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The balancing act of aging

Posted by Kerrie Denner

Getting older can make anyone feel off balance, but dizziness and a fear of falling don’t have to become a way of life, say experts.

 “You can live to be 105 and not have a balance issue because the body compensates as we get older,” according to Jennifer Montemurro, therapist with Accelerated’s Balance and Wellness Center, 6926 39th Ave. “Aging is normal but dizziness is not a function of aging,” she said.

Age-related dizziness is often the result of a breakdown in one of the body’s several systems that regulate our sense of balance, according to Dr. Jeanne Vedder, an ear, nose and throat specialist in Kenosha.

Dr. Vedder is a detective of dizziness. She sleuths out causes for complaints stemming from symptoms of disequilibrium and vertigo.

Disequilibrium — the feeling of being unsteady on your feet — is the result of miscommunication between our brain and the systems responsible for detecting gravity and position. Depending on the cause of the disequilibrium, a person may feel lightheaded or that the room is spinning.

Normally functioning balance depends on five systems working together, explained Vedder. These systems are the inner ear, the eyes, skin pressure receptors, muscle and joint receptors and the brain. When any of these systems is off, balance may be affected.

As we age, our bodies lose some functionality in these areas but others step up to compensate, Montemurro said. “Our body’s natural GPS helps recalculate position and direction, she said.

Even with built-in compensations, dizziness and imbalance can occur. “As many as 65 percent of all 60-year-olds experience dizziness on a daily basis,” Vedder said.

For the elderly, problems can arise at any place along this chain, says Vedder. Neuropathy, medications, cataract surgery, decreased range of motion, poor circulation or age-related mental processing can all lead to balance and dizziness problems, she said.

People who come in with disequilibrium or dizziness are hoping it will be an isolated (inner) ear problem but it is usually not (that simple),” Vedder said.

“The good news is that people can improve in all areas,” she said.

To begin tracking down the root of their dizziness, most patients begin with their primary physician who refers them to an ear, nose and throat specialist like Vedder. After assessing the balance systems, Vedder may refer a patient for a confirmation of a suspected problem or specialized balance therapy. She works closely with balance therapists like Montemurro.

Montemurro resolves dizziness caused by benign paroxysmal positional vertigo or the several age-related disturbances such as neuropathy. “A person is 23 times more likely to fall if he or she has a neuropathy,” Montemurro said. If there are persisting balance issues, Montemurro and her staff conduct rehabilitative therapies.

Considering the nature of the systems involved, staying on our feet is quite a feat, observes Montemurro.“The vestibular system receives 90 messages per second per ear,” notes Montemurro. This means the brain must make sense of 180 messages per second so that we do not fall down or experience dizziness.

Balance rehabilitation consists of helping patients retrain, adapt or compensate according to the areas of need or loss. If eyesight is a problem, instead of repairing the eyes, therapists try to improve balance by addressing the systems that still work, Montemurro said.

Case in point

In the past three years, Mary Ellen Werner of Kenosha has had therapy to restore and strengthen her balance following two episodes of dizziness brought on by benign paroxysmal positional vertigo.

About three years ago she woke up and “didn’t feel like herself.” That feeling was a combination of dizziness and disequilibrium. When her part-time caregiver Karen Smith arrived that day, Smith knew to call Werner’s primary doctor. Werner was referred to the Balance Center where it was confirmed that she was experiencing BPPV.

After the most recent bout of BPPV was resolved, Werner began therapy to retrain muscles she had used to compensate when she was feeling unbalanced. “I was using my arm muscles too much (with my walker), and now I need to build up my core and leg muscles,” she said. “I used to be able to just take off,” she says, “now I am a little leary of standing up.”

Werner is enthusiastic about her physical therapy sessions. Referring to her Christmas-light-decorated wheeled walker, the almost-90-year-old said, “I’ll be doing wheelies again soon!”

People resist the idea that they are getting older which means they may ignore signs such as dizziness or feelings of imbalance Montemurro said. “One of the biggest fears is that if they admit the problem, they’ll end up in a wheelchair,” she said. Vestibular therapy is strength training so that patients maintain balance and stay wheelchair-free, she said.

“Don’t live with the fact you have dizziness,” Montemurro said.

Source: Kenosha News

url: http://www.kenoshanews.com/lifestyles/the_balancing_act_of_aging_475354467.html

Accessed 01/28/2014

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