My ANA test for three years has come back normal, but I continue to get lesions, my hair falls out, and I get sick easily. I have been to two rheumatologists. Both say I do not have SLE, but my family doctor feels I do. What do you think?

I was also told that because I only have discoid lupus, this would not cause any health problems other than with my skin and hair. So why do I have it in my nose and inside both ears? I’m now 33, my bones are brittle, and I have osteoarthritis in my hands and fingers. Help!

DEAR READER: Whew, where to start? Some children have impaired immune systems, making them subject to numerous disorders. My guess is that you were unfortunate enough to fall into that category.

There are a number of forms of lupus, which is an autoimmune disease. Lupus can affect joints, skin, kidneys, brain, heart, lungs and other parts of the body. Common symptoms include skin rash, kidney problems, arthritis and unexplained fever.

Discoid lupus is a chronic skin disorder that shows as a raised red rash that ordinarily appears on the face and scalp but can appear in other areas of the body, including the nose and ears. The lesions may last for days or years and can recur. Some people diagnosed with discoid lupus may develop systemic lupus erythematosus (SLE) at a later date.

Because arthritis is a common complaint, it’s not at all surprising that you have been diagnosed with fibromyalgia, chronic pain in muscles and ligaments.

Pleurisy is swelling of the lung linings that causes pain and breathlessness during inhalation and exhalation. Causes include acute viral infections, such as influenza, and can be the result of autoimmune disorders, such as lupus.

Kidney stones and related infections have numerous causes, including dehydration, obesity, genetic factors and a diet high in protein/sugar/sodium.

Vertigo can be caused by an inner-ear disorder, migraine headache, acoustic neuroma and other causes.
Depression and anxiety can be caused by lupus, fibromyalgia, kidney stones and vertigo. You have a lot on your plate, and it has obviously resulted in a lot of stress. Osteoarthritis, a breakdown of cartilage, causes pain and stiffness of affected joints. The condition is commonly associated with the aging process, but at 33, you are far from old. Treatment is geared toward controlling pain through medication, rest, exercise and protection of the affected joint(s).

Because so many of your symptoms involve pain, I’m inclined to suggest that you be referred to a pain clinic for control or request a referral to a larger diagnostic center, such as the Mayo Clinic. You will learn methods for reducing the level of pain you presently experience that may include water aerobics and yoga. Appropriate medication might be ordered. Once you get that aspect under control, the anxiety and stress levels you are under may be reduced.

To provide related information, I am sending you a copy of my Health Report “Fibromyalgia.” Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a $2 check or money order to Newsletter, P.O. Box 167, Wickliffe, OH 44092-0167. Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.

Please help with at least a suggestion, because I have had no diagnosis from any of the five doctors I’ve seen. I even saw a neurologist, who only suggested physical therapy. I’m hoping for a response.

DEAR READER: It’s time for a second — or sixth — opinion. Something is being missed, and I am concerned about the complaint of constant pressure at the base of your neck.

There are a number of balance disorders that can be caused by a variety of medical conditions. Commonly, the first consideration is the inner ear and Meniere’s disease, followed by but not in any specific order: hematoma from a fall, brain tumors, poor vision, advanced age and medication-induced problems. Normal balance requires three systems working in harmony — visual, somatosensory and vestibular. When one fails to function properly, balance can be dramatically affected.

Meniere’s is an inner-ear abnormality associated with fluid volume changes. It presents with acute dizziness, the sensation of pain or pressure in the affected ear, tinnitus, roaring sounds and fluctuations in the ability to hear. If this were your case, it is likely only one ear would be affected, a relatively straightforward sign.

Tumors of the spine are abnormal masses causing minimal symptoms until they grow large enough to affect neurological functioning. I must state that not all tumors are cancerous. Numerous benign growths such as chordomas, schwannomas and acoustic neuromas can occur, presenting with loss of balance, dizziness, double vision and more. Diagnosis is commonly made through CT, MRI or cerebral angiography of the affected area. The good news is that enormous advances have been made in recent years and tumors that were once inoperable are now successfully removed.

Medications such as sedatives, antihistamines, tranquilizers, antiseizure drugs and those for hypertension carry the potential for causing dizziness and balance problems. If you are on any of these drugs, speak with the prescribing physician to determine whether they could be causing your balance problems. Did your physician or physicians add one more to the package about a year ago when your symptoms first began? Keep in mind that some drugs interact unfavorably with others, so perhaps a combination of drugs is to blame.

Caffeine, alcohol and tobacco products can also be contributors. If you indulge in these products, consider a trial of elimination or cutting back to see whether your symptoms disappear. It would certainly be a sad thing to know that chocolate, coffee or soda has provided you with a year of agony.

