Dizziness or Vertigo

Vertigo/Dizziness is the sensation of spinning ,swaying.That is the feeling of you or your environment moving.Also you may feel loss of balance.

Vertigo can be experienced mostly during morning and night,specially when you getup from the bed while turning your head,due to change in the vestibular system.

Vestibular system is mainly responsible for balancing our body.When we shift our head form one position to another usually the particles in the vestibular system also move,and it will stimulate our brain regarding our body/head position.

When there is an issue with those particles in the vestibular system,you may experience dizziness or vertigo. 

Vertigo is a symptom rather than a medical condition. Other symptoms that can accompany vertigo includes: 

• Hearing loss
• Tinnitus (Ringing sensation in the ear), 
• Nausea, vomiting 
• Feeling of fullness in the ear
• Loss of balance 

This rotational dizziness have two main causes: disturbance in either,

•       The balance organs of the inner ear (Peripheral vertigo)
•        Parts of the brain or sensory nerve pathways (Central vertigo).

PERIPHERAL VERTIGO

The inner ear causes include 

1) Labyrinthitis - This is the inflammation of the inner ear labyrinth; a structure that contains the organs of the senses of hearing and equilibrium.

  2) Vestibular Neuronitis - An infection of the vestibular nerve in the inner ear which causes the vestibular nerve to be inflamed, disrupting the sense of balance.

3) Meniere’s disease - Vertigo caused due to the high pressure of a fluid in a compartment of the inner    ear.

      4)  B.P.P.V - Benign paroxysmal positional vertigo occurs when micro-sized calcium crystals on the       utricle of the inner ear gets displaced which creates a false signal to the brain causing vertigo.

CENTRAL VERTIGO

It involves the central nervous system due to a disturbance in one of the following areas

1.      Parts of the brain (brainstem or cerebellum) that deals with the interaction between the senses of vision and balance.

2.      Sensory messages to and from the thalamus (part of the brain).

TREATMENT

Epley Maneuver

If your vertigo comes from your left ear and side:

1.      Sit on the edge of your bed. Turn your head 45 degrees to the left (not as far as your left shoulder). Place a pillow under you so when you lie down, it rests between your shoulders rather than under your head.

2.      Quickly lie down on your back, with your head on the bed (still at the 45-degree angle). The pillow should be under your shoulders. Wait 30 seconds (for any vertigo to stop).

3.      Turn your head halfway (90 degrees) to the right without raising it. Wait 30 seconds.

4.      Turn your head and body on its side to the right, so you're looking at the floor. Wait 30 seconds.

5.      Slowly sit up, but remain on the bed a few minutes.

If the vertigo comes from your right ear, reverse these instructions. Sit on your bed, turn your head 45 degrees to the right, and so on.

Do these movements three times before going to bed each night, until you've gone 24 hours without dizziness.

Semont Maneuver

For dizziness from the left ear and side:

1. Sit on the edge of your bed. Turn your head 45 degrees to the right.
2. Quickly lie down on your left side. Stay there for 30 seconds.
3.  Quickly move to lie down on the opposite end of your bed. Don't change the direction of your head. 
4. Keep it at a 45-degree angle and lie for 30 seconds. Look at the floor.
5.   Return slowly to sitting and wait a few minutes.
6. Reverse these moves for the right ear. 
7. Again, do these moves three times a day until you go 24 hours without vertigo.

Half-Somersault or Foster Maneuver

Some people find this maneuver easier to do:

1. Kneel down and look up at the ceiling for a few seconds.
2. Touch the floor with your head, tucking your chin so your head goes toward your knees. Wait for any vertigo to stop (about 30 seconds).
3. Turn your head in the direction of your affected ear (i.e. if you feel dizzy on your left side, turn to face your left elbow). Wait 30 seconds.
4. Quickly raise your head so it's level with your back while you're on all fours. Keep your head at that 45-degree angle. Wait 30 seconds.
5. Quickly raise your head so it's fully upright, but keep your head turned to the shoulder of the side you're working on. Then slowly stand up.

You may have to repeat this a few times for relief. After the first round, rest 15 minutes before trying a second time.

Brandt-Daroff Exercise

Here’s what you need to do for this exercise:

1. Start in an upright, seated position on your bed.
2. Tilt your head around a 45-degree angle away from the side causing your vertigo. Move into the lying position on one side with your nose pointed up.
3. Stay in this position for about 30 seconds or until the vertigo eases off, whichever is longer. Then move back to the seated position.
4. Repeat on the other side.

You should do these movements from three to five times in a session. You should have three sessions a day for up to 2 weeks, or until the vertigo is gone for 2 days.

