I posted this for subs because he´s the one with more experience on this particular question

Right now I'm doing the Cawthorne-Cooksey Exercises, I'm on my third straight week, and even as I've felt some improvement, I'm still on the "short end of the stick" specially with the visual stuff, wich I believe this set of exercises don't adress as specifically as the VRT set posted on the sticky(the one that your'e making). So as I want to give them a try etiher changing or mixing sets...

I know that my recent food poisoning, and my current, almost perennial sinus stuff, wich already clogged my bad ear, not to mention my migranious story, are all conspiring in their own way against my total compensation, but I know that I'll be dealing with them in the future(hope not with the poisoning), so even If I treat them properly, I want my brain to be ready for them, so I don't have the usual illness/vestibular tandem, each time I catch a cold...

Anyway, what I wanted to ask you is to give me the "details" on this VRT set, because even as I quite understand it all, some things are not so clear for me, so here it goes(b patient, and thanks in advance subs).

VOR stimulation exercises

"For head movements in phase with a target (X1 viewing), hold a card with lettering at arm's length with eyes focused on the letters."

What does x1 viewing exactly means? Do you have to hold the card with your arm or you just place it on the wall at arm's distance?, Size of the card and the lettering important? In your case, how long did you take to progress from the different feet stances, and now if you're(for example) doing it with one foot in front of the other, Do you still also doing it in a "normal" stance?


"For head movement out of phase with target (X2 viewing), hold a card with lettering at arm's length with eyes focused on the letters. Move the head to the right and the card to the left, keeping the eyes focused on the letters."

Same here what does x2 viewing means?, Here I supose that you DO have to hold the card? And in both cases which is the exact angle of the head's motion, is it 45 degrees? or the limit in which you can still see the letters?, And what about speed and repetitions? How fast, how many?

Ocular motor exercises

Ok here I don't move my head right?, Only question is speed, and repetitions and.. in the second set with the two cards, it means I hold one closer to my eyes and the other one at arm's length to make a focal change from one to the other, mixing planes too, Am I right? And in your case do you mix a lot of different positions in your set?

And how about videogames? Do you know anything about this? I posted something on this, and already started paying... ;) I don't know if they help, but I haven't felt dizzy playing, as I have sometimes felt with long working on computer sessions...

Balance exercises

I think I do get this set, I just want to know how long did you took from a normal stance to te single leg one, and if you still do a "complete" set, meaning that if you still do the set both with two legs and with one only

"Another exercise is making a circle with a ball. Focus the eyes on the ball. Move it in a circular fashion in both directions with increasing speed. Move the head and body with the ball. Progress from sitting to standing to a narrowed stance"

This one I make a circle standing up with the ball in my hand, following it with my eyes moving my head but how do I move my body, do I have to shale or something? ;) (I didn't get this).

Gait exercises

Walking near a wall has any purpose other than use it as a support on ex 1? In ex 2 you just walk for some period of time moving your head arround, Am I corrrect?, and then you mix it with some walking in circles, right? and in ex 3, you should decrease the gait all the way to one foot in front of the other, or just a narrow stance?, and then again, do you have to do a "complete" set using all stances progressively when you already "conquer" them all?

Combined category exercises

Do you actually walk moving your head like crazy in the supermarketor the mall? ;)

An I believe your daily night walking covers this "obstacle" course thing right?

Thanks in advance subs, I know that you should charge me for all of this questions, just don't charge me too much ;)

Hope my questions help others with the same doubts as me on this particular exercises.

Thanks again.

I`m glad that you`ve asked Subs about those VRT exercises Stargrave. I`ve been doing all of them in one session just sitting down at the mo ( 3x a day most days), but wondered when to move on to standing etc and whether to still do the sitting ones as well.


//(*_*)\\ Sally


Ps Hope Subs doesn`t charge me too much either ( being the w/e and all) lol

Hi Star/Sally

I never did those exercises---they were found/posted---after I had started---VRT exercises---that were given to me---by Univ of Penn---because of the unique vision problem(s) they discovered----I no longer have the Univ of Penn exercises---since I shifted from them---to---just the "walking day/night routine" quite a ways back--

Maybe someone who uses/used them can/will comment on ur questions---

Will say---not sure---that the precision---is all that important---at least---the Univ of Penn did not think so---for the ones they gave me---for mine---doing them---was to them(daily 3X P/day)---was more important---if I remember correctly-----

I suspect/suspected---that---they knew---that it was more important to move---in ways---u---had never done before---plus---ur normal daily movement repertoire---that would---cause u to compensate---and that a "precise" correlation did not exist---between what they were asking me to do and the vestibular/vision injury that I had---but that is just a guess

Star---not quite sure---I understand what u mean with this part of the post:

..."specially with the visual stuff, wich I believe this set of exercises don't adress as specifically as the VRT set posted on the sticky(the one that your'e making). So as I want to give them a try etiher changing or mixing sets..."........

