hypertensive

I just had lap band surgery and a hiatal hernia repair on Monday, June 30th....I am a 47 y/o female weighing 228 at 5'3...I have never had a problem with my BP until after surgery...since surgery my BP has been anywhere from 158/99 lowest to 160;112,, and just standing up I become tachycardic 109 highest...running 98 lowest sitting down...l am having some headaches and of course good ole gas pains under my diaphram secondary to the carbon dioxide they injected in my abdomen during surgery.....I have no other problems other than herniated c5-c6 and occipital/trigeminal neuralgia and have been on neurontin for 6 months....I am concerned...why am I hypertensive...I first thought it was because I was having pain but I took pain med and BP really doesn't come down much....I am not really in any pain just the gas pains occasionally and I am walking but I am afraid to do too much because of my BP...Could the CO2 be compressing some of my vessels causing me to  be hypertensive?

[Lee Kirksey, MD]

Hello
How are you and how do you feel? Anytime there is a surgery question, I always suggest beginning with a call to the surgeon performing the procedure. Each surgery is unique and there maybe some fact that enlightens you. There is no common reason for hypertension to be associated with laparoscopic surgery in the post operative period. Also the finding of tachycardia is concerning. In the postoperative period, tachycardia can have numerous causes but some of the concerning are deep venous thrombosis and pulmonary embolus, as well as infection. Needless to say, a prompt call to your doc should help with sorting things out. Good luck

[kimberly1234]

Dr. Kirksey,

Thank you for your response.  I am an RN as well...Many years...I did call my Dr. and he said I should f/u with an internist..My internist says I should call the surgeon.  I went back to the surgeons office and they did a swallow test on me and it looked good.  I am still having elevated BP when walking short distances and my heart rate is still running around 102-118 now at rest.  When getting up and ambulating a short distance it may get up to 120-128 the highest I have seen.  I am having mid back pain as earlier, no SOB, no swelling in extremities, No fever. I had an EKG and it showed ST 112 with no ectopies.. I had labs drawn and my lab work looked fine.. I can't figure out why I am running an elevated heart rate even at rest...Do you have any suggestions...I am now 9 days post op my lap with repair of my hiatal hernia and a lap band placed.  What would you do if I were your patient?  What in your opinion could be causing this?

[Lee Kirksey, MD]

Hello
As a surgeon, we're always concerned about changes in physiology that we create either locally/anatomically or in a change of the body's normal physiology. Since Im not familiar with all of the tecnical details of lap banding, Im not familiar with former for this procedure. My concerns for tachycardia are related to DVT and PE and pericarditis, both of which can cause tachycardia, sob and back pain. I would at least obtain an ultrasound for dvt and consider an echo