Balance, Vertigo, Leg Weakness


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Had my stroke almost 10 years ago and felt I was improving for several years. The past few years I have been sliding with the minor annoyances that I had been working around getting steadily worse. Increasing balance issues, vertigo, and a weak leg have led to increased falls due to foot drop and being off balance. I have started on a brace for the foot drop and it is helping. I have insurance and my doctor is giving me a referral for therapy. My question is what therapies have been most successful for improving balance and does anybody have any recommendations for a facility in the Flint/Fenton Michigan area 

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Can't help with a facility recommendation as I live on the other side of the world.

But I've done lots of work on physio using various unstable platforms from foam mats and wobble boards through to Bosu (half ball) for balance and reaction training. It's very tricky if your ankle is weak and/or unresponsive and your propriaception (knowledge of where you really are in space) is slow. The most useful I've found is obstacle courses where your therapist sets up a series of things for you to walk over, around or through in a pattern. When I get too good at it, they deliberately made it harder by putting things under gym mats then I had to walk over the top of without knowing what was underneath or where it was. A hospital setting is unlikely to do this though as they see it as too high risk. I did it at my studio gym where they are much less scared about bureaucratic paperwork if/when you fall.  You see I expect to fall when I'm pushing my limits. You don't know where your limits are if you don't push against them, but that doesn't mean be stupid. I prefer to fall in a controlled environment, where I know there is someone to help me up again, or to hold my hand so I don't actually go over.  Thankfully I haven't had vertigo but I know that there is specific retraining involved in overcoming it, not something you should really attempt on your own (risk management again).  Good luck with your new therapy.

 

Also, while the brace is great for daily activities and your overall safety and comfort remember that while you are using it the muscles/nerves etc. it is replacing get a free ride and will not be working so long term use will actually reduce your function when the brace is not available, e.g. night bathroom trips.  Make a point of not using it for a couple of hours each day and when you are doing your therapy (unless your therapist says otherwise, of course)

Edited by heathber
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Hi neighbor. I'm about an hour down 69 east of Flint. Balance for me was an issue at 1st but improved. I hope that doesn't change but nothing is for sure. There still is always a chance of falling when I'm upright and standing and I try to remember that as I have gone down a couple times. Before my stroke 6 years ago I was still ice skating as I had done most of my life and feel that my be beneficial to balance some now. The only true exercise I get now is from a stationary recumbent bike I try to ride daily and that is likely helping some too.

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Dave I really don't have any answers regarding exercises or therapy. 

 

I can tell you my balance gets worse as the day progresses due to fatigue.   I have learned the hard way not to overdo it when tired.

All the best with therapy options.

 

Willis you are rubbing it in with your bike use! I'm terrible.  Haven't used mine for a few weeks, I've got a chest infection. I cough slightly and people glare and run for miles!! No community transmission here, we all know that day will come though.  

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11 hours ago, GreenQueen said:

Dave I really don't have any answers regarding exercises or therapy. 

 

I can tell you my balance gets worse as the day progresses due to fatigue.   I have learned the hard way not to overdo it when tired.

All the best with therapy options.

 

Willis you are rubbing it in with your bike use! I'm terrible.  Haven't used mine for a few weeks, I've got a chest infection. I cough slightly and people glare and run for miles!! No community transmission here, we all know that day will come though.  

I honestly do hesitate to mention the bike because I know that I can safely use it and it has done so much for me. That said I fully understand many are not so lucky and God knows the last thing I ever want to do is make someone feel down. We are good at handling that all by ourselves. Absolutely shouldn't be anywhere near that bike. Get this respiratory issue behind you and then I have a thought for how we can ease you into falling in love with your bike. My daughter has suffered from IBS for years and has had great success finally with a holistic doctor. The antibiotics made it worse and were eating her stomach.

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5 hours ago, GreenQueen said:

Willis I hope you know I'm joking with you?

Aussie sense of humour!!

So glad you have your bike and it helps!!

💚👑

For sure I knew you were joking. Green Queen know this about Willis: many cannot handle my refusal to take life serious so unless I run into another like me I'm usually left to my own silliness. Which is cool. Love your attitude my Aussie friend!

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Welcome to the website. I understand having vertigo, balance issues and falling. The one thing that I always recommend to people and I know your stroke was 10 years ago is to get your eyes checked. Most people think that vertigo has to do with your ears , and for most, Yes it does but also if your eyes are even a fraction off or have the slightest nystagmus ( eye bouncing Nystagmus)   in it can cause your balance to be horrible . I have two  issues I have vertigo caused by my eyes, were off they were miss aligned and  I’ve had surgery to align them but I still have nystagmus in both eyes. It’s worse on my right eye so I wear a contact that occludes the sight from that eye. I can still see out of it but without the contact I see everything double and it jumps up and down so my left eye is the primary. From the same stroke I  had  damage to my brain stem and  my cerebellum. And as you know having damage to those vital organs which  is the primary source of your balance and coordination functions . I did therapy, as well, but it did not help me because the damage that was done in my cerebellum ,which controls the balance, I was told that the damage to it  means that I may or may not ever get that back. That’s not news that anybody wants to hear but that was the news I was told  12 years ago. I still have that problem. But every stroke is different and I’m not saying, as you found out in 10 years, it doesn’t get better but it becomes more manageable ,at least for me it did .Not by a lot but I can deal with a little bit better. My ears have been checked and they’re fine. I had people looking at my eyes for a long time but no one noticed that they were just slightly off ( other than when I needed prisms of course) and just that little bit will do wonders. I wish you great success in your therapy and I hope with your braces that works too because I also have a slight drop foot in my right foot that when I’m tired it drags and I do trip and I stumble. But I fall ,more often than not, by just standing. I’ll lose my balance and I cannot stop myself. I just have to ‘go with the flow’ as they say and just fall. If I turn too fast or if I get up suddenly and it throws my balance off I will fall into things. And especially when I’m tired you can almost guarantee or fall more than once

