Should I worry about vertigo while travelling?
November 15, 2015 5:22 PM   Subscribe

A few days ago I started getting vertigo, though I don't seem to have any other symptoms (nausea, dizziness) that people have asked about before. Why is this happening? Is this something to worry about? YANAD, YANMD - but right now, I have no doctor! More details inside.

I'm doing fieldwork in rural China and have been here for a month and a half now. I've stayed at this workstation before and it's a super clean (for the field), safe environment. We get 3 healthy meals a day, and we eat pretty much the same menu every week so I don't think this is a weird-food thing.

I don't experience it while standing or walking, unless I'm leaning over a sink or something. It's more pronounced when I'm sitting and especially when I'm lying down. When I'm lying down, it kind of feels like I'm on a very gently rocking boat. A couple of times my heart rate has gone up but settles down quickly if I focus on my breathing. I don't have any other symptoms, though.

It started happening after about 3 days of continuous walking and hiking, and Google told me that it may be due to dehydration so I've spent the last few days being very diligent about hydrating - but it doesn't seem to be helping. I am also menstruating pretty heavily, and apparently vertigo sometimes happens with periods if there's some anemia going on? Could this be the issue? I would find this strange since I'm probably eating more iron here than I do back home and I've never experienced this before. I know that vertigo might also be caused by an ear thing, but wouldn't this mean I'd have vertigo or dizziness while standing up too?

I could possibly head to Beijing to see a doctor, but my Mandarin is basic so I don't think I'd get much out of it. I've also been to the doctor before in this small town but they were not too helpful and, again, language issues.
I'm returning to Canada in a little over a month. Is this something I can likely wait out? Any suggestions of what I should do in the meantime? More water and beef?
posted by thebots to Health & Fitness (13 answers total) 5 users marked this as a favorite
This sounds a lot like benign positional paroxysmal vertigo to me. Here's a video with some information about the Epley maneuver, which is a treatment you could try on your own.
posted by i_am_a_fiesta at 5:48 PM on November 15, 2015 [7 favorites]

I'm really reluctant to tell you to wait it out because I am not nearly a doctor, but it sounds like what I get with (benign but annoying) ear issues. The heart thing sounds like anxiety that you are managing well, but again, not a doctor.
posted by internet fraud detective squad, station number 9 at 5:53 PM on November 15, 2015

I was going to suggest BPPV too. Otherwise called salt crystals or ear crystals. They generally can go away within a few months but can go along with other ear disorders. A doctor can also do the maneuvers to help treat them. Not a doctor but I have inner ear issues.
posted by Crystalinne at 5:56 PM on November 15, 2015 [1 favorite]

I would try taking a antihistamine because fluid buildup in your ears could cause dizziness. I went to doctor for dizziness and that is first thing he gave me to try. You haven't started wearing any new glasses have you? That was what was causing my dizziness.
posted by just asking at 5:59 PM on November 15, 2015 [1 favorite]

Sometimes taking an antihistamine can help with vertigo.
posted by sciencegeek at 6:00 PM on November 15, 2015 [1 favorite]

nthing the benign vertigo. My doc gives me Meclizine which is also called Dramamine. I've also learned not to look towards my feet when I get dizzy. I just sit or lie still, watch TV, etc.
posted by donaken at 6:01 PM on November 15, 2015

BPPV. Increases as we age. The Epley maneuvers can really help, and can't hurt, so definitely worth a try.
posted by judith at 6:06 PM on November 15, 2015

Epley is crap, do Semont instead. 3x a day.

You can tell BPPV from other kinds of vertigo because it is, as the name suggests, positional. While sitting up, tilt your head straight back as far as it can go, and then look to the right. Do it again to the left. The side which triggers the vertigo is the side you want to do Semont on. If you try to stare at a fixed point during the vertigo attacks, your eyes will jerk off to the side trying to stay still. This is normal, don't worry.

