Troubling Trifecta

Schools and daycares can be great opportunities for children to learn, grow and make friends. They’re also a playground for germs and illnesses that multiply and spread.

“Kids are exposed to hundreds of viruses and bacteria at school and daycare every day,” said Justin Fuller, MD with Riley Physicians. “There is no real way to completely prevent these kinds of problems other than emphasizing good hand hygiene.”

Three areas where children tend to have problems are in their ears, nose and throat. Older kids can usually tell their parent or guardian when they feel sick, but it can be harder to tell something is wrong when the child is too young to communicate or when they’re non-verbal.

“I tell people, they’re pretty good at knowing how their kid normally acts,” said Paul Johnson, MD with IU Health Southern Indiana Physicians Ear, Nose and Throat (ENT). “Some kids just act like they don’t feel good, and that’s the first symptom.”


Chronic ear problems are the vast majority of children’s issues seen by the ENT team. Some signs to look for include: children pulling at their ears, severe fussiness, fevers and kids who’ve been walking well who suddenly start falling more frequently.

“Children are more likely to develop ear infections in comparison to adults, based on their anatomy,” said Fuller.

“The Eustachian tubes, which equalize pressure between the middle ear and mouth/nose cavity, are more likely to become obstructed and lead to ear infections in kids than in adults.”

Ear infections or middle ear fluid that does not resolve over several months will occasionally require ear tube placement by an ENT specialist.

“Tubes help ventilate the middle ear and prevent fluid accumulation, which can prevent the necessity of antibiotics and missed days of school or work,” said Fuller. “This can also help hearing and speech development for kids who have chronic fluid in the middle ear from recurrent ear infections.”


Nose issues in kids have very simple symptoms.

“They walk around with their mouth open, they snore and have runny, drippy noses,” said Johnson. “It sounds simplistic but that’s the case. There’s not any subtlety usually when the nose is the issue.”

He said the most common nose issue in children he sees as an ENT is big adenoids that plug up the nose. Adenoids are the same type of tissue as tonsils, but they’re located behind the nasal cavity. When they are very large, they can obstruct the flow of air going through the nose and can cause breathing problems.

Allergies are another common nose problem for kids. They typically perk up in the spring and fall when pollen from different plants is in the air. One tip to reduce allergy symptoms is to monitor pollen counts and stay indoors during the times of day when the pollen levels are at the highest.


Swollen tonsils are a common indicator for illness. They’re part of the immune system, and when it revs itself up to make more white blood cells to fight the illness, it causes the tissue in the tonsils to swell.

One throat-related illness many parents deal with is strep throat. Strep throat can be accompanied by symptoms including fever, sore throat, headache and stomach ache.

“Sometimes younger children will have fever and complain of a stomach ache or headache without mentioning a sore throat, or they may just refuse to eat or drink,” said Fuller. “Strep is easy to treat, and susceptible to just about any antibiotic but can lead to missed school and work days for parents.”

Another issue may be that the child’s tonsils are large all of the time and not just when they’re sick. That can cause breathing troubles including sleep apnea.

“The most common reason I take tonsils and adenoids out in kids is for sleep apnea, not chronic tonsillitis,” said Johnson. “If you have a little kid who snores all night long, is a restless sleeper, is hyper during the day, has trouble concentrating and may wet the bed, he or she may need to see the doctor.” All of these are signs and symptoms associated with obstructive sleep apnea from big tonsils and adenoids.”

While a pediatrician can typically handle treatment for these areas, children may be referred to an ENT for reoccurring issues.

“In the case of tonsils and adenoids: I’m just a glorified plumber and they’re plugging up the works,” said Johnson. “But just because you show up in our office doesn’t mean we’re going to be signing your kid up for a tonsillectomy or ear tubes.”

Non-surgical treatments and management are used by both pediatricians and ENTs for ear, nose and throat issues. Johnson explained that it doesn’t always seem like that’s what’s happening because by the time a child gets referred to him they may need surgery.

“It’s no fun to have your tonsils and adenoids out,” said Johnson. “Some people don’t want to do it because they’re scared, but it fixes the problem and may ultimately be the way to go.”

