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779 Dealing with Dizziness

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As many as 7 million people each year have dizziness or vertigo so severe it drives them to seek medical care. But although the symptom of dizziness is common, finding the cause and the proper treatment is complicated. We learn how balance disorders are best approached.

Guest: David M. Kaylie, MD, MS, is Associate Professor in the Division of Otolaryngology--Head and Neck Surgery at Duke University Medical Center.


The podcast of this program will be available the Monday after the broadcast date. Podcasts can be downloaded for free for six weeks after the date of broadcast. After that time has passed, digital downloads are available for $2.99. CDs may be purchased at any time after broadcast for $9.99.

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33 Comments

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I used to suffer from vertigo when I would roll over in bed or lean my head back in the shower. Two different doctors said it was caused by pressure from the sinuses since I had allergies.

I heard Paul Harvey on the radio say that, when vertigo struck, to stay in that position for a minute or so instead of rolling back like I had been doing. I tried it and it worked. I very rarely experience vertigo now.

I have gotten motion sick all my life when in a boat and sometimes in a car. The last time, I was sea kayaking. It was OK when I paddled into the swells. But when we turned around and I couldn't see the swells coming, I got to feeling bad. As was typical with me, I was much better when I laid down in the kayak with my eyes closed. The moment I sat up looking at the horizon, I instantly felt horrible. (my tour guide had to tow me back to shore and I had to give him a big tip :-) ) People have told me for years to look at the horizon, but really, lying down with my eyes closed is better.

Do you have any explanation?

The information provided on this particular show ( #779 dealing with dizziness) interviewing the Director of the Duke Medical School Department of Otolarygnology (most of us refer to these as ear, nose and throat specialists ) warrants the very widest dissemination, due to the simplicity of correction of the ailment, but especially due to the exceptional magnitude of cascading damage and societal expense of caring for those who have suffered from falls.

One of the leading root causes of admissions to nursing homes is that the patient fell and suffered a debilitating injury from that fall.

The macro societal cost of caring for those in nursing homes is enormous. This is a root cause of the US having out-of-control health-care expenditures measured by both: a ) dollar expenditures per capita, and b ) percentage of gross national product allocated to health-care easily double that of any other industrialized countries.

I further suggest that not one single person in the US would chose to go to a nursing home if there were any alternative.

This is one of those health-care areas in which the key driving force is ignorance: there are easily corrected and low cost corrections, if only the problem were diagnosed and one of the best practice protocols implemented.

If you would take the time to forward the information on how to get the download for this show (which will be free of charge until mid-September, 2010) to the friends and family in your e-mail address book who might be either a) approaching their senior years, or b) facing some balance or vertigo challenges.

Simply copy and paste the
http://www.peoplespharmacy.com/2010/07/29/779-dealing-with-dizziness/

into your email (please try to convert to a hyperlink to simplify use by the recipient)

By you taking a couple of minutes to provide a solution to those who may have a challenge, you can free them from this challenge and you can actually have a profound and compelling impact on reducing our macro health-care expenses, which are entirely out of control.

In addition you will free many seniors who had considered themselves to be homebound and unable to participate in the many really great and enjoyable social factors of life by being out and interacting with others and perhaps even volunteering a one's local pet orphanage to help pets find a home with a loving family.

Thank You so much for the great program this morning on vertigo and dizziness. I have had problems off and on since 1985 after a vacation in Hawaii and flew back to Pittsburgh, PA. I was sick for 6 wks. that time. Now I am stable and haven't had a problem since Christmas Day, 2008. So many things the doctor talked about I have experienced from car sickness to sickness on a ferry, spinning, etc., etc. A job well done. I listen very week.
njm

Where r the links to the doctors and organizations mentioned during the show?

I have to tell you that for several months recently I have had and have dizziness and have been going through health examinations with my internist, heart doctor, and sleep doctor [all of which I needed anyway]but not one found any cause for dizziness. The heart doc had me try Meclizine which did not help.

