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@julieo4 Hi Julie, this is a very misplaced message because it was going to take me too long to figure out where best to put it! Any tips on that, appreciated.

Your raves about what VRT did for you had big impact on me so that tomorrow I am scheduled for my 1st app't of it. But, suddenly, after doing some research, I am having the impression it may not be appropriate for me and that is because, my only problem is balance - it is not dizziness, vertigo, posture, or vision (I do wear glasses). No nausea. So maybe I should just do regular PT - which I have done 3 or 4 times in the past and do NOT enjoy doing it because I never feel I am seeing any progress! 🙂

I would love to hear your or anyone else's thoughts about this.

Response to barbb about VRT: VRT is special PT aimed at balance issues. You have a primary balance system, your inner ear, but it can be damaged. In addition, your inner ear works less effectively as you age, whether or not there's additional damage. Your secondary balance system is vision, but using your eyes to balance leads to imbalance and, in many cases, dizziness and/or nausea. Every time you move your head, you lose your focal point, so using vision to balance leads to problems and increases your imbalance. You need to learn to use your third balance system, proprioception, or the information provided by your feet, ankles, knees, etc.--in other words, your body. Simply put, proprioception is what enables you to know which way and how much to lean against the wind when you're standing on an exposed point.

Hearing and balance are closely associated. The acoustic and vestibular nerves are side by side and are often twisted together; what affects one can easily affect the other, so many HOH people also have balance issues. In addition, both hearing and balance function decline as we age. I believe that all older people should learn to do some simple VRT...and do it every day. It will enable you to feel more stable, and it will also improve your eye-hand coordination (no more slicing your fingers instead of the veggies!).

Good news: VRT does work! Unlike most exercise, VRT is not difficult, doesn't require lots of special equipment. Bad news: you must do it every day for it to be effective. Once you learn proprioception, you can do VRT while you're doing something else. For example, I live on a gravel road and our mailbox is a quarter mile away. Every day, when I walk out to get the mail, I spend at least half the walk with my eyes closed, thinking about what my feet feel. I also have specific exercises, but I've learned that really concentrating on what my feet feel while I've "shut off" vision is the most effective thing I can do. If you really work on VRT every single day, you WILL see real improvement in a month or less.

I have a godawful disease, Meniere's, which takes both hearing and vision. I had my first serious problems with it about 40 years ago, in my 40s, after I quit taking birth control pills. I began to have increasingly bad crises every month within a day of the start of a period, so the connection between hormones and horrible imbalance, vomit fests, crises that each lasted 12-15 hours was obvious. It took my primary doc and me four years to stumble upon a safe, effective form of hormone replacement (HRT). At that time, there were hardly any PTs specializing in VRT, so I learned it long distance while working on publishing a book about Meniere's: the author sent me exercises via e-mail. The combination of good hormones and VRT so changed my life that I continued VRT every day. Then, over a year ago, I suddenly went bilateral, meaning my so-called "good" ear was now affected as well. Initially, the greatest problem was almost total deafness, but crises soon began, until I was forced to lie still, vomiting, for hours every day. I finally found a doc in this small town willing to prescribe HRT, and, not only did the vomiting and vertigo cease, but my hearing returned to about where it had been before I had gone bilateral! Still, I was having issues with lack of balance, so I scheduled a appt. with a VRT specialist. I felt that it would do me good to see someone who actually knew about VRT, since I really hadn't all those years ago. After less than a month of biweekly appts with lots of daily work, I had normal balance and could do active things again. At 78, I still do instream data collection for our state fisheries agency, in a small stream that cascades down a very steep canyon. Once again, I'm able to walk and wade 6.5 miles to do the basic surveys I've done for years, plus install temperature monitors to track summer temps. I can drive on curving roads without a problem, hike anywhere my old body is willing to go, and live a more than normal life for someone my age. VRT gave me my life back!

So, go to your appt. with an open mind and be willing to work every day. You will soon feel more stable, more able to do normal things, and you'll feel much better about yourself. It's well worth it!

IT wasn't I who share information about VRT. I believe it was joyces. Hoping she will be able to answer your questions. 🙂 Balance and hearing are definitely connected.

