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#170587 09-06-2013 04:26 PM
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sanmc Offline OP
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Hi everybody. I'm 15 months out from surgery and 10 months out from chemo and radiation. My problem that seems to be hanging on is extreme dizziness. It doesn't always happen but it is very common. When I stand up I will get dizzy. I can sit down and wait a few seconds and try again and most of the time be ok. Then, there are times like this morning that I stand up and am ok, walk about 12 feet and it will hit. I start getting dizzy, everything starts feeling funny, my ears start to burn, my right leg will begin to twitch and I'm in real trouble. I called for my husband this morning and he got to me in time to help me get to the floor without falling but I sat/squatted at such an angle that I twisted my left leg right below my knee. I have spoken with all of my doctors about this and they assure me it's not from the surgery, chemo or radiation, that it's just my blood pressure and the blood pooling in my feet and not circulating like it should.

Does anyone else have any troubles like this after HN surgery? Any suggestions on what to do other than what we are doing now? I was advised to get support stockings. This I haven't done yet. Anybody use them and does it help?

I understand that this may be something I have to learn to live with but was just wondering about any input from you wonderful folks.

Thanks so much!


Sandra
5/15/12 Diagnosed with SSC
6/20/12 Surgery-Hard/soft palate with RND, trach and PEG, teeth taken, Age 51
8/20/12 PET scan showed cancer had reoccurred
9/4/12 Began Chemo and Radiation
1X cisplatin 2X carboplatin 35 radiation
5/28/13 Latest scans---Cancer free
12/2013 Still Cancer Free MO wants no more CT scans
(not sure how I feel about that)

Blessed and Very Much So
sanmc #170588 09-06-2013 04:51 PM
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Any chance this could be a form of vertigo?

sanmc #170592 09-06-2013 05:00 PM
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I do, all the time, and was commenting on it today. As soon as I stand, I have to go back back to my chair. I have chronic anemia, neuropathy, kidney disease, tinnitis so these maybe be an issue, and assume they tested your hemoglobin, creatinine, hearing. It can also be from surgery, and had a RND also, with the neck vein, nerve and neck muscle removed, so maybe there is lack of blood flow to the brain or something unrelated, like pain medication, sitting to long, other illnesses, so I haven't found out the cause several years later. I hope you find answers.


10/09 T1N2bM0 Tonsil
11/09 Taxo Cisp 5-FU, 6 Months Hosp
01/11 35 IMRT 70Gy 7 Wks
06/11 30 HBO
08/11 RND PNI
06/12 SND PNI LVI
08/12 RND Pec Flap IORT 12 Gy
10/12 25 IMRT 50Gy 6 Wks Taxo Erbitux
10/13 SND
10/13 TBO/Angiograph
10/13 RND Carotid Remove IORT 10Gy PNI
12/13 25 Protons 50Gy 6 Wks Carbo
11/14 All Teeth Extract 30 HBO
03/15 Sequestromy Buccal Flap ORN
09/16 Mandibulectomy Fib Flap Sternotomy
04/17 Regraft hypergranulation Donor Site
06/17 Heart Attack Stent
02/19 Finally Cancer Free Took 10 yrs






sanmc #170593 09-06-2013 05:28 PM
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Yes, especially the first couple of months after treatment. I even passed out a couple of times and hit the floor. It's better now but still, there are times when I've been relaxing for a period of time that I get the same thing.

Docs say it's orthostatic hypotension. When your blood pressure drops when you stand up too quickly because it has pooled in the lower extremities of your body. My symptoms were aggravated by BP meds and I have had to lower my doses due to the amount of weight I lost during treatment.

"T"


57
Cardiac bypass 11/07
Cardiac stents 10/2012
Dx'd 11/30/2012 Tx N2b MO Stage IV HPV+
Palatine Tonsillectomy/Biopsies 12-21-12
Selective Neck Dissection/Lingual Tonsillectomy/biopsies TORS 2/7/13
Emergency Surgery/Bleeding 2/18/13
3/13/2013 30rads/6chemo
Finished Tx 4/24/13
NED Since
sanmc #170595 09-06-2013 05:46 PM
Joined: Jul 2013
Posts: 24
sanmc Offline OP
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Thanks all. I don't think it's vertigo. Mostly they say blood pressure drops due to pooling. I think I'm gonna try the support stockings/compression socks and see if that helps at all. Just really frustrating not being able to just get up and go when I need to.

Any other suggestions/opinions would be most welcome!

Thanks!


Sandra
5/15/12 Diagnosed with SSC
6/20/12 Surgery-Hard/soft palate with RND, trach and PEG, teeth taken, Age 51
8/20/12 PET scan showed cancer had reoccurred
9/4/12 Began Chemo and Radiation
1X cisplatin 2X carboplatin 35 radiation
5/28/13 Latest scans---Cancer free
12/2013 Still Cancer Free MO wants no more CT scans
(not sure how I feel about that)

Blessed and Very Much So
sanmc #170596 09-06-2013 05:54 PM
Joined: Apr 2013
Posts: 92
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Posts: 92
I do this sometimes, it seems my equilibrium is off. I know cisplatin cause cause hearing issues, I believe the ears can mess with equilibrium, I get a ringing in my ear very occasionally. I have been wondering if it has something to do with that.


