Extreme dizziness. Anyone had this?

Last night I woke up not feeling well (4:00am). I got up to go to the bathroom, took two steps and fell into the wall. I was so dizzy I couldn't walk without holding onto the wall. When I laid back down I was dizzy but it wasn't room spinning dizzy (like being drunk for those of you have been there). Right now, 5 hours later, the dizziness has mostly subsided but I've decided not to go to work even though it is a critical day for me to be there.  I haven't taken my riba. My doctor doesn't get in until 10:00am. I know that dizziness is a normal reaction but there is dizziness and there is falling down, unable to walk dizziness and they don't say what to expect.

Q: Has anyone had a reaction like this? I have a hunch that this may NOT be tx related because I had an episode just like this about 10 to 15 years ago and I wasn't on any treatment. However, I have low blood platelets (88,000) and really feel like garbage this a.m.

[portann]

I wouldn't skip my ribavirin. I'd take it as usual and then talk to my doctor as soon as possible about the dizziness. You should have it checked out by him.

Feeling dizzy for me during tx is somewhat routine. I don't know what it means but I made the decision to live with it and adhere to my meds. So far, I've survived 46 weeks on tx. Although there was a dramatic scene where I lost consciousness in a public place, I keep rolling along. It's hardest at the beginning, when it's a novelty!

[jmjm530]

Of course call your doctor right away. Do you know your current hemoglobin and what it was pre-treatment. A CBC seems in order and the helper drug Procrit if it turns out that the problem is anemia. A sudden drop in blood pressure can also account for the symptons you describe. There could also be other reasons. You haven't given us too many particulars as to what week tx you're in, etc but definitely get it checked out.

-- Jim

[jmjm530]

I  missed the last paragraph, ie that you're week 46. If you're treating 48 weeks then adding Procrit at this point may be academic since it can take 2-4 weeks to kick in. Depending on your stats and tx history, I don't see why you couldn't back off the riba some at this point if things point to anemia being the cause. You should still see the doc to get bp checked and any other tests they may want to run

[portann]

xoxo

[GTBill]

Oops. I'm in my 6th DAY! But this is the third time I've tried TX in the last 13 years. Never had this problem. Don't know about my hemoglobin but I'm scheduled for blood work (CBC etc) every week starting Friday. In 15 minutes I'll call my Doc. Thanks for the input.

[jmjm530]

OK, well, I guess it's me that's dizzy now :) That "46 week" figure was from the tail end of PA's post. So forgot my second post unless you coincidentally are on week 46 :) I do disagree with PA on one point -- if you were "holding the wall dizzy" I don't see any harm skipping the morning riba until you speak to your doc and get checked out. You can always make it up later in the day if you get the green light.

[meakea]

jmjm530

I think GTBill is only in his first week or so of TX

[GTBill]

Oh, I got a little confused there. I was trying to see where I said I was 46 weeks in but it was portann.

[Marc1955]

Reminds me of the time I got up in the middle of the night to go to the bathroom and I passed out on the floor. It was very alarming to my wife needless to say! I came to as she was calling an ambulance.

There's certainly no reason this would not be medication related. There are multiple factors – low blood counts would be my first guess. I agree with the others that I would not skip the Riba. Good luck!

[jmjm530]

If you're on day 6 sounds a little early for anemia to kick in that hard but still convince your doctor you want a CBC right away. Also, make it a point to find out what your pre-treatment hemoglobin was. Good luck.

[GTBill]

I managed to find my last blood workup. Hemoglobin was 14.6 - in the normal range. Blood platelets were 82,000 not 88,000 as I had remembered. Everything else was normal except, of course, AST (SGOT) 71, and ALT (SGPT) 66.

[GTBill]

You passed out on the floor? My wife would have a heart attack! Wow. Did they ever say what it was or was it just attributed to TX?

[chevyelcam79]

I remember when I was tx that I would get dizzy (sometimes real dizzy) due to my hemo being very very low.  I agree call your doc and get your bloodwork checked.  My blood pressure would also drop

Take Care!

[portann]

Bill, I passed out on a stone floor while my husband had his nose buried in a newspaper. He didn't notice I was 'gone' until I came to.

It was likely caused by a sudden big hemoglobin drop or blood pressure drop. I seem to be okay based on my latest labs and tests.

What I'd do is phone the doctor now. (If he told me to skip the ribavirin, I can't swear I'd listen.)

