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-   -   Is anyone else still dizzy? (https://www.neurotalk.org/traumatic-brain-injury-and-post-concussion-syndrome/238896-else-dizzy.html)

RidingRollerCoaster 08-11-2016 12:43 PM

Is anyone else still dizzy?
 
Hi there

I guess I'm just looking for some support. After over 2 years I still have this constant dizzy / off balance / and "heavy" feeling in my head. Some days it is worse than others. Activity and busy environments make it worse. I can't move around freely and always have to be careful not to get too dizzy.

I've been doing vestibular therapy which helped a lot in the first 2 years. Now it's helpfulness has seemed to wane. I feel like my neck has something to do with it. I've had that treated with good results, but something is still "off" with my neck.

I am starting vision therapy and hoping that will help some more. But I am at a loss for what else to do. Some days it is very hard to deal with the dizzy feeling.

Has anyone else been dizzy for this long? How do you deal with it in daily life?

Thank you

Mark in Idaho 08-11-2016 03:52 PM

A large part of balance is based on vision. Resolving vision issues may help with balance issues. Did your vestibular therapist consider your vision ?

As an example. When someone first gets glasses or has a major change in prescription, balance can take a while to catch up. The floor and ceiling seems to be moving or in a different place than expected. Vision issues could do the same.

Hains 08-11-2016 03:57 PM

Balance is an autonomic function with inputs from the eyes, ears and somatosensory, and is regulated by the brain stem. Balance disorders which produce dizzyness can arise from miscommunication of any of these components. If you've addressed the eyes and ears without solving the problem, look to the brain stem. Various factors can contribute to its dysfunction, including chronic inflammation. If you have neck issues, that may be irritating the brain stem. Consider Low Level Laser Therapy targeting the brain stem and the neck (muscles and bones) using 810 nm and 908 nm Near Infrared Wavelengths. This therapy is safe and backed by an overwhelming amount of scientific research. It is also cost effective, I paid $25/session at my selected facility.

Also, with vestibular loss can arise a disorder called visual-vestibular mismatch. This is treated with compensation techniques and physio that involves habituating to the motions that trigger symptoms.

I would consider the brain stem first. If that produces no results then dig deeper with the VVM. I've had success with both.

RidingRollerCoaster 08-11-2016 04:37 PM

Thank you Mark and Hains

Yes, I have been doing some vision related exercises in vestibular rehab and have recently started vision-specific therapy with a special optometrist. I am going to keep up with this and see if it helps.

Hains - I am interested in the low level laser therapy for the neck. Is there a website or organization that can help one find a practitioner that does this? How did you find your practitioner that helped you? How are your symptoms now?

CatOhio 08-11-2016 06:35 PM

I read your post and I have to say that your lingering symptoms sound a lot like mine except that this is only my 8th month. I've been in vestibular and vision therapy since March and had some improvements but I'm still constantly dizzy. After reading that you are still battling with dizziness 2 years in, that lets me know I have to continue to be patient. I wear sunglasses to manage my dizziness in my daily life outside of my house. I used to feel uncomfortable wearing them inside of stores, but they help me greatly by stabilizing the environment.

I went to see my vision therapist yesterday for our usual visit and she took my measurements again and noticed my vision has changed. Now she feels I'm ready for a little bit of prism in my glasses (I never needed glasses prior to the concussion).

I have neck issues too including a bulging disc at c6-c7 and a pinched nerve. After months of being in physical therapy, I haven't found any neck relief. I just started getting weekly medical massages 2 weeks ago and that does seem to help. I have been using a TENS unit, Theracane, half foam roller, pregnancy pillow as tools to address my neck when I'm at home and those provide some relief.

I've also just started incorporating essential oils to help me deal with stress, anxiety, and tension.

Hains 08-11-2016 06:45 PM

Quote:

Originally Posted by RidingRollerCoaster (Post 1220174)
Thank you Mark and Hains

Yes, I have been doing some vision related exercises in vestibular rehab and have recently started vision-specific therapy with a special optometrist. I am going to keep up with this and see if it helps.

Hains - I am interested in the low level laser therapy for the neck. Is there a website or organization that can help one find a practitioner that does this? How did you find your practitioner that helped you? How are your symptoms now?

My Naturopath has a unit in-house. However, in my research a came across a product locator (Google search Theralase Clinic Locator, I can't post links).

I use the Theralase TLC 900-CH which is a multi-laser unit that uses 660nm (red) and 908 nm (NIR). There are other similar products. The important parameters are wavelength and power settings. The 810 nm wavelength is also beneficial, so I wouldn't discriminate against it if you find something of the sort nearby.

I linked my insomnia and dizzyness back to my brain stem, hence the suggestion. I'm half way through my initial 10 session treatment plan and have noticed a significant improvement in sleep and my dizzyness has pretty much stopped. Additionally, my neck feels looser after every session. All this has happened since starting the LLLT treatment.

