Solve the Medical Riddle: She Constantly Feels as Though She’s Swaying and Rocking, Third Week

By Marie Savard MD

Editor’s note: Welcome to our ThirdAge feature that gives you a chance to play medical sleuth as we share the details of what happened when a patient presented with a problem that stumped the physician at first.

The first week of this riddle, the patient reported her symptoms and the doctor proceeded with the examination. This was step #1, S, of the classic S-O-A-P notes as follows:
S=Symptoms or Chief Complaint
O=Objective Findings
A=Assessment or Analysis
P=Treatment Plan or Recommendations

The second week, the doctor moved on to O and A=Assessment or Analysis to continue to look for clues to the medical riddle. This week, we’ll let you know what some people have suggested as possible diagnoses. Next week, the doctor will move on to P to reveal the actual diagnosis. Then we’ll begin a new riddle for the following month!

Some Guesses as to What the Diagnosis Will Be

“I was going to say that maybe she has ‘ear rock’ but then I read that she hadn’t had a head injury or a concussion so that’s probably not it. I got ear rock when my tire blew out on the highway and I hit the meridian. My air bag deployed but I still got a mild concussion. There are little crystals in your ear that break loose and cause dizziness and vertigo. Eventually, it goes away. I feel fine now.”
— Lucille G.

“My husband has benign paroxysmal positional vertigo or BPPV. If he’s lying down and then he gets up really fast, he feels as though he’s spinning. But this patient says her problem is chronic so it’s probably not BPPV. I can’t wait to find out what the actual diagnosis is!”
— Marnie S.

“Could she have Lyme disease? She never says whether she lives or vacations near an area that has deer ticks. I know the doctor ruled out a lot of the symptoms of Lyme disease but extreme fatigue is one symptom that the patient does have.”
— Betty R.

“This is kind of a crazy guess since she’s had her problem for two whole years, but maybe she just has sea legs and never got her land legs back after that cruise she went on for her anniversary. My father was in the Navy and he used to complain about sea legs for a long time after he was off the ship. We never gave much thought to it but now I’m wondering if he was really more bothered than he let on!”
— Susan T.

“I have Meniere’s disease so I know that’s not what this patient has because I definitely have symptoms her doctor ruled out including on-again-off-again hearing loss and ringing in my ears. I do get a spinning sensation but not rocking or swaying. This case really is a riddle!”

“I hope I’m wrong, but she might have an acoustic neuroma. That’s a benign tumor on the nerve that leads from the brain to the ear. It can cause balance issues along with a lot of other symptoms. My sister had this and even though she had surgery, she still has lot of problems including hearing loss.”
— Maureen W.

What do you think the diagnosis will be?

To be continued . . .

Come back to ThirdAge.com next Thursday when the doctor will reveal the actual diagnosis and treatment plan.
Marie Savard, M.D., a former Medical Contributor for ABC News and a frequent keynote speaker around the world, is one of the most trusted voices on women’s health, wellness, and patient empowerment. She is the author of four books, including one that made the Wall Street Journal list of the best health books of 2009: “Ask Dr. Marie: What Women Need to Know about Hormones, Libido, and the Medical Problems No One Talks About.” Dr. Marie earned a B.S. in Nursing and an M.D. degree at the University of Pennsylvania. She has served as Director of the Center for Women’s Health at the Medical College of Pennsylvania, technical advisor to the United Nations’ Fourth World Conference on Women in Beijing, advisor to the American Board of Internal Medicine Subcommittee on Clinical Competency in Women’s Health, health columnist for Woman’s Day magazine, and senior medical consultant to Lifetime Television’s Strong Medicine. Pleas visit DrSavard.com