The World Is Spinning

BPPV and Dealing with a Dizzying World

As of a week ago, Wednesday, the world was spinning. I do not mean literally spinning — though of course that’s true regardless of the date. Nor do I mean this metaphorically as in picking some political or cultural event and suggesting that it is somehow new and world-turning. I give it as a statement of perceptual truth. My world is spinning even if yours is quite stable.

The proximate cause of this vertiginous sensation is, apparently, a small crystal in the ear that becomes detached and floats inside the ear canal causing the brain to experience a sensation of floating movement even when one’s feet are firmly anchored on stable ground. The resulting condition is called BPPV — Benign Paroxysmal Positional Vertigo. And while you might be inclined to think that any condition whose first word is “benign” can’t be too bad, I’m here to tell you that it’s pretty damn hellish.

I experienced it first as a bizarre unsteadiness. I was having a fairly tense workday and had missed lunch, so I assumed I was experiencing some form of stress and caloric shortfall induced weakness. I wolfed a bar and went out to get lunch and take a walk. The result was alarming. My several block walk featured sporadic bouts of spinning sensations and a decided tendency to lurch and nearly fall. This didn’t seem like something a grilled cheese and diet coke would fix, but it never hurts to try.

I settled back into work and, in truth, the symptoms seemed to abate. I drove home (a bit more carefully than usual), but by the time I had walked up and down one or two of the innumerable flights of step that separate every functional area of my hillside home, I was feeling decidedly crappy. If you’ve ever been seasick (I’m not much afflicted but I’m pretty sure it’s the same) or you’ve felt that deeply queer sensation after a spinny ride at the amusement park goes on a little too long. I’m not much afflicted here either but I have a dark memory of a time in Seaside Oregon at a tiny amusement park when the attendant — distracted by his conversation with an attractive young lady — simply let our ride go on and on. Usually, those rides are over almost before they begin, but the despair of spinning and spinning as you, once every four seconds whip by this teenage excrescence and realize that until that girl goes away you aren’t getting off this ride? Maddening. Anyway, that’s the way I was feeling. Except I wasn’t on a ride, and it wasn’t going away. I staggered through my home routine and called my wife and asked her to come home immediately.

The next day really was hell. When I woke, lying on my side, the walls were gently rotating in a vertical direction. Like the last few turns of a roulette wheel. Nothing violent but not appearing to be in a mood to ever stop. Getting out of bed changed that. The world began spinning on the horizontal plane in a much more aggressive manner. Every step felt precarious. I made it to the toilet and, perhaps foolishly, into the shower.

In retrospect, this reminds me of the time in college when I woke up with a sharp crick in my neck. This wasn’t one of those little “my neck is sore” kind of things. It was nearly impossible to get out of bed, the pain was so intense whenever I leaned up. I finally eased up and out and, reasoning that a hot shower might help, slow-motioned down the hallway to our shared dorm shower and maxed out the steam. I spent ten minutes under that steaming cauldron, and it really did feel better. At least until I turned off the water and stepped out into the cold air, nearly fainting from the resulting pain.

This time, I made it through the shower without falling and cracking my skull, but on stepping out of the shower (did you know that there is a strong tendency to rotate your body while showering?) I found myself vomiting. At least there was a toilet handy. Live and don’t learn, as Calvin tells Hobbes. That’s us.

Thus began one of the most physically miserable days I have ever experienced.

It’s surprising that there is no medication for BPPV. I thought there was a medication for everything these days — even if it doesn’t work. But the only real “cure” is to perform a series of head turns (the Epley) designed to move the crystals out of the ear tubes. I read a post that likened the Epley to those hand-held water bubble games where you steer the bubble to the end point. That’s pretty much dead-on except you can’t see the damn bubble.

By Saturday, the dizziness had abated (thanks Epley) but I was still plagued by a lurching balance-challenged walk that made it difficult to navigate the 47 sets of stairs in my hillside home or make the arduous trek from the fridge to the couch.

It’s true that sickness is a powerful reminder that all the stuff we obsess about on a day-to-day basis doesn’t matter much compared to being able to eat, walk, talk, and breathe normally. If you can’t do those things, then fame, money, power, and success don’t mean very much. Of course, as soon as we’re well we all go right back to obsessing. The human brain is masterful at forgetting past pain.