I stick to a 7 AM and 5PM schedule for my ribavirin but there's absolutely no need for this. Ribavirin doesn't have to be taken on a rigorous schedule, as long as you take your full daily dosage per day. So you could wait to talk to your doc, which hopefully you've done by now.  My only concern is if he's not an experienced hepatologist, he may opt for reduction. Some inexperienced doctors undervalue the importance of sticking to your dosage, especially early on.

Sorry if I caused confusion in the thread about my 46 weeks of tx and your 6 days of tx. I bet you wouldn't mind trading places with me!

[Marc1955]

Yeah, I passed out – actually twice – I woke up and passed out again.

I never pursued it. I'd been feeling bad. Not eating much. Clearly I was weakened and I just lost it. Now when I get up in the middle of the night I am careful to make sure I am alert and not too groggy before I try to go to the bathroom. I haven't had a repeat incident. If I pursued every one of these side effects I wouldn't have any time to get any work done at all. I figure some I just need to struggle through with.

BTW, my blood counts have never dropped low enough to require intervention. They are borderline low, but I find that is enough to give me palpitations and shortness of breath.

[Trinity4]

My equilibrium has been off for the last couple of months.  I run into door frames, two step my way across a room sometimes.  I'm a lefty and prone to being klutzy, but nothing like lately.  It's the meds.  Can't imagine if my hgb was low.  I would probably seriously injure myself.

[GreatBird]

When I passed out in the night when I went to the bathroom (many years ago pre-tx) they made me go to a cardiologist and take a tilt-table test. Which I failed. Spectacularly. I've had a pacemaker ever since.

[GTBill]

Portann,

Typical husband I guess. My wife would agree 100%.

OK, called the Doc. BTW he's a hepatologist at Johns Hopkins. They want me to go for blood work today which I will when my son gets home from school (don't trust myself driving and my wife can no longer drive).

Trin, do you drive with your equilibrium being off all the time?

[GTBill]

GreatBird,

What is a tilt-table test? Do they make you go upside down? That would make me sick. I have to stay upright all the time. Any spinning or turning upside down will make me sick for hours. Once, about 15 years ago I went on a super fast roller coaster and I was sick for the rest of the day. Then about 5 years ago tried another (I used to love the darn things) and it had the same effect. Now I'm wondering about this tilt-table thing.

[GreatBird]

I had a history of fainting so that's why I had the test. (Not a lot but I had fainted 4 times in my life and twice in the middle of the night.)

A tilt table test is where they strap you to a table and slowly turn you 90 degrees (so you are standing upright). They make it so you can't adjust your extremities (which affects your blood pressure) and wait to see if you will faint within 30 minutes. I not only fainted (at about 32 minutes) but my heart stopped for 23 seconds. That made them all very panicked. (Such a commotion as I was coming too!) And they won't let you leave a hospital without a pacemaker when that happens. Well, they will, but they'll take away your driving privileges.

You might get a better description on wikipedia. But that was my personal experience.

I'm not suggesting they would want to do that for you for dizziness. I was actually mentioning it to Marc who *had* fainted during the night. Should not ignore that too much.

BTW--if you or anyone else does feel faint, the best thing to do is to lay down.

[GTBill]

GreatBird, just took your advice and checked out tilt table on wikipedia. Since they keep you upright I don't think I would have a problem. Not sure of course but I only seem to have problems going upside down. I have high blood pressure and take 10mg of lisinipril. However, last night I forgot to take it. This morning my wife wanted me to take the pill because I forgot but I thought the opposite. We checked my bp and it was 113/73. pretty low for me since I forgot to take the pill the night before.

[GreatBird]

I heard that tx drugs can affect the blood pressure. Plus if you forgot your pill, that might have caused the dizzy?

[nygirl7]

Plus if you forgot your pill
What PILL is this?  You should be taking SEVERAL ribavirin not a "pill" for the night. Just wanna check that fact.

I started passing out at week 2/3 but it was definitely because my hemoglobin dropped incredibly drastically which in your case it seems too early to be possible.

Do NOT skip your meds - taking every single one of the doses is crucial but skipping one pill will not make you dizzy at ALL as a matter of fact it would be the opposite if anything although it's just too early right now to make a difference if your hemo is 14.6.

Since you've called your doc and are going for blood work I'd say you did 100% the right thing...BUT I don't know but maybe you should check with your cardiologist since you have a pacemaker and your BP is low...that doesn't sounds like a hep docs specialty?

[portann]

115/75 is now considered the ideal pressure with anyone with a family history of CVD.

I'm wondering, though, why you take your lisinopril at bedtime? For many people, that's not advisable and you should check with your doctor or even pharmacist. Your pressure is usually at its lowest overnight with or without medication.

