Playing medical detective

Finding what ails someone is sometimes very difficult and requires time, patience, imagination, creativity and, best of all, extra help. 

This is the story of a couple we know, Paul and Ginette that precisely found themselves in that kind of situation. Both are in their 70s. Back in 2013, Ginette passed out once while hosting some friends for dinner and shortly thereafter at the movies. Both Paul and her put these two incidents on the count of low blood pressure and that was the end of it. 

Fast-forward to the summer of 2022. Early morning, as she woke up and went to the bathroom, Ginette passed out and fell on her bedroom floor. Luckily, she didn’t hurt herself, but experienced severe and lasting discomfort in her stomach along with terrible nausea. She stayed in bed, drained of energy, till day’s end. The following morning she felt and acted in perfect shape, could exercise as hard and as much as she regularly did. 

This incident would repeat itself eight more times in a one year period, with each time the same symptoms, discomfort and recovery. The couple seek medical advice from their family doctor who, during that period, ordered a sleep study, both a colonoscopy and an endoscopy, a brain MRI and an EKG with stress-test. All this testing would lead to nothing concrete and reassuring. 

In the meantime, Alice, the couple’s daughter searched relentlessly for solutions and first was able to match her mom’s symptoms with an extremely rare condition called “sleep syncope”. Local health professionals had never heard of such a thing. Keeping on digging deeper, Alice found that help would most likely come from a Cardiac Electrophysiologist, working on heart rhythms. 

Ginette sent a message to a bunch of them working nearby and asked “Is sleep syncope a condition you have treated in the past, or are somehow experienced with? If so, are you interested in helping me?” Out of half a dozen doctors contacted, only one responded positively saying that while he had never encountered that condition, he was motivated to help her.

After consulting with Ginette, he told her that absent a heart problem, she would have to be seen by a neurologist. However, he would monitor her heart for one month to follow its behavior. She was outfitted with a mobile cardiac telemetry unit, a monitoring method that uses a small portable device to monitor a patient's cardiac activity, recording in real time her heartbeat as she lives her normal life, working, running errands, exercising, and sleeping. 

On August 8, Ginette experienced her 9th and last “incident”. As Paul recalled, “It was scary, I thought she was having a stroke!” He registered the event on Ginette’s monitor and shortly they were summoned to rush to the hospital, where they learned that Ginette’s heart had stopped beating for a full 18 seconds (keep in mind that cardiac arrest can be fatal if it lasts more than 8 minutes without CPR, while brain damage can happen after just 5 minutes). 

The cardiologist ordered her to receive a pacemaker that was implanted in the afternoon and she was home the same night. She is now doing great and that terrible anguish of not knowing what ailed her is now lifted. 

So, the moral of the story is while it’s sometimes very difficult to reach a clear diagnosis, one has to remain extremely patient and keep searching, if possible recruit a motivated family member or friend to help along, and leave no stone unturned until a solution is found. 

Something to always keep in mind.