Dizzy no more

Thanks to all the people who have asked about my recovery from three plus years of dealing with vertigo issues. I've been getting asked about my improved health on forums, via email and even on the street. I hope that the information I have shared has been helpful to those seeking relief from their own vertigo issues, or of assistance to those seeking additional information for love ones, friends, neighbors and co-workers experiencing chronic vertigo or dizziness.

Tomorrow it will be five weeks since my last treatment at Dr. John Epley's clinic, and since then I've had no vertigo issues at all. I still have one weird thing happening ever since the treatment. Almost every day, I get a really bad headache between 3:00 and 4:00 in the afternoon. The suspicion is that it is due to eye strain as my vision has to re-adjust to being in balance once again.

I can now get out of bed without feeling like I am immediately going to fall over. I am able to shampoo my hair without holding on to the wall and keeping my eyes open. I no longer get disoriented in shopping malls or stores. I can drive on the freeway without having a panic attack, and go over high bridges without being nauseous - however, I do get this weird feeling of anxiety in my chest waiting for what no longer happens to happen. When I stop the car at a stop sign/light, or to park, the vehicle doesn't feel as if it continuing to move forward. I can parallel park again. There is no longer any dizziness associated with my allergies, heat or movement. Elevators and escalators done bother me much at all now. I don't lose my balance in the dark - or feel as if I am spinning while laying in bed. In fact, my night blindness issues seem to have gone away. I recently drove at night - for the first time in about five years - and could see very clearly. I no longer feel as if I am trapped in my own house - because, in the past, I never knew what might happen in regards to the vertigo (or panic attacks) if I went out into the world.

I have more energy than I've had in years. I've also lost just over five pounds this past month - probably because I can get up and move around much more without fear of falling over.

In the past, traveling has been a bit of a challenge due to the vertigo - but I never let it stop me completely from one of my greatest pleasures. I suppose I am feeling a bit of anxiety today as we leave for Italy for two weeks. Hopefully the trip will be one great dizzy-free adventure.

I have my life back. I actually sat down one day and wrote a thank you note to my doctor for giving me life back through his treatments. I was so lucky to be a patient of one of the leading experts on vertigo - and to have him be here in Portland.

How my partner Ed put up with me the past three years, I do not know. I suppose it would be best if I didn't question it, and was just grateful that he did.

© 2007 Jeff Fisher LogoMotives

The vertigo disappears...

...and Dr. John Epley thinks I may be cured.

Here's the text of an email I just out to friends and family in regards to my vertigo issues of the past three years or more.:

It's been interesting since I had my last treatment at Dr. Epley's clinic. Initial numbness in my face, and an intense headache went away after about a day and a half. I continue to have clear vision at night for the first time in years - but have yet to try driving in the dark. For about a week and a half, my left eye continued to feel strained as if it was constantly pulling to right - and it has continued to do so a bit since my initial treatment.

I've experienced much less dizziness, but tend to be a bit more out of balance (or just more aware of the imbalance). I've been catching myself almost falling quite a few times. Still, I'm much less dizzy when shampooing my hair, being on stairs, driving and participating in other activities. I also have not been bouncing off corners of walls, and door jambs, as in the past. (No more bruised arms or shoulders)

During six days of camping in the Wallowa Mountains I found that altitude, allergies, heat and movement were not causing me to be as dizzy as in the past. In the past I would not have been able to ride in the back of our camping van without experiencing a great deal of nausea. Coming home on the freeway this past week I had little dizziness and no nausea.

I've actually been feeling the best I've felt in the past three years.

In the morning yesterday I was driving near our house, and with a MAX light rail train moving to my left and a truck moving to my right I felt no vertigo or nausea for the first time in years. The best thing was that when the truck came to a stop at stop lights and signs I actually felt as if I was stationary, rather than sensing I was out of control and still moving into the intersections.

Yesterday afternoon, I had my second treatment in Dr. Epley's Omniax chair. After strapping me in, Dr. Epley began the chair's series of positioning movements. It seems my left eye was still looking off to the left some, rather than looking straight ahead as requested. However, I experienced almost none of the sensation of seeming to rotate counterclock-wise that I experienced previously while wearing the infra-red googles and being in the dark as I was treated with the chair.. There was one moment when I felt as if I was on a State Fair ride I should not have tried - and I didn't like being turned completely upside-down any more than before.

