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 your 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 and avoid browsing.
• Take someone with you who can take over shopping if you become too dizzy.
• Go at off-peak times – avoid weekends if possible or between 5-7 pm when many people leave work.
• 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 glasses with FL-41 optical tinted lenses and/or a peaked hat if fluorescent lights trigger symptoms.
• Wear earplugs or headphones if you are bothered by noise.

Eating out

• Avoid peak times. If meeting a friend for coffee, for example, avoid the morning or afternoon coffee-break rush hour.
• When possible, check out coffee shops or restaurants beforehand and choose one that feels most calming for your symptoms.
• Look or places with no music or soft background music. Ask to be seated away from speakers.
• Sit in a booth, if available, or in a seat facing towards a blank wall or a corner.
• 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.
• 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.

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.

At the dentist

• When possible, ask to be scheduled at your best time of day.
• Work with your dental team to get as comfortable as possible.
• If you get dizzy when leaning back in the dental chair, ask your hygienist or dentist to use a pillow or neck support to keep your head in a fairly upright position while your teeth are being cleaned or treated.
• If you are bothered by bright lights, ask for a pair of dark safety glasses.
• Take care getting up after treatment; if you tend to get dizzy, you may be more likely to fall after standing up.
• In case you do get dizzy, arrange for a ride home in advance; do not try to drive yourself.

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

Read more about motion sickness

• Eat frequent light, bland meals and snacks that are low in fat and acid, such as bananas, crackers, applesauce or toast.
• Try using a transdermal scopolamine patch (Transderm-V) to prevent motion sickness on long car rides, long-haul flights or cruises. A patch lasts for 3 days and can be used safely for up to 6 consecutive days (2 patches). Remove the patch immediately after completing your journey. Alternatively, premeditate with dimenhydrinate (Gravol) or another medication recommended by your doctor.
• Some people find taking ginger helps with nausea.
• Do not drink alcohol.
• Drink enough water to stay hydrated.
• If you have gastritis or stomach problems, get treatment for them if you can.
• Try to be well rested before you start your trip.
• Try to sleep.
• Stay dry.
• Make sure the space you are in is well ventilated and does not smell bad.
• Try not to think or talk about motion sickness.
• Distract yourself with music, breathing exercises or other relaxation techniques.
• If it is not possible to move around, brace your body and head to avoid extra movement. If you can, lie as flat as possible and close your eyes. Do not read.
• Focus on a distant point on the horizon and keep a wide view. If you cannot see the horizon, close your eyes or wear sunglasses.
• Consult with your doctor or pharmacist about medication options to counter motion sickness.
• Carry a disposable “barf bag.”

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 and imitate the driver's movements.
• 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 be 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 seat – you are away from any disorientation caused by looking out the window and are closer to the restrooms. Some people find the middle of the plane is best.
• Pack well ahead and try to 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 taking them if you have high blood pressure (hypertension).
• Eat lightly. If you are 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 are bothered by noise and vibration.

On a boat

• On a cruise ship, choose a cabin or seat where you are least likely to feel motion – some people find mid-ship close to water level is best.
• Open a window or go out on deck when possible. If possible, walk around.
• Stand with your legs bent and move with the action of the boat; do not try to stand too stiffly.
• When possible, sit or stand where you can fix your gaze on a stationary object on the horizon.

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.

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