Anyone have hot flashes after esophagectomy?

Hi @pellaw, I'm tagging fellow members like @survivorsuz @puprluvr @shilpa @rkfeeley @bethm71 @dave640 @naomicanada who have experience with esophagectomy to see if they have had hot flashes after surgery.

According to this article - "Hot flashes and night sweats are common side effects of cancer treatments such as surgery, chemotherapy and radiation therapy. Learn why and how to manage ..."
- Cancer-related hot flashes and night sweats: https://www.cancercenter.com/integrative-care/hot-flashes

I wonder if the hot flashes might be related to something other than surgery. Are you taking any medications like steroids or estrogen-reducing medication?

What you are referring to as ‘hot flashes’ are actually a symptom of dumping syndrome. This type of reaction, for me, happens as a result of pancreatic asynchrony. Because most of my vagus nerve was removed during my surgery, my pancreas does not receive the necessary signals to release insulin at the right time to help me digest carbohydrates, especially sugars. As a result, sometimes there is too much insulin in my blood and I experience severe hypoglycemia. One of the symptoms of hypoglycemia is sudden heavy sweating. Other symptoms I experience are dizziness and nausea, depending on the severity of the ‘attack.’

Whenever this happens, I immediately eat something sweet, followed by some protein. My symptoms usually subside within 10 minutes. In order to avoid dumping, I try to make sure to balance my macros - carbohydrates, proteins, and fats - every time I eat. I also take pancreatic enzymes, prescribed by my doctor, before I eat anything. Those have made a monumental difference in my quality of life and have enabled me to eat almost normally after 9 months post surgery.

This explanation from beach poet above, gives the best explanation of dumping syndrome, which I have experienced myself; not often anymore since I've learned how to eat the foods necessary to avoid it, but also to eat slowly and chew my food thoroughly. I don't take pancreatic enzymes as I do well when following the balanced eating of proteins, carbs and fats and very limited simple carbs(sweets). One of the things I do when I've experienced dumping syndrome is to go for a walk or any activity that gets my body moving. It helps to digest my food quicker.

beachpoet: Thanks very much for sharing this information. I had an esophagectomy in December 2022 and have had several episodes of hot flashes, heavy sweating, light headedness etc.

Can I ask which of your doctors helped with the pancreatic asynchrony diagnosis? I love my oncologist but I get the sense that dealing with this issue is not part of his expertise. I love my surgeon also, but the same story with him. I'm thinking this might be an issue for my PCP or a GI/Endocrinologist. Any advice?

Thanks and be well.

It was actually my dietitian who suggested it, and then my oncologist approved it. Frankly, I found both my oncologist and surgeon to be clueless about this issue. Not uncaring, just ignorant. When I asked for a consult with a gastroenterologist, I was told it was 'unnecessary.' Overall, I got the impression that there is generally very little interest in the effects of vagotomy on EC post-surgical patients, and I've done extensive research on the subject. What I have learned has been from researching medical journals, to which I have wide access, as well as consultations with my PCP, an integrative physician.

You certainly could try consulting with a gastroenterologist and hope to find one with enough intellectual curiosity to have an understanding of your situation, but I finally just asked to be put on Creon (pancreatic enzymes by prescription) to see if it helped and it did, tremendously. I also stopped losing weight when I went on it, probably because it helped with intestinal absorption of nutrients, and, as I said, it helps with my ability to handle sugars.

Another issue that has popped up since my vagotomy is that I find it much more difficult to handle stress, but that's another issue.

Going through the same with my oncologist and surgeon as well or so it seems. I’d like to hear about your stress I’m having problems with nausea, vomiting and uncomfortable; and it it appears to be related to stressful situations and my mind signals my stomach thus the nausea and vomiting. Sick and tired of this literally.