Please help me not go crazy with worry about my wife's health.
June 30, 2014 9:38 AM   Subscribe

My wife's been experiencing vertigo, dizziness and nausea for almost a week. I'm concerned; she says it's almost certainly going to go away soon. I'm extremely anxious when it comes to her health. I'm looking for reassurances or any other help to clear my mind so I can support her, as well as any ideas on what this could be.

Last Tuesday my wife started experiencing some dizziness that came and went during the day. The next day, she was fully ill, barely able to sip water or Gatorade, complaining of being hot despite her skin being cold and clammy, and essentially confined to her bed because she couldn't stand up without falling over. By Thursday it was impossible to keep even sips of fluid down. Friday I insisted she go to a clinic to see a doctor as our family doctor was closed for the long weekend here in Canada. That doctor told her it was likely gastroenteritis and prescribed Ondansetron, an anti-nausea drug. This didn't seem to help her any.

Yesterday she was pale, unable to stand, freezing cold to the touch but reported feeling very hot. We went to emergency where the medical student immediately started talking about CT scans and tumours and things. Not very reassuring. The attending had a different idea and said she was ridiculously dehydrated and her "lights" were terrible; I don't know what that means. Being as she hadn't drank a damn thing since Thursday morning I had to agree on the dehydration. He put her on a saline IV, along with diphenhydramine, lorazepam, and droperidol. My wife more or less fell asleep immediately and slept for two hours, and when she woke up she felt much better.

The attending told her this problem was probably something to do with her inner ear without any specifics. However he gave us no prognosis or timeline or guidance for further treatment other than that we should check in with our family doctor when he is back. She walked out on her own power and for the first time since Tuesday evening she was able to eat and drink. She received a prescription for betahistine, an antivertigo drug. This has helped significantly, and she's able to eat and drink this morning, but she still reports feeling off. In her own words "it feels like my head isn't properly attached to my neck".

Right now we're focusing on keeping her fed and hydrated, but she is still feeling dizzy and experiencing vertigo, and it is keeping her mostly in bed. I've had to edit this post now because she is in the bathroom vomiting again, and we can't see our doctor until Friday. So now I'm concerned because she isn't getting better, we can't go see a doctor until Friday, and what the hell could this possibly be and will she ever get better and aaaughhh. I'm quite literally on the verge of tears and puking with worry.

Basically I am a person who doesn't deal well with illness in loved ones and I'm terrified that she won't get better. I come from a family with terrible medical history; all my grandparents died before 65 and I have aunts and uncles dead before 50 from cancers and other conditions. Hell just last week Wednesday my aunt died as a result of the effects of kidney cancer, and her husband, my uncle, received his diagnosis of inoperable lung cancer only two weeks before that. When someone gets sick I immediately feel like they are going to die. I know this is not a realistic, effective response but after seeing so many relatives die in hospital it is completely ingrained into me.

I feel like a big baby so I don't speak to her about this, because she doesn't need my stress, but what the heck could this be and how can I deal with this? I've had gastroenteritis before and so has she, and this isn't like anything we've experienced there, being as there is no diarrhea, only vomiting and vertigo. I just don't know what to think or do to help her, and I know that my being stressed and anxious is not helping any. I can't even put this question together very coherently, I am so worried.
posted by Sternmeyer to Health & Fitness (24 answers total) 2 users marked this as a favorite
Okay, calm down. My cousin has vertigo and it presents exactly this way. It may also be a thyroid thing (inability to regulate body temps) both conditions are manageable with medication. An inner ear problem may also show up this way, and again, it's manageable.

You may need to head back to emergency, because dehydration contributes heavily to the feeling shitty part of this. She can't wait until Friday, so go back to Emergency, on a weekday, during daylight, so she can be seen by a specialist (who wouldn't be available on a weekend, or at night.)

"lights" are electrolytes. When you vomit and become dehydrated, they get all skiwampy so everything needs to be replaced (Gatorade is full of electrolytes) but she may need a doc to get the right levels at this point.

So get going to the ER, again.
posted by Ruthless Bunny at 9:44 AM on June 30, 2014 [4 favorites]

As a coping strategy: you said your family has a terrible medical history. Remind yourself that your family isn't her family. She has a completely different set of genetics.
posted by MexicanYenta at 9:55 AM on June 30, 2014 [8 favorites]

I had something very similar a decade or so ago, and the diagnosis from my doctor was just "vertigo". It took about two weeks for me to feel normal again (with prescription assistance). In the meantime, I had to keep hydrated (Pedialyte was my friend), not drive (my symptoms were worse when driving), and basically wait it out.

