The case of Dizzy Dolores - solution

The answer: choice number "1." Dolores's dizziness was due to neuropathy.

When we speak of neuropathy, we are generally referring to what is called 'peripheral neuropathy' which is nerve damage to the small nerve fibres in the feet (and sometimes the fingers). Peripheral neuropathy generally causes a burning, numb pain which, at times, can be very distressing. There are, however, other forms of neuropathy, one of which is called 'autonomic neuropathy' whereupon the internal nerves get damaged. Sometimes this is a cause of erectile dysfunction. Sometimes it causes an unusual condition where people start to sweat over their face when they are eating ('gustatory sweating'). Another way in which autonomic neuropathy can show itself is by a big drop in one's blood pressure when one stands up. This is termed 'orthostatic hypotension' (try dropping that term at a party if you want to impress someone - or bring the conversation to an immediate standstill!) and this is what Dolores was being bothered by.

We can treat Dolores's problem (though it is not easy) with medications to raise blood pressure (imagine that; quite a contrast to the two, three or four types of medications we often need to lower blood pressure in people with hypertension and diabetes, eh?). We can also use special support stockings (Sigvaris stockings for example).

By the way, this is the format I use in my book (What Your Doctor Really Thinks).

Old cases of the month can be found here.