I can't say for sure that this is the miracle pill because i am also doing myofacial release, VVM excercises, breath training (Wim Hof), and Vielight Intranasal Infrared, concurrently. However, since starting the Theralase treatment I actually feel like my PCS is coming to an end (after 20 months), so I definitely endorse the product and treatment.

RidingRollerCoaster 08-11-2016 08:42 PM

Hains - thank you, that is great information. I'm glad you have found things that help you! Just one more question - is cold laser the same thing as LLLT? I see a lot of PTs and Chiros that say they do cold laser but it doesn't necessarily say "LLLT".

CatOhio - yes it takes a great deal of patience! Keep up the good work! Some days are better than others, but I try not to ever give up hope. It sounds like you are doing a lot of good things. I would say keep up with the vestibular and vision therapy. It can take a long time and progress is slow, but I believe it helps a lot of people. Acupuncture also really helped me with anxiety, stress and some of the dizziness and neck issues too.

Take care

_Grace_ 08-11-2016 10:59 PM

Hi all,

Glad I am not alone in this, but I know it is brutal. Could be worse of course, but this really has me angry/depressed/slow! I need to update my history too.

Wanted to run something by everyone...I had been doing behavioral optometry, but not much progress, ( I do have prism lenses for work). Then pursued another PT (after insurance denying both PT and speech therapy).

Recently resumed Carrick chiro since not seeing improvement for nearly 2 yrs. Sorry for all the history- my question relates to vision and vestibular therapy.
I am now being told that the gaze stabilization needs to precede vestibular rehab.
Does anyone have any experience/input on that?

Thanks,
Grace

Mark in Idaho 08-12-2016 12:56 AM

RRC,

The key issue with laser or LED near infrared therapy is wavelength. 800 to 1000 nm wavelength is suggested as best.

I have a ReVive system that cost about $80. I used it for weeks on a shoulder to help with recovery from surgery. Unfortunately, it caused such an increase in inflammation that I had to stop using it. I only used it for 15 minutes 2 or 3 times a day.

Some will try to say low level laser (gas laser) is better than LED/laser diode near-infrared but both are the same if they put out the same wavelength. It is a matter of the physics of light. The research shows no difference.

Different wavelengths provide different benefits so be sure to get a deep tissue wavelength. 390 to 600 nm for skin repair and 800 to 940 nm for deep tissue. By deep tissue, the maximum depth is only 4 mm or 0.4 cm Some claim a penetration depth of 40 mm but the US NIH research says 4 mm is the deepest penetration.

Bud 08-12-2016 08:26 AM

Not sure how to explain my situation but I will attempt.

I don't always feel stable but I have no evidence to prove I am not. I am doing activities that require balance again and all seems ok, yet it never quite feels like I am solid.

Not really sure if I am making it up or I actually feel off but I certainly don't feel like the old me, I try to ignore it.

Bud

Hains 08-12-2016 11:03 AM

Quote:

Originally Posted by RidingRollerCoaster (Post 1220198)
Hains - thank you, that is great information. I'm glad you have found things that help you! Just one more question - is cold laser the same thing as LLLT? I see a lot of PTs and Chiros that say they do cold laser but it doesn't necessarily say "LLLT".

Yes, Cold Laser and LLLT are interchangeable terms.

My research differs slightly from Mark's (below). You need to focus on 2 variables: Wavelength and Power. I mentioned 660nm, 810nm, and 908nm as the specific wavelengths confirmed as therapeutic in the scientific literature. Power output is what controls the depth of penetration into the body. The scientific literature suggests that LED lights are effective but do not penetrate as deep as lasers. Therefore, lasers are more effective for large muscles, hard tissue and brain injuries. An LED will never penetrate the skull, but a laser with a high, but safe, power output (eg. 75-100mW) has a chance.

In your research you will come across varying units. Wavelengths, an expression of light, are usually measured in nanometers (nm), different wavelengths have different effects on the body. mTBI and whiplash treatment research suggest 660nm, 810nm, and 908nm. Power, the electrical output of the device projecting the wavelength, is measured in Watts (W) or milliWatts (mW). Power density (mW/cm2) is the power output per area (cm2; metric measurement), which is the coverage on your body. Energy, measured in Joules (J), is Power(w)*Time(s). Energy density (a.k.a dosage), is measured as (J/cm2). Some people will debate the appropriateness of the energy density measurement, just ignore the conversation as it will not help with your recovery. Rather, the unit you select should come with some kind of treatment protocol. Stick with that as it was approved by the manufacturer.

Also note that exceeding the recommended treatment times will cause overheating of the area and will result in inflammation, negating any therapeutic effects. I made this mistake early on. Please learn from my mistakes.

I actively use the following protocols, and am finding them to be effective. They may not be the best, but with my resources I have refined my treatment to this:

Brain Stem via back of the skull, through the cerebellum: 908nm, 60 seconds, 75mW, 1.13mW/cm2.

Neck (hard tissue): 908nm, 180 seconds, 60mW, 2.7mW/cm2.

Neck & Upper back (soft tissue): 908nm, 180 seconds, 50mW, 2.25mW/cm2.