Featured Riley Physicians provider seeing patients for pediatrics:

Justin Fuller, MD


Featured IU Health Southern Indiana Physicians provider seeing patients for ear, nose and throat issues:
Paul Johnson, MD

He Taught His Patient To Smell The Roses

Nurse Stanton Hinson, who works on the Medical Progressive Care Unit at University Hospital was recently commended for his quick call to action to aid a patient.

It was a manic Monday when Nurse Stanton Hinson took a report on a very restless patient.

“The patient had been suffering from what appeared to be severe delirium for at least 24 hours, causing the patient to become extremely restless. The nurse and supporting staff members were in and out of the room numerous times an hour in an attempt to keep the patient safe and to reassure the family at the bedside,” said Nurse Susan Elpers, MPCU Clinical Care Manager at University Hospital.  A CT scan had been ordered the day before but the test was unable to be performed due to the patient’s condition.

On this particular Monday around 6:30 in the evening, the patient began to lose consciousness, signs of delirium subsided. That’s when Hinson, 29, a travel nurse with IU Health for the past year, took action. He insisted a CT scan be given to the patient.

“As the official read of the scan was occurring, and the patient was being transported back up to the unit, Hinson made crucial calls to the covering service and to the Rapid Response RN, Frank Anderson, alerting them that quick action was needed,” said Elpers.  “Hinson anticipated that this patient needed to be emergently transported to Methodist.  The Rapid Response Team immediately initiated the Level 1 stroke protocol, and in conjunction with the covering service, neurosurgery service and LifeLine, the patient was packed up and emergently taken to Methodist Hospital.  Within the hour, the patient was in the OR, having lifesaving surgery,” said Elpers.

Three days later, the patient was recovering. Elpers credits the quick response by Hinson and Anderson for saving the patient’s life.

Hinson says his experience in critical care has helped him make tough decisions. His career includes working in both surgical and cardiovascular ICU.

“We get a wide range of diagnosis in medical progressive care,” said Hinson. “The patients are all very sick so it’s nice to have the critical care background.” Always interested in caring for others, Hinson said he knew at age 14 he wanted to be a nurse and by the age of 16, he obtained his certification as a CNA and worked his way through Bethel College to become a nurse.

One of his strengths is calming his patients during anxious moments. He recently had a patient who had been very ill and was not getting better.

“She was afraid she was dying and she kept asking me if she’d ever laugh again,” said Hinson. “She wouldn’t sleep because she was afraid she wouldn’t wake up and she continually had panic attacks and couldn’t breathe. To help her relax and breathe, I asked what her favorite flower was. When she told me it was a yellow rose I told her to pretend she was smelling the rose and then blowing out a candle. I wrote it on the white board in her room and her husband told me later that she kept repeating it over and over, ‘smell the rose; blow out the candle.’”

More about Hinson:

  • He has an Australian Shepherd named “Elvis.”
  • He has taken medical mission trips to Kenya and the Dominican Republic.
  • His co-workers presented him with an award during Nurses Week “Most Likely to Travel.” He is frequently jet setting to such places as Mexico, Iceland, France, and Honduras.

— By T.J. Banes, Associate Senior Journalist at IU Health.
   Reach Banes via email

Too Much Fun in the Sun? When to Use Urgent Care This Summer

Summer sometimes brings unexpected injuries or illnesses. Indiana University Health Urgent Care is here to keep you safe and healthy all summer long.

As part of Indiana’s largest healthcare network, all of our urgent care locations are equipped to treat a wide array of summer conditions and health needs, no appointment needed. From allergic reactions and earaches to stitches and x-rays, IU Health Urgent Care has your care needs covered.

Staying Safe this Summer

Sports Physicals

Keep your young athlete active and prepared for the upcoming season or summer camp with a physical at one of our walk-in clinics. IU Health Urgent Care has the ability to conduct full physicals for children and adults at each of our locations.

Physicals are important to a person’s overall health and can prevent future injuries. Here are some things our physicals include:

  • Vital signs screening (particularly for heart health)
  • Mobility checkup (for bones and joints)

Sports Injuries

Playing hard is part of the game. Unfortunately, so are injuries. Our urgent care locations are equipped to diagnose and treat common sports injuries so you can get on your feet and back in the game as fast as possible.

