Dizziness: A Reportable Symptom

Ladies and Gentlemen, As I write to you this month, it was with hopes that you are fully vaccinated to protect yourself, your family and friends, from COVID-19. Our great country was making such great progress in returning to a new normal life style when cases were declining, but the virus changed and the vaccinations declined. Now we are exercising even more protective strategies against the new delta variant. Unless you have a health condition where the vaccine is not recommended, please get vaccinated if you have not already. And, if you are vaccinated, please take advantage of the booster vaccines, because we are learning about those who are fully vaccinated still becoming infected. YourHarmony Team. is so concerned about your health and well-being; so, please do all you can to protect yourself from this virus.

Throughout these two years, there may have been times when you have not been feeling well. Yournbsp; Harmony Team encourages you to always, always, let your primary provider know to help you. You may have also had times when you felt dizzy. Dizziness is a symptom of a variety of medical reasons that are treatable, which is why Dizziness is a Reportable Symptom – important to report to your healthcare provider.

Ladies and Gentleman, Dizziness is a major contributing fall risk factor and a cause of falls. The two major causes of dizziness that increase fall risk are vertigo and orthostasis (postural hypotension). These two medical conditions account for 48% of the dizziness reported by other adults (Casani & Navari, 2017). These two medical conditions are different but a common condition among older adults (Alyono, 2018).

Vertigo.

Considered a symptom, vertigo is a sensation you experience that you or the environment around you is moving or spinning. The range of sensation can be mild or so serve that you have balance loss and trouble functioning, sudden and chronic. This dizziness can be abrupt, brief, and violent, resulting in nausea, balance problems, and falls. Some persons are temporarily disabled as a result, until it subsides. There a variety of causes of vertigo, such as inner ear crystals inside your middle ear becoming displaced, migraines, inner ear infection, low blood sugar, and more (Han, 2019). The dizziness experienced is a sensation that the room is spinning, especially when you turn your head – vertical and horizontal movements of your head. The treatments for this problem is dependent on etiology, sometimes as simple as learning techniques to reposition your head, restoring your inner ear crystals to their proper location in the middle ear, resting or medications. However, because the causes may be more complex, it is important to inform your primary care provider that you are experiencing vertigo, to investigate your history, medications and other medical problems that are treatable. While vertigo can occur at any age, it is more prevalent in the elderly. According to Casani & Navari (2017), unfortunately patients affected by vertigo often have late diagnosis and treatment. This finding again emphasizes the importance of letting your primary care provider know about your dizziness and describe the onset of your dizziness, so that your provider can begin your evaluation, diagnosis and treatment, reducing your fall risk.

Orthostasis.

Orthostasis, also referred to as postural hypotension, is a condition where your blood pressure is lower than normal, drops when you change position, such as from lying down to standing, sitting to standing up, standing up too quickly after bending over (Healthwise Staff, 2019). Postural hypotensive can also occur as a side effect of medications, during or after exercising, after a large meal, or in the morning when you blood pressure is normally lower. When your blood pressure drops, does not resolve quickly to your normal blood pressure, you will most likely fall unless you can sit or lie down carefully and quickly. Fortunately, many older persons will feel dizziness or light-headedness when the blood pressure is dropping – this occurs within 1-3 mins. You have a warning symptom that your blood pressure is dropping. This dizziness is a feeling that you are starting to faint. However, not all persons have this warning symptom – they are “asymptomatic”. Next thing you know, you find yourself on the floor, having fallen. The assessment of postural hypotension is very important as the causes are varied, complex, and most importantly, often modifiable by your primary care provider.

This condition is so common among older adults, that CDC included assessment, management and education related to postural hypotension as one of their 4-pronged approach to fall risk screening in their 2017 STEADI (Stopping Elderly Accidents Deaths and Injuries) Program, to inform you that the dizziness of postural hypotension is very different than the dizziness experienced with vertigo. Their education resource was developed just for you and is provided here. Please review this resource and be among those older adults who DO seek medical care is you have a medical need, concern or question.

With both conditions, if you feel dizzy or light-headed, sit down or lie down for a few minutes. Or, you can sit down and put your head between your needs (Healthwise Staff, 2019). These strategies will help your blood pressure go back to normal and help your immediate symptom to go away; but, does not treat the cause. So, please let your primary care provider know that you are experiencing dizziness.

Your Harmony Team and Healthcare Providers are dedicated to your health, wellness, function and safety, and reducing your risk for falls.

Stay strong, active, and connected with your healthcare team. We are getting through these times together. Your Harmony Team is here to help you!

Your Harmony Team is here to help you!

Thank you for reading this message and in advance for sharing with others.

Pat Quigley
8/20/21

References :

Alyono, J. (2018). Vertigo and dizziness: Understanding and managing fall risk. Otolaryngol Clin North Am, 15(4); 725-740. here.

Casani, A.P., & Navari, E. (2017). Dizziness and prevention of fall in the elderly. Geriatric care, Dec. 11. Available: here

Han, S. (2019). What causes dizziness. Medical News Today. May 22. Available: here

Healthwise Staff. (2019). Low blood pressure (Hypotension). Topic overview. HealthLinkBC. Available: here

Postural Hypotension: What it is and How to manage it. CDC STEADI Program. Available: here

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