Colorful Healing: Artist Laura Bundesen's Vestibular Neuronitis Journey

Episode Transcript

Dr. Daniel Correa:
From the American Academy of Neurology, I'm Dr. Daniel Correa. This is the Brain & Life podcast.
Each week, we all juggle our lives and work, and even that is a challenge. There are so many podcasts, articles out there that talk about this idea of work-life balance, but beyond that, just the idea of the function of balance for your brain and your body is an incredibly complex task. Most of us just walk and don't even realize or think about it. Many of us may reach for something on the counter and not realize how much our eyes, arms, our body, our spine worked to coordinate that small little task. In this week's episode, we'll talk about some of that. The coordination and the balance that you do each day with your brain works everywhere from inside your ears, an area of your brain called the brainstem, your spinal cord, and then out to your muscles and nerves.
Our guest today is a mixed media artist, Laura Bundesen, who I hope that we'll all take some inspiration from today's episode and from Laura's work to translate a challenge that she's had in her life to be inspired by her own brain and all of our brains.
In the episode, we'll also learn from our medical expert how we can understand the balance systems in our body, this term that we all refer to as dizziness when something feels off with that, the other term, when people think of as something having spinning or a sensation of movement called vertigo, and what Laura herself has experienced, vestibular neuritis.
Our medical expert is Dr. Olwen Cait Murphy. She's a specialist in neuroimmunology multiple sclerosis, spinal cord disorders and vestibular disorders, the conditions that affect this balance system. And we had such a great time also learning from her and how she talks about these different conditions and the tools to help manage them with her own patients in the community that she cares for.
Now, make sure that you stay tuned and subscribe to the podcast. We will be featuring an episode with comedian Richard Lewis who joins to talk about his Parkinson's disease diagnosis, the mental health challenges he has encountered and how he wants to join the advocacy efforts for the community living with Parkinson's.
Welcome back to the Brain & Life podcast. I'm excited today to have a chance to discuss with Laura Bundesen. She's a mixed media artist that explores the amazing aspects of our brains through her artistic expression. She herself also lives with vestibular neuronitis and some chronic symptoms of vertigo. With her art, she tries to spread joy and wonder and helps us all learn a little bit about our brains.
Thank you, Laura, so much for joining us today.

Laura Bundesen:
Thank you so much for having me. I'm really delighted to be here.

Dr. Daniel Correa:
I'm interested, you didn't work before as an artist throughout your life. How did art enter your life and what aspects did it play as you were working professionally?

Laura Bundesen:
Well, I've always done art in the background, but I was an administrator for a long time. I worked as a sponsored research officer at a college, and before that, at NYU, where I assisted faculty in submitting proposals to get their research funded. But I was trying to get my artwork out there a little bit and take myself a little more seriously as an artist. And I started doing brains because my partner and he said, "Have you ever thought about doing a brain?" And I never had. So I did my first two for a call for a fiber art exhibition, and I got really engrossed in learning about the brain and researching all the different areas, what controls what, and trying to relay that through my artwork. And then I started realizing how prevalent neurologic conditions are.
I have a stepmother who passed away of Parkinson's dementia. I have a mother who had strokes. I have a cousin with MS. It just goes on and on. So the response to my artwork immediately was people around me. In fact, a colleague at the college where I was working saw my first two pieces and instantly commissioned me to do a third piece that would represent the missing half of her daughter's brain. Her daughter had a hemispherectomy to resolve epileptic seizures.

Dr. Daniel Correa:
Wow. And you described that you choose to explore it using fiber art, so this is different types of string and other fibers? And why specifically fiber?

Laura Bundesen:
Yeah, I'm predominantly an embroidery artist. I started embroidering when I was in high school. I was the one who was embroidering things on my friend's jean jackets back in the 1970s. So I've just always liked stitching. And in fact, stitching is a calming activity for me and helps me with chronic anxiety, which I've lived with for a long time. It's a meditation in itself. So most of my work starts with embroidery and then I, about 20 years ago, started playing around with utilizing paint, and more recently, I've started adding beads, lace. Anything is game, but usually, the central brain figure is fiber of some kind.

