“I have used your half summersault maneuver with success in the past. I know how to do it and it works well. I am worried about upcoming retina surgery. Do you have any advice for the time I might not be able to move my head in the half summersault maneuver? The doctor has said that I will be flat on my back (no pillow) for the procedure. I am worried about that position as well.”
There are two issues with retina surgery for people with BPPV. First, the surgery requires you to lie flat on your back so the eye can be easily accessed, and there is a risk of causing BPPV in this position. Second, the use of a gas bubble in the eye requires you to keep face-down or on one side for several days after the surgery, so you will not be able to use exercises for BPPV during that interval. Let’s go over what you can do to reduce your risk of BPPV under these constraints.
A few days before the surgery, clear out any particles that may already be in your semicircular canals by doing the half somersault a few times in a row for the problem ear. If you have no dizziness doing this, your ear is likely clear. Sleep propped up on two pillows with the bad ear up until the day of surgery to prevent a recurrence.
When you are taken to the operating room, turn your head toward your good ear before lying down, and lower yourself very slowly. Wait at least a minute before very, very slowly turning your head to the center. Ask your surgeon if you can safely turn your head toward your good ear when arising after the surgery.
If you are allowed to turn your head toward the good ear, do this when attempting to arise. If not, lift yourself very slowly. You can have the OR staff assist in lifting you. Moving quickly or with a jerk can move crystals, so you want to move so slowly that they will stay in place. Once you are seated, stay in the position your doctor has recommended for a minute to allow the crystals to settle before any further attempts to arise from the bed.
After retina surgery you may be required to remain face-down or on one side until healing takes place. The face-down position reduces the risk of BPPV. Again, always move slowly when changing your head position. If you do happen to develop BPPV, you can reduce the severity of the attack by keeping your head in one position for several minutes to allow the particles to settle. When you move your head, move very slowly, especially when tipping up or down. Avoid tipping your head up or lying flat on your back. Once your surgeon clears you to move your head again, you can do the half somersault to remove any particles that have accumulated.