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Suggest Remedy For Vertigo And Loss Of Balance Post A Knee Replacement Surgery

Posted on Tue, 22 Dec 2015

Question: I had knee replacement surgery Oct 26. In the past few weeks I developed vertigo. I am doing therapy and the loss of balance is making it more difficult. I have an appointment Dec 12 with an ENT. What is your advice as to should I seek an emergency room or wait till Dec 12. My internist proscribed meclizine but it seemed to worsen the symptoms. Are there other practitioners out there who specialize in this? I'm in XXXXXXX KY. Any recommendations ? Thank YouI was told the longer I wait (Dec 12 appointment the earliest I could get.) the harder it is to cure. Someone said there are crystals that need to be aligned. I understand about the hairs in the ear but are they talking about the same thing? I was told a practitioner lays you horizontal and moves your head left/right. Any sense to this? Thank you for any assistance.

Answered by Dr. Abubakar Siddiqh (6 hours later)

Brief Answer:
seems to be BPPV (Benign Paroxysmal Positional Vertigo)

Detailed Answer:

Hi,

I had gone through your question and understand your concerns that you are having vertigo. I would like to ask you few more details.

Is your vertigo, episodic or continous ?
Is it associated with ear pain or deafness ?

Kindly get back to me with the details.

Based on your clinical details, it appears to be BPPV (BENIGN PAROXYMAL POSITIONAL VERTIGO).

Answer and explanation to your query.

1. Inner ear is devided into cochleA, vestibule (responsible for hearing) and semicircular canals (responsible for balance).

BPPV is a mechanical problem, calcium carbonate crystals (otoconia) that are normally embedded in gel in the utricle (part of inner ear) become dislodged and migrate into one or more of the 3 fluid-filled semicircular canals, where they are not supposed to be.

When enough of these particles accumulate in one of the canals they interfere with the normal fluid movement that these canals use to sense head motion, causing the inner ear to send false signals to the brain.

2. In your age, vertigo could be due to central (brain or blood vessels rlated) or peripheral (inner ear) or it could be due to electrolyte imbalance (sodium,potassum and chloride). It can be differentiated by clinical test (positional tests) and blood tests, x-ray cervical spine (spondylitis) and CT scan of brain.

3. If you are medically fit, kindly go ahead for this tests.

Hope this answers your question, if you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions.

Wishing you good health.

Above answer was peer-reviewed by : Dr. Sonia Raina

Follow up: Dr. Abubakar Siddiqh (17 hours later)

Thank you for responding. Possibly episodic? I had it briefly over a year ago and after a pill or two it was gone until just recently. Whenever I visited my internist and he checks my ears they were always clean (wax free). Anyway, this time it didn't go away and meclizine seemed to exaggerate the symptoms and I stopped taking it. NOTE: Last night I started thinking about a couple of relatives and their experience with vertigo and the mention of the crystals and what was done for them. So, very carefully I looked left, then right, then left, then right again for about a dozen times. The first turn to the left gave a slight "grinding" sound. No pain, just like you'd experience with a chiropractor. The turn right was smooth. Afterwards I seemed to feel less dizzy as I moved. Not a lot less but somewhat better. I finally got an appointment for Tuesday and hope they can "fine tune" me. Wish me luck.

Answered by Dr. Abubakar Siddiqh (6 hours later)

Brief Answer:
All the best.

Detailed Answer:

Hello again,

Thanks for considering my answer and for your follow up.

Yes. Your relatives are right. Different postures and manoeuvres are treatment of choice in BPPV. But, see to that, they are from an ent surgeon.

Anyway, go head for those manoeuvres. All the best and Take care.

Above answer was peer-reviewed by : Dr. Sonia Raina

Follow up: Dr. Abubakar Siddiqh (20 hours later)

I just wish to thank you for your consideration. I saw an ENT today that specializes in my problem. I told my wife Whoever works on me will be a qualified ENT. He evaluated me today and I'm set for 12/11 for test(s) with a follow up session on 12/15. I feel fortunate to have found him as my original appointment with another ENT was not till XXXXXXX 12, 2016. So, everything seems to be working for me. Your advice agreed with his assumptions. Just waiting to test next week. Again... thank you and have a blessed holiday.

Answered by Dr. Abubakar Siddiqh (4 hours later)

Brief Answer:
Take care.

Detailed Answer:

Hello again

Thank you once again and same to You. Kindly feedback to me after getting the reports and ent consultation.

Take care.

Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.

Above answer was peer-reviewed by : Dr. Prasad