Posted By: roma Please Advice Low Blood Pressure - 02-25-2011 09:30 PM
Hi Every one.
My husband is in the recovery stage currently.
I have 2 concerns:

1. His Blood Pressure has been going low this whole month. He is is drinking atleast 4-5 glasses of water and taking about 4 cans through G Tube.
2. His tongue is still hurting it has been almost 2 months he finished radiation and chemo.

Please advice has any one experienced Low BP . Should i take him to emergency?

Thanks
Posted By: Gary Re: Please Advice Low Blood Pressure - 02-25-2011 09:42 PM
My blood pressure (aka hypotension) has been so low lately that I have dizzy spells a lot. I googled it and it doesn't appear to be a problem as it occurs when I am standing up. It can be caused by various things. As far as emergency goes, if it clears up within minutes then he is probably alright. It is fairly common when going from lying down to standing.

Defintely mention it to the oncologist.

see: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0004536
Posted By: roma Re: Please Advice Low Blood Pressure - 02-25-2011 09:50 PM
Thanks Gary

I did call the hospital but the Oncologist had left for the day. Nurse adviced to take him to the nearest emergency. But he is unwilling to go to the emergency.
The Blood Pressure has been dropping this whole month. Even he gets dizzy also.

Posted By: roma Re: Please Advice Low Blood Pressure - 02-25-2011 10:05 PM
Is there a home remedy for upping Low Blood Pressure?
Posted By: EricS Re: Please Advice Low Blood Pressure - 02-25-2011 10:21 PM
If your husband is on opiate pain medications, they will cause low bp as they depress the central nervous system which slows the cardiovascular system. The big reason you shouldn't drink alcohol when you're on an opiate. Fentanyl is notorious for it as is hydro.

A great way to monitor it is just to pinch the tip of your finger and watch how fast the color returns to it. IF he is on the fentanyl patch, watch where you place it and never put it in an area that gets direct heat by showering/bathing or when he sits or lays down. They are heat activated and a raise in body temp will release more medication into his blood stream. One of the signs of this is dramatic decrease in blood pressure and could be an early sign of an overdose.

A great way to monitor this is by asking him if his extremities are cold and by pinching the end of the finger and seeing how long it takes for the color to return (capillary refill test). If his lips are blue, or his hands and feet are bluish...it's a good idea to take him to the ER. If not and it's just dizziness...just keep an eye on it.

I had the same issues when I was on fentanyl and it put me in the ER several times due to where I was placing my patches.

Hope that helps

Eric
Posted By: EricS Re: Please Advice Low Blood Pressure - 02-25-2011 10:29 PM
Oh and most home remedies would involve keeping him warm (remember the body heat thing) which is fine as long as there is no direct heat on a fentanyl patch or involve drinking or adding ginger to tea. Eating hot sauce will also do it do to the capsacin (sp?) but I know I still can't do any and I'm almost 3 years out of tx.

Ginger is a natural blood thinner...DON'T try this unless you speak to your oncologist first and get the OK. With any home remedies you really need to speak to your MO first before you try any. Remember drug interactions and the effects of what's happening to your husbands body needs to be monitored by a trained professional as you could easily cause him harm.
Posted By: ChristineB Re: Please Advice Low Blood Pressure - 02-25-2011 11:46 PM
Is your husband eating as well as taking in 4 cans of formula daily? That isnt enough calories to sustain him while he is in recovery mode. He should be having 2500 - 3000 calories to heal. His body is burning up calories faster than he is taking them in. Its working overtime trying to heal. How low is his blood pressure? Some people just run low. While weight loss can cause low blood pressure as well as taking pain meds.

I walk around with mine being usually running 98 over 56 and Im ok. Once in a while I get a bit dizzy, but overall Im pretty healthy. A couple years ago while I was doing my 2 month hospital stay, my blood pressure would drop to 78 over 38. I scared the nurses to death, they would wake me up at night to make sure I was ok.

Posted By: roma Re: Please Advice Low Blood Pressure - 02-26-2011 12:56 AM
Thank you Eric and Christine.
No he is not on fentanly patch any more. He is only taking Hydromorphone. Eric how many seconds should the colour return on finger test. Please advice.

I am surprised from past 3 months he was on fentanly patch and hydromorphone but his blood pressure was okay. Only this month it has been low.
Christine his blood pressure is around 88/ 48 . No he is not eating enough solids. He is more on 4-5 glasses of soup, water, juice plus 4 cans of Nutren 1.5.
He gets nauseated after 4 cans. Although he is also taking anti nausea pill.

Do people get low blood pressure generally during recovery ?

Thanks to both of you for your replies smile
Posted By: ChristineB Re: Please Advice Low Blood Pressure - 02-26-2011 02:21 AM
Yes, his blood pressure is very low. What does his normal blood pressure run, before the cancer? If it goes any lower then you should have it checked.

It is probably from the hydromorphone. Low blood pressure can also be from weight loss. If all he is taking in is soup, juice and 4 cans of nutren that is not enough. He is doing good with the hydration. How many calories per can of nutren? He must have minimum of 2500 calories daily to help his body recover. Over 3000 is even better!

I would drink chocolate peanut butter milkshakes that had over 2000 calories per shake and some days I would drink 3 shakes plus do my formula so I had 7000 calories. I never gained an ounce from that either.

I would call his doc on Monday and let them know about the low blood pressure. In the meantime, push those calories. Its Shamrock shake season, Im sure those are loaded with calories.
Posted By: EricS Re: Please Advice Low Blood Pressure - 02-26-2011 02:48 AM
Yeah he's what's considered "borderline low" blood pressure right now and my guess is it's from a combination of things. The hydromorphone being the main issue and my thought is probably dehydration...not due to lack of water but more to lack of electrolytes that would normally come from nutrition. So it's more then likely nutrition based.

Sodium and potassium deficiencies more then likely, which are easy to get. I'd start pumping him full of gatorade or powerade, you can also get potasium via supplements...those are a tricky thing too so before you supplement with pills ask your dr, but start immediately with gatorade or powerade.

As far as the finger test goes...don't worry about that if you can take his bp. If his bp get's to the 60/40 range take him to the ER.

Please note, I'm not a medical professional so please touch base with his Dr but monitor his BP and if it falls in the danger zone (60/40) take him to the ER.

Keep your chin up

Eric
Posted By: Gary Re: Please Advice Low Blood Pressure - 02-27-2011 08:41 AM
I am almost 8 years post Tx and have dizzy spells, quite often, when I go from laying down or sitting to standing. I have checked my BP freqently, when this happens, it drops considerably. This kind of issue is fairly normal but could be symptomatic of other medical conditions, such as diabetes, so you should discuss this with your doctor, just to rule those out.

Since Tx, my BP has been all over the map, as high as 170/119 to 63/49. My doctors don't seem very concerned (except for the high BP- they ordered me to repeat the BP test at their office).
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