Dr. Daniel Correa:
It's such an interesting idea and medium for exploring art with the brain. As I think about it as a neurologist, most of the brain is not just the structures in and of themselves or single tissues, it's all about network and interconnections. And so the idea of fiber really seems to be an interesting way to evoke that. And as we mentioned at the beginning, you have also lived with some neurologic symptoms and a neurologic disorder. What symptoms do you remember at the start of this, and what did you even think it was?

Laura Bundesen:
I had no idea. I was in a car coming home from a week-long vacation in Vermont and all of a sudden I started feeling really strange in my head and I turned to my partner who happened to be driving, thank goodness, and said, "I think you need to take me to the next hospital." And we actually pulled off the highway into a hospital. I opened the car door and tried to get out and I couldn't walk. So he helped me get into the ER. I was initially misdiagnosed in the ER as having a simple BPPV vertigo, which is more traditional and a lot of people have that. And it took me a while to get diagnosed with vestibular neuritis. It was exactly a year ago that the first onset came on very suddenly. And probably a good month or two, I had difficulty getting around walking unassisted and driving. And I went into a very aggressive physical therapy treatment. I went to ENT appointments to make sure there wasn't something else going on. It's a diagnosis, I guess, that they get to out of ruling out other things.

Dr. Daniel Correa:
Yeah, I think ruling out other things that may be causing damage to those nerves. And so great that you thought of and followed through to go to the hospital first on because even though vertigo symptoms can be chronic for some people, you really only want to rely on that possibility when you have a known condition or diagnosis that causes the symptoms. Having a sudden new onset, like you described, can be very concerning for stroke and other causes. And especially, if you all of a sudden can't walk, that's a great reason to make sure that it is a time limited symptom that will go away before damage occurs and that it affects your ability to walk or get around. In the short-term, it sounds like you had to go to several medical visits and over time. So did the symptoms go away and you were just trying to find out what it had been or were you still having some symptoms?

Laura Bundesen:
I still have symptoms to this day. It's much, much less. I would say, on a scale of zero to 100, I'm at about a 90%, but I still have some periods of unstableness. The biggest symptom for me was being off balance. Early on, I also had some really traditional vertigo where the room was spinning, but that has gone away predominantly. I think I've had some cognitive impact as well. My hearing's okay. I mean, we've checked a bunch of different things and they did an MRI. They ruled out me having any tumor or stroke. It's been really helpful. I found an organizational online called Veda, V-E-D-A, which is Vestibular Disorder Organization, and they've got a lot of information. Vestibular conditions are much more common than we know. I had never heard of the vestibular system, and here I am steeped in neurology and neuroscience and learning a lot every day, but I really didn't know anything about my vestibular system before it started.

Dr. Daniel Correa:
And for our listeners, we'll discuss more about what is the vestibular system and some of the parts and nerves that help control your balance and coordination as we continue our discussion with the medical expert after this. But Laura, seeing the doctors helps you find some information. Sometimes it's a course of physical therapy. There are some medicines that might help practically day to day in the short term, when you were still having the spinning or even just the imbalance. What did you do or what did you find helped you get through the symptoms?

Laura Bundesen:
My partner of 15 years was invaluable in helping me. He drove me to my physical therapy appointments twice a week, which were 45 minutes away. I mean, it wasn't all that easy. I had the support of my daughter who's an occupational therapist. She's helped me find a physical therapist who specialized in balance, which was really, really useful. And they did start me off in the very beginning with a course of steroids. That I felt impact from almost immediately after I took the steroids. On the advice of my physical therapist, I got a good pair of walking sticks and used those two at first, and then I went down to having one, and then I went down to walking without any walking sticks. So I might take one if I was going on a long hike now. But otherwise, I'm pretty stable enough to do anything that I could do. The only thing I still can't really do is get up on a ladder very easily. That, we need help with still.

Dr. Daniel Correa:
Now, I'm just wondering, when you have some symptoms or you don't have symptoms, but you know you're going to be doing a challenging activity, do you generally try to take the practice of doing the activity up until the point you might have symptoms or occasionally trying to push past that early onset of the symptoms?

Laura Bundesen:
I try to push myself. My physical therapist really encouraged me to push myself. I mean, he sent me home with exercises to do every day. I did a half an hour of PT at home. I went in twice a week for 45 minutes of PT. And he said, "If you're not feeling uncomfortable and you're not a little scared, you're not doing enough." So he pushed me to keep pushing myself.