@joyces Hi Joyce, thanks for your reply, much of which I recall since it has the data in it from your initial comments about VRT that had such impact on me and is the sole reason why I went about scheduling VRT for myself. The only difference from when you initially wrote about this is that my wonderful memory 🙁 told me it was from Julie, rather than you. You say, "VRT is special PT aimed at balance." Non VRT PT can also be aimed at balance so the issue to me is when does a person with balance issues choose to go to regular PT and when to VRT. What I understand so far is that the choice between the 2 therapies is determined by the cause of the balance problem and/or symptoms (in addition to balance alone). What do you think?

@julieo4 Thanks Julie for setting me straight!

Barb, if you have an issue with balance, it seems to me that it's far better to go to someone who is trained specifically to treat balance issues. Not that therapists are created equal, so you might find a PT who knows a lot about balance, but a VRT specialist should know just what to do and, more important, how to evaluate you, which a PT might not know. For example, I learned that age has lessened the ability of my feet to communicate to me what they feel, so I need to work especially hard on that.

One of the most important things is that the person will be able to motivate you to really work on balance. I know that after a month or so, with far better balance, it's very tempting to say, "Ah, that's fixed. No need to do more." But that leads you back to having the same problems you had to begin with. Right after my three bi-weekly appts with the VRT specialist, there was a wildfire near me that destroyed nearly 300 homes, mostly of low-income people. I've worked fire relief ever since, and it has been very easy to let VRT slide because I'm tired, both mentally and physically, after dealing with people who've lost everything. So many cell phone photos of a pile of burned debris! So, after sloughing off on VRT while we were evacuated, I knew I was losing function I had just regained, and I had to make time for VRT. Every day...even when I've made over a hundred sandwiches or baked many batches of cookies, or bagged dozens of little zip-locks of washed grapes or found places to store donated perishables.

The good news is that one person decided to fight back by getting his neighbors to agree to each work to clear their own lot. He then got pros to volunteer to take down huge burnt trees, cut up metal debris, haul loads to the dump, all working together. It's been just over a month, and many people are back on their own land, living in trailers or campers or motorhomes; it's beginning to look like a neighborhood again, albeit sans any trees. The fellow who always went all out to decorate his place asked to have one limbed tall tree left standing until after the holidays; it now has a huge lighted star that can be seen from a long way away, a sign of hope and rebirth. These people are taking charge of their own fate and will be living in new permanent homes months earlier than those who haven't participated.

@joyces Thanks! When you say "bi-weekly", do you mean every 2 weeks? Not twice in a week? I think your reasoning about going to a VRT, rather than PT is also the way I was thinking though hadn't articulated omself! We shall see what happens tomorrow!

Reply to Barbb: Yes, bi-weekly...every other week. FWIW, the VRT specialist said she had never worked with anyone who knew as much about vestibular issues as I do, so she felt that all I needed was to zero in on re-establishing the connection between what my feet "know" and how I perceive and use the info. The last session was a flurry of lots of different things I could try. Each session lasted an hour.

@joyces, Re: "bi weekly", before I asked for your clarification on this I actually went online to determine whether that meant every 2 weeks or twice in a week (because while I thought it was once every 2 weeks, that struck me as not so likely a therapy plan and so maybe it was twice in a week. Online, it was said that indeed, bi weekly has been used for both meanings! Anyway, I was surprised to learn your sessions were for one hour - mine would be for 1/2 hour but I'm guessing more likely 1/wk. I know someone going for VRT in my NY area whose sessions are 45 minutes!

The VRT I saw always schedules the first session for an hour, because it includes an extensive evaluation where she checks all sorts of things (made somewhat humorous thanks to masks!). She may have decided upon the every other week program because she knew I had a grasp of what needed to be done, plus I live two hours away. Some PTs also do an evaluation, sometimes pretty extensive, sometimes not. My husband saw a PT biweekly for almost a year; she did an evaluation at the start, plus he had been referred by the pain clinic. She worked very hard to convince him that moving would reduce his pain, but, in spite of all her effort, he refused to do exercises at home or even walk every day, so she "fired" him for noncompliance. His back pain has increased a great deal in the two years since he saw her, but it certainly is not her fault. He spends about half of every day lying down, which only increases the pain, although he claims that he feels better in that position. He's basically just waiting to die, which is damned depressing. The pain clinic also gave up trying to get him to help himself. I'm sure that lots of therapists see people who simply don't want to do anything beyond show up for appts., which isn't going to really improve their lot...must be awfully discouraging.