BPPV with a terrible twist
May 19, 2019 2:05 PM Subscribe
Or rather a lack of twist. I can't do any of the usual positional cures for BPPV. How do I fix this?
I can't do Epley properly because of my neck, I will never be able to do it ever again as long as I live, my head can no longer turn to the full 90 degree extensions required due to all the metal bits and bobs holding my spine together. I am trying Semont now but every attempt has led to immediate furious vomiting. How do I fix this extremely severe attack of BPPV???
I just gave myself a bloody nose getting off the toilet. There is so much vomiting (which is another problem as I am medically forbidden to barf due to esophageal issues), just constant dry heaving at all times. Obviously I will see a doctor as soon as i can next week but idk what to do in the interim.
halp im die
I can't do Epley properly because of my neck, I will never be able to do it ever again as long as I live, my head can no longer turn to the full 90 degree extensions required due to all the metal bits and bobs holding my spine together. I am trying Semont now but every attempt has led to immediate furious vomiting. How do I fix this extremely severe attack of BPPV???
I just gave myself a bloody nose getting off the toilet. There is so much vomiting (which is another problem as I am medically forbidden to barf due to esophageal issues), just constant dry heaving at all times. Obviously I will see a doctor as soon as i can next week but idk what to do in the interim.
halp im die
Response by poster: benadryl doesn't do much for me but i found some 7 year old meclizine and you bet your butt i took it
posted by poffin boffin at 2:14 PM on May 19, 2019 [1 favorite]
posted by poffin boffin at 2:14 PM on May 19, 2019 [1 favorite]
In addition to Epley and Semont there's also Brandt-Daroff and the Half-Somersault/Foster Maneuver.
I'm not able to take anti-histamines like Benedryl without experiencing nasty side-effects so I used scopolamine patches instead.
posted by Secret Sparrow at 2:21 PM on May 19, 2019
I'm not able to take anti-histamines like Benedryl without experiencing nasty side-effects so I used scopolamine patches instead.
posted by Secret Sparrow at 2:21 PM on May 19, 2019
Oh, heck. My husband just spent four and a half weeks (basically April and early May) with undiagnosed benign paroxysmal positional vertigo.
Looking up? Dizzy. Sleeping on his back or right side? Dizzy.
His regular doctor put him on steroids and a motion sickness patch. We spent a week using ear cleaning drops (with him lying down, so not fun) and did a final office swipe. Still, no relief from the dizziness and nausea.
On to the audiologist's office staff, who checked his hearing, his ears and other cranial cavities, and pronounced that he had BPPV and needed the Canalith Repositioning Procedure... with head rapping. Three minutes of hard rapping with the knuckles above and behind the ear to dislodge any calcium crystals stuck in the "balance canals" (the brocure's terms for semicircular canals).
(Important note: I am describing what happened in the office and what the audiologist's brochure says. I am not your doctor, so consult with the appropriate physician before trying any of this. Given that BPPV can be associated with head injuries, be very cautious.)
When the specialist pulled him back into the 45-degree head position with his head off the bench, I though he was going to come unglued. He had the bench in a death clutch. His eyes were... weird.
And then she started rapping -- hard -- for three minutes. Then she pointed his nose to the ceiling with more rapping for three minutes. Then over on his side and nose down, with more rapping for three minutes.
I had some instruction at this point. This was truly "Can you hear me in the back yard?" front door knocking. We joked about how I probably needed a doctor's note to prove I was allowed to do this to any authorities.
Then finally we got on either side of my husband so he could swing his feet off the bench and slowly sit up without pitching off the bench.
The big point here -- no looking down to get off the bench, just straight ahead for the next two days.
For the next 48 hours:
No looking up or down. No looking side to side -- do a whole upper body twist. Wear a "soft cervical neck collar" to keep the neck level, if necessary.
No bending over or reaching up above the head.
Sleep sitting up in a recliner instead of a bed -- nothing past a 45 degree angle. Wear a cervical collar, if necessary.
After 48 hours and for the next week:
Avoid sleeping on the side that is affected by BPPV.
Return in one week if the symptoms have not gone away. Wait one week between treatments.
A few days later my husband's symptoms were better, but still present, so we tried the regular Canalith Repositioning without the head rapping. He said he felt better (he appreciated my holding his head steady in each position for the 30 to 60 seconds until the dizziness went away and his eyes stopped rolling), and over the next several days the symptoms went away on their own.
This may sound extreme, and I haven't found anything about head rapping other than Jaslet's comment (# 16) on this e-medicine personal experience thread.
I don't know if this will help, but this has been our recent experience.
posted by TrishaU at 9:16 PM on May 19, 2019 [2 favorites]
Looking up? Dizzy. Sleeping on his back or right side? Dizzy.
His regular doctor put him on steroids and a motion sickness patch. We spent a week using ear cleaning drops (with him lying down, so not fun) and did a final office swipe. Still, no relief from the dizziness and nausea.
On to the audiologist's office staff, who checked his hearing, his ears and other cranial cavities, and pronounced that he had BPPV and needed the Canalith Repositioning Procedure... with head rapping. Three minutes of hard rapping with the knuckles above and behind the ear to dislodge any calcium crystals stuck in the "balance canals" (the brocure's terms for semicircular canals).
