The World is Spinning

 

So, as I was reading well wishes on the blog about my attempt to go back to physical therapy, I discovered why the physical therapist was so insistent on my seeing an ENT (Ear, nose, and throat doctor). Vertigo. Or at least that’s what they called it in the emergency room, after my second attack of the day refused to recede.

I’d woken up that Monday morning feeling like the world was spinning. No, not just feeling it, but seeing it spin. Every slight movement of my head made me feel like molten lava was about to pour out of my chest. It took a long time to inch into a sitting position, and even longer to stand and then to walk. I called my doctor’s office, and the secretary told me to go to the emergency room. When I told her that even walking to the front door was impossible, she said that she would have the nurse call me back.

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The girls watched me with concern, and/or suspicion.

After about forty minutes of sitting and waiting to hear back, I attempted to stand up, thinking I’d have to get to the emergency room, but I discovered that the severity of the symptoms had lessened by then. The nurse never actually called me back, but I was able to move around, slowly and carefully, and I decided not to set off to the ER and instead to go ahead with my pre-scheduled visit to the Endocrinologist, in the hopes that a doctor, of any kind, might be able to tell me what to do with what had just happened to me, or even give me an idea of what to call it.

The endocrinologist, after addressing my thyroid, which was the reason I was seeing her in the first place, listened to the symptoms I’d experienced that morning and said “it sounds vestibular.” She agreed with the physical therapist that I should see an ENT, preferably one who specialized in the middle ear, and gave me a recommendation. As soon as I got home I called for an appointment, and since the worst of the symptoms had passed, I accepted the earliest appointment available, the following week. By then I was exhausted from all of the drama, and the nausea, and the doctor visit, and trying to concentrate on homework while my head was still not quite right, so I took a nap.

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Ellie helped.

When I woke up a couple of hours later, the world was spinning again. It took ten minutes to sit up this time, and even the idea of standing made me feel wretched, so I called the doctor’s office again. The office was closed, but there was an emergency number and I called it. One of the doctors called me back immediately and he said to go to the ER. I’d been hoping he could suggest some kind of medication I could take, to lessen the symptoms, but he didn’t want to diagnose me over the phone and he was worried that my symptoms could represent any number of different things. It took me about fifteen minutes to walk from my apartment to the car (and no, I did not try to drive myself, Mom drove).

I felt silly for making such a fuss, because I figured, hey, if I can walk, I must be fine. There were so many more serious cases around me at the ER, too, like suspected heart attacks and serious diabetic wounds and dementia.

I was given a bed in the hallway, because all of the rooms in the ER were filled. There was even a number to mark out my parking spot in the hallway. I’d already had an EKG and a finger stick (to check my sugar, both fine), and once I was in my parking spot they attached me to a heart monitor and put in an IV. The girl who put the IV in was either nervous, or unwell, because her hands were shaking the whole time and she had to wipe up a lot of blood off my arm in the aftermath. When I asked the purpose of the IV she said it would be to give me medication. And then the waiting started. I was in a prime location to overhear all of the latest gossip from the doctors and nurses and Physician’s Assistants and nurse’s aides, because their desks were two feet away from my head. Confidentiality is not really a thing in the Emergency Room.

There were so many people on staff and each wearing different colored scrubs to attempt to tell you what their jobs were: navy blue, and black, and royal blue, and grey, and green, and bluish green, though no one actually explained what the colors referred to (I really could have used a chart on the wall, like a McDonald’s menu). And there were different patterns of beeps to denote different patient needs, but I couldn’t figure out which ones were serious and which ones were mundane, and I didn’t see anyone in a real rush to respond.

Oh, and they all walked around with rolling computer workstations, for when they were away from the stationary computers, but there wasn’t actually room for all of these little vehicles in the hallway, on top of patient beds and staff and wheelchairs, so it was a bit like bumper cars out there.

Time passed. The Physician’s Assistant came by to do a quick neurological exam and said I would be getting medication soon. Eventually, someone came by and gave me a Valium (a pill, not through the IV), and when I asked why I needed a Valium for dizziness they said it was the best choice for the ER (they were wrong, it did nothing for the dizziness or nausea, just made me tired). And they still hadn’t given me the anti-emetic (for nausea) or the Anti-vert (for dizziness) for my actual symptoms.

I finally went for a CT scan at around 10:30 pm (that’s three and a half hours after I’d arrived), even though by then the PA, a nurse, and a doctor had all told me that the CT scan wouldn’t show anything. Then they gave me two bags of fluids through the IV (finally, some reason for the IV!).

Mom was getting tired, and frustrated, so she started to stalk my nurse (one of three or four male nurses on the floor), while I watched cute animal videos on my phone. We were told that there was only one doctor on duty for the whole ER and he had to check on every case and that was why things were going so slowly. More blood was taken, from my non-IV arm, though no one could explain why more blood was being taken. And then the doctor’s shift ended and the new doctor had to be updated on all of the cases before he could make any decisions (like prescribing medication for me, though I’d thought that had been done much earlier in the evening. And, he had to wait for the results of the second set of blood tests.

I was finally medicated and discharged at four AM, in pretty much the same shape I’d been in when I’d gotten there nine hours earlier. They gave me Zofran for nausea and anti-vert for the dizziness. When I looked those up, and the Vertigo they had, by then, diagnosed me with, one of the first things mentioned was ear infections, but no one, the whole night, had even looked at my ears, let alone in them.

When we got home, Mom walked ahead of me to get the dogs, and they came out to greet me as I slowly made my way up the walk to our building. They were subdued but gave me lots of kisses and when we got inside we all collapsed from the exhaustion.

