The good news is that my vertigo has mostly gone away. Mostly meaning that I am a bit unsteady just when I get up in the morning. The rest of the day, I seem reasonably steady. (I can stand on one foot with my eyes closed and touch my nose with one hand then the other.) I am now focused on preventing the next paroxysm from occurring.
I am still reading online articles about the symptoms, causes, and cures of various types of vertigo. Of all the possible causes, the rocks in the ear (BPPV) and Meniere's disease (loss of level control in the inner ear) seem to be the most likely causes. Of the two, you would much rather have BPPV. Meniere's disease doesn't go away and the vertigo is accompanied by ringing in the ears and hearing loss. I have some ringing which existed before my recent episode and some hearing loss which also pre-existed. I think the descriptions for Meniere's are much more severe forms of tinnitus and hearing loss than what I have. So, I am going to assume the ER doctor's diagnosis of BPPV is correct.
I really can't find much help online on preventing recurrence. I have read some websites which advocate homeopathic remedies that are basically a healthy lifestyle. I was already doing as that as well as I can. The only thing I read that I might improve is drinking more water. I am now adding four large glasses (probably 12-16 oz each) per day to my liquid intake. I think the idea is to change the solubility of the fluid in the ear can so that calcium carbonate is not as likely to precipitate out and form crystals in the inner ear. My view on extra water is that it can't hurt. The consequences so far are that I am no longer able to sleep through the night without going to the bathroom or to make the trip from Oak Ridge to Atlanta without stopping.
The next question is whether physical activity, specifically running, biking, or swimming, triggers an onset. I have read that swimming face down and swinging the head to the side to breathe as in crawl stroke can bring on an episode. I will hold off on that. (I haven't swum regularly since 2005 anyway.) I wonder if the biking in the lowered aerodynamic position on the bicycle also may cause the otoliths to redistribute into the sensitive areas of the ear canals. It certainly seemed to be related to my first episode. I will ride exclusively up on the hoods for now. I was mostly riding in this position anyway just because it is easier on the back and shoulders.
I am going to ride my bike on a stationary trainer tomorrow to see how it goes.
