When you deal with vertigo that is associated with BPPV, you will, at some point, hear about physical therapy and the Epley and Semont maneuvers. At first when you do visit a physical therapist, they will usually treat you with the Epley maneuver. If otoconia is stuck inside one of the inner ear semicircular canals, like in my case, they will attempt the Semont maneuver. A link I posted in my references list at the end of my diary posting, gives you a brief introduction to each presented by the University of Michigan. I actually felt relief to be recommended to a physical therapist by my ENT doctor who predicted my otoconia issue was in my right ear when in fact it was in my left ear. Though it is possible for BPPV to move from one ear to another or be experienced in both ears, it's rare for this condition to resolve on its own. After learning about what these maneuvers attempt to do, I began creating a daily schedule for myself. This way I don't forget to do the maneuvers on the days when I don't see my physical therapist. It's easier when someone does it for you, especially the Semont maneuver; so, I highly recommend seeking the help of trained physical therapists as they have the education on how to do these maneuvers properly. But there are alternatives for you in case you don't have medical insurance or simply you cannot move about. When you are incapacitated and dizziness alters your quality of life, you'll do anything you can to get better and overcome this balance problem. Here are some of the tips I want to share, things which have helped and help me.
#1 Tip: DRINKING ENOUGH WATER
According to the Center for Nursing & Rehabilitation "Dehydration may affect your organs and lead to kidney stones, cholesterol issues, constipation, and liver, joint, and muscle damage. Whether it is mild, moderate, or severe dehydration, the lost liquids in your body must be immediately replaced. Mild dehydration can make you feel tired, give you a headache, and affect your mood and focus. And when you push yourself hard at the gym, all that sweating actually lowers how much blood you have for a bit." It's very easy to forget to drink water. I used to be so bad at this myself. However, since I do sit at my desk every day working from home I make sure to put the bottle water in front me on my desk. This way, I don't forget. And I do this the night before, before I go to bed, so I ensure I don't forget to drink enough water the next day. The U.S. National Academies of Sciences, Engineering, and Medicine determined that an adequate daily fluid intake is: about 15.5 cups (3.7 liters) of fluids a day for men and about 11.5 cups (2.7 liters) of fluids a day for women. According to the Mayo Clinic, "about 20% of daily fluid intake usually comes from food." The standard you very likely heard about is to drink eight glasses of water a day. That's easy enough to remember, when you have the discipline and time to count but who ever really does that? For me, the easiest way was having one large 1.5L bottle of water on my desk. That is about 6.3 cups. It's not 8 cups but it's close enough. I also drink some hot tea and do juicing at home too, so that is plenty enough. Having the bottle water in front of me every day ensures I don't forget.
#2 Tip: WALKING
When you have dizziness, walking may not be an option for you. When you feel you are spinning and the room is spinning with you, you cannot very likely move at all. I know the horror of not being able to move. For someone like me who tends to be very active, being stuck to a bed or chair was dreadful. When I had vertigo, I could only lay in bed to get relief from dizziness. I told myself this is simply no way of life. But I realized I could still move my legs. So while laid down in bed, I started to lift my toes up and down soon enough lifting my legs up and down. It was limited exercise but better than nothing. Our bodies need movement. By the time I could get myself to a physical therapist, I could move on my own feet but still feeling dizzy, lightheaded, and at times nauseated. For the first time in three weeks, I actually started running a bit. I am not saying you should do that, not at all. You don't want to fall so depending on how bad the dizziness is do only that which is comfortable and safe. If you try walking, walk next to a rail or something you can hold yourself against but keep in mind that your dizziness' severity dictates what you should do or not do. Walking and standing exercises help, but if you have a good physical therapist, which I highly recommend, they will be a great support. On the days I don't go to physical therapy I do all of my exercises at home, including a 30 min walk. Experts indicate that walking can lower blood pressure, reduce the risk of chronic diseases, make your brain sharper, and improve your mood. In Harvard Health Publishing, walking is listed amongst one of the tools to reduce the risk of developing breast cancer, boost immune function, ease joint pain, and even reduce cravings. I know most people take a 30 minute lunch break and often times that is hardly 30 minutes because they are working most of that time while shoving bites of food in their mouths here and there or forget to eat entirely; thus breaks are crucial.
