Tag Archives: vestibular dysfunction

Its awareness time for Invisible Illnesses!

A Invisible illness is a illness that you have that can’t be seen, MS, SJorden’s, Cluster headaches, migraine headaches, gastroparesis, Huntington’s disease ,fibromyalgia,chronic fatigue, lupus,reflex sympathetic Dystrophy, Myalgic Encephalomuelitis, Crohn’s disease, cystic fibrosis, RA, Prinz Metals Variant Arigina, Asthma, Hypogamma-globulinemia, PTSD, concussion, post concussion syndrome, Hep C, Chronic Back injury, Diabetes, cancer, autonomic neuropathy, autonomic small tissue neuropathy, autonomic dysfunction, Autoimmune disease of the inner ear, AIED, Menieres, So many there isn’t enough pages to list all the invisible illnesses.

The key to Invisible Illness is yet the hardest thing to do is diagnose a invisible illness, but the sooner you get diagnosis, get the right treatment, most invisible illnesses don’t have a cure. just comfort measures.

I have a invisible illness, several to be exact and I can tell you the hardest thing is having to defend your illness to everyone, they don’t believe you, they think you are doing it for attention. Believe me I would do anything to have my old life back, be able to work, go for a walk, hike, go have vacations, go to the mail box, walk in a line, Sleep! Sleep is so important and as a patient with invisible illnesses, I feel like I can sleep all the time, my brain is working on over time every day, just to get out of bed, just to do my hair..

I call it payback, if I go do something fun, the energy it takes to get ready and get somewhere be normal for a few minutes and then go home and crash, the pay back! the more stress the more pay back. It can take hours to get ready just for a simple dinner but I can sleep 14 hours after. Any Dr appointments wipe me out, specially if testing is to be done. So I plan. everything has to be planned, If I can make dinner I have to make it early so I am not sleeping when it’s dinner time, If I clean up the laundry room, I have to sleep after, I will do 1 load of laundry and pay.

When you have to defend your illness, its hurts inside, when your family doesn’t believe you it breaks your heart, your always on the defense. Your friends disappear, family disappears whether its because they can’t handle it or because they don’t want to. That’s the killer. You become the scape goat for family issues because your crazy. Its a awful place to be, your not only alone but your alone with your disease, not knowing what tomorrow may bring or if tomorrow will come or if you even want it to. Having a invisible illness F g sucks! more bad days than good, never being able to make plans.

So If you take anything from this post today is we are telling the truth, we are sick, we need your support not your drama. We don’t need to explain our illness or defend it and if you can’t be supportive then let the person go. Just be honest, Just tell the person, write them a letter, e mail them, so they don’t have a false representation of what your intentions are. That’s kinder to a person than to hang on and be a fake friend. Or family member. Every Dr that I talk to says the same thing, the hardest thing is the lack of support from family and friends and there not believed. Those are the words of the Doctors, it’s the highest complaint. Very Sad, that amongst the illness we don’t get the recognition that we are even sick let alone support from the people in your life. So if you are a family member of someone with invisible illnesses, learn about the disease, learn how you can help, not behind the patients back but from the patient “What will make your life easier”? Its not science, it doesn’t cost you anything, but be there! Remember we all die some day, some have a longer illness or life than others, so instead of nit picking, being abusive verbally, be supportive. Nothing hurts worse then being sick alone.

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Aphashia

I can tell you first hand, what it is like to live every day, unable to grab words that you know are in your head but they won’t come out your mouth. The frustration of not being able to complete a sentence or think of a common word. It’s almost like a wall is in your brain holding all the words back and you can not find them. Your family members will try to answer for you and that’s ok. But being able to locate my part of the brain that contains all the words would be such a blessing. I am a talker and I can never deny that, it’s just hard to find them.

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A letter to spread the word.

I wrote a letter to the Governor asking for help spreading the word about Vestibular dysfunction and I received a generic letter back. Look what I found in my spam folder. So excited. I am fighting for all of us and this spread the word. Knowledge is power.!!!!! If you would like to see bigger, please click on letter and you should be able to blow it up to bigger font size.

Vestibular

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My Blessings of the day!

kelly and group roseville

I had such a wonderful blessing today, I put together a support group in Roseville California, We made a connection that was amazing and they want me back. Something learned How many people have any type of vestibular dysfunction. Everyone at the table new a hand full of people with Vestibular Dysfunction of some sort. Which means we need to spread the word even more. But some ideas were brought to my attention and I am jumping on the wagon.
Kelly

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Let’s talk Vestibular Dysfunction

Dizziness is a general term that describes sensations of imbalance and unsteadiness, such as vertigo, mild turning, imbalance, and near fainting or fainting. Feelings of dizziness stem from the vestibular system, which includes the brain and the parts of the inner ear that sense position and motion, coupled with sensory information from the eyes, skin, and muscle tension.
Description

Because dizziness is a general term for a variety of feelings of instability, it spans a large range of symptoms. These symptoms range from the most dramatic, vertigo, to the least severe, imbalance. Included in these feelings is fainting, which results in a loss of consciousness.

Vertigo is an acute feeling of violent rotation. People with vertigo often feel as if they are tilting or falling through space. Vertigo is most often caused by problems with the vestibular system of the inner ear. Symptoms can be brief, or may last for extended periods of time and may be accompanied by changes in pulse and blood pressure, perspiration, nausea, and a type of rapid eye movement called nystagmus.

Mild turning is a less violent type of vertigo. People with mild turning are still able to function in normal daily routines. However, a feeling of turning may continue for weeks. Mild turning is usually a symptom of inner ear dysfunction. It may also result from transient ischemic attack , or a lack of blood flow to the brain. People who have suffered from strokes may feel mild turning for periods of time. Mild turning may also be associated with multiple sclerosis , AIDS , or head trauma.

Imbalance is a feeling of instability or floating. It is associated with many general medical problems such as the flu or infection. Imbalance can also be associated with arthritis, especially in the neck, or another neurological problem.

Fainting is a sudden loss of consciousness and near fainting is a feeling of extreme light-headedness with a sinking or falling feeling. Vision usually becomes hazy or dimmed and the extremities become weak. Both fainting and near fainting are caused by lack of blood flow to the brain. Anything that causes a rapid drop in blood pressure, such as a heart attack or an insulin reaction in a diabetic, can result in fainting or near fainting. Panic attacks that cause a person to exhale a lot of carbon dioxide can cause fainting or near fainting.
Vestibular system

The vestibular system is the sensory system located in the inner ear that helps the body to maintain balance. Balance in the human body is coordinated by the brainstem, which, with speed and precision, collects information from other parts of the brain and sensory organs throughout the body. It is the brainstem that sends neurological instructions to the muscles and joints. The sensory organs that play critical roles relaying information to the brain-stem include the skin, eyes, muscles and joints, and the vestibular system in the inner ear. Dizziness may result with dysfunction in any of these components or in the nerves that connect them.
Brain

The cerebellum , which is responsible for coordination and the cerebral cortex, provides neurological information to the brainstem. For example, the cerebellum is the organ that informs the body how to shift weight when going down a flight of stairs and how to balance on a bicycle. These processes are accomplished without conscious thinking.