Not sure if your injury is something we can handle? Here’s a look at more of the injuries we treat:

  • Minor joint pain, especially caused by repetitive or intense activity
  • Simple and minor fractures
  • Sprained ligaments, such as ankles
  • Strained muscles and tendons, such as biceps

Summer Safety

Summer is time for fun in the sun, but sometimes accidents happen. Our urgent care locations are equipped to treat minor injuries, especially those that can occur during the active summer months. That way, you can get the medical care you need quickly without a visit to the emergency room.

We treat minor injuries, such as:

  • Scrapes
  • Burns
  • Ear infections
  • Cuts that require sutures
  • Concussions
  • Allergic reactions

Vaccines and Immunizations

Don’t let an unexpected illness disrupt your travel plans this summer. Be prepared for your summer adventures with recommended vaccines and immunizations, especially if travelling abroad. Learn more about Travel Medicine here.

Each of our locations provides vaccinations and immunizations to keep you safe, healthy and adventurous. We provide vaccines and immunizations for most common illnesses, such as:

  • Tetanus, Diphtheria, Pertussis (Tdap) vaccines
  • Influenza vaccines

Find Urgent Care Locations Near You

Ready to get back to your life — or get your child back in the game — this summer? Get the care you need at any of our 10 convenient locations in Central Indiana and across the state. Shorter wait times mean you can be in and out in less than 40 minutes. Walk-in or schedule an appointment.

Find the Nearest Urgent Care Location

Want to know more about IU Health Urgent Care or need to pay your urgent care bill? Learn more here. 

Why An X-Ray Tech Wears A Red Bow

Rhonda Jones, a radiological technologist has been with IU Health University Hospital for 16 years. She loves her job and has a reason for wearing a red ribbon on Fridays.

She was 10 when Rhonda Jones was diagnosed with scoliosis. Over time she became a regular patient at Riley Hospital for Children getting X-rays every three to six months to monitor the curvature of her spine. It was one of those visits for scans when a technician allowed Jones to help process the films.

“I told my mom then that I wanted to be an X-ray tech,” said Jones, 38. Her condition eventually led to multiple corrective surgeries. “I grew two inches in one day,” she said after rods were placed in her back.

She completed her degree at Ball State and worked in the film loan area of radiology while going through school. She started working at IU Health University Hospital 16 years ago where she specializes in fluoroscopy, a type of medical imaging that shows a continuous X-ray image on a monitor, much like an X-ray movie.

“I work in GI fluoroscopy which is often called the ‘barium kitchen. It involves all GI procedures such as post op swallows, barium swallows, all the way down to enemas. We do a lot of exams that people don’t want to do,” said Jones. “The most difficult part of the job is that a lot of the exams aren’t comfortable physically or emotionally. It can be embarrassing for the patient and it’s hard knowing the patient won’t be completely comfortable. I try to remind them and myself that we’re doing a lot of good,” said Jones.

“I start off by telling the patient the truth – a lot of the contrast doesn’t taste good and our table is cold hard and flat – I say ‘welcome to the barium kitchen. Our cooking isn’t good but the end result is going to help.’”

More about Jones:

  • What she likes best about her job: “Seeing the patients after they are healthy. A lot of them come back for post-op tests and I love seeing them feeling better.”
  • Hobbies: “I love hanging out with my nieces and nephews and going with them to wrestling meets.” She is also a fan of drag racing and attends the US Nationals every year.
  • Something that would surprise people to learn: In high school she taught roller-skating to kids five and under.
  • What people may not know about her: Her dad was Vietnam Vet. He died four years ago of complications from a brain tumor. He taught her to respect US Veterans. She is a member of the American Legion Auxiliary and every Friday she wears a red ribbon in her hair in remembrance of deployed soldiers.

-T.J. Banes

The Most Shocking News Imaginable

Angela Fraley thought she had mono but when she went for further testing she heard news that would lead her to IU Health University Hospital.

It’s been 13 years since Angela Fraley’s transplant surgery. She still can’t believe the time that has passed. More than anything, she can’t believe she’s reached a point where she can say she’s in good health.

