It all began while swimming one afternoon and twisting my body I suddenly felt a little wave of dizziness. Whoa. I stopped swimming for a few minutes wondering what had happened. Then I continued my swim as normal.  However, after I returned home to take a shower, when I bent over to wrap a towel around my head, the room spun.  I grabbed the sink to prevent me from falling. That was really scary.

After that I began experiencing bouts of dizziness, especially in bed when turning over onto my side. I began to move very carefully in bed when lying down and getting up. Sometimes when I bent over to pick something up I felt dizzy.  It was very unsettling. I found myself holding on to things when walking especially on stairs, never knowing when I would feel dizzy.

After a couple of weeks I saw a doctor friend and asked her about the dizziness.  She said vertigo is usually caused by ear problems and suggested I see an ear specialist. I contacted my ear doctor and made an appointment for the next morning. After listening to my symptoms he asked me if I noticed the dizziness on one side or the other in bed. I wasn’t sure. Then he asked me to sit in his examining chair.  He checked both ears with his camera and found nothing abnormal. Then he tilted it back low and asked me to turn my head to the right. The room was spinning for several seconds. Then he asked me to turn to the left side.  Nothing. The problem was in my right inner ear.

Sitting at his desk he opened his computer and showed me images of the inner ear canal explaining that sometimes crystals become lodged in the canal which affect the brain causing vertigo. Then he showed me a video clip of Brand Danoff exercise to move the crystals. He also gave me some medication to speed up the process.

When I got home I opened my laptop and began researching vertigo treatments and learned quite a lot. There’s a second exercise used called the Epley Maneuver, which is similar to Brand Danof. It’s very disconcerting to make yourself dizzy doing these exercises twice a day. But after four days, the dizziness was gone. Hurray! I tried both techniques for vertigo but found the Epley maneuver easier.

When I put a post on Facebook about my vertigo, I was surprised how many friends had been feeling dizzy also. With my research I discovered that vertigo is quite common. Usually it’s the benign paroxysmal positional vertigo (BPPV), Meniere’s disease and labyrinthitis. The other types of vertigo are rarer with serious side effects. So I’m going to talk about BPPV as the most common type.

Dizziness affects approximately 20 -40% of people at some point in their life. It occurs more commonly with age and affects women two to three times more often than men. It’s more likely for a person with BPPV to get repeated episodes of vertigo with movement and feel normal between the episodes. The episodes should last less than a minute, producing rapid eye movement known as nystagmus. 

What causes vertigo?

Benign paroxysmal positional vertigo (BPPV) is the most common vestibular disorder and occurs when loose calcium carbonate debris has broken off of the otoconial membrane and enters a semicircular canal thereby creating the sensation of motion. People with BPPV may experience brief periods of vertigo, usually under a minute, which occur with change in the position. That doesn’t sound too serious, but small head movements cause the loose crystals to move, triggering your inner-ear sensors to send mixed messages to your brain. It occurs in 0.6% of the population yearly with 10% having an attack during their lifetime. It is believed to be due to a mechanical malfunction of the inner ear. BPPV may be diagnosed with the Dix-Hallpike test and can be effectively treated with The Epley maneuver or the Brandt-Daroff exercise.

The Epley Maneuver

1.  Begin by sitting upright in the middle of your bed. Rotate your head horizontally towards the ear causing your symptoms approximately 45 degrees. Maintain this position for 1 minute. 

2.  Keep your head and neck in this position and gently lie down. Maintain this position for 1 minute. Beware this position will likely cause dizziness, which can last for a few seconds or longer. Stay here until the vertigo stops.

3.  While still lying on your back slowly rotate your head towards the good ear as far as possible or approximately 90 degrees. Maintain this position for 1 minute. This position may again cause dizziness.

4.  With your head still rotated maximally towards your good side slowly roll your entire body on to your good side. Keep your head and neck fixed as much as possible. If done properly you should be able to stare down at the floor.  Maintain this position for 1 minute.

5.  Finally to complete the Epley maneuver return to a sitting positon with your head up but flexed forward approximately 45 degrees.  Maintain this position for 1 minute.

6.  This maneuver should take five minutes and repeated 2 more times prior to going to bed.

Does Epley maneuver work immediately?

Most people say their symptoms go away right after they do the maneuver. In some cases, it may take a few times for the procedure to work.  Or you may have another problem that’s causing your symptoms of vertigo. The home Epley maneuver only works to treat vertigo from BPPV.

Brandt-Daroff Exercise for Vertigo

1.     Start in an upright, seated position in the middle of your bed.

2. Move into the lying position on one side with your nose pointed up at about a 45-degree angle. Move to the side which you experience dizziness. You may experience dizziness when you lie down.

3.  Remain in this position for about 30 seconds (or until the vertigo subsides, whichever is longer). Then move back to the seated position.

4.  Repeat on the other side.

5.  Repeat exercises twice a day.

If you’re experiencing vertigo see an ear doctor right away. It’s a bit scary walking around never knowing when you’ll feel dizzy.

By Shari Hartman

The Boomer Corner is a column dedicated to people over  60 living in Bali.  Its mandate is to cover topics, practicalities, activities, issues, concerns and events related to senior life in Bali. We welcome suggestions from readers.

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