I am a 28 year old female. I work full time, and go to school part time at night. I am a smoker, and I currently take Adderall 4 days a week (only on school days) and ambien on those nights as well. I eat healthy, don t drink a lot of alcohol , and other than smoking have a relatively healthy lifestyle. About 3 months ago I had a random episode where every time I sood up I felt like I was going to pass out. My blood pressure jupmed up to ~ 170 s/110. My heart rate was up to 130, and my O2 sat. dropped to 89% so I obviously went to the hospital. They did a chest CT and ruled out a PE and my labs were fine. More long term that that, at times my hands and my ears turn bright red and feel like they are on fire. Since my near- syncope episode I do get a little light-headed fairly often, and my vision has started to change. My vision is not blurry, I would describe it as foggy. And my blood pressure seems to be all ove the place. It s been up to 147/92 and just this morning it was 94/60. The thing I m most concerned with is the hot hands and ears, and my blood pressure being all over the place - after all I m a 115lb, 28 year old, healthy female. Any ideas of what might be going on?