When All the World Spins – Heather Worthen

I heard the tumbles from the other room and knew instantly what it was. No mother questions the sound of her child falling down the stairs. I raced from the kitchen and somehow swept my 17-month-old from the stairs to the wood floor just in time. It was too late for me, however. In my rush, my foot caught a piece of paper on the floor beside the stairs. The stairs with bottom steps that jutted past the wall. The paper on the wood floor. I heard the crack. I felt the impact up my jaw and through my head. Felt my face hit the floor. Then that was it.

I don’t know how long I was unconscious. What I know is that I woke up to the sound of my toddler’s feet walking by, facedown on our hardwood floor. My head was killing me and there was both a warm and crunchy sensation filling my mouth. As luck would have it, I had my cell phone in my pocket. I hit the speed-dial and called my husband. I think I got maybe two words out. “Help. Fell.” I gathered my bearings and saw that my son was fine. As though nothing had just happened. My two-and-a-half-year-old was still sitting on the couch, watching television. I remembered my oldest two were playing at the neighbor’s.

I tried to stand and quickly regretted that choice. It wasn’t just that my body hurt. It was the instant nausea, dizziness, and worsening headache. I crawled to the bathroom, so I could spit out what was in my mouth. Blood and pieces of teeth. I called my neighbor. I didn’t want my kids (ages 5 and 6) coming home and seeing me like this. She let herself in, helped me to the couch, and took my other two kids back to her house.

This wasn’t my first concussion (my fourth or fifth, in fact), so I felt pretty confident I knew what to do. Rest and limited stimulation. As this was a Friday evening, a kind dentist from my church opened his office to take care of my broken teeth that were cutting up the bottom of my tongue. My jaw was sprained and unable to close fully for over a month. As a result, my teeth shifted in my mouth. I wore a dental deprogrammer for a time to help my jaw readjust, but the pain and discomfort did not improve. My teeth had shifted so much that my wisdom teeth were now trying to erupt, and I now needed braces to realign my bite.

At this point it was now three months after the accident. The accident that was the culmination of what I refer to as my ‘hell week’. The week that began with a poor reaction to a flu vaccination, followed with a miscarriage from an IUD pregnancy I was unaware of, and ended here. And since nothing in my life was simple at that point (is it ever?), I also got dry sockets when they removed my wisdom teeth.

In any case the point is this: I’d recovered from a concussion, sprained jaw, broken teeth, dry sockets, and now had braces on my teeth for the first time in my life. At 28 years old. That was when the room started to spin.

I couldn’t get up. I couldn’t even get myself to the bathroom on my own. I had four small children who needed me, but the room was spinning whether I was holding still in bed or not. I’d try to stand and I’d fall over. There was a woman at our church, who I barely knew but had known my husband growing up, who offered to take our children. My husband would drop them off on his way to work and pick them up on his way home. I’m still not even sure how long this went on. I was stuck in bed until we figured out what was going on and what to do about it. There was about a month of doctor’s visits, tests, ER visits, medication that just made me sleep, and little answers before I switched doctors. The new doctor referred me to an ENT who took one look at me and knew immediately what was going on. He performed a maneuver in his office, called an Epley maneuver, and I felt both instantly sick and finally relieved.

Unfortunately, the vertigo soon returned.

What I learned was that the accident had severely damaged the otoliths (an inner ear organ) in both of my ears. My brain had been protecting itself and holding onto this trauma until the other stuff settled down. It’s apparently not uncommon. Due to the proximity of the jaw, facial nerves, and ear canal, the trauma of the wisdom teeth and the braces finally set it all off. My otoliths were trying to repair themselves but were producing and excess of crystals that were essentially sloughing off and having a party, bouncing around on things like my optic nerve.

I spent the next six months going to physical therapy for an hour three times a week. If I had any incidents of severe spins, I would get another Epley maneuver. The maneuver was incredibly helpful, but it meant I couldn’t bend over or turn my head for 24 hours or it would come undone. I spent my days in a state of feeling like I had morning sickness, without a pregnancy to show for it. I couldn’t walk into the grocery store because walking down the aisle involved a lot of stimuli going past my eyes, which overloaded my brain that was working so hard to just keep me upright. I don’t think I have the words to describe the level of exhaustion I felt. I slept a lot.

