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Having fluctuating blood pressure. Took advil. Feeling dizzy. CT scan normal. What is causing this?

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Practicing since : 1981
Answered : 922 Questions
I have fairly low blood pressure. (100/60) everyday, sometimes lower in the morning. I took an Advil PM, during the night, I woke up(during the night) and felt dizzy, then when I woke up I was really dizzy. Drank coffee, drank a V-8, felt a little better. A few days later, I took a hot bath before bed, and woke up really dizzy again. Since then, (over a month ago), I still have a vertigo feeling everyday. I had blood work done, no problems. I don't have any other symptoms. (Not nauseous, not losing weight.) My friend who is a nurse, thought I had a sinus problem. I tried to use a neti pot, the water wouldn't funnel out. Thinking that was the problem, I went to an ENT. He thought I had sinusitus. He ordered a CT scan. The scan came back fine. Nothing! The ENT was actually irritated with me, like I was wasting his time. He told me to exercise. So I started to exercise, but finding that I still have vertigo. I'm worried. I had a vial of Botox injected in my forehead, cheeks, around eyes about 2 months ago. I'm not sure what to do. Help. I'm scared. I hate the feeling of being off.
Posted Wed, 25 Jul 2012 in General Health
Answered by Dr. Anil Grover 2 hours later
HI there,
Thanks for writing in.
I am a qualified cardiologist and read your letter with diligence.
I personally think Botox has no role in causing your symptoms.
You will have to get one BP recorder for yourself, standardize it by recording BP with the apparatus it in a Nurse's/physician assistant's office and record with your BP apparatus too if there is no difference or less than 10% difference it is OK. Either record or get your BP recorded 3-4 times in coming week. If you get more than 2 readings with associated symptoms with being dizzy of BP equal to less than 100 mm Hg systolic your point of low BP is proven.

Meanwhile, keep yourself hydrated . Like you had coffee you can have hot soup, juice etc. Do these three things on the presumption of autonomic neuropathy:
•Extra salt in the diet or taking salt tablets to increase fluid volume in blood vessels
•Sleeping with the head raised
•Wearing elastic stockings
Meanwhile get an appointment with a doctor who would like to perform certain tests for diagnosing cause for dizziness and exclude autonomic neuropathy, This time when you go for checking for inotropic insufficiency on treadmill go in with fully hydrated state in relaxed manner. What is being tested is response of your BP with exercise and you will be taken off treadmill once the doctor is sure about the diagnosis in either way you will be taken off. During any stage of Tread Mill you can decline to move further. This is an important test. At age 42 you can not live in constant fear of giddiness.
Meanwhile, Also take the precaution of making getting up from bed to going to wash room, a 4 step process:
1. You sit in the bed
2. You allow your legs to hang down the sides
3. You stand
4. You walk.
Once the diagnosis is made treatment will be started. You ought to be alright.

I hope the answer has been helpful. If you have further query, please write. I will be happy to answer.
With Best Wishes.

Dr Anil Grover,
M.B.;B.S, M.D. (Internal Medicine) D.M.(Cardiology)
http://www/ WWW.WWWW.WW
Above answer was peer-reviewed by
Follow-up: Having fluctuating blood pressure. Took advil. Feeling dizzy. CT scan normal. What is causing this? 13 minutes later
Thank you for taking time out of your busy day to help me. I really appreciated your advice and help. This sounds dumb but what kind of doctor should I make an appointment with to do the treadmill test? A cardiologist? Also what is automatic neuropathy? Thanks again! I hope you have a great day.
Answered by Dr. Anil Grover 26 minutes later

I is a pleasure to be of help. Actually, it is very early morning where I am. It must be pleasant afternoon in Pittsburgh PA. Have a pleasant evening.
You have repeated spells and documented low blood pressure if you can manage please see a cardiologist first. If it means going through an Internist (Medical Specialist) or general practitioner (medicine) doctor first that is OK. I am not sure if any insurance allows you to see a specialist in first go.

Well that is intuitive diagnosis because nerves which are supposed to change your blood pressure so as to always maintain a requisite supply to brain are not doing their job. These are autonomic nerves. First part is a fact and documented. Second part is yet to be proven. That is why I would say we are working on intuition but in the matters of heart and brain we do not take chances.
With Best wishes.

Dr Anil Grover,
M.B.;B.S, M.D. (Internal Medicine) D.M.(Cardiology)
http://www/ WWW.WWWW.WW

Above answer was peer-reviewed by
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