Reply to barbb about VRT: Almost 40 years ago, there were hardly any PTs who specialized in VRT. I was designing/editing/publishing/distributing the first book about Meniere's, so I learned VRT via e-mail from the author. After I went bilateral over a year ago and lost hearing and balance on my sorta "good" side and got the damned disease under control by finding a doc to prescribe hormones and lots of 'em, I scheduled an appt. with the Vestibular Clinic at Legacy Good Samaritan Hospital in Portland, OR (two hours northeast). Believe it or not, the best places for vestibular diagnosis and treatment start with Portland, OR! (Others are the House clinic in CA, Mayo, the balance clinic in Fort Wayne, IN, and I'm sure I'm missing a couple but those are the main places.) Decades ago, Portland had THE diagnostician for inner ear disease, Dr. F. Owen Black. He founded the Vestibular Clinic, designed some of the machines to help him figure out what was wrong with us, and worked with NASA testing astronauts before and after space flights. He spent extra time testing John Glenn, who was the oldest astronaut to fly. (I believe that's still a true fact.) Dr. Black was especially interested in how much longer it would take John Glenn to recover normal balance, due to his age and expectable loss of balance function. Because of Dr. Black, the Dizziness and Imbalance International Assn. is headquartered in Portland, although it's now known as the Vestibular Disorders Assn. or VEDA.

The VRT specialist I saw this past summer said she had never seen anyone who knew as much about how balance function works, nor who was so intent on getting better. She tested my reflexes and found that I've lost some sensation in my lower legs and feet, hence the ramped-up work on paying attention to what my feet can tell me. She had me buy a Dyne Disc, which has a pebbly surface, but I soon found that I got more done by walking the quarter mile each way every day, much of it with my eyes closed. (Sometimes, if there's something interesting in the mailbox, I look at it on the way back home. That's a form of cheating.)

Walking on a rough surface while thinking about it is a good way to connect with your feet. Walking in low light situations, esp. outside over uneven ground, is another way to learn to move without depending upon your eyes. (That's bad because you change your focal point every time you move your head. It leads to V&V or vertigo and vomiting.) Stepping down and back up from a low step, eyes open five times, then eyes closed five times, then same with opposite foot is a good way to learn how to balance without using your eyes. Another good thing to do is to put a long piece of 2x4 on the floor and walk along it, heel to toe. The VRT didn't teach me anything new (except the step exercise), but she did reinforce what I already knew. The only way to prevent falling is to practice proprioception, the information your feet and entire body provide as you move. Using night lights means that you rely on your eyes and will risk falling if you can't see. Proprioception means that you learn to move without using your eyes. It also helps with eye-hand coordination.

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