Question: I have trouble waking. I stagger a lot and have to use a cane at all times. I’m 80 years old, and, otherwise, I'm in good health. No one can give me a straight answer. What do you think?

Dr. Hibberd's Answer:

The time to seek medical attention is now. You have no doubt experienced problems with your health before, and staggering, loss of balance, and difficulty wakening are all red flags to seek immediate medical attention.

You are NOT in good health with these new symptoms. Many disorders, especially diabetes, other endocrine disorders, and circulatory and neurologic disorders including stroke, can have these symptoms. Now is no time for guessing.

Your symptoms are far too general to be more specific, and while vertebrobasilar insufficiency — symptoms such as yours that result from a lack of blood flow to an area of the brain — is common at your age, it will not affect your sense of energy.
I am concerned that you may have suffered a stroke or some other neurological or vascular insult, and you need to see your doctor for a workup without delay. A "brain attack" is just as important as a "heart attack," and this is no time for procrastination or educated guessing.

If you have consulted competent doctors without results with normal initial screens (complete blood count, comprehensive metabolic profile, thyroid profile, or TSH, electrocardiogram, MRI of brain, carotid and vertebral duplex studies), a more involved workup is indicated.

Staggering is placing you at risk of falling along with associated injuries such as fractures of your hip. It is an indication for immediate assessment and possibly even a hospital stay. If your doctors are not sure, request an emergency re-evaluation and perhaps a neurological specialty consultation.