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Nurse Susan
Nurse Susan, Nurse (RN)
Category: Health
Satisfied Customers: 1086
Experience:  RN, BSN, MSN-ED, Nurse Educator whose passion is helping people understand their health and wellness
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Since the time of waking up this morning, Ive felt off balance

Customer Question

Since the time of waking up this morning, I've felt off balance and a feeling of "passing out". I don't know why I feel this way. My current blood pressure is 164/94 (highest reading of the day). I do have anxiety, and high Bp, but I take med for both. Very scaring feeling. Please help.
Submitted: 2 years ago.
Category: Health
Expert:  On Call MD replied 2 years ago.
Hello
It is my pleasure to help you today
your high blood pressure can be the cause of that it could be related to your anxiety too which can make your BP high if you already took both meds and still feeling imbalance I advise you to go to ER ASAP for more work up
Customer: replied 2 years ago.
Can this be something very serious?
Expert:  On Call MD replied 2 years ago.
usually in 20 years old and with BP of 164 I do not think it would be serious but the fact that you are saying that there is imbalance involved more should investigations should be done in ER to be safe
Customer: replied 2 years ago.
Do you think it would be okay to wait and see how I feel tomorrow? Or do you think I should go today? Because I just feel off balance, I've never actually lost my balance. I can stand on one leg and not fall over I took another reading and it is now 128/76...I don't know why it's fluctuating like this.
Expert:  Nurse Susan replied 2 years ago.
Hello JACustomer,

I would like to possibly make a suggestion here, but before I do, I have some questions if you don't mind. This "off balance" feeling...do you feel as if you or the room you are in is spinning or moving in any way or do you feel actual light headedness?

If it is spinning or rocking moving sensations, they have been present all day? Did anything happen prior to this, like a cold or a head injury? Do you hear any ringing in your ears or have any noticeable hearing loss?

Thank you for clarifying,
Sincerely,
Susan
Expert:  On Call MD replied 2 years ago.
with 128/76 that is normal and if the imbalance is improving I say it would be ok not to rush to ER now..however if it recur again or you got any weakness in any of your limbs you should go to ER directly
Customer: replied 2 years ago.
Customer it almost feels like the room is almost tilted a bit. An no, no head injury or anything like that. Also, it has been on and off all day, but more on than off. And ON CALL md: thank you for your reassurance.
Expert:  On Call MD replied 2 years ago.

Hope you get better soon

Any questions let me know
if I was able to help you  your (EXCELLENT) rating is very important to me so I would get compensated for my time and answer
Customer: replied 2 years ago.
Do you think that this is anything too serious? Maybe my anxiety or possibly a vertigo?
Expert:  On Call MD replied 2 years ago.
if it recur again frequently without high blood pressure i would suggest seeing an ENT specialist for more e investigations
Expert:  Nurse Susan replied 2 years ago.
Hello JACustomer,

Does it get worse or better when you move your head in certain positions?
Thank you for clarifying,
Sincerely,
Susan
Customer: replied 2 years ago.
Well I would say it gets best when I'm just sitting around, but like when I move my head down I tend to feel it more, and when I look in both directions quickly I get dizzy. But like I said, it's just te feeling, because I can stand on one leg no prob
Expert:  Nurse Susan replied 2 years ago.
Hello JACustomer,

I am so sorry to hear of your situation. I am writing here because I have allot more to add and contribute. Please understand that no one online can state with any certainty what is happening, all we can do is give a best educated guess based on what you write.

From personal experience I know how distressing and disabling vertigo can be; I empathize with you....this spinning off balance sensation you seem to be describing sounds like vertigo (feeling of movement when there is none).

A bit of background: The body regulates balance three ways: the inner ear, the eyes (what we see) and the central brain which puts it all together you could say. If one of those systems are "off" and the other two cant compensate, vertigo will result.

The problem is, people have many ideas and theories, but no one knows for sure why people get vertigo, and online no one can determine your exact cause. Here are some possible causes.

Possible reasons why people get vertigo include migraines, but usually the vertigo is followed by a headache, though there can be migraine vertigo without headache.

