A few weeks ago I had some tests done to determine if there was any vestibular damage done in my ear. I had other similar tests done in the past but this particular time I was given the caloric water test. A couple of years ago I also have the chance to have this test done but I backed out. Why? The short answer is that I was scared. I know that is very logical to be scared of a test where water is poured into the ear and then drained out a moment later but I had my reasons.
When I had my gent injections probably the most painful thing was having the pain medicine dabbed on my eardrum. For some reason my eardrums especially on the ‘bad’ ear are very sensitive. Or then again it could just be me that has a low threshold for pain. That is why I wasn’t keen on having the caloric water test done.
Fortunately the test really wasn’t bad at all. The tech put in hot and cold water in one ear at a time and it was uncomfortable but not painful. Goggles were placed over my eyes and I was instructed to look at a light in the corner of my vision. After the water was put in my ears the tech can see what type of movement was coming from my eyes.
As for the results it was rather predictable. My right ear was responsive like any normal ear would be, whereas the left ear, my bad ear, wasn’t responsive at all. So there definitely was some vestibular damage in my left ear.
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Sunday, February 13, 2011
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10 comments:
I´ve done this test a couple of times. The first time was terrible, the next I had my husband with me holding my hand. But the worst thing is not the test itself but, once again, my fear of having an attack and that the test might be a trigger. The last time I did it my both ears didn´t react so much. My doctor explained that I could see it as a good sign - when the balance decreases you don´t react so much to the caloric test, which means less vertigo. Most of my Menière-friends thinks this test is very scary. Maybe it would be nice to make a visit to the balance-lab once when we don´t have to do the test so the staff can tell us about what they do during a test and what the results mean.
I hope that your good/bad result for your bad ear means you will feel even better!!
Susanna
Unfortunately, that's the whole point of gentamicin treatments: to damage the vestibular nerve that's sending signals to the brain that result in a vertigo attack. So this is a good result.
That said, I found it very upsetting to realize that I was undertaking a treatment that was designed specifically to destroy part of my ear. It's very counter-intuitive. I suppose, in a way, it's like choosing to have an amputation. You need to destroy a part of your body in order to return to a more normal life. But choosing to do that is the hardest decision I've ever made.
The caloric test can be done either with cold air or with cold water. I've only had the one that's done with air. The last time I had it, we realized that I was walking around with nystagmus all the time, which became the benchmark by which we judged the success or failure of the gentamicin and later, the labyrinthectomy.
More recently, after a long course of steady diazepam, the nystagmus has disappeared. But I do wonder whether it would come back if I go off the diazepam. No one can take that stuff forever. You hit a plateau and need to take more and more, and become dependent. That's not in my plans.
David, how are you feeling? Less dizzy, I hope, since the test did show the nerve had been damaged by the treatments. Your eyes should have shown less nystagmus, and that should mean less vertigo.
@Susanna,
Unfortunately the results of my test wasn't very positive because it also showed that there was vesitbular damage and that it could be getting worse. Which also means that my good ear is helping out as much with my balance as it should be. Hopefully that will change.
David
@Peggy,
thanks for the comment
David
My very first vertigo episode took place less than 4 hours after using a Neti Pot, which is a nasal flush. Interesting that I never had vertigo until I created intense water generated pressure in my head, although I resorted to the Neti pot when nothing seemed to relieve cold symptoms I was having at the time. Seems the Neti pot result would be similar to this water test you had and could easily create a bad reaction.
Additionally, I also have intense pain, like you, from the numbing agent dabbed onto to eardrum for various procedures. I was told I was only one of a handful of the entire patient caseload at my ENT with this type of intense reaction. I think it's another example of this disease and how it manifests itself so differently with everyone. Different sounds, lights, and pressure changes all affect me at different times and I never can predict the outcome, always fearful of the dreaded vertigo attack, of course. Always appreciate your blog, David.
Thank you again,
Lita
thanks Lita for the comment!
I am going to use it in an upcoming post
David
Lita, what temperature was the water you were using? The caloric test gets a reaction from using very cold water usually. In fact, they usually use iced water for the test. In addition, I didn't think neti pots produced any kind of pressure... more of a gentle flow of warm, salinated water. So I'm hoping that wouldn't have anything to do with the vertigo, but it might be worth asking an ENT about.
Ah, here's something I just thought of: Recently, I had vertigo and nausea because my ear became inflamed (we don't know why). Maybe your congestion caused inflammation in the ear, and that's what caused the vertigo?
I never had pain when the doctor applied anything to my eardrum to numb it, but at one point when I was putting the gentamicin into my own ear by way of a tiny tube in the eardrum, if the gentamicin wasn't warmed up to body temperature, it was agonizing when it went through the tube to the middle ear.
Hi there
I attempted to have this test today. I have a history of what my ear specialist thinks is Endolymphatic Hydrops, though I'd been vertigo-attack free until brain surgery about a year and a half ago, after which I developed multiple symptoms of a vestibular disorder (and horizontal and vertical diplopia). I have officially been diagnosed with phobic vertigo but I think my Neurologist is starting to realise it's not quite that simple.
Given that I've always had a phobia of getting water in my ears, and an understandable fear of dizziness, this test was never going to be pleasant. I survived the first 40 seconds of cold water with slight dizziness, nystigmus and nausea, but about 30 seconds to a minute after the light was turned back on (i.e. when I was supposed to start getting better) I got hit with a huge vertigo attack that lasted for nearly 15 minutes before it fully subsided. It took another half hour or so for me to stop shaking! Needless to say we didn't go on with the next three rounds of water!
I'm frustrated that I'm no closer to any kind of result, but I'm not doing that to myself again!
Pip, that sounds horrible! Whenever I've had the caloric test, it's only been with cold air. Apparently, they were able to get enough results from that without having to use the cold water. I'm glad for that, after reading horror stories like yours. I'm so sorry, and I hope you find some answers and relief soon.
Sorry to post this here, but I'm not sure where else to go. I had an episode of vertigo in October, coupled with headaches, and the doctors still haven't decided what is wrong with me. Recently I had the hot and cold air caloric tests. In one ear, the cold caloric test produced intense pain in the eye on that side. It was like someone took an ice pick and stuck it in my eye. My eye felt cold and part of my upper face felt numb. It was a horrible experience and I cried during the procedure. My other three caloric tests were uneventful. If anyone has had an experience like mine, I would love to hear about it. My doctor doesn't seem to understand just how significant the experience was to me. I don't think my eyes registered the level of trauma I experienced. Whatever is wrong with me, that test triggers it.
Hi Julie,
I don't think that I have heard about a pain in the eye during a caloric test before. That is really strange.
You might want to get a second opinion about that considering what it put you through.
thanks for the commenta and stay in touch and let us know how you are doing.
David
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