I'm spinning around, move out of my way.
TBI, Vertigo, BPPV and Betahistine Dihydrochloride.
I’ve had a version of vertigo, big and small, since I shuffled out of King’s College Hospital following a traumatic brain injury, induced coma, a good dose of high grade pain relief and not a whole load of solid food in 2023.
Vertigo has nothing to do with heights. But you aren’t silly so you knew that already; like how tomatoes are a fruit or bananas are herbs with an ABV similar to 0.5% alcohol free beers. Y’know, common knowledge.
Vertigo makes you feel like the ground is coming up to meet you when it isn’t (hence the conflation with acrophobia). Or that the spirit level bubble in your brain is tilted to one end, then the other. Or that the doorway you’re aiming for moved just a little bit and now you’ve whacked your shoulder into the frame. It’s like being fairly pissed without any of the fun bits; a semi-permanent state of unmasked inhibitions.
It’s at its worst when I’m tired. Or when I briefly forget my head doesn’t love being twisted, turned and shaken as much as it used to.
Happily, this isn’t my normal. It’s not always-on. But it is a daily factor that I’ve slowly developed sneaky hacks to minimise:
Subtly grabbing surfaces.
(I’m told this isn’t always subtle.)Avoiding sudden jolts.
(Bouncy castles and mosh pits aren’t fun anymore.)Propping myself up in bed for 10 minutes before I start the day.
Generally acting like I’m in my 90s.
All of this flies in the face of the advice of an occupational therapist, who left me with the sanguine mantra of “use it or lose it” when it came to my joints, my strength, my memory, my persistent dizziness-defying hacks and even my confidence. The point being: I shouldn’t put a whole load of things in place to stop feeling the effects of vertigo, as doing so doesn’t give me a chance to improve my resilience.
I have no idea if that’s actually true. But it feels about right. So, occasionally, I’ll do a rolly polly to test my wiles*. No luck yet.
Here are the three medical things I have tried/will try to fix my nasty case of the spins.
Canalith repositioning manoeuvres
In the days and weeks after I got home from hospital, I was struggling with vertigo quite badly. But it was a small piece of the worry pie compared to the general sadness, fucked throat and head-wound-reopening stuff.
The good news is that when you’re discharged directly from critical care, the NHS really looks after you when it comes to appointments and check-ups. I was quickly booked in for some manoeuvres that made an incredible difference.
Benign Paroxysmal Positional Vertigo (BPPV) is caused by calcium crystals in the inner ear canals moving out of place. The logic follows that an almighty thump to the side of the head would have shaken a few things loose. And being sedentary for so long (e.g. a 19-day coma) doesn’t help, either.
The Epley manoeuvre would nearly solve this (or perhaps it did, and I’m now just dealing with something else).
I know that video is annoying. But it does a good job of showing you how simple these canalith repositioning manoeuvres can be, as long as you know what you’re doing.
My eyes flickered HARD when the neurophysiologist, Amy, asked me to focus on her finger after swirling my ear crystals around. It was so bizarre and unsettling that I laughed. I had zero control over my own eyeballs. Nystagmus is as weird as it sounds/looks.
The end result, after a follow up session a week or two later, was a marked improvement in my symptoms. This felt like good progress. But I still had dizzy flare-ups.
Betahistine Dihydrochloride
In November 2024, a full year after the Epley manoeuvre, my GP (not the good one, unfortunately) prescribed me “an incredibly safe drug” called Betahistine Dihydrochloride.
What a remarkably settling phrase that is, especially when delivered by a man who wouldn’t look out of place as Count Dracula’s understudy in the local Amdram production.
Anyway, all power to you if these pills work for you.
They did sweat FA for me. And I suspect it’s due in part to the much-lauded safety of the drug. I gave up after about 5-6 weeks.
(Note: IF IT HAS BUGGER ALL SIDE EFFECTS IS IT REALLY DOING ANYTHING?)
Vestibular Rehabilitation Therapy (VRT)
Later this year I have a hugely anticipated appointment at Guy’s & St Thomas’. It’s been about 14 months in the making, and shows that once you’ve dropped off the he’s-really-not-at-all-well list things can take a wee while longer.
Anyway, fingers crossed for cameras going up my nose and into my ears and a whole room full of vertigo aficionados who just say “do this, not that” and you’ll be reet.
VRT is a form of physical therapy designed to help people with the spins, balance problems, vertigo, and inner ear disorders; it retrains the brain to adapt to abnormal signals from your inner ear/balance system. Some very quick research shows I might be doing the following, ideally under expert guidance (and not YouTube):
Gaze Stabilisation Exercises.
Helps your eyes stay focused while your head moves.Balance Training.
Strengthens stability using surfaces, posture challenges, and head movements.Habituation Exercises.
Reduces dizziness by repeated exposure to triggering movements, helping your brain adapt.Canalith Repositioning (for BPPV).
Specific manoeuvres like our old friend the Epley to reposition calcium crystals in the inner ear.
I’ve written before about how I had no real dealings with the health system in my first 30 years. So to suddenly require external help for a daily annoyance is awkward. Fundamentally, I don’t want to make a fuss. But this really is impacting my daily life. I don’t think it’s hypochondria. And my logical brain knows health is never black and white. But who wants to shuffle through life in the murky grey?
I wonder, if I manage to shift these spins, will it help me detach myself from the ever-present looming shit show that is TBI, ICU Delirium and watchful anxiety?
I'm breaking it down, I'm not the same.
Just as my head scar and battered vocal chords once stood as testament to that month in critical care, this vertigo feels like the last big hurdle to stumble over.
Until whatever rears its head next.
Notes:
This one is a bit more whingy than previous posts. But I’m trying to be upfront about some of the fallout of a traumatic brain injury. Vertigo was never on my bingo card before all this. So, I hope it’s useful and (I assume) fairly normal.
I have a note to write about scars, physical (hidden, visible) and psychological, another day. So that’ll be fun.
*Wiles. We recently watched both series of Such Brave Girls and it might be the best thing I’ve watched in 2025. I stole the word from them.