Kay Varron knows a bit about health and how to navigate the medical system. The 54-year-old former resident of Hagerstown works at Washington County Hospital as an electroencephalography (EEG) tech.
But a year ago, Varron woke up with her head spinning.
"In November of '09 I woke up in the middle of the night. Something wasn't right. I was off balance," she said.
Varron, who now lives in Gettysburg, Pa., went to her family doctor. They told her she had vertigo and gave her a prescription medication. She felt better, but not well. She still felt imbalanced physically and mentally.
"I couldn't drive. I couldn't do my work," she said. "I was slow getting my thoughts out. It really affected me."
Causes of dizziness
Varron's symptoms are typical for vertigo or chronic dizziness. Some people feel light-headed, confused or unsteady on their feet. Others feel like the world is spinning or that they themselves are spinning. Others feel as if they are moving even when they are sitting, lying down or standing.
Related symptoms include headaches, nausea, improper speech, inability to walk properly and falling.
Vertigo is a common problem among American adults. According to the National Institutes of Health, about 40 percent of people in the United States report having a dizzy spell at least once during their lifetimes.
Many things can cause vertigo, such as inner-ear infections, a head injury, an imbalanced diet, taking certain medications or low blood pressure.
Dr. Michael DeCriscio, a Hagerstown chiropractor specializing in balance and dizziness, cited three components of good balance - the motion-sensing organs of the inner ear, vision and receptors in the joints. Working together, they provide a person's proprioception - a sense of how a person is oriented in gravity. (See sidebar at end.)
"Those things have to be in sync," DeCriscio said. "If those three sensory systems aren't working together, and your nervous system can't compensate, the result could be vertigo or imbalance."
Dizziness or balance problems become more common as people age.
"It's huge," said Dr. Virginia Wise, a Hagerstown audiologist. "It's the third-most-common diagnosis in people over 65 after heart disease and cardiovascular disease."
Another set back
After Kay Varron's middle-of-the-night vertigo episode, she had to take two months off work.
Then, in May, it happened again - she awoke at night feeling dizzy and off-balance. She also had a drooping eye.
Varron wasn't satisfied with her doctor's diagnosis of Bell's palsy or the effect of the prescription drug. She believed something serious must have happened to cause her physical and psychological symptoms.
"My balance was off and my personality was bad," she said. "I was very rude. Normally, I get along with anybody and everybody."
Eventually, Varron was referred to DeCriscio at his chiropractic office in Hagerstown. That was the beginning of a dramatic turnaround.
Make it stop
Traditional treatment for vertigo involves physical therapy and prescription medication - Meclizine is the standard drug. But recent research into how the brain functions is leading to new approaches in treatment, DeCriscio said. The brain, he said, is much more flexible than once thought. It can be retrained to improve a person's function.
DeCriscio has recently opened Center for Dizziness & Balance Disorders, a multidisciplinary practice with four providers in Hagerstown. DeCriscio and Wise will work with registered dietician Sarah Hammaker and psychologist Cia Parker to address most symptoms of vertigo in one office.
"We don't want to bounce patients around the community," DeCriscio said. "There's physical components, psychological components, nutritional components. We try to find out what causes a patient's symptoms."
Step one is to look at a person's medical history and do a physical exam to confirm that the patient's condition is related to vertigo or a balance disorder. Then, as needed, a patient works with specialists within the office.
Wise will work with patients with hearing and the inner-ear balancing system. DeCriscio will work with brain-based therapy and balance retraining. He is board certified in vestibular rehabilitation.
Diet can also affect balance. Dehydration and low blood-sugar levels can cause lightheadedness, Descriscio said.
Then there are psychological issues connected to dizziness or imbalance. Understandably, people might dread going out in public if they feel nauseous, can't walk in a straight line or are afraid of falling down. This can lead to depression, anxiety or other emotional problems.
The good news is this broad approach to vertigo and dizziness can be successful. Wise emphasized the benefits to patients of a multidisciplinary office - it allows patients to go to one place for a variety of treatments.
"There's great statistics on how long it takes, how many specialists people go to before they get relief for vertigo," she said. "This office is a true collaboration with different specialists."
Kay Varron's story has taken a turn for the better. DeCriscio worked with her on a series of eye-movement exercises and balance exercises. He manipulated of her joints to improve her proprioception.
Working with DeCriscio has reduced her symptoms and brought her life back in balance.
"This has helped me in a lot of ways," she said. "I just hope I can help the next person.
To contact the Center for Dizziness & Balance Disorders, call 301-739-7667.
A health word to learn: Proprioception
Take five seconds and do this experiment: Close your eyes. Can you tell where your right hand is without looking? Now extend your left hand and slowly wave it up and down. Now right and left.
Finally, still with closed eyes, straighten both arms in front of you and bring your left and right forefingers together until they touch.
OK, now open your eyes.
Without looking, could you feel your hand in space? How close did you come to making your forefingers touch tip to tip?
This ability to locate our limbs in space is called proprioception. It is considered a specialized human sense, along with taste, smell, sight, touch and hearing. Proprioception allows us to walk without having to watch where we make our feet step. It allows us to drive a car without watching our feet so we can make them move to the proper pedal or watching our hands so we make them move to the radio knob or the turn lever.
Proprioception is one of our most taken-for-granted senses. But without it, walking, eating, playing basketball and learning to type on a keyboard would be virtually impossible.
-- Chris Copley