As the World Turns

Remember when, as a child, you spun yourself around and around and around until you couldn’t walk or see straight? As adults we sometimes do the same, but because repeatedly spinning seems a bit immature for a grownup, we take the socially acceptable route: alcohol. Either way you get there, the result is the same – the world is spinning, you can’t see straight, you’re at risk of falling over, and nausea is an unwanted companion.

Now, imagine this feeling not being fixed by sitting down for a few seconds (after spinning yourself dizzy) or detoxing and suffering through a hangover (after drinking yourself dizzy). There is such a condition and it affects approximately 5% of the adult population. It’s referred to as Vertigo, defined as the feeling of movement when one is stationary. And it doesn’t just refer to a feeling of spinning, in fact, many clients report it feels more like they’re on a small boat in stormy water. If you’re really curious, you could always try spinning yourself repeatedly for some temporary vertigo.

The dizzying culprit is the vestibular system in the inner ear (note: vertigo can be the result of dysfunction in the balance centers of the brain, but this form is usually accompanied by other neurological symptoms). The vestibular system looks kind of like a wild roller coaster or a weird snail-like creature. It is in fact a tiny, complicated organ that, when dysfunctional, wreaks havoc on the affected individual’s life. It can be a complicated system to diagnose a problem in because symptoms may include any of the following: issues with vision, hearing (ringing in ears), nausea, memory, coordination, emotions and more. The fear of a vertigo attack often keeps people at home, in bed, near a bucket.

There are a number of specific conditions that can cause vertigo, but I’d like to discuss one in particular – the one that responds incredibly well to a simple treatment.

Benign Paroxysmal Positional Vertigo (BPPV), or simply known as positional vertigo, is the most common cause of vertigo AND the easiest one to fix. The vertigo occurs because of tiny crystals of calcium carbonate (or “ear rocks”) that are normally stationary within the labyrinth of the vestibular system but have come loose. These ear rocks can be dislodged from their normal resting position by head trauma, infection, age-related degeneration, or other disorders of the inner ear. Once loose, the ear rocks interfere with the normal function of the inner ear and confuse the balance centre resulting in the symptoms of vertigo. To treat BPPV, one needs only to get those darn rocks to go back where they came from.

That’s where your trained health professional comes in. If your doctor, physiotherapist or other health care practitioner is familiar with the assessment and treatment of BPPV, relief can be yours. The treatment technique, known as the Epley maneuver (or the Canalith Repositioning Procedure), is a series of movements of the head that aim to get the ear rocks back where they belong. The Epley maneuver will “fix” over 80% of BPPV cases, BUT not necessarily forever. The problem is, once those ear rocks come loose, they stay loose, and even though this treatment will put the rocks in an area of the inner ear that won’t mess with the balance system, the rocks may drift back into the wrong area. Time to recurrence is very hard to predict, and sometimes there is never a recurrence.

Regardless, the fact that there is a simple, effective treatment for this debilitating condition is great news. There is also a home exercise (Semont exercise) that can be prescribed to help give immediate relief for recurring episodes of BPPV. Awareness of a BPPV treatment technique among physicians and rehab specialists is not as widespread as you would expect, and many people continue to suffer. If you suspect that you or anyone you know may have positional vertigo, consult your physician or physiotherapist. If you are diagnosed with BPPV, make sure the Epley maneuver is performed!

I am curious as to whether any of our readers have experienced positional vertigo. We would love to hear your story!

If you have any clinical questions regarding vertigo diagnosis and treatment, please send them to matt@aim2walk.ca

Playing with the Big Boys

Dickson "volunteering" to trial our microwave therapy. It didn't work.

Dickson joined the Aim2Walk team in January, 2011 as a small, naive co-op student with a willingness to learn.  Today, he is a small, naive co-op student that has helped Aim2Walk tremendously through our growing pains as a new clinic.  He is currently in the middle of his second placement with us and we couldn’t be happier to have such a hard working, dedicated, curious, and intelligent guinea pig.  As an innovative neuro-rehab centre, we are often trying out new therapies and technologies, and Dickson has yet to say “no” (or at least we haven’t heard him say “no”) to us trying something new with him (see pic inset).  Our clients enjoy his company and sense of humor, and we hope you enjoy his rambling…thus the Neurochangers next blog entry is courtesy of Dickson, the best co-op student a clinic could ask for.

What I felt like on my first day at Aim2Walk

Hello everyone! The bosses requested that I write about my experiences working here at Aim2Walk, so for the next 798 words I’ll be reminiscing about my good ol’ days at Aim2Walk 5 months ago. For all the co-op students that might happen to read this blog and are looking for work, make sure you know what you’re getting yourself into. You might just end up liking it so much you won’t be able to do anything else!

It was my first day at aim2walk, and it was my first placement, so to get ready for my interview, I dressed up in my big boy pants, shoes and ties, and wore my professional interview face. I nervously walked into the clinic for my interview. This being my first time being in a physiotherapy clinic, I didn’t quite know what to expect, but I was brought up to speed quickly.

