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When your world tilts, make a sandwich

I should be used to spinning out of control; I’ve been doing it most of my life.

Much of what little I recall from a now lengthy existence involves spinning of a sort — extreme fuzziness, subdued lighting in the brain chamber, a distinct lack of direction.

I am no stranger to disorientation and, in fact, I often relish it. After all, it is out of chaos and confusion that art grows.

I’m well adjusted to faculties akimbo, lifestyle and cultural planes shifting like shards in a kaleidescope.

What I’m not used to is real spinning— when the dizziness is actual, physical dizziness. (unless, of course, I bring it on myself, expect it and enjoy it). What I am not ready for is Major Tom-in-the-capsule, capsule-out-of-control spinning.

That’s what happened two weeks ago. I got a hefty dose of a lack of equilibrium I had nothing to do with. It was like someone put mescaline in the birthday party punch and, just after I polished off the ice cream and cake … kablam, another universe!

I’m sitting at my desk, at work.

As usual, I’m vaguely aware of what is happening; people say things to me and I nod, people ask questions and I fail to reply, the phone rings and I ignore it. It’s a normal day.

Then, very suddenly, I get a bit woozy. Mind you, it’s not cocktail hour, so this is a bit odd.

I decide my blood sugar level has plummeted. An apple should do the trick; I have one on my desk. I stand up and start across the room to wash the fruit.

And I nearly fall over.

I have to grab the edge of my desk then the door jamb in order to stay upright. I make it to the sink, but the trip back to my desk is alarming. The room is whirling.

I collapse into my chair and get dizzier yet. I look at the computer screen; it is tilting back and forth and I can’t track along a line of words on the screen.

I begin to sweat. This is not, “My word, the heat has made me a bit damp and I need a julep” sweaty. We’re talking, “I’ve been shot in the chest” sweaty.

I slump back in the chair. I can barely hold up my head.

I run through a checklist of things that will kill me. I was raised in the medical world, thus I have been compiling my list of “I’m a goner” scenarios for decades, reshuffling the possibilities relative to things like diet, travel to foreign countries, exercise and stress levels, ingestion of toxic materials, etc. Over the years, I’ve suffered most deadly ailments. Fortunately, my diagnoses have been wrong, but practice is valuable.

First choice in this case: a stroke.

I stick out my tongue and ask a colleague if it is pointing straight or to one side.

Straight as an arrow.

I ask a colleague to check the pupils of my eyes.

Same size.

I go through a series of hand-eye motor tests I learned when neurosurgeons cracked my melon last year.

Everything checks out.

Speech slurred?

No more than usual.

Paralysis on either side of the body?


I go to option two: heart attack.

I am sweating so much my hair is wet, but there’s no chest pain, no pain in the jaw radiating down the arm, no shortness of breath.

Probably not a heart attack.

Now, I am feeling nauseous.

Another colleague asks if she should summon an ambulance.

Call me cheap, but … no thanks. Do you know what a trip in the ambulance costs?

Instead, I call Kathy. Something is wrong, and I am not going to be manly and ignore it.

Kathy speeds to the rescue. She charges into my office, jams an aspirin in my mouth and says, “I’m calling Jim (friend and physician). We’re not going to the emergency room — it costs too much.” Kathy and I share certain values.

Jim tells her to bring me in. Stat.

The guys in the pressroom tote me to the car and Kathy asks the critical question.

“Did you get your check for this week? We can deposit it on the way to the doctor’s office.”

That’s my girl.

Every curve we take on the way to the clinic (via the drive-through at the bank) sends a wave of nausea through me. The world is whirling and tilting.

When we arrive at the clinic, I spend a bit of time barfing in the rose garden outside the building. I make my way in and am taken to an examining room.

Blood pressure?

Pretty darned good, for me.

Heart rate?

Pretty darned good, for me.


Pretty darned good, for me.

Jim puts me through a battery of neurological tests.

No signs of stroke, but I fail the heel-to-toe test worse than a DUI suspect with double the legal limit in his system. I could be a poster child for bombing the horizontal gaze nystagmus test, my eyeballs fluttering like fruitflies in a bottle.

“Have you suffered a blow to the head, lately?,” says Jim. He looks at Kathy as he asks the question.


“Been in a car accident?”


“You have benign positional vertigo.”

Seems, for no apparent reason, a bit of calcified crud has adhered to the wall of one of the chambers in my inner ear. This tells my brain I am spinning, in free-fall, totally out of control, a test pilot strapped in that Inquisition gizmo that spins him violently and erratically, up and down, side to side. The autonomic system kicks in and, thus, the sweating, the nausea.

Jim fires me up with a dose of a drug to calm that reaction, lays me down on the exam table, turns out the light and, a half hour later, writes me a scrip for a lower dose of the medication to be taken each day the condition persists. He tells me it could be as long as ten days or so before the vertigo is gone.

For now.

“It can, and probably will recur,” he says. ”Could be two weeks, could be ten years. Oh, incidentally, are we going to order any wine soon?”

“I’ll get right on that. As soon as I can walk and read.”

A day or two later, I’m pretty much over it. I continue to take the pill, because I like it. In fact, I take a pill every day for a week or so. You can’t be too careful and, after all, I am not operating heavy machinery.

Since I had this attack, I’ve discovered it is not all that rare. People have come out of the woodwork to tell me about their experiences with benign positional vertigo.

Fortunately none of them are airline pilots or long-haul truckers.

All report much the same, nasty tale.

Not to say if you suddenly find yourself losing all balance, sweating and nauseated, you should assume something more serious is not occurring. Nor should you probably take a trip to the bank to deposit a check prior to going to the ER or a clinic.

But, if it turns out you are suffering an episode of benign positional vertigo, I have some advice.

1. When you take the pill prescribed by your doc, do not chase it with a Manhattan if you plan to do anything else that evening.

2. Take care with menu planning while you are suffering vertigo (once the nausea subsides, you’ll need food). Avoid liquids, in particular scalding hot liquids. Do not eat anything that requires a great deal of head movement.

3. Think sandwiches. When the world is atilt, sandwiches are a perfect way to deliver nutrition to a body that desperately needs it (after all, you’ve barfed a bit). The sandwich should be one whose preparation does not require you to be in an upright position for long periods of time (forget the grilled options).

I indulged a couple favorites and, thus, have options ready should I start spinning again.

Here’s one of the best.

Take a tin of high quality sardines, packed in oil. Drain most of the oil, put the sardines in a bowl, mash, add a teensy bit of finely minced shallot, half a ripe avocado, mashed, a bit of salt and freshly ground black pepper. Pop a couple pieces of rye bread in the toaster. Put a hefty schmear of the sardine mix on a piece of toasted bread you have slathered with whole grain mustard. An open-face delight, with a worthy dose of Omega-3s to boot.

When this ugly vertigo hits me again, I will know what is happening, and I will be somewhat prepared.

Jim refused to give me a supply of liquid Valium I could inject at the onset of the disorder (a pity, since IM delivery is a snap), so I’ll have to make the trip to the clinic for assistance.

In the meantime, I need to stock some tins of sardines in the pantry.

And arrange for electronic deposit of my check.

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