In order to maintain balance, the brainstem depends on input from sensory organs including the eyes, muscles, joints, skin and ears. This information is relayed to the brainstem via the spinal cord. The combined neurological receptor system, which involves the brainstem, spinal cord, and sensory organs, is called the proprioceptive system. Proprioceptive dysfunction may result in dizziness, and people with problems with their proprioceptive system may fall often. Additionally, as people age, problems with proprioception become more common.
Sensory organs

Visual information is of particular importance to maintaining balance. The visual systems most involved are the optokinetic and pursuit systems. The optokinetic system is the motor impulse responsible for moving the eyes when the head moves, so that the field of vision remains clear. The pursuit system allows a person to focus on a moving object while the head remains stationary. Both of these systems feed information about the person’s position relative to the surroundings to the brainstem. A specific type of eye movement called nystagmus, which is repetitive jerky movements of the eye, most often in the horizontal direction, may cause dizziness. Nystagmus may indicate that neurologic signals from the optokinetic or pursuit systems are not in agreement with the other balance information received by the brain.

Sensory information from muscles, joints, and skin plays a key role in balance. The muscles and joints of the human body are lined with sensory receptors that send neurological information about the position of the body to the brainstem. For example, receptors in the neck muscles tell the brain which way the head is turned. The skin, in particular the skin of the feet and buttocks, is covered with pressure sensors that relay information to the brain regarding what part of the body is touching the ground.
Peripheral vestibular system

The ear, particularly the inner ear, plays a critical role in maintaining balance. The inner ear contains two major parts: the cochlea, which is mostly used for hearing, and the vestibular apparatus, also known as the peripheral vestibular system, which is important in balance. A set of channels connects the two parts of the ear and therefore any disease that affects hearing may also affect balance, and vice versa.

The peripheral vestibular system consists of a series of canals and chambers, all of which are made of membranes. This membrane system is filled with a fluid called endolymph. The peripheral vestibular system is further embedded in the temporal bone of the skull. In the space between the temporal bone and the membranes of the peripheral vestibular system resides a second fluid called perilymph. Endolymph and perilymph each have a different chemical makeup consisting of varying concentrations of water, potassium, sodium, and other salts. Endolymph flows out of the peripheral vestiubular system into an endolymphatic sac and then diffuses through a membrane into the cerebrospinal fluid that bathes the brain. Peri-lymph flows out of the peripheral vestibular system and directly into the cerebrospinal fluid. When the flow pressures or chemical compositions of the endolymph and perilymph change, feelings of dizziness can occur. These types of changes may be related to Mèniére’s disease.

The vestibular apparatus is made up of two types of sensory organs: otolith organs and semicircular canals. The otolith organs sense the direction of gravity, while the semi-circular canals sense rotation and movement of the head.

Two otolith organs in each ear are called the saccule and the utricle. The saccule is oriented in a vertical direction when a person is standing and, best senses vertical motion of the head. The utricle is nearly horizontal when a person is standing, so it best senses horizontal motion of the head. Each organ consists of calcium carbonate crystals embedded in a gel. Special hair-producing cells extend into the gel from below. As the head moves, gravity and inertia cause the crystals to bend the hairs, which are in contact with nerves. Information on the position and motion of the head is thus relayed to the brain. If the hairs or the crystals in the otolith organs are damaged, feelings of dizziness may result.

In each ear, there are also three semicircular canals that lie on planes that are perpendicular to each other. The canals are connected together by a main chamber called a vestibule. The canals and the vestibule are filled with endolymph fluid. Near its connection to the vestibule, one end of each of the canals widens into a region called the ampulla. One side of the ampulla is lined with specialized sensory cells. These cells have hairlike structures that extend into a gelatinous structure called a cupula. As the head moves in a given plane, the endolymph inside the semicircular canal in that plane remains stationary due to inertia. The cupula, however, moves because it is attached to the head. This puts pressure on the cupula, which in turn moves the hairlike structures. The bending of the hairlike structures stimulates nerves, alerting the brain that the head is moving in a particular plane. By integrating information from all three planes in which the semicircular canals lie, the brain reconstructs the three-dimensional movement of the head. If information from one of the semicircular canals does not agree with that of another, or if the information generated by semicircular canals in one ear does not agree with the information produced by the other ear, feelings of dizziness may result.

All of the signals from the peripheral vestibular system travel to the brain along the eighth cranial nerve, also called the vestibular nerve. Damage to this nerve, either through head trauma or the growth of tumors, can also cause feelings of dizziness. Neurological information from the semicircular canals seems be more important to the brain than information from the otolith structures. If the eighth cranial nerve on one side of the head is damaged, but the other side remains intact, the brain learns to compensate over time; however, the mechanics involved in this process are not well understood.
Demographics

Dizziness is an extremely common symptom occurring in people of all ages, ethnicities, and socioeconomic backgrounds. Balance disorders increase with age, and by age 75, dizziness is one of the most common reasons for visiting a doctor. In the general population, dizziness is the third most common reason that patients visit doctors. According to the National Institutes of Health (NIH), about 42% of the population of the United States will complain of dizziness at some point in their lives. In the United States, the cost of medical care for patients with symptoms of imbalance is estimated to be more than $1 billion per year.
Diseases associated with dizziness

Because it involves so many different parts of the body, the balance system may exhibit signs of dysfunction for a variety of reasons. Dizziness may be caused by problems with the central nervous system , the vestibular system, the sensory organs, including the eyes, muscles and joints, or more systemic disorders such as cardiovascular disease, bacterial and viral diseases, arthritis, blood disorders, medications, or psychological illnesses.
Central nervous system dysfunction

Any problem that affects the nerves leading to the brain from vestibular or sensory organs, the spinal cord, the cerebellum, the cerebral cortex, or the brainstem may result in dizziness. In particular, tumors that affect any of these organs are of concern. In addition, disorders that affect blood supply to the central nervous system, such as transient ischemic attacks, stroke , migraines, epilepsy , or multiple sclerosis, may result in feelings of dizziness.

BRAINTUMORS Although rare, acoustic neuroma is a benign tumor growing on the vestibulo-cochlear nerves, which reach from the inner ear to the brain. It may press as well on blood vessels that flow between the peripheral vestibular system and the brain. Symptoms included ringing in one ear, imbalance, and hearing loss. Distortion of words often becomes increased as the tumor grows and disturbs the nerve. Treatment requires surgical removal of the tumor, which nearly always returns the sense of balance to normal, although some residual hearing loss may occur.

Other brain tumors may also cause feelings of dizziness. These include tumors that originate in the brain tissue, such as meningiomas (benign tumors) and gliomas (malignant tumors). Sometimes tumors from other parts of the body may metastasize in the brain and cause problems with balance.

CEREBRAL ATROPHY Age causes atrophy (deterioration) of brain cells that may result in slight feelings of imbalance. More severe forms of dizziness may result from other neurological disorders.

BLOOD SUPPLY DISORDERS If the blood flow and oxygenation to the cerebellum, cerebral cortex, or brain-stem is not adequate, feelings of dizziness can result. Such symptoms can result from several types of disorders, including anemia, transient ischemic attacks (TIAs), and stroke.

