Dizziness - Please help!

I’m a healthy 27 year old male that worked out regularly 4 days a week consisting of weight lifting and light cardio. Drink 2 alcoholic beverages on average per week. Coffee drinker. Drank energy drinks. Steady, pretty healthy diet. I have had a history of sinus infections since I was in third grade.

Dizziness Record:
My dizziness started July 8th, 2009 when I was down in a resort southwest of Dallas, TX for a company conference, two days after I flew down. The majority of the time we were in a bright classroom type setting from generally 8am to 4pm. The dizziness would occur when I would shift my vision back and to the left, or back and to the right then to a closer point in front of me (like a document). It was like my head was swimming for only a brief couple seconds, and it would take me an extra moment to completely focus on the item in front of me.
I worked out regularly (4 to 5 days a week consisting of weight lifting and light cardio) for almost a year straight with no issues before this.
July 2nd (Thursday), a week before I flew out to Dallas, I did the “300” workout. It was one of the most challenging workouts I’ve ever done and it completely exhausted me. The workout is:
Pullups - 25 reps
Deadlifts with 135lbs - 50 reps
Pushups - 50 reps
24-inch Box jumps - 50 reps
Floor wipers - 50 reps
Single-arm Clean-and-Press with 36lbs Kettlebell - 50 reps
Pullups - 25 reps

Then on July 5th (Sunday, the day before I flew out) I did another Crossfit workout:
(Note: I had not done exhausting multi-functional workouts since I played baseball in college.)
Run 1 mile
100 pull ups
200 push ups
300 squats
Run 1 mile


Also, during the week where I did those two intense workouts (the 29th of June through the 3rd of July), I was helping coach summer baseball camp at the high school I coach at. During camp, I was throwing, hitting, and running around outside from 8am to 12pm typically. The weather outside would fluctuate each day from either extremely hot and sunny, to extremely muggy and humid with chance of rain. On the 3rd (Friday), I started to feel like I was getting a slight cold/sinus infection. Toward the back of my mouth by my wisdom tooth/roof on the right side it felt like I was getting a cotton mouth type feel.

During the trip for my work, I also felt a sinus type discomfort behind my right eye when I would move it. The only other physical thing I did that week was play 18 holes of golf.

I flew back to Chicago on the 10th (Friday). The next day after I woke up (Saturday the 11th), it was the worst dizziness I had experienced so far. When I walked around, it would take me an extra moment to kind of get my balance. Looking from side to side, then in front made my head feel like it was swimming, and I needed to focus harder on what I was physically doing.

Note: There was NEVER any spinning or nausea!!!

On July 14th (Tuesday), I went to a practitioner other than my main guy (he was on vacation), and I was diagnosed with “vestibulitis of the inner ear.” I was given the generic version of Antivert and told if it wasn’t remedied in 7 days, to call an ENT. The Antivert made me tired.

I was flying out to College Station, TX on July 20th and flying back on July 23rd for a baseball camp at Texas A&M, so I wasn’t able to get to an ENT until July 31st (earliest available). On the 21st mid day I started feeling normal again. The 24th, 25th, and 26th when I was back in Chicago, I felt normal as ever. Also, on the 24th, 25th and 26th I went to help with reconstructing the baseball field where I coach. We were breaking up stone with sledgehammers, digging ditches, moving stone, wheel barrowing all day, and nonetheless it was very tough work. I felt fine all those days.

It turned around again on the 27th, when I went to the gym and WALKED on the treadmill at an incline for 45 minutes, then came home and took a nap. I’d fallen asleep on my stomach with my head to the right (like I usually sleep), and when I woke up, I was DIZZY.

This subsided slightly until I went to the ENT on the 31st. The ENT also said it was “vestibular neuritis.” The ENT tried to put me in a few different positions, the Epley method I believe, but it didn’t induce any dizziness.

Went to the Otoneurologist, several tests were ran (balance, water in ears, eye movement tracking), and nothing extravagant came up. Was given Astaline and Ofloxacin for possible Eustachian tube dysfunction. I took that for the allotted period of time suggested, but it was to no avail.

Had a neck/headache feel mid August combined now with constant dizziness. Went to regular DO practioner and was given Flexeril and Mucinex-D to stop potential sternocleidomastoid spasms. Helped slightly. Blood work was done too, and nothing was abnormal. Same with an MRI of brain, no abnormalities. Also did a carotid Doppler…nothing abnormal.

It’s now September and I followed up with the Otoneurologist (same office, different guy), and he thinks the dizziness is directly linked to early July, when I flew on the plane and had a mild sinus infection. He believes it’s BPPV. I have been given the Epley (canalith maneuver for both sides.) I did one week for right side, and I’m just starting on the left side. NO SIGNIFICANT DIZZY SYMPTOMS HAPPEN WHILE DOING IT!

I’ve also had a floater in my right eye that I’ve had checked out (nothing significant). Recently I’ve had light flashes in the lower left corner of my left eye when I try and widen my view and look slightly upward. It doesn’t affect my vision, it’s just annoying. (Don’t know if it’s related or not…)

I don’t know what to do. I’m not sure what it is…Please help with any suggestions!

Here’s a quick run down of what I feel/when I feel it:
- No spinning
- No nausea
- Head is slightly cloudy…feel like my awareness is down
- Imbalance
- Symptoms have been subsiding over time
- Increases when I don’t eat or sleep
- Have always had sinus issues, but NEVER made me dizzy
- When I lay down at night, I have slight tinnitus (high pitched, yet soft ringing)
- No hearing loss

Please help!

Tommy,

Pretty much all of the symptoms that you've reported can be experienced as part of a headache disorder. With your dizziness and visual problems some here might speculate that you may be experiencing headache-free migraines and that could be true. But considering the multiple diagnoses of inner ear problems and the little head pain that you've experienced I do not see any reason to think that this would be linked to any sort of headache disorder.

Since there seems to be a consensus that the problem is centralized in the inner ear I'd say your best bet is to sit down and talk with your otolaryngologist and ask for some clarification and advice. Most likely your specialist will be able to address your concerns much more helpfully than any of us. That's not to say that I don't hope that someone here has some insight to share. If your ENT can't answer your questions to your satisfaction then maybe you should try getting an evaluation with a different doctor at a different practice.

I wish you the best of luck. Unfortunately this is outside the scope of my experience. But Sweden does make a good point: most medical problems (and especially neurological or vestibular ones) can be exacerbated by stress. Because the inner ear is such a fragile system, physical strain could certainly be adversely affecting your condition. Make sure to discuss your vigorous exercise routine with your doctor.

Cheers,

Ben

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DX: NDPH, Recovered(?) CRPS
RX: Lamictal, Namenda, Wellbutrin XL, Oxycodone, Oxycontin, Concerta (Methylphenidate), Clonazepam, Rozerem, Magnesium (1200 mg/d), Riboflavin (400 mg/d).

PRN: Ketamine nasal spray, Toradol IM, Celebrex, Haloperidol, Lodine, Zofran, Phenergan, Ambien CR
rarely: Migranal, Thorazine, DHE IM, Droperidol IM, Reglan, Provigil, triptans (Imitrex, Maxalt, Relpax, Zomig, Axert, Amerge)

I can be contacted personally via email at korbnep:healingwell@gmail.com.

Have you had your calcium and potassium levels checked? Are you experiencing any tingling in your hands or feet? Any medications or OTC use either before or during your episodes? Any sports supplementation - drinks or orals? There are so many things that can throw of the electrolytes and cause the extreme dizziness - including sinus pressure when you may not even feel plugged up.

~Amie