After last week's medical testing I was experiencing some swelling, numbness and tingling on the left side of my face. My doctor, Dr. John Epley, prescribed methylprednisolone to relieve the inflammation, swelling and related symptoms. The six day course of the drug began to improve the numbness about day three. The side effects of irritability and sleeplessness (six nights of sleep issues in a row) made me such a pleasant person to be around.
Yesterday I was once again at Dr. Epley's clinic - this time to get the results of my past vertigo test visits. I have been diagnosed with one of the most common forms of chronic vertigo, Benign Paroxysmal Positional Vertigo (BPPV). As described in literature from Dr. Epley's office, BPPV is caused by particles breaking off from the lining of the walls of a semicircular canal in the inner ear in the fluid that fills the canals. There are three semicircular canals located in the inner, for a total of six canals. They are part of the body's balance system responsible for a sense of spatial orientation (up, down, sideways, etc.) Moving the head in certain positions may cause the loose particles to move, causing an individual to feel a spinning sensation and make one's eyes move involuntarily. Unusual eye movement and patterns are important clues to problems in the inner ear.
With the diagnosis, Dr. Epley opted to send me to "the chair" - the Epley Onmiax chair. (He also asked that I be part of one of the research studies now being conducted with patients using the chair.) The Omniax has been developed by Dr. Epley. It is a large, motorized device that includes a chair that can be positioned at all angles and in three planes by computer controls. The device allows the study doctor, or consulting doctors, to move a patient in any position, including a 360-degree circle, to try to move the particles out of the semicircular canal. I've explained to people that it's like sitting a large gyroscope. The OregonLive.com website has a great video demonstation of the Omniax in use.
I was strapped somewhat uncomfortably into the chair. Infrared goggles, which track and record eye movements, were place on my face. The camera within the goggles records all eye movement and sends the information to a computer that creates 3D imagery of the inner ear configurations; allowing the doctor to better diagnose and treat vertigo conditions. After a series of eye movement calibrations, the actual tests began.
Complete, or partial, darkness has been one of the triggers of my vertigo the past three years. The minute the goggles were placed over my eyes I experienced some disorientation. To get accurate eye movement recordings, I needed to be looking straight ahead into the goggles. I thought I was, but the doctor and clinicians kept requesting that I look directly forward. Dr. Epley then commented that my left eye must be looking to the far left to readjust for the imbalance it perceives. When they requested I look to the far right, which actually caused my left eye to feel really strained, the computer software was then able to record my eye looking straight ahead. Dr. Epley actually said, "we're going to need to retrain Jeff's eye to see things as they are."
I was moved in a variety of positions, including almost completely upside down, in the Omniax. I felt a bit nauseous, and very dizzy when brought back to a still, upright position. In the darkness, it felt as if I was spinning counter-clockwise at a fairly fast speed - although the chair was no longer moving at all. With my eye not cooperating, I sensed that Dr. Epley was a little frustrated at not getting the accurate readings he was seeking.
He then suggested putting a vibrating pad behind my left ear, in hopes of "breaking something loose" and being able to record it with the camera and computer equipment. The vibration felt kind of soothing. With me straining my eye to look to the extreme right, which was still actually directly forward, the series of Omniax movements were executed again. I suddenly felt something different and my eye was no longer straining as much to look straight ahead. At the same time one of the clinicians said, "Wow, did you see that?"
Dr. Epley commented, "Something happened; we got something to move."
I was once again brought up to a still, stable position in the chair - and, while still seeming to rotate counter-clockwise a bit, I felt as if I was spinning much slower than the previous test. That brought my first treatment for vertigo to an end.
I was told that I should sleep on my side, with my left ear up, on two pillows in upcoming nights. The doctors and clinicians seemed a bit surprised when I told them I always sleep in that position. I was also told that I was to limit my head movement for the next 48 hours - and that some patients opt to wear a neck brace to assist them in not moving their head. I'm sure the look on my face told them that I would not be wearing that fashion accessory. The clinician said, "Well, some people are better at restricting head movement than others."
When I got out of the chair, I felt a bit wobbly and disoriented. I was able to walk out to the office lobby unassisted. Another treatment was scheduled for two weeks from today. Once I was in my truck and driving home, I realized I should not have been driving at all. It's a little difficult to drive when unable to move your head - and feeling a bit of disorientation. At home I suddenly felt incredibly exhausted and the numbness in my face had returned. It was time for a long nap.
After my nap, I did notice that my left eye felt extremely tired and "heavy." As a passenger in a car on I-5 last night, I noticed that my vision was much clearer. There were no "halos" on the headlights of oncoming traffic - and the glare seemed less disorienting. I also felt no anxiety being in the moving car at night.
After an incredible night of sleep last night, this morning my eye still feels odd, strained, and dense or heavy. My face is still numb and tingling. I have a major headache - centered where the vibrating pad had been strapped to my head. Still, something is different. For the first time in three years, something is really different.
More to come as the adventure continues...
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