And, at long last, make an appointment with a new otolaryngologist and neurologist to help you get to the bottom of the issue. You always have the right to return to your team of physicians, but a second opinion won’t hurt. And you deserve to function normally after what you have been through.

If no treatable cause is found, you may benefit from balance retraining by a physical therapist.

To provide related information, I am sending you a copy of my Health Report “Medical Specialists.” Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a $2 check or money order to Newsletter, P.O. Box 167, Wickliffe, OH 44092-0167. Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.

In February 2007, my husband was found to have high blood pressure and was started on lisinopril, hydrochlorothiazide and metoprolol which he took until October 2007 when he developed an unproductive cough, extreme fatigue and lightheadedness. He could sleep 24/7. He saw his doctor who ordered testing but nothing was found.

He then developed dizziness when turning his head or bending over and saw the doctor again after developing a slight fever. He was given amoxicillin. At that time we asked about the possible side effects of the lisinopril and were told he could stop it.

Now fearing medication my husband stopped them all. He then returned back to the physician because his symptoms persisted and was found to have very high blood pressure and a heart rate of 120. His cough had disappeared shortly after stopping the medications but he continued to be dizzy, lightheaded and tired. He was admitted to hospital that day where he had a chest X-ray and was seen by a cardiologist who prescribed atenolol, lisinopril, a low dose aspirin, and Lipitor. His symptoms continued.

We called his primary physician again when he started trembling. At that time he told us to discontinue the lisinopril. The Lipitor was never started because we felt he had enough problems already without taking more medications. My husband then developed a hiccup spasm which is very loud and happens sporadically. He continued to have the extreme tiredness, lightheadedness, dizziness, and trembling so back to the doctor we went. An ultrasound of the carotid artery was ordered and was found to be clear, despite the fact that he nearly fell over after the exam. We were referred to an ear-nose-and-throat specialist to rule out a middle ear infection. Everything appeared to be fine but recommended to our personal physician that a test be done on the inner ear and an MRI of the ear and brain. We decided to hold off on the testing at that point.

In January 2008, our doctor prescribed an antidepressant, fluoxetine. His symptoms improved slightly but two weeks later, my husband couldn’t urinate and was sent to a urologist. He finally was able to go shortly after we arrived for the appointment. During the exam everything was found to be normal but it was recommend that he have an internal exam of his bladder. That test was never done.

Back when my husband had the cough, he felt something happen in his lower torso but didn’t notice anything. He then developed a bulge in late January 2008 that was diagnosed as a hernia. By the time this arrives to you he will probably have had corrective surgery (scheduled for May 2008). He continues to have symptoms despite stopping most of his medications and now has trouble urinating, constipation and a hernia. We don’t know what to do, his doctors cannot find anything wrong and I am worried.

DEAR READER:
Your husband appears to have a series of seemingly unrelated symptoms. Some are similar to adverse effects of his medications, others of vertigo, infection and his hernia.

Your husband’s doctors appear to have done appropriate testing and exams but thus far have failed to find an explanation. Therefore, I recommend your husband get a second opinion from another internist who specializes in ailments of the whole body rather than just this part or that part. You should bring a copy of your husband’s medical record with you to the appointment which will provide an accurate history of symptoms, medications, testing and more. Perhaps having a fresh set of eyes look over the history and do another general examination will reveal something overlooked.

As for holding off on the testing, I urge you to now have that MRI of the ear and brain. The dizziness, lightheadedness and nausea may all stem from vertigo. Vertigo is caused by an abnormality within the ear that can, often upon waking, looking up, bending down and more can cause motion sickness-like symptoms.

The constipation, inability or difficulty to urinate may be part of the hernia which once repaired should stop symptoms. A hernia occurs when part of the intestine slips through an abnormal hole in the abdomen into various areas. Depending on the area of the hernia, symptoms vary. Constipation is fairly common because the stool within the bowel can become blocked in the area that has been “misplaced”. If the intestine is pushing on the tubes leading from the kidneys or the bladder, urination can be affected.

Get a second opinion and follow-up on the recommended testing. Let me know how this turns out.

I have also made an appointment with an ear-nose-and-throat specialist just to be sure that nothing more serious is going on.

DEAR READER:
I appreciate your concern. However, Lipo-Flavonoid is a real product. It is distributed by DSE Healthcare Solutions, LLC in Edison, NJ.

Lipo-Flavonoid contains bioflavonoids, inositol, calcium, vitamin C and several of the B vitamins. It was created to treat the symptoms of Meniere’s disease (dizziness, ringing in the ears and loss of hearing). Many of my readers with tinnitis (ringing in the ears) or vertigo have had success using the product as well as many with Meniere’s. Like most products, it does not work for everyone.

The product can be purchased at most pharmacies in the ear care aisle. It can also be purchased by phone at 1-800-331-0221 or online at www.dsehealth.com.

