Coping Strategies and Learning to Live with Dizziness

Since I’m experiencing dizziness right now and it is debilitating, I thought I could, at least, share this worthwhile information with those of you who may find it helpful. It is a summary of a presentation made by physiotherapist Nicole Acerra, PhD. at a meeting of the BC Balance And Dizziness Disorders Society (BADD) at St. Paul’s Hospital in Vancouver, on November 21, 2013.

Coping Strategies and Learning to Live with Dizziness

by Joyce Pinsker

No matter how long you’ve been living with dizziness, you can always learn more strategies to improve your quality of life. If the job of rehab is to maximize your energy and a longer-term maintenance program helps you keep that energy, the job of coping strategies is to help you use your energy to avoid or deal with symptoms. Collect tips from as many sources as you can; talk with others, including those with dizziness problems, therapists and researchers, and search the Internet. You will find there are many small changes you can make in your life that have a big impact.

It can take months or even years to determine a diagnosis and sometimes there is no clear answer. This can be a real source of frustration and stress. Simply not knowing what’s going on can make your dizziness feel worse. It is normal for stress to make this kind of impact. Unconfirmed medical diagnosis ranks at the top of the stress scale, right along with death of a loved one or getting fired.

Most people go through a period of active rehabilitation after diagnosis. This might involve gradually reintroducing activities on your own or formal rehabilitation with healthcare professionals. To maintain and improve the level of function and fitness you’ve achieved through rehab, make an exercise program part of your regular routine. Tailor it to your needs and lifestyle, including cardiovascular exercise; ten years of research has shown that cardiovascular activity is one of the top keys to recovery. Many people’s problems completely resolve after rehab while others continue to live with dizziness and can be helped by doing long-term rehab at home.

As much of the vestibular apparatus lies within the inner ear, no lab tests can be done to provide a precise label for what is wrong. Clinical dizziness tests, however, will show what is not working and quantify your deficits. In terms of moving forward with your life, identifying your deficits is every bit as helpful as getting a label for what is wrong.

When you know the source of your symptoms, and have rehabbed as much as possible, at some point you need to learn to live with the remaining symptoms. As we have a limited amount of energy each day, it is very important to use it strategically. Compile a list of what predictably makes your symptoms worse and what relieves them. This will give you a sense of your triggers. Then ask yourself what it is you want to do, what it is you’re struggling with, and what your goals are. Make your goals SMART (specific, measurable, attainable, relevant to you, and given a timeline).

Coping strategies vary widely and include avoiding aggravating factors, learning to prevent your symptoms or triggers from happening, learning how to prioritize and organize your day or week, eating well, keeping hydrated, maintaining fitness, avoiding safety pitfalls, and improving your sleep.

Good sleep hygiene includes falling asleep well, being able to go back to sleep well if you wake up during the night, and feeling rested when you wake up in the morning. Research shows that a disturbed sleep impairs your ability to remember things. If your dizziness symptoms feel worse when you don’t sleep well, you’ll have a bad day, and that can become cyclical. Sleep tips include avoiding evening naps as well as television viewing just before bedtime.

If you need to get up frequently at night to use the bathroom, work with your physician. Try pelvic floor (Kegel) exercises. Learn strategies to fall back to sleep quickly. For example: don’t look at the clock; keep the room at the right temperature; orient your bed for quick and easy access to the toilet; and wear uncomplicated nightclothes.

If your symptoms are worse in the dark, use a nightlight and be mindful when turning lights off as you walk to your bedroom. Keep spaces clear so you don’t bump into or trip over things in the dark. Slide your finger along the wall for extra proprioception.

Help the balance receptors in your feet by wearing the right type of footwear. Firm soles make you feel less disconnected from the ground and are usually a better choice than soft soles.

On a bus, try to sit near the front or where you can see outside. In a car, avoid the back seat. On a plane, planning ahead is often a major part of success. Pack well ahead and get a good sleep the night before. Schedule daytime flights if possible and keep well hydrated. Sit near a window and look outside during take-off and landing. When you can both see and feel the movement, your vestibular and visual systems will be more likely to agree with each other.

Proprioception can be improved through activities including a wide variety of balance exercises, rubbing your feet, or stretching tight calf muscles. Pay attention to the joints that cause you problems. Try Tai Chi, balance, or yoga classes to add a bit of fun. Many community centres offer adapted yoga and fall-proof programs. You may be eligible for a research study or fall prevention program, such as that offered by the VGH Fall Prevention Clinic. www.fallsclinic.com.

Reprinted with permission from the BC Balance And Dizziness Disorders Society’s newsletter “The Balance Sheet”. Find BADD’s website at www.balanceanddizziness.org

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