Difficult patient

GG1980

2 Posts
 
Posted - 04/30/2008 :  15:23:04  Show Profile  Reply with Quote
I have a patient that I think may have BPPV. The problem is she can not tolerate being put into supine or sidelying position for testing or for treatment. She experiences increase sx and severe anxiety. SOT positive on airdex. VOR positive for in phase and out of phase. Treated 4-5 patients in the past with BPPV and have 100% success rate. Stumped as far as what to do here as patient doesn't tolerate. Any suggestions would be appreciated.

JPT

2 Posts
 
Posted - 04/30/2008 :  17:39:05  Show Profile  Reply with Quote
Maybe you can try having two therapists treat the patient at the same time. One on each side. This may give the patient more sense of security and stability. Much encouragement will be required and it will be awhile before patient will trust you..

GG1980

2 Posts
 
Posted - 05/07/2008 :  17:48:38  Show Profile  Reply with Quote
Just saw my patient yesterday. At time of eval I had patient perform a modified Brandt-Daroff in sitting for HEP as she didn't tol sidelying or supine. This worked!! She reports decrease vertigo with sleeping and sit to stand transfers. She was even able to tol the Epley's technique today although I had to perform the maneuver slower than usual. Will keep everyone updated on my patient's progress. Thanks JPT for your suggestion.