DEAR DR. DONOHUE: I am a 30-year-old woman, recently hired into a position that was a big advancement for me. After one week on the job, I had to give a presentation. On the morning of the presentation, I couldn’t eat because of nerves. About two minutes into my talk, I fainted. My boss was very concerned and insisted that I report to the company doctor before coming back to work. The doctor gave me a very thorough exam, including an EKG. He said I had neurocardiogenic syncope. That sounds awful to me. Is it? I’m not taking any medicine. Should I be? – C.K.

Syncope (SIN-coe-pea) is a faint. “Neurocardiogenic” refers to a reflex that takes place between nerves and the heart that brings on the faint. It’s also called vasovagal reflex. The “vaso” refers to dilation of blood vessels. The dilation keeps blood in the legs and lessens the amount of blood in circulation. “Vagal” refers to the nerve that slows the heart – just what you don’t want to happen when there’s too little blood in circulation. Both of these mechanisms cause a drop in blood flow to the brain. The body responds by making you temporarily pass out so that you assume the horizontal position on the ground. In that position, blood starts circulating again, the brain gets it share of blood and you wake up.

The whole thing is a reflex over which you have no control. Stress, high emotions, fear, standing in one place for a prolonged time and an overheated room are some of the circumstances that trigger this reflex. Usually there are some warning symptoms that you’re on the verge of fainting. You might begin to sweat and feel a bit nauseated. If you’re ever in this situation again and get those warning signals, sit down immediately or, better yet, lie down. Keep tensing and relaxing your leg and arms muscles to keep blood in circulation.

For young, healthy people like you, one neurocardiogenic faint is not a sign of any serious health problem. You don’t need to be on any medicines. You can file this in your memory as an interesting story to tell your grandchildren.

DEAR DR. DONOHUE: I am one of a set of triplets. We’re not identical. I don’t know if triplets ever are identical. Anyway, one of my two sisters has just had an operation for thyroid cancer. No one else in the family has had this cancer. My nonoperated other triplet and I were talking on the phone and wonder if we might be susceptible too. Should we have our thyroid glands examined? – R.O.

Most thyroid cancers are papillary thyroid cancers. If a family member has this kind of cancer, other family members have a tenfold increased risk of having it. You should, therefore, let your doctor know about your sister. It would be very helpful if she could give you the name of her cancer.

I don’t see any information that says there is an increased risk for triplets over the risk for other family members.

The majority of papillary thyroid cancer patients don’t die from their cancer. If the cancer occurs between the ages of 20 and 45, the prognosis is usually favorable.

DEAR DR. DONOHUE: When I lie down at night, I get a pain in the back of my right leg, and it goes all the way to my ankle. Is this peripheral artery disease? I have seen the ads for that illness on TV, and it sounds like the pain I get. – B.M.

Peripheral artery disease, also known as peripheral vascular disease, is the process in which leg arteries become clogged with plaque, the buildup of cholesterol and fat on their lining. The buildup prevents blood from reaching leg muscles. The classic symptom of peripheral artery disease is leg pain on walking. The pain stops with rest. Your pain doesn’t come on with physical activity; it comes with a change in body position. I’m not sure of the cause of your pain. It might be a neurological problem. I’m quite certain that it isn’t peripheral artery disease.

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

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