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Ask Dr Ted Manos Your Own Question
Dr Ted Manos
Dr Ted Manos, Doctor (MD)
Category: Health
Satisfied Customers: 332
Experience:  Self employed 40 years experience Ob-Gyn
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How much will speaking to you cost? OK - thank you. Are you

Customer Question

How much will speaking to you cost?
JA: I'm not sure of the exact price, but there's only a $5 deposit. The rest of the price information will be on the page I send you to.
Customer: OK - thank you. Are you a qualified MD firstly?
JA: No. I'm the Doctor's Assistant.
Customer: I need to talk to an MD really.
JA: Have you seen a doctor about this yet? What medications are you taking?
Customer: No and yes ie not about the vertigo-type walking to the side but i have Pagets Disease in the skull (as well as other parts in my body - as a result of an autologous bone graft) and i'm wondering if Pagets could cause this?
JA: Anything else in your medical history you think the doctor should know?
Customer: I take escitalopram 5md daily, am 66, female and take no other medication.
JA: What medications do you take daily? Are you allergic to any medications?
Customer: Allergic only to penicillin. Meant escitalopram 5mg daily.
Submitted: 24 days ago.
Category: Health
Customer: replied 24 days ago.
I have what i think is tinnitus and yesterday fell off a chair because my brain seemed to suddenly shift in my head. It was NOT dizziness, it felt more like some part of my brain shifted inside my skull. When i righted myself on the chair, my consciousness was poorly focussed ie quite heighted and jumbled simultaneously.
Customer: replied 24 days ago.
I had simply gone to sit down in the office chair quite normally but my mind/body just seemed to shut down and i didn't completely fall onto the floor as i grabbed the desk leg top.
Customer: replied 24 days ago.
The autologous bone graft was from my right illiac crest to compound fractured left tibia but it was determined via a bone marrow biopsy that the graft had caused Pagets to my right hip and left tibia but was also detected in other places including my skull, behind an ear (don't know which one).
Expert:  Dr Ted Manos replied 24 days ago.
Hello, I'm Dr Manos, M.D. Paget's disease of bone wouldn't have your episode as a usual occurrence but escitalopram can cause this including cardiac rythym disturbance. I believe you should consult a physician. Dizziness can be seen with the skull bone changes and could call for medication used for Paget's. I hope I've been of some help.
Customer: replied 23 days ago.
Hi Dr Manos,Thanks for your reply :)
You say that "dizziness can be seen with the skull bone changes" and could call for medication used with Pagets. Also, i've been taking very low-dosage escitalopram for 2 years … why would it suddenly cause dizziness? It isn't dizziness as i've ever experienced it eg from syncope/fainting etc. This is QUITE different - it is like an extremely intense interior spinning which cannot be righted for at least a minute or so. What Pagets medication are you referring to, something like Zoledronate infusions? (i've had them). I'm not sure what skull changes can occur with Pagets, does my skull bones begin to contract? Do you think i may need to see an endocrinal specialist?Many thanks,
Expert:  Dr Ted Manos replied 23 days ago.
It's been quite sometime since I saw a patient with Paget's Disease but bone structure is constantly remodeling itself but in your case the areas affected by Paget's have softened and some time thickened bone patches. The skull looks thicker over time and can create problems with the middle ear structure that controls balance. An endocrinologist should be someone who can take care of Paget's which is a metabolic disorder of sorts. Biophosphonates are used for Paget's and medications if serum phosphate or calcium levels get too high.
Customer: replied 22 days ago.
OK, thanks for your clarification re bone remodelling and softening/thickening components. I'll see a GP/physician (i'm living in Melbourne, Australia) and ask for blood tests re alkaline phosphatase and calcium level results plus middle ear investigation. Last question here … do i need to get a hearing test also? Will that potentially identify any middle ear concerns? Thank you.
Expert:  Dr Ted Manos replied 22 days ago.
I don't think you'd need a hearing test as the hearing mechanism is a little deeper than the balance area. They could do a tuning fork test where they cause the fork to vibrate and touch the heel of the instrument to your forehead and see what you can hear and feel. I hope this helps point out what's going on.
Customer: replied 21 days ago.
OK, i get that process (i'm a classical musician) - hence a bit worried about what the implications might be. Thank you very much for your help here. Kind wishes, Sharon
Expert:  Dr Ted Manos replied 21 days ago.
You're welcome.
Customer: replied 21 days ago.
Expert:  Dr Ted Manos replied 21 days ago.