Dr. Daniel Correa:
And I think you really pointed out an important aspect there, that the work of physical therapy is not going to the therapist. That's the learning and the training and they give you some feedback. It's the day-to-day work that you're doing on your own and pushing yourself.

Laura Bundesen:
I'm actually engaged in vision therapy right now, so I've graduated from physical therapy and I'm working on some vision therapy, which is helping train my visual system to operate together.

Dr. Daniel Correa:
Yeah, your vision system is a big part of how your vestibular system or your balance systems work and coordinate together with all of your other function. So that often is a part of the therapy that you... Nowadays, how often do you have symptoms?

Laura Bundesen:
I would say I feel completely fine if I'm just sitting around at home. If I'm out and about, if I'm in really crowded environments, I might feel a little unstable. I'm a little careful on escalators and things like that. And I find driving on highways more challenging than driving on back country roads. I think the cars going by really fast and having to turn my head fast to look sets me off a little bit.

Dr. Daniel Correa:
Hopefully something maybe that improves with the vision therapy because all of those stimuli and coordinating your balance with that are some things that may be helped with that vision therapy. Now, as you're continuing to do your artwork, are there other functions or aspects of the brain that you're interested in exploring in your art?

Laura Bundesen:
More recently, I've been getting quite a few commissions that have really given me deep dives into different areas. I did a really large commission on epilepsy last year, and that was really fabulous. I learned a lot. And then, earlier this year, I did a commission for a neurologist who specializes in sleep. So I got really steeped in the whole circadian rhythm and the brainwave just associated with different times of our cycle, and that was really fascinating. And I'm actually working with a neuroscientist right now on creating a piece that represents her area of research, which is about language acquisition. So every time I do one of these and I do a deep dive... And they're sending me materials, they're saying, "Read this and look at that." And so that's really helps guide me.

Dr. Daniel Correa:
You've engaged with several people through commissions for your artwork. As you've heard back from them, how have you found and heard that your art and these artistic expressions help them understand more about themselves?

Laura Bundesen:
I've had quite a few people tell me that my artwork really inspires them and that they get a lot of joy from it. And some people who buy my artwork have neurologic conditions and that's why they're drawn to it. Some are scientists and doctors who are working with conditions, and I try to use my platforms to do a little bit of educating along the way. When I'm showing people the piece on epilepsy that I'm doing, I'm also talking about epilepsy and sharing more information about it for the general public.
I've connected with a lot of other artists online, some who also have neurological conditions. And I've also had people tell me... I have a coloring book. And I've had two different groups. One is an adult group of traumatic brain injury sufferers who decided to all buy the coloring book and color together as part of one of their group activities. And then I have a neurologist who runs a teen epilepsy group, and she uses my coloring books with the teens in her group. So to know that I can impact people in that way and to give them an activity to do that helps them in their lives, that's where my joy comes from. It really does.

Dr. Daniel Correa:
That sounds amazing. Well, Laura, it's been so great talking with you and hearing from you about your own experiences and your artwork. I'm wondering, for another person maybe lying on their couch or stuck in their bed with functionally limiting vertigo, what would you say to help them cope and keep moving forward?

Laura Bundesen:
I would suggest that they make sure that they're following the path of trying to find some help, whether that's going to see doctors or whether that's going to see physical therapists or just joining a support group on Facebook, learning more about their condition. Those are the things that really helped me. I think becoming isolated and feeling defeated when you're ill is something that we can only fight against because there's a lot of resources out there. And in the internet world, we're really blessed to be able to find a lot of information. So I would say don't give up.

Dr. Daniel Correa:
Yes, I'll have to get on your website and check out the brain coloring book, not just for brain nerds, but for all of us.

Laura Bundesen:
Yeah, for anybody. For anybody.

Dr. Daniel Correa:
Thank you so much, Laura.

Laura Bundesen:
Thank you so much. This has been really fun.

