Alan Desmond

Alan Desmond, AuD, is the director of the Balance Disorders Program at Wake Forest Baptist Health Center, and holds an adjunct assistant professor faculty position at the Wake Forest School of Medicine. He has written several books and book chapters on balance disorders and vestibular function. He is the co-author of the Clinical Practice Guideline for Benign Paroxysmal Positional Vertigo (BPPV). In 2015, he was the recipient of the President's Award from the American Academy of Audiology.

What do you mean when you say Dizzy? – Part II

Role of the Case History Interview A thorough history is critical for three main reasons: 1. Many patients have difficulty articulating their symptoms beyond simply describing themselves as being “dizzy.” 2. Additional evaluation and treatment will differ depending on the suspected site of the lesion. Patients with BPPV may not require caloric testing to achieve diagnosis and successful treatment.

Feeling Dizzy – But What Does that Actually Mean?

“Good morning Mrs. Butterworth, Tell me what you brings you here today?” Mrs. Butterworth: “I’m dizzy.” What have I learned? Nothing. The term “dizziness” serves as a catch-all phrase for a wide range of sensations, making it an inadequate descriptor. It encompasses experiences such as vertigo, lightheadedness, faintness, disorientation, and gait instability. These diverse complaints can arise from various underlying

Pitfalls of Adding Vestibular Services – Part III

Fraud and abuse in vestibular function testing Last week we discussed some of the factors that have led to such dramatic and unsustainable reductions in reimbursement for vestibular function tests. These include professional turf battles, federal deficits and Medicare’s reaction to past fraud and abuse. This week we take a closer look at the fraud and abuse issue. For

Pitfall of Adding Vestibular Services – Part II

Last week we reviewed the structure of CPT codes, developed and valued by the American Medical Association, as a primer to discuss the reasons behind recent reductions in valuation and reimburseent for vestibular procedures. Let’s start with the new “bundled” code. The CPT code 92540 (Basic Vestibular Exam) was created to combine four of the CPT codes that make up

Pitfalls of Adding Vestibular Services -Part I

Last week I proposed that dispensing audiologists should consider adding vestibular services to their practice. I have to say, I thought it was a pretty convincing argument. And I still think that overall, there is great benefit to all involved, and I have been encouraging audiologists regarding this for years. The problem is, in the second to last paragraph of

An Open Letter to Dispensing Audiologists

Adding vestibular services to your practice provides benefits to all involved Most of you are familiar with the frequently quoted statistics regarding hearing loss and hearing aid use. This quote comes directly from the Better Hearing Institute website: “The last MarkeTrak survey (2004) estimated that 31.5 million people report a hearing difficulty; that is around 10% of the U.S. population.”

Tai Chi for Balance and Steadiness

We have another post this week from Dr. Phillip Griffin, Audiologist and Vestibular Specialist in the Greensboro/High Point, NC area. Perhaps you’ve heard of a new type of exercise that is popping up everywhere at local YMCA’s, senior centers, and retirement communities. It comes from a far away land and has an exotic sounding name. Its slow graceful movements make it

Guidelines for Being a Good Patient

Is it your job to be a good patient? I will make the assumption that when you are ill, you would prefer a good doctor, as opposed to the other kind. But, as a health care practitioner (HCP), let me tell you, “It takes two.” You can find the best doctor in the world, but if you are not a good patient, he/she

A Case of Brain Stem Stroke and Dizziness

We have a guest contributor this week. Dr. Phillip Griffin is an audiologist and vestibular specialist practicing in the High Point/ Greensboro, NC area. This entry will appeal to us vestibular geeks who sit around thinking about how the inner ear and brain work together. Lay readers will struggle with some of the terminology. A case of PICA…without eating all

Fall Risk Questionnaire and Physician’s Guide – Part V

Fall Prevention, Part V – Desmond Fall Risk Questionnaire: a fifteen-item self-assessment designed to identify common risk factors for falling, and a physician’s guide with suggestions for management. Fall Risk Questionnaire and Physician Guide Desmond Fall Risk Questionnaire Please answer all questions Name __________________________Date ________________ 1. ___Yes / No___ Have you had a fall or near fall in