As far as not worrying/going crazy: poke at things until you find something that helps you. I find that research helps my worry - knowing more about what the possibilities are helps me eliminate worst-case scenarios - but I know that makes things worse for some other people. Talk with a friend. Make a worst-case contingency plan. Call a nurse's helpline, if there's one available to you. Set up some of your favorite activities to keep yourself distracted. Find something that works to ease your mind, and go at it.
posted by okayokayigive at 9:55 AM on June 30, 2014 [3 favorites]

First--do you have a way to center yourself? Whatever the cause of this, your anxiety can't fix or help it. You probably realize that because you seem very self-aware. Doesn't take away the helplessness you feel seeing your spouse sick, but gives you some perspective.

But I also have to comment on what your wife is going through. Have you ever had vertigo? It is literally the worst thing I've ever had. EVER. And I've had preeclampsia, gave birth, had appendicitis... you get the picture. Vertigo is disabling because it can come and go without warning. One minute, you're fine and the next you're not. You don't feel like you can keep anything down, because you throw up, which leads to dehydration, which is the real problem here. You can't even look at something because it makes you ill. In my case, it came as mysteriously as it went. I have no idea what caused it, but it was probably an inner ear infection of some sort.

Check out vertigo repositioning exercises (Google it). It is essentially moving your head in certain positions and holding the position for a prescribed amount of time. It may help. It won't hurt. If you go to a physical therapist, family practitioner, or ENT physician, he/she would likely try this.

If she continues to have problems with dehydration, by all means, take her back to the ER (if you can't get in to see your regular physician). Good luck and I hope you both feel better soon.
posted by FergieBelle at 10:00 AM on June 30, 2014 [5 favorites]

Look up BPPV. Benign paroxysmal positional vertigo. I've had it twice, it's scary as hell, but the key word is benign. Have your ER doc check for that (see ruthless bunny's advice about going back to the ER).

It presents exactly the way you described above and is literally loose stuff jangling around in the inner ear. It's unpleasant, but easily treatable with some simple head twists any ENT can help your wife with.

IANAD, and yes there's a chance it could be something significant; there always is. But, one hypochondriac to another? When you hear hoofbeats, look for horses, not zebras.
posted by kythuen at 10:05 AM on June 30, 2014 [4 favorites]

Look up BPPV. Benign paroxysmal positional vertigo. I've had it twice, it's scary as hell, but the key word is benign. Have your ER doc check for that

I have also had it.

One of the indicators of it is that your eyes go back and forth quickly and involuntarily when you move, which of course contributes to the vertigo. Is this happening with her?

Another note: It's worth looking up the Epley Maneuver on Youtube. If she has BPPV, it's possible to both check for it and correct it by using a series of careful slow movements of the head, which basically move the little bit of debris in the inner ear back out of the ear canal it has fallen into.

I didn't have a doctor at the time I got BPPV, and I was able to deal with it using the Epley Maneuver three times a day for several days.

posted by suelac at 10:10 AM on June 30, 2014 [6 favorites]


Based on my knowledge, the most likely scenarios are relatively good news:
* Ear infection
* Ear injury or fluid accumulation
* Acute vertigo (as described above).

The worst-case scenario, which is UNLIKELY (I'm stressing the unlikely part):
* Something inside the balance center of the brain.

The good news with the worst-case scenario is that it's easy to rule out. One good image of the head (probably an MRI) will tell an experienced neurologist whether there's anything there. If the image is clean, the other things it can be have treatments and are not life-threatening.

In summary: Make sure that someone does a scan of her head. It's probably already been done. Make sure that someone tells you that it's clean. After that, you really don't have to be so sick with worry - it will be OK.

Good luck, and wishes for a speedy recovery!
posted by Citrus at 10:23 AM on June 30, 2014

I'm quite literally on the verge of tears and puking with worry.

I am sorry you feel badly also. Please make sure you get some self-care while you support your wife. And you need to separate your own issues from the ones you wife is dealing with. She has enough on her plate without having to deal with this. If you have anti-anxiety medication of your own, now is the time to take some. Take a walk, keep the caffeine intake down and make a note to work through this on your own at some later date. Irrational medical fears are awful and worth actually spending some time to try to work out.

I've had BPPV. It's very scary the first time you have it for all the reasons you mention but it very often is nothing and it goes away. In the meantime though you are quite certain you are dying and/or you are wishing for death because it sucks and puking sucks. Eppley maneuver was helpful for me and now it's like the first step when I feel vertigo coming on and often it doesn't get to a bad stage.

