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Coping with Vertigo

There are many things that happen in an attack of severe vertigo. These are some helpful tips that I’ve discovered help in alleviating the sensations:

1. Breathe
• Deep Breaths help to calm the body
• A calm body has a lower heart-rate
• A lower heart rate means lower volumes of blood coursing through your inner ears, which keeps the pulsating, spinning sensations to minimum

2. Remind Yourself It Is All In Your Head
• As a kid I panicked and thought that the feelings I was experiencing were actually happening in the real world
• Remind yourself of reality

3. The Cold-Water Towel
• The calming effect of a wet towel on the back of your neck is irrefutable, and can help bring down the panic

4. Move Slowly and Surely
• There is no sense in rushing around trying to outrun the sensations
• Moving slowly helps your brain to analyze the situation and begin working on corrective measures

5. Most Important: Remember It Will Pass
• I thought I would spin forever that first night
• I didn’t

In recent news from the Hockey world, the Anaheim Ducks’ goalie Jonas Hiller is suffering from vertigo and is unable to play.

At first he tried to “play through it,” one post from SportingNews NHL said. That must have been extremely hard, skating while feeling as if he were spinning in circles. I have a hard enough time on the ice as it is, I can’t imagine trying to walk on the ice, walk, even, while feeling the way I do when vertigo sets in.

No word on what condition he might have, but he for sure has something. It’s not just the random wooziness or dizziness that he’s feeling. It’s lasted for months, since a game in February. It’s gotta be either Labyrinthitis, Vestibular Neuritis, or some other syndrome that attacks the inner ear.

Maybe he could read this blog and get some ideas about what might be ailing him? Who knows?

Read the post here.

4 Causes of Vertigo

I realized that I never really explained what causes vestibular neuritis, which got me wondering more broadly on what all can cause vertigo? From emedicinehealth.com I got these answers:

  1. “Benign paroxysmal positional vertigo” – basically when you move your head too fast in any direction.
  2. “Inflammation within the inner ear (Labyrinthitis or vestibular neuritis)” – this is what I have. What causes vestibular neuritis is, of all things, a virus in the herpes family (not the STD, though. My friends made fun of me for this, too ). It is like getting a canker sore on the vestibular nerve. That’s all it is. Such a small thing to cause so much anxiety and trouble. It’s like the One Ring in LotR.
  3. “Meniere’s disease” – whatever it is, it also causes vertigo, with ringing ears and hearing loss. Thankfully, I haven’t lost my hearing, so I’m pretty certain I don’t have this.
  4. “Acoustic neuroma” – a tumor on the nerve tissue. This scared me at first, because a lot of the symptoms of it are similar to what I have, and I want nothing to do with tumors. “Symptoms include vertigo with one-sided ringing in the ear and hearing loss.”

These seem to be the more common reasons for vertigo, but they’re not the only ones. Go here to see more.

From emedicinehealth.com, "cutaway of the ear"

Reverse Motion-Sickness

I do this, but off the boat.... From "itsentirelynatural.com/blog"

Most people with motion-sickness get sick – experience dizziness, wooziness, vomiting, and other awful sensations – while still in the car, still on the airplane, still riding in the boat. For me, it is the opposite. I could ride all day in an airplane, ride the seas in a boat – speed or otherwise – or take a very long road-trip, and I would be fine…until the ride stopped.

My balance therapist called this “mal de débarquement,” which, from my very novice skill in Latin (or maybe French? I’m not sure), means something like “bad stop” or “bad getting-off of—”. Essentially, it is reverse motion-sickness: I feel as if I am still in the car long after the wheels have stopped turning, and then get sick. What twisted ironic hellish devilry!

I am suffering it right now as I write this, since yesterday I had a long car ride back from home from Easter Break. I’m pretty used to it by now, since it’s been happening since my first acute vertigo attack, but I’d much rather never have a good time in cars or other vehicles if I could only feel stable while sitting at a desk or trying to sleep.

Thankfully my paint-stick exercise from “How Do You Fix Vestibular Neuritis? (2 of 3)” helps with this sort of thing.

There was an article on Mal de Débarquement in the New York Times, and I found it very interesting.

Apparently, those with the condition develop a neurological or psychological model or map of the motion of the vehicle they are in, and then adjust their balance according to it, by predicting the next motion they would feel:

“They’re the ones who are walking around the boat and having a great time,” [Dr. Hain] said. “But when they get off, they don’t give up their internal models very easily.”

Read the full article here. It is very interesting.

Dizzying Dreams

Every once in a while, I will have dreams of being dizzy, spinning just as bad as the first acute attack I had of vertigo.

One particularly vivid dream took place in a classroom. I was bringing my papers forward to hand to the professor. Or maybe it was that I had to give a presentation. The one thing I remember is walking forward from the back of the room, looking at the bluish carpet, and then seeing it spin as fast as a car wheel. Have you ever tried watching the hub-cap of a car while it is driving?

I guess that’s a bit of a bad example on my part – I’m sure there’s many people who have no trouble watching something like that. But it makes me dizzy.

Anyway, I fell down in the middle of that classroom, saw the ceiling-tiles and the fluorescent light fixtures whirling above me.

It seems almost like science fiction sometimes.

Then I woke up. And everything was still again, mostly.

Now, I wonder if I was only dizzy in the dream, or if in waking life there really was something wrong with my inner ears as I was sleeping. What causes dreams like this?

Have you ever had some illness or injury that you dreamed about?

In addition to the paint-stick exercise, there is the pillow exercise. This is the easiest exercise to do. It is intended to retrain your brain in interpreting the skewed balance signals sent from your ear.

You take a pillow, one thick enough that you can’t feel the floor through it when you stand on it.

Stand on it and close your eyes.