?????


:cool:

Star---not quite sure---I understand what u mean with this part of the post:

..."specially with the visual stuff, wich I believe this set of exercises don't adress as specifically as the VRT set posted on the sticky(the one that your'e making). So as I want to give them a try etiher changing or mixing sets..."........?????:cool:

I mean that the "general approach" of the Cawthorne-Cooksey Exercises does not seem to "attack" directly the recovery of the VOR, or stimulate the visual function as much as this posted exercises seem to do.

They are even specified for that, but that is my hunch, and I also meant that I should try to mix the sets(with the Cawthorne-Cooksey Exercises), for better results, but then again that is another "hunch".

I wanted to ask you because of your experience, recovering from the "vision trouble".

So now you only do the walking day/night routine, and that's it?

I mean that the "general approach" of the Cawthorne-Cooksey Exercises does not seem to "attack" directly the recovery of the VOR, or stimulate the visual function as much as this posted exercises seem to do.

They are even specified for that, but that is my hunch, and I also meant that I should try to mix the sets(with the Cawthorne-Cooksey Exercises), for better results, but then again that is another "hunch".

I wanted to ask you because of your experience, recovering from the "vision trouble".

So now you only do the walking day/night routine, and that's it?

Hi Star

I agree with ur comments on the Cooksey exercises---and yes only do the walking day/night---yep that's it

:cool:

Hi Subs,

I`m a little confused here. You say that you never did the VOR exercises in the sticky but I asked which VRT exercises you do or did back in a post dated 1st March and you said all the exercises in 7 of 8 in the sticky 2/3 x a day. Or maybe I`ve got that wrong ( sorry if I have ). I`m just a bit muddled now. :)

//(*_*)\\ Sally

Hi Subs,

I`m a little confused here. You say that you never did the VOR exercises in the sticky but I asked which VRT exercises you do or did back in a post dated 1st March and you said all the exercises in 7 of 8 in the sticky 2/3 x a day. Or maybe I`ve got that wrong ( sorry if I have ). I`m just a bit muddled now. :)

//(*_*)\\ Sally

Hi Sally

Nope its not u---its me---its a good news bad news story---

First the Good News:

U and Star will find out---when u fully compensate---this junk---recedes in ur rear view mirror---until---much of the detail---merges and disappears--

Now the Bad News:

I got the Sec 7 & 8 VRT confused with the Univ of Penn stuff I did---I should have double checked my "Log"---that is not to say---that the Sec 7 & 8 exercises are not good---they are excellent

In fact as the Northwestern Univ VRT web page says---any/all vrt is good---except for the injuries "ID" on their page

:cool:

Okay, thanks Subs. I was beginning to think that I was more muddled up with this junk than I thought I was! lol Anyway, I might also have a look at the other exercises too although the ones that I`ve been doing have helped a little already.

Thanks again for your advice. :)

//(*_*)\\ Sally

have any of you been to the Unv of Penn's office? i live in philly and was hoping to hear about your experiences.....think it's time i bite the bullet and get checked out by the best.....still very off when i'm out or looking at computer screens...i'm tired of not being free to go to the grocery stores or malls! i have anxiety over all of these.....

:confused:

Hi Sally

Nope its not u---its me---its a good news bad news story---

First the Good News:

U and Star will find out---when u fully compensate---this junk---recedes in ur rear view mirror---until---much of the detail---merges and disappears--

Now the Bad News:

I got the Sec 7 & 8 VRT confused with the Univ of Penn stuff I did---I should have double checked my "Log"---that is not to say---that the Sec 7 & 8 exercises are not good---they are excellent

In fact as the Northwestern Univ VRT web page says---any/all vrt is good---except for the injuries "ID" on their page

:cool:

Well I can't wait to be fully compensated, and believe me I'll throw in a virtual party when I'm done with this ;)

And I think I'll shake my head a little bit more with the Cooksey exercises, till I get the whole set complete(as instructed by the doc), while I mix it with some of the VOR oriented stuff in the sticky, I don't think it could hurt... And with some videogames too, since I'm having fun and they don't get me dizzy at all... ;)

I'll also try to blend some day walking in the mix, since here in the big Mexico City(as in most of the big ones) it's not always the safest to walk at night....

