DEAR DR. DONOHUE: I am 82 and in pretty good health except for a recent problem. During the day everything is fine, but when I lie down to go to sleep, the room starts to spin. It lasts about 10 seconds. Then if I turn my head to look at the clock, the dizziness returns. In the morning when I wake and turn my head again, the room spins.

Do I have an inner-ear infection? How can this problem be fixed? — J.C.

ANSWER: Although I can’t give you 100 percent assurance, I can say on solid ground that you have benign positional vertigo, BPH. Vertigo is dizziness. BPH is not an inner-ear infection. It comes on just as you have written, with a change in the position of the head — lying down, turning to the side or looking up to a cupboard shelf. The attacks are brief but disrupting.

Crystals normally found in one part of the inner ear have migrated to another part. Moving the head activates the displaced crystals, and they send a message to the brain that brings on dizziness. The inner ear is not only for hearing; it’s also for balance.

You can bring the crystals back to their original site through a series of movements called the Epley repositioning maneuvers. Sit on the side of a bed and bend your head to the shoulder on the side that triggers dizziness. Let’s make it the right side, so you can follow the instructions. If it’s the left, just change the direction. With the head turned to the right, lie down so your head projects off the other side of the bed. When dizziness stops, turn the head to the left side, with the left ear facing down. Next, roll over on your left side so the head faces down for 10 to 15 seconds. Finally, return to the sitting position with your head bent slightly down in front. You might have to repeat the procedure more than twice. If this is too confusing, have your family doctor or an ENT doctor put you through the motions.

The booklet on vertigo explains the common causes of it and their treatment. To obtain a copy, write: Dr. Donohue — No. 801, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: I am 33 and have always had a low sex drive. My doctor did some tests and found I have low testosterone. He also did a bone density test, and I have osteoporosis. He wants me to take testosterone therapy. The label says it has a risk of prostate cancer. I am confused as to what I should do. Should I take an osteoporosis medicine like Boniva instead of testosterone? — D.R.

ANSWER: You’re 33. You are not going to get prostate cancer by taking testosterone replacement therapy. You have a testosterone deficiency that has brought about osteoporosis at an incredibly young age. You need the hormone. You need it for the other reasons you mentioned in your letter, which I have deleted. Boniva or any other drug used for the regular kind of osteoporosis is not what you need.

Now that it’s established that you have a low testosterone blood level, the next step is finding out why. Any number of reasons can cause this problem. In addition to replacing the missing hormone, some of those causes require other treatments.

DEAR DR. DONOHUE: Why doesn’t the heart ever get cancer? I’ve never seen this question asked or talked about on TV. Blood feeds tumors, so it makes sense that the heart would be a target. — C.V.

ANSWER: Tumors do arise in the heart. A somewhat-common benign tumor is a myxoma. It can disrupt the flow of blood through the heart. Malignant cancers, ones that spread and grow rapidly, also arise in the heart. They are quite rare. A rhabdomyosarcoma is a malignant tumor of heart muscle. The blood contained in the heart doesn’t feed heart muscle. If it did, we’d never have heart attacks. Heart muscle is nourished by its own arteries. So are heart tumors.

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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