TIAs are temporary loss of blood supply to the brain, often caused by arteriosclerosis (hardening of the arteries). In addition to a brief period of dizziness or vertigo, symptoms include a transient episode of numbness on one side of the body, and slurred speech and/or lack of coordination. If the loss of blood supply to the brain is due to a blockage in one of the arteries in the neck, surgery may correct the problem.

Strokes, or cerebrovascular accidents (CVA), occur in three major ways. A thrombotic stroke occurs when a fatty deposit forms a clot in an artery, blocking blood supply to the brain. An embolic stroke occurs when part of a clot from another part of the body breaks off and obstructs an artery leading to the brain. A hemorrhagic stroke occurs when blood vessels in the brain hemorrhage, leaving a blood clot in the brain.

PERIPHERAL VESTIBULAR SYSTEM DYSFUNCTION When balance problems are brief or intermittent, the peripheral vestibular system is usually the cause. Many different problems may be at the root of vestibular disorder.

BENIGN PAROXYSMAL POSITIONAL VERTIGO (BPPV) Benign paroxysmal positional vertigo occurs following an abrupt change in position of the head. Often, onset of vertigo occurs when patients roll from their back onto the side, and it usually subsides in less than a minute. BPPV can result from head trauma, degeneration of the peripheral vestibular system with age, infection of the respiratory tract, high blood pressure, or other cardiovascular diseases. Those who suffer from an infection of their vestibular system, causing severe vertigo that lasts up to several days, can develop BPPV any time within the next eight years. BPPV is also associated with migraine headaches .

Two theories on the cause of BPPV currently exist. One suggests that BPPV will occur when the calcium carbonate crystals in the otolith organs (the saccule and the utiricle) are displaced and become lodged in the cupula of the semicircular canals due to head trauma, infection, or degeneration of the inner ear canals. This displacement will stimulate the nerves from the semicircular canals when the head rotates in a particular position, indicating to the brain that the person is spinning. However, the rest of the sensory organs in the body report that the body is stationary. This conflicting information produces vertigo. The calcium carbonate crystals dissolve after a brief time, and the symptom is rectified. The second theory suggests that cellular debris accumulates into a mass that moves around the semicircular canals, exerting pressure on the cupula and causing vertigo. When the mass dissolves, the symptoms subside.

INNER EAR INFECTIONS Inner ear infection, or vestibular neuronitis, occurs some time after a person has suffered from a viral infection. Onset includes a violent attack of vertigo, including nausea, vomiting, and the inability to stand or walk. Symptoms subside in several days, although feelings of unsteadiness may continue for a week or more. A swelling of the vestibular nerve following a viral infection causes vestibular neuronitis.

Sometimes the inflammation can recur over several years. A viral infection affecting the inner ear, but not the vestibular nerve, is called viral labyrinthitis. Labyrinthitis can cause hearing loss, but all other symptoms are similar to vestibular neuronitis.

Severe bacterial infections can also cause inflammation of the inner ear. These cases include risk of deafness, inflammation of the brain, and meningitis (inflammation of the membranes surrounding the brain and spinal cord). Otitis occurs when fluid accumulates in the middle ear, causing feelings of imbalance, mild turning, or vertigo. When the infection reaches the inner ear, the disease is called acute suppurative labyrinthitis. Treatment for any bacterial infection in the ear is critical to prevent long-term damage to hearing and balance organs.

PERILYMPH FISTULA Perilymph fistulas are openings that occur between the middle ear and the inner ear. This allows a hole through which perilymph can flow, changing the pressure of perilymph flowing into the brain and causing dizziness. Fistulas often form as a result of head trauma or abrupt changes in pressure. Symptoms may also include hearing loss, ringing in the ears, coordination problems, nystagmus, and headaches. Most fistulas heal with time; however, in severe cases, surgical procedures are used to close the hole, using a tissue graft.

MÈNIÉRE’S DISEASE In 1861, French physician Prosper Mèniére described Mèniére’s disease as having four particular symptoms: vertigo lasting for an hour or more, but less than 24 hours; ringing or buzzing sounds in the ear; feeling of pressure or fullness in the ear; and some hearing loss. Some people are affected in both ears; others just one ear. Onset of Mèniére’s may be related to stress, although not in all cases. Nystagmus is usually associated with the attacks.

Mèniére’s disease is thought to be caused by an accumulation of endolymph within the canals of the inner ear, a condition called endolymphatic hydrops. This causes produces a swelling in the canals containing endolymph, which puts pressure on the parts of the canals containing perilymph. The result affects both hearing and balance. In severe cases, it is feared that the endolymphatic compartments may burst, disrupting both the chemical and pressure balances between the two fluids.

The cause of the accumulation of endolymph is unknown, although it can be related to trauma to the head, infection, degeneration of the inner ear, or some other regulatory mechanism. Syphilis is often associated with Mèniére’s disease, as are allergies and leukemia. Some suggest that Mèniére’s disease is an autoimmune dysfunction. There may be a genetic predisposition to Mèniére’s disease.

Mèniére’s disease is usually treated with meclizine (Antivert), antihistamines, and sedatives. Diuretics can be used to rid the body of excess endolymph. Salt-free diets can also help to prevent the accumulation of fluid in the ears.
Systemic disorders

Dizziness may be a symptom of a disorder that affects the whole body, or systems within the body. Dizziness may also be the result of systemic toxicity to substances such as medications and drugs.

POSTURAL HYPOTENSION The major symptom of postural hypotension, also called orthostasis, is low blood pressure. When a person stands up from a prone position, blood vessels in the legs and feet must constrict to force blood to the brain. When blood pressure is low, the blood vessels do not constrict quickly or with enough pressure and the result is a lag before blood reaches the brain, causing dizziness. Postural hypotension can be treated with an increase in fluid intake or with blood pressure medication.

HEART CONDITIONS A variety of heart conditions can cause feelings of dizziness. In particular, arrhythmia, a dysfunction of the heart characterized by an irregular heartbeat, decreases blood supply to the brain in such a way as to cause balance problems. In most cases, symptoms of dizziness associated with arrhythmia result from problems with heart valves, such as narrowing of the aorta and mitral valve prolapse.

INFECTIOUS DISEASES Influenza and flu-like diseases can cause dizziness, especially if accompanied by fever. The virus herpes zoster oticus causes painful blisters and shingles . If the virus attacks the facial nerve, it may result in vertigo. Several bacterial diseases can result in dizziness, including tuberculosis, syphilis, meningitis, or encephalitis. One of the major symptoms of Lyme disease , which is caused by infection of a microorganism resulting from a deer tick bite, is dizziness.

BLOOD DISORDERS A variety of diseases of the blood result in feelings of dizziness. These diseases include anemia, or a depletion of iron in the blood, sickle-cell anemia, leukemia, and polycythemia.

DRUGS AND OTHER SUBSTANCES A variety of substances ingested systemically to prevent disorders of diseases can result in feelings of dizziness. In particular, overdose of aspirin and other anti-inflammatory drugs can cause problems with balance. Antibiotics taken for extended periods of time are also known to cause dizziness. Streptomycin is known to damage the vestibular system, if taken in large doses. Medicines that are used to treat high blood pressure can lower blood pressure so much as to cause feelings of light-headedness. Quinine, which is taken to treat malaria, can cause dizziness, as can antihistamines used to prevent allergy attacks. Chemotherapy drugs are well known to have various side effects, including dizziness. Alcohol, caffeine, and nicotine are also known to cause dizziness, when taken in large doses.
Diagnosis

Because maintaining posture integrates so many different parts of the body, diagnosing the actual problem responsible for dizziness often requires a battery of tests. The cardiovascular system, the neurological system, and the vestibular system are all examined.