She was 28 when she began feeling sick. After a visit to her local hospital she was sent home and told to rest. The diagnosis at the time was mono. But the symptoms persisted so she visited her local physician and was told the issues were related to her liver.  A biopsy followed and three days later she learned she had primary sclerosing cholangitis (PSC), a chronic, or long-term disease that slowly damages the bile ducts.

“It was the most shocking news that I could have ever imagined,” said Fraley, 51. “I went through so many ups and downs. I was taking as many as 28 pills a day and I was so weak that I couldn’t feed myself or even get up to walk more than 10 steps without a walker.”

She went through 10 years of tests and hospital stays.

“I even had a emergency doctor once tell me I was his hero because I wouldn’t give up even when my body wanted to,” said Fraley, who has been married to James Fraley, a retired pastor for 20 years. They were married in the early stages of her illness. She is the mother of Anthony Beasley, 30 and Jaron Fraley, 19, and has two grandsons.

“Jaron is my miracle son. Doctors said it would be hard to be pregnant with my health except my old liver did well during pregnancy,” said Fraley. “At first the placenta was not attaching as fast as it should and then he was born five weeks early and the cord had wrapped around his throat causing to lose oxygen,” she said. They spent a lot of time in the hospital the first year of Jaron’s life but he is healthy now.

Still Fraley’s heath did not improve.

Six years after Jaron’s birth, in April Fraley was put on the waiting list for a liver transplant. The following month on May 31, 2005 she received a new liver.

“They said when they hooked my new liver up that it started dancing on the table. I think it was really me smiling,” said Fraley. “Life is still a challenge at times but that day I went from death’s doors to a whole new life. I can’t say enough about my surgeon Dr. Jonathan Fridell. I had the best team of doctors, nurses, techs and of course family helping me get back to my life.”

These days, Fraley says she sees life a little differently. She enjoys movie nights with her four sisters, spending time with her grandsons who call her “Yaya,” attending church, relaxing by the ocean, and watching the Colts and Pacers games.

“I still have a few things on my bucket list and now they actually seem reachable,” said Fraley. “I’d like to visit Niagara Falls, go to a Colts game, ride on the transplant float in the Rose Bowl Parade and meet my donor’s family.”

— By T.J. Banes, Associate Senior Journalist at IU Health.
   Reach Banes via email

Nurses Pay Tribute To Their Own

When a nurse dies, fellow comrades are there dressed in white – paying tribute to one of their own.

It was close to their hearts.

The woman laid to rest was one of their peers. She walked the hospital halls, caring for patients, and consoling families until the day she died. It was an unexpected loss and they felt the need to honor her in life and in death.

So nurses Selina McNulty, Tracy Smith and Sally Lowrey, took their posts right beside the casket of fellow nurse Dana Record. It was March 9 three days after Record died of injuries sustained in an automobile accident.

Like Record, McNulty and Smith are in their 40s. Like Record, they are nurses at IU Health Arnett.

“Dana was a highly respected nurse and was loved by her patients,” said McNulty, who like Record, is also a mother. As family and friends paid tribute to Record at East Side Baptist Church, Crawfordsville, the fellow nurses solemnly stood by, dressed from head to toe in the standardized white uniform introduced by Florence Nightingale during the Crimean War. Record’s funeral was the first appearance of the West Central Region Nursing Honor Guard.

The nurses had started laying groundwork for the Honor Guard months before Record’s funeral. Throughout the country, nurses from various hospitals and healthcare communities volunteer at Honor Guards. They attend services paying tribute to nurses (including retired nurses) by “keeping watch” near the casket – similar to a military tribute.  Their involvement in services may also include reciting the “Nightingale Pledge,” and the “Nurse’s Prayer.” At Record’s funeral her peers set a table with a white cap, white bible and a lighted Nightingale lamp. At the close of the service, the lamp was blown out, symbolizing the end of Record’s service to a profession she loved. The candle was presented to the family along with bookmarks that included the “Nightingale Pledge” and the “Nurse’s Prayer.”

When news reached the nursing community of Record’s accident, the local Honor Guard was still in the process of securing uniforms. In less than 48 hours they were dressed in their whites and ready to pay their respects.

