Help me out here...See Doctor or not?

[Eagle5US]

OK-
I'm laying this out. Tell me if I need to get seen, or friggin soldier up.

BACKGROUND:
- I'm in support BN HELL and my only release is PT. Can't run (rockets / mortars) and I've always lifted - lifted smart, and am educated on doing so (form, breathing, grouping etc).
- Cardio is done on the treadmill and elliptical
- I'm a big guy (6' 1" / 230) currently calipered at 17.13% body fat (Army tape @ 20%)
- I am 40 and have not had an over 40 physical
- 18 Nov 04 I had a Pulmonary Embolism and subsequent massive GI bleed, either could have killed me, both almost did. Result was some "scarring in my R lungs" per the pulmonologist on my discharge from ICU.
- I've had lots of surgeries (Shoulders x 3, both knees (one bone graft and screws), ankle x2 with complete rebuild, fingers (bunch), kindey x2 and a few others but nothing in the last 2.5 years.

SITUATION:
- I have trained up for the past 10 weeks in order to be strong enough to start a new lift program. The new program is a beast-period. I needed something for focus and this is it. The shortest day is 500 total reps of various weight lifting excercises.
- It is a 5 day per week program, one body system per day, break any 2 days you like out of the seven.

MY "ISSUE":
- LEG DAY, doing squats (last 100 reps of the day @ 5 sets of 20), I almost blacked out...falling forward with the bar into the rack. this happened twice during the 5 sets.
- CHEST day, no issue
- ARM day-no issue
- SHOULDER day...doing overhead barbell press (5 sets of 20) -with another 120 reps between 2 excercises to go- again almost blacked out
- BACK DAY (today) doing dead lifts (@5 sets of 15) -with another 180 reps between 2 excercises to go- I finished set 4, put down the bar, and I hit the floor...out cold (10 seconds???). Another guy in the gym was slapping me when I woke up. I rested about 10 minutes and went to the next excercises (high rows @4 sets of 20) and then shrugs (@5 sets of 20). No further issues.

I AM breathing, I am at my limits with the weight I am pulling, am on no supplements / stimulants, and am eating right.

I may NOT be "feeding the machine" the way I need to for this level of intensity.....but I would like some learned input from other folks.

It appears that when I have a significant increase in my intrathoracic pressure, I'm on the way out.

The only relation in my past was in GP:
I attempted 4 pre-scubas back to back with a total of 33 shallow water blackouts before they told me I couldn't come back. The DMO said my carotid arteries went into spasm (and closed) when deprived of oxygen for extended periods of time-thus depriving the melon of blood and oxygen. Hence I would pass out.

Give some wisdom fellas..."Doctor heal thyself" never really sank in with me. My head is too friggin hard. This I have demonstrated too many times. I am asking for your help.

Thanks-
Eagle

[lksteve]

Originally Posted by Eagle5US

OK-I'm laying this out. Tell me if I need to get seen, or friggin soldier up

get seen...i say this based on 4 years as an SF Engineer Sergeant, 2.5 years on A-teams as an officer and as a C&GSC graduate...

i get light-headed doing declined bench press, pull overs or any activity when on my back and lifting weight over my head...one doc says it's postural hypotension...another doc says not to worry based on my pulse and BP...

you're 40, huh...? same age i was when i blew out my shoulder...time is not kind to us...

[SRT31B]

I'm only an EMT, so you know WAY more than me medically, but I have been lifting for a while.

If I read what you put down right it looks like you are doing lighter weights and going for more reps? On suggestion might be to try and alternate between heavy and light days.

Ex. the first week, continue your program as you described. the following week, shoot for a weight that will get you to exhaustion in 7-10 reps with 3 sets, and only do 3-4 exercises per muscle group. For that week do all your exercises with a weight like that. This will work not only your muscle endurance, but also strength when you do the heavier weights. It will also provide more variety to your workout so your body doesn't become used to what you're doing as quickly.

Another option might be to try "push/pull" days. One day do all the "pushing" exercises you can think of (bench press, tri pushdowns, dips, etc.), the next day do all the "pulling" ones (curls, pullups, rows). This is a pretty common program among power lifters as it can quickly build strength.

Again, medically... your light years ahead of me, but trying to mix up your training a little bit might keep that stuff from happening. Also, are you doing cardio everyday? I would run no more than 3 times a week, and if it was a cardio day, I would take it easier on the weights. That way you aren't working yourself to complete exhaustion and you have enough time to recover and grow.

Not an expert, but hope it helps.

[Eagle5US]

Originally Posted by SRT31B

If I read what you put down right it looks like you are doing lighter weights and going for more reps? On suggestion might be to try and alternate between heavy and light days.

