Dizziness Afflicts Nearly Everyone Now and Then. That Doesn't Make It Easy to Live With.
By Mimi Harrison
Special to The Washington Post
Tuesday, May 11, 2004; Page HE01
On the morning of Thursday, Dec. 18, 2003, I woke up dizzy.
Even before I opened my eyes, I sensed that something was wrong. I was lying in bed on my back, but I felt like Dorothy, airborne, whirling toward Oz. I opened my eyes and the feeling went on. Gingerly, I raised myself out of bed.
I could walk, my legs worked, but my gait was unsteady and the contents of my skull felt slightly . . . carbonated. I leaned on the kitchen counter and breathed. What was this? I'd probably slept in an awkward position. Who doesn't get up with a stiff neck or a weird crick now and then? I made some tea, read the paper and went to work. I don't even remember when I forgot it.
Feeling dizzy is one of those amorphous sensations that seems to afflict everyone at some point. Almost always benign in nature, the feeling passes and we move on. At least that's what's supposed to happen. In any event, I try to dismiss all symptoms when possible.
For that, you can blame Mom. My mother was a good person, but she was a morbidly anxious parent whose concern -- fascination, actually -- with death and disease led her to extravagant measures to keep me alive. That has had a rebellious effect on me. I try to ignore dysfunction. I have developed Harrison's Theory of Symmetry, which holds that if the lump, bump or indentation on the left side exists on the complementary part on the right, it's a subtle design detail and nothing to worry about. If I have a headache I lie down, and if I get a cold I blow my nose and try to sleep. I believe we can reject simple illnesses at their onset by attitude alone. I don't want them, and I don't have time for them.
When I woke up Friday, I was dizzy again.
Okay, once is an artifact. Twice is something to think about thinking about. It was one week till Christmas, and I was booked for 10 days of holiday hopping to friends -- New York for Christmas, Boston for New Year's, and then on to Vermont for a friend's birthday blowout. My calendar was full, and I was simply accepting no worries. And I was right -- after that Friday I woke up every morning rock-steady and clear as a bell.
Let me clarify that: I woke up clear and steady every morning for almost a week. In New York on Christmas, waking at dawn, I was dizzy again. My efforts to get out of bed were clumsy and although I could walk -- my legs were functioning, I wasn't numb or paralyzed -- I couldn't seem to reconcile the feeling I had with standing erect. The room was level, but the inside of my head was centrifugal. I made it to the bathroom by grasping everything in my path. I leaned flush to the wall, but the insides of my skull swirled like a dervish's skirt.
Although the feeling passed within minutes, this time I was concerned and, when it happened again the next day, I was upset.
Who has never been dizzy? Children revel in it, spinning themselves for fun into oblivion. People in boats and cars and airplanes get woozy with dizziness. Ballerinas, ice skaters and astronauts learn to cope with it as an occupational hazard. A cold, the flu, a sudden change in position, anxiety, stress, even boredom can make your head spin.
Dizziness is a feeling of light-headedness; vertigo, a feeling that one's world is whirling or tilting, is its fraternal twin. Both are very common and usually benign. Technically, vertigo is a subset of dizziness. Lawrence Lustig, associate professor of otology, neurotology and skull-base surgery at Johns Hopkins School of Medicine, calls dizziness "an umbrella symptom," which can be accompanied by nausea, vomiting, ringing in the ears, muscular weakness and a number of other physical sensations.
Accordingly, it can be tricky to understand, and devilishly hard to determine its cause. These sensations are not afflictions in themselves; rather, they are symptoms of something else. Although they can augur life-threatening conditions like tumors, multiple sclerosis, diabetes or circulatory problems, they usually indicate problems of balance, which originate in the inner ear.
The inner ear includes the organs that sense rotation, gravity and acceleration and that transmit those sensations to the brain. The brain combines this input with information from sensory receptors in the skin, joints, muscles and eyes, which allows us to stand and move. When those signals are impeded -- by an infection or an injury, for instance -- we can get dizzy.
I made it through the rest of the holidays with no more trouble on waking; rather, I started having longer, milder episodes of dizziness during the day. They came and went and varied in intensity. The feeling was there like white noise, a fizzy feeling at the base of my skull, a slight spinning behind my eyes, as if my internal gyroscope were off.
© 2004 The Washington Post Company
Getting Off the Merry-Go-Round|
To say dizziness is a common problem understates the matter. According to NASA:
• more than 2 million people a year see a doctor for the complaint.
• at least a quarter of all emergency room visitors include dizziness in their symptoms.
• 80 million Americans have experienced "clinically significant dizziness problems" at some point in their life.
But dizziness is just a symptom of an extremely wide range of problems -- some of them as simple as being hungry, thirsty, stressed or tired. It can also defy diagnosis and then dissipate.
Getting Temporary Relief
Here are some suggestions from the American Academy of Otolaryngology to help avoid or relieve temporary discomfort:
• Avoid rapid changes in position.
• Avoid extremes of head motion (especially looking up) and rapid head motion (especially turning or twisting).
• Stop or decrease use of nicotine, salt and caffeine, all of which can exacerbate symptoms.
• Chill out. Try to minimize stress and anxiety.
• Avoid allergens, such as pet dander or dust.
• Avoid activities like driving or climbing a ladder when you are having symptoms.
Diagnosing the Problem
According to the National Institutes of Health (NIH), most causes of dizziness are benign and resolve spontaneously or are easily treated. The most likely culprits are disturbances or infections of the inner ear. Dizziness can also be a sign of more serious illness, like brain tumor or a stroke, but in such cases dizziness is usually accompanied by other symptoms.
To help your doctor make a diagnosis, experts at the National Institute of Deafness and Other Communication Disorders suggest you be mindful of what is -- or is not -- happening to you during an episode of dizziness. Among questions they suggest you ask yourself:
• Has this happened before? If so, when?
• Were the circumstances the same?
• Which do you feel -- dizziness (lightheadedness) or vertigo (a sensation that the room is spinning)?
• Is your vision blurred or affected in any way?
• Have you ever fallen when dizzy? If so, when and how often?
• Are you using any medications?
• Do you feel faint?
• Are you disoriented? (Did you lose your sense of time, place or identity?)
• Are you hungry or thirsty?
• Have you been intoxicated recently or ill with flu or a flu-like infection?
• Do you tend to have low blood pressure?
• Have you just slept in an awkward position or stood up suddenly?
When to Call In a Pro
The NIH suggests you call your doctor if:
• an episode of dizziness is your first.
• dizzy symptoms progress in any way (are they longer in duration? more intense?) from those in past episodes.
• symptoms interfere with your normal activities.
• you experience any hearing loss.
Dizziness accompanied by any of the following symptoms constitutes a reason to call 911 immediately:
• fainting or loss of consciousness.
• a head injury.
• a fever over 101 degrees with a headache or a stiff neck.
• convulsions or ongoing vomiting or vomiting of fluids.
• chest pain, heart palpitations, shortness of breath, weakness, loss of function in any limbs, or changes in vision or speech.
• National Institute on Deafness and Other Communication Disorders, 800-241-1044, www.nidcd.nih.gov.
• American Academy of Otolaryngology -- Head and Neck Surgery, 703-836-4444 www.entnet.org.
• Johns Hopkins Center for Hearing and Balance, 410-955-8668, www.bme.jhu.edu/labs/chb.
• Vestibular Disorders Association, 800-837-8428, www.vestibular.org.
-- Mimi Harrison