Note:

• Reduce your salt intake
• For the rest of the day after doing any of these exercises, try not to tilt your head too far up or down. 
• If you don't feel better after a week of trying these moves, talk to your doctor/audiologist again, and ask him/her what he/she wants you to do next.
• You might not be doing the exercises right, or something else might be the cause of your dizziness.

                                                           Special thanks to 

                                                                Rhiya Grace

                                        ( Speech Language pathologist and Audiologist )

Puberphonia (Mutational falsetto)

Isn't it an interesting question to probe why some boy's end up having girls voices?Have you ever met some one like that? 

It is one of the most intriguing yet a highly confusing voice disorder which takes place during adolescence that many of you might not be aware of it.It happens as a consequence of boys larynx not achieving the expected adult dimensions during puberty.A patient with puberphonia will have their pre-pubertal voice after adolescences.

During puberty,vocal fold length and mass will increase and pitch decrease but few of them are unable to switch to the new low pitch,Therefore,we call this  condition as puberphonia

Voice characteristic

1. High pitch 
2. Breathy
3. Hoarse

It is mostly seen in boys.Usually males have a low pitch females have a high pitch.However,in this case males will have a high pitch which is similar to a female voice.

This can we vise-versa but it won't effect much in females because they have high pitch in nature.

The Social consequences for males who exhibits Puberphonia are many.

• Often though of as being effeminate,passive and immature and frequently endure much teasing from friends,schoolmates,co-workers...  

• Sexual confusing over the phone (Caller may mistakenly identify person with puberphonia as his mother or sister)

• Distress at the failure to develop a mature voice because of the social consequences 

How to over come Puberphonia??? 

worry not,In most of the cases Puberphonia can be easily treated by voice therapy given by a professional speech language pathologist.

       

DIFFICULTIES ASSOCIATED WITH NORMAL AGING

Ageing  stereotyping and discrimination on the basis of a person's age. Ageing is widespread and insidious practice which has harmful  effects on the health of older adults.in simple it is the process of becoming older.

What happens with ageing?

• There are changes to the brain size,vasculature and cognition
• Brain shrinks with increasing age and there are changes at all levels from molecules to morphology.
• Incidence of stroke
• Dementia (memory loss)
• Changes in levels of hormones and neurotransmitters

Social and environmental changes during ageing

 -Health - 

As we grow older, we become more likely to develop health problems. Someone who has been healthy most of his life may struggle with accepting health problems as he gets older.

-Mobility - 
Those who are inactive and/or have health problems may experience declines in strength, endurance, and mobility. These may limit daily activities.

-Memory-

 We process and retrieve information in different ways as we grow older. For example, we may take longer to recall information. Such changes are usually slight. 

However, stress, medication interactions, depression, dementia and a number of other conditions can cause serious memory problems. Those change in memory should be evaluated by a physician.

-Death of spouse, other family, and friends- 

One of the most difficult changes is loss of significant people in one`s life.

 -Home and personal belongings -  

Moving/Shifting houses is difficult at any age, but it can be especially difficult for someone older. One may be leaving a home of several decades or moving into a smaller home that can’t accommodate all of one’s personal possessions. The loss of familiar surroundings or things requires adjustment.

-Income.-

Incomes usually decline at retirement. Since older people don’t know how long they’ll live or what their expenses will be, they may be reluctant to spend money and/or worry about their financial security.

-Physical changes in vision, hearing, and other senses-

All of our senses tend to change with age. Such changes may be especially disruptive for those who have never experienced sensory loss.

                                     The changes that many older adults experience can affect how they see their lives. Many feel that they have lost their independence. 

Experience a loss of self-esteem

May lose a clear image of who they are at this time in their lives. So many changes and adjustments can lead to a lack of confidence in their ability to live a meaningful life and continue to make valuable contributions to the community.  And there may also be a sense of loss of the respect of others

Key Fact

• Between 2015-2050 the population of the world's population over 60 years will nearly double from 12% to 22%
• By 2020 the number of people aged 60 years and older will outnumber children younger than 5 years 
• All countries face major challenges to ensure their health and social systems are ready to make the most of this demographic shifts.
• 
  

Different task and skills that they can practice to keep themselves cognitive fit and active

Include physical activity in daily routine
physical activity increase blood floor to whole body,including the brain, this might keep there memory sharp

Eat a healthy diet
A heart healthy diet might benefit the brain.Add more fruits,vegetables and whole grains,choose low fat protein sources.
Too much alcohol,smoking lead to confusion and memory loss so avoid those behaviors

Stay mentally active
 Mentally stimulating activities help keep your brain in shape and might at bay.Do crossword puzzle,play a game of chess,take alternate routes when driving,learn to play musical instrument

Be social
 Social interaction helps wards off depression and stress.which can contribute to memory loss,look for opportunities to get together with loved ones,friends and others

                                                                   For older people, ageing is an everyday challenge. Overlooked for employment, restricted from social services and stereotyped in the media, ageism marginalizes and excludes older people in their communities 

Ageing is every where and non of them talks about it ,thinking that it's common for all so it's not widely counted as the other social problems.

