The PSL electric fence

[Daniel]

I refer to the vertigo symptom, presyncopal lightheadedness, as PSL because it's a pain in the butt to type and I'm lazy. I've suffered this form of vertigo for the more than 4 years now that I've been in recovery : it's simply been my proverbial archilles heel and wherever I go and whatever I do, it's stuck to me like a particularly large piece of nasal excretion which I don't notice until I cross a road or walk up a slope, then *bang*! dizzy.
I've been plotting my PSL recovery since day 1, when I first experienced it and thought something was about to explode inside my head. I kept track of it with telemarks, counting the number of times it presented itself, what variables like surprise, fear, a slope, and so forth caused it to occur, and I learned what to avoid and learned what things in life to keep walking past or around in order to circumnavigate this symptom. It *terrified* me because I used to think it was a precurser to brain haemorrhage, and the more it occurred, the more likely something like that was to happen and I'd end up back in the neurology ward all over again.

I finally read of the name and description of this symptom in 2007, and was overjoyed to learn it was not what I thought it to be at all, and instead a neurological blood circulatory symptom revolving around a nerve in the brain called the 'vestibular nerve' (I believe, might be wrong but I don't care right now). I also learned that the brain can adapt to it's environment and improve accordingly, but I hate that word, 'adapt' because, to me, it's a little defeatest : it says that you should resign to a less than optimal outcome. I hated my doctor for saying this word in association with myself for a long time, and often I'd go outside determined not to suffer the symptom just to proove the wanker wrong, and that I was genuinely improving, only to be usurped as I crossed some pathetic street and nearly fainted in doing so.

I wondered why it was that before arriving at that street, I felt relatively fine and not in any danger of feeling lightheaded - I didn't know, shrugged, tried to cross it and *bang* dizzy again.

At one point, arriving at the streets edge felt, to me, like standing beside an electric fence on a farm with someone (let's call him.....encephalitis, shall we?) daring me to touch it and calling me chicken when I refused and thought it was going to shock the proverbial out of me.
After eventually biting the bullet and going for it, my head would feel shaky/headachy/lightheaded, my eyes would go crazy, I'd go wobbly, and I'd feel the overpowering sense of failure as I waited for the sensation to pass at the other side of the road.

So, I learned about it, began cardiovascular rehabilitation with the intention of fixing this issue : even if nothing else improved, this symptom would die come hell or high water and nothing else mattered in life to me at that point, not a darned thing.

I rehabbed at the gym more than usual, going 7 days a week rather than the 3 I had been, doing 20 minutes rowing a night on my home rowing machine, studying in order to force my brain to work better and better and harder until the PSL finally PS'd off.

Problem was this : I was getting tired living this life : the fear of the road became shared with the fear associated just with getting up each day knowing I had about 10+ hours of rehab and study ahead that day, and the next, and the next, indefinately.

Being terrified of vertigo and perpetually tired only ever makes it worse, in my experience. In this routine, I suffered 4 brain shattering attacks on one day and felt like I wanted to die on it. The symptom was the end of my sanity at that point and I felt honestly not in control as I had no answers to how to fix the problem. All I had read about it and all I was then doing to fix it was equating to making it even worse than it had been, until.....

.....until I regulated my routine and became less stressed about this particular aspect of recovery. I cut back the 7 day/week routine to my now current 3 again, the 20 minutes rowing the evenings became 10 on gym days and 20 on non gym days. Study was on a 'do at least this much, and if you don't get it all done today, start a little earlier tomorrow' basis, and soon enough, I became more relaxed in life and less tense.

There was a week in 2008 when I crossed 'that' street and did so without an issue on each occasion I tried, 'how is that?' I asked, 'I'm not suffering this symptom when I don't go to the gym? I should be fainting by now' - and then it struck me : the catalyst for my PSL wasn't only related to encephalitis-based neurological damage, it was also emotionally fuelled and fatigue related : approaching a place where you're historically more likely to suffer vertigo when you're physically/mentally fatigued and scared stiff of the impending pain will serve *only* to make it inevitable in its presentation.

From that week on (roughly) the severity of subsequent attacks of vertigo abated (right word? Sounds good, so I'll use it), and as the regularity and severity decreased, the ability to be positive and not with ambitions of the ends arrival, became more than possible, I began to hunger for each day as I began to see that I was one day closer to the end of this symptom and not stuck on an electric fence in Groundhog Day (great movie about living the same day over and over - starring Bill Murray).

Today (September 1st, 2009) is the first day of Spring in New Zealand, and I currently stand at 258 days since my last *bad* attack of PSL : sure, I've had a few minor attacks since, but nothing like it was 2 years ago, and I'm beginning to believe that the end of it is near : this so called (by doctors) 'irrepairable' symptom is now all but repaired and my daily prayers all but answered.

To anyone else who suffers this symptom : you have my sympathies because I know it sucks and I know it also steals self confidence, daring you to test it like a seemingly switched off electric fence on a daily basis and fail as it presents itself and takes a wrecking ball to your no doubt already waning sense of self confidence.

I no longer regard myself as suffering full attacks of it. I barely even now count half attacks, and when they do occur, it's simply like a mild fart after a full blown array of flatulence happens one night after a particularly spicy Indian meal is eaten. Don't get me wrong, that's not written with a 'haha I'm almost over it and you're not' tag, quite the opposite. Part of the reason it wasn't getting better in me all that time ago, I now am sure, is because I didn't know it could get better. I only had the dismissive prognosis of a clueless neurologist to base my intense paranoia on. Truth is that not many doctors know much about the symptom to fix it, and I'm yet to meet one who advocates going to the gym and taking non prescription blood circulatory improving medications (containing the ingredient gingko biloba) as being effective in its reversal - they all believe in rigid prescription medications, medical proceedures - that might indeed be effective, but in my experience - someone who's now 99% over this symptom, doctors are nowhere near as helpful as one other group of medical specialists : physiotherapists - they deal in cardiovascular fitness, vestibular retraining and, most importantly, self confidence re-empowerment (a word? Screwit, it is now) - if doctors write you off, listen to the physios because they only deal in what you can do, not what some overpaid a$$hole says you never again will.

I began at the gym a skeptic, but now I'm an addict - medicine may work, but in my experience the best way to get over PSL (presyncopal lightheadedness - vertigo/dizziness) lies in the advice of people who physically retrain others for a living - the physios.

I hope this helps someone else to believe they can overcome their vertigo, I desperately wanted and needed to read it possible once but was met only with a pile of 'I dunno, probably not'-isms, and hopefully this will empower someone else with, what I think, is the single best medication available : self belief.