Dizziness & Vertigo (Vestibular) Problems With Younger People. The Why, & What To Do.

Speaker 0 (00:00:00) – A very common problem is younger individuals suffering with business and vertigo. And this is such a difficult situation for people suffering for themselves and their families and it can completely upend people’s lives and cause of business. And vertigo for even younger individuals can range from a number of different diagnoses. So what are these diagnoses? What’s going on? What would cause someone who’s 30, 40 years old who’s raising a family and working in management, having a career, running a business, whatever they’re doing in their life, to all of a sudden they have problems with walking, they have problems looking at a computer screen, their basic ability to walk across the room becomes very much inhibited and they’re suffering with this constant business and maybe even vertigo problem. So it’s important to recognize that business and vertigo don’t just happen to people who are older. It is more common for people to become dizzy and have vertigo as they get older.

Speaker 0 (00:00:56) – But age itself is not a cause of business and vertigo problems. In fact, there’s a lot of things that can be done as people get older to prevent these challenges in the first place. If you’re younger and you’re suffering with these problems, you’re probably experiencing a lot of frustration, finding the right specialist. You may not even have a diagnosis yet, or you’re very much questioning the diagnosis that’s been given to you by your doctor or your neurologist and your nose and throat doctor or physical therapist, whatever it might be. And you continue to struggle and suffer with the problem and nobody seems to find a solution or even the right diagnosis that’s making sense. And of course, most of all, you’re not able to find a solution and get actual relief and resolve the issue and get to go away cuz that’s really what you want.

Speaker 0 (00:01:41) – So if you’re suffering with this problem, here’s some information that hopefully will be helpful. Again, important to recognize that distance vertigo does become more common as people get older, but a lot of these causes tend to happen to people of all ages. So our main central balance system is called our vestibular system. This is our main central balance system. This is the system that you probably studied in elementary school, you know biology where he talked about the inner ear and the stal looking thing. And you know, that basically controls our balance and that’s usually about the amount of information that most people have about our balance. So the concept that comes from the inner ear and it kind of does, but that’s not the whole story. Let’s get back to that later. Now. Comment, diagnoses for business and vertigo. Problems can range from, you may have heard of some of these, uh, mine’s disease, labyrinthitis, benign positional vertigo, vestibular migraine concussion, and a new one you may not have heard about, which actually is not that new. It’s just a new name, which is persistent postural perceptual Dimus or P P P D. So if you’ve gone down this hole of struggling with business and vertigo problems, you may have read about some of these diagnoses on the internet and some of these diagnoses may have been thrown around by some, by providers. Now understand that when people are younger, we tend to

Speaker 1 (00:02:58) – Find, find that they tend to have more very specific reasons or specific diagnoses for distance and vertigo problems. There’s usually a very specific vestibular diagnosis that’s the reason for the problem. Now as people get older, we often find that more of it can be chalked up to of course a history of vestibular problems or inner ear balance problems, but also just a lack of use of our balance system overall. As we get older, we tend to move less or more years have gone by since we were children and spinning ourselves around and asking our parents to spin us around and going on amusement park rides and just absolutely loving it. And then before we know it, we’re 40 years old and not wanting to go on those amusement park rides with our younger children over and over again because it makes us sick. And then before we know it, we’re into our seventies and eighties and even just walking across the room and turning our head makes us dizzy, right?

Speaker 1 (00:03:52) – So there’s kind of that decline of the lack of use of the balance system and more of that can be chopped up to the lack of use as people get older. But what about when they’re younger? What is the cause? And especially if it comes on so abruptly maybe, or maybe someone just wakes up one morning and they’re dizzy or they wake up one morning and the room is spinning, or maybe they go out to the hospital and they’re sick and nauseous and the room is spinning and they’re so dizzy they can’t even sit up. And basically what the doctors and the specialists are looking for at that point is, is it a stroke? Is it a tumor? Is it something life-threatening that’s going that we need to intervene right now? And that’s what they’re looking for. From there, the job is to pass you off to your primary care doctor.