To give you related information, I am sending you copies of my Health Reports “Ear Infections and Disorders” and “Dr. Gott’s Compelling Home Remedies”. Other readers who would like a copy should send a self-addressed, stamped number 10 envelope and $2 (per report) to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

I am a 90-year-old female with high blood pressure, heart trouble and arthritis. I am on prescription medication for my blood pressure and heart and use over-the-counter Mineral Ice for my arthritis. I also take vitamins C and E and omega 3 fish oil.

About four months ago, I started to get dizziness. I felt like I was drunk. I didn’t do anything about it because I thought it would stop sooner or later. Well, it didn’t and one day I felt so terrible that my daughter rushed me to the emergency room where all sorts of tests were performed. They told me everything was normal and they didn’t know what was causing my dizziness.

What am I doing or not doing that would cause this terrible dizziness?

DEAR READER:
There are two types of dizziness: vertigo (which usually stems from the inner ear) and lightheadedness (which has many causes).

Treatment depends on the type and cause of your dizziness. Lightheadedness can have many causes ranging from blocked arteries to low blood pressure to medication side effects. Careful testing must be done to determine the cause. Since you have already had testing, I don’t believe that your problem stems from lightheadedness; however, you may wish to see your family physician. He or she can review your medications, order repeat or additional testing, or refer you to a specialist.

Vertigo, on the other hand, is often the result of an inner ear abnormality. It can also be caused by the vestibular center of the ear (the oval space in the middle of the ear bones) or pathways in the central nervous system. The most common symptom is the sensation of movement, similar to the effects caused by the over-indulgence of alcohol.
You appear to have a text-book case of vertigo. I recommend that you make an appointment with an ear-nose-and-throat specialist who can perform testing to make a positive diagnosis. At the same time he or she may choose to test you for other causes such as Meniere’s disease, otitis interna (inner ear infection) and more. He or she may also choose to show you special maneuvers, such as the Epley maneuver, or prescribe medication, such as Antivert, to reduce or control your symptoms.

A final option is to try an over-the-counter medication called Lipo-Flavonoid. This product is designed to reduce or eliminate tinnitus and vertigo. It is not effective (as is true for many medications) for all individuals but for those in whon it works, it can provide amazing results.

To give you related information, I am sending you a copy of my Health Report “Ear Infections and Disorders”. Other readers who would like a copy should send a self-addressed, stamped number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

DEAR READER:
It sounds to me that your friend is nauseated and dizzy because of chronic vertigo. This is a problem that stems from his ear. He desperately needs to see an ear-nose-and-throat specialist. There is therapy available for this common condition.

While awaiting his appointment he may wish to try Lipo-Flavonoid which has shown vast improvement in some individuals. (Be sure to mention this to the specialist.)

To give you related information, I am sending you a copy of my Health Report “Ear Infections and Disorders”. Other readers who would like a copy should send a self-addressed, stamped number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

My current problem is vertigo/dizziness. This started April 2007 and I can’t seem to find any relief. My doctors have ruled out my heart as the cause. I have seen my family physician, a neurologist, an ear-nose-and-throat specialist and two emergency room physicians. No one can tell me what to do to get relief, only that I have vertigo.

How do I get someone to help me rather than just telling me what I have?

DEAR READER:
Vertigo is an inability to keep normal balance while standing or sitting caused by an irritation in the inner ear. It can be accompanied by nausea and weakness. Symptoms often lessen or disappear shortly after lying down or remaining motionless for several minutes.

Doctors often recommend and have success with the Brandt-Daroff exercises and the Epley maneuver. The Brandt-Daroff exercises are done at home while sitting on a bed or couch, quickly leaning to one side for 30 seconds and then sitting up. Duplicate the exercise on the other. Repeat about 20 times. It is best to have someone with you if you are worried about the possibility of falling.

The Epley maneuver is performed by a physician and is primarily used to treat benign paroxysmal positional vertigo. While sitting down, he or she will turn your head 45 degrees toward the affected side, lean you back and finally sit you up. This is repeated on the opposite side. The last move will be to lean you forward about 30 degrees.

Another option is an over-the-counter dietary supplement called Lipo-Flavonoid. It is a combination of vitamins, minerals and bioflavonoids that was developed to treat the symptoms of Meniere’s disease (vertigo, tinnitus and hearing loss). Judging from my readers, when it works, it is amazing; however, not everyone experiences relief.

I recommend that you seek a second opinion from an ear-nose-and-throat specialist. He or she should be able to offer more treatment options and in-depth information.

To give you related information, I am sending you a copy of my Health Report “Ear Infections and Disorders”. Other readers who would like a copy should send a self-addressed, stamped number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.