And here we are, at the beginning of another year. Strange, peculiar, atypical, perhaps even more than I have ever experienced in my entire life. A year full of mixed emotions and many lessons.
In this 2021 I have learnt above all how important it is to be able to listen to ourselves, stop and have faith in our journey. To accept both the positive and the negative, the storm and the calm, and to find the right balance in this duality. Uncertainty is part of the life process, where soul and self are constantly changing (anitya), just as we are. And in this flow everything happens for a reason, to evolve us and to keep us on our path. And this doesn't mean that it has to be bright clear which one it is, but only that we have to embrace our existence, being and living in balance between the contrasts.
If there weren't bad days, we wouldn't appreciate the good ones so much; without duality there would be no balance at all. This is the theory of yin and yang. Never before has the meaning and energy of this concept been so obvious to me. And never before has it been more evident to me than during last year, reminding myself every day that we are not the sum of the events that life throws at us, but the response we give. That we always have the possibility to act on what we can control and to accept what is not up to us. And that this is fine.
As PPPD and its symptoms are such complex and individual, there is not an unilateral approach to cure it. Instead, what scientific studies show, is that you need to embrace a multidisciplinary approach including:
- Vestibular Rehabilitation Therapy (VRT): this particular type of "physiotherapy" aims to desensitize to motion stimuli, improve your balance and slowly allowing yourself be confident again in moving without the fear of falling down. In my case, I do a lot of exercises on a moving platform where I do visual games while trying to keep my balance. Don't get discouraged if at the beginning you feel worse, it's normal because all these exercises are targeted to your problem and will trigger symptoms so that you can learn to lower your hypervigilance to the stimuli;
- Medication: Selective Serotonin Reuptake Inhibitors (SSRIs) should help with the symptoms reduction (50% reduction in symptoms in 80% of patients who used these medications for at least 8-12 weeks). I was initially against the idea of taking medications, because I hardly ever take pills, because I had fear of side effects and because I knew these are used to cure depression and I didn't wanted to create an addiction. But I made up my mind because I promised myself I was ready to do everything possible and useful to heal, so I started the cure with Escitalopram (Cipralex) on minimum dosage (5mg);
- Cognitive Behavioural Therapy (CBT): while this should have been part of the treatment my neurologist prescribed, I choose not to follow this advice because I already have a psychologist but most of all because in my opinion it is not something that could help me at this stage (this is my opinion, but if you have a different one go ahed with it). My idea is that I want to deeply understand what caused BPPV and PPPD and cure the problem at its roots, and not learn about coping strategies to live my life with the symptoms because at this "early stage" I see this as giving up with the possibility of improvement. And I need to believe complete remission is possible.
To this treatment plan, I added my own personal recipe, a mix of exercises/therapies which I think helped me a lot:
- Osteopathy: after BPPV I developed a bad contracture involving my neck and upper back (result of my body trying to "compensate" the unbalance and avoiding falling down), therefore massages and specific stretching exercises were crucial to resolve pain and give my muscles some relief;
- Walking: having walks in the nature is not only a very good exercise for balance and sight, but has a huge impact on your mood too; when I started with VRT and I wasn't able to walk anymore for three days (unfortunately I am serious, this did happen), I was discouraged and had a terrible mood, but as soon as I started being on nature again and regained confidence on my body, I gained strength and energy;
- Yoga, breathing and meditation: I could spend a month writing about how yoga saved my life in various circumstances, but I don't want to too boring. In a few words, moving yourself consciously and controlling your breathing will help you more than anything else. Give it a try, you won't regret it;
- Home exercises: I have a routine of exercises (sitting, standing and on a balance board) which I do every morning and afternoon that includes both eyes movements and balance during motion (I will asap make some video where I will show you these exercises which might be useful for you too :) );
- Diet and supplements: Magnesium. Magnesium. Magnesium. And coffee. I might have vestibular migraine as well in addition to PPPD, therefore I tried to raise the amount of magnesium in my diet and also caffeine intake. As other supplements, I take Rhodiola caps, Maca caps (for PCOS), Chlorella Caps, Symfona (Gingko Bilboa) caps and various Bach drops;
- Take rests: also if you don't think you need it, always plan rests between activities. You need to think that your brain (and entire body) is working on re-building in the correct way the messages he receives from the outside world, therefore also the easiest task will require you a lot more energy that it did before your vestibular disorder. Try to actively listen to your body and respect it: avoid exercising too much when your dizziness or brain fog are too high, and push harder and experiment when you feel you can.
I don't know how long will it take to recover from PPPD and I know there might the possibility of never recovering completely. But I know I will try to leave expectations behind and do my best everyday.
To those who are fighting a battle, I wish to continue to find every day the strength to fight and to rejoice in every little achievement, the patience to accept the coexistence of yin and yang and the gratitude towards life itself. I know very little about my own rehab journey and I look forward to discovering it, step by step. What I do know for sure is that it is definitely a mountain path, and that between ascents and descents, laughter and hard work, sunrises and sunsets, it will be wonderful in its way.
Costa Rica, February 2020
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