for me since it is always worse after riding outside where I tend to drink way less than inside.
The low RHR mentioned above as well seems like a big factor, I’m at a standing desk typing this and glanced at my garmin, 67, I’ve seen low 60s while driving. Meanwhile the avg person would be glad to see this sleeping. Even slacking off this year I just checked and my avg is 51 for the past 12 months. Last 4 weeks its 46 and guess what is back more frequently?
Whilst in the hospital there was numerous tests performed taking blood pressure whilst lying down and to a standing position. This was a continous monitoring machine and what this showed was when I stood up blood pressure dopped but remained low for 20ish seconds which they think might have contributed.
My RHR was 39 at the time which wouldn’t be that unusual when trained, back to 45+ now with no training.
So pausing before rising to a standing position required.
I hope to get back training at some point but chasing wkg might be a thing of the past.