Speaker 1 (00:04:38) – And usually there’s a gap between the time that person goes into the hospital and when they get treatment later on. Cuz usually what happens is the assumption is that okay, this will get better and it will go away and their person will resume their life. And what tends to happen is if it doesn’t get better, if it doesn’t go away, then 9, 12, 18 months later, they’re trying to find the right specialist and they’re jumping from specialist to specialist from their primary care doctor to the ear, ear, nose and throat doctor, to neurologist, to cardiologist, pulmonologist, hematologist, all of these ologists. And they’re not able to find the right solution. And usually what ends up happening is at that point, you know, all the doctors have ruled out strokes and tumors and cancer and everything that could be scary, that could be life-threatening and all the systems checked out, your heart is fine, your lungs are fine and there’s nothing wrong with you.

Speaker 1 (00:05:31) – And then you start going down the psychology route because now you’re beginning to think you’re crazy and maybe some of the people around you begin to think you’re crazy, especially if there’s an anxiety component with the business and vertigo problem. Now you’re looking at seeing the physical therapist and next on the list is the psychologist. Okay? That’s often when people end to in the vestibular specialist office. So these are basically tertiary healthcare practices. So they’re very, very specialized in vestibular disorders, business and vertigo and balance is basically what this is. So vestibular specialists are very difficult to find, especially a very good vestibular specialist who truly really knows what they’re doing. They can be difficult to find. And again, they tend to work in very specialized centers. And if they’re very good, now the problem is it tends to be the younger people who get into these tertiary specialty practices.

Speaker 1 (00:06:25) – The main challenges with our older population is oftentimes visits and vertigo is just chalked up to age so often that they don’t even get to the correct specialist. Maybe they’re thrown into physical therapy or rehab somewhere, and then when it doesn’t work, then it’s like, okay, well we tried that. And then with younger people it tends to be the idea of, okay, there’s a problem here, we need to solve it. So younger people will tend to bounce from specialists to specialists more and then they’ll end up eventually into a tertiary vesta practice. But the problem is it tends to go for months and months and months, if not years and years before they end up in the correct spot. So basically the idea overall is for people to go to less specialists and spend less time with less medical tests because along the way they’ll get MRIs, CT scans, blood work, and they’ll go to all these different doctors and maybe three different neurologists, two different ear, nose and throat doctors and all this testing, all the cost all the time and all the while the person remains suffering.

Speaker 1 (00:07:28) – That is a very common story with younger people suffering with DI and vertigo problems. So what are some of these causes of DI and vertigo in the younger population? You may ask positional vertigo is when the crystals get loose in the inner ear balance system, you may have heard about this before, we basically have rocks in your head. Yes, you do have rocks in your head and your spouses and your past, uh, boyfriends and girlfriends and all your family members have been telling you for years, you have rocks in your head. And those rocks are very important because they tell our brain about acceleration. And so of course where our head is and our, where our body is in relation to gravity and then when we’re speeding up, when we’re slowing down, that’s what those rocks do. They’re supposed to be there. The problem is when those rocks get into a place where they’re not supposed to be.

Speaker 1 (00:08:17) – And when they do that, that’s when we get this false sensation of rotational spinning usually, but not always when we roll over in bed and then the room spins. Now with the younger population, by and large as a whole, the symptoms of positional vertigo tend to be more clear cut and straightforward. It tends to be the rolling over in bed and then the room spins. Generally that tends to be a very clear symptom. And if this is happening to you, you wanna go to your doctor and you want to make sure that it’s not a stroke or a tumor or anything life-threatening or anything like that. But you wanna make sure that you get the problem resolved, that you get to a vestibular specialist. If your doctor is not able to resolve it for you, then you want to to get to a vestibular specialist and resolve this problem.

Speaker 1 (00:08:57) – So basically what happens with positional vertigo is the crystals get knocked loose, they begin to, as part of the inner ear balance system, they’re not supposed to and the person will experience abnormal, basically rotational spinning when they should. And along with that, they may also have problems with just business in general. They walk across the room and then they’re moving their head. They may have problems with their balance. And so this can be very impairing and can cause a lot of problems with work and life and a large percentage of people can result with severe limitations with their daily life and mobility. Now this is what I would call the most clearcut diagnosis of all of vestibular disorders for a vestibular specialist. To me this is the most clearcut. And so we can do a very specific test and we can do specific treatments and the problem is curable.

