Tuesday, January 13, 2009

Who's down with BPPV?



Me, that's who. Benign paroxysmal positional vertigo is a condition in which the patient feels like they just stepped off the playground spinner, only the feeling doesn't go away. It makes it impossible to focus on anything, causes sea-sickness, and makes standing up difficult. It's caused when a calcium rock forms in the inner ear and finds its way into the semicircular canals that provide the body's sense of orientation. The treatment involves the Epley Maneuver: Imagine playing one of those handheld games where you navigate a ball through a maze by tilting the maze, only the maze is in 3D and the whole thing is inside your head.

I didn't know this yesterday morning when I woke up. All I knew is that I had trouble standing, and the world appeared to be spinning around me. After a few rounds of staggering to the bathroom to throw up I called Divers Alert Network (since I had been diving recently) and their on-call physician deduced that my symptoms were probably not symptoms of decompression sickness, but may have been symptoms of an inner-ear injury. I should get to a hospital emergency room as soon as possible.

With Tanya's help, I got cleaned up and took a taxi to the hospital. The triage nurse took my blood pressure, sitting and standing, and I guess she didn't like what she saw because I was very quickly sent to get a 12 point electrocardiogram. The ECG nurse asked me if I had a history of heart illness and sent me back to the waiting room.

After sitting in the waiting room with my eyes closed for some amount of time, the doctor called me in and did a neurological exam to see if my symptoms were an indicator of a stroke. After all that, she deduced that I had BPPV in my left ear, performed an Epley maneuver on me, gave me a script for some very strong anti-nausea medicine, and sent me home. I spent most of the day lying in bed with my eyes closed and after doing a couple of home Epley maneuvers on myself I was starting to feel better by about 10pm. This morning, after being careful to sleep on my right side I'm feeling much better.

All in all, considering what could have caused these symptoms, BPPV is probably the best possible outcome.

8 comments:

Chris said...

Sorry to read about the dizziness. Hopefully you won't be out of commission for too long. You must be somewhat better to make it through your longest blog without being overly nauseated all over the keyboard.

I prefer what I imagined from your description of the Epley Maneuver than how the links describe it. I was imaging you strapped into one of those 3D spinning chairs used by astronauts. Then the doctors and you would rotate the chair to navigate the rock through the labyrinth of ear canals until it fell out.

Look on the bright side; you've now got a doctor's note telling you to take your time getting out of bed.

Jit Bose said...

Sorry, man but it seems like you're feeling better which is great news. Does the Epley maneuver remove the calcium rock completely, i.e. it falls out of your ear? Are there any preventative measures you can take to stop the formation of these rocks?

Mike Just said...

Eeesh! What did I tell you about putting salt in your ear for fun? Just kidding. Hope you're feeling better. And no more scaring the bajeebers out of Tanya!

Unknown said...

Thanks for the well-wishes. After a couple of days of slight dizziness, it seems like I'm 100% again.

The rocks don't actually fall out of your ear (that would be cool though, and more reassuring). The Epley maneuver just moves them to a part of the inner that stores and removes garbage. After some time they should be completely gone.

Louise said...

Hi Pat
You don't know me but I just found your blog on googling "BPPV and diving". I've suffered from BPPV four times in the last few years, and am worried about whether I can dive again (just booked a long dive holiday for this year...). Can't find an answer on the internet. Do you happen to know the answer to that question?
Thanks!
Louise

Unknown said...

Hi Louise,

I'm not a medical doctor, but from all that I've read (and what doctors have told me) BPPV is not caused by nor aggravated by diving. For example:

Q: Will flying or swimming worsen my BPPV?

A: No. Flying can affect certain ear conditions which are pressure related. BPPV is not one of them.

It wouldn't be good if you suffered a bad case of vertigo while underwater, but I'd be more concerned about having a really bad case while, for example, driving on a highway.

Good luck,
Pat

Cousin Sue said...

The kids and I have been following you adventure and thoroughly enjoying it. Mom says Hi and take care of yourself. We didn't enjoy hearing that you weren't feeling well, but it sounds like you're coming around. Hope Tanya's feeling better too. Take Care

Icebreaker said...

Sorry to hear about your BPPV episode. I found your blog when I googled "Diving and BPPV". I'm a very active cold-water diver with about 75 dives a year, and I deal with BPPV a couple times a year. It never seems to be related to diving. It ALWAYS comes on first thing in the morning when I wake up, and never has it occurred during or after a dive. I think these crystals just work their way loose at random. Have you had any more episodes? I wind up doing the Epley maneuver whenever I get hit with an episode at home.