If the vertigo is not triggered by Semont or the head tilty thing I described above, and if it persists for a week without any other symptoms (head cold, sinus infection, migraines), I would see a doctor.
posted by poffin boffin at 6:17 PM on November 15, 2015 [7 favorites]

Also the vertigo I had while suffering from severe anemia was exertional and not positional.
posted by poffin boffin at 6:19 PM on November 15, 2015

If you have anemia take your main meat meal without tea, and with a vitamin C source. Iron is not well absorbed in the gut in the presence of calcium rich foods, tea, or eggs. Just getting an iron rich meal with at least a one hour break from these foods before and after should help.
posted by Oyéah at 9:14 PM on November 15, 2015

Thanks everyone! Frankly I feel better knowing that this is even a thing and not just "YOU WILL DIE TOMORROW". I certainly hope that BPPV is the cause. Epley did seem to work somewhat; the head-tilty thing sometimes brings on vertigo and sometimes not? It's not triggered at all by Semont, though, which worries me a little. Anyway, I'll try out all of your suggestions (and not rule out anemia), and muddle my way through a doctor if necessary.
posted by thebots at 2:22 AM on November 16, 2015 [1 favorite]

It's not triggered at all by Semont, though

BPPV responses "fatigue," so if you went directly from one triggering maneuver to another, that could be why you didn't get vertigo. It's been a while since I've worked with vertigo patients, so I don't quite recall how long the response remains fatigued.
posted by ghost phoneme at 5:54 AM on November 16, 2015

Hi, sorry this is late, but perhaps this will still be helpful. I'm an audiologist but not yours etc.

It sounds like BPPV to me, too. How long does the vertigo last when it's triggered? BPPV vertigo usuallydoesn't last more than 30 seconds. Feeling vertigo when you lie down is a very common symptom of BPPV. The reason is that most (*note: not ALL) BPPV is caused by loose otoconia in the posterior semicircular canal (in the inner ear) in one of the ears. The loose otoconia causes an abnormal flow of a chemical through your canal (called endolymph), which is the chemical that your brain uses to control the reflex of your eyes that makes them move the opposite direction of the way you turn your head. The loose otoconia causes the information to your brain to conflict with your actual movement, which gives you the sensation of spinning. While you're having these episodes, your eyes are actually showing a nystagmus, which look like they are sort of twitching in a torsional direction, and makes you feel like you're spinning or rocking on a boat.

There are actually 6 different types of BPPV, though like I said, the most common is posterior canal BPPV. Here's how you can test yourself for this. It's basically doing a Dix-Hallpike on yourself. Sit in the middle of your bed, with your back facing the end of the bed. Sit so that when you lie down, your head will hang off the end of the bed. Sit with your legs straight in front of you. First, turn your head to the right. With your head turned, lie back quickly, and let your head hang off the edge of the bed. If you feel the vertigo this way, the loose otoconia are in your right posterior canal. If not, try it with your head turned left.

It is not true that just tilting your head back and turning it to one side will trigger the vertigo most common with BPPV. You have to lie down quickly, as that is the movement that will move the otoconia and give you the vertigo. This has to do with how the canals are oriented in your head, and which direction you need to generate the flow of that chemical in your canal to trigger the reflex.

The direction you feel the vertigo on will tell you which direction you need to do the Epley on. The Epley, contrary to the above comment, is not crap. It's hands-down the most effective treatment for BPPV. The point of the Epley, or the Semont, is to try to move that otoconia (a little bit of calcium carbonite) back to where it came from (saccule or utricle). Keep in mind though that all vertigo issues are highly variable, and its often impossible to determine the exact place or etiology of the issue.

Repositioning treatments can be effective, but they are not always. If it isn't, the otoconia usually dissolve in the endolymph after a few months, and things will return to normal. Though 20% of people who have BPPV will have recurrent cases.

The heart rate issue is common, and is likely just an autonomic response to your vertigo. Probably not related per se.

If your vertigo persists, if you feel like the axis of the rotation of the room is in the vertical plane, if you have episodes of vertigo that last more than a half hour, see an ENT.

Feel free to memail me with any questions as always.
posted by Lutoslawski at 12:00 PM on November 17, 2015

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