There is also cervical vertigo, which is not well understood at all, thought to arise from injuries or trauma to the cervical vertebrae.

Head trauma can cause vertigo as well which is why I asked about that.

A condition called Meniere's disease can also cause vertigo, though that is usually accompanied by ringing in the ears and temporary hearing loss. You don't appear to have this, but no one can state anything for certain online.

Tumors of the inner ear called acoustic neuromas can cause vertigo.

The most common form of vertigo is benign paroxysmal positional...meaning that on sudden movements of the head, spinning sensations develop. That can be a result of little sediments that deposit in the inner ear canal. From what you write, this is my top contender for the cause of your distress.

Vertigo also can be a sign of multiple sclerosis. Onset here is typically sudden, and the person with MS will find themselves unable to move their eyes towards their nose, ie look inwards.

A rare brain defect called a chiari malformation can result in vertigo.

Vitamin B12 deficiency can result in vertigo.

Bacteria and viral infections as well can cause vertigo. That was the case in my situation, and why I asked if you had a recent cold.

Treatment depends on the cause, and the cause is determined by knowing the history and the results of a physical exam. In Menieres disease, often a diuretic is given, as well as a low salt diet as salt is thought to be one of the culprits. In BPPV, exercises can be prescribed to settle the sediments in the inner ear. In vertigo caused by bacteria, steroids and valium (when the vertigo was truly bad) can be used, in addition to Meclazine (sold OTC as Bonine). The Xanax you took is in the same drug category as Valium...that may be why it helped with the vertigo for a while.

The specialist you should see is an ENT (ears, nose, and throat) physician. Neurologists can help as well as vertigo can be centrally caused. There ARE tests that can be done to pinpoint where the vertigo is coming from (central vs. inner ear) . They include things like ENG's and Rotator Chair and Caloric Testing. Those all look for specific abnormal eye movements called nystagmus; the pattern helps determine where the vertigo originates. If you have not seen an ENT (and I know you've not yet) I recommend you visit one. There are special vestibular rehabilitation specialists, and they give exercises to help retrain the brain and help it rewire and correct whatever damage the vertigo did, if there is a vertigo present...they can be especially helpful with BPPV caused vertigo. There are also visual therapists as well should there be a optical cause or excaserbating factor to the vertigo; as is in my case.

What I would suggest is that make an appointment with your doctor and discuss all this, (as it may not even be vertigo...it could be something entirely different; if you feel better after eating you may have low blood sugar issues, for example). If this vertigo keeps at its present rate, you should be seen, and an urgent care center is not a bad idea...as any sudden new onset vertigo should be evaluated. Also a referral to an ENT or neurologist as needed can be discussed in addition to physical therapy with your physician.

Here is a useful website regarding all things vertigo:http://www.dizziness-and-balance.com/disorders/index.html

I really and truly hope I was able to help.

Sincerely,

Susan
Customer: replied 2 years ago.
How log can vertigo Last with a person? And will it stop me from my collegiate baseball career?
Expert:  Nurse Susan replied 2 years ago.
Hello JACustomer,

How long vertigo lasts depends on the type it is and what causes it. I strongly suspect that in your case, you do have BPPV. If that is the case, you are quite lucky as not only is it the most common form of vertigo, it is also the easiest to treat. There are special maneuvers that can be done to resettle those sediments in the inner ear which, if this is BPPV, are causing the problem, and in most people, its cured after two or three treatments. And, if it does linger, its not the constant that you feel, its just really on motions of the head, looking up, or rolling over in bed...and it lessens over time.

If this is conventional BPPV and it responds to treatment as most do, it should not at all stop you from playing college baseball.

I hope that helped,
Sincerely,
Susan
Customer: replied 2 years ago.
What if it is one of the others you've mentioned?
Expert:  Nurse Susan replied 2 years ago.
Hello JACustomer,

If is one of the others Ive mentioned, then the times will be variable dependent on the type. Menieres can last years and is controlled by diet and medication; I don't think you have that for reasons I explained, same with the acoustic neuroma. Both come with hearing loss and ringing in the ears which you don't have. This did not come about after a cold; vertigo due to a cold or virus can last many many months. Some causes are life long, like MS...which I truly do not believe you have; you have no symptoms there.

