Tag Archive: solutions


2017 was the first summer in 15 years that I didn’t ride my bike. My spouse and I were busy hiking, and September came and our bikes were still in storage.

2018 was almost the same, but we made an effort and managed to ride twice before Labor Day. I am still quite fearful on my bike. Getting rolling is hard for me. I think the trouble comes from looking straight down at the pedals to get my feet set and then looking up at the road before I begin to move, sometimes also swinging my head left and right to check for traffic. If I move my head too quickly, my balance feels scrambled. My solution is to wait a few beats after I look up and then start pedaling. Even so, my “takeoff” is still wobbly and nerve wracking.

Our first ride was in the small town/suburb were we live. We decided to bike a mile to a nearby park. The route required two right turns and had a sizable shoulder (ersatz bike lane), so it seemed like something I could easily do. It is still hard for me to check for traffic while riding and I can barely signal turns, so my spouse rides ahead of me to do these tasks for us both. (Same as in this 2014 post.) Even though this ride was short, I asked my spouse to ride slowly and stay with me. That made me feel a lot safer.

Our little jaunt around the corner to the park was terrifying for me. I actually talk out loud to myself as I ride in an attempt to calm myself down. I remind myself to breathe, to relax the muscles in my legs, to not deathgrip the handlebars. I repeat over and over, “You’re OK. Relax. You’re safe. There is plenty of room to ride here. You can always put your feet down and stop. Relax.” Yes, I say this out loud! Thankfully, the wind carries my voice away, and I don’t think my spouse notices.

Our second ride this summer was on a bike path that we know well. I feel safest cycling on bike paths, especially the ones that are flat and straight. (This one was hilly and curvy, but beautiful.) My spouse loves pedaling fast and picking up speed on the downhills (which scare me), while I prefer to go slow (even slower downhill) and ride my brakes. Our solution is for my spouse to bike as fast as they want and leave me in the dust, then wait at the major intersections so we can meet up and turn together. (Sometimes they bike back and join me.) This allows me to go at a slow pace that is comfortable and enjoyable.

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Bifocals

After about a year of “getting by” with deteriorating near vision, I finally went to the eye doctor and was not surprised to walk out with my first prescription for bifocals. I went to a local, privately-owned optical shop (i.e. not one of the big chains) so that I would have a maximum number of options and bells and whistles available to me.

Once I determined that my new prescription would work in my old frames, I spent thirty minutes discussing the lenses with the optician. I explained my past trouble with vertigo and my lazy eye (still somewhat lazy despite surgical correction) as well as current troubles with maintaining a turned position with my neck (long story; it’s better now than it used to be!). I was willing to order lenses with a visible straight line across them if that would be best for my body. Nowadays the line between the top and bottom of the lens can be made invisible, but this means that the areas where you can see clearly are circumscribed and do not extend from edge to edge across the lens. I was afraid that using the clear areas would have me holding my neck in an uncomfortable position.

The optician listened carefully and described my options. They placed opaque tape over the bottom part of my current pair of glasses to mimic the bifocal and then had me walk up and down a short set of stairs in the office. That was when I realized that vertigo would not be a problem for me. Having bad vertigo for so long made me more tolerant of not seeing and having mixed information come into my vestibular system, so having the stairs be a bit blurry was no big deal.

I opted for the lenses without the obvious line. Based on the work I do and my hobbies, as well as concerns I expressed about using bifocal lenses, the optician decided to increase the upper part of the lens by 1mm. This particular optical has a 90-day return policy, and the optician promised that if I hated the bifocals (or if they caused me pain in my neck), I could bring them back and they’d make me a pair with the visible line for free.

I’m happy to say that the glasses are working out fine. I adapted very quickly to them and have had no problems with my balance because of them.

Bowling

My workplace held its holiday party at a bowling alley this year — it was a lot of fun! I noticed, however, that the unique sequence of movements in combination with the lighting caused me to be a bit unsteady.

Lighting: We were “glow bowling,” which I though meant everything would be black lit with neon bowling pins, but in actuality it just meant that the lights over the lanes were dimmed and extra rows of colored and flashing lights made the ambiance festive.

Movements: I sat on a low bench watching my teammates bowl. I frequently looked up at the ceiling-mounted scoreboard. When it was my turn, I quickly glanced up at the board to confirm that I was next, then stood and walked to the ball return, looked down and bent over to get my ball, then turned and looked down the lane, ready to bowl.

Twice I tilted or stumbled as I rose from the bench. (This mortified me, since I was with coworkers, and my boss was on my team!) And more than once, I felt a little “off” as I readied to throw my ball. I believe this was due to the dim lighting over the lanes; after the sequence of movements that I followed to get to the head of the lane, my body needed to “reset” when I finally stood still, and the dim lighting meant that the visual input my vestibular system was processing was less sharp than usual.

Do over: Two weeks later, a friend had a bowling party for her birthday. I had no problems. Compared to the work party, these lanes were fully lit, and instead of sitting on a low bench to watch my teammates, I sat on a high stool or stood. I bowled a great game!

