Monthly Archives: January 2017

Vertigo: Why You be Trippin’?

ear

Why you be trippin’?  No really.  Physically, why is it that the world is spinning and your body can’t keep up?  Vertigo is similar to riding the loop de loop roller coaster, unable to get off.  While on the loops there’s a sense of giddiness and excitement as the whirling loss of body awareness attacks your sensory system.  Some people experience these symptoms in the absence of a roller coaster but in the presence of inner ear dysfunction.  This whirling sensation is distinguished from dizziness, which is another topic that warrants a separate discussion (see causes of vertigo below).

The inner ear houses our vestibular system (see picture), which is a complex roller coaster ride of loop de loops, fluid, crystals, and membranes precisely calibrated, working in conjunction with body and brain perceptions to keep us on our feet in the presence of uncertain terrain.  The vestibular system keeps our body and brain in check with gravity.  Life is filled with uncertain terrain that challenges our balance and vestibular system.  Examples include:  walking over gravel, jumping on a trampoline, walking on sand or cushioned carpet, maneuvering in bed, and walking through crowds.

Causes of vertigo include:

Benign Paroxysmal Positional Vertigo (BPPV):  Episodic vertigo specifically triggered by positional change.  This particular cause is often adequately treated through a specific physical therapy intervention called the Epley Maneuver.

Meniere’s Disease:  Large collection of fluid (endolymph) in the ear, causes largely unknown.

Vestibular neuritis:  Inner ear infection.

Head Injuries and Migraines:  Any sort of trauma that may have caused a head injury, also history of migraines.

Mystery Illness:  Underlying, possibly medically undetectable, viral load compromising the immune system.

In my experience, aside from BPPV for which the Epley Maneuver is used, medical treatment often offers little to no relief.  Often a patient will simply heal naturally, and other times patients will learn to live with the symptoms.

THERE IS HOPE!  When I see no glimmer of hope in my patients, we must start to discuss alternative treatments and solutions to vertigo.  Luckily, there are many avenues we can explore.

Diet:  It is severely underestimated by the general public the vast impact our diet has on EVERYTHING.  Try a cleanse, eat produce every meal, do something drastic.  Eliminate dairy and gluten.  Keep a diary of your symptoms compared to what you ate.  The cure may reside on your plate.

Environment:  Eliminate the use of pesticides and herbicides.  Stop wearing perfume and using heavily scented cleaning and beauty products.

Social support:  A good social network keeps your feet on the ground.  Living an isolated lifestyle is similar to floating in outer space.  There is no connectedness, and the body responds accordingly.  Seek out a support group, yoga or meditation group, church group, or volunteer.

Relationships:  Relationships can push you both physically and emotionally in directions you’d rather not go creating a sense of vertigo.

Spirituality:  Believing is something greater than yourself, your path toward the best version of yourself.  Without this, our physical body is untethered and lost.

Emotions:  Are you reacting to the world from a place of fear?  Fear creates stress and anxiety and translates to ischemia (a lack of blood flow), which can initiate symptoms.  Meditation and decluttering will help here.

Habituation:  The vestibular system will habituate, or normalize.  The key here is empowerment.  Once the symptoms of vertigo are aggravated, stay in that position, do not move, keep your eyes open and focus on a target until the symptoms resolve.  Avoidance of the situations that cause vertigo, give it power and allows it to take over.

Resources

11 Easy Home Remedies for the Treatment of Vertigo.  http://www.homeremedyshop.com

Netter, FH.  Atlas of Human Anatomy:  3rd edition.  Icon Learning Systems, Teterboro, NJ.  Pg 87.

Vestibular Disorders Association.  www.vestibular.org

William, A.  Medical Medium:  Secrets behind Mystery and Chronic Illness.

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Wait, I may have PTSD?!

ptsd

Post-traumatic stress disorder or PTSD is becoming a cliché term thrown around in dramatic, charismatic conversation.  Many people question if PTSD is even real.

My grandfather fought in WW II and experienced night terrors and sleep disturbances until the day he died, a common symptom of PTSD.  Medical professionals tend to reserve the PTSD diagnosis for military vets and victims of extreme trauma or violence, which may be appropriate.  But what about the individuals who suffer with no major cause often begging the question, “What the heck is wrong with me?!”

PTSD involves a traumatic disruption in the nervous system resulting in continued release of stress hormones.  Obviously war, extreme trauma, and violence are credible sources to initiate this disruption.  There are four major symptoms of PTSD paraphrased as follows:

  1. Unwanted thoughts:  This may take the form of reliving negative events via memories, day dreaming, nightmares, and flashbacks.  These thoughts intrude without warning or preface.
  2. Fear avoidance:  Simply avoiding people, places, and situations that may remind the individual of the trauma.
  3. Poor memory and negativity:  Forgetfulness, brain fog, constant blame placing, inability to see things in a positive light, flat affect (no emotion).
  4. Hyperactivity and poor reactions:  Aggression, poor value of self or others, inability to sleep and relax, hyper-alert and aware.

