Balance issues and hearing loss

Posted by joangela @joangela, Sep 5, 2019

I fall too often. A few times a year. Yesterday I was walking into the grocery store and fell on the concrete in an unlevel area right in front of the entrance. Does anybody else have issues with balance and falling that they attribute to hearing loss? What are your preventative measures?

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@judyca7

I have fallen several times in the last three years the last time breaking my wrist. I am still doing physical therapy for the wrist and also have a PT for my balance issues. I have to lower my expectations because I was hoping for a cure with the vestibular exercises. They help some and at least I feel like I am being proactive in my treatment. Lately I have had other health issues and find myself very discouraged. Too sick to do the balance exercises for a week and I really noticed a difference. You have to do these every day and for the rest of your life. I read the postings and am impressed with how positive everyone seems to be. There are too many days when I am not positive at all, just tired. Is anyone else dealing with depression over the changes in their life?

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I too deal with depression because of the profound hearing loss. Sometimes, in this hearing world, it is so hard to communicate effectively with the hearing community. There is an extreme lack of compassion for us, and an expectation of understanding them. In the general public there is a look like you are crazy if you don't understand or just don't hear them. More education needs to be done for us.

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Thanks for your reply. I find that people are empathetic at first but I think they forget. One starts talking to me while walking ahead or behind me, my physical therapist talks with me from behind a mask, one doctor looks at her computer while talking, lunch with friends is impossible when side conversations break out. Even my husband talks to me from another room. I am constantly reminding others of my situation and sometimes I think they get tired of hearing it. Every day is difficult and you always have to be advocating for yourself. Sometimes it seems easier to just stay home but I know that is not good. I have a sign on the wall that reads "taking it day by day" and I read that every morning. Seems to help. Judy.

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@judyca7 I understand your frustration with the public in general not getting how to communicate with us. I’m learning to advocate more for myself. For awhile my husband would say my wife has hearing loss but I’m saying it myself now. The other day at the initial hospital sign in I said I had hearing loss and got out my RemoteMic to hear better and he gave me a pager so I’d know when registration called my name. I was impressed. If I hadn’t told them I wouldn’t have known they had pagers. It would have been helpful to have a sign. The other way I advocate for myself is using the latest assisted listening devices. It’s like having my own wheel chair rather than try to find a venue or garden that provides one.

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@judysmayo

@judyca7 I understand your frustration with the public in general not getting how to communicate with us. I’m learning to advocate more for myself. For awhile my husband would say my wife has hearing loss but I’m saying it myself now. The other day at the initial hospital sign in I said I had hearing loss and got out my RemoteMic to hear better and he gave me a pager so I’d know when registration called my name. I was impressed. If I hadn’t told them I wouldn’t have known they had pagers. It would have been helpful to have a sign. The other way I advocate for myself is using the latest assisted listening devices. It’s like having my own wheel chair rather than try to find a venue or garden that provides one.

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@judysmayo, what a perfect description of life as a hearing-impaired person.

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@judyca7

Thanks for your reply. I find that people are empathetic at first but I think they forget. One starts talking to me while walking ahead or behind me, my physical therapist talks with me from behind a mask, one doctor looks at her computer while talking, lunch with friends is impossible when side conversations break out. Even my husband talks to me from another room. I am constantly reminding others of my situation and sometimes I think they get tired of hearing it. Every day is difficult and you always have to be advocating for yourself. Sometimes it seems easier to just stay home but I know that is not good. I have a sign on the wall that reads "taking it day by day" and I read that every morning. Seems to help. Judy.

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@judyca7 what a perfect description of living in a hearing-impaired world.

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@pegorr

Wow, I was so impressed by Joyces response and I love it when I learn something new. That being said, we all live in fear of falling, at least I know I do, and I have taken some epic falls myself. Of course they all hurt and you get up hoping nothing is broken, or that no one has seen you:-) or as in my case once I landed on the grass in front of the funeral home, having missed many piles of dog poop, which as I like to say, is "On the bright side":-) I do walk as much as I can to retain as much balance as possible, sometimes use a walking stick, and like someone else said no quick turns, fast ups and things we know are likely to make us dizzy and off balance. Know your surroundings as much as possible, hang on to a friend, but do keep moving. My husband is convinced I've perfected the tuck and roll method so I guess if we're going to fall it might be best to check out & learn the most non-injurious way. I wish you all the best. Some days my favorite colors are black, blue & green. hugs and love,peg

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Hi Peg, You are funny. I like your sense of humor. We do have to laugh some of this off. -JoAngela. 😁

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@joyces

The balance and auditory nerves are side by side, even twisted together. THE, and I do mean, THE fix is to learn to use your third balance system, proprioception. Everyone loses some balance function in their inner ear as they age, but some disease affect both hearing and balance, like Meniere's. When the little "gyroscope" in your inner ear doesn't work correctly, you automatically start to use vision for balance, but that is a really bad thing. Every time you move your head, move from one place to another, drive around a corner, you lose your focal point. So, it's time to learn to pay attention to what your feet tell you. In simple terms, proprioception is what makes you know just how far to lean into the wind when you're standing on a rocky point.

