Archive for February, 2011


Dizziness is a term to describe a sensation of lightheadedness, loss of balance, unsteadiness or faintness. Dizziness that causes a feeling that you or the room is moving or spinning is called vertigo. Although these symptoms may be incapacitating or disabling, dizziness is rarely a sign of a serious or life-threatening condition.

Symptoms may also include nausea, vomiting, weakness and fatigue. More serious symptoms prompting immediate emergency attention are severe headache, high fever (above 101 degrees), stiff neck, vision or hearing loss, weakness of an arm or leg and dizziness that results from a head injury.

There are several classifications of dizziness:


Lightheadedness is usually caused by a lack of sufficient blood getting to the brain. This can be due to very low blood pressure, an arrhythmia (irregular heartbeat), dehydration or a stroke.

Loss of balance

Problems with balance can be caused by an inner-ear disturbance, failing vision or nerve damage in the legs or may be a side effect of certain medications.


There are several types of vertigo, with different causes and symptoms.

– Benign paroxysmal positional vertigo (BPPV) occurs when a tiny mineral particle gets stuck in a sensitive section of the semicircular canal, a fluid-filled area of the inner ear that regulates our balance as we change positions. The condition is aggravated by movement or changes in the position of the head, such as turning over in bed or sitting up. Many patients can have almost instantaneous relief using a simple exercise of head movements done in a doctor’s office or, once learned, at home. The maneuvers dislodge the offending particle, thus eliminating the vertigo symptoms.

– Inflammation in the inner ear (labyrinthitis) can develop with a cold or an allergy and can cause sudden intense vertigo that lasts several days. Unlike BPPV, this condition can happen at any time and is not associated with movement of the head. An over-the-counter medication, Bonine, can often relieve the symptoms of this disorder.

– Meniere’s disease is caused by a fluid accumulation in the inner ear. It is characterized by sudden episodes of intense vertigo with nausea and vomiting. Other symptoms may include hearing loss and ringing or fullness in the ear. This is a more chronic condition and may need to be treated by an ear, nose and throat specialist.

Many patients I see with dizziness or vertigo symptoms fear they may be having a stroke or some other serious problem. Most of them have one of the above-mentioned conditions and can be treated either with the head-positioning maneuvers or with medication. Thankfully, most of these conditions resolve on their own.

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I’m writing about colon cancer this week because of two recent incidents involving people I know.

One is a patient I saw last week. He is 60 years old, and because his insurance was lapsing, he asked his doctor to order a colonoscopy exam, even though he had no symptoms. Colon cancer was found before it had spread, and his treatment gives him a good chance of survival.

The other is a very close family friend. She was 47 last year when she saw her doctor for rectal bleeding. Her workup included a colonoscopy, which showed colon cancer. She is under treatment and also has a good chance of survival.

Cancer of the colon and rectum is the third leading cause of cancer in men and the fourth leading cause in women. It’s a diagnosis that is more commonly seen in the Western, industrialized world.

Risk factors can include age (50 years and older), a family history of colon cancer, a high-fat diet, smoking and excessive alcohol intake.

Most colon cancers begin from polyps in the colon, which usually start out as benign but after time can become malignant. Therefore, timely diagnosis and removal of polyps can help prevent the development of colon cancer.

A colonoscopy exam is the current best method for detecting colon polyps. During the same procedure, the doctor can easily remove any polyps. Colonoscopy is essentially painless, is an outpatient procedure and is a small price to pay for the possible early detection of colon cancer.

The more common symptoms of colon cancer include rectal bleeding or blood in the stool, a change in bowel habits, a feeling that the bowel doesn’t empty completely, weakness or fatigue, and unexplained weight loss. Any of those symptoms should sends you to see your doctor as soon as possible.

Your doctor will most likely do a rectal exam, perform a rapid chemical test of a sample of your stool to check for trace amounts of blood, take a blood sample to check for anemia and, most likely, schedule a colonoscopy exam.

Surgery is the most common treatment for colon cancer. Chemotherapy and radiation are also often used, depending on the extent and placement of the cancer.

The bottom line is that colon cancer, if diagnosed early enough, has a very favorable prognosis — and, if found too late, after it has metastasized (spread) to other organs, has a much poorer survival rate.

Talk to your doctor about colon cancer screening if you are 50 years old or older or if you are younger and have a family history of colon cancer. Especially see your doctor if you have any of the above-mentioned symptoms. Don’t settle for anything less than a colonoscopy exam if you have persistent symptoms. Denial or delay can be a matter of life or death.

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