As I mentioned in my last post, I had an MRI and MRA done. The MRA came back completely normal, and my vertebral arteries are fine (phew!).

However, on the MRI of the spine, there was a significant discovery: severe foraminal stenosis on the right side at the C4-C5 vertebra. Now I had no idea what that meant, but my physiotherapist (who is great by the way) explained it to me. Essentially, there are nerves that come out of the spinal vertebrae through little holes on the side called foramena. When the vertebrae become unstable, the body starts growing some bone back to try to stabilize them (which also leads to osteophytes, also called bone spurs, which I have a few of on my C4 and C5 vertebrae).

So this excess of bone starts to grow into the foramen (this is the stenosis, which basically just means ‘narrowing’), causing it to get blocked and impinging on the nerve that comes out through that hole. The nerve gets pinched and this causes various symptoms, including tingling, weakness and pain (all of which I’ve had in my right arm and shoulder for about the past year). Here’s a picture that may help:

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Since it’s been over two years since I last posted, I figured I’d take a bit of time and update everyone on where things are at with me. I’ve got some more information on what’s been going on with my balance, but it’s more that I’ve narrowed it down rather than really heard a definitive diagnosis.

About a year ago, I had another round of vestibular testing — including VEMP (vestibular evoked myogenic potential) testing, hearing testing and caloric testing (where they flush hot and cold water in your ears). Guess what? All the vestibular tests came back completely normal — for the second time.

So this has lead me and the doctors I’ve been seeing to conclude that the problem may in fact be neurological — which would completely explain the lack of success I’ve had in the past with vestibular treatments. I had an MRI in the past, and it had also come up normal; so now instead I’ve got an MRA (magnetic resonance angiogram) scheduled.

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So it’s been about a month since I’ve written anything. What’s been going on the past month? Well, quite a bit actually (unfortunately none of which has allowed me to see a positive change in my symptoms).

I had another visit to the neurotologist (which I mentioned last time) — and I asked to have VEMP testing done. While the testing wasn’t much help (since it came back normal), I decided to ask the woman doing the testing if she knew of a good neurotologist.

She suggested one of two doctors, both of whom I haven’t seen before. They came highly recommended from her, so I’m starting to think it’s time to go and get a second opinion about what’s happening with my balance issues.

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I visited the neurotologist this week after getting my appointment changed from July to now. I was hoping that after getting the caloric testing done, we would finally have some answers about what exactly could be done to make me feel better.

So I went in with my fingers crossed, not quite knowing what to expect. I saw the same doctor as last time, and he had the results of my caloric test in hand.

I was completely shocked when he said, as he was flipping through the pages, “It looks like your results were normal.” I didn’t quite know what to say.

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Well, I had my caloric testing done this week, and the results were a little odd. I first did a hearing test, after which the tester informed me that the results were completely normal — I was happy about that, because I don’t particularly feel like losing my hearing.

I then did a test where I had to watch a red light move back and forth, both vertically and horizontally. I didn’t find it particularly dizziness-inducing, I was more dizzy just having to lie on an incline.

We then did the caloric testing, starting with warm water in the left ear. I had thought before that the caloric testing would be one quick squirt of water, not a continuous jet of water into your ear. The warm water in the left ear made me quite dizzy, which the tester informed me was actually normal.

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I had completely never heard of caloric testing before, but I’m hoping it will reveal something about my (potentially?) damaged vestibular nerve. If you’re like me and had never heard of caloric testing, here’s Wikipedia’s definition of it:

In medicine, the caloric reflex test is a test of the vestibulo-ocular reflex. It is used by audiologists and other trained professionals to validate a diagnosis of asymmetric function in the peripheral vestibular system. Calorics are usually a subtest of the electronystagmography (ENG) test battery.

So basically, what they do is squirt warm and cold water into your ear. In a normal person, the eye will move in a particular way — but for someone with vestibular dysfunction, the eye will move less (or perhaps not at all?).

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