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WWL>Topics>>7-7-14 2pm, Angela, Neuro-otologist

7-7-14 2pm, Angela, Neuro-otologist

Jul 7, 2014|

What is a Neuro otologist? Do you suffer from vertigo & dizziness? Do you suffer from vertigo or dizziness? 40% of Americans will experience dizziness or vertigo serious enough to see a physician. About 9% who are 65 or older experience it and most fall-related injuries are due to dizziness or balance problems. Dr. Gerard Gianoli, a Neuro-otologist, specializes in vertigo and will take your questions.

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Automatically Generated Transcript (may not be 100% accurate)

-- I really enjoyed listening to run. To our news directors to our guys in sports certainly you know so much about the Internet about what is trending it's fascinating if you're. Interested in sort of what's hot today but. And we only scratched the surface but I'd just love the feel of anyway we are moving on to something I think a great many of you are gonna find tremendous understand and they show really is for you I hope you'll feel comfortable. Calling us at 260170. Have you ever gotten up and all of a sudden you feel incredibly Disney. Or you have all of a sudden just lost your balance and wondered you know what's going on here. It happens for many reasons and here to talk about it is a Doctor Who specializes in the field of Nero totality. Neural go to college thank heavens this man has been here before the let and is not intimidated by the mine neuro apology. No wrote on saying it ten times it's doctor Jerry Jindal and I truly appreciate you coming back. And I wanna encourage or are listening audience. It's dizziness it's many things we're gonna learn a lot but you have a specific issue he'd love to talk to and that's again to 60. 187. So let's talk about these balance -- to talk about vertigo. Yes -- Well you know the the the big distinction we start off with is their bank comes in the exit is -- The problem is the definition of the word dizziness. When I ask you what is the medical definition of the word dizziness often -- the patients and adults I don't know what is that I don't know either because it has no medical definition. I've seen people come in saying that they were dizzy and what they meant was they were spinning and others that it says there were dizzy -- that meant they were gonna blacked out. In others who actually felt to have -- headache and call the dizziness. On the other hand on the word vertigo has a very different meaning it's a very specific medical term. It is the hallucination of motion. Specifically. The most common form of vertigo is a spending tighten up and feel like you are spinning. Where the world is spinning or war or one of those type movement to it can also be. A sensation of being pulled or pushed or feel like you're going down and -- leadership after when that kind of thing. So all of once you distinguish between those two that's probably the most important part of the first visit with folks. Then you can delve into exactly what it is when someone has vertigo. It's almost always due to -- There is nothing from the heart that will cause a blood pressure that will -- to -- which is a big misconception monologue a lot of positions. And I think some of it's just don't ever quite get the history that you know the patients spinning the dispute is in the go to a cardiac work. But as far as -- -- there's a lot of things besides using cause dizziness. You know that is very very interesting not gonna say too much from this but years ago I was in an exercise class. Which I've been an everyday in my life forever and I got down the floor have been -- -- and that world started spent literally the Jim spent. And I got on all force. To try to get I mean it was such a frightening feeling. And only gosh I mean anything brain to movement going all kinds of awful things and stroke the other when yes and it ended up being part. It will the -- most common cause of vertigo and do things that we sees something called an on Turks as more positional vertigo. And it is so common that we've seen it all age groups from little kids up to the most oldest and oldest patient BC. It is indicates more more common older week. It is so common that I will -- say everybody will have at some point in life. Look at that how common it is now most patients it will go away on its own you never need treatment. But there isn't some group week keeps coming back in the as the ones that one up in my office. But that's probably what you had asked him you know it's it's usually from changing your head position. It's abrupt onset know who hearing related symptoms. And that usually subside to Arizona and very often it doesn't mean come back. I think because I would exercise -- -- regularly at that point that it threw me off if I hadn't been Reynolds and I change position well. But no one atomic after the doctor I was. Riding on the will look at -- we got a caller let's go to justice in the -- justice. -- yes justice. Has been. They're. Played the other guy -- company op and that lack of a lot and that didn't happen a lot more than you have been out. Now I think -- -- clear -- -- On the other. There -- apparently lived here. But -- and check -- -- respect and I'm back. Well on another common reason for quote -- dizziness is something we call with the static type of tension. And what happens is when you stand up very quickly. Your blood vessels in your lower after how many years in your body have to contract to -- the blown up you head it needs to get up there quicker. And if you get up faster than the blood can get up there basically you're gonna feel light headed you're gonna have some. Some graying out of your vision. And it's