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low BP after chemo infusions ??

RainbowRita's picture
RainbowRita
Posts: 49
Joined: May 2021

As I mentioned in my earlier post, I had my chemo infusion a week ago today. Did pretty well in regards to side effects until yesterday around noon when I had an "episode" where I think I was close to passing out. I had the same thing happen on day 8 after my 3rd cycle of chemo. Ended up in the ED that day because I also had a temp, albeit for just a short while. That time I was a lot more shaky and for a longer time. I was also quite pale and my breathing was fast. Lactic acid was also elevated. Because they were concerned about septic shock I was admitted and a bunch of tests were run.  Fortunately, they ruled out septic shock. Put me on IV fluids, which helped. I was hypotensive and bradycardic while at the ED and at my follow up appointment a week later my PCP suggested I get a BP monitor, so I could keep closer tabs if something like that happens again. So I did as she suggested.

So yesterday when I suddenly felt light-headed and dizzy and the lights seem to flicker, just like that other time, I checked my BP. It was 98/66 and my pulse was 109.  Later BP readings yesterday were even lower 88/56, pulse 122 at 4:00 pm, for example. My BP with that monitor and also at the Dr. appointments is usually around 125/80, never below 120 except for the time when I was the ED after infusion #3. Then it was upper 80’s over upper 40’s, pulse about the same, around 110-120. Even though I didn’t feel as shaky yesterday as the first time it happened, I called my oncologist’s clinic number, left a message and a nurse called me back a few hours later. She said that they don’t normally send people to the ED unless their BP is under 80/60. She thought I was dehydrated and told me to drink more fluids, which I did. My BP stayed about the same for the rest of the day and my heart rate never really dropped much, stayed around 120 until I went to bed. Fortunately this morning things had improved in that regard. Pulse now around 90, so that was good news. BP around 100/65 most readings today. Fortunately I feel OK, just tired, but no light-headedness.

My question for all of you is: Do you experience similar symptoms about a week after an infusion? I don’t think just dehydration was the issue. I am thinking that the chemo or it being nadir (low point in blood counts after chemo) was the real reason for the low BP. So the next time I’m going to expect to have this happen again and take it easy on those days so that I don’t push myself into one of these “episodes” again. My WBC and RBC and lymphocytes were all flagged as low on the day of the infusion, so I’m sure they are even lower now. I am thinking that the low red blood cells might be the reason for the weakness and low BP. I normally take two different medications for high blood pressure, but hadn’t taken either one yesterday, so definitely can’t blame the medication for the change.

MAbound
Posts: 1153
Joined: Jun 2016

It can't be overemphasized how important it is to drink about 2 liters of water a day during chemo. It's more than a lot of us are used to, but it plays a big role in getting us through it all. Low blood pressure from inadequate hydration could be a sign that you are having trouble keeping up with that (it is a chore) and maybe it would help if you have someone in charge of keeping an eye on how much you are drinking and pushing you a bit on those days when you are too exhausted to do it for yourself. I know it sure helped me to have my husband nagging me about it because I was usually more of a 3-4 cup a day person prior to going through treatment. Chemo drugs are potent drugs and while they are healing they are also hard to handle. Water helps more than you'd think.

alicia2020
Posts: 162
Joined: Sep 2020

and at about 7-8 days after infusion. I know the symptoms and took my blood pressure..I don't remember numbers, but it was low..probably about like yours. It didn't happen after any other rounds.

Funny, MAbound talking about her husband nagging her cuz mine did the same thing! I'm not normally a big drinker if anything...sodas or even tea, and I hate water! I just have to force myself to drink it!

I hope it gets better and I'm glad you were at least a little better today.

RainbowRita's picture
RainbowRita
Posts: 49
Joined: May 2021

So appears the nurse was right then about the dehydration. I had diarrhea the night before and didn’t drink a lot that morning, so it certainly didn’t help matters. I’ll have to try harder to drink more fluids.

As far as having someone around to nag me to drink more. No significant other to keep track of that. Only my 86 year old mother lives with me and she has dementia, so she’d be of no help there. ;-) A friend of mine who has heart issues told me that she has an app that reminds her to drink water. I’ll have to check into that. I do get busy and forget to drink water and I normally don’t eat until around noon. The nurse told me I should really eat breakfast, even if a small amount as that would help me to drink more. So I guess I’ll have to do that also.

Thanks for the advice Alicia & MAbound. :-) 

One other question, I've been having some persistent pain up under my ribs for the past few days. Not much nausea, but this pain is just kind of hanging there. I never had this with other infusions, so am wondering what's up with that. Have any of you experienced this?

 

Harmanygroves's picture
Harmanygroves
Posts: 226
Joined: Jun 2021

I find that eating watermelon really helps me when I just don't feel like drinking. It's just got so much fluid in it. Would that maybe help? Just thinking of perhaps finding ways to hydrate you via the food. 

