Blacked out from workout again. thoughts on stopping entirely?

Triathlon Forum
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tl;dr version: I blacked out from physical activity today for the 7th time in 10 years. Considering quitting altogether as I may have a medical issue? Not sure what I should do or if that’s being too drastic.

I was about an hour into my trainer workout today when I felt really sleepy, which I’ve known from experience is bad news bears. I immediately stopped my workout, felt tunnel vision start to creep in, and hustled to the kitchen to start drinking some chocolate milk to get some calories in me asap. Next thing I know, my roommate is lifting me off the floor, my chocolate milk is all over the stove, my nose is bleeding, etc. Dizziness went away pretty quick after that and I was perfectly fine within 15 minutes (except for the residual headache from a mild concussion on the fall).

Anyway, this was not my first time blacking out from a workout. I swam D1 in college, and blacked out about once per year. Since then, I’ve done it twice on the trainer, once at the end of a sprint finish of a race, and once at Crossfit (I’m 27). I’ve never been out for more than a couple seconds, and this is my first time getting a concussion from falling.

Every single time, today included, there’s been a “reason”, almost always from starting a hard workout in a state of severe caloric deficit (today was a struggle in the morning, and at 4pm I started a workout having eaten a few muffins all day, but had two gels at the start of the workout), or from not being in the best of shape and trying to do a harder workout than I can handle. And then one time I tried a new, legal, nitrous oxide based supplement before a 100 freestyle while in college, and blacked out minutes after the race; I have since never taken any supplement other than gatorade or gu gels because of how shaken I was from that incident.

But I’m starting to worry that it’s not just me messing up the hours prior to the workout and not being prepared, but that I’m predisposed to it somehow. This idea scares me when I read about people dying in races and workouts because of all the times I’ve had workout related black outs. I’ve also only blacked out when I’m around other people, and the idea of it happening when I’m at an isolated portion of a running trail is scary as well.

My body does not do well with high intensity work unless I have tons of warm up, which is the main reason I quit Crossfit. I cant do explosive workouts like that with only 15 minutes of warm up, and I got tunnel vision probably once a week. Endurance stuff is better because I warm up as long as I’d like, but I’m obviously still at risk because today was really low intensity.

I like triathlon and trail running a lot, and I like working out, but I’m starting to think this is riskier than I’d like it to be. Probably in the same boat as people who love cycling but got buzzed by a driver one to many times and is scared to get back on the road.

Any thoughts? I’m looking for input from others who’ve had stuff like this happen to them. And whether, if you were me, you would consider just hanging it up, or if you think that’s a bit drastic.

Also, could I have some undiagnosed medical issue, possibly?

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Also, could I have some undiagnosed medical issue, possibly?

Yes,

First see a good medical professional to rule out physiological problems…
… and then seek counseling with a sports psychologist (who ideally has experience with (former) collegiate athletes).

I see similar patterns to what you describe in quite a few former collegiate athletes, who have problems having a healthy relationship with sports/exercise after a successful but mentally draining college career.

Best of Luck!

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I skimmed so I might have missed this: Have you ever had a full cardiac work-up? If not, do it.

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Blacking out and hitting your head is a heart problem until proven otherwise. Go see a doctor.

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Friend of mine had the same thing happen several times during extreme workouts when he played college football. Turned out to be a large blood clot behind his eye that would swell during intense activity causing pressure on the brain which led to the tunnel vision “night night”. He turned out to be okay, but had to take blood thinners for a while…and his football career was over…
Hope they get yours figured out…

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Did I read your post correctly? You have blacked out 7 times in 10 years and have not been to a doctor? I hope I read this wrong.

