Melissa Bosserman

You can vomit at home and do nothing, or you can vomit out there and accomplish something.

Diagnosis: Perilymph Fistula

HEY! Where’s the snow?” I hear for the umpteenth time. I crack a wry smile, but inside I’m not laughing. If only they knew.

People stare at me when I walk. At first, it made me uncomfortable, until I decided to stare right back just as intently as if they were the strange sight.

It’s true—I am quite the strange sight with my black spandex shorts, green tank top, black gloves, and bright red Leki Nordic walking poles. It’s really the poles people are staring at, not me. They are simply curious and wondering why I am walking strangely with what appears to be ski poles.

In the summer of 1997, I was a typical thirteen year old girl, excited about traveling to visit family on the East coast. My world was shattered on June 5th, when my ears did not “pop” as they should while flying on a commercial airplane. Instead, the round and oval windows of both ears ruptured. I had boarded the airplane with excellent balance, only to leave the same airplane with terrible dizziness and nausea.

I was diagnosed with bilateral perilymph fistulas (PLFs) and endolymphatic hydrops. At first, I could not function because of the constant dizziness, nausea, visual disturbances, brain fog, ear pain, tinnitus, and headaches. I missed three years of school and ended up dropping out because I could not even do the work at home. My symptoms gradually improved, allowing me to slowly increase my activity. Treatment consisted of multiple rounds of bed rest, bilateral surgical repair of the PLFs, endolymphatic sac decompression, vestibular therapy, medications, and dietary modifications. By the summer of 2000, I began taking classes at the local community college with the assistance of disabled student services, a tape recorder for note taking, and anti-nausea medication. My motto that kept me going through the worst days was this: “You can vomit at home and do nothing, or you can vomit out there and accomplish something.”

Ten years after my injury, I graduated with a Master of Science in Speech and Hearing Sciences from Portland State University and began working full time as a speech-language pathologist. Even after all this time, I still have symptoms, mostly a constant mild dizziness. There are good days and bad days, but I have learned how to adapt and manage the symptoms.

As a younger individual with a vestibular disorder, it was frustrating and difficult to find a form of exercise that felt safe (low risk of falling or re-injury), provided good cardio, and was fun. My doctor had encouraged me multiple times to try walking—it was the safest form of exercise, he said. Unfortunately, the horizon bounced up and down with each step; I felt like I was going to fall when I got tired; and it was boring. As I browsed a sporting goods store in 2008, the solution came to me—two hiking poles. I bought them and taught myself the Nordic walking technique through instructional videos and articles on the Internet. When I walked with the poles, it felt more secure and interesting, burned more calories, and engaged my abdominal and arm muscles.

For the past three years, I have been an avid Nordic walker. I joined a local walking club,  entered races, and gradually increased my distance and speed. I find that when I don’t get out and walk, the dizziness and visual disturbances increase; whereas, if I do get my walk, I am better. Last year, I walked my first full length marathon—26.2 miles.

This year, I competed in the Nordic Walk division of Portland Marathon for a second time. I walked 26.2 miles in 5 hours, 50 minutes. I won first place in the women’s Nordic Walk division and second place overall for the Nordic Walk division. It was not easy! I was so terribly dizzy when I finished that I had to lie down on the sidewalk. After a couple of glasses of orange juice and a brief rest, the dizziness went back to “normal.” My muscles, on the other hand, were very sore and stiff for four days afterward!

People say that completing a marathon is life changing. In a way, it isn’t—I am still me, and I still have a vestibular disorder. Yet in another way, it is because I regained the confidence in myself that I will persevere and have the inner strength to push myself beyond the barriers.

The 2011 Portland Marathon was my last race as a Nordic walker. Over the summer, I discovered that I no longer needed to rely on the poles for balance and I increased my speed by learning “race-walk technique.” I have recently begun to compete at local Track and Field  race-walking competitions and am training with hopes of qualifying to compete in the Team USA Olympic Trials held in Eugene, Oregon this summer.

Until then, happy walking!

About Nordic Walking
As a person with a vestibular disorder, I have found Nordic Walking to be a safe and enjoyable method of exercise that promotes greater feelings of stability. Nordic walking involves actively using two poles, similar to trekking and ski poles, which have a slanted foot. The poles should be long enough to be held comfortably with the arms bent at a 90 degree angle when planted by the feet. The motions of Nordic walking involve an alternating rhythm and trunk rotation. The opposing arm swings forward and plants the pole at an angle slightly behind the leading foot. As the walker rolls through the foot, she pushes off with the pole, extending the arm behind and propelling herself forward. This results in an increased stride length1.

The benefits of Nordic walking when compared to regular walking are increased heart rate, increased oxygen consumption, increased caloric consumption, decreased perceived effort, reduced fatigue, improved aerobic capacity, better mental health, improved endurance, and improved coordination of movements1,2,3 . No studies have been conducted on balance and Nordic walking to date, although Church et al (2002) notes, “The use of Nordic walking poles is particularly promising, as the poles provide stability that may promote physical activity among older individuals and those with orthopedic and balance concerns.”

1 Kocur P, Wilk M. Nordic Walking—a new form of exercise in rehabilitation. Medical Rehabilitation. 2006;10(2):1–8.
2 Church T, Earnest C, Morss G. Field Testing of Physiological Responses Associated with Nordic Walking. Res Q Exerc Sport.  2002;73(3):296–300.
3 Strombeck BE, Theander E, Jacobsson LT. Effects of exercise on aerobic capacity and fatigue in women with primary Sjogren’s syndrome. Rheumatology. 2007;46(5):868–871.