Your radio broadcast comes on very early here in the Dallas,TX area so many times along with my sleep disorder I miss the broadcast. Today my clock radio came on and I heard the word dizzy. I awoke with a start and began listening. I was a bit late for the beginning and yet it really sounded very informative. I had to rapidly find a pen and paper and had to wait for a commercial break to go get my eye glasses to take notes. Now that is not easy for just arising and groggy [along with my sleep disorder and blurry vision].

Compliments to you for the broadcast and to and your guest speaker Dr. ''K LEE'' of DUKE UNIVERSITY who seemed extremely knowledgeable and gave great advice in a logical and understandable manner. I am impatiently waiting for the Monday podcast to rehear it more accurately and use it to point me to the correct medical professional.

THANK YOU !

A year ago, I suffered from what Terry touched upon, "mal de debarqement" for over 2 months after a week long cruise. I was fine on the cruise ship, but even 2 months after the cruise, i continued to perceive motion. Even in bed, i felt the motion of the ship. Oddly enough, driving in the car felt normal. I took motion sickness meds, and tried the Cleveland Clinic's youtube dizzyness exercise, but nothing worked. Finally before the third month, the sensation of being on the cruise ship went away.

I was diagnosed with vertigo about 4 yrs ago. I was taught the movements to get my crystals back in place (which sometimes helps), but after 3 therapy sessions at which they told me most people are 'over it' by then, I was sent for an MRI (which was fine), had my hearing checked, saw an ENT specialist. The last thing I was told was about 20% of people continue to experience vertigo for years and I was in that group.

He also told me to do whatever creates the vertigo so my brain could train itself to 'fix' itself. I tried that for a time or two and decided that was not for me!

I am learning to live with it, or basically avoiding what creates the vertigo. I hate it, it is very annoying and distracting. I always hold the handrails on steps, I avoid shopping or watching traffic go by.


Name of procedure to move the crystals around to stop dizziness?
M.R.

I thoroughly enjoyed Dr. Kaylie, with hope that he can assist with my Vertigo regime. Thanks, for informing us of this great outlet that can lead us down the path of possible relief--this would be nice after 10 years of suffering. Continue to keep us apprised of various health issues/topics, you guys are great!!!

Vertigo SOLUTION

No caffeine. I now drink 2 cups of decaf tea per day.

Sea Bands!!!!! This is a device that is in the drugstore in the motion sickness department next to the dramadine. It is an elastic wristband with a plastic ball that rests on an acupressure point on the wrists. I thought this was crazy but it cured my dizziness that I had for over a year.

It can also be used for car sickness and symptoms caused by chemo and for pregnancy.

I only heard the last part of the program but decided to relate my experience with dizziness. Years ago I was teaching in CA, having moved there shortly after my marriage. I started getting dizzy spells in the afternoon which progressed to the point of having to be taken home by my principal after a particularly rough time. I went to the standard Family Physician and he didn't have any suggestions.

After a number of years and various trips to different types of medical doctors, it was finally found out (by a Chiropractor who was into Naturopathic healing) that I had been suffering from Hypoglycemia (low blood sugar) all those years. Once I changed my diet, took different types of vitamins and herbs specifically for strengthening the endocrine system plus liver, pancreas, my dizziness disappeared totally (plus other problems that had developed due to the low blood sugar). I have had no problems with dizziness since.

Sugar and caffeine are extremely negative substances for most bodies; along with them, and the standard American diet, plus the stress most people live with, we set ourselves up for real problems. Anyone with dizziness might want to try getting off junk food, sugars and caffeine, eat whole foods and see what happens. It certainly is worth a try and costs next to nothing. I have helped many " dizzy people" overcome it with a simple change of diet after I relate my experience.

HI, I Have a question regarding losing balance. My mother has not been diagnosed with any specific thyroid type problems but she shows all symptoms. She loses her balance on a daily basis, does the doctor know or have heard of any relevance or connection to inner ear problems. Thanks for taking my question and for always a great show.

My husband has had these exact sensations for four years now. But he was never on a boat. You are so fortunate that it stopped on its own. Did you have any ear pressure? My husband does.

