From the community

TAMC’s vestibular treatment gives Caribou woman new lease on life

Posted Jan. 31, 2014, at 9:26 a.m.

- A Caribou woman has regained her balance and, as a result, her life thanks to the specialized work of a TAMC physical therapist who treats vestibular disorders.

Imagine waking up one morning and suddenly the whole world feels unsteady and even upside down. Imagine that for the next 12 years, life is plagued by bouts of dizziness, disorientation and even vomiting uncontrollably to the point that leaving bed and walking or going out of the house is a frightening prospect. That’s exactly what life was like for 79-year-old Jeanine Stairs of Caribou until recently, and almost by accident, she happened upon the office of Heather Caron, MSPT, the lead physical therapist at TAMC.

Stairs suffered with severe attacks of benign paroxysmal positional vertigo (BPPV) for more than 12 years. BPPV occurs when small crystals of calcium carbonate dislodge and float around in the fluid inside the ear canals that normally moves in relation to gravity and sends messages to the brain about the head’s position.

“When a patient with BPPV moves their head in certain positions, these crystals move and stimulate the receptor and send the brain an incorrect message. The brain gets the sensation of spinning or vertigo and certain eye muscles are stimulated causing a nystagmus. Patients may have imbalance or nausea that persists,” explained Caron about the type of BPPV from which Stairs suffered.

After seeing several doctors from as far away as Bangor, Stairs had resigned herself to a life confined to her home.

“I was frightened to go in public places, even to church,” said Stairs. “It’s not a good way to live – with that fear all the time.”

Stairs spent days at a time in bed, and even avoided family functions. She was unable to move her head from side to side or to look up at the ceiling for fear of bringing on another attack of vertigo. When she did gather the courage to walk, she had a tendency to lean to the right and often bumped into things. Her family helped her to doctor’s appointments, but felt helpless to do anything for her condition.

Stairs’ daughter Cheryl Bossie missed having her mom more involved in her life, saying, “If we had a family event, she would decide not to go. It became very clear that her quality of life was not what it should have been for someone who was once normally very active and enjoyed walking and exercising. She had to stop doing things because she couldn’t even look up.”

Stairs son, who also suffered from problems with vertigo, had a successful treatment in Connecticut at a specialized clinic there. Stairs was seriously considering making an appointment at that clinic, but dreaded the thought of having to travel so far in her condition. Coincidentally, at about that same time, she was visiting a local doctor for another condition when she learned about TAMC’s Heather Caron. Stairs had gone in for an x-ray and when the technician asked her to lay on her left side on the table, the room began to spin and she felt the need to vomit.

“As many doctors as I’ve spoken to over the years, nobody had ever suggested this place in Presque Isle,” said Stairs. This time was different, though. “She said, ‘before you go to Connecticut, why don’t you try the therapist over here in Presque Isle.’ They’ve had it there for 12 or 13 years. Isn’t that a coincidence? I’ve had this about the same time.”

Although Stairs and her daughter had their reservations, since previous attempts at treatment had failed, they figured it was worth a chance since it was so close to home. The decision paid off. On Stair’s very first visit, Caron was able to identify the problem and correct it.

“The evaluation of these patients is critical so we can determine the canal and the type of BPPV to successfully treat it. I performed a repositioning maneuver based on the involved canal and moved the displaced crystal out of the semicircular canal,” explained Caron. “This entire process can be scary and anxiety producing in many cases because part of our evaluation is putting patients in these positions they have been avoiding because it makes them feel so awful- laying on the affected side, lying flat for example. They have to be able to trust us to evaluate them and provoke these symptoms in order to treat them successfully.”

Though Caron is quick to point out that some patients requiring treatment for vestibular disorders take more visits and time before seeing results, depending on the diagnosis, the first treatment for Stairs made a remarkable difference.

“Even the very next day, I went over to visit her and she was putting up curtains in a bedroom and she said, ‘I have not been able to look up in ten years,’” said Bossie about her mother’s results. “She would never have been able to put up curtains before that, and she just started crying. Even my husband said you could hear it in her voice. I could say at this point that mom does not have vertigo anymore.”

Caron says the chances of the condition recurring are slim. “Many of my patients with BPPV I never see after the successful repositioning. If it does come back we can absolutely see them again and I would anticipate the same success.”

The physical therapists at TAMC can help patients with a wide variety of diagnoses, but most of the vestibular rehabilitation patients they see have vertigo, BPPV, balance deficits, gait dysfunction, frequent falls, and difficulty focusing on objects while their head or body is moving. Caron obtained her certification in Vestibular Rehabilitation through Emory University and the APTA (American Physical Therapy Association) in 2009.

“I have had a special interest in vestibular rehabilitation my entire career (13.5 years) and have taken many continuing education classes on the topic. The certification really strengthened my ability to make a physical therapy diagnosis and effectively and efficiently treat this population.”

When asked how the treatment has improved her quality of life, Stairs response was quick. “Dramatically,” she said. “I’m going to be 79 this month and I’m not frightened as much about my walking, and I no longer have a fear of falling. To me, it’s a miracle. It’s a whole different life.”

Patients like Stairs are why Caron enjoys her job so much.

“I love my job, I have the best job in the world. I am not sure I can accurately put into words how rewarding this is,” said Caron. “In Ms. Stairs’ case, this is something that altered her activities every day for 12 plus years – I realize how life changing this was for her.”

Of course, feeling better has its drawbacks too, said Stairs. For instance, it makes a person realize some of the things they’ve been missing and sometimes those things mean that the individual has work to do. In Stairs’ instance, when she returned home from her life-changing treatment and was able to look up at her ceiling for the first time in over a decade, she noticed how dim the light was in her entryway. She says she was compelled to take the fixture down to clean it now that she could finally see how dirty it was.

Caron says patients who think they might benefit from treatment for a vestibular disorder should talk to their provider about receiving an order for an evaluation. The phone number to the physical therapy office where Caron works is 768-4169.

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