Not the program that I am on....like I said before, it took me 10 weeks to get strong enough to even start this program.
This was calculated and a LOT of effort put into getting to this point. And no, this isn't a "lighter weight / higher rep" program or it wouldn't have needed my former training goal to be "able to start this program".

Thank you though.

Eagle

[Razor]

It sounds like the lifts that are causing you problems (squat, deadlift, overhead press) are also lifts where its common for a guy to really tense up his neck and shoulders during the lift. I've heard of folks (especially someone with giant traps and no neck, sound familiar?) being able to occlude bloodflow to the brain by tensing the neck and shoulders...I think Pappy Boyington did this during dogfights to keep the blood in his brainpan during high-G turns in WWII. You're breathing fine, but perhaps you're inadvertently closing off vessels in your neck for too long due to the higher # of reps per set than you're used to doing?

[jasonglh]

I am 40 and have not had an over 40 physical

We make bad patients.


Does sound like a carotid issue with your past scuba experience. Does carotid sinus massage cause you brady down or hypotension? Do you have a hx of HTN or CAD? Need a carotid study and maybe a tilt table test?


What caused the PE?

[NousDefionsDoc]

Go yer ass to a Doc.

[18C/GS 0602]

Personally I think you should get checked out. It sounds like it might be vaso-vegal, but as you know syncope is nothing to mess around with. If you came in to my ED I would at least get an EKG and some basic blood work. Regardless of what you choose to do, I wish you the best of luck.

[Doczilla]

I'm with the others. You've gotta see your doctor.

The potential causes of your syncope are many and varied. It may be something as simple as hydration status, though I imagine you know a whole lot more about this than the average patient, and have addressed this. There are other things to consider. Carotid stenosis has already been mentioned. There could be an arrhythmia, subclavian steal, vagal hypersensitivity, or other things. The fact that you actually lost consciousness means that this is something that should not be ignored. There are a great many simple, non-invasive tests which can and should be done here. Bloodwork, carotid ultrasound, and an EKG have been mentioned. I would add a holter monitor, 2D cardiac echo, and stress test (preferrably a stress echo). If you have an MRI available (probably not, given that there are mortars and rockets where you are), I'd do an MRA of your brain and neck vessels instead of a carotid U/S, since that will give a whole lot more information about the posterior circulation.

Your training and experience make you a valuable asset to SF, an asset and invesment that should be well guarded. This syncope is a clue that there is something that needs to be addressed. Better to heed the clues now and get the workup while there is time and the ability to do so, and head off a potentially worrisome problem before it gets worse.


'zilla

[Eagle5US]

Thanks folks...
Guess I just needed to hear it from someone else.

I'll get all that stuff done this winter when I redeploy

That being said-I have some "Doctor folks" I can talk to.

Thanks for the input.

Eagle

[Intel_Airman]

Originally Posted by Razor

It sounds like the lifts that are causing you problems (squat, deadlift, overhead press) are also lifts where its common for a guy to really tense up his neck and shoulders during the lift. I've heard of folks (especially someone with giant traps and no neck, sound familiar?) being able to occlude bloodflow to the brain by tensing the neck and shoulders...I think Pappy Boyington did this during dogfights to keep the blood in his brainpan during high-G turns in WWII. You're breathing fine, but perhaps you're inadvertently closing off vessels in your neck for too long due to the higher # of reps per set than you're used to doing?

This happened to a friend of mine quite a bit. He was about 5'9 and had some huge traps. Well, there were many of leg days when I had to pick his ass up of the floor from squats and a few times after he finished leg presses. I personally have come close to blacking out on legs many times. But I find that it's the weight I'm pushing (I'm going to my limit). Doing this with lighter reps and passing out doesn't sound familiar to me. If you are going heavy and this is happening, well; I've seen that more common. I second the others and say get checked out if you are just repping.

[Eagle5US]

So-
in the spirit of all things worth doing are worth doing again...I took an ER Doc with me to the gym last night (CHEST) and decided we were going to try and reproduce my symptoms at the end of my workout.

We figured out the following...

I tilt my head up at more than 30 degrees and have heavy strain or valsalva (i.e. heavy weight, end of set etc), my neck musculature does indeed decrease my blood flow to my melon. This was only the case though when I focused "up" at an angle.

He thought it quite interesting to watch my neck "swell" as he put it and see my body's reaction. After a few instances, he was able to predict within a couple of reps when I would start getting light based on the look of my head stem.

Solution will be to (of course) do those excercises more "lightly". I KNOW you didn't think I was going to say complete avoidance....c'mon!

Thanks for the input folks...

Eagle

[Sweetbriar]

It's good to hear you aren't going to croak, then.