I could not believe the synchronicity of your program on dizziness. Dr. Kaylie mentioned that there are 3 senses that need to be functioning properly in order for normal balance. Muscle sense was one of them. A light bulb went off when I heard that!

This is the second time after knee replacement surgeries that I have experienced vertigo. So when it happened this time, I knew it had to be related to the knee surgery, but that was only MY diagnosis. The first time it lasted a few weeks and then was gone (related to how well the leg muscles were recovering). This time it is a lot worse, but so are the sore muscles. So now I have lots of hope it will eventually just go away as my leg heals more, just as it did the first time.

I would hate to go to doctor who would most likely misdiagnose me and put me on totally useless medications.

It was nice to hear that that muscles do indeed affect our balance. I think knee surgeons should be made aware of this. My surgeon had no idea what was going on with me.

I am anxious to download tomorrow's podcast to hear the part about the 3 senses affecting balance again.

I live in SC and when visiting my niece last October in Charlottesville, Va. I had a severe case of vertigo. The day before the onset (which happened during the night when I turned on my side in bed) I had walked some very steep hills. Could the walk or different elevation cause vertigo? I am getting ready to visit her again and am a little worried about the vertigo returning.

Hello Terry & Joe,
Our local PBS station is airing your show right now, 1 August, I wish I could call in live! Forty years ago I had an episode of wicked dizziness. I literally thought the building I was in had fallen over. I was violently wrenched sideways and for 2 hours afterwards I could not stand or walk and had awful spining dizziness when I tried to move my head.

For 3 days afterwards I continued to have the violent body wrenching spells and accompanying dizziness. (During one I was washing dishes and got plunged into the sink!)

When they finally stopped I went to a doctor who did tests and told me I had Menieres. I endured nasty treatments for months, the doctor threaded a thin tube through my nose into my iner ear and squirted awful tasting stuff in. I was on a low sodium diet also. I've never had another spell and after reading up on Menieres I was convinved I did not have that. I thought I was crazy. I thought maybe stress caused it and have been fearful ever since of getting too stressed.

I've always worried I'd have a spell while driving. I now know, thanks to this show, that what I had was the BPP thing with the canaliths! I am so relieved to know I am not crazy! Thank you so much for this show.
Francesca

Like one previous writer, I also perked up when I heard Vertigo.

Never having known or heard of Vertigo 8 yrs ago, it hit me one evening and I thought I had a heart attack.

Over the course of 5 years, it would come on suddenly and unexpectedly and totally incapacitate me.

To make a long story short, after years of living in constant fear of it, my researching everything possible, many tests and temporary medications, and no causes "found", I am now convinced it was connected to my Rheumatoid Arthritis 8 yrs ago, the inflammation in my body and the inner ear as part of my body.

The RA is gone and the last weaker and weaker episode of Vertigo was 3 years ago.
I have become a big believer in inflammatory causes of illnesses and am doing what I can to keep it in check with diet and supplements and a daily Ibuprofen.
I am so glad you devoted an hour to it, because everything is so much guesswork when it comes to this horrible and terrifying Vertigo.

I was diagnosed with Benign Postional Vertigo about 17 years ago. The neurologist advised me to position my head so as to trigger the vertigo several times per day and hold the position until the vertigo sensation diminished or subsided.
The doctor's advice worked but I continued to have bouts of vertigo until I decided that, because the ears, sinus & equilibrium are all related, I should try NOT blowing my nose.

I stopped blowing my nose several years ago and no longer EVER experience vertigo.

I have Meniere's. It is a very scary illness in that not only am I slowly losing my hearing and balance, I suffer from vertigo that never seems to end. I am going to Mayo to see a neurologist and I will be bringing up your show. I would love to sleep for 2 days and wake-up vertigo free. How simple that seems, but sometimes it is the most simple things that can work...

Thank you--

MKS

After a fall I suffered terribly with dizziness. It took me 14 years to find a Dr who finally explained the problem. My neck!

With the Pettibon Chiropractic manipulations and the exercises I do at home this problem is gone!

