Elderly parent dizziness advice please

[adviceonchildplease]

Please can anyone advise on my elderly parent, I have a list of symptoms and things they have tried without success, we are at our wits end for things that might help. She is late 70’s. No cognitive issues or hearing loss.

symptoms

— severe dizziness daily, sometimes it’s not as bad for an short while upon waking, then comes back. Sometimes it’s there upon waking and remains all day.

her left ear feels like it’s blocked, describes it as feeling like she has got a heavy cold all the time. Not so much hearing loss, just the blocked sensation.

occasional nasal drip, leading to a cough bringing up phlegm at times.

the dizziness can at times make her feel sick, and occasionally be sick

she is reluctant to go outside or anywhere other than the lower level in her house due to feeling dizzy, and is worried about falling. She has had a couple of falls and this has knocked her confidence.

cataract in one eye, was due to have surgery but the journey to the hospital for this was too much for her and she was ill the night before so the surgery was cancelled. Not sure if the cataract surgery would have made that much difference

What we have tried-

she has had treatment for BPPV, from a couple of different doctors. One said she didn’t have ear crystals as her eyes didn’t flicker. The other said she did have it as her eyes did move, so 🤷🏽‍♀️
Slight improvement briefly after one of these appmnts but then it returned.

we have done hair samples to see if there was any food allergies, and have followed these results but not much change.
cut out dairy. Very slight improvement

kept food diary to see if there was any trigger but there doesn’t appear to be any rhyme nor reason to it.

Doctors have done numerous tests and changed/ stopped her medications, to no avail. The only medication she is on now is her asthma inhaler.

using a stick/ zimmer to help with walking, has had occupational health to visit and they have sorted all the necessary house improvements to help reduce the risk of falls.

We have got her a wonderful carer who is a nurse, who comes to help her with things around the house that she needs.

she has lost her driving licence as the doctor recommended she shouldn’t drive.

she has got a balance physio appointment next week which hopefully will help

I’ve seen about some types of vertigo that can be helped with antihistamine??

her Mum had Ménière’s disease, but the doctors have said this isn’t hereditary.

this has been going on since around covid time, maybe a little before, when she would have had a day here and there with dizzy spells, but now it’s constant.

doctors just say that’s it’s old age and there’s nothing they can do.

please does anyone have any advice on what this could be, or anything else to try. She has such a limited life just now and would like to feel better.

thank you.

Doctor's who are saying it's old age, there's nothing you can do are fobbing you off and waving you out the door. Are you able to go to apts with her and advocate for her? Has she seen an ENT consultant? Aside from BPPV, what else ear-y has been investigated? Have they looked a dodgy sinuses/eustachian tube inflamation? Does she have reflux or silent reflux? Have they trialed her on a proton pump inhibitor? Have they looked at inner ear problems eg labyrinthitis- could be post viral after covid, but 5 years is a very long time to have it for. Sometimes if you have the funds, it's worth seeing a consultant privately for a couple of hundred pounds. They'll write back to your gp advising whatever tests/meds are sensible to try (which would then happen via the NHS). It jump starts the process a bit and gets you quick access to an expert.
All the very best to you and your mum

Have they tried her on betahistine, that's what they usually prescribe for these symptoms.

Thank you so much for your helpful reply, and for the time you took to think of these things, we really appreciate it.

yes we get the feeling we are being fobbed off, and it’s very frustrating. There has to be more to it than that.

yes we have been going with her to her appmnts more recently and have found this helpful.

she says they have checked all her ear canals etc and they always come back as clear.
they don’t seem to take her seriously about her ear issue, so theENT consultant might be the way to go now. The sinus/eustachian tube inflammation, would that produce these symptoms?

she does sometimes talk of heartburn, now you mention it. Years ago she suffered from IBS but that seems to have lessened with the non- dairy diet, I think she was on Omeprazole way before Covid.
is there a link from reflux to dizziness that we could explore?

I have found the NHS page about labyrinthitis and vestibular neuritis, the Neuritis sounds very like it. We will bring this up at her appmnt next week.

