Diana's vertigo

posted by Jeff | Tuesday, October 21, 2008, 9:31 PM | comments: 9

Diana has had a two shitty weeks now dealing with her vertigo issues. It really scares the shit out of me because no matter what the popular medicine says, namely that this sort of thing is caused by inner-ear problems, you can't help but wonder if it's something really wrong with the brain.

Diana has missed some work, slept in all kinds of strange positions, has only been able to drive her car once in the last two weeks, and is generally not able to be herself. Fortunately her doctor was able to refer her to the absolute right genius doctor at the Cleveland Clinic, and with great urgency we got to see him this afternoon. The alternative was December, which would not be acceptable.

She spent an hour with the doctor, who spent probably a half-hour just getting her history with the symptoms. The worst it ever got was several years ago while in Florida when she could barely crawl around and was throwing up and a total mess. I couldn't believe how much data he wanted, but like some TV medical drama, he was able to put it all together after doing a great many diagnostic exercises, poking her with sharp things, putting a tuning fork on her head and manipulating her head all over the place.

The diagnosis was not simple, and that's what makes this guy a fucking genius. First off, everything points to some kind of viral damage to her left ear, resulting in a condition called Benign Paroxysmal Positional Vertigo (BPPV). Different people at different ages and a bazillion other variables lose small fragments of calcium carbonate crystals that start to float around in the ear canals. Depending on the position of the head relative to gravity, these tiny crystals, or stones as the doc called them, stimulate the nerved endings that normally sense fluid motion to help you balance. The problem is that it's counter to what your other senses are taking in, confusing your brain, and making you one dizzy bastard. I can't even imagine how frightening that could be.

That in itself is treated with "particle repositioning therapy," which for most people, given the placement of where the crystals are trapped, means a whole lot of not lying down until the crystals land in a place where they can gradually dissolve over time without causing any further problems. This means that Diana can't sleep flat for the next two nights, which sucks. She'll have to do it in her favorite chair, upright.

Like I said, this guy is a genius because he put together other, seemingly non-related symptoms that confirm the diagnosis as well as address other problems. For as long as I've known Diana, she's had issues with neck and shoulder pain, which she attributed to sleeping funny. I doubt there's a person in the world who would ever think it was anything else. Her headache issues she has largely attributed to allergies. However, while not a popular medical opinion, but not fringe science either, the doctor strongly believes that the brain and the body compensate for more minor BPPV symptoms by trying to orient the body in a way that minimizes the imbalance. In Diana's case, it's accomplished by repositioning the head a certain way. Of course, the body is only built to carry the weight of your head one way, so this can cause muscles and bones to do all kinds of ugly things that cause pain.

The disorientation from the vertigo, combined with muscles pulling on her neck and head in unnatural ways cause headaches, while stress and computer screens (and apparently trying to sleep facing me!) further aggravate each other. So all of these symptoms appear to be inter-related, and need to be treated as such. She has to see a physical therapist to start working her neck and shoulder into a more natural position.

This is all ridiculously inconvenient for her, but we could only leave the clinic feeling like, "Holy shit, that guy was awesome." He added up so many things, explained the science, and figured it out in a way that wasn't simplified just to get us out of there. Most importantly, Diana has reason to hope this will be taken care of, and she can get back to driving, playing tennis, sleeping normally, and hopefully even address her muscle pain and headaches. And in the short-term, hopefully she'll be in good shape for our vacation, as she really has her eye on those tea cups!

I've had a lot on my mind lately, and this thing has been one of the things that trouble me. I was very happy to be there today, and I hope this treatment gets my redhead back to normal.



October 22, 2008, 1:43 AM #

I truly believe the Cleveland Clinic is the most amazing hospital in the world. My hematologist there is the most wonderful person, and truly the best, most caring doctor I have ever met. He too spent more than an hour with me and my family on our first visit. We came in thinking I would need chemo and surgery and left with much more hope and positivity, and we found a way to address my illness that did not involve surgery. And you KNOW the clinic has saved Michelle's life over and over again. I am so glad you guys found some peace of mind and someone you can trust - sounds like you're on the right track and I hope she feels better soon!


October 22, 2008, 2:26 AM #

Cleveland Clinic FTW again!!!!!!!1111

Sorry. Obviously I am also a big fan of the place. I think what struck me most about the first meeting with my surgeon was the way he planted questions in my mind for me to chew on. He came into the room, told me he had read my entire history, told me it was time for surgery, and then wouldn't let me say much in protest.

Rather than let me justify why things "weren't that bad," to him, he said, "Let me ask you a couple of questions. I don't want you to answer them right now. I want you to go home and think about them." Doctors in the past had always told me that my quality of life sucked worse than I realized and the UC was ruling over everything I should be enjoying...blah, blah, blah. It's easy to brush all of that off.

The first thing he said to me when I went back for my pre-op appointment was, "I expected to see you again. You're a bright young man and you knew the right answers all along." His letting me come to my own conclusions allowed me to feel as thoughI had control over making a decision to a problem that really only had one solution.


October 22, 2008, 4:46 AM #

Wow, it's weird to hear that you have faith in doctors!

I can't believe how crazy it must be for Diana to feel like that and even weirder to think that her body subconsciously tries to "correct" it when she's sleeping. I really hope that things get better for the both of you. Diana's too cool to have stuff like this fuck with her :(.


October 22, 2008, 5:22 AM #

I am so glad you and Diana were able to get to one of the many great MD's in the Cleveland Medical community and particularly Cleveland Clinic. I know personally, having experienced both, that few things in life are scarier than an unknown possible threat to your or a loved one's health and well being. Just understanding the problem goes a long way to bring comfort, but learning that the condition is treatable is a blessing beyond words. Both of you, keep your eye on the Mouse and enjoy.


October 22, 2008, 7:48 AM #

You guys are lucky. The Cleveland clinic would let me die before they even asked me my name!


October 22, 2008, 1:08 PM #

I know people who have traveled from Michigan to the Cleveland Clinic, so I've heard good things about the hospital and docs there.

I'm glad this guy figured things out for Diana and hope he can clear this thing up.

Are those crystals something that will continue to form? Or once they are repositioned and dissolved will that take care of things once and for all?


October 22, 2008, 2:30 PM #

It's likely to occur again, every couple of years. But knowing how to deal with it makes a big difference, so you aren't unknowingly prolonging it.


November 1, 2008, 12:32 AM #

What about a bit of chiropractic therapy once a month or so--would that help prevent it or is the return inevitable?

Great post. It's a hell of a thing to watch someone you love go through something like that and have a limit on what you can do, but you have to believe that being there with you through this and just about everything else has made an unbelievable difference in everything about her life.

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