Doc, why do I get dizzy after exercise?

Dear Dr Flo,
What could be the reason for feeling dizzy after exercise?

Dear reader,
Dizziness after exercise can be a result of low blood sugar and reduced blood supply to the brain. This can develop as a result of the excess utilization of energy and oxygen within the muscles, and the diversion of blood supply to the muscles during exercise.

In addition, due to the generation of heat during the workout, you sweat a lot to cool down, which can lead to dehydration and even low blood pressure.

The dizziness may also be a result of a dysfunction in the nervous system that usually balances out all these elements in the body.

To prevent dizziness, eat before exercise (preferably whole grain and protein) take a snack afterwards and practice diaphragmatic breathing (or belly breathing) to improve oxygen supply and muscle function during exercise. In addition, take adequate amounts of water before, during and after exercise. Do warm-ups before exercising, and cool down exercises thereafter.

For every exercise activity that you engage in, start slowly and build up intensity gradually. If the dizziness persists despite these measures, then it is advisable for you to be reviewed by a doctor to check for any underlying conditions and to get the appropriate treatment.

Dear doctor,
I am a 54-year-old lady who is now going through menopause. For the past few months, I have been waking up many times to pee at night. I thought this was a problem for men. What could be wrong with me?
Hilda

Dear Hilda,
Having to wake up several times at night to go and urinate is called nocturia. It can happen because your body is making too much urine or because the urinary bladder is unable to hold the urine until morning.

The body may make too much urine because you had too many fluids just before bedtime, or because there is an imbalance in the system that produces urine. It can also occur as a result of taking medication or substances like alcohol and caffeine that increase the amount of urine your body makes.

Nocturia resulting from the bladder not holding urine well can occur in any gender and at any age. For older women, after menopause, less estrogen in the body causes changes in the urinary tract that can lead to you needing to urinate more frequently. The muscles of the pelvis may also be weaker, especially if you have given birth previously

Nocturia can also be due to convenience voiding. This is when you wake up at night, and decide to go and pass urine since you are already up anyway. Waking up at night may be a result of hot flashes or due to body changes that come with advancing age.

Other illnesses can also cause nocturia such as urinary tract infection, urinary bladder problems, diabetes, heart disease, liver disease and some neurological conditions.

It is advisable for you to be reviewed by a health provider for evaluation and treatment of any underlying conditions. In addition, limit your fluid intake in the evening; use the bathroom just before sleeping; avoid caffeine and alcohol, especially in the evening; and practice sleep hygiene.

Find out from your doctor if there are any medications you are taking that could be causing the symptoms and whether they can be substituted. There are also hormonal treatments that can be used to address some menopause symptoms.

Dear Dr Flo,
My 5-year-old son has episodes of vomiting on and off. This started some time back, and though the episodes are not as frequent now, they still occur. During the episodes, he has abdominal pain and then vomits several times, and then after that he is perfectly fine. The episodes happen after several weeks of being okay. When he is taken to hospital, all tests done usually come out negative.
What could this be?
Richard

Dear Richard,
Your son may be suffering from cyclic vomiting syndrome. With this condition, the person experiences a sudden onset of vomiting that lasts for several hours or days, and then the symptoms resolve. After the vomiting episodes, there are longer periods where there are no symptoms.

Other symptoms include severe nausea, sweating, abdominal pain, headache, diarrhoea, dizziness, sensitivity to light, and gagging or retching. The episodes tend to be similar in that they may start at around the same time of the day, and last for a similar duration, and the symptoms are similar.

Cyclic vomiting syndrome tends to affect children more than adults, and in any child, it resolves before they get to adulthood. There is no known cause of the condition, though it is likely to be affected by genetics, problems with the nervous system, the digestive system or hormonal disorders.

If an individual suffers from migraine headaches or has a parent who gets migraines, they have a higher chance of experiencing the condition. Certain factors may trigger an episode e.g. stress, excitement, illness, headache, motion sickness, overeating, fasting, exhaustion, overheating, or certain foods and drinks e.g. cheese, chocolate, caffeine, alcohol or foods with monosodium glutamate (MSG).

There is no known cure for the syndrome, though it tends to resolve in most children as they grow older. Some medications may be used to stop an episode once it starts, and if the episodes are severe, some medications may be given to prevent them. Avoiding or managing the triggers may also help reduce the number of episodes.

Other possible causes of the recurrent episodes of vomiting include infection, gastro-oesophageal reflux and functional disorders of the digestive system or hormonal problems, respiratory infection, certain foods (chocolate, caffeine, cheese, MSG), physical exhaustion, over-eating, fasting or eating just before sleeping.

Your son should be reviewed by a specialist (a paediatric gastroenterologist) for evaluation, necessary tests, and appropriate treatment.