How to handle (and possibly eliminate) Vertigo

Here are some tips on dealing with the occasional dizziness associated with vertigo, based on my experiences. This dizziness can range from a momentary sense of imbalance to a full-blown "eposide", where the scene around you appears to tilt, spin, or partially rotate, and you have to sit down or (if driving) immediately pull over and stop. Having one of these "episodes" can be a very unsettling experience, and can leave you in an unsteady and uneasy state for several days.

But there are some "conditioning exercises" that can - if practiced regularly - prevent these episodes from ever ocurring. You can teach yourself to be "down" with dizziness. "What? Am I feeling a little dizzy? No problem. I practice dizziness!

(Need a crutch to help you along? We got that, too. It's meclizine, the compound in Bonine or Dramamine.)

OK. It's disclaimer time: If you have experienced some sort of profound dizziness event, you know who you should probably see. If you have not had a physical in some time, this might be a good time to get one, just to eliminate a possible shortage or excess of some nutrient, and eliminate any serious issues, such as with your ticker. I did in fact get a physical after two of the three events, and both times I was asked to wear a 24 hour "Holter monitor", which records heart rate and such. (And, both times, no problems were found.) On the other hand, if you know that you have a history of vertigo - of if family members did (my father and aunt in my case), and if the dizziness is due to a perceived spinning or movement of the surroundings, then it is possible that the dizziness was vertigo-related.

So, I'll be talking about:

Warning signs for an "episode"

Triggers that might bring on an episode

What you can do to proactively lessen the severity of your vertigo and virtually eliminate it.

Going deeper: Acceptance. Too much awareness. The Release. Vertigo as possible cause of other issues

For me, I can recall three distinct "episodes":

The first occurred in 2004 just as I was walking away from the building at work, and the second was right in front of the computer at work (during a highly stressful preparation for a software demo). It is now clear that the stress was the main cause, along with an extended session in front of a computer screen with no break.

The third occurred about two years later. As I was driving down the street away from work, suddenly the entire scene began to spin wildly. The trees and landscape seemed to rotate, as if the scene were being rapidly tilted, or as if I were in a boat rocking wildy from side to side. I managed to pull into a church parking lot, where I sat dizzy and nauseated (the spinning stopped quickly). After a few minutes I got out of the car and walked unsteadily - holding on to the car at first and then taking a few steps unaided. I drove back to work and called my wife to drive me home.

It is of interest to note that, of the "warning signals" which I will describe later, the only one I recall was an uneasiness in the stomach and a little extra tension. As I was walking out to the car from the building, I was aware that I was unusually excited about the current project I was doing at work. I thought nothing of it, since more than two years had elapsed since any prior vertigo episodes.

This is what I will refer to a vertigo "attack" or "event". It's a pretty profound experience, leaving one weak for the rest of the day, and followed by several weeks of smaller events and heightened awareness of dizzy sensations. Vertigo differs from dizziness in that it is a perception that either you or the world is moving or spinning. There are countless web sites that explain the symptoms in detail, and I will offer a couple of references later.

There are various causes for vertigo experiences, but for these I would again refer you to these sites. I will be speaking here of "benign paroxysmal positional vertigo". (When you spaz out in a moving vehicle on a busy freeway, you might be inclined to call it "malignant dismal disposition vertigo", but we'll let the name stand.) This vertigo is thought to be due to calcium carbonate particles that form in the ear and irritate the portion of the ear that sends signals necessary to maintain balance.

So what precedes a vertigo episode? For me it seems to be one or more of these sensations and symptoms (yours may differ):

A sense of unease. After all, a full "episode" is right up there with loss of consciousness.

A rise of tension and anxiety.

Churning in the stomach.

Heart irregularity (this may not be "universal" - in my case, I have always had a "heart murmur" and experience occasional irregularity from time to time anyway)

There may also be a slight nausea

So, when one or more of these "precursors" start to occur, this might be a good time to try a meclizine tablet. Meclizine is the common "motion sickness" compound that can be purchased over the counter. Brand names include Bonine, Dramamine, and Antivert. Furthermore, don't swallow the tablet; let it dissolve in your mouth - perhaps under the tongue. The medicine is absorbed through the "buccal mucosa". This is the "Nicorette effect", the mode of action for the nicotine gums. Once you have been doing the "balancing/conditioning exercizes" (described below), this is probably all it will take. You should feel fine in a few minutes.
Meclizine is a mild antihistamine, and partially shuts down the signals from the inner ear canal, the "vestibular balance system".