She needs to stay hydrated and make sure she's drinking something that's salty/electrolyte-y and not just water otherwise she'll feel crappier. If she can't keep down fluids that's reasoning to go back to the ER. Sometimes stuff like Dramamine can help with nausea and make you sleepy. If she's not freaking out, having stuff that she can just listen to, eyes closed and head immobile can also help. Sudafed may help if there's an inner ear congestion thing that is making it worse.

I'm not a doctor, just someone who thought I was dying of vertigo once and did not. I wish you the best getting through this.
posted by jessamyn at 10:25 AM on June 30, 2014

You don't mention her age, but if she is young to middle age, the chances of her having a deadly illness are extremely low Statistically, she is likely to have a virus or non-life-threatening issue that will resolve itself. The numbers are your friend and they are telling you that she is going to be fine. I would try get her to drink a lot of Pedialyte while she is waiting for another consult.
posted by waving at 10:26 AM on June 30, 2014

re: Epley - Semont is more widely recommended these days, apparently.
posted by elizardbits at 10:26 AM on June 30, 2014

You don't mention her age. Is it possible that she is pregnant? Did they give her a pregnancy test in the ER? This sounds pretty extreme even for hyperemesis gravidarum, but they should certainly be ruling everything out. When I went to the ER for fainting years ago, and to an urgent care for gastroenteritis more recently, a pregnancy test was their first check.

Dehydration can contribute to dizziness and nausea. If she can't keep down liquids again, head back to the hospital. No need to wait until Friday to see your doctor.
posted by peanut_mcgillicuty at 10:45 AM on June 30, 2014

If I downplayed the hell she is going through I didn't mean to do so. It might suck for me to think and worry about it but it sucks a lot more for her to go through it, and that's why I'm trying not to burden her with my concerns. She's got enough on her plate already.

Re: zebras versus horses, that was literally what my wife said about the CC3 that told her she probably had a tumour and she would need imaging. She's an ICU nurse so she's a lot more familiar with doctor stuff than me. This probably is why she's not nearly as worried as me.

Re: eye movements, the attending had her follow his finger and then said she had something that sounded like "stigmus" and said that was a good sign. Basically he said her eyes are moving because her brain thinks her head is moving when it isn't, is my understanding.

Re: age, she is 33 and not pregnant.

Re: returning to the ER, if she can't keep things down then it's back to the ER we go. The change when she got a bunch of saline into her was incredible. I almost had to carry her in, and when we left she ate and drank and was generally much happier.

Re: maneuvers (what a challenging word to type correctly), she is trying the Epley maneuver per a video from a medical school. I figure it can't possibly harm anything.
posted by Sternmeyer at 11:18 AM on June 30, 2014

I'm not a doctor, but the doctor probably said "Nystagmus". My wife had a fairly long period of vertigo symptoms after stopping a psychoactive drug. It's crippling, good luck.
posted by demiurge at 11:32 AM on June 30, 2014 [1 favorite]

Have your wife try learning to juggle. I remember hearing a story, probably on NPR, years ago that juggling can cure vertigo.
posted by catatethebird at 11:55 AM on June 30, 2014

My mother-in-law had Ménière's disease for a while. She wound up with some hearing loss in one ear ultimately after some years, but lived till the age of 89. I think she did find the Epley maneuver and physical therapy helpful in the long run.
posted by gudrun at 12:30 PM on June 30, 2014

This sounds a lot like labyrinthitis or BPPV. Despite the fact both made me feel like dying, neither is life-threatening.

Long term, if you are experiencing this level of anxiety about your wife's health, you might want to seek some mental health help for yourself. While I realise this is not (and should not be!) your highest priority at the moment, I think you need to consider that it's also not really tenable over the long term. Life is long and things will happen, to both of you. You owe it to both of you to be able to face those things with as much calm as possible.
posted by DarlingBri at 1:25 PM on June 30, 2014 [2 favorites]

Feel almost sure this is BPPV, plus dehydration. Do the Epley. It fixed me after 12 hours of vomiting and nystagmus in the ER. It can take some days to calm all the way down, even weeks, but Epley twice a day will very likely help.

The ER also gave me a Cat scan they said was abnormal, and scopolomine which made me feel I was losing all brain power. I was fine, and these things were red herrings.
posted by Riverine at 1:43 PM on June 30, 2014

There are some viruses around that make people extremely dizzy - my son and I both had it a few weeks ago - I was flattened and dizzy for a couple days, he could hardly stand up for more than a week. Just a very nasty virus though so one more datapoint.
posted by leslies at 1:58 PM on June 30, 2014

The "half-somersault" maneuver is gaining wide acceptance as a limited sort of Epley maneuver you can do at home.

