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DR. ROIZEN | How to handle positional dizziness; managing long COVID-19

January 14, 2022 at 10:00 p.m.

Q: Occasionally I get dizzy. If I roll over in bed it happens sometimes, or if I am playing tennis it can be terrible. But then it goes away. Is it caused by an ear infection, or am I just getting old and batty? -- Susan F., Palo Alto, California

A: Chances are the answer is "neither." What you are describing sounds like benign paroxysmal positional vertigo -- although when it strikes, it hardly feels benign. In addition to dizziness that can knock you off your feet, it can cause nausea and vomiting. Episodes may last a few minutes or for hours, depending on what's going on in your inner ear.

Where it begins: In your inner ear there are cilia -- thread-like structures that are attached to tiny nerves that help your brain know when you are moving, what your position is and how to orient yourself to the outside world. Tiny calcium crystals sit atop each cilium -- when you move, they move, and that starts the cascade of "messages" that let you know what's going on with your body in space and time.

Unfortunately, sometimes those crystals just keep moving even if you're not in motion, or they become dislodged from their perch, and the nerves signal your brain that you are in motion when you are not. That sends conflicting messages from your inner ear and your eyes (they perceive that you are still), and the result is dizziness.

How to manage it: There are some effective exercises -- called the Epley maneuver -- that can reverse the dizziness pretty quickly. "When done in a medical setting, the success rate for these exercises is up to 90%," says the Cleveland Clinic's neurologist Dr. Neil Cherian. You should have your doctor go through a simple test to figure out which ear is affected -- or if it is both. You can then learn a five-step Epley routine to quiet those cantankerous crystals. Make an appointment today.

Q: I had a mild case of COVID-19 about eight months ago. I stayed out of the hospital, thankfully, but now I find I'm short of breath when I exercise, and I get worn out very easily. I'm betting I have long COVID-19 -- but I don't really know what that means. What does it do to the body? -- Gerry T., Lancaster, Pennsylvania

A: "Long COVID" is a term used to describe a hodgepodge of symptoms ranging from cognition and memory problems to headaches, fatigue and breathing problems that persist in folks who get COVID-19 -- even mild cases. We are still learning about it, but in general, it's identified when symptoms persist 12 weeks after infection with COVID-19.

One study in the U.K. found that 5% of patients reported any of 12 common symptoms 12 to 16 weeks after infection and more than 11% said they'd experienced long COVID-19 (based on self-classification rather than reporting one of the 12 common symptoms) 12 weeks after infection. For patients who were hospitalized with COVID-19, the risk may be even greater.

Just recently, a 66-patient study was presented at EuroEcho 2021. The researchers found that among patients who were hospitalized for COVID-19, 35% had labored, difficult breathing during physical activity one year after being discharged. They also found that the problem was associated with abnormal heart function. (Get it checked!)

But whatever the cause of your long-haul symptoms, if you persist in having brain fog or cognition problems, headaches, fatigue, difficulty breathing, fever, nausea/vomiting, abdominal pain, diarrhea, sore throat, cough, loss of taste or smell in the months after your illness, contact your doc.

Ask about getting a COVID-19 vaccine or booster, taking antivirals, statins, steroids, CCR5 inhibitors (originally designed to treat HIV) or monoclonal antibodies. These are currently being investigated/used as possible treatments.

Then find out where a long COVID-19 clinic is in your area. You can go to for a map of centers across the country.

Health pioneer Michael Roizen, M.D., is chief wellness officer emeritus at the Cleveland Clinic and author of four No. 1 New York Times bestsellers. His next book is "The Great Age Reboot: Cracking the Longevity Code for a Younger Tomorrow." Do you have a topic Dr. Mike should cover in a future column? If so, please email [email protected]

(c)2022 Michael Roizen, M.D. and Mehmet Oz, M.D.

Distributed by King Features Syndicate, Inc.

Print Headline: How to handle positional dizziness; managing long COVID-19


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