And we'll se what happens...

By the way, how long did you took for total compensation subs?, and refresh me please, what was your Dx in the first place?

Best.

Star

..."how long did you took for total compensation subs?, and refresh me please, what was your Dx in the first place?"....

12/13/14 months to total compensation---got hung up at 10/11 month---at about 90%---because of vision problem(found by Univ of Penn)

Dx---first dx was VN, second Dx was Lab, third Dx was Lab w/BPPV---the BPPV part I buy---but doubt they ever knew---which on---the VN or Lab part----and as the Univ of Penn pointed out---at 10/11 months & 90%--it was a mute point--at that point in time---vision---was the culprit---to be worked on---which I/they did.

U'll get there ur doing all the right stuff---and asking all the right questions---

:cool:

Hi Manchak

If u can get to Univ of Penn Balance Center---they are the best---as u say---kind of expensive---but I found them to be---excellent---they have a great reputation---in this area---the Director of the Balance Center--is a co-author of the item in the "sticky" called Chronic Dizziness---and prob one of the two best in the U.S. in this area---take a look at their Univ of Penn Balance Center web site---if u have not already---done so---

:cool:

Hi Subs,
Please forgive me for dropping in on this post with a rather unrelated question, but since you have become the inner ear disorder "consultant" for so many of us, I knew I had to ask your perspective on my current concern, and this seemed like the right opportunity!

I've asked you before about your take on the low dose benzos, and you have, in the past, put my mind greatly at ease regarding their usage. Now, that I'm a little further into it, I have a few more questions.

Though I would obviously much prefer to not take the 2 mg. valium at all due to the highly-broadcasted concerns (compensation-hindrance, addictiveness, etc.), I guess I have to weigh the quality of life issue with all of that, right?

Drs. Solomon and Shepard state,"There is no role for chronic treatment of dizziness or vertigo with meclizine, scopolamine, or other antihistamine or anticholinergic medications. These are appropriately used acutely in the first days to a week after a vestibular crisis, and on a daily basis when significant nausea or spontaneous spells of vertigo are expected. Patients may wish to keep some on hand as "security," but habitual use of these agents generally is not helpful and may be counterproductive to the central compensation process." (italics mine) (Though this paragraph doesn't make specific reference to the benzodiazepines, I wonder if these drs. would include klonepin or valium in their list of meds that should not be used for chronic dizziness.)

Then, Dr. Hain (and others) say, "low doses of valium (2 mg.) can be quite effective." I am experiencing that, indeed, the 2 mg. valium can really help me facilitate my busy life, but I find that I continue to battle that internal, "You should not be taking this" voice! As I continue to try to maintain my ever-increasing busy schedule at far less than 100%, I can honestly say that it would just be easier to take the valium every single day. (My rx says every 6-8 hours, which would be just fine with me!) As of now, I'm trying to hold out and save it for the really bad days... but when I have classes and appointments that I need to keep, I just can't afford to have to worry about how I'm going to be doing vestibularly.

I guess the conflict I deal with every day is this: Am I just prolonging my recovery by masking the symptoms with the valium? Am I heading towards a dependency upon it? (Frankly, at this point, I need to be able to fully function, and am really tempted to not be too concerned about that aspect of it. So what if I have to take it for the rest of my life?)

I've been out walking in the hills as often as I can (sometimes a little hard to do it daily with my schedule, but at least 3-4x a week), I'm doing my VOR and gaze stablization exercises.... but then wonder if I should even bother on the days I take the vallium - is the medication is negating the effect of the VRT? I could go on and on with the thoughts I've entertained about all of this... but I won't!

If you have a chance, I'd surely appreciate your insight and perspective... I have so many other people's problems at work to be dealing with at this point in time, that I'd really like to give my own a rest!!!!!

Thanks so much -
Robin

Hi Robin

I was wondering how u were doing.

Some thoughts/comments

First---not sure either Dr Shepard or Hain---would--define---u as having--- Chronic Dizziness---now

Second---I would tend to lean more in the direction of Dr Hain's expertise/experience/background when it comes to this item---seems to have a lot more strength & depth and a wider perspective in this area---I suspect---his, the facility's & Northwestern research interests are broader and deeper---with more resources committed to both research and clinical---a guess---but the way their writings etc...strike me

...."wonder if I should even bother on the days I take the vallium - is the medication is negating the effect of the VRT?"....