(Important note: I am describing what happened in the office and what the audiologist's brochure says. I am not your doctor, so consult with the appropriate physician before trying any of this. Given that BPPV can be associated with head injuries, be very cautious.)
When the specialist pulled him back into the 45-degree head position with his head off the bench, I though he was going to come unglued. He had the bench in a death clutch. His eyes were... weird.
And then she started rapping -- hard -- for three minutes. Then she pointed his nose to the ceiling with more rapping for three minutes. Then over on his side and nose down, with more rapping for three minutes.
I had some instruction at this point. This was truly "Can you hear me in the back yard?" front door knocking. We joked about how I probably needed a doctor's note to prove I was allowed to do this to any authorities.
Then finally we got on either side of my husband so he could swing his feet off the bench and slowly sit up without pitching off the bench.
The big point here -- no looking down to get off the bench, just straight ahead for the next two days.
For the next 48 hours:
No looking up or down. No looking side to side -- do a whole upper body twist. Wear a "soft cervical neck collar" to keep the neck level, if necessary.
No bending over or reaching up above the head.
Sleep sitting up in a recliner instead of a bed -- nothing past a 45 degree angle. Wear a cervical collar, if necessary.
After 48 hours and for the next week:
Avoid sleeping on the side that is affected by BPPV.
Return in one week if the symptoms have not gone away. Wait one week between treatments.
A few days later my husband's symptoms were better, but still present, so we tried the regular Canalith Repositioning without the head rapping. He said he felt better (he appreciated my holding his head steady in each position for the 30 to 60 seconds until the dizziness went away and his eyes stopped rolling), and over the next several days the symptoms went away on their own.
This may sound extreme, and I haven't found anything about head rapping other than Jaslet's comment (# 16) on this e-medicine personal experience thread.
I don't know if this will help, but this has been our recent experience.
posted by TrishaU at 9:16 PM on May 19, 2019 [2 favorites]
Response by poster: yeah i unfortunately have way too many sensory issues specific to touch and my head for that to be feasible, i think. plus the head injury situation with me has been bad in the past; i'm aware of 5 concussions but that doesn't mean there haven't been more.
right now the meclizine seems to be doing enough for me to risk doing semont all day tomorrow so hopefully that will do. something? maybe?
posted by poffin boffin at 10:22 PM on May 19, 2019
right now the meclizine seems to be doing enough for me to risk doing semont all day tomorrow so hopefully that will do. something? maybe?
posted by poffin boffin at 10:22 PM on May 19, 2019
My thoughts are with you. Slow movements during the repositioning, give the calcium crystals plenty of time to settle in the next area, maybe? This is rough.
The audiologist team specifically were asking about head injuries (my husband didn't have any to account for it).
posted by TrishaU at 11:25 PM on May 19, 2019
The audiologist team specifically were asking about head injuries (my husband didn't have any to account for it).
posted by TrishaU at 11:25 PM on May 19, 2019
[...but i found some 7 year old meclizine...]
You know meclizine is OTC, right? I've known a couple of people who were surprised by this. It's often sold as Bonnie or Drammimine II (less sleepy) at most drugstores for a premium, and for much less when purchased off-brand/bulk.
posted by bindr at 2:50 AM on May 20, 2019 [1 favorite]
+1 for meclizine (dramamine less drowsy). If you have access to a benzo like Ativan or Xanax it can calm the inner ear (hence why you can't take it before balance tests.) Also see if you can get your doctor to fax in an RX for Zofran (anti nausea medication) or try to get to a walk in clinic for some. I would get to an ENT or balance center ASAP. Vertigo is hell.
posted by Crystalinne at 2:55 AM on May 20, 2019
posted by Crystalinne at 2:55 AM on May 20, 2019
Response by poster: You know meclizine is OTC, right?
not on sundays in my neighborhood
posted by poffin boffin at 11:23 PM on May 20, 2019
not on sundays in my neighborhood
posted by poffin boffin at 11:23 PM on May 20, 2019
It sounds like meclizine helped you a little. Maybe some of the potency has worn off given that the drug you had is so old.
It is similar to my experience with dimenhydrinate, which is a first-generation anti-histamine like meclizine. I get BPPV due to migraine. My migraine meds treat the head pain but apparently not the BPPV. If the BPPV is bad enough, I take dimenhydrinate. I did not find the Epley/Semont/Brandt-Daroff moves helpful.
Since you responded well to meclizine, a more recent unexpired batch may provide more potency and relief. Or you could try dimenhydrinate (Dramamine Original Formula).
I hope you feel better soon.
posted by cynical pinnacle at 7:09 PM on May 21, 2019
It is similar to my experience with dimenhydrinate, which is a first-generation anti-histamine like meclizine. I get BPPV due to migraine. My migraine meds treat the head pain but apparently not the BPPV. If the BPPV is bad enough, I take dimenhydrinate. I did not find the Epley/Semont/Brandt-Daroff moves helpful.
Since you responded well to meclizine, a more recent unexpired batch may provide more potency and relief. Or you could try dimenhydrinate (Dramamine Original Formula).
I hope you feel better soon.
posted by cynical pinnacle at 7:09 PM on May 21, 2019
This thread is closed to new comments.
posted by congen at 2:09 PM on May 19, 2019