On the other hand if you have recently had one or more "acute" dizziness episodes, then it's time to stop what you're doing and become "centered", more calm. You may find that it is helpful to slowly move your head up and down, and from side to side. (This might sound a little crazy, but it makes more sense if you have been doing this on purpose as part of the balancing exercises. These exercises help "condition" you for dizziness events.) If it looks like the dizziness is about to escalate, it might help to do one of the "particle repositioning maneuvers", which I will describe and provide references for below.

It might be reassuring to remember that if the above techniques relieve the dizziness, this is another indicator that your dizziness is vertigo-related.

And what are some triggers that may precipitate an episode? Here's some:

Reading while you are eating. Why? Because the jaw movement may be causing the particles to jostle around, irritating the balance structures. Furthermore, your head is tilted down (for example, in reading a newspaper spread out on the table). If you start to feel dizzy, quit reading and just eat your din-din! Or at least wait a bit, and prop the paper/book up in front of you.

Computer work, especially for an extended period. Why is that? Well, for starters there's all that motion on the screen. And consider what you are doing - head up looking at the screen, head down searching the keyboard for the left and right parentheses, head up while you type some more, head down looking for "control V", and so forth.

Watching movies that have lots of motion. Of course, they're ALL high intensity pixel pushers nowadays! So maybe Superhero movies are out for a while. At least look away from the screen periodically.

Any sudden raising or lowering of the head.

Eating while driving. Again, the jaws are moving the area in the inner ear, and at the same time there's all this movement in front of you.

New glasses(?) Just before my last event, I had just put on my new glasses (with shaded covers) before I left work that afternoon. The astigmatism correction in the glasses caused the horizon to move out of sync with what I was used to. That'll do it!

And, if you would like to get more philosophical, how about the vertigo as representing a consciousness reacting to change that is a little too fast - thoughts constantly buzzing in your head about that work project (which itself might be an interruption of another project you were working on). or fretting about that last stock purchase going bad, or what to do about a retirement that seems so far away.

So, what can you do to deal with the vertigo in a proactive manner? Three things:

Using one of the "particle draining maneuvers".

Doing the "balance and dizziness conditioning exercises".

Possibly taking the meclizine every morning for a while after an episode of high dizziness, just like you would take an antibiotic for a period of time, even after you feel better. (This also lets you make use of the confidence-building "Medicine Effect".)

The particle draining maneuvers:

There are several maneuvers designed to rotate any excess particles out of the ear canals. It appears that the most recommended one is the "Epley Maneuver". When you make that appointment with your health care provider, they may decide to perform this on you in the office. This would be a good idea, since your provider would be trained in what to do should there be any problem. For example, the first time this maneuver is done, there might be quite a bit of dizziness or possibly even nausea. Also, it's necessary to know which ear is responsible for the vertigo, and your doctor may be trained in determining this. In my case, my right ear has permanent tinnitus, and constantly feels as if it were "full", so we decided on the right ear

Here's a link to a very informative site describing "benign paroxysmal positional vertigo", and the Epley and other maneuvers.
NOTE: The site's author mentions sleeping with the head propped up for a night or two after the procedure, but suggests that
this may not be absolutely necessary. I found it to quite OK to sleep normally.

www.dizziness-and-balance.com

If you (and your doctor) decide on the Epley, and you want to continue doing the maneuver at home, here's a link showing a
pictorial description. The exercise is really quite simple:

www.activator.com. . .Epley Handouts

It is helpful to do it a couple of times in the morning and evening during and after an "attack". As mentioned, it can actually cause a slight temporary dizziness right after you do the procedure. So don't do it and then jump in the car and head to work. I also found it helpful to perform the maneuver at work when I felt a rise of dizziness.

After the strong phase passes (implying that the particles have cleared), it might be well to do this procedure once in the morning and once in the evening, perhaps every day or at least several times a week, for a period of time. You can do it right after your morning muscle stretching (you are doing your regular muscle work, aren't you?)

Balance and dizziness conditioning exercises -- turning a negative into a positive

The most exiting thing for me was discovering the "balance and dizziness conditioning exercises". You can actually improve and enhance your sense of balance. This is a fine example of turning a negative condition into a positive one. If - no, WHEN - you succeed in performing these exercises, you will have improved your sense of balance, and this enhancement will serve you well when you reach your 60s and up.

Exercise #1 Stand with both feet placed side-by-side (near a wall for support if necessary)

Too easy, huh? Now close your eyes.

