DEAR DR. DONOHUE: From the minute I get out of bed, I have attacks of dizziness. I don’t know what brings them on. I’m afraid these spells are going to make me fall and break something. Do you have any thoughts that could help? I’m 82. — R.M.

ANSWER: The causes of dizziness (vertigo) are many. I’ll mention a couple, but you need a doctor’s exam to determine what the exact problem is.

Meniere’s (main-YAIRS) disease is a triad of dizziness, hearing loss and ear noises (tinnitus). It comes in brief attacks, with recovery in a short time. As time passes, attacks last longer, with briefer periods of relief. A buildup of fluid in the inner ear is responsible. Water pills and a strict low-sodium diet help. Surgical drainage of the fluid is another treatment.

A viral infection of the inner ear is a common dizziness cause. Time eventually takes care of the virus. During the period of infection, a medicine like meclizine improves symptoms.

A third common problem is benign positional vertigo — dizziness attacks with head movement. Getting out of bed, rolling over in bed, looking up at a high shelf and just about any change in head position trigger an attack, which is short-lived. Tiny calcium crystals in the inner ear have migrated to places where they engender a discharge of confusing signals to the brain. Repositioning the crystals puts an end to the attacks.

Sit in the middle of a bed, far enough to the opposite side of the bed that your head will project over that side when you lie down. If a head turn to the right provokes an attack, quickly turn your head to the right, and keep it turned until dizziness goes. Then lie down quickly with your head off the side of the bed and still turned to the right. Then, from that position, turn your head to the left. Roll over onto your left side, with your nose pointed down to the floor, for 30 seconds. Then go back to the starting sitting position with head bent. If dizziness persists, repeat. If this is too complicated, let your doctor lead you through it.

The booklet on dizziness discusses in greater depth its various causes and treatments. 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: My gynecologist says I have a small rectocele. She didn’t mention any treatment for it. She said it doesn’t merit treatment now. How will I know when it does? — B.A.

ANSWER: A rectocele is a falling down of the rectum. It pushes into the vagina, creating a bulge. Your bulge must be so slight that it causes no trouble.

Should the bulge pass through the vaginal opening, the rectocele tissues will become irritated, and some intervention will be necessary.

Or if you are having trouble passing stool, then rectocele repair is indicated.

Having no symptoms means you have no need of interference. You might never have any. You should go on a high-fiber program to ensure soft stools. Straining to eliminate makes the situation worse.

DEAR DR. DONOHUE: My right cheek puffed up so much that it makes me look like a chipmunk. It isn’t the least bit painful. My family doctor has me scheduled to see a specialist because he thinks it could be a parotid gland tumor. How common are parotid tumors? — L.F.

ANSWER: They aren’t common.

The parotid glands, right and left, are the major salivary glands. They swell when infected with the mumps virus.

Even though your doctor used the word “tumor,” that doesn’t automatically mean cancer. It could be a noncancerous growth. Or it could be that a small stone is blocking one of the drainage tubes. A blocked tube often can be taken care of right in the office.

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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