As the world turns

Posted by Joe Kirst, N.P.
December 24, 2015

ENTcanalithrepositioningprocedure6colOne of the more challenging aspects of working with patients with dizziness issues is trying to gain an understanding of what they are experiencing. “What do you feel when you have a dizzy spell?’’ This question often is met with a reply such as, “Mmm...sometimes, I spin, but sometimes I don’t. I just feel ‘off.’” Let’s face it, whether you feel a spinning sensation, a sense of imbalance, near fainting, a strange sensation within your head or a combination of any or all of these symptoms, it’s hard to put it into words.

It wasn’t until I recently experienced dizziness myself that I really appreciated this tall order. My experience began while bow hunting with a few of my compadres in Buffalo County. Awakening early in the morning getting ready for the trek up the mountain to the ridgetop, I grabbed my water bottle to take a drink. As I tipped my head back to take a swig, I experienced an immediate sense of spinning and imbalance. I didn’t fall, but I needed to take a few steps to keep on my feet. My eyes felt like they were being pulled off to the side, and it was hard to focus. I felt weird. My head just didn’t feel right, like it was being pulled to my left. Yuck! 

Knowing what I know about dizziness, I immediately thought it was loose crystals in one of my inner ears. A quick maneuver called Epley, also called the canalith repositioning procedure, actually made me feel mostly back to normal, and I made it from the hill to my stand. The Epley maneuver can be used by anyone to treat benign paroxysmal positional vertigo (BPPV), which causes dizziness when you move your head. The procedure consists of head maneuvers that move particles or crystals in your inner ear, which cause dizziness, to a part of your ear where they don't.

Unfortunately, the next morning, the same thing happened when I headed outside and happened to tip my head back to look at the incredible display of morning stars. This time though, the dizziness and whirling were more intense. I immediately felt hot, sweaty and a bit nauseated. I never did make it out hunting that morning. Since then, I have had a few bouts of dizziness — all head-movement provoked. I suspect the loose pieces of crystal aren’t yet reabsorbed, and thus, the symptoms sporadically appear.

All through this experience, I have thought of my patients and the questions I ask of them to describe their symptoms. I realize how difficult it is to describe what one is feeling when experiencing a bout of dizziness. Over time, as I have diagnosed, treated and counseled those with dizziness issues, I have gained a respect for the difficult task of trying to describe symptoms. I trust it will make me even more attuned to this tough task, and perhaps my experience will help me help patients describe their symptoms so an accurate diagnosis and treatment plan can be made.



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