I started having dizzy spells about 10 years ago, but it only occurred a few times over a period of years, and only lasted for hrs. Then last year it happened twice. The first time it scared me because it upset my stomach to the point where I laid on the bathroom floor in case I got sick. That lasted for a few days. The last time I actually passed out and was taken to the hospital, where tests were run for the heart. When I came too the paramedics took my blood pressure and it was way low. Have not had it since. Some of the comments here are interesting.

How do I find a doctor that does the Epley manuever?

PEOPLE'S PHARMACY RESPONSE: TRY THE OTOLARYNGOLOGISTS' ASSOCIATION: http://www.entnet.org/

I had been diagnosed with Meniers Disease about 8 years ago. I had severe episodes of Vertigo followed by violent vomiting (so bad that my chest muscles hurt for the next three days). I finally was able to get an appointment with an Otolaryngolist at Wake Forest University (Baptist Hospital). When he tested me I had lost some hearing in my left ear (I realized I had been reading lips for some time).

He then put me on a diuretic and a low salt diet. I have not had an episode for the last five years. I recently met with him and my hearing test was normal. I am so grateful to him. I sure wish I had been able to hear the broadcast. Thank you for all your good work!

I started having dizziness about three months ago. Ranges from hold on to something because the dizziness is so bad to only dizziness when I turn quickly. I have always had ear issues but have never had my adenoids or tonsils out. I am only 29 and take blood pressure medicine since I have been on the medicine. It controls my high blood pressure but not dizziness. I have reoccurring sinus infections that for in my ear and spread to the rest of my sinuses. I never had problems as a child.

I went to the ENT and they tested my hearing and balance and everything came back ok. He said my adenoids were very inflamed but did not want to remove them. He sent me to an allergist which found random allergies that I am not exposed to often like cockroaches, mold and dust mites. I take several allergy medicines and it seems to be under control.

From reading about adenoids, it seems that they could be causing dizziness, high blood pressure, and various other issues.

He will not take out my adenoids and wants me to solve it through allergy shots. Should I get a second opinion? He said it was rare for adults to have inflamed adenoids, but I do.

What should I do? Any advice or similar stories would be greatly appreciated. thank you.

I'm 33 years old and a year ago, I snapped my head up while blow-drying my hair. I've had vertigo ever since! I've been to an ENT, chiropractor and acupuncturist. The symptoms started off as BPV on the right side while lying down but now it seems that whenever I turn my head, my eyes don't catch up fast enough - it's very frustrating. Any suggestions as to how & cure this???

Since gall bladder surgery many years ago, if I eat something that does not sit quite right in my digestive system, I will experience vertigo... it requires many efforts to burp, including finger down throat for massive burps, etc. Eventually the vertigo will stop... so with me, it is all connected to my stomach, without it feeling upset at all.

Hi!
Since my youngest daughter died in 1995, I've had several attacks of vertigo. I've sure wondered if stress is an issue with this. For the past years I have been taking niacin regularly & haven't really had a major attack since doing that. I have a friend who had serious problems with vertigo & she had an older Dr. who treated her & he put her on niacin & she has no longer had a problem with vertigo either. She had a serious allergy to chocolate which would trigger bad migraines for her & now that she no longer eats any chocolate, she no longer has the migraines.

Could these be connected? Recently, I had an inner ear infection & the ENT Doc put me on predisone, 2 batches, which finally helped to clear it up, but it did take the 6-8wks that the doc told me it would take. I had some dizziness, but not as bad as when I've had the vertigo attacks. I was concerned about all of this as I did have an uncle who had the Meniere's ear disease & suffered much from it. I did have some relief from taking the meclizine 12.5 mgs. Thanks for your shows! They're great & so full of valuable info.

My husband woke up one day last summer with severe vertigo. Several MDs, including a neurologist, and a chiropractor were of no help. CT and MRI showed nothing. He did much research on his own to learn anti-vertigo meds often prolong an attack and that a neurotologist (a special ENT) likely could help him. Our local ENTs had no appointments for weeks for new patients and he was off work as driving is part of his job and greatly worsened his symptoms.

