bobble head doll

June 11, 2016

On May 1, 2016, I was taken to the ED at with severe dizziness, vomiting, sudden hearing loss in my right ear, no motor control of my right arm and my head bobbing to the right. I informed them that I had been having recurring dizzy spells and had been attributing them to a recent tooth extraction surgery. I had a bad headache in the low back of my head. I have been an otherwise very healthy 47 year old female that has never had a GP as I have never needed one. I was released with a diagnosis of vertigo. The following day I went to an ENT to address my ear. He recommended that I see a neurologist, but that “you won’t get in with one for months”. He said to go to a GP and “get other things off the table”. I was able to get in with a GP () on May 9th, who did a general evaluation and ordered a CT scan which came back clear. He told me to wait two weeks and see what happens.
I felt the need to address my hearing, so I went to an audiologist () who confirmed the hearing loss and sent me back to the ENT. The ENT prescribed Acyclovir and put an injection of steroid in my ear. The following morning, moments after showering, I felt suddenly weak and fainted. In addition to the steady tinnitus that had started with the original hearing loss, I now had a loud heartbeat in my right ear. My husband contacted the ENT (Doxey) who said he did not believe either drug was the cause of the fainting episode. Over that week and a half, my original spinning vertigo was abating, but I was having episodes of dizziness, weakness and nausea. I returned to work on light duty on May 16th. On May 19th, I went to a different GP (Dr. ) as I felt a GP follow up was in order and I was still getting spells of deep weakness, yet was not happy with the first GP’s advice to wait two weeks with my hearing on the line. Callahan ordered an MRI (June 1, 2016) of the brain. It came back clear. Regardless I was (and remain) often light headed/dizzy, nauseous, weak and often have the feeling of a blood pressure collar on my neck. I often note significant glass crunching sounds when I move my neck. I started getting frequent tingling and numbness in my hands and feet, and a bobble head doll effect like my initial symptoms on May 1. Blurry vision comes and goes. I noted that neck movement seems to be exacerbating my dizziness. I returned to the Callahan Clinic on Friday June 3rd and saw Dr. . He said he would refer me to a neurologist. He said most neurological diseases progress slowly, so the time frame regarding getting an appointment was not an issue. Throughout the day, I had more numbness, weakness, dizziness, a sense like my knees might buckle, bobble head, all progressing faster than disease might indicate. On Saturday the 4th, I went to the ED at Dixie RMC. The Dr. on duty consulted with a neurologist on duty who thought I should be admitted for more complete testing. He ordered an MRI of brain, neck, and neck arteries with contrast, all in a neutral position, with 800mg ibuprofen. He also ordered several lab tests, which all came back negative. I spent the next 24 hours horizontal in a hospital bed. I noted that symptoms don’t occur when I’m horizontal. MRIs came back generally clear. Neurologist was at a loss to explain symptoms, as he felt the initial 5/1/16 event was a lack of blood to the brain, but my bloodwork, quality heart condition and quality overall health contradict such a finding. Prior to discharge, a physical therapist stopped in to advise. She moved my head this way and that, but when she asked me to move it up and down, I thought I might faint, not spinning, just a lights out feeling. She said to get vestibular rehab therapy. I was discharged with “dehydration” as the diagnosis and told I was free to move my neck. Monday June 6th, I was preparing for work and went to reach for a small greek yogurt cup. I debated it as the last time I had one was on May 1st when I publicly vomited one. Recalling that morning, I remembered I did not have a spoon, and so was repeatedly attempting to eat the yogurt with my head tilted back, waiting for the slow moving greek yogurt to slide out of the cup. I tied that to the PT telling me to move my head up and down and realized how similar the feeling was. I then realized that the morning that I fainted, I had just had my ear injected and he had told me to keep it dry, and I had my neck tilted in the shower to avoid water getting in my ear. Upon realizing this, I called the neurologist’s office, who said they had not received the referral and I could not make an appointment without one. I called the GP and asked them to send it again and the neurologist still did not have it Tuesday. I tried again on Wednesday and still no. I went back to the ED with the added information that all of my significant events were preceded by neck movement and my concern that this has been a recent phenomenon and may not be stable. That the neck movement might be triggering these events and could they look at that. I also informed him of a recent difficulty swallowing. I asked if the imaging could rule out my neck movement as the cause of all of these events. He said no, the imaging doesn’t show what happens when I tilt my neck but that he had looked at the prior imaging, and there “is nothing more we can do for you here.” He said I needed to see with a neurologist. He was very clearly frustrated that I had returned to the ED. I told him I had been trying to, but that there were none available. He diagnosed me with vertigo and told me if I’m concerned, “just don’t move your neck”. That afternoon the neurologist received the Callahan referral and won’t be able to see me until July 5th.
On Friday June 10th, I had a severe dizzy spell with numbness in my left arm, left leg and left lip. I have been very conscious to not tilt my back, but had been bending it forward. Now I don’t bend it forward either.

My symptoms are minimized when my neck is neutral, but the ROM to minimize symptoms is very small, seems to be shrinking and consequences of movement seemingly potentially very high. I get lightheaded with very little activity, including walking or standing for very long. I was very fit two months ago. My concern is that the onset of this is of recent origin, and may not be stable. Perhaps looseness from the original bobble doll on May 1, perhaps a yoga injury, perhaps a bad angle in the dentist’s chair, or something else altogether. I fear another incident like May 1st before this gets examined.

Update June 12, 2016: Swallowing/talking seems even more awkward. Any forward bend of my neck puts pressure at the top of my throat, around my where my nose would reach the back of my head.

June 18, 2016 current symptoms: lightheaded, tinnitus, weakness, occasional blurry vision, restricted neck movement to prevent the blood pressure collar effect on my neck and the other associated symptoms (tingling hands, hands not moving correctly, headaches, headrushes) nausea, vertigo, swallowing is awkward, travelled as a passenger in the car and my head feels like it my tip off when we go over even small bumps, crunching at base of skull/top of neck, pressure at top of throat from back of neck

Thank you for your time.