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Dizziness/headache lying down or sitting up....

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slipkid

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Anyone have experience with this post-surgery and have clues as to what it might be?

Starting about 3 weeks ago (roughly 3 months post-CABG & AVR) when I lie down flat on my back I feel dizzy, like either the room, the bed, or me, is moving, even though nothing actually is. At the same time I get a moderate headache. This lasts about 10-15 seconds then stops. Then after I stabilize when I sit up it happens again for about 10-15 seconds or so. I have to wait for it to stop before I can walk around safely.

When this first started I only got it lying down. Then it started when sitting up some of the time. Now it does it sitting up ALL of the time in addition to when I lie down flat.

The dizziness is not of the vertigo variety. I've had that in the past, years ago, an inner ear type thing, where everything spins around visually in front of me, and that was triggered mostly by rolling over on my side. With what I have now there is no, or only very slight if any visual disturbance, it is just a horrible feeling of dizziness, falling, moving, weirdness.

I mentioned this to the cardiologist and his knee-jerk reaction was to cut my dose of Atenolol in half (I was only on 25mg, and am now on 12.5mg/day). However this has had no effect on my dizziness - in fact it has gotten worse since the dosage was lowered. I do not believe this is anything to do with blood pressure per se, but I could be wrong.

The cardiologist did not check my BP at all either lying or sitting up to see if my BP was too low, and I mentioned this to someone in physical therapy (I am getting PT on my shoulder & I get very dizzy there lying down/sitting up while they work on me), that I would like to know my BP while this is going on, so they measured it both ways (lying down then sitting up) while I was dizzy and both times the BP seems OK (about 100/60something and 110/60 something).

My BP seems on the low side btw, although within "normal" limits. For some odd reason, when they check my resting BP in cardiac rehab before working out I am always around 95/55 by their count, yet when checked anywhere else (doctor's offices) they always say I am around 110ish/60-ish.
 

Paleowoman

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Hi Skipkid,

I've no experience of dizziness per se, but when I get an epidsode of double vision I certainly feel like I'm going to fall over. I've only got this double vision since surgery - I also get other visual disturbances, all started a couple of days afte surgery and I'm still getting them seven months on. I had thought originally they were due to beta blockers, like you I was on 25mg Atenolol which my cardiologist halved to 12.5mg, but that made no difference and I've been off Atenolol since April now. I know you write you have no visual problems but you get a headache and the visual problems I, and some others get appaer to be migraine auras - in this thread I copied a link to a thread on the previous forum in which people discussing migraines with and without headaches. It might be something you want to look into as these things appear to be something many valvers get after surgery: http://www.valvereplacement.org/for...problems-following-cardiac-surgery#post845964 - there's a link in the first post to the bigger one.
 

Duffey

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I don't have any experience with what you're experiencing, but I would contact my family doctor since the cardiologist doesn't seem to know what's going on. I would be concerned about the accompanying pain with the dizziness.
 

slipkid

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Thanks. I did also mention the dizziness to the GP's office during a phone call but they did not follow up on it. The accompanying pain in my head is kind of new though - it is kind of like a pressure at the top my skull that accompanies the dizziness. I don't think I mentioned that to them but I don't recall. I kind of have a dull headache like that quite often now anyways, even without the dizziness.

As far as migraines go, post surgery I have had a huge increase in the number of migraines that I get. I get the kind with the aura's btw (multi-colored shimmering zwiggly lines that last about 20-30 minutes, followed by a dull headachy or just overall feeling of feeling kind of dazed/lousy; I don't get a bad headache, sometimes just a dull one, usually in my forehead over my right eye).

The number of migraines post-surgery that I am having has gone steadily down thank God though. During the month of May I counted 28 migraine episodes that I know of (I say "that I know of" because sometimes I get migrainces while I am asleep and am not aware of it - I know this because there have been times I have awoken from sleep & see the lines already in full bloom, and it is likely I have had some that I just slept through).

The migraine behavior that I get, which I have had for the past 30+ years btw, starts slow with my realizing I cannot quite see right, as if I had stared into a bright light and there is a gap in my vision. That progresses over the next 5 minutes with the gap taking on a small shimmering shape, which then over the next 20 minutes or so grows into either singular or multiple large shimmering squiggly lines.