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  • 4 weeks later...
On 2/25/2021 at 6:19 PM, heathber said:

Thank you all for the responses. Please forgive my slow reply, as I am currently working about 70 hrs /wk. and a little freaked over the therapy starting. I'm pretty sure there will be no bike riding for a while.

Last week was an evaluation and during the check for vertigo my right eye was significantly jerking when following the finger movement horizontally indicating vertigo was a possibility. Today we did more of an in depth check where I would sit and lie down making different head movements while the therapist watched my eyes. During this exam I felt very little dizziness and there was no jerking eye movement, She had me follow her finger again and today there was no jerking in my eye movement. The therapist said it was nor normal for the jerking eye movement to be sporadic and needed to consult with their vestibular specialist. OK. 

The rest of therapy day 1 went well. A good stretching exercise and stationary bike workout that I am sure that I will be feeling more tomorrow, but a good pain. Looking forward to day 2 on Wednesday.

Thanks again all, I will update my progress.

 

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I'm glad  it is going well. Please keep us up to date on your balance 🙂 

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Chiming in late here but this is a topic I very much relate to. My stroke was in the cerebellum (bilateral) and I have balance issues, disequilibrium and central vertigo (not proximinal?... central is caused by brain damage). With that said, I still experience these things often. I definately do not fall as much (I am laughing thinking back to some of my falls and thank goodness none have caused serious damage). I have learned many coping techniques. 1. Stare at a stationary object in the distance when trying to balnace in place. 2. For me I have to use my eyes to balance more now because my vestibular system is basically shot (vestibular therapy was not helpful to me but for many it is). 3. Fatigue can really increase my vertigo and balance issues. I try to pay attention to my activity so as not to over do things. On days where I am more dizzy than others I take it easy, get up and get down slowly, hold on (I have my cane close by even though I rarely have to grab for it). 4. I am extra careful at night (my sight is the pits at night and therefore my balance helper doesn't help as much). 5. Have the Drs said anything about it being proximinal vertigo? My mom has this and there are some maneuvers a physician can do to help correct something in your ears (sorry... mine doesn't have anything to do with my ears so I'm not sure what it is). You did say you were going to PT right? This definately is something I would recommend...especially after 10 years post. I think our brains and bodies get lax at mechanics some times so revisiting some therapies is a great way to refresh yourself. I definately have declined in physical weakness over time and ROM which means Tracy gets clumsier. I have been going to PT for neck and shoulder pain but we are also doing some things that can help to improve my coping skills (my vertigo doesn't have a cure but it can improve by learning how to cope better). I wish you all the best and I wish I could give you some ideas of good places in Flint but I'm in Tennessee. Oh, when I was in PT after my stroke we practiced body mechanics when I feel like I might fall or if I start falling. It has helped but not 100%... as Kelli stated earlier sometimes just a pebble can trip me and sometimes I fall (splat) so fast I dont have a chance to use these. During these moments going with the flow is sometimes better than reaching out to catch yourself (usually less painful and heck all I need is a broken arm or wrist lol). Again, I sure hope you find some helpful answers.

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  • 3 weeks later...

OMG Tracy, I was just telling someone that when there is a big gust of wind,  swear I will blow over

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  • 1 month later...

Ha ha Kelli you and me both! The other day at PT I bent down to tie my shoe and as I came up my body kept going I almost did a back bend which would have ended with a splat on the floor. Thankfully my PT was close by and he reached out and said "Just where are you going?" . Needless to say sitting in a chair for a few was amust. I am so thankful I have had many stumbles that didn't end in a fall but one could take me as befuttled, boozed up, canned, feeling no pain, flying, hammered, lit up, Mel Gibsoned, plastered, polluted, sauced, shnockered, sloshed, tanked, three sheets to the wind, wankered and all the other endearing terms! :cheers:

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  • 1 month later...

Ok...so what does Mel Gibsoned mean?

 

I know it's not going to be flattering!

 

He is the original Mad Max. Which is set in 2021!!

 

He was also in one of Australia's best movies: Gallipoli. 

 

Both 80s movies. Maybe late 70s for Mad Max.

 

Very curious!