typically something that results after a few seconds or so it's very very comic now this everybody will have this at some point if they get up too quickly. But it is it made worse. When you have other issues with blood pressure for example. Suppose you've worked out in year you sweat a whole lot you're dehydrated when your blood pressure is going to be starting off at a lower level. And if you get a -- quickly in that situation it's going to be worse. Amongst. Another -- in favor of Obama but -- -- -- not been happening a lot -- -- the -- model output that angered animal there here and there aren't that. Yeah -- again though the term dizziness as though though when I go back to its. It's that he'll define term and certainly when your blood sugar level gets too low which is a a common problem for type one diabetics. Good brains gonna misfire is the bottom like is your brain lives off of shipments to you don't have enough sugar years you can have all kind of weird deals anything he can do. That that now that this is increasing a little bit. Well one is you know mean maintain hydration so you don't get dehydrated when you're working out and the other thing is particularly for type one diabetic. They have to be careful with the management of their insulin when they're working out because when they're working out they're not gonna need as much insulin is when they're not working. And that's -- and Eddie you need to talk -- doctor that's prescribed in the -- about it. I ever that your heroes emerged ideological. Hurry and I picked up and then. That is the it's not like a big problem. Well yeah I mean getting up slower usually solves the issue. Thank you so very much justice let's go to Jay in New Orleans. You. Some of what I -- like Oregon and why it was happening you know a little bit on it you know upbeat. And later all -- birdie -- -- out back a little bit more yeah. When -- situations a little bit different than the previous -- His situation he wasn't -- now in your case when you're getting up in your spending. You're much more likely have been the thing we talked about earlier that I spoke with a neutral about the -- gnawing Perritt says more positional vertigo. The most common scenario in -- -- -- whole bunch of variations on the theme but the most common scenario is its worst first thing in the morning when you get out. Then as the day progresses it tends to get better in May actually go way. Until the next time it happens in the typical scenario for somebody who's had for. A whole bunch like -- years or whatever is that it will wax and Wayne will get better get worse get better and get worse. And the reason why you get this is there is on. Two types of sensors in the -- year you've got. The semi circular canals I think most people heard about me give you angular acceleration information. And then have these other organs called the portal with the organs we have these crystals. On top of the sensor in the given weights -- commission gravity. And Linear acceleration. Well of those crystals -- break loose. And float on in to the semi circular canals. Now you've gotten waits impacting on something that's not supposed to have any weight in -- screws up the input and that's when you get these episodes of spinning. But they can also depending on how you put your head whatever float back out and it goes away until the next time -- back it. Very very interesting thing QJ very much -- stay with this every -- we're gonna have to take a break but. The doctors in the house and were talking about are you agency. I'll be right back this is Angela into the W whales are very special guest today doctor Jerry G in building who is a specialist in. Dermatology. I'm going to go to them are today and hill in Metairie because this actually was the next thing we were gonna talk about Daniel. Hi. I mean you're in. Air and read your. Screen is. It -- -- All. I ain't right here. And -- -- -- sure and I didn't eat a. Well I would definitely disagree with your doctors there and there are definitely things you can view from in years disease. But the first the first now is actually an appropriate diagnosis. And I would I would put two things out for you first all -- worthy. Those who -- with -- years disease. On the start off with the definition of the word in years syndrome. Syndrome is basically a word that means a collection of symptoms that doesn't mean a particular diagnosis but it's on symptoms ECB -- Specifically. Mean years syndrome. Is for things fluctuating hearing loss. Pressuring -- year. Ringing in the year that usually low pitch they don't collect the ocean or motor types. And in the last one is steaming vertigo. Lasting at least twenty minutes but typically -- freedoms. So those -- symptoms together constitute New -- syndrome. Well the problem is what causes in years syndrome package package layout pages and pages of things that -- clause in years syndrome. If we've gone through all the potential causes and we can't figure out what is causing -- in years syndrome. And we call -- in years disease. In years disease by definition means we can't figure out why you have this. The problem I see with most patients is they'd get labeled with New Year's disease and no one really ever looked to see why there. So for every ten patients NIC with the diagnosis -- years disease. At least not on leave with a different diagnosis because we find out why they. What you know what's the call is suddenly. The treatment is immensely more success. But even if you're stuck with the diagnosis of New -- disease there are a lot of things you can do for absolutely. That is great news. Why did great things. Where. You're. -- -- -- -- -- Yeah that's one of the potential causes of many years syndrome. And like -- said there is