2010-03-03

Vertigo

Last week, I took a couple of days off to go skiing with my friend Therese, who was visiting from Stockholm. We woke up early and took the train from Zürich to Andermatt, the place I went skiing with Swedish friends the winter before I moved to Zürich.

We had a great time skiing Wednesday afternoon, had a beer in the sunshine after the last run of the day, and then relaxed in the sauna for a while before having dinner and retiring for the night. I looked forward to a great full day of skiing on Thursday. Unfortunately, fate stepped in the way of that plan.

When I awoke Thursday morning and began to stretch and roll out of bed, I was hit with a wave of paralyzing dizziness. The world seemed to spin around me, and I could not tell up from down. It felt like being very, very intoxicated—only I was completely sober and had just had a solid night’s sleep.

I couldn’t see clearly, partly because my eyes were still cloudy from a night of sleep, but also because they were not entirely under my control. With each episode of dizziness, my eyes would shudder back and forth involuntarily. Still in the haze of early morning half-wakefulness, I was a bit unsure if I was truly awake, or just having a bad nightmare.

I sat up in bed. I felt sick to my stomach. Was it food poisoning? The dinner the previous night had seemed perfectly fine, and I had slept soundly. So that didn’t seem like a plausible explanation. I turned my head to the window to see a beautiful morning of white snow-covered slopes and bright sunshine. Another wave of dizziness and nausea overtook me, and I broke out in a cold sweat. I was terrified.

I stumbled out of bed and struggled to right myself. I fumbled around, leaning on the wall to remain upright. I managed to make my way to the bathroom, where I stood under the shower to warm up. I felt sick and chilled. The shower helped a bit, but I was still in a state of mild panic.

Thankfully, the scientist in me took charge at this point, and I began to analyze my situation. I realized that the dizziness was associated with motion—specifically, it got worse when I moved my head. I naturally became very slow and careful in my movements, turning my whole body instead of just turning my head, and getting up or sitting down without leaning over. I felt like an old man, moving in such a cautious and deliberate way; but it was working. The dizziness was subsiding, and the nausea and chills were gradually fading away.

I returned to the bed, propped up a few pillows behind my back, and just sat very very still. Therese kindly brought to me some breakfast from the hotel buffet. I managed to eat some cereal and drink some juice and coffee, despite a bit of lingering nausea. The fact that I could eat was a very good sign, I thought. Food poisoning, this was not. A bit of experimentation revealed a crucial detail: the vertigo was triggered when I leaned my head to the left—in other words, when my left ear was facing the ground. I then realized that the nausea and cold sweat were only side effects of the dizziness and panic, respectively.

This was the first time in my life that I had experienced vertigo like this, so its onset had surprised and scared me. Once I realized that the feelings of sickness were merely secondary effects of the dizziness, the situation began to feel less frightening and more manageable. The realization that I could control the dizziness to a degree by limiting my movements made me calmer and more relaxed. I could handle this. I was going to be okay.

With Therese’s help, I got dressed and walked to the doctor in Andermatt. His office was in an old building, and had lovely parquet floors and furnishings. In its appearance, it was was like a doctor’s office from 100 years ago. Visiting the doctor was a very calming and reassuring experience. A very friendly nurse there explained that what I was experiencing was quite common, and was caused by a mechanical problem in the semicircular canals of the inner ear. Apparently, bits of crystalline debris can detach and wander in these canals, causing irregular movement of the fluid whose flow in response to head movements gives us our sense of balance. I later learned that the condition is called benign paroxysmal positional vertigo. The nurse told me that BPPV often goes away after just a couple of days, but that it could last longer, and that in some people, it comes back weeks, months, or years later. The doctor prescribed a couple of medications: one for the dizziness and another for the nausea.

I was feeling a bit unsteady, and still suffering the after-effects of the morning’s exhausting episode; but I felt better and much reassured after visiting to the doctor. On the way back to the hotel, I even felt well enough to go by the post office and mail my application for a new U.S. passport to the embassy in Bern.

Back at the hotel, I ate a bit more, took my medicine, and went back to bed. Therese went skiing, and I slept the whole day. I was mostly ok that evening, and felt even better the next day. By the time we had returned to Zürich on Friday evening, it seemed that the vertigo had almost completely disappeared.

I still experience a brief moment of dizziness occasionally—often when I rouse myself from sleep in the morning. I also sometimes get a faint sensation of my balance being a bit off-kilter; but these are minor nuisances compared to the debilitating dizziness I felt last Thursday. One of my mother’s best friends has a more chronic form of vertigo, and I have a deepened sympathy for her after having experienced a taste of it. I am enormously grateful for my good health!

Update
The Epley maneuver helps alleviate symptoms in many sufferers of BPPV.

2 comments:

ZZamboni said...

Hey Michael, glad to know you are feeling better. I have also experienced vertigo sporadically, for the same reason as you, and I agree it's an awful feeling.

What has worked for me (it was prescribed by my doctor in Waedenswil) is the Epley Maneuver, which helps by repositioning those particles that cause the vertigo:

http://en.wikipedia.org/wiki/Epley_maneuver

Equus venaticus said...

I experienced vertigo night skiing last weekend. It passed after I sat in the lodge a couple of hours. I'm hoping that doesn't happen everytime I night ski now! A few years ago my mom (also a skier) suffered benign paroxysmal positional vertigo for a few days until she underwent the Epley maneuver. It worked for her and she hasn't suffered vertigo again since. Worth a try! Best of luck. Motion sickness is awful.