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Man if this isn’t exactly my story. I’ll try not to blabber to much. Same as you with regards to college athletics. D1 runner. No history of issues at that point. Continued running through dental school and finally switched to Tris in 2012/13. This past winter I went out for a normal run at at minute 3 I felt what you felt. Tunnel vision and dizziness and next thing I know some person is waking me up. I feel into some metal fence. Hit head and shoulder but nothing serious. Woke up and was totally out of it. I actually thought I’d been asleep for awhile and I think I was actually dreaming bc I was so confused when I got up. The person had already called 911 but I told him not to worry about it as I was close to home and I felt I could walk home. I called my PCP and went on for an emergency visit to her. She hooked me up to the heart leads to look at my qrst wave and saw that I had an abnormal right bundle branch firing. Obviously that sounded fancy and scary to me. She sent me to a cardiologist. Went over there soon after. The made me wear a device that records all your hearts activity for 24 hours. The result with that was zip. Then he had me do a stress test which is where you are hooked up to all these wires that monitor your heart and you are placed on a treadmill and they slowly elevate the incline. It’s a bit of a challenge and obviously being competitive I wanted to go as long and hard as I can but they cut you off before you really die. Results of that-nothing. He threw words out like cardiomyopathy. That’s the big one that you hear high school kids drop dead from on the field playing sports. Freaked me out obviously. He felt he still couldn’t give me the clear to workout till I saw another cardiologist. He sent m to Mass general (in boston great hospital) and I saw a doc that was supposedly the top doc in this field. All tests repeated with the addition of an MRI of my heart. That was hell bc you go all the way into the MRI tube and are strapped down and it’s just a shitty feeling. Result -zero.
I can tell you I have a really high max heart rate. I’m 36. I did max heart rate test last year on a treadmill. Found it online but it involves running hard as crap with a steep incline. The treadmill actually shut down/broke about 30 seconds from the finish. I was at about a 5 min mile on a 5 degree incline I think. My heart rate from my Garmin was 206. My resting heart rate is around 38-40. From what the doc told me I have such a huge range that more then likely I just fell over bc I wasn’t warmed up and I had bad scncopy. I have blacked out after 3-4 half ironman a also on a side note. Most if not all have happened sometime after I finish. I’ve been standing in line to get a massage about 1-1.5 hours after a race and I just went down. Buddy said I looked like will ferrel in the movie old school where he falls into the pool.
Moral of my story is go see your doc. Could be nothing like me or could be something very serious like cardiomyopathy. Not to scare you with that but it’s best to get it looked at. I’d bet it’s your nutrition but get an apt with your doc.

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Sounds just like my first husband. He worked out all of the time and was in his 30’s and looked healthy. He ran ultras and did Ironmans but started passing out when he pushed things. After passing out on a run and getting his teeth chipped from hitting the pavement, he finally went to the doctor. Turns out he had a defective heart valve, a bicuspid aortic. He said he wasn’t going to have open heart surgery. Period. Refused to consider it.
He died of a heart attack during a marathon a year later.
Get a physical. You can feel just fine and have something like this going on.

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Wow, so sorry to hear about your husband.

This is why I keep getting stress tests. At least if I go, it is not like I did not try to make sure I had no obvious issue.
I am glad I am not afraid to go to the doctor is I feel something funny.

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carotid hypersensitivity? Mrs. bob loblaw has a similar condition, just that it’s not exercise that makes her pass out. Tentative diagnosis is carotid hypersensitivity, coudl be something to keep an eye out for.

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Sounds just like my first husband. He worked out all of the time and was in his 30’s and looked healthy. He ran ultras and did Ironmans but started passing out when he pushed things. After passing out on a run and getting his teeth chipped from hitting the pavement, he finally went to the doctor. Turns out he had a defective heart valve, a bicuspid aortic. He said he wasn’t going to have open heart surgery. Period. Refused to consider it.
He died of a heart attack during a marathon a year later.
Get a physical. You can feel just fine and have something like this going on.

so sad to hear that… not sure what else to say, sounds like a terrible thing to have to have gone through.

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Thanks Bob and Dave. This was a long time ago. I hope my story makes people realize they can feel just fine but have something serious going on if they are passing out.

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The issue is unknown but the proper course of action is easy, go see your doctor. It may be something very simple and very treatable but you won’t know until then.

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I passed out a year ago after getting up too quickly from the couch.

When I get in good shape, my resting heart rate goes down and I will get light headed if I get up too quickly. I haven’t been training hard for the last year and I no longer get light headed.

Obviously different than passing out during exercise but I thought it was worth mentioning because I think my issue is fairly common.

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where are you? What part of the country do you live?

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Wow, thanks everyone for the responses. I guess I had never seen a doctor about it because I was always thinking “theres no problem, I just didnt warm up”, or “I guess I hadn’t eaten enough today”, etc. I scheduled an appointment for Tuesday morning, so hopefully that goes well.

In the meantime, I’m gonna skip my workouts (a concept ST has never seen before…).

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Sorry to hear about your first husband; something like that is what I’m worried about. I’m going to the doctor on Tuesday, so we’ll see what happens then.

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where are you? What part of the country do you live?
right now I live in the San Francisco bay area, but I’m from Houston.

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I passed out during a workout once. Turned out not to be a big deal, but I was ferried away in an ambulance and they did all sorts of testing on me over 2 days to make sure I did not have a heart problem. Here is my thread on it:

http://forum.slowtwitch.com/cgi-bin/gforum.cgi?post=4621046;search_string=passed%20out%20rowtotri;#4621046

I would definitely go get checked out. I highly doubt it has anything to do with caloric deficit. Might just be a vaso-vagal reflex like me, or it could be something serious - best to know so you know how to avoid passing out permanently…

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Oh yeah, you definitely need to see a doc; your health is so much more important that racing triathlons. It also sounds like you know the pre-cursors are diet-related (but don’t always follow a good nutrition regimen in advance of exercise) and intensity related. Assuming a doc even allows you to continue, you need to make sure your ALWAYS adequately fueled prior to doing any exercise. Now make that appointment!