I Was Diagnosed With Sleep Apnea A Few Years Ago I Had Bypass Surgery I Am Also Going To An Neurologist My BP Went Up 20 Points And I Was So Dizzy I Had To Be Helped To Stand. What Going On?

Posted on Tue, 4 Apr 2023

Question: I was diagnosed with sleep apnea a few years ago. I was having some health problems at the time. The symptoms went away and I quit doing the CPAP. Last year I had bypass surgery. One symptom I had was waking up in the motel, at 7,000 + feet feeling SOB. It passed but it was less than 6 months an I was on the verge of a heart attack. Now I woke up and had several incidents of SOB. I breath normal and then all of a sudden my body would take a deep breat, like spnea breathing but I was awake. See history. I am also going to an Neurologist. because of bad dizziness and h/a. It appears to be a nerve problem. I was tested by laying down flat and then sitting up. My BP went up 20 points and I was so dizzy I had to be helped to stand. What going on?

Answered by Dr. Dr Sameer Maheshwari (1 hour later)

Brief Answer:
Please let me know, why are you not on Aspirin currently

Detailed Answer:
Hi,

I went through the detailed history which you have written beautifully. I understand that you also had a Bypass surgery done.

The symptoms you are having could be because of 3 things. Waking in the middle of night dyspnoic is called Paroxysmal Nocturnal Dyspnea (PND) and important causes for you can be sleep apnea leading to high CO2 in the body causing you to wake up.

Other cause could be chest congestion due to low heart function (kindly let me know the heart function on the latest echo). It could also be a sinusitis related problem and I can see that you stay at 7000+ feet (I'd also recommend you to move downhill, if possible, your symptoms will be much better gradually).

One other thing is why are you not on aspirin and statin. Every bypass patient should be on aspirin to prevent new blockage in the grafts. So kindly start it soon. as you are meeting a neurologist, I guess you will be fine.

Kindly follow up with latest echo report.
Thanks.

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Dr Sameer Maheshwari (5 days later)

I only live at 3,500 feet. We were on a XXXXXXX vacation at 7,000 ft. I had another incident. Both of them have been in the afternoon. SOB upon awakening but a bad incident of weakness. I could not get up. My husband got me an extra strength ASA and some strong cayenne pepper. I also had a cup of coffee. It took a few min. but I finally had the strength to get up. My O2 stat were OK when I finally got my husband to take them. They were 90-91 and there usually 97-98. (I have been sleeping in a lounge chair with my feet and head up since my surgery. Suture area hurts when I try to lay down. I went and saw my neurologist and failed the test of going from lying flat to standing quickly. Had to be helped to stand. BP^ too much. The neurologist is going to do a study of my nervous system now. I won't be able to see him till Oct. He is the only neurologist in 200 miles. Dr. suggested that I wear support hose. I have no to min. swelling in my legs what st. support hose should I wear?

Answered by Dr. Dr Sameer Maheshwari (27 hours later)

Brief Answer:
Detailed answer ahead

Detailed Answer:
Hi,
Welcome back.
I can understand your episode of breathlessness are also occuring during afternoon.
I again will advice you that you should get a sleep study done to evaluate for sleep apnea.
As the time of bypass surgery has been quite a lot before, the chest should not hurt now. If it is still hurting so much that you can not even lye down, you should see the surgeon soon as the scar formed over the surgery area could be causing you this breathlessness.
We generally advice for a tight leg stoking but i dont expect you need it now.
You also didnt tell me the echo report and the cause you are not taking aspirin. These are really important for you.
Kindly reply with these.
Thanks and take care

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Dr Sameer Maheshwari (3 days later)

It was my choice to not take a statin. I do take ASA. I don't see my Cardiologist until this Wed. My surgeon is 200 miles away so have not seen him since the surgery. I have been told by my GP that it the nerves growing back in my chest that is causing my pain? It both the area to the right of my suture area and some of the suture area. hurts.

Answered by Dr. Dr Sameer Maheshwari (30 hours later)

Brief Answer:
Please see detailed answer

Detailed Answer:
Hi,
Welcome back
Both Aspirin and statin are important for a coronary artery bypass patient.
For the neurological pain after CABG we advise our patients to take Tab Diclofenac twice daily along with a Vitamin B complex like Neurobione forte.
You should feel better after that.
You should also wear a chest support and things should be better in a week.
Eat lot of green leafy vegetables. Also do some mild exercise which is comfortable for you.

Thanks and take care

Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Remy Koshy