On 14 July this year, Rachel took mum to Target to do some underwear shopping. They had been standing, looking at clothes on racks, when Rachel noticed that mum was looking ill and hanging on to one of the racks. Mum then collapsed and was unconscious for several minutes.

Rachel's first reaction was to go perfectly calm and rational: "Mum's fainted. I need to get help with this. I shall get the staff to help, and get an ambulance here." She set about doing all the right things.

Rachel recalls:

The first aid worker in Target declared mum's pulse to be very weak and her breathing was very shallow (so much so I wasn't certain she was still alive). This was prior to the ambulance men arriving. They had told us by phone to lay her on her side on the floor and keep her there until they got to her, so that is what we did. Of course, by the time I drove home mum had forgotten all about the event and later ate a good roast dinner. She had just finished this when her own GP arrived.

The ambulance men checked for low blood pressure, low blood sugar, and pulse rate. Mum scored 'normal' on all three counts. Once she was home she seemed none the worse for wear, and later in the evening when her GP, Dr Patella, came round to the house she could find nothing wrong with mum.

I recalled this incident this week when I noticed that mum's first scans, the MRIs done in 2000, had been a reaction to her 'episodic falls'. Mum has fallen several times, usually with only the most minor bruises. In fact, when she falls, it is the ground I am worried about. She seems to be made of leather and steel. They could probably use her as a secret weapon, dropping her from 30,000 ft to destroy terrorist training compounds in the desert.

Before drawing too many conclusions, I acknowledge that there could easily be multiple explanations for mum's falls, such as:

  • poor reaction time and weak muscles which lead to slow footwork when unbalanced
  • ear trouble which leads to an erroneous sense of what's up and what's down
  • brain problems which can cause... well, just about any problem
  • poor blood flow - as with dad

In dad's case we discovered that his falls, which were more like fainting spells, were caused by malfunctioning blood pressure sensors (the baroceptors) in his neck. The pacemaker has largely fixed that problem. With mum, it seems to be something different - a general unsteadiness, poor balance, perhaps combined with occasional poor blood flow to the brain.

The professionals refer to this as TIA, or Transient Ischemic Attack - a grandiose piece of jargon that describes a temporary stroke. It is considered a warning sign of the increased likelihood of more serious strokes ahead. Mum does not really fit the profile for TIA's or strokes, except that she is old, which means she is beginning to fit the profile for just about anything. Consequently, it seems the standard 'good living model' (healthy foods, sufficient liquids, and exercise) is the best we can do for mum.

The importance of adequate hydration should not be underestimated. I remember fainting once. It was back in the days when I considered sunbathing a worthwhile pasttime. I'd been on the beach all day, had had practically nothing to drink, and was probably as dehydrated as a piece of beef jerky. I recall feeling faint and nauseous as I climbed up the rocks from the sand to my car. I had to stop and rest on the way; quite unusual, I remember thinking. I drove home and happily pottered around the apartment for half an hour, unaware of any further problem, then went to the local corner shop. I was fine while I was walking around the aisles, selecting what I wanted to buy, but while I waited in the queue at the checkout I began to lose consciousness. It was like a palpable grey curtain slowly descending over my eyes. I collapsed on the spot, my face hitting the shop counter on the way down. I came around to sense people gathered around me, all talking and offering advice. The consensus seemed to be to get me on my feet again. I knew this was the last thing I wanted to do, but couldn't resist. I was dragged up, dusted down, sold my groceries and sent off home. I drank a lot of liquid, slept for a couple of hours despite a cracking headache, and awoke feeling fine.

The odd thing about this whole episode was how much worse standing and waiting had been than walking around. When I heard Rachel's account of mum's faint in Target, I immediately thought of this. I nowadays find myself visually scanning shops and public spaces, looking for the location of the nearest seat in case I need to steer mum or dad towards it. These days I don't like to keep them waiting on their feet for any length of time.