Pulse-taking on carotid artery can lead to fainting

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DEAR DR. DONOHUE: Recently, while walking on my home treadmill, I stepped off to check my pulse. Normally a walk like the one I was taking would raise it to 110. I did so by pressing two fingers on my left neck artery. I had to press rather hard to find the pulse. After counting for six beats, like a flash, my right arm went numb and my right leg buckled as I went to my knees. The episode lasted about 15 seconds, and then everything returned to normal. My first thought was a mini-stroke. I didn’t go to the hospital, but I have made an appointment with my doctor to discuss this. Is it possible to apply too much pressure to the neck and effect something similar to what I experienced? – D.T.

ANSWER:
The carotid artery in the neck brings blood to the brain. There’s a carotid artery on either side of the neck. In that artery is a small area called the carotid sinus. It monitors blood pressure and heartbeat. If blood pressure is too high or if the heart is beating too quickly, the carotid sinus detects the changes and sets in motion a reflex that slows the heart and lowers blood pressure.

You could have pressed on the carotid sinus and triggered heart slowing or heart stoppage, along with a drop in blood pressure. That brought you to your knees. Doctors sometimes massage the carotid sinus to put an end to a rapid heartbeat. Doing it unknowingly and doing it when alone can be dangerous.

Millions of people take their pulse by feeling their carotid arteries. I try to discourage this practice because of the very thing that happened to you. People can learn to take their pulse by feeling it on the thumb side of the wrist. If they can’t feel the pulse there, they can put a hand over their heart and count the heartbeat. It’s the same thing as a pulse.

There could be another explanation. You might have dislodged a piece of clot in the neck artery. The piece might have been swept into a brain artery, where it temporarily blocked blood flow. I’m glad you’re seeing your doctor.

DEAR DR. DONOHUE: Would you give some ideas on how young boys can lift weights safely? – C.P.

ANSWER:
Children 12 and younger should lift weights only under supervision. They need instruction, and they need someone with a cool head who won’t allow them to overdo it.

Older children must exercise common sense as well as their muscles when they’re lifting weights. They shouldn’t turn it into a contest of who can lift the heaviest weight – that’s an invitation to injury. They should lift a weight that they can raise eight times consecutively without straining. They should not add more weight until they can lift a weight 12 times in a row. They should take a two-minute break between sets of consecutive lifts. Three sets are enough. Forty-eight hours should elapse before they exercise the same muscle.

All children, regardless of age, should have instructions in proper form when lifting. They should not hold their breath while straining to lift. Doing so impedes blood return to the heart. They should exhale while they are lifting the weight, and inhale while they return the weight to the starting position.

DEAR DR. DONOHUE: One thing I am not good at in basketball is moving to the side. I am very clumsy when it comes to that. I can shoot well and run fast, but I’m no good at side movement. What can I do? – R.B.

ANSWER:
This is a question better answered by a basketball coach, but I’ll give it a try.

If you have a basement or if you can do this outside, then make yourself a track with five or more cones. Place the cones alternately on the right and left sides of the track. You run straight toward the first cone and then rapidly change direction by running to its outside on the right and continuing this practice by running toward the next cone and running on its left side. Alternate the change of direction with each cone.

When you have one pattern of running down pat, then change the positions of the cones so you have a completely new obstacle course.

DEAR DR. DONOHUE: I am 74. I was diagnosed with polio when I was a child. As a consequence, I have one leg that is shorter and thinner than the other. I saw a doctor who noticed my leg and said I have Charcot-Marie-Tooth disease. I looked it up on the Internet, but I don’t have any of the symptoms that were mentioned. I play tennis for hours. What do you make of this? – S.B.

ANSWER:
Charcot-Marie-Tooth disease, named after the three doctors who first described it, is an inherited nerve disease. It’s actually a group of nerve diseases with different degrees of involvement and impairment. The most common variety is due to a gene that comes from the mother or father.

The illness features muscle weakness, muscle wasting and impaired sensation. The area most often involved is the lower leg. Affected people have to walk by taking high steps because the foot flops downward and, with an ordinary step, it would hit the ground. It’s a progressive disease, getting slowly worse over time. It starts in the first or second decade of life.

Your illness started quite quickly, correct? It affects both the upper and lower parts of your leg, correct? You are now able to walk without difficulty or you wouldn’t be able to play tennis for hours. You don’t sound like you have Charcot-Marie-Tooth disease.

I am at a disadvantage by not being able to examine your leg. If you want absolute certainty, a neurologist can provide it for you.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com

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