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Vertigo: More Than Just a Hitchcock Movie

While vertigo can be upsetting, it’s often not serious. Professionals weigh in on what to do to keep things nice and still.

By Michele Wojciechowski

I've seen Alfred Hitchock's "Vertigo" on the big screen a few times at a historic theater. But no matter how much the cinematographer spun the camera to give you the feeling of vertigo, it didn't even come close to how it actually feels. I know. I've experienced vertigo a few times.

It was scarier than Kim Novak's eyebrows.

Looking down the center of a spiral staircase. Next Avenue, vertigo signs symptoms, Meniere's disease
Credit: Faris Mohammed

Besides the room looking as though it was literally spinning, I completely lost my sense of balance. Thank goodness my husband was home, as he helped me to the bathroom, where I proceeded to get sick.

I had been seeing an ENT, which stands for "ear, nose, and throat"(apparently otorhinolaryngologist is too long for folks to say) for an inner ear problem. But I hadn't had vertigo before.

"Vision, inner ear function and sensation in our feet work together to let us know where we are in space. If any of these parts is not functioning well, we may experience poor balance, dizziness and vertigo."

After my doctor called in prescriptions to stop the vertigo and the accompanying nausea, the world looked normal again. I then went through a series of tests — a hearing test, an MRI and many others.

Once a number of conditions were ruled out, one thing was ruled in: I had atypical Meniere's disease — a somewhat mysterious condition that can cause vertigo, tinnitus and hearing loss.

Perhaps you've heard of it: Rocker and singer/songwriter Huey Lewis has Meniere's disease and now a few more people seem to know what it is. Mine was considering "atypical" since I wasn't experiencing flare-ups regularly.

When other treatments didn't seem to work, my ENT suggested I get a steroid shot in my ear drum (and before you freak out: it doesn't hurt). They numb the membrane that the needle passes through, but it doesn't actually stick into anything; it just deposits the steroid into the area. Research showed that it could help. I had tried everything else, so I went with it. I even wrote a humor column about the steroid shot.

The good news was that it worked.

I was in remission for 14 years. Until the coronavirus pandemic changed everything.

While I didn't get COVID-19, I was completely stressed out about it. Just before everything shut down, I woke up one morning with a sensation I hadn't felt in more than a decade.

I had vertigo… again.

Not the Cause, But the Symptom

If you're a fan of The Rocky Horror Picture Show, you may recall Tim Curry singing that he would remove "the cause, but not the symptom." And that's what vertigo is — it's a symptom of something else, which is why it's important to seek medical care and not ignore it.

"Vertigo can be a sign of more rare and serious conditions such as brain tumors, rare forms of neurological dysfunction or the onset of a stroke."

"Vertigo is part of a dizziness category, but more specifically a term used to describe the sensation of spinning," says Dallas Reynolds, district director and doctor of physical therapy at ATI Physical Therapy in Las Vegas. "A person can experience vertigo from many different causes, but the most common is Benign Paroxysmal Positional Vertigo (BPPV), a disorder of the inner ear — the balance portion of your ears."

It is caused, Reynolds said, "when the Otoconia, commonly known as the 'inner ear crystals,' dislodge off the walls of the inner ear and are floating freely. When BPPV is the cause of vertigo, symptoms are felt with head motion. This is common when lying in bed, getting your hair washed at the salon, or looking up."

While vertigo is rarely a sign of imminent danger, it's still important to get the cause diagnosed, says Joey Remenyi, an Australian vestibular audiologist, founder of Seeking Balance International and author of "Rock Steady: Healing Vertigo or Tinnitus with Neuroplasticity."

She explains: "Vertigo can be a sign of more rare and serious conditions such as brain tumors, rare forms of neurological dysfunction or the onset of a stroke."

If you have no other symptoms but vertigo, and mostly notice it when you move your head, Reynolds says, it can likely be resolved by visiting your physician or a physical therapist trained in the diagnosis and treatment of vestibular issues. You may then be asked to have tests done, which is what happened to me.

"A common test is the Dix-Hallpike test, where the patient is laid down rapidly, often with camera goggles on for better visual of the eyes. The provider is watching for specific eye motions called 'nystagmus' to diagnose the presence of BPPV," Reynolds says. "There are also tests that are performed to test inner ear and vestibular nerve function that can help diagnose other forms of vertigo other than the common BPPV."

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Stop the Whirl — You Wanna Get Off

Unless you want to feel like a whirling dervish for the rest of your life, seek help.

"Like a muscle, our vestibular system can become weak after experiencing illness that attacks this system or just over time with aging," Reynolds says. "Our vestibular system is our balance system and is a combination of vision, inner ear function and sensation in our feet. These three systems work together to let us know where we are in space. If any of these parts is not functioning well, we may experience poor balance, dizziness, and vertigo.

"One thing I can do to help prevent another episode is manage my stress. Since that could be what triggered it to return in the first place."

Reynolds goes on to say that, "Vestibular rehab works to strengthen these systems through specific exercises and working with a trained vestibular rehab specialist who will find what part of the system is weak and work to improve it."

Typically, she says, "change to the vestibular system doesn't happen overnight and may require several weeks of work, but the therapist will reassess along the way and keep you informed on your progress." Vestibular rehab has been shown to be very effective, Reynolds notes, and often, patients can see 100% improvement of symptoms.

Since I have Meniere's disease, vestibular rehab wouldn't help. Knowing that oral steroids never worked for me, my new ENT (my first ENT decided to retire) suggested I try a diuretic.

According to the Mayo Clinic, "The cause of Meniere's disease is unknown. Symptoms of Meniere's disease appear to be the result of an abnormal amount of fluid (endolymph) in the inner ear, but it isn't clear what causes that to happen."

Hence, the diuretic which works to eliminate fluids in the inner ear.

I also got another steroid shot in the ear. And this time, the shot, or the combination of it, with the diuretic, worked.

Because there is no cure for Meniere's, I may be in remission forever or my problem could come back again tomorrow.

One thing I can do to help prevent another episode is manage my stress, since that could be what triggered it to return in the first place. After all, I was experiencing my first global pandemic — what could be frightening about that?

Regardless of what ends up causing your vertigo, it's important to get it checked. Then watching "Vertigo," as opposed to experiencing it, can be its own special nightmare.  

Michele Wojciechowski"Wojo" Wojciechowski is an award-winning writer who lives in Baltimore, Md. She's the author of the humor book Next Time I Move, They'll Carry Me Out in a Box. Reach her at www.WojosWorld.com. Read More
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