Anthony William, The Medical Medium suggests in his blog that there is an “epidemic of hidden PTSD.” It’s hard not to agree with this as a medical professional.  It is not uncommon to see these exact four symptoms in individuals with no preceding traumatic or violent event.  As a physical therapist it is my responsibility to restore normal physical function but with symptoms of hypervigilance, sleep disturbance, and disrupted mood it’s difficult to believe that simple exercise is the full answer.  May it get the ball rolling?  Yes, but the underlying cause is a mystery.  Or is it?  From my point of view, the death of a spouse or child, failure in school, and parental disappointment are a few of the so-called “minor” traumas that may have started a downward tailspin into Stress Hormone City, eliciting one or more of the above symptoms.  Recognizing the signs and symptoms that mimic PTSD is the first step in creating and cultivating a cure.

The national library of medicine (NIH) and biotechnology (NCBI) house a host of articles supporting the usefulness of meditation to combat PTSD in soldiers.  In my opinion, meditation can be an educational point for anyone presenting with one or more symptoms of PTSD.

Besides meditation, Anthony William suggests a dietary approach.  Glucose acts as a protector of the brain and nervous system.  Glucose is readily available for muscular use through the liver, its own glycogen storages, and fat metabolism but not for the brain.  The brain is extremely sensitive and prefers blood glucose from just eaten carb sources favoring fruits and vegetables.  When glucose is not readily available, it will attempt to get what it needs from the liver but this is not an endless supply.  The brain is quite sensitive to just the right amount of glucose.  Utilizing unhealthy, just eaten, glucose laden food (such as grains, soda, and sugar) actually damages brain tissue—kind of like over-watering a plant, the brain becomes over-glucosed compromising neural health.  Hello hangry, brain fog, and memory problems!

Because PTSD is a disorder of the nervous system, providing it with the right sources and amount of glucose may help.  Great brain food can be found in the produce aisle!

There are many facets of wellness, and to fully heal from or manage PTSD one must create a positive relationship with spirituality, occupation, friendships, family, animals, and the environment.  Meditation is one suggestion to aide in transmuting negativity in any of these areas to positivity.

The evidence supports the use of multiple psychotherapeutic approaches as well, and these will also aide in returning the body to a de-stressed state.

*None of this information is to be a substituted for professional healthcare.

Catastrophizing: Why is it ALWAYS so bad?

Last week on @LoveinActionTV on the Periscope app my sister and I talked about PTSD.  Closely linked to PTSD is catastrophizing.  These two are similar to the chicken and egg theory.  Many catastrophizers experience PTSD and many people with PTSD are catastrophizers.  So what is catastrophizing anyway?

Catastrophizing is thinking something is much worse than it actually is.  Guilty as charged.  We all do it but some people get stuck in a catastrophic wheel unable to pull the breaks, stop, and get off, which tailspins catching a multitude of other problems along the way such as:

  • Poor interpersonal relationships
  • Missed opportunities and underachievement
  • Hopelessness
  • Irrational thought patterns
  • Constant pity parties and disappointment
  • Chronic or uncontrollable pain
  • Anxiety, depression, negative mood
  • Illness
  • Suicidal ideation

I see this situation all the time in my practice as a physical therapist.  When treating acute or chronic pain, the person’s outlook on their ability to improve, heal, and move on speaks more to their prognosis than the actual diagnosis.  Those who constantly think about the situation, depend on others to give them answers, and allow one injury to segue to multiple tend to have poor outcomes no matter how simple the medical and PT diagnosis may be.

These problems can be classified into three major categories, which identifies those exhibiting catastrophizing behaviors about a situation or the future:

  • Magnification: Having fear that a situation will worsen
  • Rumination: Unable to stop thinking about the situation
  • Helplessness: The feeling that you have no power to change or improve the situation

Simple techniques get out of catastrophizing:

  • You become aware that you’re doing it!
  • Fake it. Visualize the best possible outcome and begin to act, talk, and be the reflection of greatness.
  • Take charge. Be an advocate for yourself, empower yourself as your ultimate healer.
  • Draw a line between catastrophe and something very unfortunate that you can deal with.
  • Meditate, breathe, and pray. This will increase your ability to cope with negative situations.

References

Boyls A.  What is Catastrophizing?-Cognitive Distortions  www.psychologytoday.com/blog/in-practice/201301/what-is-catastrophizing-cognitive-distortions

Grohol JM.  What is Catastrophizing?  https://psychcentral.com/lib/what-is-catastrophizing/

Quartana PJ, Claudia MC, Edwards, RR.  Pain catastrophizing:  a critical review.  Expert Rev Neurother.  2009 May; 9(5): 745-758. Doi:10.1586/ERN.09.34

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