#3 Tip: EATING NUTRITIOUS MEALS
I cannot stress the importance of this enough. I am sure you are familiar with the saying, "You are what you read." Well, it's true. But you also are what you eat. The quinoa dish depicted here took me about 30 minutes to prepare at home. I definitely wouldn't have time enough to prepare it, eat it, and also take my lunchtime walk every day. So, I prepare in advance. I try to make enough for at least 2-3 days. Sometimes I make soups at home which last me up to 4-5 days. I refuse fructose syrup, white processed sugar or flour, canned or bottled juices, diet sodas, anything that contains aspartame and monosodium glutamate these last two which are excitotoxins. If you want to know what these are, do your research. Try to get most of your nutrition from fruits, vegetables, and antibiotic free meats if you do eat meat. Avoid fried foods as much as you can and try instead to boil, broil, bake, or steam. And I hate to say it but here it is, already prepared meals that come in fancy boxes for you to just heat up inside a microwave are dangerous if for no other reason because of the massive amounts of salt they contain. You want to eat food that has not been grown with chemical fertilizers, pesticides, herbicides as much as possible. And try to avoid foods which are bad for your stomach. I absolutely love cheese. Living without cheese for me, at first, felt like someone asking a monk to live without meditation. I love cheese! I could eat it every day! I always had it in my fridge and for me being I am from Europe not having cheese would seem abnormal. Despite all the good values found in cheese, like calcium, vitamins, etc., the amount of salt cheese contains alone makes it worrisome. I am not dairy intolerant; however, I just became way more disciplined about what dairy products I consume and how often and how much. One of the problems we have is not with what we eat as much as with how much we eat. A study I read suggests that we should stop eating by the time we are 80% full. Many people I know will eat until they are 110% full. We wait until we are "starving" and that is when we eat the most. So, what you eat and how much of it you eat both will have consequences. Like always, if you want to educate yourself about nutrition then you should read about it and learn what works for your body because everyone is slightly different.
#4 Tip: THE REAL STUFF
Real nutrition to me is going straight to the source. There is a reason why doctors recommend fruits and vegetables as part of your diet. Per an article by Harvard School of Public Health, "A diet rich in vegetables and fruits can lower blood pressure, reduce the risk of heart disease and stroke, prevent some types of cancer, lower risk of eye and digestive problems, and have a positive effect upon blood sugar, which can help keep appetite in check. Eating non-starchy vegetables and fruits like apples, pears, and green leafy vegetables may even promote weight loss. Their low glycemic loads prevent blood sugar spikes that can increase hunger." There is compelling evidence that a diet rich in fruits and vegetables can lower the risk of heart disease and stroke. Need I say more? I am not telling you to juice daily or often. Some of us don't have the time for it or don't want to deal with the cleanup or simply don't have a juicer. Plus, fruits do contain a lot of sugar already. But if you cannot juice then definitely eat the fruit itself. Nothing beats that! Instead of buying canned juices which are filtered, processed, and stored on shelves, for God knows only how long, I highly recommend the direct source.
#5 Tip: BREATHING DEEPLY IN NATURE
By breathing outside a little bit each day, you motivate yourself to go for a walk and also get some sunlight. As mentioned by Harvard Health, "The term 'fight or flight' is also known as the stress response. It's what the body does as it prepares to confront or avoid danger. When appropriately invoked, the stress response helps us rise to many challenges. But trouble starts when this response is constantly provoked by less momentous, day-to-day events, such as money woes, traffic jams, job worries, or relationship problems." Furthermore, "For many of us, deep breathing seems unnatural. There are several reasons for this. For one, body image has a negative impact on respiration in our culture. A flat stomach is considered attractive, so women (and men) tend to hold in their stomach muscles. This interferes with deep breathing and gradually makes shallow "chest breathing" seem normal, which increases tension and anxiety. Shallow breathing limits the diaphragm's range of motion. The lowest part of the lungs doesn't get a full share of oxygenated air. That can make you feel short of breath and anxious. Deep abdominal breathing encourages full oxygen exchange — that is, the beneficial trade of incoming oxygen for outgoing carbon dioxide. Not surprisingly, it can slow the heartbeat and lower or stabilize blood pressure." If you have dizziness, search for videos online for breathing exercises specific for vertigo. Do only what you can, avoiding any injuries or the worsening of your condition.
