Vertigo

Vertigo is any inappropriate sense of movement. It may be associated with staggering or falling, but not fainting or loss of consciousness. It may vary from mild unsteadiness to severe subjective spinning and vomiting. It may occur suddenly at rest or can sometimes be brought on by movement - eg, rolling in bed or driving around a roundabout in the car.

It is important to take appropriate precautions in order to avoid accidents and mishaps, especially when one gets a little older and stiffer; when working at heights or when operating machinery.
This is particularly important if you are taking medications such as sedatives, antihistamines, anti-depressants, or pain medication.

Make efforts to reduce stress, and get plenty of sleep. These 2 measures have a marked impact on the brain's ability to cope and recover from vertigo. Avoid caffeine, alcohol and nicotine; eat a well-balanced diet; regulate fluid intake throughout the day; avoid excessive salt on food.

Regular exercise (eg; walking, bowls, golf, Tai Chi, Yoga, etc) will all help the brain restore normal balance function as soon as possible. It is known that 50% of people over the age of 50 will experience vertigo at some time. Time to recovery is dependent upon age, general health (eg; associated arthritis or visual impairment) and in some people will still be slower than others. DO NOT DESPAIR! Seek emotional support from your family, friends and persons where you work.

Excessive early use of sedatives to control vomiting may delay and affect recovery.

After an acute severe vertigo attack

In the dark, before getting out of bed - TURN A LIGHT ON!

When moving from lying to standing

When getting up in the morning and on first opening your eyes, focus on something on the ceiling in order to help develop your stability. Next, slowly move to the side of the bed and sit up, again focusing on something before you stand up. Finally, stand up, but be sure to focus on something once more before you start to walk.

When moving from sitting to standing

First, slide to the middle of your chair. Next, place your hands next to your hips on the chair seat. Then, focus on an object straight ahead. Rise slowly with your head and back straight and upright. Stand and perform isometric exercises (contract your muscles without moving) for your trunk muscles before you walk. When you stand, be sure to keep your knees slightly bent.

When moving from standing to sitting

Walk to your chair and turn slowly until the back of your knees touch the chair. Reach back with both hands to hold the chair so that it will not slide. Focus on something ahead, then sit down slowly with your head and back straight and upright.

When starting to walk

It is important that you feel stable while standing still before walking. When you start to walk, focus on something straight ahead. When you look down, try to use your eyes rather that your head.

Walking or Standing

Position feet comfortably apart (not too close together). Focus on distant objects, using side vision for close objects. When walking, do not look down, but select a distant point for fixation, using peripheral vision to avoid nearby objects. Do not use bi- or trifocal glasses, especially when going downstairs. Avoid dark areas and places, for example, dark restaurants.

Bending over

When getting up from bending over, look up and away at a distant object.

Close up work

When sitting, become aware of the feel of your feet on the floor. When reading try to limit the amount of time; if you notice a problem after 5 or 10 minutes, do something else and go back to reading later. When standing, and before attempting to work, steady your feet apart in a comfortable position.

Driving

Ride in the front seat of the car. Look out the window at distant earth-fixed objects. When going around curves, look at a distant object, for example, a tree that is beyond the curve.

Airplanes

The larger the airplane, the better the cabin pressure, so the less possible turbulence effects. Sit near the front where the turbulence is less. Sit in a window seat so you can see the horizon.

Balance assistance devices

• Glasses; the best visual function possible should be achieved; use separate glasses for distance and close-up work.
• Good hearing also helps orientation; use hearing aids and other hearing assistive devices, if appropriate.
• Cervical collar, if appropriate; in patients who have significant cervical spondylosis, and particularly if head turning increases unsteadiness, use a soft, foam rubber cervical collar, which often limits this motion and improves stability.
• Cane(s) for walking; carry a light can, which is often extremely valuable not only for support, but also to provide additional tactile and proprioceptive orientating information.
• Use a walker if appropriate
• Wear substantial lace-up shoes with wide rubber soles and low or flat heels.
• Choose carpets with a thin pile; the fewer scatter rugs the better; be sure that they do not slip; use non-skid floor wax
• Leave a light on in different areas of the house, including the bathroom, corridors, and stairways; have a bed-side lamp.
• Staircases: place coloured tape on the first and last steps.
• Install handrails where appropriate.
• Use bath bench, shower chair, and non-slip bath and shower mats.
• Use goggles when swimming in order to maintain orientation.

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