Headache, Dizziness, Swollen Vocal Cords, Reflux Of Acid. Had Ablation, Hystescope. What Caused This After Surgery?
Thank you for your query.
1. Was your surgery done under local, spinal or general anesthesia? Was an endotracheal intubation done? I would like to rule out a post intubation hoarseness.
2. If you can share the videolaryngoscopy and GI endoscopy, I will be able to give you an accurate assessment of the hoarseness.
3. All these symptoms sound like reflux. It may be laryngopharyngeal reflux (LPR) as opposed to GERD (Gastro Esophageal Reflux Disease). Get an abdominal ultrasound to rule out a hiatus (sliding) hernia. A gut motility disorder should be ruled out.
4. What is your BMI (Body Mass Index) ? It is also possible to do an esophageal manometry study?
5. Your headaches, dizziness and light headed feeling may be due to gastritis. Do you have any sinus and nasal symptoms (post nasal drip)?
6. What is your current medication? Kindly let me know the results of your investigations. This will help decide medication and further treatment.
I hope that I have answered your queries. If you have any further questions, I will be available to answer them.
Regards.
2)I do have copy of my endoscopy pictures not a video tape. How can I send it to you?
3)Thank you I will ask for an abdominal Ultrasound. I do have a hiatal hernia,and they were aware of this.
4) I am slightly overwt I do not know what my BMI is
5)I was not having any at that time. Now I am having some off and on since the surgery. Only get the headaches dizziness and light headiness with stars when I talk for 5min or more. Also I get S.O.B. with coughing,and I get diaphoretic.
6) MS contin 30mg TID zanaflex 4mg 1 in am 1 pm 3 @HS Skelaxin 800mg QID Propanolol ER 80mg Daily Norvasc 5mg Daily Vicodin 1-2 tabs q4hrs PRN Prilosec BID Gaviscon in between PCP dc'd Prilosec today due to cause of kidney failure switched to Zantac BID Ibuprofen800mg TID
Thank you for writing back.
1. The possibility of post intubation hoarseness is high.
2. You have the option of uploading images and test results on the lower right of the query page. Without a video, it will not be possible to comment on aspects such as movements of the vocal cords.
3. Hiatus hernia is detected in more than a third of patients with reflux related symptoms.
4. Weight reduction will definitely help reduce reflux.
5. Dizziness, headaches and light headedness may be due to Zanaflex (Tizanidine) and Skelaxin (Metaxalone). Both are muscle relaxants and you should review the need for multiple drugs.
6. Propranolol may also cause dizziness and weight gain.
7. Norvasc (Amlodipine) and Vicodin (Hydrocodone + Paracetamol) may also cause dizziness, headaches, light headedness and gastric upsets. 2 q4hrs is a high dose.
8. Your dose of MS Contin is also high. It may be the cause of your kidney failure in addition to Prilosec. Gaviscon should not be used for a very long term.
9. Zantaz (Ranitidine) should be used in a reduced dose in kidney failure.
10. Ibuprofen may also cause gastritis, headaches, dizziness and light headedness.
11. You need to discuss this with your physicians and review the multiple drugs that you are taking. Some of these medications may be reduced or replaced. Most of your problems seem to be drug induced.
12. If your post intubation trauma is not severe, it will settle and recovery should be good.
I hope that I have answered your queries. If you have any further questions, I will be available to answer them.
Regards.
Thank you for writing back.
1. If you cannot upload any images, get an appointment with a local ENT Specialist and review the images.
2. Post intubation edema or trauma will settle with treatment, which may include short term steroids, since you need to talk for long hours and cannot get adequate voice rest.
3. The feeling of pills getting stuck in the throat is due to dryness in the throat which is seen in reflux. You nee to get a GI Specialist to look into the reflux, hiatus hernia and gastric upset every time you eat.
4. At least some of these symptoms could be drug induced and duration of therapy is no yardstick. Some of these are definitely related to and possibly worsened after your surgery and anesthesia.
5. If you can address these problems individually as mentioned in detail earlier, you will definitely improve. you have to reduce your current medication.
I hope that I have answered your queries. If you have any further questions, I will be available to answer them.
Regards.
Thank you for following up.
1. With no access to your endoscopy images, I have identified the following conditions which you must seek treatment for:
a. Post intubation laryngeal trauma or edema.
b. Reflux.
c. Hiatus hernia.
d. Multiple, overlapping drug induced side effects.
e. Kidney failure.
2. Get a second opinion form a GI Specialist. Your laryngeal problem, if not severe, will settle down, however, if all the Gi Specialists do not agree regarding gastritis, reflux and hiatus hernia, then some of your symptoms are drug induced and related to Kidney failure.
3. What are your Renal Function Test values?
4. The time to recovery will be different for each of the above mentioned conditions. In n=my experience, persistent hoarseness beyond three months raises the possibility of arytenoid dislocation and vocal cord granulomas. Both are easily recognized on endoscopy.
I hope that I have answered your queries. If you have any further questions, I will be available to answer them.
Regards.