Don't think its that precise--and suspect---for each of us---even if it were---the answers---would be different---think---all vrt---helps---it gives the brain a shot--at compensation

..."Am I just prolonging my recovery by masking the symptoms with the valium?"....

---I see it---(imperfectly I'm sure to medical types)--like this---

If I know I have to get from point "A" to "B" using a certain road defined and engineered by others

---at 100mph---I get there fast

---at a slower speed---I still get there

for each person there is a fit---and most---are innately smart and wise enough to chose the one---that will--work for them

--with both choices u get there but---as--- "Frank" said "my way"

---its "benign" so its the road not the speed

......"Am I heading towards a dependency upon it?".....

Don't know---dependency---perhaps---but way to early---to go there---remains to be seen---what taking the Rx at the prescribed dosage---gets u

----as for in addiction---doubt it---different animal

..."(Frankly, at this point, I need to be able to fully function, and am really tempted to not be too concerned about that aspect of it. So what if I have to take it for the rest of my life?)"....

Its a choice---u get fully informed---do the trade-offs---prepare the back-up plan---and make the choice---

---if does not go well---u---shift to the back-up

---but u--stay on the road to point "B"

Not likely u'll fail to compensate--Robin.

:cool:

Thanks so much, Subs -

I knew your perspective would give me a little bit more objective take on the situation! Thanks for getting back to me so quickly. Thanks for standing at the finish line and cheering us "laggers" on! :bouncing: (Here's to getting from A to B as quickly as possible!) By the way, curious as to what you think might qualify as "chronic dizziness" - someone who is struggling for years and years with this stuff?

How's the drivers training going? I'm sure it keeps you quite busy!!! Just want to tell you that I'm really glad you keep enough time in your schedule for all of us!!

XOXO ~ Robin

Hey Subs,
I see from this post that you received 3 different dx's (VN then Labs then Labs and BPPV) I was wondering if you experienced any tinnitus and or ear fullness amongst your symptoms. I too have been dual "dx" w/ BPPV and something else but they are not sure what. Docs are taking a wait and see. The best they could say was BPPV w/ Menieres like symptoms. I think the on and off ear pressure and the tinnitus seems to (in their eyes at least) put me in another catagory beyond the BPPV. The tinnitus is strange, I hope it goes. It's like a tea kettle whistle and its always there almost between both ears. More like it's coming out of my brain then my ears. Strange huh?

adrienne.

Hi Adrienne

Yep---I had/have tinnitus---but had it before this---it comes and goes---during this junk---it turned into a pulsating tinnitus(from a tone)---its gone for now---

As for "other categories"---this junk can cause so many symptoms---some of us have the same---some partially the same---etc.....I don't worry---to much(well really not at all) about Doc's---that talk about "other" far as I'm concerned---the whole thing is an "other"---with none of them having any real handle on the clinical aspects of it---they almost stand back in wonderment---it seems at times----watching the brain do it's thing

By the way---looks like their(medical research types)running clinical trials---with "botox" as a fix for tinnitus---very early stages

:cool:

Thanks so much, Subs -

I knew your perspective would give me a little bit more objective take on the situation! Thanks for getting back to me so quickly. Thanks for standing at the finish line and cheering us "laggers" on! :bouncing: (Here's to getting from A to B as quickly as possible!) By the way, curious as to what you think might qualify as "chronic dizziness" - someone who is struggling for years and years with this stuff?

How's the drivers training going? I'm sure it keeps you quite busy!!! Just want to tell you that I'm really glad you keep enough time in your schedule for all of us!!

XOXO ~ Robin

Hi Robin

...."might qualify as "chronic dizziness"...

Well---they(Doc's) hate to admit it---but---its kind of like a two year journey---to full compensation so my guess is---something---along the lines of three/four years---and beyond---think they would look---at what u tired, VRT, etc---past testing results---new testing---comparing that---original Dx---etc---then Dx chronic---if they thought it was warranted

..."How's the drivers training going?"....

Its going good---lot of fun---usually a great class---interested in learning---etc---their critique sheets always seem to say---they learned something(or at least one thing they did not know) that they can/will use to become better/safer drivers---for themselves as well as others

---so it seems to be making a difference---making things better then---what they were---and closer to what they can be----good stuff!!

:cool:

Good for you!!! There's nothing like making a difference in someone's life for the better, is there!? Keep up the great work!