 

A family affair

One night a few weeks ago, my spouse awoke at 2:38 a.m. with vertigo. They tried to get up to go to the bathroom, felt the room spinning, and immediately lay back down flat on the bed, their hand scrabbling under the covers to grip my arm. Thus awakened, I asked questions to determine what was going on and then offered advice based on my many months with vertigo. What was frightening to my spouse was old-hat and not at all alarming to me, so I could offer some calming words.

  • I had them put their feet flat on the mattress as they lay there. This provides reliable data for the vestibular system and helps promote stability.
  • They told me that the spinning died down after a few minutes, and I reminded them that the same thing would happen with the spinning they experienced when they sat up. I encouraged them to sit up and then hang in there while the spinning subsided. (First I got a big bowl in case it was needed for nausea!)
  • After they sat up, I held their hand and helped them scoot back so their back was against the wall and then had them bend their knees so that their feet were once again flat on the mattress. This position has been very helpful for me when I am trying to help my body know where it is in space and the data from my eyes is unreliable.
  • I coached them as they got out of bed and moved carefully to the bathroom, suggesting that they put their hands on the door jambs and walls and that they not bend over.
  • I held their hand as they eased back into bed and waited for the spinning to stop.

In the morning, they felt better but not completely well, so I urged caution while exercising and while driving. I have found that if I modify my usual 30-minute exercise routine to accommodate any unsteadiness I feel, I usually feel close to normal by the end of it. Going through the motions and moving my body in a variety of ways seems to help recalibrate my vestibular system.

My spouse said they gained a new appreciation for what I went through during my many months with vertigo. They couldn’t imagine feeling “that way” for so long. Thankfully, their vertigo cleared up by the end of the day without treatment. Whew.

Boot camp graduate – sort of

Last month I decided to complete a self-designed Balance Boot Camp to fine tune my vestibular system. For two days I did the balance exercises that my vestibular physical therapist gave me two years ago, and in addition, I walked up and down stairs without using the walls or handrail. (Especially at home, this had become a bad habit.)

After two days, I saw improvement and totally slacked off on the exercises. So much for boot camp! All month I continued to use my eyes–instead of my hands–while walking up and down stairs. It feels dicey sometimes, and that’s how I know it is good for me to push my limits. I’ve been turning on the lights in the stairwell at home to help me be more safe and secure. I avoid walking indoors in dim light or darkness because that is when my eyes “check out” and I rely on my hands instead.

When I look back, I realize that I was running into the walls a lot during June. I was off balance to some extent every day. Now that it’s August, I am pleased that these modest efforts improved my balance.

 

Balance BOOT CAMP

I am embarking on a self-created balance boot camp–join me!

My BPPV has been very mild for about a year. The last notable “improvement” I can remember is 13-14 months ago when I began a workout program. I was laying down on my back to do exercises a few times a week, and each time I felt nauseous and the room spun briefly. As the weeks passed, though, my symptoms improved until I could lie down without any vestibular nonsense. Success!

Since then things have stayed pretty stable, which is to say that I have a vestibular issue at least once a week. These episodes are short-lived and mild and for the most part do not interfere with my daily life. (I believe this is true; I need to check my notes to be certain that I am not wearing my rose-colored glasses here.) Periodically my symptoms worsen while remaining mild. During these times I have mild symptoms several days in a row while my vestibular system is obviously trying to sort itself out.

For the past several months, though, the increased symptoms have been my norm. I have been careening into door jambs with some regularity, and I lose my balance around the house fairly often. I decided that since I have had no major flare-ups for a year, it is time to clean up this mess. I am headed to BOOT CAMP!

I have pulled out the exercises that my vestibular physical therapist gave me and will be doing them throughout the month of July. I will tune my vestibular system as finely as possible and reach my maximum ability–which I hope will be “normal” (but I’ll settle for as good as possible). Beyond the exercises, I’ll be challenging myself to walk down stairs without using the handrails (it is so easy to “check out” with my eyes if my hands are telling where I am in space) and looking for other ways in which I am cheating my vestibular system. Wish me luck!

Car sick

After months of very stable and very minor symptoms, I was surprised to experience several hours of nauseating vertigo symptoms earlier today. Contributing factors were a 30-minute yoga workout (even though I avoided problematic positions) and rushing around the house (i.e. eyes and body in constant motion) getting ready to leave. There was traffic, so my spouse’s driving was a bit on and off the accelerator. This taxed my vestibular system further, and I began to feel car sick for only the second time in my life. She took it easy at my request, and we ended up arriving on time for our engagement.

Within an hour, though, I felt nauseous even though I had been sitting still. I laid down to rest my body and then sat on the floor with my back against the wall and both feet flat on the ground. (This position provides a lot of input points for the vestibular system.) After another hour, I felt better, though it took more time to return to normal.

