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Checkup #2 – The Surgeons Are Happy!

Tue Jun 5, 2012

Today was the second post-surgical follow-up appointment with Dr. Kupferman and Dr. Relle. They were both amazed when they entered the room and saw my face – they couldn’t believe it had only been two weeks since surgery, and my swelling is almost completely gone!

Dr. Kupferman checked my bite and decided that, given my demonstrated ability to heal quickly, decided to allow me to go rubber band-free during the day, and just use one rubber band in the front while sleeping. This is huge for me, because it greatly reduces the amount of time I’m spending doing oral hygiene, and allows me to talk much more clearly.

Diagnosing the Dizziness: Dr. Relle had a theory as to why I’ve been experiencing acute dizziness since last week. He suggested in an earlier email that I might have something called “Benign Paroxysmal Positional Vertigo” (BPPV).

The idea here is that small particles of calcium carbonate, which grow like stalactites in the inner-ear, break off during the rigors of surgery and float into the inner-ear canals where the sense of balance is derived. These little particles cause the dizziness when I move my head in certain ways. This apparently happened in my right ear during surgery, and began manifesting itself when I attempted to start sleeping flat (rather than elevated).

Dr. Relle performed a simple test (called the Dix-Hallpike Test), which basically has me sitting up and turning my head 45 degrees to one side, then the doctor quickly guiding me into a laying down position. While there, he watches me for specific pattern of involuntary eye movements (called nystagmus) one gets when vertigo happens. I didn’t demonstrate nystagmus when my head was turned toward the left, but when he repeated the Dix-Hallpike test with my head turned toward the right, I got dizzy a few seconds later and my eyes did the nystagmus dance!

Fortunately, there’s a very quick and easy treatment for BPPV: It’s a sequence of head/body movements called the “Epley Maneuver” which, when performed correctly, can coax the particles out of the inner-ear canals and back where they came from (to be reabsorbed into the body). Dr. Relle advised me to go home and look it up on YouTube and perform it. I did this, and the dizziness was instantly gone! Amazing! It’s possible it can recur if the particles find their way back into the vestibular canals before they are reabsorbed. If that happens, I can just perform the maneuver again. Eventually, the symptoms won’t return.

So, now my dizzy spells are gone, and my energy is returning. With that big setback behind me, I’m looking forward to continuing my quest for “normal”…
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