Persistent dizziness
Reader: I am in reasonably good health except for one ailment that has troubled me for the past three years. I am in a constant state of dizziness that worsens each year. I now must be very careful when walking, although I still manage to walk two miles a day, which I have done for the past 50 years. I work out at a fitness center three days a week and ride my exercise bike 40 minutes a day. I have had x-rays, CAT scan of the brain, MRI, carotid artery screening, EKG, and blood tests–all with negative results. My medication consists of one blood pressure pill (Triamterine) daily. I would certainly appreciate any helpful advice you can offer.
Dr. Zipes. From the tests you describe, you have had a thorough evaluation, I assume by a neurologist, for the common causes of dizziness, and there is not a lot I can add. However, I can make two suggestions, both of which you may have already considered. First, an evaluation of inner ear function by an expert ear specialist would be appropriate, if it has not already been done. Second, consider stopping the triamterene for a period of time to see if that might be the cause. Certainly your blood pressure needs to be controlled, but it could be that this drug is causing the dizziness, and another type of blood pressure pill could be substituted. Keep up the exercise. That is great.
Reader: I am in fairly good health, but with a problem. In January 2001 I had a mild heart attack. Two or three days later, I had three stents put in, had a fast recuperation, but have been dizzy ever since. I have found that trying to distinguish between “dizzy” and “no balance” is difficult. My doctor is a leading cardiologist and has done everything he knows to do, but I still have no balance, making it more and more difficult to walk unaided. I now use a cane most of the time. Other than this terrible lack of balance, I feel fine. Sitting in a chair, driving a car, or doing anything I want to do while seated is fine. When I get to my feet, I cannot correct any tendency to fall over. Any suggestions?
Dr. Zipes: See my response to the previous letter. You need an evaluation by a neurologist who may want to do some of the tests I just mentioned.
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