On foot

So long as you are not in the middle of an active episode of dizziness, regular walking is a good way to help your brain get used to what makes you uncomfortable. Stay within a short distance of home until you are more confident. Try to find a place for short circuits that you can repeat or expand over time.

• Choose the right footwear for your foot type.
• Walk in clutter-free areas.
• Wear polarized sunglasses on bright days.
• Choose a pace and gait that makes it possible to maintain comfortable balance.
• Consider using a walker – this gives you a safe a convenient place to take a break.
• For a full-body workout, use Nordic-style walking poles – these have many benefits for people with dizziness.
• Avoid heavily patterned pavements if these trigger dizziness.
• When possible, avoid busy environments with a lot of traffic, noise and visual distractions.
• Ignore old advice to “either walk or talk” – recent evidence suggests that balancing while doing something that needs you to think at the same time may improve gait.
• Wearing white when walking at night does not make you more visible to drivers – if you are not convinced, watch the short YouTube video No White at Night. Clothing and accessories with reflective strips considerably improve your chance of being seen by a motorist or cyclist.

Shopping

• Make a detailed shopping list to help you stay focused.
• Go at off-peak times – avoid weekends if possible.
• Use a shopping cart for extra support.
• If the visual business of grocery store aisles makes you dizzy, try shopping at smaller stores when possible.
• Browse one side of the aisle at a time rather than looking back and forth across the aisle.
• Consider ordering groceries online and having items delivered or ready for pickup if this service is offered in your area. Or ask a family member, friend or neighbour to shop for you.
• Wear tinted glasses or a peaked hat if fluorescent lights trigger symptoms.
• Wear earplugs or headphones if you are bothered by noise.

Eating out

• If salt triggers your symptoms, check ingredients before you order. This information is available on some menus (either online or at the restaurant). Ask for food to be prepared with no salt (for example, steamed vegetables and grilled fish). Ask for gravy, sauce and dressing “on the side” and use small amounts. Order smaller portions or share.
• When possible, choose restaurants with no music or soft background music. Ask to be seated away from speakers.
• Avoid peak times.
• Avoid restaurants with busy décor that may provoke your symptoms.
• If the flicker of flames bothers you, ask for candles to be removed from the table.
• Try wearing musician’s ear plugs in order to cut down excess surrounding noise but still allow you to converse with your companions.

Public events

• If you have hearing loss, many theatres have listening systems to amplify sound. Call and ask if they have a listening system you can use during the performance.
• When reserving a seat, take a good look at the seating plan or ask about seats away from high traffic areas.
• If you do not have a reserved seat, arrive early and find yourself a place to sit away from high traffic areas.
• If light and noise are triggers for you, use tinted lenses and/or earplugs to avoid over stimulation.
• Take advantage of natural breaks during the event to rest in a quiet area if your symptoms are triggered.

Travel tips

General tips

• If you need medical advice for travelling or additional medications talk to your doctor well before you leave.
• Make a packing list well before your trip – double check everything before you leave.
• Pack enough medications. Make sure you have extras to tide you over in case of loss or delay. If flying, keep medications in carry-on baggage.
• If crossing borders, carry all prescription medications in original containers.
• Try to book a room on a single level.
• Bring a pillow that supports your neck both while travelling and sleeping at your destination, especially if a neck condition contributes to your dizziness.
• When possible, avoid any other plans on your travel day. Give yourself time to rest and recover from travel at your destination.
• If you have major dietary restrictions, consider accommodations with a kitchenette.
• Prevent falls in your room. Clear a path from the bed to the bathroom. Use your phone or flashlight – small, LED versions are inexpensive and lightweight – if you need to use the toilet in the middle of the night.
• Carry a flashlight or use a headlamp when walking in poorly lit areas at night.

Tips to minimize and cope with motion sickness

• Eat and drink lightly. Avoid alcohol.
• Sit or stand where you can fix your gaze on a stationary object on the horizon.
• Lie down and close your eyes. Do not read.
• Choose a cabin or seat where you are least likely to feel motion – some people find mid-ship close to water level or the middle of a plane is best.
• On a boat, open a window or go out on deck when possible.
• Consult with your doctor or pharmacist about medication options to counter motion sickness.
• Carry a disposable “barf bag.”
• Taking ginger may help with nausea.