#6 Tip: STRETCHING, BALANCE, AND EPLEY MANEUVERS
Stretching brings relief to tensed-up muscle tissues. For those of us like me who work from home, sitting at a desk can put a lot of strain on your neck and back muscles. Stretching daily became a routine for me since BPPV and now I realize how much my body actually craves stretching. Sitting down for hours is simply not what we were designed to do, naturally. Our body craves movement. Walking provides a great way to provide movement so I make it my objective to get a 30 min walk every day, whenever I can. Anything is better than nothing but safety does come first. So, always practice caution. Thankfully, through persistence and daily routine I have improved by much in the last month. Don't become impatient if you don't get past it fast. It does take time and patience is key to seeing progress over time.
With a balance pad you can do the same exercises at home that your PT does with you. A balance pad is actually great even for people without balance problems. It helps strengthen muscles. When you do yoga exercises, these pads offer support to your body and joints. Having sufficient balance can improve a workout and also aid in specific areas such as strengthening core muscles and giving better support for more fluid movements that reduce the risk of injury. Balance training offers many benefits and one of those is improving posture. Poor posture is one of the biggest contributors to lower back pain and is often the result of weak back muscles. One of my dear friends recommended the Airex brand which is a very nice, quality pad that lasts a long time. There are also other brands more affordable you can find online and dozens of exercises you can find online as well. At home, I have been using a pillow instead of a pad at first. That works too, just not as good in my opinion.
If you live alone and you want to do the Epley maneuver at home, by yourself, this little gadget helps you do it accurately. It is called "Dizzy Fix" and it was invented by an ENT. I use it every day while I recover. The Epley maneuver is best performed by a trained professional, since they can hold your head while performing the maneuver. If you have a family member or loved one living with you, they can assist you too in completing the maneuvers. But for those of you who may be alone, this might be helpful. It helps me, not sure it would help others but it was better than nothing for me. It definitely helps guide me.
#7 Tip: STAYING FOCUSED ON THE POSITIVE
This is critical. You have to tune out all stress as much as you can. Negativity should simply have no room in your life while you recover from vertigo. I know with everything going on right now in the world, this is harder said than done these days. While I was having vertigo I could not do anything other than lay in bed on my back. I never felt so debilitated in my life before. And though my vertigo lasted only one day, light dizziness, lightheadedness, and occasionally the sensation of nausea have been my on-and-off symptoms since. I decided since I was able to sit in a chair that I will write my next book. I am grateful that I can do it because I realized how important this was to me. I read, write, and am grateful I can do the things I love. If the dizziness comes, I am prepared with the exercises I know now how to do and which I will do in order by the schedule I set up for myself. First, I do the Semont maneuver, then the Epley. Then, take lots of water, deep breaths, and I try the standing exercises on a flat and uneven surface like the pillow or balance pad. At lunch I will either do a 30 min walk or stretch. In my case, I cannot be more grateful for my physical therapists. They truly have been one great, big support. But if you cannot get yourself out of the home, don't have insurance, or simply cannot make it to a physical therapist for whatever reason, there are dozens of very useful free videos of exercises you can do for vertigo at home including but not limited to breathing techniques for vertigo. Take advantage of free videos and resources online. If you suffer today from BPPV or vertigo, regardless of whether it is related to BPPV or not, I pray for your smooth recovery.
NEVER GIVE UP HOPE
Carmen A. Cisnadean
Author, Artist, Poetess