Prior to my surgery I might have around, I dunno, anywhere from only 3 or 4 to maybe about a dozen migraines spread out over an entire year; some years are better/worse than others. This month so far I have had 5 (that I know of). If I stay at 5 this month that is a hell of a lot better than 28 though!
 

Guyswell

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About 2 years after my first surgery, I experienced a very slow heart rate (bradycardia). There was no headache involved but I would sometimes get intensely dizzy and have to lie down immediately for fear of passing out. One time, I was lying in bed watching TV when this occurred. I passed out (syncope) and when I awoke a short time later, my daughter said I had been snoring with my eyes open. I went to the ER that night and received a pacemaker within two days.

When you have valve replacement surgery, the cutting and stitching is done very close to the AV node - part of the heart's electrical control system. It's not that rare to develop heart rhythm issues after surgery. When your cardiologist reduced your dose of Atenolol, that's because it (and other varieties of beta blockers) are known to slow your heart rate down. In your situation, you should go back to your cardiologist and ask for additional follow-up to make sure you do not have bardycardia or blood pressure that's too low. Even though you've measured it in other settings and found it to be fine, blood pressure can vary a lot and can drop suddenly when getting up from a sitting position or when getting out of bed.

I'm no doctor, but my guess is that your symptoms are related to low blood pressure or slow heart rate. Insist on appropriate follow-up to make sure the problem is addressed before you fall and hit your head.
 

river-wear

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What you're describing sounds very much like when I had benign paroxysmal vertigo a few years ago. It's caused by a small crystal in your inner ear and is triggered by movement, such as laying down. I didn't have any visual involvement, but it felt like the bed would spin. The fact that you get dizzy when you lay down (not just getting up) makes it seem more like BPV than a BP issue.
http://www.mayoclinic.org/diseases-conditions/vertigo/basics/definition/con-20028216

Mine wasn't too bad most of the time, so I just waited it out and it went away on its own in 2-3 months. The treatment for it can be a bit unpleasant because it induces extreme nausea. A good ENT doctor can give you a diagnosis. I've also heard of some people being successfully treated for this by a chiropractor.
 

Tejumurthy

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Hi,
I'm 36 year old, waiting for my AVR on Sept 18th.

Interestingly even i'm getting the same kind of dizziness and symptoms you mentioned since from last few weeks.

Unfortunately i do not have answer for your symptoms and seeking help from others if anyone come across.

Appreciate anyone inputs here :)
 

slipkid

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Guyswell;n846112 said:
I'm no doctor, but my guess is that your symptoms are related to low blood pressure or slow heart rate. Insist on appropriate follow-up to make sure the problem is addressed before you fall and hit your head.
Thanks. Unfortunately the cardiologist's office makes it kind of hard to bring things up, their default attitude with me is always "there is nothing wrong, why are you bothering us with this, you are fine and doing great, see us in 6 months for a checkup". I'm not going back to them with this to be made to feel like a time wasting fool again....
 

slipkid

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river-wear;n846205 said:
What you're describing sounds very much like when I had benign paroxysmal vertigo a few years ago. It's caused by a small crystal in your inner ear and is triggered by movement, such as laying down. I didn't have any visual involvement, but it felt like the bed would spin. The fact that you get dizzy when you lay down (not just getting up) makes it seem more like BPV than a BP issue.
http://www.mayoclinic.org/diseases-conditions/vertigo/basics/definition/con-20028216

Mine wasn't too bad most of the time, so I just waited it out and it went away on its own in 2-3 months. The treatment for it can be a bit unpleasant because it induces extreme nausea. A good ENT doctor can give you a diagnosis. I've also heard of some people being successfully treated for this by a chiropractor.
Yeah, could be that, I have had a long history with vertigo (some very serious and disabling, twice so bad it was vomit inducing & incapacitating and would last a very long time) and also something that was called "benign positional vertigo" (I would only get it if rolling over).....long stories I won't bore you with other than to say I was seen by multiple doctors back then, including Ear/Nose/Throat, meniere's disease was a possiblity but ruled out. Eventually in all cases it just cleared up, although I did have exercises to do that were supposed to allow "substances" in my inner ear to get out of there, maybe that helped, I dunno.

