How to wrap a cat for Christmas. How to make an origami boomerang. How to zombie-proof your car.
YouTube, the popular video-sharing website, offers us all sorts of important tips, tricks and tidbits. Now, a new study suggests that it may be a trustworthy source if your query happens to be "How to treat your vertigo."
Researchers at the University of Michigan studied how YouTube users searched for solutions to a condition known as benign paroxysmal positional vertigo (BPPV). It is a condition that affects more than 6 million people in the United States every year and is responsible for up to 40 percent of doctor visits related to dizziness.
Authors searched the YouTube website and found more than 3,000 videos related to dizziness, accounting for 3 million hits. Thirty-three of those videos demonstrated "How to do the Epley Maneuver" -- a repositioning procedure used to treat dizziness caused by BPPV.
Sixty-four percent of videos accurately depicted the maneuver. The video with the most hits was produced by the American Academy of Neurology, a leading professional organization for neurologists.
The disabling sensations of spinning or vertigo associated with BPPV can be blamed on calcium crystals that develop in the inner ear, an area that contains the organs we rely on for our sense of balance and equilibrium. Sometimes these crystals can get stuck in the wrong position within these organs, leading to the dizziness, nausea, balance problems and hearing loss that vertigo sufferers associate with their condition.
The good news is that 90 percent of the time, BPPV can be cured within minutes using the Epley maneuver -- a technique available since the 1980s that is used to dislodge the calcium particles.
It is a technique that Dr. Kevin Kerber, a neuro-otologist at the University of Michigan and lead author of the study, says is often effective but which "hasn't been disseminated properly and is not being implemented."
That, he says, is why the videos on YouTube captured his interest.
"YouTube seemed like such an amazing tool to disseminate information" he says, adding that videos contain the added bonus of viewer commentary that provides additional information about how videos might be helping, or hindering treatment.
"Patients have reported they are cured of their symptoms, which is very impressive," Kerber says. "To be able to go to the computer and do treatments, well, that would be awesome.
"No frustrating calls for appointments, no expensive referrals to a specialist -- it's kind of the perfect intervention. ..."
Moreover, Kerber says, the videos may obviate the need for the sedating medication Antivert in many cases. As he notes, "you don't want a sedated dizzy person walking around out there when they can be cured."
The comments on the YouTube videos demonstrating the technique suggest that presenting this maneuver in this way is helpful to many.
"I've had vertigo on and off for three or more years," one such comment, posted by YouTube user jsdmonty, reads. "My doctor suggested I go to see a specialist, so I tried You Tube instead! Tried this exercise ... and total bliss, no spinning or vertigo at all ...Thanks YouTube, that's what the internet should be all about."
Vertigo specialists agree that the YouTube approach can help. "For people who already know what their problem is, these videos can be useful tools," says Dr. Erika Woodson of Cleveland Clinic's Head and Neck Institute.
There could also be cost savings associated with this approach. "The cost of a single episode of BPPV in the emergency room has been estimated at $2,700," says Dr. Dennis C. Fitzgerald, director of otology and neuro-otology at MedStar Washington Hospital Center. "If only 25 percent of BPPV victims go to the ER for their first BPPV episode, the cost can approach over $16 billion."
Still, doctors warn, the videos can only go so far -- and in many cases, they are no substitute for seeing a doctor in person.
"People looking for information on the Internet are not experts and do not have a way to know which are valid videos and which are not," says Dr. Helen S. Cohen, professor of otolaryngology at Baylor College of Medicine in Texas. "To treat any health condition properly, and in a cost-effective manner, the condition must be diagnosed correctly. ... [BPPV] can mask or be caused by other problems that affect the inner ear."
"The vertigo seen in BPPV can also be a symptom of stroke," warns Dr. Constantine Farmakidis, a neurologist with Montefiore Medical Center in New York. He says that in these cases, people should see their doctor immediately.
All the more reason that the "when to" may be as important as the "how to" when it comes to YouTube.
"YouTube is a wonderful resource," says Dr. Gregory T. Whitman of Massachusetts Eye and Ear Infirmary. "I have used it to learn things such as 'How to make crepes,' and I have used [it] as a teaching tool, but it is unlikely to replace the benefits of seeing a provider with expertise in diagnosis and treatment of BPPV."
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