Dr. Daniel Correa:
Want to learn more about the conditions discussed in this episode and other factors that could impact your brain health? For the latest on causes, symptoms, diagnosis, treatment, and management of more than 250 of some of the most common and rare neurologic conditions, please visit brainandlife.org/disorders.
So we got to hear a lot about Laura's art, but then also her own challenges living with vestibular neuronitis and the balance issues that she's had at different times. Now we'll continue our discussion with a guest medical expert who's a neurologist who specializes in the function of the hearing and balance systems in our brain and body, along with neuroimmunology encompassing the autoimmune conditions that affect our brains and spinal cord. Dr. Olwen Cait Murphy joins us from Johns Hopkins University in Baltimore, Maryland.
Thank you so much, Olwen, for taking the time to join us and our listeners.

Dr. Olwen Cait Murphy:
Thank you for the opportunity to be here today, Daniel.

Dr. Daniel Correa:
This is our first time, and we've had an episode where we're talking about vertigo and the system that controls our balance. We refer to that, as neurologists, as the vestibular system. So now I'm going to ask you the challenging thing. Can you explain to us what is that vestibular system?

Dr. Olwen Cait Murphy:
The vestibular system is really crucial in terms of our sensation of balance, basically. The structure of the vestibular system is such that in our inner ear we have canals filled with fluids. When our head and our body moves, the fluid transmits signals in these canals, which gets sensed by the vestibular nerves, and then the vestibular nerves travel to the brain, bringing these signals. At the brain level, it gets very complicated. There's a lot of areas involved in processing vestibular signals, but at the end of the day, what the system does is translate motion of our head and our body into a sensation that we can feel.
For example, when you go up in an elevator, how do you know that you're going up? When you go down, how do you know that you're going down? When you're sitting as a passenger in a car with your eyes closed even, how does your brain know that you're moving forwards or backwards? These are all things that are coming from the vestibular system and how we process these signals.
The vestibular system is also really closely linked with how the eyes work. So for example, if you're a professional soccer player, you need to be able to run while keeping your eyes focused on the ball. The ball might be moving as well. How does your brain tackle that complicated set of circumstances? And this is really due to what's called the vestibular ocular reflex, where your motion and acceleration can be refined in terms of your eye movements. And your eyes are able to track things in motion and you're able to track things while you are in motion. So this combination of vision and motion is also integral to the vestibular system.

Dr. Daniel Correa:
So it's an amazing idea. It's between the structures in your inner ear and the structures in your brain. It's taking in signals from your vision, from your sensation and your feet and movement of your body, movement of your head, all this different information and processing that to tell us what position we're in and how to make a quick adjustment whether we're playing soccer or how to just prevent us from falling.

Dr. Olwen Cait Murphy:
Exactly. And it's a system that we really take for granted and we don't think about on a day-to-day basis. It's very reflexive and innate to us. And it's only when we run into a problem with the vestibular system that we really can appreciate what it's doing for us.

Dr. Daniel Correa:
It sounds like it interacts and connects to so many of our coordinations and functions, like you have an issue with balance, maybe there's a difficulty going downstairs or managing going on things that are uneven ground, but your body doesn't even have to be moving for it to be impacted. That's amazing.

Dr. Olwen Cait Murphy:
Absolutely. And there's a whole host of very unusual symptoms that people can get from the vestibular system because it's so fine-tuned. For example, people who have severe problems of the vestibular system, even when they're chewing, this might make them feel off balance and dizzy because of that tiny motion in the jaw and the head that the brain doesn't know how to process that anymore.

Dr. Daniel Correa:
And as you said, this is a system and types of symptoms that most of us don't think about. This is innate and reflexive. Our body's just working in that way, and maybe we might be training it in certain ways by doing certain activities or exercises and not knowing and strengthening it, but we don't really overall notice it until something all of a sudden goes wrong.
Now, let's think about that in the situation when someone who's never had an issue really with balance or hasn't noticed problems with balance or dizziness before all of a sudden has a disruption and is having dizziness, what are the things that we're most concerned with in that situation? And when should that person maybe go see a doctor or go to the emergency room versus go take a nap and see if it gets better?

Dr. Olwen Cait Murphy:
The main message is that what we're looking for in terms of dangerous or severe problems of the vestibular system is things that are new and fairly abrupt. So often a person will come into the ER, they'll describe waking up with the room spinning. They might feel very nauseated, be vomiting, struggled to get out of bed, have to hold onto furniture or hold onto the wall because their balance is so impaired. So these very acute and abrupt changes in our sensation of balance basically. And symptoms of acute vertigo are the things of concern that would typically bring people to their doctors or to the emergency department.

