When you constantly feel like you’ll fall down
What causes vertigo? Also, is it so serious that it requires medical care?
AW
Dear AW,
Vertigo refers to imbalance because of feeling that you or the world is spinning. It lasts between a few seconds and hours, though severe vertigo can last for weeks or months. Symptoms of vertigo may be a feeling of spinning, tilting, imbalance or swaying, and this may be accompanied by nausea, vomiting, headache, abnormal eye movements, sweating, hearing loss or ringing ears (tinnitus).
Most of the time, vertigo happens due to problems in the inner ear, since the inner ear is important in coordinating movement and balance. The inner ear problems could be due to:
BPPV: It stands for benign paroxysmal positional vertigo. This refers to episodes of mild to intense dizziness that are triggered by change in the position of the head or by lying down. It can also cause loss of balance, feeling that the room is spinning, abnormal eye movements, nausea and vomiting.
Most of the time, there is no known cause for the BPPV, though in some people it may be triggered by a head injury. It can also occur due to inner ear problems or due to prolonged periods lying on the back, for example, for a dental procedure.
Meniere’s disease: Thought to be caused by fluid build up and pressure changes in the inner ear, that can cause vertigo, a ringing sensation and hearing loss.
Vestibular neuritis or labyrinthitis: Inflammation of the vestibular nerve, usually due to viral infection
Other possible causes of vertigo include head injury, stroke, brain tumour, migraines, some medications. Anxiety and stress can worsen the vertigo.
Treatment depends on the cause. Possible treatments include anti-histamine medication (meclizine or cinnarizine) to reduce the vertigo or physical vestibular rehabilitation to help improve coordination and balance.
If you have BPPV, an ENT doctor or a physiotherapist can help manage the symptoms by taking you through some manoeuvres called canalith repositioning. These manoeuvres help to restore balance by repositioning parts of the inner ear. You can also be taught how to do this positioning on your own.
If this doesn’t work, there is a surgical procedure that can be done in the ears. Surgery can also be done to remove brain tumours. Management of underlying conditions can help reduce the symptoms e.g. treatment of migraine headaches; antibiotics to treat infection; steroids to manage inflammation; diuretics to reduce the fluid build-up in Meniere’s disease.
Of Kenyans suffering from syphilis, what proportion seek medical care? What can be done?
Reader
Dear reader,
Local data on infection, diagnosis, treatment and complication rates for syphilis is minimal and difficult to come by. Part of the challenge in seeking health care for syphilis is in how the disease presents itself. Its symptoms can mimic symptoms of other diseases. They develop in four stages over many years if untreated.
Syphilis is a bacterial infection, which is mostly transmitted through sexual contact, but can also be transmitted from mother to child during pregnancy and delivery. For transmission to occur, there is contact with the syphilis sore (chancre) which is found in or around the vagina, penis, anus, rectum, mouth or lips.
Primary stage: When one is infected, they develop a syphilis sore/chancre between 10 to 90 days after exposure. The chancre is located where the infection entered the body, and is usually firm, round and painless. It lasts about 3 to 6 weeks, and disappears whether or not there is treatment. If there is no treatment, the disease progresses to the next stage.
Secondary stage: Rashes and/or lesions on the mucous membranes appear when the chancre is healing or several weeks after it has healed. The rash may be on the palms or soles of the feet, or under arm or groin region.
The lesions may appear on the mucous membrane of the mouth, the vagina or the anus. During this stage, there may also be fever, swollen lymph nodes, sore throat, hair loss and aches and pains. The symptoms resolve with or without treatment. If there is no treatment, the disease progresses to the next stage.
Latent stage: This “hidden” stage has no symptoms, and this stage can last for years
Tertiary stage: This is rare and affects a few persons with untreated syphilis, occurring 10 to 30 years after primary syphilis. Usually, the body organs are affected, and the resulting illness can lead to death. It can affect the brain, the nerves, the eyes, the heart, the liver, the blood vessels, the bones and the joints. Symptoms depend on which organ is affected.
Congenital syphilis: A pregnant woman can transmit syphilis to the unborn child, resulting in high rates of stillbirths or death of the baby soon after birth. A baby born with syphilis may not show any immediate symptoms, but if untreated, can develop seizures, developmental challenges or infant death.
Syphilis can be easily tested using a blood test for anyone who is at risk. This test is mandatory in Kenya for all pregnant women. Treatment is also easy using penicillin, which is highly effective. Doxycycline or tetracycline may be used when there is penicillin allergy. Prevention is through practicing safe sex, plus screening and treatment of those infected.
Hey doc,
I usually have skin rashes in my body and I don't understand what causes them. I have visited a couple of hospitals given medicine but still they haven’t gone away since childhood up to now and I'm 21 years old. What might be the cause of the disease?
She
Dear She,
The recurrent rashes on your body may be due to a number of causes including allergic skin conditions, inflammatory conditions like psoriasis etc, reaction to heat (miliaria rubra), infection, acne, or allergy to drugs, fabrics, metal etc, or genetic skin conditions.
Treatment should be based on the exact cause, which can be determined by visiting a skin specialist for examination, and possibly taking a skin sample. To promote skin health, take lots of water, fruits and vegetables, and also exercise. Avoid skin products that may be harsh to your skin and protect your skin from the sun.
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