Monday, Monday…

So this morning I got out of bed and noticed right away that I had some vertigo going on. The best way to describe it is to say my eyes felt wobbly. To be honest, things have been a little worse lately, if I can even say that with my symptoms being so mild. Not long ago I was rejoicing in my ability to pull a sweatshirt over my head while walking down stairs (!!) and to duck laterally under a barrier at the airport in order to retrieve my dropped boarding pass. But recently I fell out of balance twice in one day, hit the wall in my stairwell a few times (always when I am turning the corner), and even took off my sunglasses before going down steps. Clearly my vestibular system was struggling.

I decided to try my exercise video this morning and to stop if I couldn’t do it. The routine starts with jogging in place, and I took one step and almost burst out laughing. There was no way I could jog! So I followed the “modifier” on the video and marched in place. I modified many of the moves and found that by the end of the video, I was nearly back to normal. It seems that 30 minutes of familiar, controlled, and constant movement was enough input for my vestibular system to get its groove back.

Update: I noticed a pattern of having vertigo on three of the past four Mondays. At first I thought: gee, am I that stressed out about going to work on Mondays?! But then I realized that I do a yoga exercise routine on Sundays, and in that routine I bend over and put my head straight down for at least 30 seconds. I think that is the problem. I have had this happen before where the trigger and the symptoms are separated by a day. (Lying down in bed seems to exacerbate things.) So  next Sunday I’ll not put my head in such extreme positions, and we’ll see how I feel on Monday.

Later update: it worked! I haven’t had any “Monday trouble” since modifying my Sunday yoga workout.

Return to cycling

Every summer, my wife and I take a day trip to a nearby state conservation area where we enjoy a beautiful three-mile bike trail. I’ve been trying to get back on my bike in preparation for a triathlon later this season, and this trail was going to be my first bike outing since last fall. Back then cycling was pretty scary for me. It took a lot of concentration, and since I couldn’t let go of the handlebars to signal, I had to stick with closed roads. It was stressful. It was not fun.

This spring I experimented with using adult training wheels on my bike for stability, and I tried different bike mirrors in an effort to eliminate the need to look over my left shoulder (turning my right ear down is a trigger for me). A few weeks ago I rode around in circles in a parking lot to see how I was doing. I was OK riding but had some trouble getting going, making sharp turns, and signaling. I hoped to practice more before our day trip, but I didn’t have a chance.

This past weekend was my test on the bike trail. It was awesome! I was steady but nervous on a short section of road we had to go on to reach the trail. My wife checked for traffic and told me when it was safe to turn left. On the trail I cruised along and eventually realized that I was biking without thinking about biking — just like before I got vertigo! I’ve always been cautious on downhills (I assumed it was due to a bad crash I had as a child, but maybe it is also the inner ear hypofunction), but otherwise I was confident and unconcerned. On the way back I road with traffic like a pro and even signaled a turn! It was amazing.

This demonstrates how far I’ve come. I’ve regained other skills recently such as drinking the dregs of my tea while walking to the sink, and staring at something over my left or right shoulder as I walk past it IN A STRAIGHT LINE. I went on a hike this weekend as well and discovered that I can hike without thinking about hiking. That is also a big difference! Sometimes my unsteadiness is quite subtle, but even if the adjustments I make are nearly unconscious, I always notice when the need to pay extra attention is gone.

This feels great, and I am so excited!

Return to ONE PILLOW

sleep_300px-Little_Nemo_1906-02-11_last_panelI have been sleeping up on two pillows for the better part of a year and half. Every time I tried to go down to one, my vertigo got worse, so I’ve stayed up–but my goal has been to get back down to one. I decided I would make my move after the Splash and Dash I participated in this summer. (I didn’t want to screw things up right before I was to swim in the ocean!)

I had hints that it might work out. First, last January I had an MRI and had absolutely no vertigo even though I was lying flat on the table. I was so surprised! And second, the vertigo and nystagmus that I have experienced nearly every night for the past 500 nights when I lie back in bed has gradually diminished. It was a curious process, as the nystagmus got very disorganized and weaker, symptoms came and went, very inconsistent. But lately I can lie back and feel nothing. Nothing at all. Novel!

I’ve been getting acupuncture to help manage my stress levels and occasionally to help with the nausea of vertigo. My acupuncturist has been very willing to work with me, for example, when I suggested doing habituation exercises (which are nausea-inducing) immediately before treatment. Likewise, she was game for me to experiment with one pillow during treatment. I lay on a table with only one…and it was fine. That night I went down to one pillow in bed. That was…weird. It felt very unfamiliar and as if my head was at a negative tilt, even though it was level. I was unsteady for a few days, but now I am sleeping on one pillow with no ill effects. It’s been such an easy transition that I am wondering if staying up for as long as I did was a mistake! Then again, the nightly vertigo was so nauseating and strong that I think I can forgive myself. Even my vestibular physical therapist thought I might never sleep on one pillow again. So we’ll see how it goes. Maybe I can put my extra pillow back in storage!