Perhaps the only cheering thing was that my sister told me she’d had BPPV about five months earlier and gotten over it. I didn’t know that because it’s the kind of thing my sister would never discuss unless I was complaining about it. Hers lasted about 10 days (mine ended up being a bit shorter) and, of course, she self-cured — reading up on it and doing the Epley based on YouTube. She’s a vet, so if you think of a person as just another large animal that kind of self-diagnosis makes sense.

It’s always risky to draw conclusions from a sample size of 1, but this feels like one of those weird genetic predestination things. Our ears go bad at almost exactly the same time. And in way I was lucky, because my sister is far more prone to seasickness and stomach upset than I (so much for genetics), so she spent much of those ten days unable to eat.

Except for that Thursday, I mostly ate fine.

By Monday my continuing walking problems without the dizziness were beginning to alarm me. And an appointment with a physical therapist (I am not my sister) mostly confirmed by fears. The BPPV is gone (he said), but you’ve got some neurological issues. Now I wasn’t doing the Epley, I was moving a big letter E back and forth in front of my face while my eyes twitched, and my head hurt.

My doctor scheduled me for an MRI and I had to face the possibility of a stroke diagnosis. Perhaps my finely tuned brain (this is how I thought about it) was so wacked out by the BPPV that it re-volted. I’ve done an MRI before (for prostate) and it’s kind of daunting. It’s painless of course, but the experience is unpleasant: cold, dark, obnoxiously loud, and existentially threatening.

I have to say that this one wasn’t as bad and didn’t take as long. That’s surprising — you’d think your head would be harder. Perhaps my prostate is just that enlarged or maybe that is, as the old joke has it, where all the real thinking gets done. But my brain MRI lasted a little less than twenty minutes. And except for one shot where it seemed like Phillip Glass had taken up residence in my head and was pounding out Rubric on some synthesizer:


Dododo. Dooodooodooo. DooooDooooDooo.


It was pretty painless.

Why couldn’t they have gotten Johann Johannsson? Even Yiruma.

As a mild claustrophobic I always worry about what it’s going to be like in the machine. But it’s not really that awful. Mostly I just close my eyes and try to think about work. Work is a great solace to the mind; it rarely presents existential threats, and most work problems are at least somewhat solvable.

I deeply appreciated how quickly Kaiser got back to me with the results (which were fine). I’ve spent other weekends wondering what blood-tests or CT scans or MRIs are going to show, and it sucks. So now I’m just moving big letter E’s back and forth and telling myself (with some conviction) that in a day or two it will all be normal, and I won’t be doing old geezer stuff anymore. I mean except for the other old geezer stuff I do all the time, and which no longer registers.

Hey I even did a bit of plumbing this morning battling my old enemy — pipes. This entailed climbing over a fence and rappelling down a hillside to turn off the water to the house. All accomplished with, I admit, even less grace than normal. But the leak is fixed and I’m not in the ER with a broken leg or cracked skull so…scoreboard.

I will say that having my perceptual world set spinning didn’t spur any anxieties about the fallible nature of the senses. It’s true, a tiny crystal set loose in your ear can make virtually every action impossible and render your view of the world catastrophically unbalanced. Yet I take this to be strong evidence of how hard it is to navigate a complex physical world successfully. The fact that we can do it routinely is not proof that our sense perceptions are reliable, but it is strong evidence in their favor. Even when I first got BPPV, I knew the world hadn’t suddenly started spinning violently around whichever axis I tilted my head. But I couldn’t move within the world I was seeing. I couldn’t bend over. I couldn’t pick things up. And I couldn’t hold things (like food) down. We do all these things effortlessly and well because our brain has been trained to respond reliably to a world that does, in fact, work in a stable fashion. Indeed, so dependable is the world, that we can know when it is our own minds that have gone haywire.

Of course, not every impairment in the mind lends itself to that clarity. We can go wrong so very easily, but that things mostly go right is a testament to the power of our brains to learn well and a tribute to the stability of the world around us. The world may be spinning, but it’s damn stable. And thank heavens for that.

I don’t have a lot of takeaways from this. Getting old sucks. Yes of course. Your health matters. Yes of course. We obsess about a bunch of stuff that doesn’t matter very much. Yes of course.

We all know this stuff. We just have a hard time living it.

What I mainly realized is how little I’ve learned from all the other times this kind of thing has happened to me. And if that doesn’t quite sound like I’m on the path to enlightenment, at least I have a lot of company crowding the path I’m on.

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