Some people on tx experience lower blood pressure than usual but some have the opposite experience.

It's something you should monitor regularly, in case it becomes erratic. You could head in one direction or the other and require adjusting. My tx nurse never once took my blood pressure reading, assuming my PCP would.

My BP went from normal before tx to 196/ 97 at one point during tx!

I've since been able to get better control with ramipril, except for my diastolic, which is an ongoing puzzle.

Since starting tx, I've quadrupled my ramipril dose to 10 mg but hope I can reduce it once I'm done and increase my exercise. (BTW, 10 mg of lisinopril is equivalent to 2.5 mg of ramipril for HBP dosing.)

The important thing is to monitor your BP because tx may impact it in one direction or the other.

[jmjm530]

It's usually LOW blood pressure that makes you dizzy like that, not high blood pressure -- assuming of course that the dizzy spell was bp related which it may not have been. I just started Hyzaar for bp control that contains a diuretic and almost passed out yesterday after getting up too fast from bed. Not uncommon with diuretics especially in the beginning while the body adjusts.

As to the tilt table test, I would not rush into that unless the doctors think it would be very helpful. A lot of people get quite ill from the test itself.

[portann]

You started yesterday!

You weren't trying to go to the bathroom again when you got up too fast from bed? Diuretics, gotta love them.

BTW, for those with sulpha allergies, do you know most diuretics are sulfanomides?

[jmjm530]

I think I'm on day 3 or 4 of Hyzaar (100Losartan, 12.5 Hydroclorizide) but it was yesterday (day 3 or maybe day 2, who is counting LOL) that I almost passed out. And when I mean almost passed out I don't just mean dizzy (very common getting up fast especially in the beginning) but I had to drop to my knees cause I started to feel myself going out. Actually the bathroom thing with diuretics isn't all that bad for me and actually have been getting up to go to the bathroom at night less. I suppose just more comes out each time. LOL.

[GreatBird]

*I'm* the one with the pacemaker. Not GTBill. Let's not start any rumors here. :)

[nygirl7]

Bird!

Sorry about that - one thing I can't blame on the tx anymore is the lack of live brain cells...it appears I can't even read a thread and keep it in short term long enough to make a cohesive post!

Sorry about that I think it's cause I always think of you as GB that GT is too close! Nah it was just a good rumor!  ;)

[portann]

As you can see, there's an awful lot of near-passing out or passing out going on!

I recommend carpeting for the bathroom, as gross and unsanitary as that is. :)

[chevyelcam79]

John Hopkins?  Would that be Dr. S?  or Sherilyn?  I went to Hopkins also.  Green Spring Station.

My bp dropped several times during treatment.  I just had to take it easy when I felt dizzy.

SHari

[GTBill]

Portann: I take the bp in the evening because it makes me sleepy (I have an hour drive to work). PCP said that is fine as it is supposed to work for 24 hours. Of course, I haven't gone over it with him since I started tx.

GreatBird: Don't think I'm a candidate for the tilt-o-wheel (jk).

Nygirl: I forgot my bp pill. I take 3 ribavirins. BUT, my doc told me to hold off all tx until I get the rushed results back (tomorrow?). Since I've only been on tx for 5 days it doesn't bother me. He's really worried about my platelets being so low. I got the feeling he didn't think I'd make it through tx (although he didn't say that).

Also, for the record, I didn't come anywhere near passing out. Just couldn't walk (and my bedroom is already carpeted as gross as that is). Kinda wish I had a video of it for those days in future when I need a good laugh.

SHari: No, I have Dr. L and Jackie. Cedar Lane

[thegypsy9164]

At week 8ish I started getting real dizzy.  At week 9, I passed smooth out face up in the rain in a restaurant parking lot and discovered a few days later that my RBC was 7.1, which resulted in a blood transfusion.  SEE YOUR DOC!
Joey

[AnotherJourney]

I have had serious dizziness this week which is week 12 for me. Fortunately, I have not passes out but a few times it was so bad walking down the hall at work that I had to stop and lean against the wall. Had my blood work done and everything is like last month (low hgb but only 11.2.) But a new drop for me was a drop in RBC and an increase in RDW. Yesterday my blood pressure was low for me at 115/64 then today it was 140/95.

[GTBill]

Thanks for all the input. I called my doctor and had me get some blood work stat. It's funny because I'm in stage 3 but my only areas (SO FAR, I know it will probably change) out of the normal are low blood platelets (82,000) and the ALT (66) and AST (71). So, I missed 1.5 days of riba but took my second shot on schedule.