Mark in Idaho 08-12-2016 01:50 PM

I totally disagree based on the NCBI.NLM.NIH website and basic physics. Power output relates to the amount of area that can be treated. There is a limit to the power per area (milliWatts/square centimeter) that can be safely tolerated. This varies by the wavelength. Think sunburn. The power per area is limited to 10 to 20 times the power of noontime sun, depending on the wavelength.

Wavelength relates to depth of penetration. Light wavelength is well known as related to penetration of an object. Long wavelength infrared light will pass through glass but short wavelength ultraviolet light will not. Again, think sunburn. UVA/UVB sunblock prevents short wavelength light from penetrating the skin and causing damage. It does not stop long wavelength so you still feel the warmth from the sun.


PubMed Central, Figure 2: Semin Cutan Med Surg. 213 Mar; 32(1): 41–52.

http://www.ncbi.nlm.nih.gov/pmc/arti...ms430657f2.gif

The primary difference between a Laser Diode and LEDs is the focus of the energy. Lasers transmit the light in a narrow beam. Some LD systems use multiple beams to cover a larger area. Lasers were originally developed for therapeutic uses because they were the only way the wavelength could be controlled

LEDs transmit the light in a wider spray.

The laser system manufacturers have been trying to distort the facts to maintain sales as LED systems have become available at affordable purchase for home prices. But, the research shows LED's to be just as effective. Laser systems have higher power outputs that require more technical understanding of the therapy protocols so as to not cause harm. This higher power means a treatment can be shorter. Home LED systems require more time.

But, only the therapist benefits from the time savings as the therapist can treat more patients during each day. The patient has to drive to the appointment, wait, get treated, settle the bill and drive home and schedule these treatments around a daily schedule of life.

So, for me, a home LED system was the choice. Unfortunately, my shoulders have had chronic inflammation problems for 40 years and stimulating healing causes an increase in blood flow increasing already bad inflammation. As my surgeon said, I have angry shoulders but he can't see what is causing them to be so angry.

I have not tried my system on my upper neck but based on recent neck struggles, I am considering it.

Here is an interesting study about NIR penetration.
Near-IR light penetrates skull to aid traumatic brain injury - Laser Focus World

russiarulez 08-12-2016 03:45 PM

Quote:

Originally Posted by Bud (Post 1220251)
Not sure how to explain my situation but I will attempt.

I don't always feel stable but I have no evidence to prove I am not. I am doing activities that require balance again and all seems ok, yet it never quite feels like I am solid.

Not really sure if I am making it up or I actually feel off but I certainly don't feel like the old me, I try to ignore it.

Bud

Bud, I have the same issues. I can go out on a boat and balance standing on the bow with a fishing rod just fine, but always feel dizzy/off balance when walking or even sitting still. I can also ride a bicycle just fine.
So far one possibility for these issues is the binocular vision problems, and supposedly prism glasses and vision therapy is going to help (but hasn't so far).

Bud 08-14-2016 10:33 AM

RR,

Interesting, I'm glad you responded.

I usually handle things pretty well but there are times the frustration rears its head and I have to remind myself that despite the odd feelings I am getting to do what I enjoy again.

I suspect eyes also.

Bud

Estreetfan 08-14-2016 03:45 PM

Bud and RR

I have had intermittent dizziness and constant off balance issues for 4 years now. I have prisms for reading. These helped me with headaches related to reading but not the balance issues. When I am stressed or fatigued (which is not hard to do with me) my balance gets worse and the dizziness appears. It also comes on fast if I am out at an event where there is alot of sensory stimulation but never actually progresses beyond being very uncomfortable. I can still walk (carefully) and have never actually fallen altho I have bounced off walls regularly. I have figured out many ways to accommodate my other symptoms but this one continues to get the best of me.

RidingRollerCoaster 08-14-2016 05:50 PM

Ok. Thank you Mark and Hains for all of the great info. Some of it is a little to technical for me though, and it goes right over my head ;)

It sounds like you all bought your own LLLT unit and are doing it at home? I don't feel like I have enough knowledge about it to do that. Any practical advice on what to look for in a practitioner that can treat me with LLLT? So each treatment will only last a few minutes?

Mark in Idaho 08-14-2016 08:25 PM

Clinic treatments should last a few minutes per location. At home treatments last 10 to 15 minutes per location.

pcslife 08-15-2016 06:56 AM

I have been dizzy for 7 years. Not really the room spinning but sorta. Also head pressure and weird feeling goes with it. Some days bad than others. I have tried most of the things mentioned in this forum.
So far I had only temporary success.

Now I go to office full time and when I come home evening like a drunk. My work involves looking at the computer and thinking. Not really helping and I feel depressed too. I like to apply for disability at this point.

What helps me alcohol and then I can even dance :) Also antibiotics helps me as well. I take Xanax minimum dose everyday. Or I cannot get through the day. Also my dizziness and headache gets worse in cold weather. All these things I already mentioned before in the forum.

Bud 08-15-2016 09:56 PM

May sound corny but my heart really does go out to you all, I'm familiar with your club!

Keep finding ways to go forward.

Bud


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