The way to teach yourself is to start by standing, in your sock feet, feet fairly close together, with your eyes closed. At first, you'll begin to wobble pretty quickly, so you need to start in a hallway or with someone next to you. Once you can stand without wavering, walk a short distance with your eyes closed, again, in a hallway to start with. Do this for 5 or 10 minutes every day, and you'll see a real improvement in your balance within a couple of weeks. As you gain skills, wear shoes, which makes it harder for you to "feel" your feet giving your information. Everywhere you walk, think about what your feet tell you. You may find that you often stare at the surface in front of you while you're walking. Instead, check the area ahead of you to make certain there's nothing to trip over, and walk a short distance without looking at the surface, then check again for obstacles, and walk another short distance. You will be surprised at how much there is to see! You need to work on this every single day, until it becomes natural. Walking in low light situations, including outside, will help reinforce learning.

It's really important to work on this every day--evenings are best, because you can turn out all the lights before going to bed and walk through your house, where you're familiar with where things are. This is called VRT (Vestibular Rehab Therapy). I had done it for several years when it became necessary to tear out much of both of our bathrooms due to dry rot. Since there were old counters, toilets, tile, etc. and boxes of new stuff in the hallway and living room, I quit walking in the dark for two weeks...and lost my ability to know where I was in space. Good news was that after only a few intense sessions I was stable again. You'll find that not only do you have far more confidence in moving about (including driving), but you will have much better ability to know where things are in relation to your hands. No more slicing your fingers instead of the veggies! Because I still do instream river surveys in spite of being 77, I also try to dress or undress standing, without touching the counter or dresser beside me. You do want to have something stable nearby in case you begin to lose your balance. This is a special test for women when they wear pantyhose! You'll find that it's harder to have good balance when you first wake up, but things improve pretty quickly.

I can't begin to say how much learning to use proprioception improved my life! I've been doing it for nearly 40 years. In addition, anything you do that challenges your vestibular system, like working off a ladder, will improve your balance for a couple of days. For me, it means that cleaning gutters (which no one in their right mind ever wants to do) has the benefit of making it possible for me to wade and fish without needing to use a wading staff...for a couple of days.

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Hello. What exactly is proprioception? How would you describe it if you have issues with it?

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@joyces

The balance and auditory nerves are side by side, even twisted together. THE, and I do mean, THE fix is to learn to use your third balance system, proprioception. Everyone loses some balance function in their inner ear as they age, but some disease affect both hearing and balance, like Meniere's. When the little "gyroscope" in your inner ear doesn't work correctly, you automatically start to use vision for balance, but that is a really bad thing. Every time you move your head, move from one place to another, drive around a corner, you lose your focal point. So, it's time to learn to pay attention to what your feet tell you. In simple terms, proprioception is what makes you know just how far to lean into the wind when you're standing on a rocky point.

The way to teach yourself is to start by standing, in your sock feet, feet fairly close together, with your eyes closed. At first, you'll begin to wobble pretty quickly, so you need to start in a hallway or with someone next to you. Once you can stand without wavering, walk a short distance with your eyes closed, again, in a hallway to start with. Do this for 5 or 10 minutes every day, and you'll see a real improvement in your balance within a couple of weeks. As you gain skills, wear shoes, which makes it harder for you to "feel" your feet giving your information. Everywhere you walk, think about what your feet tell you. You may find that you often stare at the surface in front of you while you're walking. Instead, check the area ahead of you to make certain there's nothing to trip over, and walk a short distance without looking at the surface, then check again for obstacles, and walk another short distance. You will be surprised at how much there is to see! You need to work on this every single day, until it becomes natural. Walking in low light situations, including outside, will help reinforce learning.