a bunch but that's wonderful. He. Might be eaten in both -- Who have yeah rhetoric thank you so much for calling. It ain't. This is a man I have to tell you that people. All over the world come to see him for one particular thing call superior can now. Stay here since -- cassettes yes ma'am there's condition. It's basically a developmental. Or congenital anomaly we're. A part of the bone is missing over the proper balance canal which we called the superior semi circular can now. And in children it usually does not cause any symptoms it's not until. Later on in life that something happens that didn't provokes the symptoms they get. And the most commonly identified symptom is either head trauma or a severe pressure altering event and by that I mean think. Childbirth and don't want you know. You'll a very common scenario lady goes along she's never had any trouble and didn't she cast her first baby has a very. On difficult -- to leverage training for hours. And then after that suddenly she's got vertigo and dizziness. Well the interesting thing about menu -- -- superior canal the pistons is. It's been termed the little logic mimic her because he can mimic a lot of other. You're related disorders including me -- years disease it's one of the causes. For many years diseases matter fact. From a previous call that's one of the things they need to check the can also look like apparently official. But. The interesting thing at some of the symptoms are quite unique one album is called to -- Phnom. And this is when certain -- -- will make the patient feel like they're spinning. And there is there's actually eight. A Grey's Anatomy episode on this recently in Demi Lovato. Played this patient to Arabic thought she was you know just schizophrenic or something they were get rated admitted to -- to the psych unit in one of the dock so commit I think she may have superior get -- -- isn't intro. And sure enough that's -- she had on the other interesting symptom and this -- in her case. If you don't hear internal voices extremely loud like the computer -- news and they're they're joint news been built here the foot hit the ground amid loud enough that it really is bothersome. I had one lady who. She worked at a -- senator. And she told me she'd have to hold her breath. In order to hear people on the phone chiefs couldn't breathe at the same time that's how loud it what's. That is fascinating. And so people come to you and what do you do. Well we do variety of different things depending on the severity of the problem is fortunately a lot of the folks. All requires is avoidance of certain things are -- trigger. That symptoms. But for those that are severely affected surgeries actually string was successful on basically we just. Put bone where there is no about separate each cranial cavity from but hold in the inner a year and it's highly successful surgery. Do you make it sound so easy but it's just -- let me think about this very small area of our body. It's drilling that you. And all of the catastrophe it can cause absolutely. Learning a lot. I'm really really appreciative we got a bunch of callers I want everyone to stay with -- We're gonna have to break what boxing but let's go ahead and take a million in camp. -- -- In the afternoon. I have a question I think that's the mount an -- at a maybe. Gupta spoke about just now. But I have an expanded. Does -- -- About what five times in the last few years and just. Not to aggravating that gave him because it would take hours. I would have to look it up straight and then I would find mildly to debated the the Internet to people -- and I'll wake up to now go back. And put them does not have a bit -- do you know when you get up and down out of then all of a sudden I'm getting worried and -- could come back on and nothing happened to. So I don't know what to do indifferent -- -- that -- to -- boy. -- the first thing is again you needed diagnosis but the the other interesting thing about inner ear disorders as you can have more than one at the same time and very frequently what you'll see is a combination. Of of benign positional vertigo with something else. You can happen along with mean years disease you can have along with -- canal the pistons syndrome you -- -- along with. Just about any inner your maturity can name and what it does is. It confuses the picture for the doctors some because some spells are long summer short and and some reduced by a position change in summer and -- and it. It's almost sort of like you have to factor that part of it -- to figure out what's the other thing that's going on. And it's such a common thing that I have to admit when someone comes to union and vertigo and dizziness. I just assumed an oppositional vertigo and separate them out from whatever else was going. Practice -- apparently. For me if I advocated again and hope I don't do it then to come. Make. See you make an assessment because right now tested it out anyway. Well it does it depends of me if it's been a long time since you've had you've probably better off just waiting right as it may not come back he may not come back again. Yeah I'm hoping. And -- Thank you don't. Thanks so much very much for for listening and calling and I want to Kevin in Linden NJ to stay with this gonna break for news will be right back talking to the good doctor I -- Angela into the our very special guest today doctor Jerry Giannone and he assaulting. -- solving a lot of our problems. -- a -- dizziness and otherwise but let's go over to Linda in Metairie Linda. -- -- -- -- -- -- -- -- -- -- -- -- -- -- Some of my brain and I can't and it is did see is light headed is the vertigo whatever term you want he's that you he sent me an act. And found nothing wrong. He was checking to make sure I