The pollens are out and hay fever season is upon us.
It is always interesting to me that there is a swell in vestibular problems at this time of year. People often ask if allergies could be the cause of their dizziness. The short answer is: we don’t know for sure.
The literature suggests that allergies could possibly make symptoms worse but it is not clear if they cause the vestibular system to malfunction.
If we look at the anatomy of the nose and ear, the eustachian tube connects between the nose and the middle ear. It is usually air filled and helps us to maintain our pressure gradient; for example when flying or driving up or down a mountain. When we have allergies our nose gets stuffed and the eustachian tube gets blocked. This can change the pressure in the ear complex and can lead to dizziness. A good nasal decongestant, antihistamines and avoiding the allergens, as much as possible, will help get you through this beautiful, but pollen-filled season.
“It is hard to explain to others what it is like to have hearing loss — the lack of clarity in speech, the sensitivity to loud noise, and the exhaustion that comes with heavy bursts of communication. It is an invisible disability so it is often misunderstood, downplayed or even ignored — sometimes even by those closest to you. But it can have a huge impact on your life, and the lives of those who love you.”
In addition to the introductory course, Susan Rankin is also offering two Advanced Facial Neuromuscular Retraining courses; one in Vancouver and another in Victoria. The Advanced course consists of 2 days of training for 3 therapists. Participants will assess and treat real patients applying the principles taught in the introductory session.
Though the Vancouver advanced course is already full and has a waiting list, there is still space in Victoria for therapists from the island. The Victoria advanced course will take place on February 27 and 28.
Please note that the one-day introductory course (February 19) is a prerequisite for the advanced course. You can register here.
For further information on attending the advanced course in Victoria please contact Susan Rankin directly at firstname.lastname@example.org.
One-day Introductory Course Susan Rankin, Instructor
Facial palsy can affect every aspect of a person’s life. More than just an absence of movement, it often changes the way people think about themselves and how others perceive them. Treatment techniques for peripheral nerve injuries of the extremities do not work on the face. The facial muscles are different physiologically and so is the treatment of peripheral facial palsies.
This lecture-based course will introduce therapists to an effective and validated method for treating lower motor neuron facial palsies. Typical diagnoses include Bell’s Palsy, Ramsay Hunt syndrome, Acoustic Neuroma, Cholesteatoma, parotid cancer, trauma to the facial nerve, Guillain Barre and congenital among others. This technique is not effective for upper motor neuron facial palsy e.g. stroke.
The cost for this one-day course will be $135 for NSD members and $160 for non-NSD members, plus GST. The cost will include a catered lunch and printed lecture materials. This course is open to PTs, OTs, and SLPs.
GF Strong Rehabilitation Centre – 4255 Laurel Street. Lecture Hall. Vancouver, BC
The second Facial Nerve Clinic at St. Paul’s hospital was held on November 25th and was fully booked. If you’re interested in attending the next clinic, it will be held in February 2016.
In order to book into the clinic, your doctor needs to refer you to Dr. Van Laeken‘s office at 604-669-1633. Dr. Van Laeken is a plastic surgeon who specializes in the facial nerve and heads the Facial Nerve Clinic.
This clinic is a teaching clinic so there will be medical students, interns, residents and physiotherapy students attending at different times.
I recently attended a week-end workshop on balance. It was taught by Dr. Faye Horak from Oregon, a Physical Therapist who does research in the area of balance and has done so for most of her career. She suggested a systems approach to balance which is divided into 6 sections.
Biomechanical constraints, which include things like deformities in the feet, weakness, decreased ROM and pain
Stability limits which are assessed by leaning in sitting and functional reach measurements
Anticipatory postural adjustments that are tested by sit to stand, toe raises, standing on one leg and arm raises
Reactive postural responses done by giving and removing resistance to see what reactions occur (i.e. ankle strategy or stepping responses)
Sensory orientation which is checked by varying the amount of input from one of three systems: visual, proprioceptive or vestibular
Stability in gait which includes components of the Dynamic Gait assessment and the timed up and go tests
Dr. Horak has devised a balance assessment to include all 6 components called the BESTest. There is also a mini-BESTest. I’m looking forward to integrating these aspects of testing and treatment into my practice.
Much has happened since my last post about the creation of a Facial Nerve clinic in BC.
The BC Facial Nerve Clinic will officially begin at St. Paul’s hospital on August 26, 2015. This clinic is already fully booked, but there will be 4 clinics a year.
This is an excellent opportunity for Residents, Interns, Fellows and students, in a variety of disciplines, to attend and learn about the options for treating facial patients. Most importantly, facial patients will be seen by a multidisciplinary team who will develop the best treatment plan for their face.
Creating a Facial Nerve Clinic is something I’ve dreamed about for many years and I’m excited to take part in its inception.
Rankin Physiotherapy operates out of the Canopy Integrated Health clinic. The clinic is located in the Lynn Valley Library Square, adjacent to the Lynn Valley Centre.
Wednesdays: 10:00am – 1:00pm and Fridays: 1:30pm – 7:30pm