Canalith
Canalith
Vertigo rarely injures anyone directly. What injures people is the edge of a bath, a stair tread, a coffee table, or a tiled floor arriving while the room is turning. The good news is that almost everything worth changing is cheap, reversible, and takes an afternoon — and most of it is about the two places episodes actually happen, which are the bed and the bathroom.
Decide now what you will do, because you will not be deciding anything once it starts. The pattern that keeps people upright is short enough to remember: stop, lower, hold, look.
Stop moving your head. The instinct is to whip round to see what is happening, or to sit bolt upright. Both usually make it worse and both are how people fall. Freeze the head where it is.
Get low. Sit down where you are, or lie down. The floor is not undignified; it is the one surface you cannot fall off. If you are already in bed, stay in bed.
Hold something fixed. A door frame, a worktop, the side of the bath, the wall. Two points of contact if you can manage it.
Look at something still. Fixing your gaze on a stationary object — a light switch, a picture, the corner of a door — gives the visual system something honest to work with while the inner ear disagrees with it. Some people find closing their eyes easier; both are fine, but choose one rather than scanning the room.
Then wait. Do not attempt stairs or carry anything until you have stood still for a while and are confident. Positional episodes are typically brief, but the shakiness afterwards lasts much longer than the spinning does, and that unsteady tail is when a lot of falls happen.
If your episodes are set off by rolling over, lying down or sitting up, then the bedroom is where most of them will happen, usually in the dark, usually when you are half asleep. Three things help more than anything else.
Light the route. A plug-in night light or a motion-sensing lamp at floor level, on the path from your side of the bed to the bathroom, removes the worst combination there is: no visual reference, an unsteady head, and a hard floor. Dim warm light is enough — you need orientation, not brightness.
Clear the path. Whatever is between the bed and the bathroom door goes: charging cables, laundry baskets, the bedside chair that collects clothes, the corner of a rug. Walk it barefoot in the dark once and be honest about what you had to step over.
Bring things to the bed. A water glass, a phone, tissues, a bowl if nausea is part of your picture, and anything you take at night, within reach without leaning out. Every trip you avoid at 3am is a risk removed.
One more that costs nothing: get up in stages. Sit on the edge of the bed for half a minute before standing. Take the same care at the hairdresser and the dentist, where someone else will tip your head back for you — say so before you sit down.
The bathroom is the highest-risk room in the house for anyone with vertigo, and it is not close. Hard edges everywhere, wet slippery floors, small spaces with nothing safe to grab, and the two movements that provoke a great many episodes: tipping the head back to rinse hair, and bending down.
Looking up at a high shelf and bending to a bottom drawer are the two everyday movements that most often catch people out. Move the things you use daily into the band between waist and shoulder height, and leave rarely-used items up high and down low. Kitchen cupboards, wardrobes, the bathroom cabinet: an hour of rearranging removes dozens of provoking movements a week.
While episodes are active, stop using step stools and ladders altogether. If you must retrieve something low, squat with a hand on something solid rather than bending at the waist with your head down.
Loose rugs go, or get grippers or anti-slip tape underneath. Trailing cables get taped down or rerouted. The low coffee table with the sharp corner is worth moving out of the main walking line.
On the stairs you want a rail you can reach without leaning, on at least one side. Mark the top and bottom step if the carpet is a single flat colour — the transitions are where footing is misjudged. If an episode starts on the stairs, sit down on a step immediately; do not try to finish the flight.
Raise the general light level in the rooms you use in the evening: balance leans heavily on vision when the inner ear is unreliable, and dim rooms take that support away at the worst time. Consider your feet too — thin-soled shoes give better positional feedback than thick soft soles, and much better than socks on wood.
Keep a phone in a pocket rather than on a table in another room — that is the whole plan for most people. If you live alone, agree a simple check-in with a friend or neighbour, and make sure someone can get in.
In the kitchen, sit to chop and prepare, and use the back rings of the hob so you are not reaching over heat. Do not carry a pan of boiling water across the room while episodes are frequent — drain in the sink. Carry one thing at a time so a hand is always free.
Once the spinning has stopped, note where you were, what you had just done with your head, which direction you had turned, and whether anything in the room made it worse — the dark landing, the wet tiles, the low cupboard. A month of those notes turns vague caution into a specific list of three or four changes that would actually have helped.
That is also exactly the information a clinician wants. Our guide to recording an episode accurately when the room is spinning covers capturing it one-handed, keeping a diary your doctor can use covers what to keep across weeks, and why the room spins when you roll over in bed explains the mechanism.
Canalith exists for that moment of capture: severity is one drag on a dial, symptoms are a few taps, the time and the barometric pressure are recorded for you, and it will follow along with the exercise your clinician prescribed and taught you. It keeps a diary and prints a one-page report. It does not diagnose or treat anything. It is not on the App Store yet — join the waitlist and we will tell you when it is.
This guide is about home safety and record-keeping. It is not medical advice and it is not a substitute for an examination. Nothing here tells you how to perform a repositioning manoeuvre; only a clinician who has examined you should prescribe and teach one. See a clinician about new or recurring vertigo, and treat it as urgent — emergency care, the same day — if vertigo comes on suddenly together with any of: double vision, weakness or numbness on one side, trouble speaking or swallowing, a severe or unusual headache, difficulty walking or standing, new hearing loss in one ear, chest pain or fainting. Also seek prompt advice if you have fallen and hit your head.