Speaker 1 (00:09:51) – And so since it’s completely curable, it’s very important that people find the right specialist if they’re experiencing rotational spinning. It is not normal for anybody to experience rotational spinning and especially if you’re a younger individual and it’s not normal for an older individual either. Regardless, you need to find a vestibular specialist and get treatment. Now, what to do from here, it’s important to understand that even when positional vertigo is treated properly, one of the challenges is a large percentage of people will also continue to have remaining what we call vestibular deficits or something just not quite right with the vestibular system that’s just slightly off. And it doesn’t tend to be, you know, severe, it might be very subtle. And so a lot of times people may not seek treatment for these sorts of problems. The problem is more underlying and it’s more subtle. It’s important to understand that because if you’ve been treated for a positional vertigo, but there’s some problems that just are not resolved completely, could be a couple things.

Speaker 1 (00:10:50) – One, it could be that your positional vertigo was not treated all the way through and there’s still some crystals floating around that should not be, and that problem is not completely resolved. Another potential cause is that that positional vertigo may have caused an underlying vestibular problem that is solvable, but it just needs a little bit more work, a little bit more tweaking and a little more effort, but not usually a whole lot. So it’s important to understand with positional vertigo that I just talked about how sometimes the problem doesn’t get resolved completely. And part of the re some of the reasons for this is there are a number of different ways that positional vertigo can show up as a positive test. And usually your general healthcare provider can only think or is only taught one way for positional vertigo to be positive. And in fact there’s about three different ways for the test to be positive, but most healthcare providers don’t realize that.

Speaker 1 (00:11:49) – So what often happens is a lot of times people will have positional vertigo but they won’t get diagnosed properly because a lot of the times general healthcare providers or people who believe they’re vestibular specialist but lack a little bit more in the experience in guidance and coaching and everything else that really takes a bit of vestibular specialist, they’re not able to identify all the ways in which someone can be positive for positional vertigo. What does all that mean? It means a large number of people are left continuing to have the problem and have not gotten the right treatment. It’s also not uncommon. We see this quite a bit when people come to us that even people who claim to be vestibular specialist will do the testing and then also believe that it’s the treatment. And so then the person suffering does not actually get the treatment.

Speaker 1 (00:12:34) – They only get the test. And so they’re told, okay, you’re fine. You know, you can go home now. And that’s basically it. And of course they continue to suffer and suffer along the way. Now you also wanna make sure that if you are treated for positional vertigo, that of course it goes away completely. If you’re continuing to suffer with rotational spinning and you’ve been told that, yep, we took care of it, it’s gone, then there’s something wrong because you should not be experiencing any type of rotational spinning. Few reasons for this one, just oftentimes the symptoms can get better, uh, to the point where the healthcare provider might think that the positional vertigo is gone, but the positional vertigo might still be there. There’s still some crystals in the inner ear balance system that are still there and it just takes a little bit more treatment, but the problem hasn’t been resolved completely.

Speaker 1 (00:13:16) – And what often will happen is then the symptoms will come back with a vengeance. It might be when you go and get your hair washed, it might go when you just bend over and pick up an object or look up or something provokes that rotational spinning. Again. Also with positional vertigo is very normal for people to begin to change their movement patterns to avoid certain movements and also for the body to become desensitized to the symptoms. And so what happens is people continue to believe that they no longer have the condition basically because they don’t move in those positions anymore and they may or may not even realize it. And so you want to make sure that the positional vertigo is treated completely. And also that if it does come back, you know the right specialist to go to because the reality is positional vertigo can come back and that’s not abnormal at all.

Speaker 1 (00:14:05) – And now you can reduce the risk of the positional vertigo coming back by a few ways. One, make sure that your medical complexity is reduced overall, what does that mean? Basically go to your doctor on a regular basis, make sure that if you have high blood pressure, diabetes, you know any of these challenges, make sure that they’re addressed properly with diet, exercise, and medication and reduce your medical complexity overall. Because if you are more medically complex, you are more likely to get positional vertigo and you’re more likely for the positional vertigo to return if you have it treated properly to begin with. The big one that you can do is vitamin D deficiency and bone density. And these are couple very good randomized control trials where they actually treated or supplemented people with low vitamin D who had positional vertigo and they were treated

Speaker 2 (00:14:50) – Properly, properly for a positional vertigo. And then they would see compared to a placebo group if the vertigo would return by treating the vitamin D deficiency in one group versus a placebo in another. And you are significantly less likely for the positional vertigo to return if your vitamin D deficiency is treated properly. And of course, just make sure that your vitamin D is taken care of, get your blood work done and make sure that your vitamin D numbers are good to reduce the risk of getting positional vertigo. And then of course if you’re treated for it, then it reduces your risk of the positional vertigo coming back. So why is the case, why vitamin D? Basically the crystals that get loose in the inner ear balance system, they’re basically calcium carbonate crystals and there’s a lot of physiological mechanisms now being looked at that tie, the main central balance system that vest stabler system to our bone density overall, there’s a lot of physiological connections.