I seem to remember there was a private consultant years back but they weren’t very helpful, maybe we weren’t asking the right questions. It might be time to try private again.
thank you again for your help

The sinus/eustachian tube inflammation, would that produce these symptoms?
she does sometimes talk of heartburn, now you mention it. Years ago she suffered from IBS but that seems to have lessened with the non- dairy diet, I think she was on Omeprazole way before Covid.
is there a link from reflux to dizziness that we could explore

Yes the eustachian tube is the tube connecting the inner ear to the throat. It gets blocked sometimes when you have a cold. If its inflamed, partially or fully blocked it feels like you have a blocked ear but doesn't cause haring loss. It can cause dizziness/imbalance... Not really a feeling of spinning usually. And it causes post-nasal drip. The inflammation can be caused by reflux or silent reflux (without the heartburn feeling) You mentioned about antihistamines - allergic reactions can also cause inflammation which can be damped with antihistamines

In your shoes I would certainly ask the gp if she'd be able to trial omeprazole and a prescription antihistamine for a few months to see if symptoms improve. And look into a ENT referral (either nhs or private) at the same time in case my wonderings are not the answer!

Forgot to say, the improvement of symptoms after lying down (ie she's better on waking) fits with the eustachian tube dysfunction too

I was diagnosed with BPPV in summer 2023. I had treatment at a local hospital ENT department, in treatment sessions sometimes I had Nystagmus (the eye flickering) and sometimes I didn’t. I also had a MRI of the brain as part of my investigations just to exclude anything more serious. It sounds as though your mum should be seen by the ENT department at the hospital rather than a GP. My symptoms took about two years to settle down . I did not have any sickness though and I was told by ENT that this was more a sign of Ménière’s disease especially if the dizzy spells last for a long period of time, (mine didn’t) which your mums seem to. It can run in families, I know people who have Meniere’s and they have a family member with it also. Maybe have a look at the uk Meniere’s website and see if they can help and push for further investigations with ENT. Get a second opinion elsewhere if you can. It is outrageous that they are saying it’s just old age, these symptoms are very debilitating and it is wrong to just expect her to live with it without any further help. Wishing you luck.

I am assuming that causes unrelated to ears eg low sodium, low blood pressure, has been ruled out. They would usually cause faintness rather than dizziness/nausea but still...

Too much bp medication (the dose needed can go down as people age because the metabolism slows) and specifically diuretics that can send sodium too low, can make you feel faint. We think this may be was caused my 90-y-old mum to faint and fall recently.

I do appreciate that dizziness is something distinct, but faintness would probably make it feel even worse?

@adviceonchildplease I could have written your OP about my mum. She experienced the same symptoms you describe over the last 2 years on and off, usually at same time of year. We've had ENT tests, hearing tests, balance clinic review, an MRI, looked at allergies and a private consultation and had no confirmed outcome.

Response from NHS clinics is its possibly viral or post viral or stress or old age as she has had some hearing loss. The private consultation suggested it could be menieres and gave a prescription of betahistine which she's taken for 6 months now and no further episodes so we're cautiously optimistic. Good luck the symptoms are highly debilitating and the process frustrating and very time consuming.

I had vestibular neuritis. GP tried every drug for dizziness going. Antibiotics from the dentist six weeks later cured it. Did see a consultant, had an MRI. All fine. He said a cold bug kicked it off possibly.

What I did have to do was retrain my brain with exercises because it remained confused visually. The physio gave them to me on a sheet. I remember having to do them lying down, then sitting to start with. They made the world spin.

It's a horrid feeling. I'll try to find the exercises.

"Cawthorne-Cooksey exercises | ENT UK" https://www.entuk.org/patients/conditions/93/cawthornecooksey_exercises/#Exercise_1___Eye_movements

Don't worry if it feels weird dizzy making. She can do the eyes lying down. You build it up over time.

I couldn't use an escalator for two years.

My mum is experiencing dizziness too. Ears apparently clear, had brain scans, ECG, altered blood pressure medication. They are now suggesting it’s just down to stress. It’s worrying and we feel it’s just seen as ‘old age’. Not sure what to try next.