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    Slight ear pressure and off balance/dizzy feeling
    rrny80 posted:
    About a month ago, a day after receiving my first flu shot (im 31), I started not to feel well. I'm not blaming the flu shot, but thought it was worth a mention.
    It started around 5pm the day after, I had a small off balance spell, i say spell, because i am not walking around dizzy all the time. I thought nothing of it, until it happened again. The next day I didn't feel well in general, but had no fever, no congestion etc.
    I called my dr as i was going to be away for a week (no flying) and she prescibed 5 days of azithromycin. When i was taking it, the facial pressure got worse. Mostly at night where it would be so intense that it would make me feel like i was in a dream. the intermintent dizzy?off balance feeling continued as well. About 2 days after finishing the anitbiotic I felt better, only to have the symptoms return about a week later with ear fullness and pressure...with no pain.
    I went to my GP who told me I had post nasal drip and a small amount of clear fluid in my ears. Put me on a regimin of claritin D, nasal steroid spray and neti pot. this seemed to work, although some slight pressure around my cheeks and bridge of nose could be felt. The ears still popped a bit, but the off balance spells seemed to go away.
    twice i have mistakingly missed a dose of the claritin and each time the symptoms return with a force and I feel set back by about 2 days.
    I do have an appointment with an ENT this week, but was looking for any advice or thoughts anyone can give..just to ease my mind. As I am sure the anxiety I am creating over this is only strengthening the symptoms. the more I think about it the worse it seems.
    thanks in advance.
    rrny80 responded:
    I should mention that its been about a month since the first symptom.
    Rod Moser, PA, PhD responded:
    If your primary symptom is dizziness, I was surprised that your doctor used azithromycin. Did he/she think you had an ear or sinus BACTERIAL infection? You did not have any fever or signs of illness at that time, correct?

    Vertigo may be one of the most difficult medical conditions to diagnose and treat. There can be hundreds of causes, involving nearly every body system, but commonly in the inner ear, but can also arise from the brain itself. The mechanism of vertigo is very complex. Unfortunately, a cause is often not found in many cases, so people (and their medical providers) are often left frustrated.

    Benign paroxysmal positional vertigo (BPPV) is the most common cause of vertigo. The person usually describes bouts of recurring vertigo lasting several minutes or less. Episodes may be as brief as 15 seconds. Specific movements of the head often provoke the attack, usually following a brief delay of several seconds. Patients can often indicate the specific head motion or motions, which tend to trigger an attack.

    The second most common cause of vertigo is labyrinthitis. The disease is thought to be a sequel of a viral infection, like a simple cold or even the herpes virus. It is gradual in onset, reaches maximal intensity within one hour, and resolves within 24 hours. The episode is associated with nausea and vomiting. There is often a significant phase of balance and equilibrium problems that may persist from days to months. This would be higher on my list in your case than sinusitis or ear infections.

    Other medical conditions that are associated with dizziness and vertigo include: M?ni?re's disease, medication side effects, otitis media (middle ear infections), sinusitis, migraines, trauma, brainstem dysfunction, multiple sclerosis, diabetes, reactive hypoglycemia, anemia, hypovolemia (loss of blood), hypoxia (low oxygen), hyperventilation syndrome, epilepsy, heart rhythm problems and other heart disease, and brain tumors. There are even psychogenic causes.

    If your symptoms persist, seeing a specialist that has some expertise in vertigo and balance disorders is often the best way to go.
    rrny80 replied to Rod Moser, PA, PhD's response:
    the reason I was prescirbed the ani-biotic is because i did feel some pressure around my sinus area. I still do to some degree. Although I have no drainage from the nose, the PA is saw at my dr's office did notice post nasal drip and fluid in my ears.
    I never did have any spinning vertigo, so hard to even explain the exact feeling, more like un-balanced dis-orientation for a few seconds. no nausea or vomitting etc.
    I'm sure anxiety does not help the symptoms and if anything makes it worse...
    Jerry3535 replied to rrny80's response:
    I appear to have the same symptoms. Ear pressure and dizziness. After a while, on a bad day, of moving about with the dizziness I do experience a bit of nausea. Not wanting to vomit or anything, just sit down or lay down. I have no problem with this lying down, or sleeping. No other pains or apparent symptoms. I feel like I need to clear my ears as you would do on an airplane, but only brief, and minimal relief. It's been going on a few months now. Was not any every day occurrence until recently. I think I had similar, and possibly the same situation a couple year's back that went away after a dose of antibiotics..but possibly just a coincidence. I am 44, male.