 

💚👑

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  • 2 months later...

i too have some balance issues,, what helps are online programs for eye stability..using them on an ipad or such is very helpful.

have someone hold ap a pencil in front of your eyes and then follow it as they move it around.

Also my PT has me stand on a small suspension bridge i too have some balance issues,.

Also my PT has me stand on a small suspension bridge that is held up by chains, they ask me to raise my weak leg.This is very hard as the thing keeps moving. The evening after my first work on this I felt my leg normalize for the first time in 4 years.It was exciting but only lasted that evening. It gave me real hope though.The bosu ball inverted is good too. Close your eyes while touching  a counter top or similar.Its hard but helpful.

I saw a Neuro doc who told me to resume PT and OT and was referred to a Neuro based clinic. They only serve stroke survivors and TBI.

They are terrific, but very busy, so I cant yet get in there  that often. It is important to keep trying.

 

 

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On 6/21/2021 at 4:08 AM, GreenQueen said:

Ok...so what does Mel Gibsoned mean?

 

I know it's not going to be flattering!

 

He is the original Mad Max. Which is set in 2021!!

 

He was also in one of Australia's best movies: Gallipoli. 

 

Both 80s movies. Maybe late 70s for Mad Max.

 

Very curious!

 

💚👑

Don't have any idea about what that might mean but great movie! Did not know it took place now. Well they were kinda close. lol

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Mel Gibson certainly got bigger than his boots.

 

 

I have balance issues when wearing certain shoes.  I have two pairs of shoes. Oh and a pair of boots. They have a zip on both sides but no good for summer.

 

My shoes are extremely comfy, but because of drop foot and the fact my ankle is weak my shoe won't stay on my foot properly. 

 

My sandals have quite a wide sole, as the sandals can accommodate orthodics. So the sole gets caught on everything. 

 

So shoe shopping I go. I'm a US ladies 13. So yes, shopping for shoes that are comfortable, won't fall off, are easy to put on and are huge...very frustrating. 

 

💚👑

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Oh goodness US 13, I have enough trouble with US 11, I highly recommend Mary Jane styles with either velcro or buckle strap.  I find them a great compromise of style, comfort, and ease of putting on one handed. My most common brands are Keen or Merell, I have no idea if you can get 13s in them though. Good luck with the hunt 💜

 

I also wear Merell brand sandals, lots of options, I've found best to look for structured heel enclosure, rather than super strapy looks.

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I go for heel closures too, Heather. 

My foot kind of slides to the edge, won't stay on the sole of the shoe.

Whoops, bit carried away there! I'm a us 11 as well! Must be an aus 13? I look for a 43.

💚👑

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What always gets me is the intermittent or unexpected foot drops that come and go. It's not an ordinary event either, and catches me unwittingly and off-guard. As a result I've taken my share of tumbles and hospitalized with a fractured vertebrae over the years. My first fall was even in the hospital after the brain surgery, they didn't tie me down to my bed, nor was I aware that my legs didn't work and slipped off the bed to use the bathroom and down I went. The collapse resulted in 7 stitches above my left eye and the panic that ensued from the staff that ran to assist. And that was just days after the surgery to start my legacy of tumbles. My last was unexpectedly due to a flash downpour and a water puddle on the sidewalk out front. My humid environment causes a mold/algae growth to develop on concrete surfaces like the pool deck and/or sidewalks because of the lengthy time water sits on the surfaces in this humid climate. It doesn't rear it's ugly tendencies until another downpour and standing water makes the algae/mold surface like slippery ice conditions. When I stepped onto it, down I went on the sidewalk and a passerby postal employee ran over to help me upright..that left a mark :tongue: The unexpected foot drop that resulted in the fractured vertebrae was in the house from stepping up from a sunken TV room. The foot drop just comes and goes. You'd think that I'd likely be more prepared or aware but the interval between the falls puts me into the "complacent camp" and I loose the awareness. I can take precautions most of the time but due to the long intervals between he tumbles is what eventually gets me. Whoda thought falling would be an issue when your younger and as you age. But I also never gave a seconds thought to having an aneurysm rupture and stroke during surgery. :hmmmm:

 

Then again, whoda thought I'd be living during a Global Pandemic either, if anything it's made me rethink that nothing in life is taken for granted and drawn me closer to a higher power, I needed that! Falls...yea, I've had a few.:wine:

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Oh Will! That's no good at all!

 

Foot drop is annoying and I will admit that I'd rather have full time annoying than intermittent!

 

Easy to say take care etc, but when it's unexpected what's to be done??

 

You could possibly wear a brace, but if you are anything like me, and the weather you have, you probably don't even wear shoes inside?

 

Yet another thing to upset a lovely day 

 

💚👑

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Yep agree with the full time vs intermittent thing. I've been falling quite a bit the last few months. The physio says its probably because I'm now living in a more physically challenging environment. So the stabiliser muscles, which are the small ones that I have most trouble with coordinating properly are over worked and sometimes they just don't function 100% and because most of the time they are fine when they quit unexpectedly the larger muscles don't compensate like they should, so with my propriaception issues that means I fall. I just say rude words and hope I haven't done any major damage (so far I've been lucky)

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