When I was brought back up into an upright position I felt no vertigo or dizziness - although I was a little disoriented. Dr. Epley said, that after the initial effects of the treatment wear off, he feels as if my vertigo has been cured - and my night vision issues may have been eliminated in the process. I'm to keep a journal of any vertigo or dizzy episodes that may occur and inform the clinic. I've also been instructed to avoid moving too fast or turning my head real quickly for a while.

As I left the clinic I was told, "It's been very nice getting to know, and working with, you - but we hope to never see you again."

I felt a little odd walking down the street to meet Ed at a nearby coffeeshop. I was surprised at experiencing a some level of emotion as I realized my three years of dealing with vertigo may be a thing of the past. I have my life back.

On the way home we stopped at a large Fred Meyer grocery/department store. For the first time in a long time I felt no anxiety, or the sense of an oncoming panic attack in a large store. There was no disorientation due to the lights, colors, noise and large number of people. I was totally exhausted when we got home. The treatment experience takes a lot out of you.

Today I feel a bit like I've had some kind of accident. I'm just a little "scrambled." The left side of my face is numb and tingly again - but I know that will go away. I do have the splitting headache again as well. My left eye feels very strained once more. Still, I've experienced no vertigo or dizziness since getting home yesterday. It really is amazing - and exciting!

Thank you so much to everyone who has supported, and put up with, me the last three years. Most of all, thanks to Dr. John Epley and his incredible staff - they are miracle workers!

© 2007 Jeff Fisher LogoMotives

I'm not so dizzy...after being sent to "the chair"

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...

© 2007 Jeff Fisher LogoMotives

I'm so dizzy... (another update)

Last week I posted an entry about my first series of medical tests in regards to my ongoing vertigo issues. I just wanted to update people after the second round of tests at Dr. Epley's clinic on Wednesday. The following is the email I sent to friends and family yeasterday:

I feel a bit wobbly, and in a fog, today after the second round of vertigo testing yesterday. I had a videonystagmography (VNG) test yesterday - and it was an interesting "ride." The test determines if there are problems with the balance system in the inner ear by measuring eye movements, which are recorded by an infrared camera mounted in a pair of goggles. Disturbances in the balance system may cause involuntary eye movements called nystagmus.

The first stage of the exam involved remaining stationery while following vertical and horizontal light movements on a screen with my eyes. Just keeping my eyes open long enough for the proper recording of information (30+ seconds) was difficult and the faster the speed of the light on the screen caused me to be dizzy.

The second part of the test involved shaking my head back and forth at a variety of speeds while keeping my eyes open and focused on a stationery light. There were four levels of speed at which I needed to shake my head - and I really couldn't do it quick enough at the fastest light speed. In fact, I started feeling nauseous.

In the third part of the exam I had to move around in various positions, with the examination chair position changed a couple times, in the complete darkness of the goggles, while my eye movements were recorded. When I was still on the chair it felt as if it was spinning counter-clockwise.

In the fourth test, the "calorics," small balloons were inserted into my ear canal, and cool and warm water inflated the balloon (ouch!) and was circulated through the balloon. In the darkness of the goggles I had to keep my eyes open as long as possible while my reactions to a bright green light was recorded. Again, when done it felt as if the chair was spinning.

At the completion of the tests I felt really disoriented and dizzy. The times I experienced complete darkness with the goggles seemed to cause the most issues with my balance. (No night driving for me) I also kind of felt as if I was on the verge of a panic attack. I couldn't get out of the doctor's clinic fast enough to wait on a park bench outside for my partner Ed to pick me up.

When I got home I was exhausted and went directly to bed. After sleeping for about 1.5 hours I got up to dizziness and the left side of my face being swollen, tingling and numb. Today I woke up to feeling dizzy and in a fog - and I knew better than to even attempt driving a car anywhere. Over the course of the morning my face has gotten increasingly numb and tingling.

I called the clinic about the numbness and Dr. Epley said that with some patients the testing causes inflammation and swelling in the ear and head. I'm now being put on a five-day course of methylprednisolone to relieve the inflammation, swelling and related symptoms. Luckily, I can just walk over to the drugstore to pick up the prescription. Of course, the drug has a wide variety of side effects - including vertigo!