Blood pressure is one of the most important cardiovascular measurements made to determine the cause of imbalance. Usually the physician will measure blood pressure and heart rate with the patient lying down, and then again after the patient stands up. If blood pressure drops significantly and the heart rate increases more than five beats per minute, this signals the existence of postural hypotension. Dizziness in people suffering from diabetes or on blood pressure medicine may be caused by postural hypotension.
Neurological tests

Because the central nervous system is integral to maintaining balance, neurological tests are often performed on patients with symptoms of dizziness. A test of mental status is often performed to ascertain that mental function is healthy. Physicians may test tendon reflexes to determine the status of peripheral and motor nerves, as well as spinal cord function. Nerves in different parts of the body may also be evaluated. In addition, physicians may test muscle strength and tone, coordination, and gait.

Neurologists may also perform a variety of computerized scans that determine if tumors or acoustic neuromas are present. These tests include magnetic resonance imaging (MRI) , computerized tomography (CT ), and electroencephalogram (EEG).
Tests of the vestibular system

Most often performed by a otolaryngologist, the battery of tests performed to determine the health of the vestibular system include the Dix-Halpike test, electrostagmography, hearing tests, rotation tests, and posturography.

DIX-HALPIKE TEST The Dix-Halpike test, also called the Halpike test, is performed to determine if a patient suffers from benign paroxysmal positional vertigo (BPPV). The patient is seated and positioned so that his or her head hangs off the edge of the table when lying down. The patient’s head is moved 45 degrees in one direction. The patient is then asked to lie down, without moving his or her head. The same procedure will be repeated on the other side. If feelings of vertigo result from this movement, BPPV is usually diagnosed.

ELECTRONYSTAGMOGRAPHY (ENG) Considered one of the most telling diagnostic tests to determine the cause of dizziness, electronystagmography consists of a series of evaluations that test the interactions between the vestibular organs and the eyes, also called the vestibulo-ocular reflex. Results from this test can inform the physician whether problems are caused by the vestibular system or by the central nervous system.

The most common diagnostic feature observed during ENG is nystagmus, an involuntary movement of the pupils that allows a person to maintain balance. In healthy persons, nystagmus consists of a slow movement in one direction in response to a change in the visual field and quick corrective movement in the other direction. In persons with disorders of the vestibular organs, nystagmus will produce quick movements in the horizontal direction. People with neurologic disorders will show signs of nystagmus in the vertical direction or even in a circular pattern.

In most of the ENG tests, electrodes taped to the patient’s head record nystagmus as the patient is exposed to a variety of moving lights or patterns of stripes that stimulate the vestibular system. The patient may be asked to stand and lie in various positions for the tests. Also, included in the ENG is a caloric test in which warm water and cool water are circulated through the outer ear. This causes a slight expansion or contraction of the endolymph in the inner ear and simulates movement cues to the brain.

HEARING TESTS Because the cochlea and the vestibular organs are adjacent to one another, hearing dysfunction can often be related to problems with dizziness. Audiograms include tests for both hearing and interpreting sounds, and can determine whether or not problems exist in the middle ear, the inner ear, or the auditory nerve.

ROTATION TESTS Rotation tests evaluate the vestibulo-ocular reflex and provide important information when the dysfunction is common to both ears. Electrodes are usually taped to the face to monitor eye movement, and the patient is placed in a chair. The chair rotates at different speeds through different arcs of a circle. The audiologist may also ask the patient to focus on different objects as the chair is rotated.

POSTUROGRAPHY During posturography tests, a patient stands on a platform that measures how weight is distributed. During the test, the patient will close and open his or her eyes or look into a box with different visual stimuli. The platform is computer controlled so that it can gently tip forward or backward or from side to side. Posturography measures how much the patient sways or moves in response to the stimuli. This provides information on the function of the proprioceptive system, as well as the vestibular system.
Treatment

If symptoms of dizziness are found to be associated with systemic diseases such as diabetes, hypotension, or other infectious diseases, or with neurological disorders, treatment for the dizziness is usually successful.

In many patients, dizziness caused by vestibular dysfunction tends to dissipate with time and with little treatment. However, available and common treatments for vestibular problems include physical therapies, medications, and surgeries. In addition, low-salt diets, relaxation techniques, and psychological counseling may be used as treatment.
Exercises and therapy

The physical therapies to decrease dizziness fall into two major groups. Compensation therapies help train the patient’s brain to rely on the sensory information it receives to maintain balance, and to ignore information from damaged organs. Exercises in a compensation program are designed to focus on the movements that cause dizziness so that the brain can adapt to these behaviors. In addition, exercises that teach the patient how to keep the eye movements separate from head movements and to practice balancing in various positions are used.

Specific exercises aimed at relieving benign paroxysmal positional vertigo (BPPV), called canalith repositioning procedures, have recently been developed. By turning the head to one side and moving from a sitting to lying position in a certain sequence, BPPV can be quickly relieved. The movements in the canalith repositioning procedures are intended to move calcium carbonate crystals from the semicircular canals back to the utricle. The success rate with these exercises can be up to 90%.
Medications

A variety of medications are used to treat vertigo. These include vestibular suppressants, which seem to work by decreasing the rate of firing of nerve cells. Common vestibular suppressants are meclizine (Antivert, Bonine, and Vetrol). Also prescribed are anti-nausea medications such as promethazane (Phenergan) and anti-histamines (Benadryl, Dramamine). For dizziness brought on by anxiety attacks, anti-anxiety drugs such as diazepam (Valium) and lorazepam (Ativan) may be used. These drugs all have side effects and are seldom prescribed for long periods of time.
Surgery

Surgery is usually the last step in the treatment of dizziness, only used after therapy and medications have failed. One of the more common surgical procedures for treating vestibular disorders is patching perilymph fistulas, or tears, at the tops of the semicircular canals. Surgery may also be used to drain excess fluid from the endolymphatic canals to relieve endolymphatic hydrops. Cutting the vestibular nerve just before it joins with the auditory nerve to form the eighth cranial nerve can also be performed to alleviate severe problems with dizziness. Finally, the entire labyrinth can be destroyed in a procedure called a labyrinthectomy, although this is usually only performed when hearing has been completely lost as well.
Resources
BOOKS

Blakely, Brian W., and Mary-Ellen Siegel. Feeling Dizzy: Understanding and Treating Dizziness, Vertigo, and Other Balance Disorders. New York: Macmillan USA, 1997.

Olsen, Wayne, ed. Mayo Clinic on Hearing: Strategies for Managing Hearing Loss, Dizziness, and Other Ear Problems. Rochester, MN: Mayo Clinic Health Information, 2003.
OTHER

“Vestibular Disorders: An Overview.” The Vestibular Disorders Association. November 3, 2003. (April 4, 2004). .

“Equilibrium Pathologies.” Archives for Sensology and Neurootology in Science and Practice. January 2004 (April 4, 2004). .

“Dizziness.” The Mayo Clinic. October 10, 2002 (April 4, 2004). .