You can check your Vitamin B12 levels by a blood test, if its that, then the proper levels B12 will correct it. MRI will detect a chiari malformation and they are really rare, and many with that are uncoordinated; I don't think you would be able to play college level baseball.

My advice is to see your doctor and get a referral to an ENT...if it continues at this level tonight, be seen at an ER or urgent care center just to make sure nothing horrid is happening...if it is BPPV it is truly easily managed.

Sincerely,
Susan
Customer: replied 2 years ago.
I have had this on and off for a little less than a year. I'll have it for a couple weeks and then go away and come back
Expert:  Nurse Susan replied 2 years ago.
Hello JACustomer,

That really raises my suspicion that this is BPPV, so I'm going to write about it a bit more. Your inner ear has these round structures that control balance, and in them are fine little hairs rooted to the bottom of it which are floating in fluid. When you move, the fluid moves, the hairs move, and that sensation triggers a nerve which helps us keep our balance.

But, in BPPV for some reason no one really knows, sediments form, and these little stone things fall on those hair follicles and mess up the fluid, and send really false signals to the brain, and those stones tend to move most when you move your head in certain ways. Thats why the special exercises that a trained therapist will do and help you learn will help settle those stones so they don't move as much.

If you've never seen an ENT for this, of course it hasn't gone away. It comes back every now and then...and its dreadfully annoying when it does. This makes me more comfortable actually; you had not mentioned that you've had these episodes before. So this is not a sudden and FIRST onset of severe vertigo; this is something you have had a while.

Thats why I think you should see an ENT, have the test to see if you have this and the treatment if you do...its one of the easiest types of vertigo to treat.

I hope that was helpful,
Sincerely,
Susan
Customer: replied 2 years ago.
Will they be able to 100% know if it's vertigo if that's what I have? And yeah, since like last spring it's been happening
Expert:  Nurse Susan replied 2 years ago.
Hello JACustomer,

If it is BPPV, absolutely, 100% they will be able to see it on the test they do for it. The test will make characteristic eye movements which will let them know what and where the problem lies. You don't have to suffer with this.

Please see an ENT and have testing and treatment for this rather easy to treat form of vertigo.

Sincerely,
Susan
Customer: replied 2 years ago.
thank you Sooo much, such a relief to talk to someone that actually dealt with the problem themselves and can actually relate to me. Best dr. By far on this website. Can I ask you something?...what would be considered to be too low of a pulse when laying around watching tv before bed?
Expert:  Nurse Susan replied 2 years ago.
Hello JACustomer,

Vertigo is horrid, but at least my experience makes me VERY sympathetic to others with it. Not many can understand the hell that it is unless they've been through it.

Thank you so much for your kind words. I am not a doctor though, I am a nurse.

Site policy says that follow up questions are fine, but new questions should be asked upon a new question thread. I don't wish to get in trouble by violating site policy. Because of that, I need to ask you to please rate / accept (if you feel its been of help) this one and open a new thread....I may not be able to answer that one though because its 1:30 am in NY and I am truly quite exhausted.

One of the other experts on the site can help you now with the new question, unless if you wish me and you do not mind the wait on a new question...I can answer it tomorrow.

I thank you again for your kind words and please see the ENT.
Sincerely,
Susan
Customer: replied 2 years ago.
I've tried calling numerous offices and no one will be in until Monday. Did you ever experience like your legs were weak or even your body because of it?
Expert:  Nurse Susan replied 2 years ago.
Hello JACustomer,

Vertigo is exhausting. When mine flares, yes, I feel weak, and I often end up going to sleep because of it. Not being there examining you of course I cant state for sure what is happening, but its common for people with vertigo to feel utterly, truly miserable and wretched.