Actually an interesting story - I used to get the "benign positional vertigo" type like clockwork every Fall, starting around September and lasting around 4-6 months then going away. It only affected me if I rolled over on my side, either way. So I learned to stay still in bed, just lay flat. This went on for about 10 years or so, in my 20's. Anyways, during one of these periods, I got into a car accident, was hit head-on by another car, and not wearing a seatbelt I was propelled into the windshield (although I have no memory of the accident at all btw). I was knocked out, had a concussion, hospitalized briefly with (mostly) minor injuries, was lucky. But something very positive emerged from that accident, in that to my amazement, the vertigo that I had been suffering from all month, had been "knocked out of me".

It has been at least 10-15 years since I had any of that though, and what I feel now is a bit different. With the types I've had before, with both kinds that I had, it always included distinct visual spinning, everything in my vision would spin (counterclockwise if I remember correctly). What I have now I see no spinning, and don't feel like I'm spinning per se - it's more like I feel very unstable, like the bed (or the physical therapy table) beneath me is moving, even though it isn't. And my head kind of hurts/feels weird. Hard to explain.
 

slipkid

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Guyswell;n846112 said:
I'm no doctor, but my guess is that your symptoms are related to low blood pressure or slow heart rate.
Thanks again, made me think of something else.

I have a heartrate/pulsox finger device thing. I can measure my heartrate any time I want. Usually at rest I am in the 50's/60's btw. I have been told this is good. I will see if it drops lower (or behaves strangely) when I lie down flat or sit back up, when I feel weird. I think I said above that I had my BP checked when I was experiencing this (in physical therapy) and that looked OK. I didn't check my HR though.
 

slipkid

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Tejumurthy;n846207 said:
Hi,
I'm 36 year old, waiting for my AVR on Sept 18th.

Interestingly even i'm getting the same kind of dizziness and symptoms you mentioned since from last few weeks.

Unfortunately i do not have answer for your symptoms and seeking help from others if anyone come across.

Appreciate anyone inputs here :)
Just wanted to say good luck with your AVR. Don't worry about the upcoming procedure; it may sound scary but we all made it OK and so should you; your youth I think should even help you recover faster than most of us. Read threads up here & ask anything on your mind, there is a lot of good info up here.
 

Julian

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Always consult with your medical team about any health concerns. I'm 3 years post op and still experience mild visual disturbances and dizziness , very mild. The first two years after surgery for me was full of little strange disturbances. Now in the third year I can say I'm completely back to "normal". I'll go as far as saying I feel like I'm 21 again except I'm 31. For you it could be medication conflicts or body SLOWLY adjusting itself like mine did. Recovery after surgery for me involved a lot of physical, mental, and spiritual healing. Still your symptoms could be something serious and that's why consulting with your physician is strongly suggested.
 

slipkid

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Thanks. I haven't updated this thread....will do so now...

My dizziness has gotten worse. I do notice some visual component of it now - not horrible spinning like I used to have when diagnosed with BPPV years ago but I can definitely see "shifting" with what is front of me. And my balance is way off when this is going on, I can't walk straight.

I went to the Dr. on Tuesday to discuss this. He thinks it is BPPV and based on some head manipulations he did (a "Dix-Hallpike" test) he thinks the problem is rooted in my right ear. So he performed the "Eply maneuver" on me, using the right ear positioning method, to try to get the inner ear debris out of there. Told me to keep head elevated (not lie down, nothing greater than a 45 degree angle) for a day. It seemed to help the next day. But now is as bad as before again (actually worse). I had a catscan on Thursday and got really really dizzy getting up afterwards. Took me a while to feel well enough to stand/walk. Had similar problem at Physical Therapy yesterday too. If this is inner ear problem then from what I have researched I need to have the eply done more times, it is not always successful just done once. Am going to try it at home following directions for it I have printed out off the 'net. I also did these years ago so it is not completely unfamiliar to me.
 

Paleowoman

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Julian;n846620 said:
Recovery after surgery for me involved a lot of physical, mental, and spiritual healing.
Hi Julian, I don't want to hijack this thread so I tried to send you a private message but this 'new' forum doesn't seem to work too well so don't know if you got my message. I was very interested in what you wrote above. I'm wondering if you have a mo (and if you feel inclined) if you could write a bit in a thread about your recovery - I think it would interest those of us who sometimes struggle a bit.
 
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