“Dizziness and Motion Sickness.” The American Academy of Otolaryngology and Head and Neck Surgery. January 30, 2004 (April 4, 2004). .

“Balance, Dizziness and You.” National Institute on Deafness and other Communication Disorders. November 20, 2003 (April 4, 2004). .
ORGANIZATIONS

Vestibular Disorders Association. P.O. Box 4467, Portland, OR 97208. (503) 229-7705 or (800) 837-8428. .

Juli M. Berwald, PhD

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Positive Thinking doesn’t work, Positive Action does

Positive Thinking Doesn’t Work – Positive Action Does
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Mind over Meniere’s via mail88.atl11.rsgsv.net

May 26 (8 days ago)

to me
Positive Thinking Doesn’t Work – Positive Action Does

Living with chronic illness is hard in the age of the 24-hour news cycle.

The never ending circus of tragedy, crisis, and fear is hard to avoid. Somehow, we’ve decided that the darkest aspects of humanity are what want to see, and all the time.

It finds us on Facebook and Twitter, where the celebrities we follow, and our family and friends, parrot the fear.

We’ve never been more connected, but so many people just use that connection to spread negativity. You see it on social media, in the comments on YouTube, and on blog posts and articles. Everyone’s a critic now.

It’s way too easy to see the world as a depressing place because, from a lot of angles, it is. But it’s also beautiful, and finding a sense of happiness is so important, especially when you have a chronic illness.

I believe in the power of positive thinking, but I also know it’s not practical advice. Happiness and positivity require positive action.

“Action may not always bring happiness, but there is no happiness without action.” – Benjamin Disraeli

So today, I offer you a set of actions that can help boost your happiness. It is possible to live well with chronic illness; it just takes a bit more work.
1) Avoid the news:

While I don’t believe you have to practice positive thinking, you should make an effort to avoid negativity.

The news today is like a fire hose of sadness. It’s a constant barrage of negativity, hopelessness, and despair, without ever offering any solution. Every now and then we’ll see a positive piece thrown in for good measure but the overall trend is unmistakable, and it’s impacting you whether you realize it or not.

“News is to the mind what sugar is to the body.” – Rolf Dobelli

Just imagine what your life might look like if it was the opposite were true. If 99% of the news covered the triumph of the human spirit, our capacity to help others, and our greatest achievements, while only 1% was negative. I know I would be a happier person.

And while it may not be possible to avoid negativity altogether, you can get half way there by choosing to avoid the news. If anything truly important ever happens, you can be sure you’ll hear about it, one way or another.
2) Listen to something inspiring:

It’s important to cut out the negative content you consume, but you will also probably need something to replace it. It’s good then that we have more choices than we’ve ever had before.

The internet has given us access to an unfathomably large new source of information, content, and entertainment. Streaming services like Netflix, YouTube, and Amazon, have changed the way we watch TV, giving us access to the shows we want when we want. But in my opinion nothing is more powerful than audio entertainment, and we happen to be in a golden age of audio.

The internet has not only breathed new life into audiobooks but has also created the opportunity for anyone to have a radio show, called a podcast, that can reach millions of people. Over the last few years, podcasts have exploded in popularity, quality, and quantity, and there is now something for everyone.

Audio is so powerful because it forces you into the present moment, holding your focus and attention, as it activates your imagination. I find that listening to an inspiring story, audiobook, or interview, works wonders on my mental state when I’m struggling with Meniere’s disease.

Some of my current favorite podcasts:

This American Life – The most popular podcast in the US. Highly produced radio documentaries featuring inspiring storytelling on a new theme each week.

Radio Lab – “Radiolab is a show about curiosity. Where sound illuminates ideas, and the boundaries blur between science, philosophy, and human experience.”

Serial – “Serial tells one story—a true story—over the course of a season.” I highly recommend season one. It’s fantastic!

The Tim Ferriss Show – An interview show where Tim deconstructs top-performers in a wide variety of fields to extract the tools, techniques, and routines they use to be so successful.

Reply All – An amazing storytelling show about the weird world of the internet.

Audiobooks: You can use this special link to get 2 free books on Audible (it’s part of Amazon.) You have to sign up for the 30-day free trial of their paid subscription service, but you get to keep the books, even if you cancel before the 30 days are up!
3) Surround yourself with positive people:

We may not get to choose our family, but we can choose to spend time with the right people.

The motivational speaker Jim Rohn used to say, “You are the average of the five people you spend the most time with.” Who are the five people closest to you? Do they support you and your ideas? Do they make you laugh? When you are with them, do you feel like you matter? Or do some of them drain energy, and fill your life with constant and unnecessary drama?

“Let go of the people who dull your shine, poison your spirit, and bring you drama. Cancel your subscription to their issues.” – Dr. Steve Maraboli

Living with a chronic illness is hard enough. You don’t need the added headache of emotionally toxic people. You deserve to be supported, loved, and inspired, and you have a say in whether that happens or not.

Keep the people who truly care, who motivate and uplift you, close to you, and try to spend less time with anyone who brings you down.
4) Hand write a thank you card to someone you love:

If you are already lucky enough to have positive and supportive people in your life, let them know how much they mean to you.

There is something deeply personal about hand writing a sincere and heartfelt thank you note to someone special. It’s such a simple act and one that can have such profound impact on your personal happiness.

“It is not happy people who are thankful. It is thankful people who are happy.” – Unknown

First are foremost, you will strengthen your relationship with that person. Let them know that you care about them, and that having them in your life makes a difference.

It’s also a great way to practice gratitude. When you live with a chronic illness, it’s very easy to get caught up in self-pity and resentment. You may be limited in what you are physically able to do, and that can be hard to accept. But hand writing a heartfelt letter forces you to find and focus on something positive, someone you are grateful for, and gives you the opportunity to express it to them directly.

I challenge every single one of you to hand write and send a thank you card to someone important in your life today. It’s such a simple thing to do, and it will immediately put you in a better mood.
5) Do what you can to help others:

When you live with a chronic illness, you are predisposed to hardship, adversity, and pain. Suffering is usually a part of the deal. But you can alleviate your own pain and suffering, by alleviating the suffering of others. There is nothing in this world that does more to raise the human spirit, than helping others in need.

“Life’s most persistent and urgent question is, ‘What are you doing for others?'”- Dr. Martin Luther King Jr.

Helping others can be as simple as being there to listen to someone in need. You may not be able to solve their problems, but you can be the one to understand their pain.

You can share your story with others, to inspire, or teach, or to help people avoid the same mistakes that you’ve made. You can start a blog for free at wordpress.com, or even just leave a comment on this page. Starting Mind Over Meniere’s has been one of the most rewarding decisions I’ve ever made.

“No one is useless in this world who lightens the burdens of another.” – Charles Dickens

You can also volunteer your time for a charity that means something to you, helping them make a difference by spreading the word, raising money, or doing whatever it is that you can to help the cause. Volunteering for the Vestibular Disorders Association has been a wonderfully rewarding experience for me, and one that I recommend highly.
6) Achieve a small win:

When you live with a chronic illness, odds are, you are going to have difficult days. And it’s hard to feel positive when you’re too sick to accomplish anything important, or anything at all for that matter.

But even on our worst days, it’s rare to be completely incapacitated the entire time. One of the best things you can do is focus on achieving a small win.

