If you deal with a physical ailment, there’s a veritable laundry list of physical therapists here in Missoula that are all more than capable of helping you ease your discomfort and getting you back to a semblance of normalcy. But sometimes what manifests on the outside is reflective of something internal; that kind of ailment often requires someone with special knowledge and skills to help you regain equilibrium.
When Amy Downing purchased Element Physical Therapy in 2011, there were not a lot of providers treating vestibular (or inner ear) disorders.
In some ways, Amy was almost forced into the decision to have her own practice.
Amy says, “when my kids were in high school, I went back to work more full-time at the University of Montana” as a physical therapist. “And my supervisor said, ‘Amy, there are so many people requesting to see you that we can't get our own patients in. So, it might be an opportunity for you to go out on your own.’ It’s kind of a nice way to get kicked out of a place.”
Additionally, and perhaps more germane, Amy has personal experience with vestibular disorders. Vestibular conditions can result in dizziness, vertigo, and other issues. One study found that roughly 35% of adults over 40 in the U.S. have dealt with some kind of vestibular condition.
“I have bilateral Meniere’s disease,” Amy says, “and was losing some of my hearing and had a lot of vertigo problems.”
“What really happened,” she says, “was that a physician looked at me and said, ‘you know, Amy, there’s nothing else I can do to help you.’ And I said to myself, ‘that’s not true.’ We can help these people.”
“I went to Emory University,” she continues, “and got certified in vestibular, and then I went to the University of Pittsburgh and got advanced certified. Then I came back and said, ‘this is what I’m doing.’ So I opened and hired someone who was fresh out of college but had a rotation through a vestibular clinic in Oregon.”
At first, it was just Amy and this one other therapist. Element has since grown to a staff of ten care providers, and they stay current via continuing education and the latest technology in the field to best serve their clients.
“I have specialized equipment here to diagnose and treat balance disorders, concussions, neurologic conditions, orthopedics, things like Parkinson's,” she says. “We were the first clinic in the United States [to have this piece of equipment]. Not only can we diagnose, but we can treat very efficiently. It's really been nice to see these people get better in a shorter amount of time.”
So much of Amy’s passion for care comes back to her firsthand experience as someone with a vestibular condition. Amy brings deep understanding and empathy to her work because she knows some of the challenges her clients are up against.
“I have a lot of compassion for my patients—and for my staff who treat patients—with dizziness and vertigo,” she explains. “It's something that's very difficult to explain to someone unless you've gone through it. And that's no fault to anyone, but it's just when you go through it, you have a special appreciation of how hard that day was or how hard that task was to complete.”
“And I do believe in listening, because I just find people so fascinating, you know, because everyone has their own story,” Amy says. “So, I really listen to my patients because they tell me so much about what's wrong with their body and what they've been through.”
As you can probably imagine, it’s not easy to communicate about disorders whose causes are often invisible and whose symptoms are sometimes ambiguous and variable.
“It’s made me a different therapist,” Amy says. “I’ve had Meniere’s for 30 years, and I didn't know what it was at the beginning. I've had horrible vertigo attacks and I've had days that are very difficult to walk. I look intoxicated when I haven’t been drinking. I’ve been able to move on from people’s judgment and say, ‘I have a true disability.’ But I can help people with my disability.
“And when I share that with patients, they tend to share their story and that gives them hope. Because there is hope: there’s hope to get better, and a lot of people do get better.”
Having a vestibular condition—and being a care specialist in this particular field—has blended work and life for Amy in ways that challenge the oft-discussed “work-life balance” paradigm. It’s not as much of a dichotomy for her as it is for many of us; it seems more symbiotic, the life informing the work and vice versa.
“I try my best to keep very current in our field, and so if there's something new that comes up, I'll test it on myself at home,” she says, “and then use it with my patients.”
“My sister had BPPV [benign paroxysmal positional vertigo] yesterday, the ‘crystals in the ear,’ and she called me and I walked her through it on the phone,” Amy says. “And this morning she texted saying she felt so much better, but she also apologized for not understanding the depth of what this dizziness causes. And I said, ‘you don't need to apologize to me.’ It's just that we do live in a different world, where we look normal, but we don't feel normal.”
The latter is particularly salient. Navigating the world as a woman, with this disability, has made extra clear what should be clear to many of us:
“I think women in general are so strong, a lot stronger than we show on the outside,” Amy says, “and for that reason, sometimes when women have vertigo or other issues, I get to see the other side, where we are strong and tough as nails, we try to do everything, yet we're suffering on the inside. I think women in general need to give themselves more credit for what we do, and also remember that we do also have down days just like everyone, and that's okay.”
"I think women in general need to give themselves more credit for what we do, and also remember that we do also have down days just like everyone, and that's okay.”