“Aim 2 walk is a clinic that specializes in neuro rehab”. I nod and jotted that down in my notes.

“Washrooms are down the hallway to the right, and the beer is in the fridge”. I nod and jotted that down, underlining the last part.

“Washroom to the right, beer in the fridge

I was surprised by how relaxed everyone was at Aim2Walk. Everyone was patient (no pun intended) when they explained how the equipment worked, they didn’t treat me any differently because I was a student, in fact, they even encouraged me to think for myself and question what we did. I know for a fact that that can’t be done with just anyone, a lot of inflated egos out there that wouldn’t be too happy about the questions or be so patient with a student. Good thing too or my big mouth would have gotten into trouble really quickly.

It didn’t stay relaxing for long, at least not for me. Business picked up really quickly soon after training was done and I was tossed into the deep end, it was all I could do to keep my head above the water. Matt, Jesse, Aaron and I were juggling with patients like clowns in a ball pool, and I had to learn quickly how to take care of things by myself with minimal help and supervision. Of course help was always close at hand for both the patient and me, in case something came up. The times that I wasn’t working alone, I was with either Matt or Jesse (Aaron was usually off somewhere working his magic), listening in on their conversations with the patients and absorb whatever I could. Most of those conversations ended up being directed at me as Matt and Jesse shared their wealth of knowledge.

Working one on one with the patients turned out to be beneficial for me. Everyone that came into the clinic knew what they wanted, and what works best for them, so the patients were able to help me out big time. I learned a lot about what some of our patients go through because of their injuries. Working with and talking to with these amazing people and helped me to appreciate the work that was being done here, and I knew, that if I had to do everything within my power, even if it only eases them down the path they are going, I would do it for them.

This went on for quite a while, when finally we started hiring more help (Yay!). Just as I thought my days of frenzied dashing around the clinic was over… it actually was, haha imagine that. It was the end of my four months of co-op and I had to leave before I could enjoy some more time with my pals (old and new) at Aim2Walk.

So even though my rib cage was showing by the end of that four months (cookies and water for lunch isn’t the best when it comes down to nutrition), I was a veritable giant when it came down to the experience I had gained from both the patients and the therapists. So who knows? Maybe this time around I could even hold my own against the giants at Aim2Walk.                                                                              Dickson

What I was capable of by the end of my placement


Why Zombies Want Your Brains for Lunch

I did a stupid thing. I sat alone the other night and watched a zombie movie. Bad idea. I spent the night tossing and turning, running for my life, a frenzied horde of starved zombies at my heels. Any guess what was on the menu? Yep… my brain.

Ever ask yourself why zombies are dying (I know, bad pun) to bite into 3lbs of electrical mush? Well, I guess because brains are pretty amazing. Ok, maybe not for lunch, but certainly for a lot of other things.

Here are a few interesting facts about your brain:

• Your brain is about 2% of your total body weight but uses 20% of your body’s energy.

• The energy used by your brain is enough to light a 25 watt bulb.

• More electrical impulses are generated in one day by your brain than by all the telephones in the world.

• On average your brain produces 70,000 thoughts a day.

• There are about 100 billion neurons in your brain, the same number of stars in the galaxy.

• Your brain is 80% water.

And the most interesting fact (one that always stirs up a rebuttal from someone)…

… You DON’T only use 10% of your brain! Yep, you actually use 100% of it. It’s a common misconception that 10% of our brains are used while 90% lays dormant in a quiet slumber, one day to supposedly be awakened and reveal the secrets of the universe to us. Sorry, while the brain is certainly the most super-duper of organs, every part of it in fact does have a known function. Brain imaging methods like PET (positron emission tomography) and FMRI (functional magnetic resonance imaging) have proven it. What is correct, however, is that in any particular moment, you may functionally only be using 10%. By the end of a day though, it’s guaranteed you’ll have activated most of it for something or other.

Some say this misconception originated back in 1908, with with William James’ quote:

We are making use of only a small part of our possible mental and physical resources“.

I’m sure everyone would agree that we all have the potential to improve ourselves, but there’s certainly nothing mysterious or unknown about how to go about it. Neuroplasticity proves that our brain can change, that it can make new connections and adapt as needed, but not because a big part of us lies dormant. We have the potential to improve because we can REORGANIZE ourselves in a more efficient way. I suspect some people may find that hard to swallow because it puts responsibility for our faults and misunderstandings back on us. You see, now when you don’t have all the answers you can’t just sit back and say “But it’s not my fault! I only use 10% of my brain… what do you expect?!”

So now that we’ve established how amazing your brain is, perhaps you’ll see why mindless zombies treating my skull like a bowl full of mash potatoes upsets me. Your brain is no less than a 5 star meal! Every little part of it is special and deserves recognition. So to end this blog (and get my mind off zombies), I’ve recruited some childhood buddies to give you a little lesson in your brain. Enjoy!