Balance issues and hearing loss

Posted by joangela @joangela, Thu, Sep 5 2:44am

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?

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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My hope is that anyone who works on VRT daily for at least a month will see a real improvement in balance and knowing where they are in space. I've almost never fallen, although I used to be afraid all of the time. Now, I'm only afraid of falling when I'm on a steep overlook or following a narrow trail carved out of the side of a steep hill–places where most people are at least uneasy. The one time I've fallen recently was at the warehouse where I load 300-500 loaves from bread trays into my totes and then load the totes into the van. I'm always tired by the time I finish, so I wasn't really thinking when I raised my foot to stomp on the plate at the bottom of the big overhead door to get it flush with the floor. Instead of stepping on the plate, I found myself on my back, feeling incredibly foolish, not hurt at all, except for my pride. Since Meniere's ramped up three months ago, I do have lots of bruises from thrashing into things as I walk around corners, so I'm definitely in Peg's color club of black, blue, and green!

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@sarasally2

I to have an AN but am on a wait and see program. I have been dizzy with vertigo for years and they just now found the tumor. I have done vestibular therapy for years and am going again although I can do it at home. I think it helps but some days I can't get out of bed. Pounding in my ear drives me nuts. I use a cane when out of the house because when I am in open spaces I get even wobblier. Falling is not an option with osteoporosis so I try to move as much as possible.

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Get a good pair of hiking sticks!! Be sure and get a pair of supplemental rubber tips to put on them so that you have better stability and traction. They have been life savers for me for the past two years. I haven’t fallen once. Use a fanny pack when going out to keep my hands free.

Liked by joangela

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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?

Liked by joangela

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Yes, you need to do balance exercises EVERY DAY for the rest of your life. If you are feeling less balanced than usual, you need to increase the exercises. Once you've learned about proprioception, you can "exercise" by paying attention to what your feet tell you as you move about. That will lessen the amount of time you need to do actual exercises. I haven't done exercises very often for the past 20 years or more…after having done them daily for over a decade, BUT I think about how I'm moving, don't look at the surface in front of me except to determine whether or not there are any hazards, and walk in very low light or dark situations every day.

Depression! We probably all have it from time to time. I've really been fighting it, not because of my situation but because my husband absolutely refuses to do PT to lessen his pain and allow him to live normally, to enjoy all the outdoor activities we used to share. I never expected to spend the last years of my life trapped in the house, caring for him. Before she "fired" him for non-compliance (not doing anything between visits), his PT demonstrated how moving increases blood flow and lessens his pain. Still, he will not do anything but move from his recliner to the couch or his bed when he has pain. He refuses to leave the house unless he has an appt. If people come here, he says he's having "too much pain" to sit at the table or join them on our deck. He spends all day every day either in the recliner or on the couch. I *hate* eating off a plate on my lap! I miss after-meal chit-chat. If I leave to enjoy a walk on the beach, he's in trouble when I get home–although he's here alone for one day a week while I drive to the Portland area and hasn't ever had a problem. I know that he'll soon need to move to a care facility, which will use up everything we've saved. I've gained 20 pounds I definitely don't need by snacking when I'm depressed. Some days seem pretty hopeless

One way to fight depression is with a light box alarm that gradually turns on and then stays on full strength for at least a half hour. That really helps during winter! The gradual light, even though your eyes are closed, is natural and allows you to wake up feeling good. It also helps to sit facing the light box for a half hour after you're up. You can place it beside your computer monitor or on a table close to your face while reading. I don't need mine much during the summer, but it's time to start using it now as my room doesn't get light nearly as early as it did a couple of months ago.

Liked by joangela

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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.

Liked by joangela

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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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