NOTE: If you find yourself getting excessively dizzy, stop and try later.
BUT: You want to elicit some dizziness, so that the exercises will do some good

Exercise #2 Now try standing on one foot. Alternate between right and left foot.

After you get used to this, try it with your eyes closed.

Or, as an alternate, do this while slowly turning your head from side to side.

Exercise #3 Try standing on both feet, but one foot in front of the other. The toes of one foot touch the heel of the other.

Later, try this with eyes closed, or with eyes open but slowly turning your head from side to side.

Exercise #4 Now try "walking" with the feet in line as in exercise 3. You are just placing one foot in front of the other with each step.

Now try this walking with eyes closed. NOTE: This won't be easy!

Exercise #5 Hold something at arm's length and move the object in a big circle, while following it with your eyes. It's OK to move the head while doing this.

NOTE: This will cause dizziness! Just stop when you think it's too much. As you become used to this, yiou can move the object a little faster in circles.

Exercise #6 Walk (normally) toward a wall, but keep your eyes focused on an object on the wall. (A picture, a doorknob, any object). While walking toward the object, move your head from side to side.

NOTE: It may be a week or two (or more) before you want to try this. Even "normal" folks will have trouble with this one! This exercise will be the one you should consider doing on a regular basis for an indefinite period. It will be your daily "balance training".

As a variation on this exercise, walk toward the wall while moving your head up and down.

Once you have graduated to this level, try the ultimate: Walk toward the wall while rotating your head in circles (while focusing on an object on the wall. NOT EASY (and almost guaranteed to cause a bit of dizzyness!) You should be very proud of yourself if you can do this. Give yourself a PhD in "balance training!"

You are doing two things with these exercises:

The first is you are strengthing the under-used part of your balance suite. It is said that our balance is mediated by three bodily systems, the vestibular (inner ear), the visual, and your "proprioception" (the input from muscles, joints, the soles of your feet, and the like). For those with occasional vertigo, the vestibular system is, well, not at its best. So it might be said that by interrupting the visual, you are retraining your propriocentric system so that you can depend more on it. Or possibly you are retraining yourself to get more accustomed to the flawed vestibular system.

The second is that you are teaching yourself to be "down with spinning". Ice skaters and dancers train themselves by repeated practice to handle rotating environments. These exercises can help you do the same. After a while you might find that sensing an impending bout of dizziness is not as much a threat. "A little spinning? So what. I do this on purpose."

After a couple months of doing these exercises somewhat regularly, you will find your balance dramatically improved. Indeed, this sort of thing would help anybody, whether or not they are subject to vertigo episodes. If you still have the Wii Fit package, you will soon find that you can ace the "balance" test, and you can glide through the ski slaloms much more accurately (bearing in mind that if you have recently experienced an "acute" phase, you can only do these once!).

Here's a link to an article on our balance systems:          www.vestibular.org

So, let's take this a little deeper...
1) Acceptance
 You could say that the exercises help you "accept" the dizziness. This brings to mind the thoughts expressed in the Tao Te Ching. "What you want to overcome, you must first submit to."
2) Too much awareness
 The condition of vertigo causes you to be very aware of your sensations. This is to be expected since an "attack" is a pretty profound event - especially if you happen to be driving in the middle lane of a crowded freeway. So you become introspective of any little dizziness, or knots in the stomach, or irregular heart beat.
 Then you become aware of "causes". "Is it more likely to happen if I work at the computer too long? If work is stressing me, will an event be more likely? I've been trying some eye exercises (stretching the eye muscles up/down/right/left. Is that what it is? Maybe it's when I am hungry and low on blood sugar. Too cold? Too tired? Too much reading? Too much exercise - causing a fast heartbeat?"
 Ironically, it is this very awareness that makes it difficult to "forget" about the vertigo and allow the "cure" to happen. "If I could just forget about it for a week or two, it would probably just go away, as it did those other times in the past."
 And what might all this remind some of you of? Well, this bears a striking resemblance to "mental" issues. You know: "depression", "anxiety", and the like. These (temporary) episodes in your life also tend to make you acutely aware of your feelings, your stance during conversations with others, your reaction to food, exercise, sleeping, work, stress - the list goes on.
 And, just like with the vertigo, you become aware of causes. "Am I working too much? Should I take more time off? If I exercise more often, would it help? What about the foods I eat? Maybe it would help if I ate different foods. Maybe I should not have any beer. Maybe I should have more beer. I should be calmer. I should not be concerned about work tension. I'm not having enough sexual relief. No wait, having sex creates more tension." This list goes on forever, and as with the awareness of dizziness/vertigo, makes it hard to forget about the problem.
 So the vertigo episodes are one of our physical analogues. If you pay attention to physical analogues, you can learn things that will help you release "mental" problems, such as the following two tidbits:

Our advantage, as time-bound beings, is time itself. We are not immortal, and all things will pass.