Speaker 2 (00:15:42) – So the other main connection is bone density. In general. If a person has low bone mineral density, then the researchers are suggesting to screen the vestibular system for problems or impairments and weaknesses and things like that, and vice versa as well. If they have a vestibular problem, the recommendation is make sure you screen the bone density of that person because the two systems are so associated with one another is so strongly associated with one another that if there’s a problem in one, then make sure that you check the other. That’s positional vertigo. The solution is to find a vestibular specialist and make sure that you get treated properly and then the symptoms should go away completely. And if you have a subtle amount of symptoms afterwards to then go back to the vestibular specialist, have them retest your entire vestibular system and make sure that all the weaknesses and everything that might be knocked off balance, everything that’s not quite tuned up properly is taken care of.

Speaker 2 (00:16:38) – Now another group of disorders that are in the vestibular world, so ER’s disease and vestibular migraine. Now with both of these disorders, you want to make sure that you are seen by two specialists. You want to make sure that if you have vestibular migraine and you’ve been diagnosed with that, you want to be seeing a neurologist to be treating the migraine portion of it and certainly the head pain portion of the migraines and any other symptoms that might go with the migraines. And you also want to be seeing a vestibular specialist, or at least you want the connection to a vestibular specialist to treat, treat the business and possibly even vertigo part of the problem. Now Manila’s disease is very similar. Instead of a neurologist, you want an ear, nose and throat doctor if you’ve been diagnosed with manila’s disease because when you have a maner attack, you want that ear, nose and throat doctor that you can reach out to and have them help you address those severe symptoms when you have those attacks.

Speaker 2 (00:17:34) – Now with both of these disorders with vestibular migraine and man’s disease, the problem is oftentimes people will get the diagnosis and they might, you know, see the doctor or might be several years since they’ve seen the doctor and they might go on suffering with ness imbalance problems and maybe even vertigo. And they’re not sent to a vestibular specialist that whether it’s a physical therapist, occupational therapist, chiropractor, whoever it is who’s actually addressing the vestibular component of the disorder, make sure that you also have a vestibular specialist that you’re seeing to address the vestibular part of these conditions because these disorders do need to be diagnosed by a physician who is a specialist in these areas. But you also want a vestibular specialist to treat the business and possible even the vertigo component and to tease out what is the pure vestibular migraine, the men’s disease versus what is vestibular related.

Speaker 2 (00:18:26) – So basically over the long term you want to make sure that you are doing exercises that are specific to you that address the vestibular component of the condition. So you might find that you have problems moving your head and getting dizzy or looking at a computer screen and you might get dizzy when objects move in front of your eyes, you get dizzy at that point. And of course some of these can relate back to head pain and everything else and can exacerbate some of that and the symptoms feed on one another. So the main thing is with these types of disorders, you want two specialists, you want the ear, nose, and throat doctor. If you, if you’ve been diagnosed with mane’s disease and you want a neurologist, if you’ve been diagnosed with vestibular migraine, but you also want a vestibular specialist to be treating the vestibular part of this condition and without the vestibular specialist, then people tend to end up suffering with continued business and balance problems that don’t get resolved.

Speaker 2 (00:19:19) – They might get the migraine portion addressed and under control with the medication from the neurologist for instance. But in between then they’re also having problems with dias and balance problems. So you wanna make sure that you have two specialists, at least if you’ve been diagnosed with those types of conditions. Now another common diagnosis is called labyrinthitis or distibular neuritis. And this is basically infections of the deep inner ear balance system. Very difficult for anything to get to our inner ear balance system because it’s so locked up in our skull and for good reason. And so very few things can get to it, bacteria, viruses can. So when people get an infection of the deep inner air balance system, it’s not uncommon for them to have severe ness and vertigo and sometimes they’ll even go to the ER as a result. Sometimes it can be more subtle than that, but basically that’s one of the telltale signs.

