Dizziness and reduced vision when standing

Dear Ask The Doctor: I am an overweight, non-smoking, 44 year old male. Recently, I have extreme dizziness, reduced vision, and a pounding sound in my ears when I stand from sitting for any length of time. It seems to be getting worse. I currently cannot afford a doctor visit and am worried about this condition. Any ideas? Thank You!

Dear Rob: You seem to have what is called, orthostatic or postural hypotension. It occurs due to pooling of  venous blood into the lower limbs due to gravity, with any change of position and a simultaneous, temporary reduction in perfusion of the brain. You need to make slow and careful changes in the position and may use compressive stockings to reduce the pooling of blood associated with position changes. You may want to avoid vigorous exercise and hot environments to prevent these symptoms, try to have small frequent meals and keep your head slightly raised using pillows, compared to the rest of your body.