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Headache, dizziness, swollen vocal cords, reflux of acid. Had ablation, hystescope. What caused this after surgery?

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ENT Specialist
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I had surgery on March 23 and have been hoarse since. Everytime I talk I get really light headed with a severe headache they said its from me straining to talk. Also I get dizzy. I have had the speech therapist and the ENT state my throat is raw and my vocal cords are swollen. Speech viewed my throat with a video cam and ENT numbed my throat to look at it. When I eat it feels as though my food do not go down and I continue to Belch. I can not lay down my food comes back up and if my head slips off the pillow I choke in my sleep with food coming up. None of this happen before this surgery. The GI Dr, states when he did the endoscope he didnt see anything and didnt think my reflux was acting up. The ENT thinks when they extubated me that acid came back in my throat and I believe this to. The Anesthetiologist states this has never happen. Something happen after surgery I was not hoarse till afterwards. I had a simple procedure ablation,hystescope,and a D&C. Surgeon stated they had me back in the surgery suite for awhile and he had to go back and ask if everything was ok.
Posted Wed, 23 May 2012 in Ear, Nose and Throat Problems
 
 
Answered by Dr. Sumit Bhatti 1 hour later
Hi,

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.
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Follow-up: Headache, dizziness, swollen vocal cords, reflux of acid. Had ablation, hystescope. What caused this after surgery? 20 minutes later
1)Yes I was placed under general anesthesia,and I was intubated.
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
 
 
Answered by Dr. Sumit Bhatti 14 hours later
Hi,

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.
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Follow-up: Headache, dizziness, swollen vocal cords, reflux of acid. Had ablation, hystescope. What caused this after surgery? 4 hours later
I have had the headache, lightheadiness, and dizziness since the surgery when I am straining to talk after 5-15min. It feels like my head is going to explode. My neck has been very stiff and soire since the surgery also. I have never had this prior to surgery. Ive been on all these meds for years none of the symptoms started till after the surgery which is frustrating. so it is not due to meds at all its due to the post intubation. Even my GI Dr has said my Reflux has never been like this. The PCP switched my prilosec to zantac due to the probablity of kidney failure since they increased the dosage of prilosec trying to get the reflux under control. My voice keeps coming and going. I am a RN my job isteaching pt. over the phone 8hrs of day. They say my throat is still raw and my vocal cords are still swollen in which I feel like my pills are getting stuck in my throat and everytime I eat my stomach is in an uproar.
 
 
Answered by Dr. Sumit Bhatti 4 hours later
Hi,

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.
Above answer was peer-reviewed by
 
Follow-up: Headache, dizziness, swollen vocal cords, reflux of acid. Had ablation, hystescope. What caused this after surgery? 17 hours later
I was on prednisone a tapered dose for 10days a wk after the surgery. The ENT did not place me back on it again due to it was a temp fix. This is 4wks out my throat is still sore with ear pain with the difficulty in swallowing off and on. I try to clear my throat suttlely ive been on voice rest. The GI doesnt think its reflux but i and everyone else does. Do you think I need another GI opinion. I am so tired. I get easily fatigued after talking and my voice only last temporarily the more I talk the sore the throat gets with the light headiness and headache increases. Im constantly drinking trying to keep my throat moist. I was told I cant return to work unless im at a 100%. I might start off with a voice but 15min into it and the voice is gone. How long do you predict this can last or is it one of those things you cant put a timeline on it?
 
 
Answered by Dr. Sumit Bhatti 6 hours later
Hi,

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.
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