Orthostatic hypotension is kicking my Butt!

[Elode 8,093]

I know this can happen and boy is it happening. I'd say 80% of the time when I stand up my BP drops and I get light headed. I haven't passed out....yet but my vision has gone pretty dark. I'm just wondering how many others have had this as a side effect. It didn't start until around the 8th month post op. I'm 10 months now. It's annoying but I see my surgeon on the 17th so we will have to figure something out. I drink plenty and I eat fine. Anyone else dealing with this madness? I have to remind myself to get up slooooow.

[KeepCalm 223]

I hope you get it figured out, if someone doesn't have an answer on here. I'd really like to know, so I'm prepared. I don't have any normal co-morbidity obese diseases, but I do worry because there is high BP and heart disease that runs in my family... These are the major factors in why I choose to get help with my weight.

[newmebithebypass 713]

I've always had this problem and it gets worse the heavier you are also dramatic weight loss will bring it on. It could go away but if it doesn't then you might need a bp med to help I take sprolaktone

[Elode 8,093]

@ I didn't have any co-morbid's either. This is the only weird thing I have going.

@ I've got my fingers crossed that it will just go away.

[VSGAnn2014 12,992]

I had that when I started losing weight -- for about 4-5 months.

I haven't had it for at least half a year.

It seems weird to me that it would just now start happening.

Let us know what your doc says about it.

[Elode 8,093]

@@VSGAnn2014 Oh good then maybe it will go away. It is weird, and annoying!

[Rebecca Friesen 80]

I'm 8 months out and it's been happening for about 6 weeks. Went to the doctor and got checked up and everything seems fine. I tend to have low blood pressure to start with but it has gotten worse. No answers but I completely understand.

[suitechicguy 105]

It happens to me once and awhile if i get up really fast. I used to have high blood pressure but after losing the weight it seems to be normal now every time I go to the doctors. This never happened to me before though.

[Justme24 69]

That really interesting, because I'm 9 months out, and have been experiencing this for a few week, just sometimes, when I get up too quick. I've never come too close to passing out, but definitely experience a mild case of orthostatic hypotension. I also drink and eat plenty, no problem there.

[Elode 8,093]

@@Rebecca Friesen Wow! I'm not walking out of that office without an answer!

[Elode 8,093]

I've been researching and I found this....Orthostatic Hypotension/Intolerance

One of the possible side effects of rapid weight loss after undergoing weight loss surgery is orthostatic hypotension or orthostatic intolerance. These terms describe a significant drop in blood pressure upon standing from a seated or reclined position. Drip in blood pressure causes a decrease in blood flow to the brain. There are several studies discussing this after RNY gastric bypass and sleeve gastrectomy. However, this can also be an issue post Duodenal Switch. The process is still not completely understood but can be due to several factors. Rapid weight loss, sympathetic nervous system dysfunction, dehydration, electrolyte imbalance, malnutrition, thyroid issues, cardiac issues, post prandial hypotension (blood pressure lowering after meals due to blood flow shifting to the gut) or medications are all suspected as possible causefor orthostatic hypotension.

Symptoms can include dizziness, lightheadedness, nausea, blurry vision, weakness, fatigue, palpitations, headache, exercise intolerance, intermittent confusion and can culminate to passing out. This can be diagnoses with blood pressure monitoring while positioning change, ECG, laboratory studies, echocardiogram, tilt table test and possibly Valsalva maneuver.

There is a direct link between obesity and hypertension. A large number of patients undergoing weight loss surgery are on anti-hypertension medications. Patients need to be followed closely in the hospital and in the rapid weight loss phase post surgery for medication changes and eventually termination of anti-hypertensive medications. Follow up and monitoring with a primary care physician is crucial due to these rapid changes.

Dehydration, anemia, and low Protein intake need close surveillance after weight loss surgery. The patient may require laboratory studies to investigate these causes.

Treatments may include increasing hydration, Protein intake, changing medications and treating anemia. Also, allowing time for the body to adjust to the rapid weight loss if all the underlying issues are within normal limits. If symptoms persist, after all underlying issues are investigated, the patient will need to be diligent with hydration, protein intake, supplements and other treatments. Things that may also help is to slow down in moving from one position to the other, take a moment to adjust to your new position. Compression stocking and increasing salt intake can also help if all other causes are investigated. Post prandial hypotension can be avoided with low carbohydrate and small meals. Also, moderately increasing salt intake can improve symptoms.

Posted by Dr. Ara Keshishian at 9:02 AM

Labels: Duodenal Switch, orthostatic hypotension, weight loss surgery

[Elode 8,093]

@@suitechicguy This is def new for me too. I have passed out before but once was from sticking a toddler that was throwing up charcoal from having her belly Pumped (she got into her brothers seizure medications) and another time when I was holding a patient while she was having a bone tap. Both times I was pregnant so I think it had a lot to do with it.

[Elode 8,093]

@@Justme24 That's how mine started but it worse now. Maybe I am a bit dehydrated from drinking coffee. I will run that theory past my surgeon.

[KeepCalm 223]

Or I could just have read the rest of the posts before commenting

Edited September 9, 2015 by Raenh

[KarenLoh 128]

It's not something to mess around with, that's for sure. My brother had it after his roux n y and he fell and hurt himself pretty badly. Get a fix from your MD.