This stuff is all kind of a P.I.T.A., but I told Ed that I really am feeling the best I've felt in years - simply because I feel like I'm doing something positive about the problems and finding a possible solution.

Next Thursday I go back to the clinic for another consultation with Dr. Epley, where the testing results will be reviewed and possible treatments will be discussed. At that time I will also most likely get to go for a ride in Dr. Epley's Omniax chair.

It's been three years since my vertigo issues began. Yesterday I was told that the average patient has experienced vertigo for eight years before getting to where I am today with diagnosis and possible treatment. I think I'd go crazy if I had to deal with this for that long.

Thanks for all your support. Thanks also to Lisa Horne and Ed for being my personal chauffeurs.

I will keep you posted as things progress....

© 2007 Jeff Fisher LogoMotives

I'm so dizzy... (an update)

...my head is spinning...

Many people know that I have been experiencing serious vertigo for over three years now. Over that time my issues with vertigo, dizziness, panic attacks and more have increased a great deal. I first wrote about it on bLog-oMotives this past January after reading about one of the leading specialists on vertigo, Dr. John Epley, in our local newspaper. Dr. Epley's clinic is here in Portland. I promised my partner Ed that when I was done writing my latest book I would contact the clinic and begin the process of diagnosis - and hopefully treatment for the condition.

When I initially contacted the clinic, I was told that it would be several months before I could have a consultation and be tested. It actually turned out that I could be seen as a patient over a month sooner that expected. This past week I had my first appointment. The following is the text of a forum posting, and email sent to family and friends, from this past Friday about that experience:
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"Still feel kind of out of it after my vertigo testing experience yesterday. This morning it feels like my head has been shaken repeatedly by someone.

The major first portion of my appointment was an interview about my medical history and the past three years of vertigo experiences. The doctor wanted information about head injuries I've had in my lifetime (a fall when I was 11, a car accident in college and our car accident about 11 years ago). I guess that sometimes old accidents can manifest themselves years later as inner ear problems. I had to detail any surgeries I'd had over the years and medications I had taken. My experience with Cipro destroying ALL the bacteria in my body about six years ago, after picking up a "bug" on our travels, was detailed as it may have impacted good bacteria in my ears. I was asked a lot about my heart attack/stroke scare two years ago - which may have been somehow related to my vertigo issues. I also had to explain in detail how at times it feels that I am moving while everything around me is standing still - while the opposite is actually reality. My fairly recent panic attacks - two while in stores and two while driving - where also topics of many questions. We went into a great deal of detail how my allergies, heat, movement, high pitched noises, colors (yellow and orange) and altitude impact my dizziness and vertigo.

Then I went through some extensive hearing tests. These are the hearing tests, in the soundproof booth, that we had as a kid - except that I could hear a constant high-pitched sound from something in the electrical system. Some of the tones emitted actually caused sharp pains in my ears. The test results ended up showing that I had absolutely no hearing loss - a great thing for "someone of my age."

The next series of tests was to test the ability of my eardrums to withstand pressure. Again, some of the tests were incredibly painful. Twice the equipment shut down automatically and the audiologist said I must have some weird electrical energy in my body, as that never happens.

The next series of test almost made me ill - and I'm glad there are no photos of the process. I had to put on a vest and harness, which was then hooked up to a system that would keep me from falling, and stand on a pressure-sensitive platform in a three-sided booth. I imagine I kind of looked like a human marionette. Staring at the back wall, the platform was moved in a variety of directions. The same was then done with my eyes closed. In next procedure the walls were moved repeatedly and the platform remained steady - eye open and eyes closed. This was done again with the platform AND walls moving (almost making me sick). The eyes open and eyes closed thing was then done tipping the platform backwards violently and forwards in the same manner. Numerous times during the testing I had to grab the straps of the harness to keep myself from falling - although I wouldn't really have fallen. When all was done I still felt like I was moving for a couple hours afterwards. It's a good thing they have handrails in the hallways of the office. On these tests I scored a 60, when a 70 is "normal" for "someone of my age." The tester explained that this indicates that there really is something going on - and it's not all in my head (although it is all in my head). When I asked a woman about the test score later, with a smile she said "it means you're not normal."