We requested our family doctor send us to our university hospital's balance center. After a four hour appointment, we had an answer-something (likely a virus) had wiped out the balance mechanism in his left ear permanently. They suggested vertibular rehabilitation.

After 6 weeks of appointments and working daily home, he was able to return to work and is 85% of normal.

There is information about Mal de Debarquement Syndrome at www.mddsfoundation.org

More research is needed to explain this debilitating illness.

I found this show very informative. It answered all the questions I had about BPPV and even made the connection between BPPV & migraine headaches. After having a vertigo episode, I sometimes feel like I have the remnants of a headache. I also learned that the epley maneuver is a treatment not a diagnostic tool. Thank you for being such a wonderful resource.

I am dizzy 24 hours a day. It is caused by "torsional nystagmus." I have been seen by many Drs. There is no cure for it. It is caused by a lesion in the mid brain. Another cause is vestibular (and ear problem), but not in my case. Prisms in my eye glasses help me not to see double. Do you know of any possible cure?

I have suffered with occasional debilitating vertigo for about 25-30 years and have been to dozens of doctors, who tried many medications and exercises, but they mostly told me to learn to live with it. It has been so debilitating that it was impossible for me to work at times. Sometimes I could only crawl through my home, as standing was impossible. It is accompanied by violent nausea and vomiting, and last Fall I lost 15 pounds in 4 weeks from vertigo, while recovering from a total knee replacement. My diagnoses are BPPV and Meniere's Disease.

Until the past few years most of the suggested medications or regimens did not work for me. At times steroids and decongestants have helped me a little, probably because they reduce pressure in the inner ear, but I mostly had to knock myself out with Phenergan, anti-nausea medication, but then I just slept all the time. After I lost hearing in one ear and was told by ENTs that no surgery or hearing aid could help me, I found a wonderful ear specialist who understands my problems more than most ENT's have. He place a tube in my ear (myringotomy) and occasionally we do a series of Dexamethasone injections through the tube, which seem to calm down the noise in my ear, the pressure, the vertigo & its accompanying nausea and disequilibrium.

A year ago he decided that we should try a chemical labyrinthectomy, performed by injecting a toxic antibiotic called Gentomycin, into the inner ear to destroy some of the overactive hair cells in the inner ear. Rogue hair cells are believed to produce too much fluid in the inner ear which causes the vertigo. Usually when allergens or other variables (like salt) increase fluid or pressure in the inner ear, we may be more vulnerable to vertigo. I also learned there are vertigo seasons in the Spring and Fall when most vertigo patients have flare-ups, and indeed my flare-ups follow those timelines. August-September is usually my worst time.

Chemical labryrinthectomy makes one worse before better, and indeed it carries about a 1/3 risk of making one worse, so it is only for those patients who come to a point in their lives when they feel they can not live with the poor quality of life vertigo has caused them. I have my fingers crossed as I write, because this is my first August-September vertigo season in many years when I have not experienced debilitating vertigo. (My chemical labyrinthectomy was last November.)

I did experience the anticipated but pretty severe disequilibrium (without spinning or nausea) for several months following that surgery, but a neurologist placed me on Topamax migraine medication (I do not have migraines) that has the specific effect of further reducing hydrops in the inner ear. The combination of these two interventions has me feeling vertigo free with normal equilibrium.

I thought I would never feel this way again, so I am thrilled and very grateful to these knowledgeable physicians. A bonus from the Gentomycin surgery, which my ear doctor had also thought might happen based on his experience, was that my hearing improved drastically in the affected ear, so that with a hearing aid I can hear almost at a normal level now.

My best advice to everyone is that if anyone tells you they can't help you and to go home and live with it, find someone else to help you, and keep trying until you find someone who knows how to help you. I think they all do the best they can for you, but some have learned things in this area that others have not been exposed to. Some have studied it with a curiosity and passion for trying to solve the puzzle. Find those doctors to help you.

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