What this involves, exactly, is going to be different for everyone. But you can always make the choice to take some small action, to achieve some small obtainable victory, and it can make all the difference.

“If opening your eyes, or getting out of bed, or holding a spoon, or combing your hair is the daunting Mount Everest you climb today, that is okay.” – Carmen Ambrosio

For me, that might mean going for a walk when I don’t feel like leaving the house, or meditating if I’m too fatigued. It could mean eating a something healthy when all I want is comfort food. Sometimes, if I’m working on a book or a blog post, it means just writing a couple of sentences. More of the time, however, it means allowing myself to rest without feeling lazy or guilty.

Whatever small win is within your reach today, take it. It will make you feel better.
Conclusion:

You don’t have to practice positive thinking to be a positive person. It can help, sure. But nothing beats positive action. The things you choose to do make just as much, if not more of an impact, than how you choose to think. And when you act first, the mindset follows.

“The measure of who we are is what we do with what we have.” – Vince Lombardi

I hope you will give some of these suggestions a try. You didn’t choose to live with a chronic illness, but you can choose what you’ll do next. I hope you choose something positive.

Written by Mind over Meniers.

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What is an Invisible Disability?

March30,2016
What is an Invisible Disability?
Invisible Disabilities Association – InvisibleDisabilities.org

By Guest Blogger Wayne Connell, Founder, Invisible Disabilities Association

What is an “invisible disability?” Is it a specific illness or condition, such as multiple sclerosis, fibromyalgia, bipolar disorder, diabetes, a Chiari malformation or syringomyelia? Is it the symptoms of an illness or disability, such as pain or fatigue or neuropathy or brain fog? Why do we even use the phrase or where did it come from? Isn’t a disability just a disability, no matter if you can see it or not? Are people treated differently because their disability manifests itself visibly? Is having a disability different from being disabled? All great questions! Is someone, who has an illness or is in pain or has a disability or is disabled, a bad person who should be treated like a lesser human? I can answer that one. NO!

Twenty years ago in 1996, my wife, Sherri, coined the term “invisible disability.” Why did she come up with it? After receiving a diagnosis of primary progressive multiple sclerosis and chronic late stage Lyme disease in 1991, at the young age of 27, Sherri endured the stares and accusations and disbelief of strangers and friends that questioned how she could be disabled and still walk with seemingly unapparent outward signs of her disabilities. People would often scream at her when she parked in an accessible space or ignore her when she collapsed on the floor of a department store. So the phrase, “I have an invisible disability,” became an apt description of what she was living with.

As a tech guy, I decided to use some of Sherri’s pamphlets she wrote to help friends and family better understand what she was going through such as “Multiple What? Untangling the Perplexities of Multiple Sclerosis” and “Don’t Judge by Appearances – Parking with Invisible Disabilities” and created the InvisibleDisabilities.org website. That is when The Invisible Disabilities Advocate® was launched (which became the Invisible Disabilities® Association (IDA)). Almost immediately, 25,000 people a month started coming to IDA’s website and said that we put into words what they had been trying to tell their friends and families. “Invisible disabilities” progressed from a very descriptive term to an international organization and movement.

Of course, the question most-asked of our organization is, “what is an ‘invisible disability?’” In general, the term “disability” is often used to describe an ongoing physical challenge. This could be a bump in life that can be well-managed or a mountain that creates serious changes and loss. Either way, this term should not be used to describe a person as weaker or lesser than anyone else! Every person has a purpose, special uniqueness and value, no matter what hurdles they may face.

In addition, just because a person has a disability does not mean they are disabled. Many living with these challenges are still fully active in their work, families, sports or hobbies. Some with disabilities are able to work full or part time, but struggle to get through their day, with little or no energy for other things. Others are unable to maintain gainful or substantial employment due to their disability, have trouble with daily living activities and/or need assistance with their care.

According to the Americans with Disabilities Act of 1990 (ADA), an individual with a disability is a person who: has a physical or mental impairment that substantially limits one or more major life activities; has a record of such an impairment; or is regarded as having such an impairment.

Furthermore, “A person is considered to have a disability if he or she has difficulty performing certain functions (seeing, hearing, talking, walking, climbing stairs and lifting and carrying), or has difficulty performing activities of daily living, or has difficulty with certain social roles (doing school work for children, working at a job and around the house for adults).”

Often people think the term “disability” only refers to people using a wheelchair or walker. On the contrary, the 1994-1995 Survey of Income and Program Participation (SIPP) found that 26 million Americans (almost one in 10) were considered to have a severe disability, while only 1.8 million used a wheelchair and 5.2 million used a cane, crutches or walker. In other words, 74 percent of Americans who live with a severe disability do not use such devices. Therefore, a disability cannot be determined solely on whether or not a person uses assistive equipment.

The term “invisible disability” refers to symptoms such as debilitating pain, fatigue, dizziness, cognitive dysfunctions, brain injuries, learning differences and mental health disorders, as well as hearing and vision impairments. These are not always obvious to the onlooker, but can sometimes or always limit daily activities, range from mild challenges to severe limitations and vary from person to person.

Also, someone who has a visible impairment or uses an assistive device such as a wheelchair, walker or cane can also have an invisible disability. For example, whether or not a person utilizes an assistive device, if they are debilitated by such symptoms as described above, they live with an invisible disability.

Unfortunately, people often judge others by what they see and often conclude a person can or cannot do something by the way they look. This can be equally frustrating for those who may appear unable, but are perfectly capable, as well as those who appear able, but are not.

International Disability expert Joni Eareckson Tada explained it well when she told someone living with debilitating fatigue, “people have such high expectations of folks like you [with invisible disabilities], like, ‘come on, get your act together.’ But they have such low expectations of folks like me in wheelchairs, as though it’s expected that we can’t do much.”

The bottom line is that everyone with a disability is different, with varying challenges and needs, as well as abilities and attributes. Thus, we all should learn to listen with our ears, instead of judging with our eyes.

At the Invisible Disabilities® Association, we do not maintain a list of specific illnesses and diagnoses that are considered invisible disabilities. There are thousands of illnesses, disorders, diseases, dysfunctions, genetic defects, impairments and injuries that can be debilitating. Therefore, all conditions that are debilitating are included when we talk about invisible disabilities. However, our focus is not to attempt to provide a vast amount of information about thousands of specific conditions (there are plenty of amazing organizations that do that).

IDA is here to provide awareness, education, connection and support for everyone who lives with a debilitating condition. We do this by offering articles, pamphlets, books, resources, radio interviews, video, seminars, symposiums and more to give hope and compassion to all living with invisible disabilities as well as information for loved ones to better understand.

IDA’s mission is to encourage, educate and connect people and organizations touched by illness, pain and disability around the globe. Hard to believe it has been twenty years yet there is still so much more work to do. Will you join us on this journey and envision a world where people living with illness, pain and disability will be Invisible No More®?
About the Guest Blogger

Wayne Connell, the founder and president of the Invisible Disabilities® Association (IDA), established IDA twenty years ago in 1996 out of the desire to educate friends and family about his wife’s debilitating illness. Soon afterwards, people around the globe began sending emails sharing how IDA had changed their relationships with their loved ones. He is co-author of the book, “But You LOOK Good, How to Encourage and Understand People Living with Illness and Pain.” Wayne’s background fueled his passion for helping people living with illness, pain and disability. His experience includes that of a professional, multitasking husband caregiver with an extensive background in management, media and technology. This man on a mission quickly launched IDA into a world-wide outreach for millions living with invisible disabilities.