Speaker 2 (00:20:07) – Now often sometimes people will get actually diagnosed with the condition and so then the question is what to do about it later. Oftentimes people will be discharged out of the hospital and the assumption is that that infection will go away on its own and the person will end up being just fine. Now a lot of times the person does not end up just fine and they’ll go on to experience problems with business and balanced problems months and years down the line, and that’s when they’ll see multiple specialists and then eventually down the road end up in a vestibular specialist’s office and then seek treatment. Now I understand that this is a very, very treatable situation. Basically what happens is that infection basically knocks our balance system off kilter and then as a result we suffer with dizziness and balance problems. Now the treatment of course, by the vestibular specialist is very similar to a lot of the other diagnoses.

Speaker 2 (00:20:58) – We treat the impairments of the vestibular system very specifically based on the individual. And so that way they’re able to progress themselves to a resolution of their symptoms. They’re able to significantly reduce, if not completely eliminate the dizziness. They’re able to improve their balance, if not get it back to where it was before and they’re able to get their life back. And so that’s the main takeaway I want you to get from this information is these are solvable solutions. Just because you’ve been given a diagnosis doesn’t mean you have to continue to go on and continue to suffer with the condition. Now, yes, some of these conditions are not treatable conditions, meaning you’re not gonna get rid of them entirely. ER’s disease for instance is, is one of those. However, a lot of the life altering symptoms that occur with these disorders are addressable very significantly.

Speaker 2 (00:21:47) – And so it can make a big impact in your life if it’s treated properly. Now what about the other newer disorder that I talked about, which is called persistent postural perceptual business? Again, this is not actually a new diagnosis. It used to be called chronic subjective business and about five or six other names and all these disorders have been kind of lumped into one. So what are these? Basically, you can think of it as business with anxiety. And what happens is about a quarter to a third of all people who have some type of business or vertigo end up with this condition. So if this is actually a very large number of people who go on suffering for months and years and the condition goes undiagnosed, unrecognized and untreated, and basically what happens is, uh, the person will be walking across the room and they’ll be very dizzy and they’ll also have this sense of anxiety and panic along with it.

Speaker 2 (00:22:42) – So this is called persistent postural perceptual business. The person will walk around like they’re walking on eggshells, they’ll tend to furniture walk, they’ll have a lot of anxiety and panic, even if they’re not an anxious person overall. And so this can be a very, very impairing disorder. And this is usually the person who’s seen the most specialist and is about to see the psychologist as well, because what looks like a psychiatric condition is actually a vestibular condition. This is also where a lot of people will be a agoraphobic or basically they’re afraid to go outdoors basically because all the outdoor stimulation that they experience really bothers them and exacerbates their symptoms of dizziness. Now, especially with persistent postural perceptual dizziness, it takes a specialist to treat the condition because you also don’t want to overstimulate that person. And so a lot of people will get treated for this condition by vestibular specialist and they’ll just get overstimulated by this vestibular specialist.

Speaker 2 (00:23:42) – And this is not uncommon at all and basically just need to find a new vestibular specialist if they’re repeatedly overstimulating you. It doesn’t mean that you’re not seeing the right type of specialist, it just means you need to find one who’s more tuned to treating this condition, who’s gotten coaching and mentoring on it, who’s seen it thousands of times and knows exactly how to treat the person at the proper level. So if they’re not overstimulating them, and again, this is overall by and large, a very treatable condition and it can be beneficial to work with a neurologist as well if this condition persists, it can be beneficial to work with the neurologist as well. But to start with, start with a vestibular specialist and then go from there. And oftentimes just knowing what’s going on can be very, very, very helpful. Also important to understand that overstimulation of the vestibular system is common with all these diagnoses.

Speaker 2 (00:24:36) – So whether you’ve been diagnosed with manila’s disease or vestibular migraine or persistent postural perceptual dizziness or you don’t know what your diagnosis is, but you do get overstimulated very easily by moving your head or objects moving in front of your eyes or tracking objects and things like this, then it overstimulates your body and makes your symptoms worse. This is not uncommon with a lot of these vestibular diagnoses. So the key is again, defined the right specialists who can treat it at the proper amount. It’s a lot like taking blood pressure medication with vestibular disorders. It’s a specific amount, a specific dosage, a specific number of repetitions done with the feet in a certain position so that the system’s not being overwhelmed too much and at the same time the system is getting the right amount of stimulation that it needs to resolve it. Of course, there’s also concussion, and this is a problem with the younger population for a number of reasons.