Dr. Daniel Correa:
If you're all of a sudden unable to walk and do some of the key coordination tasks of just even reaching for things and drinking, then that's definitely much more concerning. Is it more concerning also in the setting of when you're having that dizziness, you're also having other functions of your neurologic system that are wrong?

Dr. Olwen Cait Murphy:
Definitely. And I think, over the last few years, the general population, as well as doctors, have become more aware of the signs of stroke, which is something that we worry about with acute dizziness. And these things can go together. So people can have sudden problems with their speech, sudden weakness on one side of the body or the face and abrupt problems with your vision, like double vision or visual loss. In the context of dizziness, when we see any of those things alongside us, that definitely rings alarm bells and we need to consider dangerous things such as stroke.

Dr. Daniel Correa:
Yeah. I will remind our listeners, in the past, we've talked about an acronym called BEFAST. This acronym refers to your balance, which we're talking about today and your eyes, which Olwen was just mentioning, double vision or changes in your vision, but also you're taking a look at your face for F, that it's symmetric and you're moving everything, that A being, your arms, your arms are moving the same on both sides, and you haven't had any change in strength, S being your speech and T bringing it all together with time. The whole idea that BEFAST because the timing for the care and for the possibilities of what might be going on is important. So taking a look at the time, knowing when your last felt normal or when the person last was feeling normal and the timing of their symptoms and then getting to the hospital. So we'll include again, that information about that acronym.
Now, some people have either a more mild start or they have dizziness and balance issues that seem to come and go, but never really go away or start to become more chronic. How do you look at that and evaluating that type of vertigo or vestibular dysfunction differently and work with those individuals?

Dr. Olwen Cait Murphy:
Yeah, I think that's a really important distinction. The crisis scenario is when people get an abrupt continuous onset of symptoms. But probably more commonly, what we actually see in the clinic, for example, is people that are coming with episodes of what we would consider vestibular symptoms. So they might feel dizzy or they have vertigo for a few minutes or a few hours, and this could come and go over the course of weeks or even months. And that raises different possibilities for us in our head in terms of what the underlying problem could be. We're talking more about disorders, the inner ear, such as Meniere's disease, and then often brain disorders like migraine. Migraine can affect the vestibular system and cause these episodic symptoms.
And then there's also a very common mechanical disorder called benign paroxysmal positional vertigo, where people get very brief attacks of vertigo often actually when they're turning over in bed. Might only last 30 seconds, but people feel severely dizzy and unwell for that period. And it's a simple enough disorder where we've got little crystals lining canals of the inner ear, which are filled with fluid. And when those crystals can break off, which is just a simple mild mechanical issue, they cause confusion for our brain in terms of vertigo. And so this is a simple enough disorder that can be resolved with physical therapy specific maneuvers to put these crystals back in place and is definitely one of the most common things we see in the clinic.
So you're absolutely correct in that the things that we think of for short episodes of dizziness are very different to the things that we think of for acute, prolonged severe dizziness.

Dr. Daniel Correa:
But it sounds like in some of those cases, those things that eventually are going to be short and episodic, if the first time it happens, you can't get up, you can't walk comfortably or you feel like there's anything else other than dizziness happening, maybe in that instance it's best to get checked out, rule out the things that are urgent, and then start working on the more long-term management and making sure that there's not another condition because even though we come in and say, "Oh, thankfully it's not a stroke," maybe it's one of these other chronic episodic things that doesn't necessarily rule out some of the other causes or conditions that might be injuring or affecting the vestibular symptom.

Dr. Olwen Cait Murphy:
Yes, you're exactly right, that when symptoms first start, we don't have the benefit of the course of time yet to see how they're going to play out. So if people are experiencing new symptoms and they're in any way concerned, it's definitely best to seek medical advice straight away. And it's also important to remember that dizziness is quite a vague symptom. What do I mean if I say I feel dizzy? That sensation for me could be quite different to that sensation for somebody else. And there's many potential medical causes of dizziness as well as neurological or brain causes. People can have abnormal rhythms of the heart, for example. People can have low blood pressure episodes. People can have reaction to medications that they're on. So the possibilities are so broad that it can be very hard to disentangle these symptoms at home yourself. And when in doubt, it's best to seek medical attention.

