I sat on the side of the road with the world spinning around
my head. I could not stand. I had the feeling of impending nausea. The actual nausea soon followed. Just moments ago, I had been riding my
bicycle, enjoying the sun, the crisp gear changes of a perfectly designed and
tuned drive train, and hurrying toward home so as not to be fussed at for being
out too long.
The vertigo, that’s what it’s called, came on suddenly as I
was riding. At first, it felt like the
road was moving underneath me, like I was being blown about by a strong
wind. I looked around and I listened. I
realized that the wind was not that strong.
The spinning was happening inside my head. I rode more slowly trying to keep the bike in
the bike lane. It was not working. I began to be afraid that I would fall or
worse yet swerve out in front of a car. I
pulled into a parking lot of empty storefronts to assess and see if it would go
away. I was about eight miles from home. Janice was at home getting ready to go to the
lake house for the evening. I needed to
be home so I got back on the bike and tried to ride. About a quarter mile or less, I recognized
that I had to call Janice to come get me.
So I stopped on the side of the road.
I could not stand on one leg and swing the other over the bike seat like
a normal person. I laid the bike down
and tried to step over the bike on the ground and I just tumbled onto the
concrete sidewalk. I sat and called Janice. I am sure the voice sounded normal but the
words could not have made sense to her. “I
can’t make it home. I need you to come
get me.” I did not say I had a wreck or
a flat or anything recognizable. I could
not yet put words to what the problem was.
I did not know. I told Janice to
pick me up from a grocery store parking lot across the street from where I sat. I thought it would be easier and safer to load
the bike in a parking lot than on the side of the street.
Now, as I waited, my head spun. I wondered what was causing it. Did I have food poisoning? I had not changed the water in the water
bottle before leaving. Could the old water
be contaminated with bacteria? Was it a
stroke, a tumor? I then tried to get up
to walk across the street. I could not
stand at all. I leaned against a metal
light pole for balance. The parking lot
was as far beyond my ability at the moment as flying to the moon. I sat and called again. “Pick me up from the Turnpike,” I said, “across
from Bruner’s. I can’t make it to the
parking lot.” The concern was evident in
Janice’s voice but she followed with no questions, no comment. She said, “I am coming.”
I was no help loading the bike. Janice put it in the back of the station
wagon by herself. This in itself felt
unnatural to sit while Janice took care of my bike. I sat in the passenger seat feeling very strange. I soon felt the nausea rising in my
throat. I opened the door and saw my
lunch and breakfast spread before me on the curb in a slurry of brown
liquid. “Feeding the birds” was what the
coach called it a thousand years ago in track.
I thought of the phrase as a leaned out waiting for the next wave to
hit. Janice waited. I heaved until there was nothing left but
wrenching spasms. “What can I do?” she
asked. The nausea began to wane. “I want to go home.” I asked for a plastic bag to use if the nausea
came back on the way.
As we drove the few miles to the house, I did need the bag
several times. It was the violent kind
of sickness that feels as if you are dying even when you are not. I know that it eventually goes away when the
stomach is completely empty. I am aware
that dizziness can cause vomiting and stomach upsets that result in vomiting
can cause dizziness. I was wondering
which was the cause and which the effect.
Once back at our house, I staggered in holding onto anything
handy and banging from one wall to another.
We had to decide our next move, “wait and see,” “ go to the ER,” or “call
the family doctor’s Saturday walk-in clinic,” were on the table. Janice opted for the last. After a brief description of symptoms, the
response from the doctor’s office was quick and emphatic. Go to the ER now. So I changed out of my bike clothes and we
went. I vomited again at the door to the
ER. They brought a wheelchair for me. I wondered if I would be treated by people in
hazmat suits as a potential ebola case.
I was asked if I had been in West Africa and my answer of no was
sufficient I suppose. People treating me
just wore normal latex gloves.