It's really important to work on this every day--evenings are best, because you can turn out all the lights before going to bed and walk through your house, where you're familiar with where things are. This is called VRT (Vestibular Rehab Therapy). I had done it for several years when it became necessary to tear out much of both of our bathrooms due to dry rot. Since there were old counters, toilets, tile, etc. and boxes of new stuff in the hallway and living room, I quit walking in the dark for two weeks...and lost my ability to know where I was in space. Good news was that after only a few intense sessions I was stable again. You'll find that not only do you have far more confidence in moving about (including driving), but you will have much better ability to know where things are in relation to your hands. No more slicing your fingers instead of the veggies! Because I still do instream river surveys in spite of being 77, I also try to dress or undress standing, without touching the counter or dresser beside me. You do want to have something stable nearby in case you begin to lose your balance. This is a special test for women when they wear pantyhose! You'll find that it's harder to have good balance when you first wake up, but things improve pretty quickly.

I can't begin to say how much learning to use proprioception improved my life! I've been doing it for nearly 40 years. In addition, anything you do that challenges your vestibular system, like working off a ladder, will improve your balance for a couple of days. For me, it means that cleaning gutters (which no one in their right mind ever wants to do) has the benefit of making it possible for me to wade and fish without needing to use a wading staff...for a couple of days.

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Wow Joyce! I can't believe what you are saying about the effectiveness of proprioception with balance. It just sounds too good to be true! But I will have to try your recommendations. I have had balance issues since 1996 and been to various physical therapists (including the well known Rusk Institute) and have never been advised in the way you do here. In fairness, I'm sure I was asked to stand with my eyes shut but the details about standing in your bare feet and noticing the feelings in your feet I have never heard of. My balance problems initially were caused by surgery to remove the benign tumor on my acoustic nerve which, as you know, is next to the balance nerve. I am wondering what if your balance nerve is really damaged, can proprioception really compensate? Living in NYC with its wealth of medical resources, if what you say really could work, I don't understand how I could not have heard of it!!!

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The entire topic of balance is largely ignored by medical professionals. PTs know it's important, but most have no training in how to compensate for loss of balance function. Because the auditory and vestibular nerves are usualy twisted together, surgery on the auditory can very easily do damage to the vestibular nerve. Loss of the tiny hairs in the inner ear is not only bad for hearing, but for balance as well. I lost most of that function in my right ear over 30 years ago, thanks to ongoing vestibular crises 2-3 times a week for four years. At that time, it was believed that nothing could be done until you were able to cease having crises. Now, we know that's not true. Worse, it's possible that I wouldn't have lost so much function then if I had known how to to VRT. In May, my left ear, which had been affected only by age-related deafness, was invaded by the Meniere's monster. I certainly have had/do have increased balance issues, but am working harder on balance exercises, in addition to the usual work to always use proprioception, which does become somewhat natural after years of working at it.

If older people were taught to use proprioception as their inner ear function declines rather than using night lights, removing throw rugs, never taking chances, etc., there would be far fewer falls. However, it's much easier and safer (in the eyes of the doc or PT handing out the swell advice) to just tell people to remove obstacles, use light all the time, avoid difficult surfaces, never do anything risky. Heck, one young bone specialist who came to this small town advised all "older" people over 30 (!!!!!) to avoid using ladders, walking on uneven surfaces, etc. For most people that would mean creeping around in fear for 2/3 of their expectable life span. I wonder where he is today, and how he feels about his advice 20 years later...when he's more than old, according to his own thinking!

There are a few PTs today who actually specialize in vestibular therapy, but there aren't many. I drove my husband to a PT who worked hard to improve his dismal situation (of his own making), but she had no real awareness of how much pain is generated by lack of balance, how important balance is overall. Surprisingly, the small town of 10,000 (largest in our county!) 40 miles away does have a woman who really understands balance and works for the Senior Center there. During the years the e-mail Meniere's discussion group I moderated existed, we had one woman in Austin, Texas who specialized in VRT...one person out of hundreds of "wackos" with inner ear disease and balance issues.

There are lots of other relatively simple balance exercises, like standing on one foot or sitting and standing with a chair quickly, repeatedly. There are also lifestyle things you can do, like getting dressed standing up without touching a nearby counter or dresser. Still, the basic thing is to learn to use your third balance system ALL THE TIME. Fifteen minutes a day isn't much when it will improve your life immensely within the first month...but then you must keep it up forever. Granted, once it has become natural to use proprioception, you won't need to spend time doing exercises because it will simply be part of your life. Even then, you will need to do small things, like dressing while standing, to reinforce it every day. I find that an easy way to sneak in some "exercise" that's just part of daily life. I hope that you'll try it, because I'm positive it WILL help you.

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