    My Dr. handled me similarly to RRNY80. He too mentioned a little bit of clear fluid, but nothing else. I was prescribed an Antibiotic, a steroid shot in the but and he gave me sample of Respaire-30 for congestion (even though that did not appear to be a symptom.) After a week, no change...unless I too a Respaire. (It's the only thing to give me relief...2 pills does the trick) I was away in Canada (from US) during the antibiotic week, and when ran out of Respaire, went to a pharmacy to get something similar. The pharmacist recommended Drixoral (this too gave me relief..thank goodness. one pill a day, but made me a bit drowsy and did not work quite as well as the Respaire) When returning home and to my Dr., he put me on prescription Allegra, steriod pills, and more Respaire samples. After this regimen, still no change..except if I take the Respaire or any of my leftover Drixoral...which is unfortunately not available in the US)

    My Doc referred me to an ENT. He did a hearing test and everything was normal. He appeared stumped...especially for the fact the Respaire helped. (Respaire 30 = 30gm Pseudoedephrine, 150mg Guaifenesin. Apparently, its the Pseudephederine that is giving me relief..according to the ENT.) He was considering treating for Menieres disease and putting me on a low sodium diet. I mentioned my father died of a brain AVM (anterior veinous malformation?) and WE decided to have a MRI done next. I am not expecting this to be the complication but I have been considering a MRI since my father's death as some believe AVM's are hereditary.

    Anyway, that is all I know about my situation. I have looked on other sites and forums but while others have the ear pressure and dizziness, most complain of other symptoms like headaches, vertigo, severe nausea, etc. and that just doesn't fit me. I hope RRNY80 will report back any findings or information, as will I.

    Lastly, I have read about the conditions Dr. Moser mentioned above, but as I said, the symptoms just don't seem to mach up.
    Rod Moser, PA, PhD replied to rrny80's response:
    Anxiety is a part of the vertigo package. There are sooooo many different causes, that it is very important that you have a higher level (ENT) exam if you are not getting better.
    Rod Moser, PA, PhD replied to Jerry3535's response:
    Everyone is different, as you know. Two people can have the same identical symptoms, but yet have different causes...and different treatment regimes. Stick with the ENT (it is not uncommon for the cause to remain elusive) and use the medications that seem to help.

    Decongestants, like pseudoephedrine, has been used for middle ear effusion (fluid) but the jury is still out on the overall effectiveness. Antihistamines can help if there are underlying allergies. Many of the anti-vertigo medications, like meclizine, are antihistamine based. most definitely need that MRI (or an MRA). Let me know how things turn out.
    rrny80 replied to Rod Moser, PA, PhD's response:
    I saw my ENT today. The fluid in my years is now gone. However upon looking up in my nose with his instrument he told me I do have extra mucus producing up there, and my sinus and nasal cavity are inflamed. he is treating me again for the sinus infection, but this time with augmenten. Also prescribed a medicated nasal rinse that they have to mix at the pharmacy.
    I'll report back...
    I am pretty convinced the episodes of off balance or lightheadedness are being amplified by anxiety, which i am working to keep at a minimum...
    Rod Moser, PA, PhD replied to rrny80's response:
    You are now being more definitely treated for sinusitis. A large number of sinus infections are difficult to treat, requiring several weeks of antibiotics. Hang in there.

    Are you taking anything for your anxiety?
    rrny80 replied to Rod Moser, PA, PhD's response:
    I take xanax as needed. I am also just started bio feedback.
    Rod Moser, PA, PhD replied to rrny80's response:
    Excellent. Xanax is also used for vertigo and equilibrium issues.
    rrny80 replied to Rod Moser, PA, PhD's response:
    thank you so much for continuing to reply to me.
    I am wondering how long antibiotics take to truly kick in and fight off whatever might be going up in my sinus.
    In the last two days, the pressure on bridge of nose and above my eyes, and temples has gotten worse, leading to headaches and the lightheaded feeling.
    Still nothing coming out of my crazy colors etc.
    Been taking advil to get rid of headaches..but I hopng every day when i wake up I will feel a difference.
    The only difference so far is that I feel like I need to pop my less often.
    Rod Moser, PA, PhD replied to rrny80's response:
    There are few guarantees in medicine. It is not possible to determine when, or even if, they will work. Sinusitis can be very difficult to treat, often taking several weeks of antibiotics (not just one course). Unlike other infections, sinusitis is considered "bone" and the blood supply into bony areas -- the only transport for antibiotics -- is considered poor. Because of this, a longer course of a stronger antibiotic is often needed.

    I suggest that you see or contact your medical provider if your sinus infection has not seemed to improve after this first course of treatment.
    danieles84 replied to Rod Moser, PA, PhD's response:
    Hi!Everything started in July with a feeling off balance at work!I went to mygeneral Gp.She said that i have mucus in my nose and infection in my ears,but the dizzy feeling was there.I went to Ent specialist- they did scopy and said that i have allergy.I did a blood allergy test and it said that i realy have allergy.I went to allergy doctor-tryin almost evrything(nasals sprays,steroids pils and antihistamins)but the presure in my ears was kiling me.I started allergy shots from 2 months.was fine for a while but after some kinde of virus before 3 weeks i started to feel worse off balance again.I cant work.I am feeling fullness and pressure in my right my allergy doctor`s office i saw Ent specialist.They did audio tests (was fine),they did Ct scan on my sinus was fine too , except showing little mucus in my nose.they said that i am fine and i need give time to go away.
    but i cant stand it -dizzynes and off balance make me staying in my bed all day.I still feel the presure in my ear and thick mucus behind my nose and i can not take it out.I dont know what to do! i am thinking abot ETD but Ent doctor didnt said anything about that......
    riverviewgator responded:
    Hello RRNY80,
    I'm having symptoms very much like what you described you were having three years ago. I was wondering if you were ever given a definitive diagnosis or if your symptoms finally went away.

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