“When something like this happens, it affects everyone in the hospital. Even people who didn’t know Dana well, knew that she was kind-hearted and always had a smile and caring heart. We knew it was something we had to do,” said Smith. “We had a huge response from family and friends of Dana. One gentleman cried and cried and said it was so beautiful and that it reminded him of the military.”  Family members returned to Records’ workplace in May, when the hospital announced “The Dana Record Preceptor of the Year Award” during National Nurses Week. The award recognizes Record’s dedication to coaching fellow nurses.

Since Records funeral, the West Central Regional Honor Guard has attended one other service for an 86-year-old retired nurse.

The three nurses have received marketing and financial support from IU Health for their efforts and are working to expand the guard and get the word out to local funeral homes about their service.

“After Dana’s funeral we said ‘nurses dedicate their time giving and nurturing,” said McNulty. “This is our turn to take care of this nurse one last time right at the end.”

— By T.J. Banes, Associate Senior Journalist at IU Health.
   Reach Banes via email at
 T.J. Banes or on Twitter @tjbanes.

Care for baby, close to home

Distance from a Neonatal Intensive Care Unit (NICU) facility and factors, including jobs and other children, can affect how often families may see their newborns. But having a Level III NICU at IU Health Bloomington Hospital is keeping more south central Indiana newborns closer to home and family while providing the quality care they need.

“It means that families can stay together,” said Anna Weigand, RN, BA, IBCLC. “Imagine it: you have two kids here in Bloomington, your husband is driving back and forth up state Road 37 all the time … you have to take all of this time off of work because your baby’s in Indy and you want to be there, and then you lose your job because you have to take all this time. It’s really hard on families.”

Having a Level III NICU close by can really help these parents and children as they’re counting down the days to being able to bring the baby home. “Babies who were born at 26-week gestation can stay for two to four months, or 100 days,” said Abhay Singhal, MD, MS. “That’s a lot of commuting. Here, families can visit a few times a day since they’re close.”

IU Health Bloomington Hospital functions as a Level III NICU, having earned the designation just over a year ago. One of the requirements of meeting this level of care is having neonatologists or nurse practitioners in the unit 24 hours a day, seven days a week.

“In the past, pediatricians would be called in to deliver,” said Dr. Singhal. “Now we’re in-house and can provide quality care right away.”

That’s improved immediate care for all deliveries, but Level III also means the hospital can take smaller and sicker babies, including those below 34-weeks gestation and infants who need ventilators.

“Some of the 26-week babies are a pound-and-a-half, maybe close to two pounds,” said Dr. Singhal. “Very few of our newborns now are transferred to other facilities.”

“The whole idea is to keep people closer to their own communities so they can heal better,” said Weigand. “It allows parents to learn how to care for their baby, so they are better prepared for when the baby goes home.”

“With advanced Neonatology and Maternal Fetal Medicine in Bloomington, our south central Indiana families can stay close to home while still receiving world-class care. This allows obstetricians in our community to foster a holistic pregnancy and newborn experience for our highest-risk patients,” said Tashera Perry, MD.

Labor with laughing gas

A new option at IU Health Bloomington Hospital nitrous oxide, also known as “laughing gas,” is a form of pain relief generally associated with dentist appointments, but it’s becoming more popular for women who are having babies, said IU Health Bloomington Hospital Manager of Clinical Operations Anna Weigand, RN, BA, IBCLC.

The mother-to-be will utilize the gas as needed to offset pain.

Offered here:
Obstetricians brought this medically-safe option up for discussion with IU Health Bloomington Hospital because they wanted to offer their patients more options for deliveries. The hospital started offering nitrous oxide for pain management during labor in the late spring of 2017.

How it works:
Women who choose this option will be given a special breathing mask which releases a low-dose of nitrous oxide. It takes less than a minute for the gas to start working and a few minutes to leave the body.

What it does:
The nitrous oxide lessens the pain, but the low dosage means the mothers remain alert and in control. Some mothers may choose to use laughing gas to prolong the time before an epidural is needed. Others may only use the nitrous oxide for labor pain management.

Learn more:
Talk to your IU Health Southern Indiana Physicians obstetrician about including nitrous oxide in your birthing plan.

Featured IU Health Southern Indiana Physicians provider seeing patients for pregnancy-related issues:
Tashera Perry, MD

The Winning G.O.A.L.