We spent most of the afternoon and evening in the ER being
evaluated. I gave my medical history
(very limited), allergies (none), and medications (a vitamin) several times. I got some curious comments that I was the
easiest patient all day because the list was so short. I think the ER doctor came to the correct
diagnosis pretty quickly but he still evaluated the other more serious possibilities
of stroke and cancer. I had a CAT scan
which came back normal. The ER doctor described
to me what he thought it was. He said
that crystals (called canilyths) had formed in my inner ear and when they broke
loose from the upper wall of the cochlea or the vestibule, they came to rest on
the sensitive nerves involved in balance and perception of motion. The dizziness was the manifestation of false
signals to the nerves. The ER doctor
said he expected my dizziness to subside rather quickly. He tried a maneuver of rotating my head from
one side to the other. The objective he
said might reposition the crystals into the less sensitive anterior portion of
the cochlea. He said it might help. We tried a test walk down the hall. I failed.
He recommended admission for overnight observation and probably an MRI
the next day. This was just good careful
medicine I think. He was pretty sure of
the diagnosis, just not too confident in the success of the recommended
treatment. So I spent the night in the
hospital. I had a dose of AntiVert
(meclizine) in the ER. A side effect is
drowsiness. I slept well in the
hospital.
I got an IV the next day for hydration. I thought this was curious. The nurse’s explanation was not particularly
satisfying but eventually it became clear from reading the internet that liquid
levels in the ear can be affected by dehydration. My weight that I reported in giving my
medical history was more that 10 pounds greater than what they measured in the
hospital. (It must be the calibration of
the scales. My home reading is still read the same.) Anyway I got a saline drip all day. There is nothing like being attached to a pole
to make you feel seriously ill. About 11:30,
I went for an MRI. About 1:30 the
hospital doctor (different doctor from the ER doctor) came by to tell me I was
free to go. The MRI came back
normal. He gave me a name for the
diagnosis, benign paroxysmal positional vertigo or BPPV. He prescribed AntiVert and physical therapy
where presumably they will do the head maneuvers again to help reposition my
sloshing crystals. He told me not to drive. He recommended a cane to help with balance.
This last is funny because Janice and I have been discussing
with our friends how to get parents to agree to stop driving and how we will
handle it ourselves. In those
discussions, we have been noble about how well we would handle it. I envisioned this scene in 20 or so years
with my Google self-driving car already in the driveway. It is ironic, that I am facing the
possibility of never driving again at the ripe old age of 62. The cane is just as ironic. I pleaded with my mother, whose balance
became poor in old age, to use a walker or a can. Her pride kept her from doing it. And, she fell repeatedly. Now, I will be carrying either the cane with
me or the hyprocrisy of leaving it behind.
I had BPPV googled within seconds of the doctor’s departure
from the room. It is common and
frequently, as in my case, idiopathic, meaning that there is no obvious cause for
the onset of symptoms. The consequences
are wide ranging. It can be serious
enough to be considered a permanent disability.
Sometimes it goes away, sometimes it recurs intermittently, sometimes it
is permanent and totally debilitating.
My outcome is still unclear. My
symptoms on day two after onset are not too severe. I feel some dizziness when standing. When reading a book or the screen of the
computer, the words jiggle. It is tiring
to keep the words in focus. I have a
cane that was used as a decoration in an umbrella stand at my side but I don’t
use it.
I am at the point of comparing before and after. Before, I was aware that my balance and
reflexes were good, much better than average.
I was quick, agile, and confident in my sense of balance. I
bought a fine racing bicycle at age 60, a world-class water ski boat at age 62
as a testament to my enjoyment of sports requiring balance, reflexes, and
strength. I climbed ladders, stood on
chairs, and generally took risks that would not be wise for a person of less ability
of any age. Now, I am a completely
different person.
What will I do now? As
you might guess, there is an online forum for those who have BPPV. I am a sucker for reading such things. I will probably waste a few hours a day there
for a while until it]the questions and answers become repetitious. I am wondering what I can do for
exercise. I may be able to walk
eventually, possibly jog. These two activities
have been approaching becoming the same exercise for a while now anyway. My current health issue may bring them closer
together. I am worried about finishing
the cabinets in the kitchen. Shop safety
depends on balance too. I am not sure if
I can work safely. I will have to give
it some thought and give my body some time to adapt. Maybe, I will be one of the lucky ones whose
symptoms go away. I don’t know.
I have a doctor’s appointment at 3:00 with an old friend and
physician. It will be an interesting
discussion.
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