A Different Spin on Dizziness Business

I was surprised that "Spin Control" [May 11] did not include discussion of a medical procedure that helps people suffering from vertigo. I have suffered from a mild form of vertigo for almost 30 years, but on a recent cruise woke up one morning unable to walk. I told the doctor I had a history of vertigo but was treated for seasickness.

The next day, still unsteady on my feet, I saw a different doctor. After I described my symptoms, she said with a gleam in her eye, "I know exactly what's wrong with you, and I can help you."

She called her assistants in, laid me down on an examining table and proceeded to turn me up and down and around. "I have just used the Epley maneuver," she told me. I had never heard of this procedure before.

She later explained that it is a treatment for BPPV (benign paroxsymal positional vertigo), when crystals in your ear are out of position. Previously the doctor had worked in a dizziness clinic. I was walking easily by that evening and was able to fly home on schedule two days later from Los Angeles to Washington.

Mary B. Vogel

Bethesda

The article caught my attention big time, and I want to share my experience with a different outcome.

In autumn of 2001, I started experiencing unexplained bouts of dizziness. My internist was puzzled as much as I was, and the episodes were getting gradually worse, to the point where I was afraid to drive or venture out on my own. Thus started a litany of visits to various doctors, looking for a diagnosis.

From my internist I went to an ENT, who tested me with every imaginable test; after ruling out Meniere's, lupus and MS he suggested I see a neurologist. The neurologist performed even more tests on me (thank God for great insurance coverage) and determined it was something out of his realm and that I should see an orthopedist.

Finally we got some answers. In March of 2002, I was diagnosed with a congenital spinal defect that was causing my spinal cord to be "nicked" every time I bent my neck forward. In July of 2002, I underwent surgery to fuse my spinal column (top five vertebrae) together, thus alleviating any danger of my spinal cord being broken and rendering me paralyzed or dead.

Other than having a stiff neck, I am fine and have not been dizzy since.

Diane S. Stahl

Gaithersburg

I was surprised that none of the author's doctors mentioned weak neck muscles. When I had such spells some years back, my doctor told me that most dizziness is caused by weakened muscles in the neck. I started doing simple neck exercises and have never again been dizzy.

Joan B. Maurer

McLean

Lost (and Found) in Translation

"Only in America" [May 11] reminded me of my own experience with German health care while living in Freiburg as a Fulbright Scholar in 1990 and 1991.

As soon as I arrived, I broke a tooth and had to get a crown for it right away. My health care plan, provided by Fulbright, covered the whole ordeal. Can you imagine, fellow Americans? But what was even better was that I got pregnant in Germany and had the most wonderful experience one could possibly imagine.

Because I was 35, it was suggested that I have an amniocentisis. That procedure was paid in full, as were my monthly visits, sonograms and the attention of a loving doctor. I was issued a "Mutterspass" that I carried with me to each visit. My treatments, information about the pregnancy and so forth were recorded in the booklet that I proudly placed in a scrapbook upon my return home.

When I returned to the United States, my care was mediocre at best, disappointing at worst. I could not get my HMO doctors to perform a single sonogram; I was turned away on several visits to the hospital for not being "close enough" to delivery time for them to accept me as a patient, despite the regularity of my labor pains. Once I was admitted, I was kicked out of the hospital after 24 hours, only to come down with infections that required I return to the hospital for a full week without space for my newborn baby.

Oh, my dreams of German health care. . . . If I only could have delivered her there.

Sally Stoecker

Washington

Giving Electrodiagnosis a Bad Name

I am writing in response to "A Test of Nerves" [March 9]. I am a board-certified electrodiagnostic technologist with 20 years' experience. The director of the EMG Laboratory is board-certified in neurology and clinical neurophysiology. Limbs do not leap like trout, and electricity is not coursed down the arm through a needle. The needle EMG portion of the exam helps to record activity in muscle generated at rest or by the subject. No electricity is given through the needle.

As a result of this article, some patients have canceled EMG appointments in our lab, citing fears engendered by your story. This test has added significant precision to our ability to diagnose and then treat people with weakness, numbness, tingling and pain. We have found that with proper explanation of the test, the vast majority of people do not report significant discomfort.

Mary Russo, chief technologist

Perry Richardson, MD, director, EMG Lab

Department of Neurology

The George Washington University Medical Faculty Associates

Washington