In a car

• When driving, pick your route carefully if you anticipate the flicker of sunlight through trees or picket-style fences may trigger your symptoms.
• As a passenger, avoid the back seat.
• Plan and memorize your route, so you can avoid looking at maps or GPS devices during the trip. Or, ask a passenger to be your navigator.
• When necessary, take advantage of the one “safe ride” home a year offered by most automobile clubs to members unable to drive for a medical reason.
• If your balance issues impede your ability to walk to and from a car, you may be eligible for a disability parking permit.
• The Canadian Medical Association recommends that people with:
  • Vestibular disorders that affect one ear (unilateral), such as labyrinthitis or vestibular neuritis, not drive until their condition has subsided and the acute symptoms are resolved.
  • Ménière's disease or other recurrent vestibular disorders pull off the road at the first sign of an acute attack and wait until symptoms ease off. Those prone to severe, prolonged attacks should avoid driving long distances alone.
  • Acute episodes without warning symptoms, particularly sudden drop attacks, not drive until symptoms have been controlled or have eased off for at least 6 months.
  • Benign paroxysmal positional vertigo (BPPV) are usually safe to drive unless they are sensitive to horizontal head movements, in which case they should not to drive until their condition has eased off or responded to treatment.
  • Little or no balance function in both ears (bilateral vestibulopathy) may not be safe to drive.

On public transit

• On a bus, try to sit near the front or where you can see outside.
• Do not hesitate to let the driver know you need the bus to remain fully stopped until you are seated and when preparing to disembark.
• Courtesy/priority seats are sometimes available.  Be aware that bus drivers may not required to intervene to enforce the requirement.
• If the priority seats are full, do not be shy about asking someone to give up their seat. It is not just your safety at risk; if you fall, people around you might get injured.

In flight

Coping with a dizziness or imbalance may make you hesitant to fly – planning ahead to minimize discomfort is key.

• Schedule daytime flights if possible.
• Choose your seat wisely. Sometimes it helps to sit near a window and look outside during take-off and landing – when you can both see and feel the movement, your vestibular and visual systems will be more likely to agree with each other. However, if you are concerned about a vertigo attack, it may be better to book an aisle sea – you are away from any disorientation caused by looking out the window and are closer to the restrooms.
• Pack well ahead and get a good sleep the night before your flight.
• Dress in layers.
• Swallow or yawn to help your ears adjust to changing altitude as the plane takes off or lands. If this is not effective, clear your ears by pinching your nostrils shut, breathing in through your mouth and gently forcing the air into the back of your nose (as if you are trying to blow your nose).
• Consider wearing EarPlanes®, specially designed earplugs with a filter that slows the shift in air pressure during take-off and landing. They can be bought at most drugstores and airports.
• When possible, avoid flying when you have a cold or stuffy nose.
• Over-the-counter decongestants can help open up nasal passages – avoid if you have high blood pressure (hypertension).
• Eat lightly. If you’re following a special diet, for example low-sodium, book special meals with the airline well in advance. Or bring your own food.
• Take extra care to stay well hydrated. Air conditioning makes the humidity on a plane lower than in some of the world’s driest deserts.
• Use noise-cancelling headphones and sit well away from the engines if you’re bothered by noise and vibration.

Travel insurance

Travel insurance for trips outside Canada, as well as outside your province or territority, is recommended. Remember to declare your balance or dizziness disorder in advance as a pre-existing condition.

More resources

The following can offer more help and support for affected individuals and their families.

BalancePro
A Canadian manufacturer of balance-enhancing insoles designed to give people better sensation and appreciation of the distribution of weight on their feet.

SoundPrint
Like Yelp, but for noise. Use this iOS app to search for, rate and review restaurants, coffeeshops and other places based on their sound level.

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Sources

Conradsson D, Halvarsson A. The effects of dual-task balance training on gain in older women with osteoporosis: a randomized controlled trial. Gait & Posture, Vol 68, Feb 2019, pp 562-568. Available from: https://bit.ly/2R7RE8c