Dr. Daniel Correa:
Yeah. In my own experience, both within my family, let alone with the communities I've taken care of, I've also noticed that just even individually and culturally how people use the term dizziness can vary so much. Some people will use dizziness as just a general term for not feeling well and may not actually be the same kind of spinning or falling sensations that some of us might think of as doctors.

Dr. Olwen Cait Murphy:
Definitely. And that's why thinking about the circumstances, the things that provoke it, how long it lasts, what are the recent changes in lifestyle, changes in medications, changes in routines, physical activity, all these things are really important in figuring out why a person might be dizzy.

Dr. Daniel Correa:
It's a silent condition that a person feels and very much impacts their life and quality of life and their activities, but people don't always see about them unless it's actually gotten to the point where they're having problems with their coordination or walking. And I imagine there's also many other symptoms that they live with beyond the dizziness and imbalance. What kinds of things do you work with the community that you care for beyond just the dizzy and the balance issues?

Dr. Olwen Cait Murphy:
These symptoms really take their toll on people in the population that we work with, people dealing with recurrent or chronic dizziness in particular. It can be very impairing in terms of people's life function.
For example, one thing that people can struggle with is transportation and driving. People may be uncomfortable behind the wheel because they're scared of getting a dizzy episode. And then, because the balance sensations in the brain can be heightened or altered, we often hear people describe that they find it really difficult to go through tunnels, for example, in the car or to go across bridges because that provokes their sensation of dizziness and imbalance. So there are just some examples on a day-to-day basis of problems that our patients can experience. These can become quite pervasive across people's lifestyle.
There's environments that people go to every day that can provoke a lot of dizzy symptoms. For example, a busy grocery store, you've got lights on, you've got people moving around, you've got all your senses being stimulated with music, with announcements, motion, and these kinds of environments can be really tricky for people with chronic dizziness and vestibular disorders and provoke symptoms of what we can sometimes call visual vertigo. And so we work with our patients to try and identify what kind of environments or scenarios trigger their symptoms and what kind of coping techniques or interventions we can work on to improve how they are managing on a day-to-day basis. And the most integral part for a lot of people dealing with chronic or recurrent dizziness is working with a vestibular physical therapist. These are typically physical therapists that have developed expertise in managing chronic vestibular disorders, and they can really help in terms of retraining the brain to help process balance signals better and allow people to reintegrate more into day-to-day life.
And then, another thing that people with chronic dizziness can experience is anxiety and depression. This affects their life in so many ways and can impact people's ability to work, to socialize, to enjoy the things that they like to do with their leisure time. So sometimes we find that management of anxiety and depression alongside the underlying vestibular disorder can really help people in terms of how they're managing on a day-to-day basis.
Alongside the medical interventions like vestibular physical therapy and other things, there are lots of things that people can do in their day-to-day lives to try and improve their vestibular system slowly and gently and carefully. For example, Tai Chi and Qigong, these are simple things that can be done at home, often just with YouTube videos, safe, slow exercises to improve balance and vestibular responses.
And then, for people who are so inclined, there are more strenuous activities. Some of our patients have told us that pickleball is great for recovering after some insults of the balance system, promotes a lot of quick motion and activity, and then pinging pong or ballroom dancing, Zumba, all these activities that people can build up over time to increase their ability to tolerate motion and promote the natural recovery of their balance system.

Dr. Daniel Correa:
Now, we often see people in our offices or coming from the ER who have been given a whole variety of other medicines to treat dizzy symptoms. How do you approach selecting a medicine for vertigo and dizziness, and when do you get a little bit more concerned with some of these medications that are used?

