Oct 22, 2019

By Trevor Shewfelt, Pharmacist at the Dauphin Clinic Pharmacy

In the spring, I saw Alex Lytwyn walking with a very cute new girl. Alex is always fun to talk to in Winnipegosis. He is an author and disability advocate, but on this spring day, the girl in the uniform definitely had my attention. She looked very smart but quiet, and she was very attentive to Alex. Her name was unusual, but memorable. Alex said I wasn't allow to pet her because she was working. Alex made me promise I wouldn't write about her until she was fully trained. By the fall, Alex felt she would be up to speed.

When you drive by a school yard in the fall, sometimes you will see kids spinning until they topple over. Kids seem to love the feeling of being dizzy. Dizziness can be a variety of symptoms including lightheadedness, fainting, spinning and giddiness. Technically vertigo is one type of dizziness where the person has a sense of motion when they aren't moving or an exaggerated sense of motion in response to a bodily movement. Vertigo is very common if there are problems with the inner ear. Vertigo usually comes with varying degrees of nausea and vomiting as well as being pale and sweating a lot.

Dizziness can have non-inner ear causes as well. Heart conditions like irregular heart beats like arrhythmias and high blood pressure, anemia, diabetes, migraine and head injuries. Dizziness can also be caused by medications like blood pressure pills, anti-depressants, alcohol, anti-Parkinson medication and anti-seizure medications.

There is a big red flag to watch for with dizziness. If a person is dizzy and has numbness, tingling, or weakness in any part of the body, vision problems, confusion or has difficulty speaking call 911 or take them to an emergency room. The person may be having a stroke.

What can be done for dizziness? Well, there are drug and non-drug treatments. My sister is a physiotherapist in British Columbia. She tells me that sometimes she can help patients by having them do some specific movements. She tells me that these semi-circular cannels in the ear that control balance can get debris moving through the fluid and making the person dizzy. If a trained health care professional rotates the patient in a special way the debris can moved "out of the way" so the dizziness gets better. If the dizziness is caused by Meniere's disease, sometime doctors will recommend reducing salt in the diet and avoiding caffeine and smoking to reduce the number of dizzy attacks.

There are a few medications that can be used to treat dizziness. Most people are probably familiar with dimenhydrinate (brand name gravol). It can help dizziness but often causes drowsiness and dry mouth. There are also patches which contain scopolamine which can last for up to 3 days. These are popular to combat sea sickness for people going on boats. By prescription there is betahistine (brand name serc). It usually lasts about 8 hours and has less sedation than the other dizziness medications. It is controversial how often these medications should be used for dizziness. They are probably fine for up to two weeks. After that, we are unsure if they are doing any good. And betahistine was compared to placebo for Meniere's disease and didn't work any better than the sugar pill. All of these medications are called antihistamines. To differing degrees they can all treat nausea and vomiting as well as dizziness. Also to varying degrees they can all cause drowsiness, confusion, dry mouth, blurred vision, constipation and trouble urinating. They should be used with caution with people on antidepressants. They should be avoided in certain types of glaucoma (closed angle), certain prostate problems and if the person already has trouble with urinary retention.

Fanta is a beautiful black lab and Alex's new service dog. Around Winnipegosis you'll see the pair rolling around town. Alex had to go to Oakville, Ontario to train with Fanta for 3 weeks before she could come home with him. Alex and Fanta came home March 9, 2019. Fanta knows at least 17 different commands. My dog Sheldon is very cute too. However, Sheldon's biggest accomplishment is that he knows to sprint to the coffee maker when I turn it on for a cookie. Fanta can open a door to a business with a wheelchair access button. She can open Alex's fridge with a rope tied to the fridge door. Fanta can bring Alex his water bottle. If a business like the Winnipegosis Clinic Pharmacy doesn't have a wheel chair access button, Fanta will bark outside the building until she gets our attention and we can open the door for Alex. And unfortunately Alex says no petting and if they see Fanta doing a task, don't talk to her or Alex. Let her do her job.

The information in this article is intended as a helpful guide only. It is not intended to be used as a substitute for professional advice. If you have any questions about your medications and what is right for you see your doctor, pharmacist or other health care professional.

As always if you have any questions or concerns about these or other products, ask your pharmacist.

Roller coasters and spinning fair rides can be thrilling. Sometimes after the ride the participants stagger a bit for a short time. They say they are dizzy. Dizziness refers to a variety of sensations such as lightheadedness, fainting, spinning and giddiness. Vertigo is the sensation of movement when there is none, or an exaggerated sense of movement to a give body motion. Dizziness can be caused by a number of non-ear related conditions like high or low blood pressure, diabetes, migraine or head injury. Dizziness can also be caused by medications like blood pressure pills, anti-depressants, alcohol, anti-Parkinson medication and anti-seizure medications. We will talk mostly about ear related dizziness.

Firstly, though, all patients with dizziness and vertigo should be assessed by a physician. It is important to find the cases of dizziness and not just let them go untreated.


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