AGE 38 10-2012 thru 3-2012 swollen lymph node,painful jaw and ear,2 antibiotics,X-ray,CAT scan,needle biopsy,scope, no answers
3-4-13 tonsillectomy and selective neck dissection, DX R tonsil SCC,METS to 1 lymph node,BOT,HPV+, stage IV
TX 35 RAD,3 chemo cisplatin/Taxol started 4-8-13
rad end 5-29-13
sanmc #170597 09-06-2013 06:00 PM
Joined: Apr 2013
Posts: 92
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And I did wake up on the floor of my kitchen once. Checked my BP and it was low. Most days I don't take my BP meds anymore, I guess that can be attributed to the weight loss.


AGE 38 10-2012 thru 3-2012 swollen lymph node,painful jaw and ear,2 antibiotics,X-ray,CAT scan,needle biopsy,scope, no answers
3-4-13 tonsillectomy and selective neck dissection, DX R tonsil SCC,METS to 1 lymph node,BOT,HPV+, stage IV
TX 35 RAD,3 chemo cisplatin/Taxol started 4-8-13
rad end 5-29-13
sanmc #170598 09-06-2013 06:06 PM
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Posts: 3,267
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Oh, and another could be blood sugar. I have diabetes too, so is usually high, but if I take too much insulin, it can drop too low, which happened yesterday, and know the feelings of it coming on, went to get orange juice, and fell back into my chair. I love that recliner lol. Could be a combination of factors.


10/09 T1N2bM0 Tonsil
11/09 Taxo Cisp 5-FU, 6 Months Hosp
01/11 35 IMRT 70Gy 7 Wks
06/11 30 HBO
08/11 RND PNI
06/12 SND PNI LVI
08/12 RND Pec Flap IORT 12 Gy
10/12 25 IMRT 50Gy 6 Wks Taxo Erbitux
10/13 SND
10/13 TBO/Angiograph
10/13 RND Carotid Remove IORT 10Gy PNI
12/13 25 Protons 50Gy 6 Wks Carbo
11/14 All Teeth Extract 30 HBO
03/15 Sequestromy Buccal Flap ORN
09/16 Mandibulectomy Fib Flap Sternotomy
04/17 Regraft hypergranulation Donor Site
06/17 Heart Attack Stent
02/19 Finally Cancer Free Took 10 yrs






sanmc #170630 09-07-2013 11:08 AM
Joined: Dec 2003
Posts: 2,606
Likes: 2
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Sandra,

The problem you describe is fairly common after chemo and radiation. Orthostatic hypotension as Mr "T" points out is the clinical diagnosis. Check the bp in your ankles immediately after it happens. You should see elevated bp with arm bp normal or maybe low. The problem is really from nerve damage created by chemo and much more so by radiation. Dehydration, electrolyte imbalance, especially potassium, exacerbates it. Checking bp in each arm, ankles can also help identify carotid issues from surgery early on and the carotid should be periodically checked.

With all the nerves in the neck it is difficult for the signals to get past the neck both coming and going. The nerve involved is the longest in the body and has two main branches, one down the left and one down the right. The right side senses the needed change in bp and heart rate then adjusts things as you get up and walk

If the dizziness happens almost as soon as you stand it is more likely a dehydration problem. Of it usually happens between 7-12 steps it is a lag in nerve impulses from radiation, chemo or any combination.

The easiest check for dehydration is taking bp standing and sitting. If it is much lower standing there is a high likelihood dehydration is the cause.

Another contributor to the problem is excess calcium and calcifications of veins. This is pretty common too after treatment. The natural process of cellular destruction/trauma is using more potassium while throwing off calcium. High serum calcium needs to be addressed as calcium plaque buildup has a lot of problems. It is often ignored unless over 11 with abnormal parathyroid hormone levels as the parathyroid glands regulate calcium levels.


SCC Stage IV, BOT, T2N2bM0
Cisplatin/5FU x 3, 40 days radiation
Diagnosis 07/21/03 tx completed 10/08/03
Post Radiation Lower Motor Neuron Syndrome 3/08.
Cervical Spinal Stenosis 01/11
Cervical Myelitis 09/12
Thoracic Paraplegia 10/12
Dysautonomia 11/12
Hospice care 09/12-01/13.
COPD 01/14
Intermittent CHF 6/15
Feeding tube NPO 03/16
VFI 12/2016
ORN 12/2017
Cardiac Event 06/2018
Bilateral VFI 01/2021
Thoracotomy Bilobectomy 01/2022
Bilateral VFI 05/2022
Total Laryngectomy 01/2023
sanmc #170634 09-07-2013 02:06 PM
Joined: Sep 2006
Posts: 8,311
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Sounds like low BP. Have you had that checked recently?


David

Age 58 at Dx, HPV16+ SCC, Stage IV BOT+2 nodes, non smoker, casual drinker, exercise nut, Cisplatin x 3 & concurrent IMRT x 35,(70 Gy), no surgery, no Peg, Tx at Moffitt over Aug 06. Jun 07, back to riding my bike 100 miles a wk. Now doing 12 Spin classes and 60 outdoor miles per wk. Nov 13 completed Hilly Century ride for Cancer, 104 miles, 1st Place in my age group. Apr 2014 & 15, Spun for 9 straight hrs to raise $$ for YMCA's Livestrong Program. Certified Spin Instructor Jun 2014.
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