This physical therapist has a dizzying job

Kathy Joy, a physical therapist, has specialized in helping off-balance and dizzy patients for the past 16 years. She works at a dizziness clinic that opened last July at Massachusetts Eye and Ear’s new Longwood outpost. I chatted with her on a recent afternoon in her one-room gym, stocked with beds, a high-tech balance station, and a pair of thick goggles.

What brings people to see you?

Some have had a concussion, or whiplash, she said. Some are elderly, with numbness in their feet. Others get dizzy while watching a tennis match. A lot of people come in with BPPV (benign paroxysmal positional vertigo). That happens when calcium carbonate crystals in the inner ear fall out of place. People feel fine when they’re upright, but if they look up to the top shelf, or lie down, they get the spins. You can actually lie them down and roll them so that the crystals fall back into alignment. After a couple of days, they feel better. “It’s fun because it’s such a significant relief,” she said.

What are those goggles for?

“The eyes are the window to the inner ear,” she said. For instance, involuntary eye twitching, called nystagmus, can be a sign of BPPV. When that happens, patients can sometimes focus their eyes to make the twitching stop, covering up the symptom. Frenzel goggles “magnify the world” so the patient can’t focus clearly. That allows Joy to look into the goggles and get “a true picture of what’s going on.”

What’s the hardest part of your job?

“Getting the patient to buy into doing the things that make them dizzy” — which is often the way dizziness is treated. When I met with her, Joy had just seen a patient with BPPV. She tried to convince the patient to lie down so she could treat the problem. “I told her the treatment only took three minutes,” Joy said. But the patient just couldn’t bear to enter vertigo, so she left without treatment.

Have you ever felt really dizzy?

Yes, in 1989. Joy was working as a general physical therapist. While she was helping to put a brace on a stroke patient, “the whole world tipped,” she said. “I hit the floor hard.” It turned out she had an inner ear infection, which messed up her balance. “It was extremely disorienting.” That was before the field of vestibular therapy, using physical therapy to address inner ear problems, became widespread. “I hadn’t even heard of treatment for dizziness,” she said. Luckily, she went home to rest and, after about three weeks, her ear infection got better on its own.

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