Tuesday, October 5, 2010

Positional vertigo

Every once in a while (maybe every other year for the last 8 years) I get positional vertigo. This condition leads to severe room-spinning dizziness when my head is tilted in a certain position; otherwise I maintain normal balance. The condition is caused by calcium deposits in the inner ear, specifically the semicircular canals. The semicircular canals are tubular loops that contain a fluid, and the inside walls of the tubular loops are lined with fine hair cells. The hair cells wash back and forth in a predictable pattern every time a person moves his head. However, when calcium crystallizes in the fluid surrounding the hair cells, the hair cells fail to move in the predicted way and the brain receives contradictory information with regards to the motion (or lack of motion) the person is experiencing. Sorry to go into all this detail, but the condition is extremely disconcerting and sickening and when I experienced it on Sunday morning I was worried that it would keep me from doing workouts of any kind, particularly swimming.

The treatment for positional vertigo is actually very simple. A doctor wrote down these instructions back in 2004 when it first happened to me:
  1. Lay on your back and tilt your head back and to the left for 3 minutes.
  2. Continue to lay on your back with your head turned back, but now turn it to the right. Hold for 3 minutes.
  3. Turn over on your right side and look down at the floor for 3 minutes.
  4. Sit up by bringing your legs over the edge of the bed and lifting your still-turned torso up over your legs.
  5. Don't lay down for at least 4 hours.
  6. Repeat.
Admittedly, these are wacky instructions. But they work because they position the head in a way that uses gravity to pull the calcium crystals through the curves and loops of the semicircular canals so that the crystals are removed from the area containing hair cells. Eventually the crystals re-dissolve in the fluid and the person no longer feels dizzy.

Sunday morning I did the above procedure but continued to feel woozy and spent for the rest of the day. Overnight the dizziness returned, so on Monday morning I again did the procedure. This time it seems to have worked. I was feeling so much better that I went swimming Monday night. Swimming was a risky thing to do because I had to be horizontal and face down during the activity. This could have allowed all the calcium crystals to find their way back into the region where they could wreak havoc. But it didn't happen. I didn't even experience any disorientation during my dives or flip-turns. Hurray!

It wasn't an entirely enjoyable swim though, because it seems that my posterior deltoid was injured last week during a practice session with my coach. We were working on my backstroke and I thought I just overworked the muscle. However, last night the muscle gave me noticeable pain and was weak during a couple laps of breastroke. The pain continued into today, so I didn't swim today. Fingers are crossed for tomorrow, but I bet I won't be in top form when I meet with my coach in the morning.

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