Vertigo and Folfirinox?

Posted by lisn @lisn, Nov 5, 2023

Has anyone experienced vertigo attacks while undergoing Folfirinox treatment? My husband has been suffering from vertigo since 10/17 which was a week after treatment #3. He had a physical therapy appointment and had the epley maneuver done which took care of the vertigo but he still had some residual dizziness even after doing the vestibular exercises she had prescribed. The vertigo came back a week after treatment #4, he went back to the physical therapist and the epley maneuver did not work. She did another maneuver and he was okay for 2 days but now it's back again, so he will go back to the physical therapist tomorrow and hope for some resolution from it. However, treatment #5 is coming up on Tuesday, and I fear that it will happen again. He mentioned this to the nurse practitioner, and she said that it may be from the chemo being that chemo is a stress to the body. I've been looking into this online and have seen some references to ototoxicity from Platinum based chemo drugs. We definitely will be bringing the vertigo issue up to the oncologist on Tuesday, but I wanted to see if anyone else has had this issue. Thank you.

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I got vertigo AFTER my chemo was done. It literally woke me up in the middle of the night with the bed spinning. I was alone and away on vacation in another country, so when it happened, I did the epley maneuver on my bed with a pillow. As per a simple google search, it explains you may need to do this several times over several days. It worked. And I did need to repeat it again the next day cause I was still pretty dizzy and afraid to jump back on my bicycle. It worked. Be patient. It never returned after these incidents. If you research it, it has to do with crystal in your inner ear. I always remind myself that these things, along with neuropathy, are minor things I need to deal with to be ALIVE !! Thank you chemo !

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My husband has been light headed continually for the last few months from chemo, but has not described it as vertigo. He thought at first it was from blood thinners, but the oncologist and nurses felt more likely from dehydration.

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@sheridanb

My husband has been light headed continually for the last few months from chemo, but has not described it as vertigo. He thought at first it was from blood thinners, but the oncologist and nurses felt more likely from dehydration.

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Four causes of syncope (dizziness) come to mind when I was on Folfirinox treatment.:

Orthostatic hypotension (postural hypotension) is one common cause. It happens after lying or sitting down. It happened to me several times with the worst episode of passing out and hitting the ground. A cardiovascular exam found no issues with cardiac output, BP or occlusions in the arteries.

A second cause is dehydration and this was my most frequent cause, especially when I was on Folfirinox. Post infusion hydration therapy was helpful in stopping it.

Vertigo (Benign Paroxsimal Positional Vertigo-BPPV) also happened when on Folfirinox. It results from crystals of calcium carbonate in a semi-circular canal of the inner ear that break off and float into a different semi-circular canal affecting balance. If diagnosed, there is a procedure done by an occupational therapist making head positional movements to get the crystals back into the middle loop. There are YouTube videos for self-treatment if diagnosed, but I found it just as easy seeing an occupational therapist that resolved the symptoms within minutes.

The fourth cause was occurring from a maintenance drug I take that causes anemia. With a significant decrease in RBC’s, Hgb and HCT parameters, there is less oxygen carrying capacity of RBC’s.I would notice the symptoms doing strenuous activities, getting up suddenly from a lying position or after squatting. That was the clue I needed to take a short break from the medication to give the bone marrow a rest so more RBC’s got produced. When caused by suppression by medication impacting the bone marrow, it took about three weeks to recover. I am aware of onset of symptoms and don’t try to push it to the point I would need a transfusion. Taking pauses every six months of the drug has been effective.

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@stageivsurvivor

Four causes of syncope (dizziness) come to mind when I was on Folfirinox treatment.:

Orthostatic hypotension (postural hypotension) is one common cause. It happens after lying or sitting down. It happened to me several times with the worst episode of passing out and hitting the ground. A cardiovascular exam found no issues with cardiac output, BP or occlusions in the arteries.

A second cause is dehydration and this was my most frequent cause, especially when I was on Folfirinox. Post infusion hydration therapy was helpful in stopping it.

Vertigo (Benign Paroxsimal Positional Vertigo-BPPV) also happened when on Folfirinox. It results from crystals of calcium carbonate in a semi-circular canal of the inner ear that break off and float into a different semi-circular canal affecting balance. If diagnosed, there is a procedure done by an occupational therapist making head positional movements to get the crystals back into the middle loop. There are YouTube videos for self-treatment if diagnosed, but I found it just as easy seeing an occupational therapist that resolved the symptoms within minutes.

The fourth cause was occurring from a maintenance drug I take that causes anemia. With a significant decrease in RBC’s, Hgb and HCT parameters, there is less oxygen carrying capacity of RBC’s.I would notice the symptoms doing strenuous activities, getting up suddenly from a lying position or after squatting. That was the clue I needed to take a short break from the medication to give the bone marrow a rest so more RBC’s got produced. When caused by suppression by medication impacting the bone marrow, it took about three weeks to recover. I am aware of onset of symptoms and don’t try to push it to the point I would need a transfusion. Taking pauses every six months of the drug has been effective.

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Thank you. Yes, my husband passed out once too from standing from a sitting position and walking up the stairs. Luckily he was at the top of the steps when he went down. He's now more careful about going from laying down, sitting up straight, and getting ready to stand and that has helped the fainting. He's been going in for hydration every few days. Just had #12 a week ago, so we'll see next week what the doctor will suggest next... and hopefully this was a folfirinox issue that will be resolved. I appreciate your comprehensive reply!

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