Surrounded by shelves full of colorful books and desks in neat rows, Ivan and Diego – rambunctious, curly-headed twins—plop down on balance balls and light up as they talk about their fifth-grade G.O.A.L. classroom in Bloomington.

“The first thing I do in the morning is look to see if a machine is open,” says Ivan, one of the twins. “They definitely help me learn, and it gets the blood pumping to my brain.”

His brother, Diego, agrees, saying the equipment helps him focus. “I think some people like to fiddle with things when they’re at their desk … when you go to the equipment, all you bring with you is the stuff you need for the assignment,” Diego explains.

Ivan adds, “You don’t really need to fiddle with other things because you’re moving your legs.”

This is a big change from more traditional classrooms, and it’s especially helpful for those seemingly endless school days.

“When our school day changed from the shortest school day in Indiana to the longest, the kids became very antsy, fidgety, restless and just plain-old tired. I thought that if we’re going to be having this extended day then we need to get the kids up and moving, get that blood flowing and get more oxygen to the brain,” says Wendy Tamborrino, a Binford Elementary fifth-grade teacher. “Here we are three years later, and now I have the equipment in the room, and it has been just the most amazing transformation.”

“I’m really excited about these G.O.A.L. classrooms because they’re another opportunity to help our kids be healthier … Physical activity can be great for both the body and the mind. It can reduce the risk of childhood obesity, reducing the risk of health problems for children now and in the future. It can also help with anxiety and depression,” said James Laughlin, MD.

Tamborrino uses her class’s G.O.A.L. equipment as an enhancement to her teaching. The students notice the difference.

“When I’m at my desk, it’s hard to keep focused on the teachers,” says Ivan. “My mind drifts … but if I go on the equipment, my mind is just focused and not just drifting around.”

While Ivan and Diego may prefer the bike and strider desks, other students may do better with the standing desk or balance balls during lessons. As Tamborrino says, “Finding the right motion that works best for each student can maximize and increase their stamina for learning.”

The teacher continues, “ … it almost calms and focuses them, I think because it’s unique and it’s a special privilege. They hold themselves up a little straighter, and when their body is in the proper position, they’re ready to learn. This equipment does this for them.”

Active learning becomes a reality in G.O.A.L. classrooms

Many students in Indiana spend their school days sitting for hours at a time with little physical activity. Being this still for almost eight hours a day isn’t healthy. Childhood obesity rates are up while children are missing out on almost a week’s worth of activity by spending most of their time from Monday to Friday at school or doing homework.

Recess, P.E. and after-school activities may help some students, but they’re not enough to break this trend of unhealthiness, so some area teachers have been trying a new approach. With new, high-quality equipment, these teachers are incorporating active learning into their classrooms, now known as G.O.A.L. classrooms.

What is a G.O.A.L. classroom?

G.O.A.L. classrooms promote active learning by adding physical activity to the educational environment. The goal is to promote lifelong healthy habits for the students and make the healthy choice the easy choice.

How does it work?

G.O.A.L. classrooms incorporate the use of stability balls, standing desks, pedal desks, strider desks and resistance bands in order to keep the children’s bodies moving along with their minds.

Which classrooms have the equipment?

Fifteen fifth-grade classrooms in schools throughout the Monroe County Community and Richland-Bean Blossom School Corporations were selected as G.O.A.L. classrooms.

Who will benefit?

Close to 400 students will reap the benefits of participating in a G.O.A.L. Classroom. There are about 25 kids per classroom, and some classrooms will rotate, impacting multiple groups of students.

Who’s supporting this?

The active learning classroom equipment was purchased with proceeds from the 100 Men Who Cook event, the Bloomington Hospital Foundation and Old National Bank.

Call the G.O.A.L. program director at 812.353.5040 for more information about the program.

Featured Riley Physicians provider seeing children in the South Central Region:
James Laughlin, MD
812.353.DOCS (3627)

Dancing to Defeat Dementia

Dancing, it turns out, can be more than a fun date-night activity. It can help you both physically and mentally. It can even help lower your chances of developing dementia.

“For non-inherited dementia, the concept is to improve the flow of blood, antioxidants and nutrients to damaged brain cells,” says Mehyar Mehrizi, MD, who specializes in neuro-related diseases with IU Health Southern Indiana Physicians. “It will lead to these cells being able to live longer and prevent the onset of disease.”

