Medical issues, need thoughts

OK all I'll start this by saying I believe I'll be going to cardiologist but thought I'd pick some of your brains.  
Here are my symptoms:
When I go from sitting to standing I get a very lightheaded feeling and often severe dizzyness.  I have passed out once because of this issue.  
At the conclusion of the NYC marathon this year I had to go to the medical tent because I was just out of it.  While in there they checked my blood pressure and it was roughly 110/70 (extremely low following a marathon).
Just now I did my blood pressure, the first time was 106/65 the second was 114/74.  
Things seem to be a little worse today, but I did 40 minutes of running, 1:10 of cycling, and about 1:15 of swimming.

Again, I know I'll be going in to the doctors but would love to hear any thoughts any of you had. My fiancee got quite concerned when I made it halfway to the sink and had to sit down at the table.  
Thanks for the thoughts!
--Dan

Dan - I remember you saying something about this earlier. So sorry you are still having problems with it. When are you taking your bp? Do you have something at home to take your bp or are you going somewhere to take it? If you have the ability to take it at home....Sit down close to where you will take your bp, relax for a little while (10- 15 minutes) then without getting up take your bloodpressure. Wait a couple of minutes, stand up and take it again while standing. This might give you some idea if your bp is dropping significantly when you stand. I had similar episodes a few years ago and this is one of the first things the nurse on the scene did.

Hope they figure it out for you soon!

Also: I yesterday i started a thread on the RNY board about having normal bp before surgery and then having low BP after surgery. There are a couple of responses there you may be interested it reading as they have some of the same symptoms as you. I'll try and post a link for you, but I'm a techno-phobe and my links don't always work, LOL. So if it doesn't just look through the RNY board I believe the thread is still on the first page.

http://www.obesityhelp.com/forums/rny/4123471/Any-one-have-NORMAL-BP-before-surgery-and-then-develope-LOW/

 I've been having a similar issue of getting dizzy when going sitting to standing.  I had chalked it up to my new body and just the increase in cardio work, all combined with a lack of sodium in the diet. If you do some googling on Orthostatic hypotension there is some good info out there.

My non-medical first guess for both of us is sodium levels.

Dang bro, sorry this is still a prob! I think it is normal, to an extent, to get a little dizzy if I stand too fast from laying down or sitting. I have learned to just go at it a little slower. It looks like you worked out for about 3 hours today. What was your nutrition like? Have you had all vitamin levels checked with your bloodwork? Do you take antioxidants? Pro Biotics? I have heard that folks who take a lot of Beta Blockers can have severly low blood pressure... You do any of those? It sounds like if you are getting dizzy during and after workouts, you may be experiencing Hyponatremia. It's a long boring read, but might help you:
http://www.overhydration.org/downloads/EAH_Statement_2008.pd f

I hope you get this figured out soon, so you can have FULL confidence of everthing going in to IM...

Could be a simple case of dehydration.  I have read some reviews and they all tend to lean toward a lack of proper fuel. 

http://www.pfitzinger.com/labreports/dehydration.shtml

Bloodwork should eliminate all of the obvious malabsorption issues, like iron deficiencies.  I started taking extra iron about three years ago when I going through some dizzy times.  Haven't had a problem since.   Evidently we sweat out a lot of that iron, so we need to supplment.  Good luck and do some research.
Rob

You sound like your having a condition called orthostatic blood pressure.  Was the 106/65 pressure after you first stood up? 


I've been in the Fire and Rescue field for about 12 years and I've seen it a thousand times...Orthostatic blood pressure is when your pressure drops when you go from a sitting to standing position.  Your body senses this drop and goes into a sort of rescue mode, causing you to feel lightheaded and sometimes pass out...the passing out is to get you horizontal...once horizontal the blood returns to your core and your pressure will come up.  It's a natural mechanism.  However, passing out is not good, because you could hurt yourself or somebody else.  And it COULD be something more serious.  So it is wise to be evaluated to rule out anything else.  Also could be dehydration which is the same concept.  You have a lower blood volume because of the dehyrdation causing your pressure to be lower.  Regardless, hope all is well and you get to feeling better soon!

Dan,

It also sounds like orthostatic hypotension to me.  I'm not sure what can be done to help correct the situation.  If it's dehydration-caused, the answer is simple.  If it's some other sympathetic nervous system response, the answer may not be so easy.

Another thing you might check out is blood glucose levels.  Low blood sugar can also cause a lot of strange responses.

I hope they can figure out a cause.  I do remember that I had some trouble in my first year out, but you're 2 years post op now (I thought that's what I saw on your profile), so you'd think the body will have made its adjustments by now.  

Take care of yourself,

Linn

 Thanks all!
I have an appointment with a sports medicine doctor next week.  His bio lists that he has been the medical director of the Detroit Marathon so I'm optimistic that he understands endurance athletes.
I was diagnosed last year with Orthostatic hypotension, BUT this seems a little different.  It hits me hardest about 1-2 hours after my workouts.  I've actually felt pretty weak/out of it the last couple of days.  
I'm hoping to just be told that there's nothing to worry too much about.  There's part of me that thinks there's something else going on though.  Hopefully it's fairly easy to fix.
My hydration levels are pretty good.  When biking I tend to drink about 40-60 oz/hour and my daily fluid intake tends to be about 150-200 oz (haven't measured it recently but I'm ALWAYS drinking).
I'll keep you all posted when after my appointment.
--Dan

Sounds like you are on the right track to get yourself diagnosed properly. It might not just be hydration issues but electrolytes, as well. Let us know what the doctor says!  Good luck!