Bill Hurwitch was biking near his Acton home last September when he fell, breaking his left shoulder, collarbone and a rib. Mr. Hurwitch, a technology management consultant, soon realized he had another problem: after lying down, he felt extremely dizzy when he stood up. Marcia Reinstein, PT, his Emerson Hospital physical therapist, suspected benign paroxysmal positional vertigo (BPPV) and referred him to Naseem Chatiwala, DPT, NCS, who specializes in vestibular rehabilitation. As Mr. Hurwitch learned, the source of his problem was his vestibular system, the tiny canals located in the inner ear.
Even though I was wearing a helmet, I hit my head pretty hard, because I lost consciousness, and a CT scan of my head showed a small amount of blood. However, the initial concern was with my shoulder and collarbone. Once I got home from the hospital, I noticed the dizziness — like the room was spinning — when I got out of bed in the morning. I had to wait and sit there until it stopped.
I also became dizzy if I moved suddenly. I didn’t think of it as vertigo. I thought it was a symptom left over from banging my head. I had to raise the head of the bed when I slept, and that helped with the dizziness.
About seven weeks after the accident, I was cleared to take off the sling and begin physical therapy at Emerson. During my second week, Marcia, my PT, was working on my range of motion and noticed that, after lying down, I had trouble sitting up. I told her about my symptoms, and she explained that it could be a problem with my vestibular system — specifically, that the crystals in my inner ear may have been knocked out of place during my accident. By coincidence, she had attended training at Emerson on this subject the week before. When I got home, I did some research.
The following week, Marcia gave me a test to see if I had nystygmus — involuntary eye movement — which indicates BPPV. She and a colleague used a pencil and moved their fingers around; they determined there was a problem on my right side. Then they had me lie back on a table with my head over the edge and brought me back up. I had a very strong reaction — everything was spinning, and I thought I was going to fall off the table. They said it was time to call in Naseem, who is the expert and performs a fairly simple procedure that would most likely cure my BPPV.
Naseem was great. She explained every step of the procedure, answered all my questions and demonstrated the entire maneuver, which uses gravity to put the crystals back where they belong. She told me the treatment would go quickly, wouldn’t harm me and couldn’t make things worse.
I laid on a table, and Naseem and a colleague supported me the whole time. First they turned my head to the right, along with my right side, and then they turned my head to the left, followed by my left side. They were careful to support my left side, which was still sore from the accident. Then they sat me up.
It took ten minutes; Naseem stopped every so often. She had warned me that I might experience very bad vertigo, but it wasn’t bad. They repeated the procedure to make sure it was successful and, when I sat up a second time, there was no spinning.
The big test for me was that night. I slept on a flat bed with no extra pillows, which I had needed to support my shoulder and lessen the vertigo. When I got up the next morning, I had no symptoms. I didn’t need to hold onto anything to get out of bed. From there, I became more and more confident.
Naseem’s treatment consisted of one quick session. I was lucky my physical therapist attended that presentation on BPPV, and I was lucky I went to Emerson.
