Today's column

is not for everybody and, in fact, may be applicable to only a handful

of readers, specifically those who are prone to fainting (syncope episodes).

I occasionally

get lightheaded when I bend over and stand back up, or even sometimes

when I am in a sitting position and stand up quickly. This irritating

little symptom has been worse since my August surgery.

Perhaps some

of you have experienced such symptoms as well. If so then you might be

interested in a study I just learned about. Please, please, please if

you have just developed symptoms of lightheadedness, or only recently

become prone to fainting, see your doctor before you try what I am about

to describe. But, if the fainting has been a longtime problem, this might

interest you.

It seems a

combination of leg crossing and muscle tensing may help prevent fainting,

providing a simple solution for people prone to fainting during emotional

stress or prolonged standing. The counter-maneuver could prove a simple,

inexpensive alternative to medication or pacemaker implantation, says

study senior author Wouter Wieling, M.D., Ph.D. associate professor of

internal medicine and head of the syncope unit at the Academic Medical

Center of the University of Amsterdam, the Netherlands.

According to

an article in Circulation magazine (September 2002), vasovagal syncope,

or fainting, results from a neurological reflex that originates in the

brain. In response to a physical or emotional trigger, the brain emits

signals that cause blood vessels to dilate and causes blood to pool in

the legs. The heart rate also slows. Subsequently, the brain does not

receive enough oxygen-carrying blood, leading to fainting.

Standard treatment

includes educating patients about the causes of the condition, instructing

them how to avoid situations that trigger fainting, and maintaining adequate

salt and fluid intake. Several drugs have been studied as treatment, but

results have been inconsistent.

"Leg muscle

crossing and tensing should be part of an intense nonpharmacological regimen

for patients with vasovagal faints," says Wieling.

Physical counter-maneuvers

such as leg crossing and muscle tensing have been developed in patients

with low blood pressure when rising from a reclining position (orthostatic

hypotension) ­ a condition caused by rare diseases of the autonomic

nervous system. Wieling and colleagues in Amsterdam and the United States

theorized that the same maneuvers might help people who have vasovagal

syncope.

The researchers

evaluated the maneuver in 20 patients (ages 17 to 74) who had a history

of vasovagal syncope, but were otherwise healthy. The number of lifetime

syncope episodes ranged between one and 200.

Patients learned

to cross their legs while in a standing position and tense the muscles

of the legs, abdomen, and buttocks. In a controlled test setting, the

counter-maneuver stabilized blood pressure and heart rate in all patients.

Symptoms disappeared shortly after blood pressure became stable, and none

of the patients lost consciousness while performing the counter-maneuver.

In five patients syncope was prevented. The remaining 15 patients either

could not prevent fainting or asked to be tilted