It’s called orthostatic hypotension

It’s another of those fun things that many senior citizens have to put up with, but it’s only become a notable problem for me in the last few weeks. The medical term for it is orthostatic hypotension. It’s that dizzy feeling you sometimes get when you stand up after sitting or lying down for a while.

Throughout my life, on occasion, I’ve experienced it. Most people do at one time or another. I can remember it happening as long ago as high school, when I’d jump up suddenly to cheer for a touchdown or something. But in the last few weeks it’s been occurring much more often and can take a minute or two to subside — while I either carry on, a bit unsteadily, or hold up a wall until my head clears. Makes me think twice and act a lot more cautiously when I remember all the warnings about seniors falling. And yes, it does occur more frequently in the elderly. (I, of course, am not yet “elderly.”)

When I talked to the pulmonologist yesterday about adjusting some of my meds, I asked her whether the hypotension could be related. After some discussion of blood pressures and heart rates (which I’d been carefully noting for several days), she decided it was most likely the result of mild dehydration, probably exacerbated by the diuretic my primary care physician prescribed some years ago. It seemed the tell for her was that while my BP (roughly 115/75) didn’t change notably on standing, my heart rate jumped more than 20 bpm, to 111.

She suggested I cut back on or eliminate the diuretic, and remember to tell my PCP about it. So from today forward, no more diuretic. Also, a concerted effort to drink more. And as always, a vow to try to get into better physical condition overall. I’m hoping to see some quick improvement. Frequent dizziness when I stand up is not acceptable. It’s annoying, inconvenient, and worse, potentially dangerous.

Note: Feb. 4 — I didn’t think to mention to the doctor that for several weeks I’ve been waking with very puffy eyelids. So puffy that it actually interferes with my vision for an hour or two. I’d attributed it to fluid retention caused by prednisone. A little research this morning found that dehydration is also a cause. It seems when you get dehydrated, your body starts trying to retain fluid, and your eyelids are one of the first places to show it. Poor eyelids. Both too little and too much fluid can make them puffy.

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10 thoughts on “It’s called orthostatic hypotension

  1. Jim Wheeler Thursday, February 04, 2016 / 7:40 am MDT

    Mollie and I have found that heart rate and blood pressure are separate things. Her problem with the dizziness, spells lasting several hours, was resolved by getting a pacemaker. No more “spells”.

    Stuff changes as you age and when it does you can’t help but feel a little outraged. “But I’ve always had low blood pressure!” (That’s me.) How can it be spiking? (Turns out, it was mainly psychosomatic.) Welcome to the world of change. And of aging, young lady. 🙂

    • PiedType Thursday, February 04, 2016 / 9:35 am MDT

      The fun never ends, does it? I do hope the current situation is temporary, or that it will at least occur less frequently. Everything points to dehydration as the problem. You’ll recall I also had a problem with dehydration last summer and ended up in the hospital. Looks like something I’ll be constantly monitoring from now on, since it’s common in us old folks and probably exacerbated by Denver’s very dry climate.

  2. Margie Thursday, February 04, 2016 / 9:51 am MDT

    I agree – aging adds challenges!
    I suddenly had big time dizzy problems a few months ago, but mine were worst (worse ?) when I was lying down. I was diagnosed with ‘Paroxysmal Positional Vertigo’. Fortunately, two trips to a physio clinic and the loose particles within my inner ear were back where they should be and the vertigo was gone!

    • PiedType Thursday, February 04, 2016 / 10:04 am MDT

      Dizziness while lying down would certainly get my attention; I expect to be “safe” when lying down. Must have been a huge relief for you when there was a fix for your vertigo.

  3. philosophermouseofthehedge Thursday, February 04, 2016 / 2:41 pm MDT

    Thirsty creates puffy? Who knew?
    I started drinking much more water a few years ago (got sick and taking some medicine that required a lot of water intake) and now try to have water within reach until 8 pm or so. Found out extra water eliminated almost all of my severe headaches that I’ve had all my life. Apparently I was also mistaking needing water for being hungry,too, so now when craving a snack I grab water first ( most of the time HA HA). Water and walking seem to be critical as we age.
    I also have developed “White Coat Syndrome” which means now my blood pressure ( which has always been low all my life) gets crazy high at Dr offices.) And is normal or low when checked any other location. It’s stress and fear of medicine! HA HA

    • PiedType Thursday, February 04, 2016 / 5:35 pm MDT

      Sure surprised me. I always thought puffy meant too much fluid. Who knew it could also mean just the opposite. I usually have a bottle of Powerade Zero at hand all the time when at home, but I guess I need to actually drink from it for it to do any good. And most certainly I should drink before reaching for a snack, which I do all too often.

      I’ve never had White Coat Syndrome. I guess I’ve been around doctors all my life and they don’t scare me (I’m thinking if I didn’t develop it this last year, I probably never will). If my BP is up for them, it’s usually because I just came rushing in at the last minute, afraid of being late (I always stress about being late). But I do have a good BP cuff at home so I can keep tabs on things and report anything unusual to the doctor. Came in handy when I had those readings for the pulmonologist.

      • philosophermouseofthehedge Thursday, February 04, 2016 / 8:13 pm MDT

        The home readings are a lifesaver. I developed WCS a few years ago – after doc started trying to shove “preventative” meds that I was really not in the range for, but had some family history. The “preventative meds” made me so sick I went back and told him I’d take my chances without them. It’s an old much tested drug, but I always seem to react in the worst possible way to most drugs. Since then, I’m always worried I’ll have to fight that battle again. Stress…and then there’s the traffic to get there.
        Oh, check the sodium content of Gatorade/Powerade type liquids? At this point I try to opt for real sugar over imitations. I do miss Dr Peppers which I used to drink daily. It took getting really sick to get me to drink water. Heard carbonation is supposed to be bad as you get older, too Sigh. Unfair all the fun stuff seems to be off limits – or at least reduced in use. But happy note is those little tiny Dr Pepper bottles are great once in a while – we can get the real sugar ones here.

        • PiedType Thursday, February 04, 2016 / 10:55 pm MDT

          I’m 90% convinced the diuretic doctors keep prescribing for me is more preventative than anything else. It was originally prescribed 20-30 years ago (!) and every doctor since then has continued it because obviously the previous doctor must have had a reason … I think they justify it because I complain of occasional puffiness. Gonna be a discussion about that next time I see my PCP.

          The Powerade I drink has 150 mg sodium in a 1 qt bottle, which lasts me most of a day (and apparently that’s not enough). At the moment, trying to avoid dehydration, sodium is probably a plus. Plus it helps with electrolyte replacement. Recommended by my docs and others when dehydration is a problem. I just like it because it’s calorie- and caffeine-free.

        • philosophermouseofthehedge Friday, February 05, 2016 / 6:56 am MDT

          Actually we load up the pantry on that when it’s on sale as husband drinks it for the same reasons. And the same concerns with diuretics which are good news and bad news. Discussions are good! Hope it’s back to CO sunny there.

"You don’t have to say everything to say something." ~Beth Moore

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