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Interviewer: When someone says, “Why am I dizzy?”, what are the main possibilities?
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Physiotherapist: So dizziness could mean quite a few things. It could mean that you’re feeling lightheaded or that the room is spinning, and there can be various causes for that as well. It could be coming from the inner ear, it could be coming from blood pressure fluctuations, or it could be coming from the neck.
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Physiotherapist: And then certain medications can also cause dizziness as well. So it depends, I suppose, on how they’re feeling and how they classify their symptoms as well.
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Interviewer: If I start feeling dizzy, what can I do straight away?
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Physiotherapist: So stop what you’re doing while you’re feeling dizzy, and if you can, sit or lie down where you feel safe. That would be the first thing I would do. Wait until you feel steady, and then slowly start to move from lying to sitting, or sitting to slowly standing.
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Physiotherapist: Make sure you’ve got something around you that’s stable, whether it be the armrests on a chair or walls or anything around you to help with that transition. And most importantly, make sure you’re not trying to go up or down stairs, or driving or operating any heavy machinery while you’re feeling like this.
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Interviewer: Sometimes people feel lightheaded when they get out of bed or stand up. What can help?
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Physiotherapist: So before standing up, you can try, in sitting, rocking your feet forwards and backwards just to get a bit of blood flow back up towards your head again, and then gradually having a stand up. Sometimes a drop in blood pressure is what can make you feel a little bit lightheaded when you go from sitting to standing.
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Physiotherapist: So taking it easy, using your hands on the armrests or on your legs to stand up, and making sure you’ve got something nearby to grab onto if you need to, something stable. Making sure you’re drinking enough water throughout the day is really important to keep your blood pressure stable, and keeping your blood sugar levels steady as well can really help.
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Physiotherapist: Some medications can also make you feel lightheaded, so check in with your GP about whether that could be a possible side effect of your medication.
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Interviewer: What could cause spinning when I roll over, lie back or look up?
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Physiotherapist: So this is a very common one, and quite often it’s caused by BPPV, which is basically when you have crystals in your inner ear that sit in a part of the inner ear called the utricle. They look a little bit like stalagmites in a cave, and they’re calcium carbonate projections, like finger-like projections that come up.
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Physiotherapist: Sometimes they can fragment off and land in a different part of the inner ear called the semicircular canal, and suddenly it tells your brain your head’s moving really fast in one direction. So that can cause vertigo, that room spinning, dizzy feeling, in various positions, whether it be lying back in bed, rolling to one side, or going from lying to sitting, depending on which semicircular canal those crystals are sitting in.
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Interviewer: Can I just look up an exercise and try it?
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Physiotherapist: I wouldn’t advise it. There are lots of different exercises out there. There are some that help reposition the crystals in the ear, so if you do have BPPV, that can be helpful. But an assessment is really needed to find out which canal it’s in, because the exercise will change drastically based on the canal it’s in.
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Physiotherapist: There are other exercises out there which help with visual tracking, so eye exercises, which can be helpful, but under the right circumstances. So I would recommend a physiotherapist assessment to make sure you’re prescribed the correct exercises for what is needed and what your goals are as well.
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Interviewer: If I’m having dizzy spells, what simple changes can I make around home?
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Physiotherapist: So one very important thing is making sure you’ve got good lighting, especially at night. A lot of people experience dizziness at night when they get up to go to the bathroom, for instance, and if there isn’t adequate lighting, that can increase the risk of dizziness and potentially falls as well.
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Physiotherapist: So that’s a really big one. Keeping walking routes clear as well. So if you are getting up in the night, or even during the day walking around your house, if you’re feeling dizzy, try and make sure there are fewer obstacles around those routes that you might be walking. Keep your everyday things that you’re using within reach and easy to access as well.
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Physiotherapist: So keep them at heights that you’re not having to reach up too high for. And ask for help too. If you feel uncomfortable doing a certain task and you might feel dizzy, like hanging out the washing, see if someone else can assist with that.
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Interviewer: What can I notice that might help me understand what’s happening?
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Physiotherapist: So when you do feel dizzy, try and notice what activity it is you’re doing. If you were in a certain position, if you’re rolling in bed, for instance, which way you were rolling, or if you’re going from sitting to standing. How long it lasted for as well.
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Physiotherapist: It can be really helpful to know if it was just a few seconds or if it went on for hours. That can tell us a lot of information.
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Physiotherapist: Also, if you’re having any other symptoms at the same time. So if you have a headache, or you’re feeling nauseous or sensitive to light, any of those things as well. And then if anything in particular makes it worse, so if it’s bending down, or looking in your pantry for something and scanning the shelves with your eyes, or reading a book.
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Physiotherapist: If that type of thing is making you particularly dizzy as well.
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Interviewer: When should someone stop trying to manage it at home and get help?
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Physiotherapist: So most importantly, if you have any new onset of dizziness that’s severe and you have any weakness down one side, trouble speaking or swallowing, chest pain, or you’re suddenly unable to walk, call 000. Also, if you have any new dizziness that you’ve never had before and it’s quite severe and affecting your day-to-day functioning, so you’re having trouble walking,
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Physiotherapist: and you’re very nauseous, or there’s any hearing loss with that as well, seek help straight away.
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Physiotherapist: Also, if you have any persistent dizziness, so it’s been going on for a few days and you’ve tried some exercises yourself at home and it’s just not improving, I’d be seeking help then as well.