Dr. Olwen Cait Murphy:
Yeah, I think this is a really important question because there's a lack of expertise out there, I guess, in managing a lot of acute dizzy disorders. Often people get prescribed generic things that we use for a lot of neurological problems. So things like Lyrica, gabapentin, these medications that suppress a lot of brain signaling. And then, the other thing that people can get prescribed is a lot of anti-nausea medications, like metoclopramide, prochlorperazine and these kind of things. And in our experience, those anti-nausea medicines, they don't really make a long-term difference to people. So it's fine if you're in the midst of an acute attack and you're in the ER and somebody gives you some of these, but if you're coming to the point where you're relying on those medicines at home to get through the day, it's not a good long-term solution.
So a lot of the things that people are prescribed, say, in urgent care, an ER, should really only be used for a few days. And if you're getting to the point where they're not helping you and your symptoms aren't improving, you need to likely see it a neurologist or somebody at least more specialized in the management of dizziness.

Dr. Daniel Correa:
Yeah, so it sounds like really a lot of those treatments that are given in the urgent setting just for the symptoms are just to soothe. And effectively, a lot of them sedate the different signals of our brain activity and don't sound like they're very specific to vertigo. So even though some of them are marketed as medicines for vertigo or talked about that way, we don't want anyone relying on them and taking them chronically. Probably affects the adaptation that we talked about.

Dr. Olwen Cait Murphy:
Definitely. We know that if people rely on what we would consider vestibular suppressants. It reduces the ability of their own brain to compensate naturally over time. And often, that's the first thing we do when people come to us in the clinic and they say they're taking these kind of medicines every day, is we need to get them off those medications and start the brain in the process of retraining itself.

Dr. Daniel Correa:
And I'm just wondering to close out, Olwen, I wanted to hear from you. You have a new patient who's come to you, has had a miserable set of few days. They were in the ER. They were actually able maybe to at least get out of bed and get to clinic, but they've been having lots of issues with vertigo. And as you're working through this process, what do you tell them to help them feel like at some point this will be managed and they'll be able to move forward?

Dr. Olwen Cait Murphy:
I guess, from my experiences, that the people are resilient and the brain is very adaptable. And I've seen many, many patients at this point in the midst of really severe or chronic dizziness, and it can be hard for people to see the light at the end of the tunnel in that scenario. Often, people, by the time they come to a dizzy specialist, they might've been dizzy every day for years. And we have seen many people break out of this cycle with basic interventions such as the things we've talked about, vestibular physical therapy, treating the underlying disorder if there's something like migraine or Meniere's disease underlying it, and then a gradual resumption of regular activities, and then more in-depth activities that are actually going to promote the recovery of the balance system is what people need to be aiming for over time.
We always think of the people we never see in our clinics. Those are people like figure skaters, ballroom dancers. These are people who are constantly exercising their balance systems and they don't get dizzy because they have such good adaptation. So obviously, that's not an achievable goal for everybody, but it tells us that with practice and with time, the vestibular system is very good at recovering and managing symptoms once it's given the right opportunities.

Dr. Daniel Correa:
Well, thank you Dr. Olwen Cait Murphy. Thank you for taking the time, joining with us, sharing with us your expertise and really the hope and the practical approaches for many people living with vertigo.

Dr. Olwen Cait Murphy:
That's no problem. I'm happy to be here. And this is a really common and important problem, and I wish everybody the best who's dealing with these kinds of symptoms.

Dr. Daniel Correa:
Thank you again for joining us today on the Brain & Life podcast. Follow and subscribe to this podcast so you don't miss our weekly episodes. You can also sign up to receive the Brain & Life magazine for free at brainandlife.org and even get the Espanol version. For each episode, you can find out how to connect with our team and our guests, along with great resources in our show notes. We love it when we hear your ideas or questions. You can send these in by email to blpodcast@brainandlife.org and leave us a message at 612 928 6206. You can also follow the Brain and Life Magazine and me on any of your preferred social media channels.
These episodes would not be possible without the Brain & Life podcast team, including Nicole Lussier, our Public Engagement Program Manager, Rachel Coleman, our Public Engagement Coordinator, and Twin Cities Sound, our audio editing partner. I'm your host, Dr. Daniel Correa, connecting with you from New York City and online, @neurodrcorrea. Most importantly, thanks to our community members that trust us with their health and everyone living with neurologic conditions. We hope together we can take steps to better brain health and each thrive with our own abilities every day. Before you start the next episode, we would appreciate it if you could give us five stars and leave a review. This helps others find the Brain & Life podcast. See you next week.

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