About 20% of all dizziness and 50% of all dizziness in older people is due to Benign Paroxysmal Positional Vertigo (BPPV). The symptoms of BPPV include dizziness or vertigo (spinning), imbalance, nausea, or lightheadedness with movement of the head. Many patients will tell me that they simply rolled over in bed or leaned their heads back and began to experience dizziness. The symptoms can last for a long time or they can come and go in short durations. The most common cause is head trauma, but much of the time there is no known cause.
In BPPV, the dizziness is thought to be due to the collection of debris or calcium carbonate crystals which form a plug in the inner ear canals. The calcium plugs don’t allow for the normal movement of fluid in the inner ear and the result is the sensation of spinning. This can be terrifying to someone to say the least. Imagine spinning around several times and having that feeling 24 hours a day!
The solution for this particular type of vertigo can be very simple and effective. Basically a practitioner places an infrared camera over the patients’ eyes and leans them back with their head off the table. If the person has true BPPV, the eyes will jump back and forth (nystagmus). This test is called the Dix Hallpike test. The procedure to move the calcium out of the canal is called the Epely Maneuver and can be performed right then in the office. Basically, the practitioner brings the patient backwards with their head back and observes their eyes with the camera. The patient is then rolled to one side slowly while the practitioner watches the eyes. When the nystagmus is reduced, they are rolled further, finally to a seated position. The patient then has to be careful to not lean their head back farther than 45 degrees for about 48 hours. This is usually a small price to pay for the benefits of the canal repositioning. Research has shown that the Epley Maneuver/Canal Repositioning is effective in about 80% of people with BPPV (Herdman et al, 1993). Please check out this website that does a great job of explaining the cause and treatments for BPPV: http://www.tchain.com/otoneurology/disorders/bppv/bppv.html
Also, the Vestibular Disorders Association has a list of practitioners around the country who perform canal repositioning maneuvers and is a great resource for those suffering from dizziness/vertigo. www.vestibular.org.
~ Dr. Reynolds
Showing posts with label Holistic. Show all posts
Showing posts with label Holistic. Show all posts
Sunday, September 13, 2009
Wednesday, August 19, 2009
Departures, Arrivals, and Healthcare Reform
It’s been an interesting summer watching the healthcare debate and trying to obtain sound, rational advice from different sources to decide which way to go on healthcare. You may have noticed there are people who are strongly against an overhaul of our healthcare system. Our healthcare system is full of high tech gadgets, machines that go “bing” and tests, tests, and more tests. There are lifesaving procedures, procedures to clean out arteries, not to mention the huge amount of prescription drugs that are given to reduce cholesterol, manage Diabetes, and the list goes on. Basically, if...sorry, when you get sick...(you’re supposed to get sick you know..it’s “normal.”) When you do, don’t worry, there are the contrivances to save you.
I was recently in the Orlando airport and looking for something to eat. I didn’t have a lot of time, so decided on a healthy smoothie from a place with a sign that said “healthy choices” including salads, fresh fruit, etc. I looked around and there were several places advertising their healthy menus…no lines, yippee! I can remember just a few years ago where airport food was considered 3 rungs below the average menu at a fraternity house. I was pleasantly surprised that airport food has come along way. I couldn’t help but notice that there was hardly anyone at these places. I felt free to shop around and made my smoothie choice after perusing the assortment of salads, wraps, whole wheat turkey paninis, and fresh fruit. I wasn’t starving, but wanted something to tie me over for the 2 hour flight. The one or two employees actually looked eager to help me and provide me with service. They looked down right lonely. We partook in small talk, weather, what a beautiful airport, etc. The lack of activity around the restaurant lulled me into a peacefulness that I almost forgot that I should be getting to my gate for my flight. Did I hear a cricket?
I purchased my Acai, blueberry, almond, banana smoothie and bag of almonds which were both delicious I might add and made my way to my gate. I noticed ahead of me a large gathering of people and noise, and lots of red and yellow colors. Was there an accident? No..it was..McDonalds. It was like coming out of a spa after a massage and walking onto the floor of the New York Stock Exchange. There were 5 registers manned with exhausted looking employees all in matching uniforms reminding me of a military battalion. Each line was 6-8 customers deep, who were staring as if hypnotized by the pictures of awesomeness at the menu above. There was a flurry of activity behind the counter as managers (3) shouted orders while one manned the fry station in place of an employee wrapped up in other business down the aisle. Employees ran around whipping out food on trays and narrowly dodged each other in an effort to shovel the product to the waiting masses. They looked overwhelmed. Did I hear a manager yell “broken arrow!”? No, just my imagination.
