Vertigo, hives aren’t related issues
DEAR DR. ROACH: Growing up, I had episodes of hives, vertigo and migraines.
While I haven’t suffered migraine pain in years, I still experience the “aura” from time to time.
For the past couple of years, the vertigo has been frequent, even debilitating on some days.
Vomiting and bed rest are a given. This is treated with an antihistamine.
Also, bouts with what I assumed was hives have begun. These hives appear on my head as large lumps. A few times they caused swelling of my eyes, mouth and ears.
The itching is almost unbearable. An urgent-care doctor said I had angioedema, brought on by the blood pressure medication I was taking. I had been taking it only two months. Obviously, my doctor changed that.
Seven months have passed and I am still experiencing the symptoms. My doctor hasn’t ordered any tests and offers little in the way of relief.
I do have a prescription for an antihistamine for the itching. I stopped taking any meds four weeks ago, hoping to clean my system, but I am still having symptoms. Is there anything else I should be doing?
ANSWER: It sounds like there are two separate issues: vertigo and hives. If they are related, medications are the most likely culprit. However, the fact that you aren’t any better after four weeks off of medicines suggests that the medicines are not the cause of your symptoms (symptoms are usually gone within days, but sometimes can continue during the first month after stopping, and rarely longer).
Food allergies can cause hives, sometimes are associated with migraines and rarely cause vertigo.
Incidentally, I hope you are continuing to see your doctor, as stopping your blood pressure medication suddenly isn’t a good idea and you should be monitored carefully.
If they aren’t related, then you should be evaluated separately for the two problems.
Angioedema, a dangerous allergic reaction usually involving swelling of the lips and face, can be a hereditary condition requiring treatment. An allergist is likely to have the most expertise in this condition.
Recurrent vertigo has many possible causes, but I am always concerned when I hear people treating it with antihistamines; these treat symptoms but don’t allow the body to fully recover. Neurologists and ENT doctors often are expert in vertigo if your regular doctor hasn’t been able to help.
The booklet on vertigo explains this condition and outlines its treatment. Readers can order a copy by writing to Dr. Roach, Book No. 801, 628 Virginia Dr., Orlando, Fla., U.S.A., 32803. Enclose a cheque or money order for C$6 with the recipient’s printed name and address.
DEAR DR. ROACH: After a colonoscopy, are we more susceptible to bugs when our colon has been stripped of everything? Is there a protocol for reintroducing foods into your body? Is it risky to take antibiotics at a time when you presumably are trying to repopulate the colon with good bacteria?
ANSWER: Preparation for colonoscopy removes more than 99.9 per cent of the bacteria from the bowel (you would need 28 more nines). Many of those bacteria are healthy and aid digestion, so supplementing the gut with healthy bacteria, either with probiotics or just healthy bacteria from live yogurt, can help prevent the diarrhea some people get after a colonoscopy. Eating easier-to-digest foods for a few days is wise.
Antibiotics should be used judiciously at any time: They kill healthy bacteria and promote resistance of dangerous bacteria. However, it is particularly important when your bowel is already depopulated by the colonoscopy preparation.
DEAR DR. ROACH: My husband, 82, had prostate cancer surgery 11 years ago. His PSA goes up and down, mostly down, due to a Lupron shot. Does a higher PSA level mean cancer cells are present? If so, how does lowering the PSA count treat cancer cells?
ANSWER: After prostate surgery, there usually are no more normal prostate cancer cells. This is confirmed when the PSA level goes to zero after surgery. Since only prostate and prostate cancer cells make PSA, any amount of PSA present in the blood probably is coming from prostate cancer. The higher the PSA level, the more cancer cells in the body. If the Lupron (which blocks testosterone, a hormone that helps prostate cancer cells grow) reduces the PSA, it means it is effective at treating the prostate cancer cells. Sometimes we cannot cure the prostate cancer, but can keep its growth controlled.
Readers may email questions to ToYourGoodHealth@med.cornell.edu.