Dr. Shyam Kalyan. N
Otolaryngology (E.N.T)
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hi doctor,
I have dizziness and vertigo for two and a half years now. We think of this condition as cervicogenic. But I do not get a real solution. Please help me.
Hi,
I am glad you chose icliniq for your medical-related queries.
I understand your concern and will try to help you with it.
Please mention some more details about your problem. Please mention whether these problems are constant, any associated hearing loss or tinnitus or ear fullness, and any fever or pain. Please mention whether you have diabetes or hypertension, and any heart-related ailment. Please mention the medications taken for it.
Thank you.
I appreciate your trust in icliniq.com and for giving me the chance to serve you.
Our goal is to prioritize your health and help you according to your preferences and needs.
Patient's Query
Hi doctor,
Thank you for the reply.
I have done a brain magnetic resonance imaging (MRI) and the result was normal. I did a stress echo, and it was normal. The tilt table test showed a slightly elevated pulse upon standing. Vertigo comes and goes often. I have pressure in my head frequently. When I start to walk, the head pressure becomes worse. When I walk for more than 15 minutes, I have heaviness in my legs and my head starts to feel heavy. It prevents me from doing exercise more. I do not have a fever and diabetes. I have tinnitus with hearing loss, and it lasts for a minute. I get skipped heartbeats but the holter monitor showed that they are benign PVCS. I have sleep apnea. Sometimes I wake up with a heart-pounding feeling like I am going to faint, and it resolves within four minutes. I have lung congestion slightly and I have consulted a pulmonologist and allergist. The breathing tests were normal. I have hives occasionally and so I think that there is an allergic component. I have discussed about mast cell disorder with a doctor, and I need to have a follow up with the blood work.
Hi,
Welcome back to icliniq.com.
I do understand your concern.
Thanks for asking again.
You need to do a complete vestibular assessment with a pure tone audiogram, tympanometry, and SISI (short increment sensitivity index test) to have decisive diagnosis and treatment. The details provided by you are not sufficient to have a single diagnosis. Please mention whether you have any ear discharge.
Regards.
Once more, thank you for allowing us to be of service to you.
We value the high level of confidence you have in us!
Patient's Query
Hi doctor,
Thank you for the reply.
I do not have discharge from ears, but I have a build-up of wax and there is some rumbling in my right ear.
Hi,
Welcome back to icliniq.com.
I do understand your concern.
Thanks for asking again.
We can arrive at a clear diagnosis after doing the tests. Otherwise, we can only come to a conclusion that the vestibular system is the cause of these problems. Then I can give you vestibular suppressants alone. The rumbling sounds have to be investigated. The tests mentioned above will give us an idea to know the cause for having the sound. Please provide some more details regarding the sound. Please mention whether it occurs constantly, and there are any fixed times. Please mention whether the sound is more during night or evening and any diet with a lot of salt or having stress. Please mention whether you smoke or drink alcohol or any stress-causing factors. Please mention whether you have tinnitus along with hearing loss. With these symptoms, you come under criteria called endolymphatic hydrops and we need to do tests to confirm it. Please mention whether you have giddiness with spinning or imbalance or problems in gait. Please say the reason for considering the problem as cervicogenic. Please mention whether you have diagnosed neck pain or spondylosis. Please mention in detail about allergy reports and sleep apnea. Please mention whether you have lung congestion at the time of infection or during normal days and any wheezing or breathing problems.
Regards.
Once more, thank you for allowing us to be of service to you.
We value the high level of confidence you have in us!
Patient's Query
Hi doctor,
Thank you for the reply.
I have a rumbling sound during the day and night. For example, if I hear a sound in the left ear, I will hear rumbling vibrations in my right ear. It does not occur always. I do not have them at a fixed time. I was told to consume more salt to keep my blood pressure up because the doctor felt the blood pressure is causing these symptoms. I have a lot of stress after starting a new career. When I wake up, my sinus seems to be stuffy and when I swallow, I have a pop in my ear. When I pinch my nose and try to pop my ears, I notice my left ear regulating air easily than my right ear and the right ear seems to be inflamed or clogged in that condition. I have tinnitus suddenly with hearing loss and it happens on any one of the ears. I do not smoke or drink alcohol. I smoked and drank alcohol occasionally before three years. Vertigo occurs as spinning and I have an imbalance at that time. It happens when I look down while holding my phone and when I am washing my dishes. I do not have neck pain and spondylosis. I have seasonal allergies and dust allergies. I took Penicillin and Doxycycline for it. It helped me a lot. Before a month, I tried taking it and got hives. I underwent septoplasty before seven years. After two years, I started to have these symptoms and it was diagnosed as MRSA in my nose and I was given Levaquin. But it did not help me. After two years, I took Doxycycline, and I got some relief. I have been shown with sinus cysts on the imaging studies of maxillary cysts. I do not have wheezing or infection, but I have chest tightness sometimes. My only concern is vertigo, and it is debilitating more.
Hi,
Welcome back to icliniq.com.
I do understand your concern.
Thanks for asking again.
If you have images of your sinus taken in the last three months, then you can upload them. If it is older, then please upload it. Please mention whether you have taken any nasal sprays and antihistamines.
Regards.
Once more, thank you for allowing us to be of service to you.
We value the high level of confidence you have in us!
Patient's Query
Thank you doctor,
I do not have the images of it. I have tried using Rhinocort and Flonase nasal sprays. I took Allegra for four months and I did not take them for a long term. I have a rash on my chest and stomach for two years. I have attached the picture.
Hi,
Welcome back to icliniq.com.
Please mention whether these rashes are itchy with a burning sensation. Please mention whether it came after the removal of hair. Please mention whether you shave it or use a trimmer for the removal of hair. Please mention whether you have any reaction to the hair removal products and mention your age. Please mention whether you use cream or astringent after the removal of hair. The rashes appear like hair follicle infection or inflammation.
Patient's Query
Thank you doctor,
I do not have itching or burning. I use an electric trimmer and they did not appear directly after trimming. I do not apply cream or astringent. I am 31 years old. I thought it was folliculitis.
Hi,
Welcome back to icliniq.com.
Your symptoms match folliculitis. You can follow these measures to prevent it. Always clean the metal part of the trimmer with a brush before and after using it. You can use alcohol to clean the surface before using it on the body. Before trimming the hair, wash your body with warm water and use soap or body wash. Allow the area to become dry. If there is excess hair, it is good to use a pair of scissors to remove it and after that, you can use an electric trimmer. After removing the hair, I suggest you take a warm water bath followed by towel drying. Apply an aloe vera cream or gel over the area twice daily for three to four days. If the area is kept clean and adequately moisturized, then folliculitis will not develop in that region. You can apply Clindamycin face cream or any antiseptic or antibiotic cream over the affected region for a couple of days. If you follow these measures, then you can keep them in a minimum range.
Patient's Query
Is there any pain? Any swelling? Since when is it there? Any fever?
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Otolaryngology (E.N.T)
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