did not hand in that -- on the beginning of parkinson's. All that came not negative. I am greatly affected by bright light. Or if I definitely hate sometimes into restaurant. Are in places like fans Wal-Mart Home Depot. Even unconsciously taking a very long drive to -- a lot of Hammond Clark when under the outcome might -- it. Loud noises affected if I'm in a restaurant or at a wedding that vibrating. Well I can feel within Nike air plan that will make he did -- Moving back and forth around like -- -- on from the -- to the back in elect. Will -- -- -- -- where I want my count there. But without it did it but backpacking at this off and corn for years and it seemed to be worked in the Scott -- And adopt -- -- immediately -- I exercises. And the head exercises. And that has helped. But it. Not and has gotten -- You have will have a death. And yet there's actually. Few different diagnoses that come to mind your case sin and we have to. Tested to see which would hand out. The first thing is you know exercises to help win the inner -- stable meaning. You're not getting extra stimulation to the -- year. And the problem is it sounds like in your case you keep getting hit with another new problem and he keeps balance and on your inner ear. Consequently the -- access only to be of limited utility. The other thing that you mentioned the whole issue with bright lights in Wal-Mart and things like that. What happens when your brain when your inner ear gets damaged. OK can cause very go but then the brain tries to adapt okay. And eventually starts to realize that what it's getting from the inner ear. Is not normal does not something wrong with it starts to shift importance to other senses. And the one big -- shifts to his allegation. Problem is vision is not a good balance sense when you've got people moving shift hollering and you. You don't know is the -- moving in my removing my head and it's very disconcerting to patients with interior problems. The other thing is the the white bothering your lines. One of the things that can do that is all form all of vertical -- migraine associated vertigo. It's a real controversial diagnosis that is. Treated basically as a migraine itself. If you haven't been evaluated for that that's a good thing to be evaluated for. And then the last when you mentioned about does he owned inducing -- spells -- dizziness. That actually goes along with the thing we talked about just a little while ago about the -- here in Al Davis and syndrome that's called to Leo's phenomenon. So there's several different things in your case and -- movement inducing. Vertical and -- it certainly can be positional vertigo as well so there's there's several different issues that need to be sorted out your case in. Certainly could figure about it if you want confidently take a look at. Wait wait. -- I can't thank you enough and his name is doctor Jerry Jindal. -- hold -- to be forgotten. On actor on where my cane and I mean -- -- -- -- the. And in a few from -- with Covington died that big health center cult stone creek and just on the root them out there. Thank you in difficult Jay in New Orleans. I. What I think is sort of bizarre thing -- is probably not uncommon for you doctor. I. Yet I'm taking them commands. And I hit it any -- and I walked up -- Not one not walk around day. I have the feeling lately at all. And I started looking great -- let them down and seeing you got better. Quite a bit. I'm wondering. It's more -- -- -- that -- collapse or about -- that when I go off the but. He said it it's worse when you're looking game owner looking up is that what you said. I looked straight. -- went on bill. Very much at all. It went on -- model. That they're tree which isn't normal to. I can -- -- are. Always classmate and I think well. This is that the most likely thing it's -- that benign positional vertigo even though you're not spinning. Milder forms of it it it basically one of the big tip offs is the patient gets -- when their when their head as did you know position and owner and over. You don't Nestle have to have the big spinning spells can be milder in balance. But that's one thing I'd be very suspicious of in your case. You get the -- positions where you know you. It it does not sound like it's a drug related problem it was medication related to be happen all the time not just when you have your head in that position. -- -- Well been my position vertigo is is actually each truly easy credit. There is a maneuver we do. There's actually several different maneuvers that the the big one was the aptly maneuver which we can do and in on a papal office. We also have a device in my office called athlete on the accident looks like big giant human gyroscope. And we strap the patient in and we can basically turn in any direction we want. On the -- maneuver on the table really only effectively treat one of the three canals. In the big -- on the next year we can treat all all of the canals. Like that's great news thank you very much OJ calling organized into the break but we'll be right back I'm Angela on WW well. I love that all of you -- -- calling because this is a wonderful doctor here who really does -- help. And I like I can just seen his face that realization that he is -- Just even over the phone you're helping speak. We are talking again to doctor Jerry -- link and we're talking about dizziness and other balance issues. And I just wanted to -- to ask you about that is something to work with is. Facial nerve disorders. And so things like Bell's palsy which many of us have heard about. What can you do. Yeah Bell's palsy is. A basically it's a viral. Record deficits meaning there's a virus that you got many years ago. You went away for example like the chicken pox virus when we we almost