There has been some recent discussion over Cawthorne-Cooksey exercises for
patients with uni-lateral or bilateral vestibular disorders.
A PERSONAL BPPV CASE HISTORY
I first heard about these exercises from kind members of this group more than
two years ago after I related my unsuccessful attempts to 'cure' the
Benign Paroxysmal Positional Vertigo (BPPV) which I have suffered from for
more than 20 years. To rule out the possibility of more serious brain
tumours and central disorders, I had CAT scans and EEG recordings done. It was
confirmed that I indeed had that four-lettered disorder BPPV that can make
one's life quite a misery at times.
I periodically had to warn my students that my occasional staggering and
disoriented demeanour in lectures was not due to alcoholic poisoning! Anyway,
BPPV became a part of my life and I learned to cope extremely well with it,
even continuing a competitive career in Olympic weightlifting, in which it can
be reasonably unhealthy to lose control with heavy weights directly overhead!
A LATER CASE HISTORY
Came last year and I was lecturing to a large auditorium of my new engineering
students when the Angel of Dizziness decided to visit again. As usual I gave
my standard mini-medical lesson about my BPPV to the bemused class and
insisted that the class continue while I lectured from a chair on the podium.
Well, less than a minute later the dizziness became so overpowering that I
could not even sit, so I lay flat on my back, feet raised on the chair, saying
to my students that the "show will go on". Since I tend to be a fairly
lighthearted lecturer who often jokes around with students, they probably
thought that this was the same old Siff at it again - many years before 'Dead
Poets Society' ever was screened I used to jump, walk, stand and demonstrate
biomechanics in action on the desk or anywhere physics principles could best
be illustrated - so why on earth would any student think that anything unusual
was happening?
Lying in agony as if being crushed alive under a collapsing building, I had
this overwhelming sense that I was dying and called out to the nearest
students to call the Campus doctor immediately. Fortunately the lecture hall
was less than 1 minute away and she was there to stabilise me during a massive
heart attack. A subsequent angiogram revealed major occlusion of most of my
coronary arteries, yet I had no prior warnings, classical risk factors, family
history, elevated cholesterol - I think that after a quadruple bypass
operation I described my case history and rehabilitation on this group quite
thoroughly last year.
IMPLICATIONS?
The relevance here is that I am now wondering after all these years whether or
not the 'BPPV' was really an early warning of arterial narrowing or sclerosing
elsewhere in the body - especially since the Cawthorne-Cooksey exercises did
not really seem to help. Books on medical diagnosis mentioned quite casually
the possibility of vertigo being associated with cardiac disease. Would anyone
like to add their thoughts on my 'post-monition'? ('delayed premonition' -
like 'predictions' by most astrologers!).
Is it possible that medical specialists and radiographers may have missed
early signs of heart disease in my case? This would have profound
implications for others who may have been in my position.
I suppose that I could have phrased this as a Puzzle & Paradox (since it has
been one of my personal ones for so long!), but as it is, it may still
generate some valuable insights.
Dr Mel C Siff
Littleton, Colorado, USA
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