Make sure you check out IDA’s website for additional resources and stories at www.InvisibleDisabilities.org. Share your personal video story with us at www.InvisibleNoMore.tv. You can also be part of other people’s stories by joining them at www.Facebook.com/invisibledisabilities or becoming a member of InvisibleDisabilities.Inspire.com. Join IDA at our 2nd annual Brain IDEAS Symposium on August 5th. Invisible Disabilities Week is Oct 16 through 22, 2016. Our 9th Annual Awards Gala, “Jazzed About You” will be Octob

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Till it’s gone by Hockey Player Bryce Salvador

‘Til It’s Gone
Sep 2 2015
Bryce Salvador
Defenseman / New Jersey Devils

The slap shot hit me in the face with 53 seconds left in the game. I could actually feel the force of the puck go all the way through my head and then out my right ear. My teammates on the New Jersey Devils immediately rushed over to where I was slumped on the ice. I looked up, bleeding badly from my face, and saw all these blurry red jerseys standing over me. Their mouths were moving, but I couldn’t hear what they were saying. All I heard was a high-pitched ringing.

When I got home that night to my wife and kids, my ears were still ringing. I could barely hear what my wife was saying. Two days later, we played the Rangers. I played 20 minutes and had an assist, but I could hardly hear the crowd. My ears didn’t stop ringing for months, but I finished the rest of the 2009-2010 season. Call it dumb hockey player pride or whatever you want, but the fact of the matter is that we play through pain, even broken bones. My teammates have done it. I’ve done it. In my mind I was hurt, not injured. So I adapted and gritted my way through it.

All spring, my wife and kids had to shout at me like I was a 90-year-old grandpa, but the crazy thing is I finished the season playing well. I had to take five injections directly into my eardrum for the ringing to finally go away, but on the spectrum of all my hockey injuries I thought this was nothing. A bunch of stitches and ringing in my head? I’ve had worse.

That summer, I was doing some routine one-legged exercises when I noticed something was off. I was practically falling over. When both feet were on the ground, my balance was fine. Great, even. But when I lifted one leg, I was a mess. In my head, I’m thinking, Maybe I’m just getting old? So I went nuts, and doubled down on my training. I didn’t know it at the time, but my body was essentially “faking it.” I was running on fumes, smoke and mirrors. There was much more going on under the surface.

The following preseason, everything changed. I got into a little scrap, and my opponent punched my helmet with a pretty weak shot. It sent me to my knees. I’m thinking, Okay, that’s weird.

After that, every time the puck would get rimmed around the boards or I’d try to receive a pass during practice, my stick would completely miss the puck. I mean, I couldn’t chalk this up to a few bad workouts. I’d go to make a pass and the puck wouldn’t even be on my stick. This was serious. My depth perception was totally off. It was an embarrassing blow to my confidence. I worried that I was letting my teammates down. Now the fear was starting to creep in. Maybe I lost more than just a step…

Then it got worse. I’d get checked — not a big shot, just normal stuff like getting rubbed out along the boards — and the next two seconds would be a blur. It felt like my system was taking time to reboot after each hit. If I had to skate circles and spin around, I would get so nauseous that I’d almost be sick. My first thought was that I had the flu or something.

Later in the preseason, I took a shoulder to the chin. It wasn’t anything spectacular, just another routine hit like thousands of others before. But I was just… out. I didn’t know where I was. The ringing returned. I was taken to the hospital, and when the doctors told me what happened, I was almost relieved. “Okay, I’ve got a concussion. At least I know what’s wrong.”

Then things got really weird.

I traveled everywhere and saw all the right doctors. I followed all the right protocols. I took all the tests. After a few weeks of rest, I did feel better, but also strangely off. Cognitively, I was fine. My memory was good. I didn’t have headaches. I passed my tests. But when I tried to step onto the ice, I had no concept of where I was in relation to anything else. Everything was white. The ice was white. The boards were white. All the visual signposts were gone. I’ve skated on the same ice hundreds of times, but now all of a sudden I felt lost. When I tried to drive at night, it felt like I was floating through space.

And yet nobody could seem to tell me what was wrong. I spent an entire month at the Kessler Institute for Rehabilitation in New Jersey running through a battery of tests, and all my progress seemed to plateau at a certain point. Whenever I had to exert myself, I’d feel a wave of nausea and dizziness, like I was seasick. One day, out of frustration, I just quit going. Not that they hadn’t helped me; actually it was quite to the contrary. I was learning to sense instinctively what my body was telling me.

I did not like what it was saying.

I told the specialists, “This isn’t working, anymore. I don’t know how I know, but I just know.” The sad and scary thing was that while I knew it was no longer helping, I also understood that I had no idea where to turn to next.

At home with my family, I was becoming someone they didn’t know. My boys were four- and one-years-old. Any little thing they did, I would lose my temper. Noise bothered me. Light bothered me. I couldn’t go out to dinner. I couldn’t do anything social. I couldn’t train. I couldn’t even drive with my wife and kids to a movie at night without getting sick.

The uncertainty was turning me into a monster. Then I had one of the scariest thoughts I’ve ever experienced: Am I going to feel like this for the rest of my life?

One morning, I woke up and my wife turned to me and said, “You need to figure this out. You can’t just give up. You need to get better for us.”

I went and sat down with Devils general manager Lou Lamoriello and I admitted to him that I was not getting better. That was a tough moment. Here I am making good money, and I’m telling my GM that the doctors can’t figure out what’s wrong with me. But Lou was phenomenal about it. He said, “Bryce, just keep seeing specialists. Wherever you want to go, whatever you want to do, take as much time as you need.”

Lou, thank you.

A few weeks later, the NHLPA’s Dr. John Rizos was able to get me an appointment with Dr. James Kelly, a military doctor who only sees civilian patients one day a month. After a battery of tests, Dr. Kelly explained that it wasn’t just my head that was the problem, it was my eyes and ears, too. My vestibular system was broken. Basically, the computer chip controlling my spatial awareness, vision, and balance was damaged.

The vestibular system runs on three tools: Your feet, eyes and inner-ear. If you lose one of those tools, your body can still function. Lose two and you’re done playing professional sports. Period. When I was hit in the face with that slap shot the force caused an inner-ear concussion, so my feet and eyes took over and I was able to fake it. But somewhere along the way a different hit caused damage to my right eye. Now my two eyes were not communicating with one another and as a result my system short circuited.

I was skeptical, but Dr. Kelly looked at me and said, “Look, I’ve seen soldiers come in here after IED explosions in a lot worse shape than you. You are going to get better.”

That’s the moment I stopped feeling frustrated and sorry for myself. At the very least, I finally had an answer. So how do you rebuild a broken vestibular system? Well, that’s a funny story …

I was sent to a vestibular rehab center in Denver, where I was essentially taught in the art of child’s play. It turns out that the vestibular system is like a muscle. Kids exercise this muscle all the time by jumping around, doing tumbles, spinning, and just generally being kids. So in order to re-calibrate my system and build up my muscle, I had to embrace my inner child.

