Dizziness and nausea lead to a trip to Vanderbilt Skull Base Center
Just standing up would make the room spin.
Betsy's dizziness and nausea had been getting worse for about two years. Now, it had gotten so bad that turning too quickly or even rolling over in bed would flip the world upside down.
I felt like I would eventually become an invalid if I didn't get this fixed, said the Bell Buckle, Tenn., resident.
Betsy's primary care doctor at Vanderbilt referred her to the neurology clinic for testing. Answers were hard to come by at first, but Betsy's caregivers wouldn't give up until they pinpointed what was causing her problems.
"It was a wonderful reassurance that it wasn't going to be one of those situations where a doctor says, 'It's not my department,'" she said.
She went to the Vanderbilt Skull Base Center and saw George Wanna, M.D., who ordered imaging scans. The diagnosis: dehiscence of the upper anterior semicircular canal.
In short, Betsy had a small hole in one of the hearing bones in her inner ear. This hole was throwing off her body's sense of place and balance, and her brain was receiving too many signals from the inner ear. In a sense, too much of the world was getting into her head.
Surgery was an option for her, but Wanna explained that it wasn't a guaranteed cure and that she should take some time to think about it. Patients with the same condition who have surgery can see dramatic improvement, partial improvement or none at all.
"I called back within a week," said Betsy.
She missed working in her perennial flowerbeds and garden. She missed walking her dogs and woodworking. The things she loved had fallen away until all she could do was work for a few hours a day, and that with difficulty.
"I really didn't feel like doing anything, but if I sat still I could continue to do my work," she said.
Back in balance
Betsy decided to schedule surgery with Kyle Weaver, M.D., and a patient care coordinator got in touch with her right away. She explained everything that was going to happen, from preparation to surgery to recovery. Betsy's surgical team did the same, making time for her questions and concerns.
"They were very willing to take the time to listen to questions, and not just that, but they gave you time to think," she said. "So often you go to the doctors office and if you don't have questions written down, it takes you a minute to think and internalize the information before you can think of what you want to ask."
Betsy went in for surgery in January 2013, and she remembers everyone on the surgical team taking time to introduce themselves and explain their roles.
"Everybody made you feel as though you were involved in your health care and wanted to be sure that you knew who they were, and what their role was," she said.
"You didn't feel like you were being handled by anonymous people. That was very calming."
After the surgery, Betsy recovered in the hospital for two nights.
On the second night, there was a tornado warning, and the patients on her hall had to be moved away from the windows. Though rattling, the experience showed her how much her caregivers valued her needs.
"Through the whole process, everybody was very calm, making sure everybody was cared for," she said. "The orderly just worked nonstop to make sure that all the patients were where they should be."
As for her condition, Betsy said, "From the time I woke up, I felt so much better. I had to regain my balance somewhat, but I didn't need any therapy at all. I didn't have any nausea anymore; my balance came back very quickly; and I haven't had any of those symptoms since then."
The Skull Base Center team has stayed in touch with Betsy to check on her progress. She's now able to garden and enjoy life to the fullest, and she reports no hearing loss.
When there was a glitch with her employer's insurance about arranging payment for her care, Vanderbilt specialists helped send the paperwork to get the problem ironed out.
"It worked out beautifully," she said. "The care, professionalism and the desire to make sure I was fully informed could not have been better. It was superlative."