Dr. Epley, one of the leading vertigo specialists in the U.S., then interviewed me himself, clarifying and asking questions about a lot of the earlier answers I had given. I immediately liked this man. He was very conversational, engaging and asked a lot about my work as a designer and a writer, in addition to the requests for medical information. He was also curious about how acupuncture and chiropractic treatments has alleviated some of my vertigo symptoms over the past three years. He also did a series of examinations and additional basic balance tests - like having me walk down the hall with my eyes closed. It was then back to the harness apparatus for tests on how sound and air pressure impacted the movement in my eyes. I had to wear what they called "field glasses" (actually a camera that looked like binoculars) that filmed my eye movements as high-pitched sounds were piped into some headphones. Another headset was then used to force air into my ear canals as the camera recorded my eye reactions.

When done the doctor said he suspects I have a condition called "hyperactive labyrinthine dysfunction" - a condition in which an ear labyrinth is in an abnormally sensitive state with respect to certain stimuli and/or inputs. (More appropriately called "irritable labyrinth", in that the labyrinth becomes easily "irritated" by non-vestibular stimuli such as sound or pressure change). However, he said much more testing is necessary before a possible treatment can be recommended. So, next Wednesday afternoon I will go through a more testing - including a video stimuli test and possible tests in the Omniax "chair" that Dr. Epley has developed.

I was so exhausted when I got home that I slept 2+ hours yesterday afternoon. Today I feel as if I'm in a fog or almost moving in slow-motion. At least the process has begun and, after all this time, I know I'm not completely crazy in regards to my health issues."
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Over the past weekend I continued to feel the effects of some of the testing. I do go back to the clinic on Wednesday afternoon for additional tests. Then next week I have a review of all the test results with Dr. Epley. Hopefully those findings will lead to some treatment for my vertigo issues.

© 2007 Jeff Fisher LogoMotives

I'm so dizzy...but hopefully not forever

Many bLog-oMotives readers are aware of the fact that I have been dealing with vertigo since being diagnosed with an inner ear virus about two and half years ago. A couple months after having the virus I literally just fell over in the shower one morning, breaking several ribs in the process. I knew I hadn't slipped - I simply fell over.

Since that time I've had many issues with the vertigo. I have difficulty driving over bridges without feeling nauseous, heights of any kind are not my friend, and I've developed agoraphobia when it comes to being in large groups or public places where visual over-stimulation is a possibility. Watching some television shows or movies will cause me to feel ill. At times it's difficult to work while being dizzy and sitting at a computer for a number of hours. When driving and coming to a halt at a stoplight, or stop sign, I usually have the sensation that the car is still moving. Many times I've reached for the emergency brake to stop a vehicle that is actually not moving. Twice recently, while driving on the freeway, I've had panic attacks - something I had never experienced before. This condition can be somewhat debilitating at times and frustrating because, as my doctor told me, I am a very healthy sick person.

The vertigo has been controlled a bit by medications (some which have the side effect of dizziness), ear candling, and acupuncture. My love of travel has not been hampered too much by my dizziness. With motion-sickness medications I have been able to travel in cars, planes and boats. On a recent crabbing trip I was fine on the boat having taking Meclizine, but visually my brain saw the body of water standing still and the land moving. I could not focus on the horizon at all. Actually being in water is very disorienting - I sometimes can't tell which way is up - so I have avoided swimming or snorkeling.

For some this condition just disappears one day with no known or reasonable explanation. However, I recently talked to a woman who has been dealing with chronic vertigo for over 30 years. I know I don't want to lead that life.

Over that past couple years I've heard of a local doctor who has dealt with this issue successfully with many patients. This past Sunday our local newspaper, The Oregonian, had a lengthy article about Dr. John Epley and his work with those dealing with vertigo. Dr. Epley has developed a treatment, known as "The Epley Maneuvers," that repositions chalk-like particles collecting in the fluid-filled canals of the inner ear, and it seems to eliminate the false sensations of movement. Several alternative medicine professionals have suggested that perhaps the "crystals" in my inner ear need to be realigned - so this does make sense to me. Epley's own invention, the Omniax chair, is used to tilt and rotate the patient in a precise sequence of moves and the newspaper's website has a video demonstration of the equipment.

As I told my partner Ed, I'm willing to try anything at this point. Hopefully, I'll soon be able to get on the schedule for an initial consultation with the clinic to see if I qualify for the treatment. It would be so nice to no longer feel as if I was just going to fall over all the time.

© 2006 Jeff Fisher LogoMotives