One of the challenges is finding out what is wrong. There are several medical tests that doctors use to figure out the severity of a head injury.
My evalutaion started with my primary care physician. She went through a set of test that reminded me of what you see on Cops for a field soberiety test. I failed. I fell sideways in attempting to walk heal to toe, couldn’t balance on one foot, and was unable to track a moving object smoothly visually. I had “nystagmus”, meaning that my eyes “jerked” while tracking. My tracking is also slow. Other things she did was check pupil response and have me try to subtract 7 from 100 and continue down for five responses. She also asked about other symptoms. Since I wrote about them earlier, I won’t go into them again. She referred me to a neurologist.
A week later, I had my appointment with the neurologist. His exam was more in depth. I don’t remember many of the details. I had gotten extremely car sick getting there and was not able to focus/ concentrate. My friend Carol drove me and helped answer some of the questions. He referred me for an MRI, EEG, and a vestibular evaluation for the balance and vision issues.
The EEG measures electrical activity in the brain. It was about a week later. The EEG was a “sleep deprvied” one. I had no sleep the night before. My EEG showed some irregularities but no seizure activity.
Two days later, I had the MRI. It showed areas of change but it was unclear what they meant.
The brain is very complex. It is not unusual for MRI, EEG, and CT scans to be negative even if there is an injury. And, at times, the injuries can be fairly severe. Much of the brain activity happens at a microscopic level and those tools aren’t designed to read microscopically. I was frustrated by the test findings. Although both had changes, it was unclear what, if anything, could be done. And no answer to what was really wrong. Unlike a broken bone that can be seen by x-ray and has a specific treatment, my injuries weren’t as clear.
The vestibular tests examine visual, hearing, and balance issues. Finally, there were clear, objective results about the effects of the injury. It was a wicked experience. During the first test, I was put into a harness and stood on a platform. Surrounding the platform was a semi-circular wall that was painted in pastel-like colors with patterns. It looked similiar to clouds, hills, and sky. But, the patterns varied and repeated. Just standing on the platform was enough that I was dizzy, disoriented, and felt sick. Then, the “fun” began. During a series of tests, the platform and wall were moved in various directions: tilting in, tilting out, sideways, back, forward, etc. If I stepped, it counted as a “fall.” The harness and doctor caught me, so I never hit the ground. This was an awful experience, leaving me shaking, sick, dizzy and almost in tears. I “fell” alot; indicating problems in vision and balance.
The next test was better. It was just a standard hearing test. The accident caused no damage to my hearing. Yeah!
Then we went into a dark room with a light bar and a head apparatus. It’s hard to describe this test. During a series of tests, the light bar was used to provide a “target” for my eyes to track. The head appartus had something to measure my eye movements. The information was sent into a computer. There were several tests- following the light in various patterns. It showed visual field problems and tracking issues.
The worst test was for crystals in my ears. I laid down on a bed and the doctor blew hot air into my left ear. It was very painful and I was unable to tolerate it. He changed it to cool air. It was painful but tolerable. The air flow made me dizzy- the world was literally spinning. The process was repeated in my right ear, but started with cool air.
These tests gave me information about the symptoms and a treatment track: vestibular therapy. They also provided clearer insight into what I was experiencing and why riding in a car or going into a crowded store or room was causing problems.
I still have problems with vision and balance. But, I have improved a little. My “smooth pursuit” has gotten better.
I’m in vestibular therapy as part of physical therapy for my injuries now. I’ll explain more about the process in a later post.