Hope that helps,
Sincerely,
Susan
Customer: replied 2 years ago.
It is by far the worst feeling I have ever had. It's so shitty (pardon my language) but it really almost feels like death, like I'm just sitting here watching tv feeling like I can pass out at any minute. Haha.
Expert:  Nurse Susan replied 2 years ago.
Hello JACustomer,

I know. I do. And as long as its the vertigo you know you have, you know there is nothing truly horrid...its just the vertigo. Lie down, and if TV helps, by all means watch TV. Hold on to the couch or bed if it makes you feel like you have more stability.

I am happy you are seeing someone on Monday. But that does not mean that if you are concerned now and think something worse or not vertigo is happening, to wait...I am not there and you are. If you feel this is different, worse, etc. PLEASE be seen sooner, at the ER if you think you need to.

I don't mind working with you in the slightest and have enjoyed our long interaction. But I only get paid if you Accept my answer (just a reminder as you have written so kindly about how helpful I have been)...and I am happy to keep talking after you Accept. Please don't think positive rating/ accept means I wont continue this chat.

Sincerely,
Susan
Customer: replied 2 years ago.
It has been better since yesterday, I slept with the pillows kind of holding my head in a more upright position with less moving around at night I believe. I'm sorry that the interaction is taking long, I will be sure to "tip" well. I don't actually have an appt made for Monday, as I got the answering service when I called, but hopefully someone has an opening. I do believe that it is in fact vertigo and nothing more. I do have high Bp and anxiety, but both are controlled like stated before.
Expert:  Nurse Susan replied 2 years ago.
Hello JACustomer,

Don't be sorry...you write well and are clearly intelligent, thus I am happy to help you. And I am in a good position to do it...as you said, its good to speak to someone who knows what it is like; I have had it for a long time and even still it can be scary when it is very bad.

And I do want to know what happens at your ENT visit.
How is your breathing? People with anxiety tend to breathe WAY too fast even if they are not aware of it, and that quick breathing changes ...temporarily...body chemistry and THAT can make you feel miserable as well. I want you to try to take deep calm breaths, as that can help a bit.

Sincerely, XXXXX XXXXX hope that helps also....
Susan
Customer: replied 2 years ago.
My breathing is okay to my knowledge. My brother is a EMT and says I'm fine and that it's all in my head, but I highly believe it to be vertigo. Once treated, if it is vertigo which I'm hoping and am starting to believe more and mee that it is in fact vertigo, is there high chances of it reoccurring and coming back?
Expert:  Nurse Susan replied 2 years ago.
Hello JACustomer,

From what you write, I also believe it may be vertigo...and if it is BPPV type of vertigo, which is what I suspect given your description, it is the easiest form to treat. Most people with BPPV have their vertigo essentially cured after two or three treatments (the special maneuver of which I wrote). Some people with BPPV get it mildly after the treatments, but nothing like it was.

I hope that helps,
Sincerely,
Susan
Nurse Susan, Nurse (RN)
Category: Health
Satisfied Customers: 1086
Experience: RN, BSN, MSN-ED, Nurse Educator whose passion is helping people understand their health and wellness
Nurse Susan and 6 other Health Specialists are ready to help you
Customer: replied 2 years ago.
I just drove to get food, I also feel like its brought upon driving alot, did this happen with you?
Expert:  Nurse Susan replied 2 years ago.
Hello JACustomer,

Thank you for the Accept! When I have vertigo really badly, I can not drive, I don't feel safe doing so. I don't have your presumed type of vertigo though, so we are going to have different triggers. My triggers are very visual. In BPPV the triggers are allot of head motions; in driving people move their heads allot. So I am not surprised it happened with you driving, but I am surprised you drove at all.

Hope you got something good to eat.

Sincerely,
Susan
Customer: replied 2 years ago.
Am I not supposed to drive? I had to drive my fiancé to the hospital today because we found out she was pregnant today. I feel that head movement does it
More as well as standing for a period of time. And it doesn't help that I have anxiety, because I feel tat makes it worse
Expert:  Nurse Susan replied 2 years ago.
Hello JACustomer...