I've lived with an inner ear (vestibular) disorder, and its accompanying vertigo, for fifteen years now. It has caused a great deal of misery, but I occasionally have long periods of remission/minimal symptoms, and I'm otherwise doing fine (employed, married, kid, etc.). The majority of people who develop vestibular symptoms are not like me—they get completely well within a few weeks to a few months. If it is a vestibular disease, your wife will probably continue to suffer for some indeterminate period, and then she will get well again, one way or another. Vertigo is pure misery, but it will not kill her.
posted by bennett being thrown at 2:19 PM on June 30, 2014

Hi there, I'm a doctor but not your wife's doctor. Yes to "nystagmus". It's the back and forth movements of the eyes that were referred to by other answerers above.

The good news with the worst-case scenario is that it's easy to rule out. One good image of the head (probably an MRI) will tell an experienced neurologist whether there's anything there. If the image is clean, the other things it can be have treatments and are not life-threatening.

In summary: Make sure that someone does a scan of her head. It's probably already been done. Make sure that someone tells you that it's clean. After that, you really don't have to be so sick with worry - it will be OK.

I don't need to comment much because you've already received so many good answers. But I do need to address this one. You do not need a scan to diagnose someone with peripheral vertigo. This can generally be done with just a history and physical exam. If there are signs on the history and physical exam that are concerning for central vertigo (coming from a brain issue), then an MRI is needed. Because you mentioned you are a worrier I did not want you to think that you could not rest until a scan was done.

Someone in my family has Meniere's disease, and I can tell you that it is a terrible thing to have to care for someone you love during, even if you are a physician and you know why and what is happening. It can only be scarier for a lay person. Not sure if it's available in Canada but look into Antivert/meclizine. If antihistamine type meds aren't helping enough, the second line is medications like Valium/diazepam (at least here in the USA) - so there are other options you can look into and should talk to a doctor about if needed.
posted by treehorn+bunny at 2:58 PM on June 30, 2014 [2 favorites]

I have vertigo that shows up whenever I get bad sinus congestion, it got disabling a couple years ago and was treated with strong steroids, both internally and as nasal lavage. Since then it's been very sporadic and quite mild. It was just like you're describing, though I didn't have the nausea outside of the really disabling episodes -- but a lot of people do. Fifteen thousand dollars of my insurance company's money later, nobody is sure why it happens, so I just make really sure I don't get bad sinus congestion.

It is miserable and it is terrifying but it will not kill you on its own. It sucks, in large part because it's not well understood, and for me personally it was quite exhausting -- I slept as much as humanly possible, given that I'm a SAHM to two young children. BUT: what you are experiencing now is almost certainly as bad as it gets. It can stay this bad for a while, or it can get better, but the chances of it getting drastically worse are functionally nil.

Feel free to memail me if you want to know more about my experiences with it; I was seen by a really fantastic balance clinic. I am not a doctor or anything like one but I did a STAGGERING amount of research when I was in the grips of my terriblest vertigo and even hypochondriac me was unable to come up with a compelling case that something was likely to be badly wrong with me.
posted by KathrynT at 6:08 PM on June 30, 2014 [1 favorite]

I got my first case of vertigo at age 52 and it scared the shit out of me. Thought I was having a stroke. What I did have was a raging sinus/ear infection that screwed everything up. Got meclizine for the nausea, antibiotics for the crud, and when the pressure subsided and I felt a little better started doing the maneuvers described above. The maneuvers were hard to get through, but really worked. Just make sure to keep her hydrated as best you can to keep her "lights" in order when she's nauseated.
posted by PJMoore at 7:28 PM on June 30, 2014

This probably won't apply, but just in case -- has your wife gotten new glasses recently? About eight years ago I got a new pair glasses; within a few months I developed awful vertigo and nausea that kept me sick and housebound for weeks at a time. My doc ran a bunch of tests, couldn't find a thing, and referred me to a neurologist for more tests (which I couldn't afford because I was uninsured).

At one point I went back to the eyeglass place for some minor adjustment to the new glasses. The employee took one look at how they'd been fitted the first time, said they were all wrong, and proceeded to reshape the frames and refit them to my face pretty drastically. Turned out the badly-fitted glasses had been making me focus differently, which strained my eyes like crazy and eventually triggered the vertigo.

The vertigo lessened after the adjustment, but the experience left me a lot more susceptible to recurring vertigo. It still kicks in from time to time when I strain my eyes or get dehydrated or whatever, but I've learned how to keep it under control most of the time.

Again, this probably won't apply. But it took me a long time to figure out the cause of my vertigo, so I tend to throw it out there when others are having similar problems.
posted by QuickedWeen at 9:41 AM on July 1, 2014

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