Take care, Rainbow Rita!

Forherself's picture
Forherself
Posts: 563
Joined: Jan 2019

My daughter had bariatric surgery, and has an App for recording her fluid intake.  She uses a bluetooth water bottle. She finds it fun because the app rewards her for keeping up with the intake.  I don't know if that is something that would help but when you said you didn't have someone there to help, this came to mind.  It is kind of rewarding to have the feedback when you are trying so hard to do this.   

EZLiving66's picture
EZLiving66
Posts: 1479
Joined: Oct 2015

I had just the opposite. My BP shot up to 220/140 the day of my third chemo and they STILL did the infusion. Not too long after that, I had a stroke and that was my last chemo. I should have refused the chemo but they told me they'd monitor it during the session. I guess the moral of the story is to go with your gut. If you think something is wrong, it probably is. 

Love,

Eldri

CancerFreeSunny
Posts: 35
Joined: Sep 2018

I experience low BP (70/41) during and after dialysis. (not infusions) I take Midodrine, which raises my BP before I begin. The other day this occured and she tried to get me to drink water but that did not work. So she gave me 100cc of saline and it brought it back up.  The signs that I am crashing BP are: start sweating, feeling very hot, feeling like doom (death) nauseated and very weak and dizzy. I go through this 3 times a week and 4 hours a day to keep alive. I always suffer the same experience. I need a transplant. That's my way out! 

RainbowRita's picture
RainbowRita
Posts: 49
Joined: May 2021

I can't believe Eldri, that they went through with the chemo infusion with a BP that high. How scary that must have been for you.

And you also CancerFreeSunny to have to go through those low BP episodes three times a week. Interesting that the IV helped you more than drinking water. 100 cc isn't really that much. Must work faster that way than injesting water. I sure hope you are able that soon you will be able to get that transplant you need.

RainbowRita's picture
RainbowRita
Posts: 49
Joined: May 2021

Found an article on the NCBI, National Institute of Health website that hypotension (low BP) and tachcaradia (fast resting heart rate) is quite common in women (study was on women being treated for breast cancer) after they've had chemo.  I copied a link to the article below but this was in the summary:

"During chemotherapy, resting tachycardia and hypotension were common, occurring in one third and half of women."

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6369953 

So now I know this really is a "thing". I wish I had been warned about it as a possible side effect to chemo. They warn about possible nausea and bone pain, but no one mentioned that a low BP was also a possible side effect and what to do if it happened. So seems it isn't just dehydration that causes it either. At least now I know and what to do and I'll have less anxiety about it if it happens again. 

BluebirdOne's picture
BluebirdOne
Posts: 452
Joined: Jul 2018

I had developed very high blood pressure in the months just before my dx, so we were trying to control it as I was going through treatment. I also have had bradycardia for many years so I had high blood pressure and an extemely low heartbeat during chemo. My cardiologist says that sometimes they go hand in hand, the heart beats slower in response to the high pressure, he didn't think they had anything to do with the chemo as I had both prior.  I have developed an irregurlar heat beat as detected on an ekg since chemo which may or may not have been from chemo. No one knows.

Denise

dgrdalton's picture
dgrdalton
Posts: 160
Joined: Jun 2017

This is very interesting. I've not had chemo for 6.5 weeks and have been having episodes of very low heart rate on my iPhone. Tomorrow I will start taking my BP with my machine as it gives the heart rate also. During those times I feel very weak and shaky and just wanting to sit. Articles or questions about unusual symptoms can really help others to look "outside the box" for a solution.

 

BluebirdOne's picture
BluebirdOne
Posts: 452
Joined: Jul 2018

So glad to see your smiling face! I hope you are doing well. I had a double whammy with the low heart rate. I am normally asymptomatic, meaning, I have no physical symptoms of a low heart rate, high 30's, low 40s. But the entire time during chemo, lasting for about 6 months after, I was  out of breath and had extreme exhaustion. I could not walk very far without huffing and puffing, and many times had to take the stairs very slowly or I would almost pass out. The doctors said as my blood counts returned to normal both would improve and they did. Now that I have my blood pressure under control, my heart rate is now high 40's, low 50's, which is great as I  would have to have a pace maker if they didn't improve. For me the worst side effect of the chemo was the extreme exhaustion and being out of breath all the time. 

Thanks for updating us. Are you totally finished with chemo now?

xxoo

Denise 

RainbowRita's picture
RainbowRita
Posts: 49
Joined: May 2021

Funny how chemo side effects can vary so much from person to person. I had a low BP, but a fast heart rate, but Donna had similar physical symptoms as I had with a very low heart rate, not a fast one like me  (it was up in the 120's for a time). A good friend of mine has trouble with A Fib and she is on medications that lower her heart rate. Just like you she is often out of breath when doing physical exercise and and also experiences exhaustion because of it. She had heart ablation for the a fib and that has improved, but she still has some issues with it occasionally. 

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