Orthostatic hypotension

Posted by ajh5285 @ajh5285, Apr 22 10:38pm

Back again with several new questions based on the observation by my brother that a number of my current complaints sound as if they are related to orthostatic hypotension.
Diagnosed about September 2022 with inoperable pancreatic adenocarcinoma (then aged 73), since then I've developed "chemo feet" and balance issues which I have passed off as originating in spending too much time lying down. On weekends following a Chemotherapy infusion (Abraxane & Gemcitabine) I become more aware of lightheadedness, often occurring when I first stand up from lying around "taking it easy" to recover, or standing up after sitting up to eat in a chair that fits me properly.

After reading this review from a reputable source
I have several questions that I'd welcome comments related to the following
(1) are some of the symptoms I'm currently attributing to "chemo feet" caused by orthostatic hypotension? if so, does that advance the cause at all, in determining appropriate therapy?
(2) hydration: there is little doubt in my mind that I'm not getting enough fluids on board, although I do agree that in a normal person (and have to add now, I think, younger) individual, thirst is most likely an adequate guide to drinking enough
(3) Can potassium replace sodium? given that my current oncologist would like me to reduce my sodium intake (I do not typically add salt except to a daily meal of organic mixed veggies which does need some "salt" to bring out the flavor; I've recently switched to a commercial blend of half sodium and half potassium – don't remember the name of the product purchased by my husband). IIRC this is to address what my doc has assessed as venous insufficiency affecting my left leg where I have an old pinned fracture of the ankle; I don't particularly notice anything similar with my right leg where what is obvious is wasting of muscles and subcutaneous tissues
(4) I've been propping my feet up at night, again (IIRC) to address the supposed venous insufficiency happening in my left leg, when maybe I should be propping up my head. Since I've never really been comfortable sleeping on my back and have slept on my side as long as I remember, should I still be elevating my head?

Possibly this question belongs in a different group.

Interested in more discussions like this? Go to the Pancreatic Cancer Support Group.

Have you done orthostatic blood pressure checks? Lying, sitting, and standing blood pressures. After my first round of Folfirinox, I landed in the hospital. My blood pressure was low, even after lots of hydration. I stopped the irenotecan and I have continued to do well with a response without it. I saw a cardiologist with an interest in effects of chemotherapy on the heart, and my heart was fine. I am off blood pressure medication.


Thanks for the suggestion. I haven't and since I don't have a blood pressure cuff at home, it will have to wait till my next medical visit on May 5th.


Thanks for the suggestion. I haven't and since I don't have a blood pressure cuff at home, it will have to wait till my next medical visit on May 5th.

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Good blood pressure machines are available without a prescription. Check for the ratings and see which one you would like. Doesn't require two people, the machines are designed for a patient to use by themselves. You can check on the accuracy by taking your own machine with you when you go to the doctor's office


@ajh5285, you may be interested in this discussion about orthostatic hypotension in the Heart & Blood Health group on Connect:

– Postural orthostatic hypotension: How is it treated? https://connect.mayoclinic.org/discussion/postural-orthostatic-hypotension/

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