Fiance?? And a pregnant fiance?? CONGRATULATIONS on your upcoming wedding and the birth of your child! Thats terrific! I am so happy for you. When is the wedding? When is your fiance due, proud Papa? Where will you two honeymoon? I'd ask about her dress but I know you would not know the answer to that one <smiles>

What happened that she needed to go to the hospital? I hope she is OK.

As for your driving, if you feel safe and able to drive competently, there is nothing at all wrong with your choice to drive. You aren't made worse by things you see; so if you know you can drive, its fine to do so.

I am made worse by things I see, and I know that it does affect my driving, so I know when not to drive. As long as you know when you can drive and when you can't, you will be fine.

Absolutely, anxiety will make it worse. Thats because you are nervous so magnify what you feel...and vertigo leaves you miserable enough as it is.

Congratulations again...
Sincerely,
Susan
Customer: replied 2 years ago.
Haha. Thank you..and we just found out yesterday!!! We went to hospital just to make sure our test wasn't wrong. And this morning, of course I feel like shit, lightheaded, etc the usual. I'm hoping that one of the doctors I call has an opening tomorrow
Customer: replied 2 years ago.
Relist: Other.
Offline
Expert:  Nurse72 replied 2 years ago.
Hello, how can I help you? Did you have further questions?
Customer: replied 2 years ago.
Yeah I was searching bppv and it says that the feeling usually only lasts las than a minute, however, I have the feeling throughout the whole day almost.
Expert:  Nurse72 replied 2 years ago.
I was reading your post, I do have another opinion. This could be an inner ear infection. This can disrupt the equilibrium and cause you to feel dizzy, light headed and nauseated. This can be diagnosed by your physician in an office visit.
Customer: replied 2 years ago.
can the Ent also diagnose?
Expert:  Nurse72 replied 2 years ago.
Yes of course. That's a better choice
Customer: replied 2 years ago.
but can the vertigo (bppv) last all day like I described? It's been through the past 3 days so far
Expert:  Nurse72 replied 2 years ago.
I'm not sure about that. That's why I think it's more likely an inner ear infection
Customer: replied 2 years ago.
but this has been going on on and off for a little over a year now and it kind of is ruining my college baseball career. Do you think it is serious? After reading the previous posts as well?
Expert:  Nurse72 replied 2 years ago.
If it's been going on for that long you should have an MRI scan for sure
Customer: replied 2 years ago.
I've had a ct scan. Normal
Expert:  Nurse72 replied 2 years ago.
Good, then it's not anything serious. I strongly suspect it is an inner ear issue
Expert:  Nurse Susan replied 2 years ago.
Hello JACustomer,

I'm back again; I just went to sleep for the night. I need to sleep some times <grins> and thats so great about your fiancee. When is the baby due?

Most times with vertigo, an MRI will not find anything...especially if it is BPPV related as I suspect. CT scan is good, but MRI is "the gold standard" if a test like that has to be done for vertigo. I think the ENT is a good first start. At times, though, vertigo can be caused by anxiety, which you know you have...but no one should say vertigo is caused by psychological reasons until all the physical ones are ruled out. And you do have symptoms that strongly make me suspect you might have BPPV caused vertigo...and if so, thats the easiest to treat. Wish that was my cause.

Sincerely,
Susan
Customer: replied 2 years ago.
HeyCustomer Glad your back. We aren't sure yet when she is due, she has an appt with her obgyn on July 7th. Hopefully we find out then! And as I mentioned to the other person, can the vertigo last the whole day and not just a couple minutes as in my case?
Expert:  Nurse Susan replied 2 years ago.
Hello JACustomer,

My apologies! Next time I will write that I am heading off to bed but will be back the next day. Yes, in BPPV it can last as it keeps coming and going with head movements. It can indeed stay around a while. I really hope you get an appointment with an ENT tomorrow. Please keep me informed about that, and what results she or he found. A general practitioner can DO these tests but he or she wont have had the experience with it and would not be as reliable, in this. This is getting to be a specialized area an ENT should address.