And also this, which might be the most important thing of all: There are no answers, and it is usually asking questions that is the problem. There are times for which no words that I (or any friend, doctor, or priest) can say that will bring about the cure. Only you can speak the words of healing. You can speak these words with the authority of your participation in the Universal Consciousness. You are Spirit interpreting the Earth as you. Just as the Timeless Formless One speaks the words of Creation, you can speak the words of cure.

3) The "release")
 There is a period of time between the onset of some condition and the release of that condition, which we sometimes call the "cure". The problem was there (with all its attendant anxiety) and then it is gone, forgotten.
 Is this period a "cure" or is it merely a function of forgetting? The feelings - often strong - gradually disappear amid all the affairs of life.
 So is the cure accomplished by the compounds we take to counter the condition or that, by forgetting we no longer fear (and thus create) the condition.

4) An interesting thought: Low grade Vertigo as "cause" of anxiety, "panic" attacks
 During pre-vertigo episodes, the sense of groundlessness is so profound, the upright stance so tenuous, that it literally leads to physical imbalance. It's no wonder that it gives rise to anxiety and churning of the gut.
 So what about those times of extra tension in the gut, or the occasional "panic" when in conversation with others. After my workplace episode I was talking to a female co-worker and I could suddenly feel the sudden pre-dizziness arise. "Oh great. Not now. Hope I can control it until I can get back to my cube."
 It was later that I realized that "this is just vertigo", and I could not help but feel a sense of relief. "It's not shyness; it's not lack of self confidence. It's just plain ol' vertigo." So who knows? How many countless other times have I experienced such anxiety when in conversation with others, or in meetings. Could it have been low-grade vertigo? An interesting speculation, and I offer it to my readers for consideration.

5) Oh, and one more thing:
 Try not to let Medical Science condemn you with the "D" words.
 "I Diagnose you with Meneire's Disease" (Medical Science's name for severe vertigo). Or, "You have Meneire's Disease."
 Nameing has power; once named, your experience now becomes a thing over which you have very little control. It's the same as the names for "mental" diseases, like "Depression" and "Scizophrenia". (And you walk out of the office thinking, "I 'have' Meneire's?" Or, "I 'have' depression. Oh great. Now what do I do?")
 You don't "have" depression. Instead you are experiencing a time in your life in which you don't quite have the upright stance; you are not walking in tune with the beat of your heart. Likewise you doesn't "have" schizophrenia. Instead you are experiencing a time in your life in which you are temporarily out of touch with your physicality.
 Thus it is important to say a "time" rather than a "condition" of one's life. Saying a "time" implies the possibility of change as time passes, whereas saying a "condition", "problem", "disease", or similiar term implies something (some thing) that needs "answers", or that needs to be "cured".
 During those "episode" times in my past I had several of the symptoms that are given for Meneire's Disease. I had (and still do have) ringing in my right ear 24/7. Indeed it pulsates so much that I don't use a metronome when I compose music! I just time the music to the pulsating tinnitus! Also, I remember having a sense of fullness in that ear. On one of the episodes, I had to immediately squat down on the sidewalk. On another I had to immediately stop driving and pull into a parking lot; fortunately I was not on a freeway.
  All that was a long time ago. Lately I go about my daily life with no thought about balance. I do the balance exercise (Number 6 above) when I think about it. I have a sense of slight dizziness every once in a while, especially while driving on the curvy mountain roads on the way to the interior valley. If I feel it might escalate, I suck on a single meclizine tablet.
 But let me be quick to point out that "I" haven't solved my problem with dizziness. I'll let the Cosmos take credit for that one. Every morning, during my morning affirmations, I usually include something like this: "Thank You for calm, balance, and peace." Or "I speak the words of calm, balance, and peace."
 When thanking the Timeless Formless One, be sure to get the direction right.
 You are not thanking some nebulous being up "there" (direction OUT). You thanking the Spirit within (direction IN).
 Each of us has a physical form that is the Incarnation of the Great Spirit. This physical form is what we point to and (erroneously) call "my body".

In that sense, each of us is the Christ.

Each of us is at the same time the Speaker of the Words of Release, the Words themselves, and the receipient of the healing words.

Copyright © 2017 J.A.