Speaker 2 (00:25:31) – Of course, risk taking behavior with the younger population, sports speed of life, you know, all these different reasons increase the risk of head injuries amongst younger people. And of course, younger people can get positional vertigo when they’ve had a head injury. It’s less likely than the older population when an older person falls in the hi their head, their risk of getting positional vertigo dramatically increases. It increases as well with the younger population, but not quite as much. However, with concussion, a big takeaway is a lot of specialists claim to be very specialized in this. And what we’re seeing is they’re not. They’re doing things such as Botox injections or just kind of like a one type of medication type thing, and they’re basically claiming to have a concussion, you know, treatment with what they do, or they claim to be concussion specialists. And you want to be very careful that this is not the case.

Speaker 2 (00:26:24) – Concussion treatment is an interdisciplinary approach. There needs to be a neurologist involved and there needs to be a physical therapist involved if the symptoms are severe to the point where they’re impairing someone’s life and it’s been, let’s say, a good chunk of time. What needs to happen is if the person has head pain as a result of the concussion, and if they have DI or vertigo because of the concussion, they need two specialists, their head pain needs to be controlled, much like vestibular migraine, their head pain needs to be controlled, so they need to be seeing a neurologist, but they also need to be seeing a vestibular specialist for the DI and or vertigo component of the head injury or concussion or what have you. So notice a trend with these conditions. So notice a trend with a lot of these conditions. Oftentimes it takes multiple disciplines, multiple specialists to treat the problems successfully.

Speaker 2 (00:27:15) – Of course the medical along with the physical therapist, and it takes a vestibular specialist to treat these conditions to address the business balance and vertigo problems that may be there. And treating the vestibular impairments with these conditions is very, very, very important. And often this is what’s missing in our healthcare system. They might be seeing the ear, nose and throat doctor or the neurologist, but they very likely are missing out on seeing a vestibular specialist or at least one that can see them over the long term if necessary, especially if they’ve been diagnosed with something that is not curable, such as mine’s disease or vestibular migraine. You want a vestibular specialist that can work with you over the long term that if your symptoms flare up or maybe you get a new bout of rotational spinning and it won’t go away. And you want to have these problems addressed by a vestibular specialist as well and help to be screened down.

Speaker 2 (00:28:09) – So another problem with a lot of these conditions is people can have multiple vestibular diagnoses that may be related to the first diagnosis or might be completely unrelated to the first diagnosis. It’s just that people can have multiple diagnoses and we will often run into people if they think that all their symptoms are because of, let’s say, mane’s disease or vestibular migraine, and actually also have positional vertigo as well. So the crystals in their inner ear balance system are also loose and then the wrong spot. And so their positional vertigo needs to be treated as well as their vestibular migraine and their men’s disease and their concussion, let’s say they might have positional vertigo. And another diagnosis, important to recognize how many diagnoses do they have and to also make sure that they have the right diagnosis to begin with because oftentimes these diagnoses are used as just kind of blanketed diagnoses as well.

Speaker 2 (00:29:04) – And this is one of the other challenges in our healthcare system, especially mine’s disease or positional vertigo will just be kind of thrown out as a diagnosis when someone goes to their doctor for distance of vertigo problems without a specialist teasing out specifically what is what. And of course this causes a lot of problems because this can result in medications that the person doesn’t need to take. And even worse, the person goes around with a label with this diagnosis and thinking that this is a condition that’s not curable and whether this is the correct diagnosis or not. One, if they’re not seeing a vestibular specialist to have the rest of those problems addressed, that’s

Speaker 1 (00:29:40) – A a problem. It’s even worse if they go along with that label of having that diagnosis and they just assume that just that’s just the case and that’s their story and that’s the way it is and that’s how they live their life now. And that’s very unfortunate because a lot of these problems can be addressed. If you’re a younger person and you’re suffering with business vertigo problems, then understand that there’s a lot that can be done. There are solutions. Don’t give up on it. Find the right specialist for you that’s gonna help you feel better, cuz these problems are very treatable. Don’t give up on it. If you wanna learn more, subscribe to our channel. We talk a lot about this sort of stuff, and so it can give you more great information for yourself or someone that you care about. Subscribe to our channel. You can also download our tips reports about business and anxiousness, about vertigo, about balance problems, and a whole host of other challenges that people face with their mobility. We have a lot of great information on our website@optummovedfw.com where you can download helpful tips, reports that will put the power back in your hands, that would give you actionable items that you can use to build a fined solution for yourself or someone you care.