At the tables in front children ran around while mothers yelled, cell phones rang, people conversed, laughed. People, people, and more people! This is where the party is! There was a plethora of activity. For a split second I wanted to be apart of this gathering. The red and yellow colors made me feel anxious, like I “needed something.” I thought there might be time for a..quarter pound...no...must...pull...away. Childhood memories came flooding back: The Hamburglar, Ronald, Saturday morning cartoons, birthday parties. Party! I’m in line now. What will I order? Must figure out now! Time is short! Yellow, red...screaming, adrenaline! Then, a thought popped in my head. I was dressed in a gown sitting on a table covered with paper and being told: “I’m sorry, with what you have…the machines can’t help you.” I slowly gathered my strength and extracted myself from the frenzied vortex of sensory stimulation of cooking meat, pictures of perfect burgers, and fries..ah…fries, apple pies...OMG they brought the McRib back!!? The cold smoothie in my hand brought me to consciousness. Pull away...pull away now!
I sipped on my smoothie for strength and tried to counter act the seductive thoughts of naughtier delights by focusing on antioxidants. I’m going to feel good. I stepped out of the line with defiance. “This smoothie is great!” I said loudly so that all around could hear me in an effort to save others. No one heard me. Too late...they were all mesmerized by the MENU. Gone, with no antioxidants in hand, they didn’t have a chance.
I got to my gate in time with a sense of accomplishment and survival. I’m pleased that in 2009, there are places to choose from in an airport. I didn’t have to feel like there was one agency forcing me to eat junk food like in past where choice meant sick, sicker, or “Pepto won’t touch this.” I’m grateful to have a choice. I’m lovin it!
~Dr. Reynolds
I was recently in the Orlando airport and looking for something to eat. I didn’t have a lot of time, so decided on a healthy smoothie from a place with a sign that said “healthy choices” including salads, fresh fruit, etc. I looked around and there were several places advertising their healthy menus…no lines, yippee! I can remember just a few years ago where airport food was considered 3 rungs below the average menu at a fraternity house. I was pleasantly surprised that airport food has come along way. I couldn’t help but notice that there was hardly anyone at these places. I felt free to shop around and made my smoothie choice after perusing the assortment of salads, wraps, whole wheat turkey paninis, and fresh fruit. I wasn’t starving, but wanted something to tie me over for the 2 hour flight. The one or two employees actually looked eager to help me and provide me with service. They looked down right lonely. We partook in small talk, weather, what a beautiful airport, etc. The lack of activity around the restaurant lulled me into a peacefulness that I almost forgot that I should be getting to my gate for my flight. Did I hear a cricket?
I purchased my Acai, blueberry, almond, banana smoothie and bag of almonds which were both delicious I might add and made my way to my gate. I noticed ahead of me a large gathering of people and noise, and lots of red and yellow colors. Was there an accident? No..it was..McDonalds. It was like coming out of a spa after a massage and walking onto the floor of the New York Stock Exchange. There were 5 registers manned with exhausted looking employees all in matching uniforms reminding me of a military battalion. Each line was 6-8 customers deep, who were staring as if hypnotized by the pictures of awesomeness at the menu above. There was a flurry of activity behind the counter as managers (3) shouted orders while one manned the fry station in place of an employee wrapped up in other business down the aisle. Employees ran around whipping out food on trays and narrowly dodged each other in an effort to shovel the product to the waiting masses. They looked overwhelmed. Did I hear a manager yell “broken arrow!”? No, just my imagination.
At the tables in front children ran around while mothers yelled, cell phones rang, people conversed, laughed. People, people, and more people! This is where the party is! There was a plethora of activity. For a split second I wanted to be apart of this gathering. The red and yellow colors made me feel anxious, like I “needed something.” I thought there might be time for a..quarter pound...no...must...pull...away. Childhood memories came flooding back: The Hamburglar, Ronald, Saturday morning cartoons, birthday parties. Party! I’m in line now. What will I order? Must figure out now! Time is short! Yellow, red...screaming, adrenaline! Then, a thought popped in my head. I was dressed in a gown sitting on a table covered with paper and being told: “I’m sorry, with what you have…the machines can’t help you.” I slowly gathered my strength and extracted myself from the frenzied vortex of sensory stimulation of cooking meat, pictures of perfect burgers, and fries..ah…fries, apple pies...OMG they brought the McRib back!!? The cold smoothie in my hand brought me to consciousness. Pull away...pull away now!
I sipped on my smoothie for strength and tried to counter act the seductive thoughts of naughtier delights by focusing on antioxidants. I’m going to feel good. I stepped out of the line with defiance. “This smoothie is great!” I said loudly so that all around could hear me in an effort to save others. No one heard me. Too late...they were all mesmerized by the MENU. Gone, with no antioxidants in hand, they didn’t have a chance.
I got to my gate in time with a sense of accomplishment and survival. I’m pleased that in 2009, there are places to choose from in an airport. I didn’t have to feel like there was one agency forcing me to eat junk food like in past where choice meant sick, sicker, or “Pepto won’t touch this.” I’m grateful to have a choice. I’m lovin it!
~Dr. Reynolds
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