On Tuesday I got to experience visiting a large hospital for the first time in awhile. Since last September I’ve been putting up with spells of vertigo, and after trying a number of home remedies I decided to seek out an expert.

I found Dr. Oliver Adunka by searching on-line and made an appointment to visit with him at UNC Hospital. As someone who has only gone to small practices for much of the last decade, the trip to UNCH was an experience.

First, you can’t park near the place. The hospital complex takes up several city blocks so you have to park in a similarly-sized parking garage down the street. While I left in plenty of time to make my appointment, I was glad I did since I walked in to the office right on time.

Adunka works in the Ear, Nose and Throat section of the Neurology Building. While the outside looks pretty new, the inside was a little shabby. I am always surprised with I see both CRT televisions as well as pictures that aren’t perfectly clear since I’ve become so accustomed to flat panels and digital signals. Anyway, I got checked in and was handed a pretty simple form to fill out and told to wait for my ear test. The form was straightforward, except for a couple of questions asking about home life. I’m not sure if there has been a spike in spousal abuse, but this was a recurring theme throughout my stay.

Another theme was a notice about payment. Since Andrea works at the hospital I knew that there were at least two main financial entities involved with most of the care provided at UNCH – the hospital itself and “P&A” (Physicians and Associates) which are the doctors. The notice stated to expect two bills: one from your doctor and one from the hospital for any tests performed. Since I was getting a hearing test I assume that I will get two bills.

I didn’t wait too long before I was seen by the audiologist and she started the hearing test.

My hearing was excellent until I had ear surgery to remove a small tumor on my eardrum back in 2004. Since then I have hearing loss in my left ear as well as a steady high-pitched ringing (tinnitus). The test confirmed what I’d known, but they added a test which bypassed the middle ear by using a metal device that is positioned behind the ear to transmit sound direct to the inner ear. My hearing was much better on that test, indicating that the issue is in my middle ear.

Anyway, after that I was shown to a small waiting room (with the ubiquitous “does your spouse beat you” and “remember: two bills” flyers) where I sat for awhile until another woman came and got me. As I was following her she said we were going for a hearing test. I told her that while the one I just had wasn’t hard or uncomfortable, I ask if I really needed another so soon. This stopped her in her tracks and I was sent back to the little room to wait. Never saw her again but I finally did get to meet Dr. Adunka.

He’s a nice guy with a little bit of an accent (Adunka is an Austrian name – wouldn’t have guessed that). We talked about my ear issues and the vertigo, and he pretty bluntly said we’d probably need to do more tests. One, a “balance test” apparently takes about 90 minutes and involves flushing both ears out with some sort of fluid. He also seemed positive that he could correct the hearing loss in my left ear, but in order to do that he’d need to see a CAT scan (never had one of those).

We then got to the diagnostic part of the program. He checked out my ears, etc. and then tried to bring on the vertigo by having me lay back. Nothing happened when I lay back on my right side, but I could feel an exceptionally strong vertigo attack when I lay on my left. He was pretty excited in that my eyes did a movement that was indicative of [Benign Paroxysmal Positional Vertigo][3] (the movement is called Nystagmus). While I had assumed that Positional Vertigo what was I was dealing with (other forms of vertigo can be much more severe) it was nice to have a firm diagnosis and to know that it was treatable.

BPPV is caused by calcium crystals in the inner ear. The main treatment is to move them out of the labyrinth of the inner ear using gravity, usually through a procedure called the Epley maneuver. They did this to me in the office and it seemed to help.

That was pretty much it for the visit. I have an appointment in February for the CAT scan, and while the Epley maneuver definitely helped, my vertigo hasn’t gone away, but at least I know enough now to perform the procedure myself so I am going to try it for a few days and see if I can make it stick.