Your anxiety about it will also make it seem worse as you focus on it. I still think you may be breathing more quickly than you realize and making yourself feel miserable that way as well. So, the two combined are not a good mix.

Sincerely,
Susan
Expert:  Nurse72 replied 2 years ago.
Ill let you continue withCustomer I hope you feel better soon! Best if luck and warm regards!
Nurse72
Customer: replied 2 years ago.
Oh no, it's alright. Figured it was about time for bed anyways. I am hoping to get an appt tomorrow with the Ent specialist. I really think this will help, I hope it's nothing more serious than that
Expert:  Nurse Susan replied 2 years ago.
Hello JACustomer,

Please let me know how it goes tomorrow. And good luck at your appointment which I hope that you do get.
Sincerely,
Susan
Customer: replied 2 years ago.
It's really bothering me right now. But I think it's just a mix of anxiety plus the possible vertigo. Do you believe that this is what it is? I took my Bp, 144/80 pulse 81. I'm not going to pass out right?
Expert:  Nurse Susan replied 2 years ago.
Hello JACustomer,

If you feel that dizzy, please lie down. There is a difference between the dizziness of vertigo and the light headedness of feeling like you are about to pass out. Anxiety can cause light headedness, by the way. What are you feeling now, and is it any different than what you have been feeling with this vertigo and anxiety that you have had for so long?

Sincerely,
Susan
Customer: replied 2 years ago.
No, no different. I'm just afraid of passing out. You don't think I will, right? Or is there a possibility?
Expert:  Nurse Susan replied 2 years ago.
Hello JACustomer (JACustomer sounds so formal...what is your first name, if I may ask?)

OK. So this is the same as whats been ongoing for a while. You have not passed out with this so far...I don't think you will pass out so long as you do not over exert yourself. Control your breathing. I DO think you could fall though...anxiety and vertigo are not a good combination. I think you should lie down or sit down...somewhere comfortable, somewhere calming...think of something that soothes and relaxes you, that will take your mind off the anxiety if not the vertigo.


Tell me of a happy experience...where did you meet your fiancee?

Sincerely,
Susan
Customer: replied 2 years ago.
My name is Rocco, and I met my fiancé through a friend of mine that I went to high school with.
Expert:  Nurse Susan replied 2 years ago.
HI Rocco,

Thats so sweet. I bet you are all excited for the wedding. That is a good form of stress :)

Sincerely,
Susan
Customer: replied 2 years ago.
Yes, more excited to find out if we are having a boy or girl. :) hopefully everything is okay with the baby, my fiancé (Jill) has had a miscarriage before. But I think everything will be okay. We find out more on the 7th. I fee sometimes when I lay down that the room is tilted a bit, is that normal for a vertigo suspect? I really hope I can get this appt tomorrow.
Expert:  Nurse Susan replied 2 years ago.
Hello Rocco.

Oh I hope everything is OK with the little one also. I am sorry to hear of Jill's miscarriage..thats lousy. Do you want a boy or girl or do you care at all?

It is very normal for vertigo to feel the room and floors and everything is off or canted or tilted; its very disconcerting. I have to put pillows on the bed to form a "wall" so I don't feel so like I will fall off. Or I sleep on the couch...that helps also.

I hope you can get the appointment also...definitely let me know what happens.

Sincerely,
Susan
Expert:  Nurse Susan replied 2 years ago.
Hello Rocco,

Just a note to let you know I am off the site for the night but will be back again tomorrow.
Let me know how the doctor goes!
Sincerely,
Susan
Customer: replied 2 years ago.
I called and I have an appt for Wednesday.
Expert:  Nurse Susan replied 2 years ago.
Hello Rocco,

Thats wonderful! Do let me know how it goes and what happens when you see this ENT. If you can, take someone with you to the appointment who can drive you. You will be anxious and nervous enough as it is and so may not recall all that the doctor says...and you may also feel lousy afterwords depending on what tests he runs so may not wish to drive back yourself.

I may not be on the site much tonight, my own vertigo is misbehaving today.

Sincerely,
Susan

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