The management of all cardiovascular risk factors is important for reducing the risk of dementia. This includes not smoking, keeping blood pressure under control, having healthy cholesterol numbers, managing diabetes if you have it and reducing your risk of developing diabetes.

“Regular cognitive exercises which include social activity are preferred,” said Mehrizi.

Make your fight against dementia full of fun – regular activities that get you moving with friends and family.


  1. Dance 20 to 30 minutes at a time, at least five times a week.
  2. Choose a type of dancing where risk of falls is low.
  3. Heart rate needs to be elevated. Discuss safe levels with your cardiologist.
  4. If you can’t stand for long periods of time, try recumbent bikes, recumbent elliptical and swimming.

Featured IU Health Southern Indiana Physicians provider seeing patients for Neurology:

Mehyar Mehrizi, MD

ENT Specialist with Southern Indiana Physicians Explains Vertigo Symptoms

Do you ever feel like the world around you is spinning even when you are standing still? “Vertigo is a symptom of a balance disorder,” explains Paul Johnson, MD, an Ear, Nose and Throat (ENT) specialist with IU Health Southern Indiana Physicians.

“When we say vertigo, we are talking about the sensation of spinning or movement.” Dizziness, sensations of feeling off balance, swaying, or feeling pulled to one direction are all symptoms of vertigo. Vertigo is typically a result of an ear condition balance disorder. “From the ENT perspective, when you have a balance disorder and there’s not vertigo, it’s probably not from your ear,” says Dr. Johnson.

Q: What are the disorders associated with vertigo?

Benign Positional Vertigo (BPV), Meniere’s Disease and Labyrinthitis. BPV is most common. The latter two are inner ear disorders that can cause vertigo. Additional major causes of vertigo are head trauma and neuronitis.

Q: What are the symptoms of each?

Benign Positional Vertigo (BPV) results from problems within your inner ear and causes mild or intense dizziness. Because the disorder is benign, it is not caused by a tumor or disease, nor is it life threatening. The symptoms of BPV increase with movement, therefore it is positional.

Meniere’s disease is a disorder in the inner ear that causes spinning and fluctuating hearing loss. This disease most commonly starts between the ages of 20 and 50. It can result in permanent hearing loss and usually only affects one ear. “Meniere’s disease will have episodes of vertigo and can last from several hours to a day or two,” Johnson explained.

Labyrinthitis: The Labyrinth is the part of the ear that controls your balance. When it becomes swollen or inflamed it causes Labyrinthitis. It can initiate sudden spells of vertigo, causing you to feel like you are spinning. This can result in hearing loss that is temporary.

Q: How common are these disorders?

BPV is pretty common. In fact, around two-thirds of the problems related with the vestibular system that result in dizziness can be credited to BPV. “It’s not uncommon for us to see about two to five people a month with BPV in the office, whereas Meniere’s disease is much less frequent than that,” according to Johnson.

Q: How are they treated?

BPV is treated with physical therapy. “Most BPV patients will get better in as little as one or two sessions,” explains Dr. Johnson. However, Meniere’s disease is chronic and is medically treated with diuretics. Surgeries can be helpful if it is progressive or severe. Additionally, an acute inner ear infection is treated with fluids and anti-nausea and anti-vertigo medicine. Labyrinthitis, with time, can clear up on its own.

Q: Is there a cure?

Every individual is different. A cure for BPV is dependent on the cause, the vestibular system and the extent of the damage to the system. In many cases of vertigo, symptoms tend to dissipate on their own over time.

Q: What can be done to reduce symptoms?

Maintaining a healthy diet and decreasing salt, alcohol and caffeine intake are important to vertigo treatment.  Additionally, medications can be prescribed to decrease symptoms. Exercises can also be done to help reduce vertigo during daily activities. Also, be aware of your surroundings, as losing balance is always possible. Take a seat whenever you feel dizzy to avoid falling and to avoid aggravating the symptoms.

If you are experiencing any of these symptoms, please contact your Southern Indiana Physicians primary care provider. If needed, the provider can refer you to the featured expert Paul Johnson, MD.