I was a 28-year-old going to a balance center for physical therapy. As you might guess, there weren’t many others there like me. Most were elderly individuals recovering from hip surgery. My entire session was spent strapped into a harness connected to the ceiling, in case of a fall. My first visits involved staying standing with my eyes closed for 5 seconds. Harder than it sounds. It progressed to 30 seconds and holding my head in various positions. I’d do the same standing on uneven surfaces, moving across a variety of surfaces, and finally while walking on an incredibly slow treadmill. I’ll never forget the day I thought I was doing so well and my trainer challenged me to close my eyes and march in place. I was SO proud that I could march in place with my eyes closed. I didn’t fall over! However, when I opened my eyes, I discovered that I had not marched in place at all. I was across the room! My body had no sense of where it was in space.

I tell you all this because it was an important learning period of my life. One that would set me up for many lessons I needed to get me through upcoming trials.

There were many days that it seemed this would never end. Therapy felt like 2 steps forward, three steps back for much of the beginning. There was a day where they stuck me in a gyroscope looking apparatus, one I’m pretty sure astronauts use, and told me to keep my eyes looking straight ahead while they moved me around. They had cameras measuring my eye movements and they spun me in every direction. Let’s just say it didn’t feel so great. However, the doctors determined that my body was consistently inconsistent in its responses. Laughable really. Evidently that sort of response is consistent with mild traumatic brain injuries. Do you see where I’m going with this?

It was in the middle of my treatments for BPPV/mTBI that I discovered my husband had been lying to me for years and was deep in addiction. I had been seeing a lot of improvements in my balance and brain health but suddenly took a turn for the worse. When I went to the doctor for a maneuver, to put my ear crystals back where they belong, he asked me if I had been under an exceptional amount of stress. I lost it and told him everything. My body wouldn’t let me hide it anyway. You see, the brain really can only handle so much. It has amazing built-in protections for saving itself, and you, from the excess. In this case, it was trying to heal and repair but needed extra support and rest, not stress.

During my time at physical therapy, it was constantly reiterated to me that I needed to listen to my body. I was to let my therapist know if it became too much, if I got nauseated. I figured, however, that I needed to push through any discomfort if I wanted to get better quickly and get on with my life. So, I kept quiet. Until the day that I couldn’t, and I threw up on the doctor. That’s when I learned that the nausea signal actually functions to tell you of the brain being overloaded. Too much stimulus. Too much movement. Too much stress. Too much and the brain tries to get you to stop or tries to expel the excess by leaving you feeling like you might throw up. And then sometimes you do. Pushing myself wasn’t going to get me through this faster. It was going to hamper my progress. I had to learn to listen to my body, to the messages it was sending me, and act accordingly. My body had held this trauma until it was safe enough to deal with it. It knew how to heal itself. I needed to help it do so correctly and safely. Whenever we have an injury, we compensate. When we leave an injury untreated, or inadequately treated, for too long, we end up with harmful compensations or unhealthy coping mechanisms. This can lead to further injury or delayed healing. My brain had developed ways to cope with its injury, something I was so grateful for as it kept me surviving, but it now needed to relearn the correct way of balance and being upright. As my PT put it, “Sometimes when things heal incorrectly, we have to break them in order to allow them the chance to be put back together correctly. It has to get worse before it gets better.”

Truer words have never been spoken.

I spent six months going to physical therapy for an injury I never saw coming. I had to get rides from anyone I could (Uber sure would’ve been helpful then!). I had to accept help from strangers. Admit that I needed help. I hated my body for betraying me, when I’d already suffered through so much, until I loved my body for healing and being capable. I spent six months doing something I definitely did not want to do, felt forced into, and I learned a lifetime of lessons. Lessons immediately applicable as I moved from that to healing from the betrayal trauma in my life.

There is only so much I can do. I need boundaries.

Rest is paramount to healing. Self-care is self-preservation.

Listen to the professionals. They have the degrees for a reason.

Ask for help when you need it. Not doing so will prolong your recovery efforts. Humility speeds up healing.

God didn’t make me get injured so I would learn lessons to help me through the next phase of my life. It was an accident and accidents happen. He did, however, provide me opportunities to take this difficult thing and use it for my good if I chose to be wise enough to see the lessons in the experience.

I’m still susceptible, and always will be, to attacks of vertigo and nausea. This is due to the extent of the injury I received. If I pay close enough attention, I can get ahead of it and calm it down before it gets too out of hand and become debilitating to where I need a doctor to do the maneuvers or have to sleep for 2 days straight. I can laugh, now, at the irony of that… at how similar it is to triggers and other traumas. I’m told what leaves me susceptible is getting too worn down, dehydration, illness, and allergies (an inflammatory response). I could write a whole paper on those correlations with trauma. The gift, however, is that I have a body that reminds me of the need for self-care in a very real way. A body that has taught me lessons through it. A brain that has shown me that I can break it and heal it and rewire it and listen to it.

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