But every one talk about it when there children drop them to a senior housing/community center/Old-aged home or media portrays  all old peoples as "Frail" and "Dependent"

these attitude and actions lead to feel isolated and unimportant of older people within our communities and have negative impacts on their health and well-being.

                                                   

                                                        Special thanks to 

    

  Aditi Ravikumar

(Speech Language pathologist)

TELEVISION & KIDS

The new generation is bombarded with all sorts of Electronic Media ( which includes TV,Mobile phones,Tabs). From streaming videos to the latest game apps, kids nowadays are technically advanced than kids of the past.
Adults must assure to say no, or shorten the time period they spend with these items,specially if your child is under 2 years of age. One should know that it is a critical stage when a child's brain & language acquisition takes  place.

Researchers  have found that there is an association with a decrease in the number and length of child vocalization when the number of hours watching television increase.Some of these reductions are likely due to child being left alone in front of the television.

Do you remember how your childhood was? If not ask your parents or your grand parents..However,as our grandparents always say,they lived at a time where they didn't have electronic devices in-front of them.They were happy and full of spirit,creative and energy...

Do you want your child to have good memories like that? I'm sure you will say "Yes,of course"
I believe that parents have a big role in this. Therefore, they should have good parenting skills and be willing to learn more about how technology impacts a child's growth.

Top concerns parents might want to keep in mind.

1. Delay in speaking in most of the children

Remember that communication is always two ways.(When I  speak someone will reply)

But in TV it's always only one way communication, there wont be any input from the child because conversation take place in the television with there dialog.

How to maintain your hearing aid

Hearing aid needs a special daily care to make sure it functions properly, also it's an electronic device and is costly.

Your audiologist will demonstrate and teach you how to maintain your hearing aid before they dispense it to you.

Make sure you will get your,

• Warranty card -which is authorized by the audiologist and the purchase date on it
• Dry box -keep your hearing aid when your not using it 
• Soft dry cloth-to wipe your hearing aid
• Wax remover -used to clean the ear wax from ear tips and tubes 
• Forced air blower (depends on your hearing aid company)

HOW TO TAKE CARE OF YOUR VOICE

This post will help people who use their voice as a means of living ; we call them as professional voice users.
                           

Which occupations are at risk ?

• Teachers 
• Singers
• Lawyers
• Bus conductors
• Salesmen
• Telephone operators
• Politicians
• Army officers
• Monks

Why are only these professionals at high risk?
        Because above professionals use their voice for a living than general population.
For an example teachers: primary and secondary teachers are at high risk than the others, because they frequently have to raise their voice. Reason behind this is that the students are too young to understand a comment/task at first, so the teachers have to keep instructing them and guide them.

What are the causes for vocal disorders?

• Misuse and abuse : singing out of range, frequent coughing, throat clearing, overuse of voice, poor hydration of vocal folds   
• Medical problems: vocal fold surgery, gastritis, allergy, poor diet, infections in the throat, hearing loss, cancer

        Structural anomalies in vocal folds : nodules, polyps, sub-mucous cysts, rinke's edema, scars....

• Environmental factors: performing in dusty, dry, smoky environment
• Emotional factors:anxiety, stress, depression   

Cochlear Implants

What is Cochlear implant ?
Cochlear implant (CI) is a surgically implanted device that helps overcome problems in the inner ear or cochlear.
It provides direct electrical stimulation to auditory nerve,which is responsible for hearing. Patient can't undergo for CI implant suddenly he/she have to undergo for different test before the implant.The age that the implant can be done is still debatable according to FDA the minimum age for a implant was 5 years but now a days we can find out children who undergo for CI less than 2 years. 

Who are the candidates?

• Children and adults with severe to profound hearing loss
• The patient has to have a Functional auditory nerve 
• The patient should not have medical and radiological contradictions to surgery
• Motivation of the family and the patient 

(Please note that above factors are basic factors.When it comes to children there are many more factors which we have to consider before the implant takes place.)

It consists of 

1. Implant package ( which is inside the skull )

                                                           -Receiver  and electrode -