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Diagnosis: Dizziness and Giddiness

When we were children, we enjoyed spinning until we dropped. We giggled, held our head in our hands, and fell on the lawn as we looked up to watch the clouds, tree-tops and the faces of our playmates above us turning like the spin cycle of a clothes drier. I remember feeling this “giddiness” as I stumbled off the merry-go-round in the school yard or local park. Unfortunately to many people, this sensation can feel sickening and can surprise us when it happens out of the blue or after an unfriendly event such as a head injury, whiplash or a medical condition.

Eleven years ago, I was very congested and blew my nose a bit too hard and the next thing I felt was that same kind of spinning after being on the teacup ride at the fair. I became nauseous and fell to my knees. I became clammy and cold sweats took over my body as I crawled to the edge of my bed to hold on to something I knew wasn’t moving. I prayed for God to stop the spinning and tried my best not to lose my stomach on my bed. It was a horrible experience that many people live with on a regular basis so I set out to find answers not only for myself but for people in my community who were/are living with this malady. As soon as I could get an appointment, I saw an ear and balance specialist, who unlike a general Ear, Nose, and Throat (ENT), has a fellowship in this specialty. The diagnosis was Perilymph Fistula. I found out that the congestion from a head cold had changed the pressure in my inner ear and blowing my nose too hard forced the perilymph fluid in the tiny tubular inner ear structures too hard, creating a pocket (called a fistula) into the thin membrane of the labyrinth. The inner ear structures involved in balance and vertigo symptoms belong to the VESTIBULAR system which is so deep, that it is located just below the eyes on both sides.

I have had mild re-occurrences but have learned to manage the condition, however, this event changed my body’s perception of gravity and it forever changed how I respond to roller coasters and swings (which I had always enjoyed up until this happened!). It even made me more sensitive to the acceleration and cabin pressure in airplanes – mostly in smaller commercial aircraft so when booking flights, I search for aircraft that are larger than commuter planes.

There are over 25 ADULT Vestibular Disorders, but children can also suffer from vestibular system dysfunction and the leading type is due to concussions. In this short article, we will only briefly discuss the most common type of adult vestibular disorder, Benign Paroxysmal Positional Vertigo (BPPV).

BPPV is a mechanical malfunction of the inner ear, specifically, when the motion sensitive ear calcium carbonate crystals are jarred out of their permanent place in the vestibular system. It is helpful to define those medical words into layman’s terms as follows:

Benign: not life-threatening

Paroxysmal: it comes on suddenly

Positional: certain positions or movements will trigger symptoms

Vertigo: the sensation of spinning – not the fun type!

Treatment for BPPV involves proper assessment to determine where those dislodged ear crystals traveled to within the tiny labyrinth and surrounding spaces followed by quick head movements (maneuvers) to lead them back to home base. Naturally, this provokes dizziness and nausea – far from giddiness! Clinicians who perform these maneuvers have taken extra courses to learn how to assess and administer them. Once the clinician successfully completes the maneuvers, they will send the patient home with instructions on how to avoid sleeping positions and activities that may dislodging them again. Occupational Therapists (OTs) are experts in returning patients back to their pre-injury roles utilizing therapeutic solutions for the skills of living. They will add functional tasks to treatments after the re-positioning maneuvers; teach patients symptom management; and teach adaptive body mechanics to keep them independent with their self-care tasks because bending down during self-care tasks can provoke debilitating symptoms.

Occupational Therapists will add functional tasks after re-

positioning maneuvers and teach patients symptom management so their patient can manage a flare up between visits as well teach adaptive body mechanics to keep them independent with their self-care tasks because bending down to tie shoes, clean out cat litter, pick up small children and pets, etc. can provoke a flare-up.

OTs are experts in returning patients back to their pre-injury roles and come up with therapeutic solutions for the skills of living. If you or someone you know have experienced dizziness without the giddiness, ask your doctor for a referral to a Occupational Therapist who is skilled at evaluation and treatment for your condition.

If you have been living with vertigo, please call Integrative Therapeutic Solutions for a brief phone consult at: 253-514-6842 and INTEGRATE YOUR LIFE TODAY!

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