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Ask Dr. Gott 3/7
Epley maneuver eases vertigo
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    DEAR DR. GOTT: I am a 79-year-old male. I have had three separate heart-bypass surgeries. Needless to say, I do have heart problems. I am currently under the care of two doctors for this — a cardiologist and a defibrillator specialist.
    My current problem is vertigo/dizziness. This started in April 2007, and I can't seem to find any relief. My doctors have ruled out my heart as the cause. I have seen my family physician, a neurologist, an ear-nose-and-throat specialist and two emergency-room physicians. No one can tell me what to do to get relief, only that I have vertigo.
    How do I get someone to help me rather than just tell me what I have?
    DEAR READER: Vertigo is the inability to keep normal balance while standing or sitting, caused by an irritation in the inner ear. It can be accompanied by nausea and weakness. Symptoms often lessen or disappear shortly after lying down or remaining motionless for several minutes.
    Doctors often recommend and have success with the Brandt-Daroff exercises and the Epley maneuver. The Brandt-Daroff exercises are done at home while sitting on a bed or couch. Lean quickly to one side for 30 seconds, and then sit up. Duplicate the exercise on the other. Repeat about 20 times. It is best to have someone with you if you are worried about the possibility of falling. If you have access to the Internet, the Web site www.dizziness-and-balance.com/disorders/bppv/brandt/first.html offers step-by-step instructions for these exercises.
    The Epley maneuver is performed by a physician and is used primarily to treat benign paroxysmal positional vertigo. While sitting down, he or she will turn your head 45 degrees toward the affected side, lean you back and finally sit you up. This is repeated on the opposite side. The last move will be to lean you forward about 30 degrees. The Web site www.dizziness-and-balance.com/disorders/bppv/epley/first.html will give you an idea of what to expect, but rememeber: Your doctor should perform this procedure.
    Another option is an over-the-counter dietary supplement called Lipo-Flavonoid. It is a combination of vitamins, minerals and bioflavonoids that was developed to treat the symptoms of Meniere's disease (vertigo, tinnitus and hearing loss). Judging from my readers, when it works, it is amazing; however, not everyone experiences relief.
    Get a second opinion from an ear-nose-and-throat specialist. He or she should be able to offer more treatment options and in-depth information.
    To give you related information, I am sending you a copy of my Health Report "Ear Infections and Disorders."

    DEAR DR. GOTT: I read your column every day and have not seen you address a concern I have. I was told that "curved fingernails indicate that a heart attack is imminent." I want to know if this is based on any medical facts, since I have them on both hands. I had a normal stress test in 2005.
    DEAR READER: You don't need to worry. The fingernails can become ridged or curved as we get older or if a vitamin deficiency is present. This is normal. To my knowledge, there is no relation between the fingernails and the heart.
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