have -- chicken pox. When he goes away it doesn't really go away it just goes into what we call a dormant state hiding inside an hour. Until later sometime later in your life something happens and it will get reactivated. What that would Bell's palsy -- is a virus that's living in the nerve. And then something will happen like stressful or bench trauma whatever. And the virus will get reactivated the problem is in the facial nerve -- gets in the facial nerve and you get swelling in there. The facial nerves got a long -- connect channel. And as it's finals. It can basically choke off its own blood supply and then you will see the facial paralysis that's the manifestation of Bell's palsy. The treatment for is. Mainly medical you treat with steroids to reduce the swelling. And anti viral medicines to reduce the viral reactivation. Vast majority of patients do extremely well with this and it's not like it's overnight did it eventually comes back. There's a very very small percentage where the swelling so intense that even that doesn't work. And in those cases we can do a surgical decompression. Of that dead bony canal. But it's something that's going to be done early in the onset and it's extremely few patients had ever need that. The let's go quickly over to Bruce on the North Shore. Hello Bruce. Yeah -- you had a question for the doctor. Yes do -- on the government tremendous problem with this year problems he's got a constant ringing in -- and beer Beers nor. Is like here -- -- this properly disturbed -- and Sutter is operated you know down -- -- yeah. And he's browse -- and the body actually but nothing changed -- -- the big issue is the underlying problem which is he's he's that we call chronic ear disease he's cat. Basically a chronic in the infection in his man to waiter or his middle years that -- cost the perforation. And that has to basically be result first and that can be resolved with those. Antibiotics and with surgery and it -- like most of the cases in Stanley probably your son's situation. He probably needs amassed an act to mean in -- appeared all year round. Now unfortunately. Ringing in the year is not a disorder it's a symptom and it's usually a symptom of hearing loss. My -- issues on probably has some hearing loss. And the ringing is a symptom of the hearing loss now whether you can make the ringing go away or not depends on what you can do for the hearing. If the hearing loss is because the the infection is eaten away when that your bones you can put a prosthesis and -- boost up hearing. Which would -- improve is his the ringing in his year. On the other hand if it's due to the inner ear problem the prognosis is not nearly as it. Now what you candy for patients let's say you get revolt the infection and you fix the whole year from. And he still has the ringing in his -- for somebody who's got hearing loss and wringing their -- probably one of the more effective treatments for the ringing in the ears are hearing it. Because -- The the day the ringing in that situation is sort of analogous to someone call phantom limb syndrome. It never hurts someone who's had their former league chopped off to say they can still fear of their their toes to their fingers will. Obviously the toes and fingers aren't they here but the part of the brain that -- the -- is still here and it's active and it's the same thing when you -- hearing. When you lose hearing there's specific part of the brain that we're -- low frequencies I frequencies in middle frequencies and if you've you've lost your high frequencies that part of the brain will activate you hear ringing. The only way to overcome that very easily or its actions that the only way that. But the more easy way is to. Override it by supplying saint if you if you've got enough hearing that if you -- hearing in there and will override we're you're hearing is that usually is effect. Unfortunately only works when you kept hearing it. So change it courses though the concern is is that you're -- stupid this system not appear in. Posters -- in language. One of the doctrine -- -- -- that would call it preparation -- consumers of the year but doubt Richard but you know it was spiritual it. -- people with holes in their ear drum probably not a good candidate for scuba -- scuba diving. Just in general. Did he get the whole -- drawn from the scuba diving was it from infection. You know I would -- to thank you from a correction in the picture and had tried numerous antibiotics. There's been searched. Yeah I think I would be you know I don't I don't know your son nick and I know all this history but just from the little -- told me how I wouldn't be real anxious for him to go scuba -- Right -- -- and urged the logos are stretched a bit but it. That's a -- -- Did that the risk of of having interior damage when you scuba diving you can get very go to the point where you know -- up with stimulant and and people have drowned. In situations like that so it's it's not exits in the area. Thank you are very very much for the calls now is the -- here to dentists. Well it's tomato to motto it's its -- -- tonight it's moats most medical professionals say -- it is mostly people seat and. But that is what that is assuming the stay with -- everybody we're not done yet -- -- under the anyway. I cannot think of doctor Jerry -- enough. For spending the whole hour with -- wish we could get to all of our callers thank you so much for calling it. He does have Leo website -- and balance dot net Fehr and balanced dot net. Thank you so much sir you're welcome thank you we're gonna have a back again stay with this we're going to be talking about how -- we fix America right after this I'm Angela under the February.

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