For two minutes stand there and balance, with your eyes closed, moving your head 30 degrees right and left of your face’s imaginary centerline (like in the paint-stick exercise).

Essentially this is a balance exercise and would train someone how to balance even if he or she didn’t have vestibular neuritis. It really strengthens the little-used leg muscles also, and trains you to trust in your legs and not in the tipping or spinning sensations you feel.

***

These three exercises I’ve been describing in the “How Do You Fix Vestibular Neuritis?” posts, are all that I have needed to fix my neuritis down to a manageable state. I do still get woozy and sometimes the spinning comes back, but very rarely.

If you have vestibular neuritis, you have nothing to lose by trying these exercises. Try them!

Also, I have discovered on my own other little things to do that help alleviate the feelings: stress balls, stress-releasing breathing exercises, getting enough sleep, closing my eyelids and moving my eyes back and forth and up and down, or even just massaging below my ears and moving my head slowly side to side.

Once you know the symptoms and how to treat them, it becomes much easier to experiment with exercises.

Find ways to help yourself!

After the ear rocks are dissolved and out of your semicircular canal, the next thing you will probably want to do is stop your eyes from twitching, or what my doctor called “nystagmus.”

The brain tries to see the things it is feeling. If I feel like I’m spinning in circles, my brain, utilizing all of its senses, will cause the strongest signal of motion (from the ear) to override the visual senses – the brain causes the muscles in my eyes to twitch, rapidly, the direction it feels that it is moving.

My therapist gave me this exercise to do to reset my eyes:

This Blog Brought to You by the Letter "E"

Tape a capital letter E to the end of a paint stick. Hold it straight in front of you at eye-level.

Look at the E.

Never taking your eyes off the E, start to move your head sideways, left to right, keeping your eyes always on the E. Only move your head 30 degrees either way from the imaginary centerline of your nose and chin – no reason to strain your eyes that much. Do this for no more than 2 minutes.

This is basically an eye-muscle workout, training them the way you would train any muscle to be physically fit. The letter E is also important: it has 90 degree corners so it is easier to focus on.

The more advanced stages of this exercise use the letter A, because it has slanted lines.

The idea is to get your eye muscles back under your voluntary muscle control.

My friends make fun of me for doing this exercise. It looks silly, it really does. But the cessation of the world’s spinning is worth it, trust me.

Sadly, there is no magic pill to cure Vestibular Neuritis. It is not a disease. It is more like a physical condition. Physical therapy is what’s needed. Or perhaps I should say, “micro-physical therapy.” It is like making incremental adjustments to a gyroscope – which is nearer to the truth than anything.

The first thing my doctor did, when I went to visit a neurologist and balance physician, was get the calcium crystals out of the semicircular canal and down into the utricle and saccule again, so that they could be dissolved.

Calcium "Ear Rocks" via Sciencephoto

I was pretty agitated at the time, understandably. So she put a cold towel on my neck, which has a remarkable effect of calming (I’ve used that trick for other things besides vertigo, by the way). Then she had me get onto a couch that looks like an inverse of the Freudian psychoanalysis couch that is so iconic: but it bent down, not up.

I felt like I was falling or spinning to my right. So she had me turn my head about 30o to the right, and then lie back, down the slant, so that my head was lower than my legs and feet. The room spun violently for a few seconds, but then calmed relatively down.

After about a minute she had me turn my head to the left – which caused a violent spin again, but not as long as the first time. She said that it soon would feel like I was in a car that just went over a bump – and it did. That was the crystals falling out of the canal and into the utricle and saccule again – what a blessed feeling of relief!

One final turn of the head, involving shifting my body to my side and looking down, caused the crystals to fall into the little chamber that dissolves them.

After this I felt a million times better! It was like falling asleep after a long day of heavy labor (I’m a farmboy, I know what that is).

Simple physics is what helped the most – the rocks just “fell out” – which amazes me. But after this the effects of the inflammation of the vestibular nerve and the eye-twitches had to be addressed. I will talk about those in the 2nd and 3rd parts of this post.

The Structure of the Inner Ear, via John Hopkins.

Knowledge of why something bad happens in the body can be almost as much a relief as the cure itself. Here is a layman’s layout of the inner ear during Vestibular Neuritis:

  1. In the inner ear is the cochlea, the thing that sort of looks like a coiled snake in the first picture.
  2. Vestibular Neuritis is inflammation of the vestibular nerve, which runs through the cochlea.
  3. When it becomes inflamed the whole cochlea is affected, including the semicircular canals on the left and the utricle and saccule.
  4. Within the utricle and saccule there are little hair follicles, slenderer than the hair on your knuckles, bundled up and incased in a sort of gel.
  5. Embedded in the gel are little crystals of calcium that sort of wave in the fluid that fills the semicircular canals and the utricle and saccule. That is how our bodies detect gravity and balance – the semicircular canals are an “organic gyroscope.”

When I shook my head so violently in the first acute attack, what happened was this:

The inflammation had dislodged some of those calcium crystals. That caused my “organic gyroscope” to go haywire. The crystals are not supposed to be free-floating. My brain interpreted the skewed signals as incredibly fast spinning movement, and worse, some of those crystals made their way into the horizontal semicircular canal: they never are supposed to get in there.

That, more than anything, is the cause of the terrible vertigo people with Vestibular Neuritis experience.

When I shook my head, I unknowingly helped move the freeloading crystals out of the canal and back into where they should be in the utricule and saccule. God made fail-safes in our bodies: in the bottom of the utricle and saccule is a little hole where dislodged crystals go and get dissolved. That halted the spinning sensations, and was the first step on getting better.

All this my doctor explained to me in more medical terms, and gave me exercises to do to completely revive. I will give those exercises in my next post.

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