DEAR DR. DONOHUE: One morning this past week, I woke up with such dizziness that I can’t describe it adequately. It made me sick to my stomach, and I threw up. I went back to bed and lay there for an hour before I could get up and navigate at all. I have never been seasick, but I think this is the closest I’ll ever come to it. What causes this, and what can I do for it? – M.M.

ANSWER:
The causes of dizziness are dizzyingly numerous, but if you insist I take a stab at the diagnosis, I would choose vestibular neuritis. The vestibular nerve is the nerve that takes balance signals to the brain from the inner ear. Inflammation of that nerve makes people feel like they’re aboard a ship that’s rocking and rolling in gigantic waves.

The inflammation is often due to a viral infection. It comes on quickly, the way you describe what happened to you. Nausea and vomiting are almost always part of the picture.

I’d like to tell you that things will be well in short order, but the nerve inflammation can last a long time. Symptoms lessen, but lingering dizziness can remain. Cortisone drugs quicken recovery. At least, studies have shown that people who take those drugs regain their equilibrium faster than those who don’t.

Motion-sickness drugs like Antivert can also be tried.

What you must do is see the family doctor. I have briefly outlined one common cause of dizziness, but vestibular neuritis is only one of many causes. Treatment of those conditions is quite different from treatment of vestibular disturbance.

The booklet on vertigo (dizziness) discusses the more-common conditions where dizziness is the prominent feature. It also provides information on treatment of those causes.

Readers who would like a copy can obtain one by writing: Dr. Donohue – No. 801, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6.75 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: A year ago, two red patches appeared on the back of my right hand. I thought I had some kind of ringworm and used a fungal medicine I picked up in the drugstore. It didn’t work. I saw a doctor, who tentatively diagnosed this as granuloma annulare. He didn’t give me any medicine, because he said it would go away in a year. It hasn’t. What now? I am 27 and a woman. – K.R.

ANSWER:
What now? Get the “tentative” removed from the diagnosis. See a dermatologist.

Your description fits that of granuloma annulare. It’s a red, tan or violet circle with a diameter that measures anywhere from 0.2 inches (0.5 cm) to 2 inches (5 cm).

There can be more than one circle. The circle’s edges slowly expand and the center pales.

About 50 percent of people with it will have a complete recovery in two years. Perhaps you only need a little more time. However, 50 percent is not all that reassuring. Half don’t see it disappear in two years.

If a particular circle is distressing, a doctor can inject it with one of the cortisone drugs, but relapses are frequent. Applying a cortisone cream or ointment to the skin sometimes causes it to leave. Many people choose to ignore it.

There is another kind of granuloma annulare where there are many red circles on the body. This variety is even harder to treat than the kind with a limited number.

The cause? It hasn’t been found.

DEAR DR. DONOHUE: I am 35 and would like to have a flu shot. My doctor says I’m too young to get the shot. Won’t it work? – G.M.

ANSWER: I
t’ll work for you. Anyone of any age can get a flu shot if he or she requests. The only reason why you might be refused is a shortage of the vaccine. That shouldn’t happen this year.

DEAR DR. DONOHUE: Is there a season when more hair falls out? I have been told that in winter more hair falls out than in summer. Is that the case? I seem to be losing a lot of it now. – W.K.

ANSWER:
Anywhere from 50 to 100 hairs fall out every day. There is no season when hair loss is greater. It’s the same year-round.

There are times when more hair is lost, regardless of season. Serious illness, a high fever, giving birth, psychological stress or a malfunctioning thyroid gland can increase hair loss. Once the condition is corrected, the lost hair comes back in time.

If you count the hairs in your brush and comb and the count is below 100 every day, you’re OK.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com


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