Every single day, for hours on end, this was my rehab routine: I would walk, jog and run with my eyes closed. I would jump on a trampoline and call out the names of shapes and colors until my brain was in a fog. I would sit in an office chair and spin until I was so dizzy that I was on the verge of puking. They told me it should take a normal person 10 seconds after spinning in a chair for the dizziness to go away. That was my target. When I first started, it took me more than a minute to re-calibrate.

In addition to all that, I was doing intensive vision therapy in hopes to “reconnect” my eyes back to each other, and then back to my circuit board. This went on for seven months.

When I would go to the rink, teammates would ask me, “What’s wrong? You seem to look just fine.” They didn’t mean anything by it, but what was I supposed to say? Was I supposed to tell them I was jumping on a trampoline and spinning in chairs for hours a day while they are gutting out the NHL season? They didn’t want to hear that. It was one of those injuries where coming back to play was based on “How do you feel?” It made me crazy to think that maybe — just maybe — people were thinking, “Is he really even injured?”

But what fueled me even more was the thought that my kids didn’t really understand what Daddy did for a living. They were just starting to understand hockey when I got hurt. Now I was just this grumpy guy they were stuck with all day. They had to see me back out on the ice in a Devils jersey, even if I had to go through hell to get there.

Slowly but surely, the rehab worked. I would stand up from the office chair and be dizzy for 45 seconds. Then 30 seconds. Then 15. There’s a cliche that you don’t know what you got ’til it’s gone. When my dizziness went down to the standard 10 seconds, I thought I was going to start crying.

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That summer, I spoke to Lou Lamoriello over the phone. I told him, “I’m going to play. I’ll be ready come training camp. You have my word.”

When my dizziness went down to the standard 10 seconds, I thought I was going to start crying.

Look, I was 35 and had just spent an entire NHL season in the wilderness. The trend of the NHL getting a lot younger and faster wasn’t exactly working in my favor. Contract aside, a lot of GMs would’ve found a nice and professional way to politely move on without me. But Lou gave me a real chance.

I just had one request: No special treatment. No kid gloves, and definitely no sympathy. Treat me like a everyone else on this team. That season, I played all 82 games and helped the Devils reach the 2012 Stanley Cup Finals. It was by far the most rewarding season of hockey in my life. Not because I had personal success or even because I overcame my injury, but because the team came together and sacrificed everything to get to the Finals. You can’t believe how good it feels.

I have a photo in my house of my two children banging on the glass while watching me take warmups before Game 1. They’re wearing No. 24 Salvador jerseys.

That’s their Daddy. That’s what he does.

Today, I am retiring from the National Hockey League. I achieved my goal of coming back so that my boys would be able to remember me as an NHL player, and now I am content to step away on my own terms. But I am not leaving hockey, and I am not leaving New Jersey or the Devils. This organization never stopped believing in me, even when I was spinning around in office chairs.

This place made me.

Now, by working with the Devils and local New Jersey hockey organizations, I hope to be an example for young players and spread access to the game for everyone. I want to pass on the lessons of perseverance, sacrifice, and determination that I was fortunate enough to have learned while playing hockey. If I believe in one thing in life, it’s that hockey is a force for good. It can change kids’ lives and give them an outlet so that no matter what’s going on with them personally, they can get on the ice for a few hours and forget about everything but that little black piece of rubber.

I’m ready for my next shift, one that includes spending time with my wife and boys. Thank you to everyone who made this journey possible. It wasn’t easy. After I was drafted, an NHL scout told me, “Salvador, you’re never going to make it. Too slow, too soft. You’ll never play a game in the NHL.”

Here I am, 786 regular season and 74 playoff games later, retiring as a captain. No matter what anybody says, they can’t take this away from me:

I played in the freaking NHL.

It’s enough to make you dizzy.
Bryce Salvador / Contributor
Salvador signature

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How to communicate living with Vestibular Dysfunction

Well written words written by Fran Barnett about living with Vestibular Disorders.

Vestibular Disorders Association (VEDA)
February 25, 2015

TO ALL PEOPLE STRUGGLING WITH VESTIBULAR DISORDERS… THE CHOICES OF CONVERSATION….. As we survive in this big , beautiful world. We are taught and persuaded to always engage in good communication.That communication will and can be the best tool in life. So, therefore we have all participated in conversations with friends or family. We choose sometimes to talk about work, family, struggles, relatipnships, or fun things we have engaged in. So, the question remains in my head…unanswered.. How does discussing a chronic illness in a general conversation, be so often thought of as complaining or negative? For to learn and educate yourself or others, they must be discussed or read. We teach our children everyday by discussing things or reading. Sometimes, things are positive and sometimes negative. Life consists of both. HOW , we choose to handle them is what determines our existence. So, WHY…would discussing a chronic illness be any different than just a regular conversation. Is it so horrible to accept that we choose to discuss it. Does it make others feel uncomfortable. Or does maybe just the real reality of the conversation make others uncomfortable. Why would I have to watch the way I discuss it. ITS MY ILLNESS…AND I CAN CHOOSE TO DISCUSS IN My way…Whether I use it as a release, or an education process for myself and others. Or simply as a way to prepare myself for my new life. By preparing, I mean the changes you adjust to. The things you cannot engage in. Day by day, we can choose. We make our day as comfortable and easy to help us get by. EVERYONE, in life does that. So, why when a chronic illness sufferer tries to make their day easier is it any different than a healthy human doing the same. For, if we discuss how we plan our day to make it easier, we are sometimes looked upon as thinking about the illness to much, and therefore bringing it on more. IN OTHER WORDS…CAUSING OUR SYMPTOMS BY TALKING ABOUT IT. Are others so uncomfortable, because they just don’t get it. I would think to myself, that is their issue. Of course, they probably don’t get it….unless they actually got it.. But, I have found ….EXPRESSION. …To be a healthy release.. So, if communicating and expressing my feelings are so negative to others…Why, I think they should rethink it. Lets just for one day…have a healthy human spin themselves in a chair for 30 minutes. STOP…THEN….lets just see how easily you can function….Maybe. possibly…they may get it for a bit… But. Truly…I believe that we all have the right to use our words.They are yours to release your inner thoughts. NEVER HAVE I HEARD OF A LAW. RESTRICTING CONVERSATION ABOUT CHRONIC ILLNESS. So, if you feel the need to speak, go ahead. DO NOT allow others to make you feel guilty or as though you cannot express yourself. For. I have found my best medicine to be my expressing. YOU and ONLY YOU ……can determine what is best for you to manage yourself. No one else…unless they live it. So, if I choose to be positive or negative. My choice…mostly positive. Its still my choice and I determine how I will manage my new lifes reality. How others react is beyond our control, but with education we can all learn about this disorder. Making our lives a beautiful, UNIQUE, new reality. NEVER… be afraid to express yourself to others…whether positive or negative. We are who we are..just humans..not perfect..just trying to find a balanced recipe for our new life. Try to always remember the good days(positive) …..but dont feel ashamed for a bad day..(negative). I’m happy with my existence whether perfect or not. I. Now UNIQUE in a way I never knew existed. I WISH YOU ALL A UNIQUE HAPPY DAY!

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