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HEALTH MATTERS: Spotting, coping with vertigo

Joshua Wynne

Q. I have been having episodes of dizziness over the last few days that make me feel like I’m spinning. The spells typically occur when I roll over in bed. My doctor says that I have vertigo and prescribed some medication, but I continue to have symptoms.

A. Vertigo refers to a spinning or whirling sensation, just as you describe.

While there are multiple causes of vertigo, the most common type, called benign paroxysmal positional vertigo, is caused by dislodgement of small crystals in the inner ear that alter the movement of the fluid found there that helps control balance. So the reason that you get vertigo when you roll over in bed is because it causes those crystals to move and disrupt the normal flow of fluid in the tubes that are found in the inner ear, called semicircular canals, causing you to feel like you’re spinning.

The best treatment is one of several maneuvers that trained therapists can do to get the crystals out of the way so they no longer cause symptoms. The most common approach is called the Epley maneuver, which consists of turning the head sequentially in several directions in an effort to get the crystals to move out of the semicircular canals. The Epley or other similar maneuvers generally are effective in resolving the vertigo; medication typically is needed only to help with nausea and vomiting.

If you have associated hearing loss or ringing in an ear, what we call tinnitus, that may indicate a more serious problem. But the bottom line is that a simple maneuver that moves the head in a specified pattern usually will promptly resolve the symptoms of benign paroxysmal positional vertigo.

Q. What is smoke inhalation?

A. Most fatal injuries after a fire are caused by smoke inhalation. This refers to damage to the lungs that is the result of irritation by chemicals in the smoke along with problems with getting sufficient oxygen to the tissues of the body. While terrible burns also can be life-threatening, death after fires most commonly is from the complications of smoke inhalation. Because symptoms of smoke inhalation can progress quickly, it is important that all subjects exposed to a fire who may be at risk are evaluated by trained health care workers.

Milder symptoms include cough, hoarseness and difficulty breathing; severe symptoms include confusion or coma. The single most important first step in treatment is to remove the subject from the scene and get the individual to a safe location; the second most important step is to utilize supplemental oxygen. Severe cases require a breathing tube to be inserted to help maintain adequate levels of oxygen in the blood.

But the best treatment for smoke inhalation is prevention. So if you didn’t do so on the first day of daylight saving time recently, please check the batteries in the smoke detectors in your house — and do it now!

Wynne is vice president for health affairs at the University of North Dakota, dean of the School of Medicine and Health Sciences, and a professor of medicine. He is a cardiologist by training.

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The content of this column is for informational purposes only and does not substitute for professional medical advice or care. The information provided herein should not be used for diagnosing or treating a health problem or disease. If you have or suspect you may have a health problem, you should consult your health care provider. Never disregard professional medical advice or delay in seeking it because of something you have read in this column.