I was afraid I would wake up in the morning and the whole thing would start again, but, luckily, the symptoms were more muted the next day. I was still dizzy and nauseous, but at least not having the I-am-going-to-die level of intensity. The world was still spinning, and I couldn’t quite predict which direction my feet were going to go in, but I could, slowly, sit up and move from one room to another, so I had to cancel my physical therapy appointment, and email my rabbi to let him know I wouldn’t be able to do my public reading for Yom Kippur services (some part of my brain wondered if I’d gotten sick at this particular time just to get out of dealing with Yom Kippur, but I tried to ignore that though; missing Yom Kippur was just a perk).

Mom was exhausted. She’d survived on granola bars and Cheetos and caffeine in the hospital the night before, and got as little sleep as I did, so we were both a little bit worried that we’d end up back at the ER, for her this time. While Mom napped, I made the herculean effort to walk the dogs in the pouring rain, and they were wonderful! They didn’t pull or bark or complain at the incredibly slow speed of their walk, and when we got back inside, Cricket went back on duty, watching Grandma sleep and Ellie came back to nap with me, so we were both in good hands.

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Don’t be fooled; Cricket is on duty.

The symptoms receded a little bit each day, with the help of medication and rest. And when I went to the ENT the following Monday, he diagnosed me with Benign Positional Vertigo, even though I wasn’t showing symptoms anymore. He said I should come back if the symptoms returned and then he could do a maneuver that would shake my ear crystals back into the right place, but other than that, Shoo. No cause, no cure, you’re fine.

The physical therapist was relieved at the news and started me back on track with my exercise plan the next day, and so far, the world isn’t spinning, much. Just a bit blurry, at times, with some double vision, but, that’s normal. Right?

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“I’m supposed to be blurry, Mommy. I’m moving.”

About rachelmankowitz

I am a fiction writer, a writing coach, and an obsessive chronicler of my dogs' lives.

135 responses »

  1. Sounds about typical of encounters with medical care, from my experience anyway. Hope you’re feeling better now!

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  2. Your description of this experience is too familiar. I’ve been through it many times for different ailments. I’m glad you went to ER and super glad you didn’t get a scary diagnosis. I have a lot of trouble with “vertigo” as well, and never really know what causes it.
    As frustrating as ER visits can be it’s always a good idea to go. In some cases I have been sent home, but plenty of other times they found life-threatening things like sepsis!!! In those cases trying to ride out the symptoms at home would have been a bad idea. Anyway, I can relate to the “drama” you referred to, as well as the mystery of the dizziness, but I’m glad you are home and recovering with your precious canine helpers!

    Reply
  3. Steven Humphreys

    I hope you are feeling better.

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  4. So sorry to hear you’re going through this Rachel and hope it settles down quickly. I’ve had quite a few weird and wonderful symptoms as you know and it doesn’t get any easier to deal with. Lucky you had your Mum with you. Hope you’re feeling better soon.
    Best wishes,
    Rowena
    PS Rosie has deposited a stick on my laptop. If only I could zap it over your way. That would be fun and would really confuse Rosie. Where did it go?

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  5. I love the way you wrote this blog… Its touching and it is wonderful how you and your dog keep each other company… Ever dog has its own master but I feel every person’s life is incomplete without dogs… keep yourself and your dog always healthy!

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  6. What an ordeal, Rachel. I hope you are feeling better now. Despite the topic, I love your writing – as always.

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  7. Prior to the next emergency, would you consider signing up for a virtual doctor? Most of the online services (accessible via your phone) might be of more help than the ER. My research shows that Aetna, Blue Cross Clue Shield and others all have their own versions for $50, your copay or less.

    Good luck, and I hope you’re feeling better by now.

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  8. Sorry, “Blue Cross Blue Shield” vs. the typo.

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  9. So sorry you had to go through all of that to get a vertigo diagnosis. I have had it twice and know firsthand that it is not fun to go through. I did learn that it is caused by a virus, so basically it has to run it’s course. No meds for it, but they can give meds for the feeling sick and the dizziness. I hear Dramamine works great. I do hope you are past it now and back to your regular schedule.

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  10. The experience of A&E (Accident and Emergency) in the UK can be very similar. I think there are two main reasons – overworked services and a rule-bound approach. Because people may sue, and because health agencies are attacked bitterly if something goes wrong and they didn’t follow the rules, they must follow the rules even if they don’t make sense. This leads for some staff to a state of mind in which they feel they’ve done a good job if they’ve done all prescribed tasks by the book and the question of whether that’s helped anyone isn’t asked. This process can happen whether the service is government-funded or private. Of course there are many more positive experiences.

    I had something similar a few years back. I woke up in the early hours feeling that something was wrong, tried to turn in the bed and the whole world went spinning. I had to get downstairs stage by stage on my bum and was repeatedly sick. Fortunately we now have a general phone healthcare service for non-emergencies and it worked very well. The man ran through a series of questions and I could tell he was eliminating heart attack, stroke, brain haemorrhage and all the real nasties. Finally he advised me to see my local out-of-hours doctor service at the clinic and I went there by taxi. The doctor had all the information, checked, confirmed ear infection which had got into the inner ear, had medication ready and it worked.

    Reply
  11. Something similar happened to me after I took a flight from Hawaii to Texas.
    The next morning when I got up, everything appeared to be spinning…I kept falling into the wall just trying to walk out of the bedroom.
    I was sent to physical therapy, and the therapist did the “Epley maneuver”–turning my head in certain ways to try and put misplaced “ear crystals’ back in place.
    I visited the physical therapist twice, and then the dizziness and spinning was gone.

    Reply

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