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 "episode", 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.

Around 2006, 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 (although 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 finally taking a step or two unaided. I drove the short distance back to work and called my wife to drive me home.

Having one of these "acute episodes" can be a very unsettling experience, and can leave you in an unsteady and uneasy state for several days.
 But if you practice the balance exercises described below, you'll soon find that any dizzyness "episode" you have will be minor, and can be treated with some simple "particle draining maneuvers" and some meclizine (Bonine, Dramamine) tablets.

There are various causes for vertigo experiences, but 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.

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.

Some signs that an episode might be about to happen:

A rise of tension and anxiety.

Churning in the stomach.

A sense that your head is bouncing when you walk. This is even more pronounced when decending stairs. It's the "vertigo bobblehead".

Heart irregularity (for those who have a bit of "heart murmer" or occasional irregularity anyway).

A sense of unease.

There may also be a slight nausea.

OR: You just might suddenly get dizzy with no particular warning.

And what are some of the triggers that may precipitate an episode?

It's often associated with a sudden change in your head position, or perhaps any quick raising or lowering of the head. This may be something simple like putting on your pants or reaching for the toilet paper while seated on the toilet(!)

If you have had prior vertigo episodes, particularly any "acute" ones, and haven't had a chance to condition yourself for dizziness by doing the exercises described below, you might be sensitive to one or more of these scenarios:

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 magazine 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 - your head's 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.

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 one of my prior episodes, I had just put on my new glasses 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.

What to do?

So, when you suddenly feel dizzy, with or without one of these "precursors":
This might be a good time to take a meclizine tablet.

And why meclizine?
 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. Meclizine is a mild antihistamine, and partially shuts down the signals from the inner ear canal, the "vestibular balance system".
 Consider 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".)

And the second step is to do a Particle Draining Maneuver ("Epley" Maneuver) as soon as possible.

Of the various maneuvers designed to rotate any excess particles out of the ear canals, the "Epley Maneuver" is usually the most recommended one. You lay back on a bed or couch with your head hanging partly over the edge and tilt it in a prescribed manner (described in the link below). 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.
 It helps to continue these maneuvers for a day or two, perhaps in the morning and in the evening.

Once you have been doing the "balancing/conditioning exercizes" (described below) on a regular basis, the meclizine and the Epleys are probably all it will take. You should feel fine in a few minutes, with some queasiness perhaps lingering for a few hours.

Here's a link to a downloadable PDF file showing how to do the "Epley Maneuver": . .Epley Handouts

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

Consider doing the following exercise every morning, along with your morning muscle stretches or massages. (Not doing any morning muscle work? Please see my "Self-applied muscle massage" article. You can eliminate muscle pain by doing a bit of muscle work each morning.)

Stand somewhere with some space around you. Place one foot behind the other, as if taking a step, but the feet are in line as much as possible - one foot in front of the other.
 Some folks find it to be easier if they hold their arms outward. Personally I like to just leave them by my side.
 Close your eyes.
 If you have just had a vertigo episode recently or have just started doing this exercise, just stand there for a bit.
 It's perfectly normal to sometimes feel like you are about to lose your balance. Just relax and keep standing there for a bit. This exercise forces you to be mindful and to calm down and forget about all the day's plans!
 If you do not find this too dizzying, you can go to the next level.
 Take a few steps, while your eyes are closed. Pause and stand there for a few seconds after each step. Try to keep the feet in line while you take several steps, pausing a bit after each step. (Make sure you start with some space in front of you!)

That's it. Just 5 or 6 steps a day should help you improve your balance. By all means, take more if you want to. This is a good exercise for everybody, "normal" or not! By doing this balance exercise each morning, you can actually improve and enhance your sense of balance, and this enhancement alone will serve you well when you reach your 60s and up - vertigo or no vertigo.
Also, this is a fine example of turning a negative condition into a positive one. You will have turned a problem with balance into an improvement in balance.

After some months of doing this, preferably daily, you could add this extra bit of "balance conditioning":
 As you are taking you steps with your eyes closed, while you are paused between steps, turn your head to the left and to the right (with your eyes still closed). Just once or twice will do. Then take the next step. You may find this to be a bit disorienting. I do, even though I have been doing these balance exercises for years. I sometimes have to pause a bit before taking the next step. So this is NOT something you want to be doing the first time you start performing these exercises.

Want to add an additional balance perk to you life? Improve your ability to balance on one foot!
When you are finished with your "balance conditioning steps", line up your feet and then, with your eyes still closed, stand on just one foot. See how long you can do this. Then transfer to the other foot. Alternate standing on one foot and then the other for a couple of times. This will allow you to be able to stand on one foot much easier throughout the day. You can practice putting on your shoes while standing upright. Or you can confidently put on your pants without having to lean against the wall. Showoff!!
 Indeed, you can extend your balance training to be a all day thing. For quite some time now I no longer sit down to put on my shoes. I put them on while standing on one foot at at a time. I slip my foot into each shoe and then raise that leg to pull the shoe over the heel. It was a bit tricky at first, but now I easily keep my balance while doing so. Another ongoing balance training is that when I reach for some furniture or the wall to balance myself - especially in the middle of the night when balance isn't at its best - I pull my hand back from the wall and force myself to maintain my upright posture without the benefit of the extra support. Yes, old men get up in the middle of the night (to pee) on a fairly regular basis. . .

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

your "proprioception" (the input from muscles, joints, the soles of your feet, and the like). You actually have neural "motion sensors" in your muscles and joints!

So, for those with occasional vertigo, the vestibular system is, well, not at its best. So by interrupting the visual feedback, 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 by chance 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:

Here's a link to a very informative site describing "benign paroxysmal positional vertigo", and the Epley and other maneuvers.

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 the physical analogues. Sometimes if you pay attention to physical analogues like vertigo (or even something as simple as a bad back), you can learn things that will help you release "mental" problems, things 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 answers 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, (especially in meetings!). 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 lack of self confidence or self-esteem. 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 don'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 "acute" episodes.
  All that was a long time ago. Lately I go about my daily life with no thought about balance. I do the inline balance exercise (described above) daily. I put on my shoes and pants while standing upright.
 I do 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 Universe 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 are 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 recipient of the healing words.

Copyright © 2023 J.A.    (Initial Copyright © 2010 J.A.)