Scheduling Letter for Vestibular Evaluation

The next two posts are part 1 and part 2 (front and back page) of a letter we send out to every patient scheduled for a vestibular evaluation. Included with this letter are some questionnaires, an appointment card, and directions to the clinic. We find that providing this information ahead of time puts patients at ease as they know what to expect in terms of what will be done and how long it will take. Invariably, some patients misread and stop medications they shouldn’t, or diabetics show up not having eaten in too long, but for the most part having a letter like this helps keep the ship sailing smoothly.

Here’s the front page:

 Blue Ridge Hearing and Balance Clinic

The Balance Disorders Clinic is the result of a joint effort between Alan Desmond, Au.D., Dr. Brian Collie, Dr. Robert Jones, and Dr. Lee Smith. Our goal is to provide comprehensive evaluation and treatment for a variety of balance disorders, including vertigo, disequilibrium, imbalance, and unsteadiness. These symptoms can have many different causes and treatment varies depending on the source of the problem. While it is estimated that the majority of people complaining of vertigo (spinning sensation) have inner ear disorders, other types of balance problems may be the result of medication or related medical conditions, visual deficits, poor sense of touch, decreased sensation or strength in the legs, reduced reaction time or a combination of some of the above. To provide the most comprehensive approach to diagnosing and treating balance complaints, we have established a team of specialists. The evaluation process involves no pain or risk, but does typically require more than one visit to the center.

The first step in receiving help is to consult your family physician. Frequently they can determine the cause of your balance problems and provide treatment. Your family doctor can help you determine whether you might be a candidate for the Balance Disorders Clinic. Additionally, they will provide us with important information about your medical background and a list of your current medications.

Typically, your initial appointment will include an extensive review of your past medical history, an analysis of all your current medications, and exams to “classify” your type of dizziness. Balance and vestibular tests take time and require specialized equipment. The initial appointment typically takes 2 to 3 hours to complete. There may be a few minutes of waiting between each exam. Based on these results, we will determine what additional exams are likely to provide helpful information, and schedule you to return to do additional testing.

Preparing For Your Appointment

It is important that you keep your scheduled appointment. We block almost 3 hours of our schedule for this. If you must change your appointment, please do so at least 24 hours prior. Failure to keep or cancel your appointment in a timely manner may result in the inability to reschedule your appointment.

Prior to your initial appointment, you should have received a questionnaire and registration form. Please fill these out before arriving for your appointment. If you are not ready to be seen, your appointment may need to be rescheduled. Bring a list of your current medications and any medical records pertaining to your balance or dizziness (particularly reports of any previous exams such as CT or MRI scans). Certain medications can affect the sensitivity of these exams, so it is helpful to cease, if possible, the use of any medications used for dizziness, anxiety, depression, sleep, or nerves. It is NOT necessary to cease medications used for treating diabetes, blood pressure, and heart or lung disease. Please discuss this with the physician referring you for this exam. It is helpful if you come to this evaluation with a mostly empty stomach. Diabetics should eat a light meal. Refrain from wearing excessive makeup, especially eye liner and mascara.

Your second appointment will typically involve a series of tests to determine the cause of your dizziness or balance complaints. A description of these tests follows. If your test results indicate that your complaints may be the result of a possible abnormality treated by a different specialist (most frequently neurology or cardiology), we will make that recommendation to the referring doctor.

At the completion of your evaluation, we will go over all of your test results, and discuss treatment options. Some balance problems can be treated quickly in one or two office visits; however, some require ongoing therapy that typically lasts for several weeks.



About Alan Desmond

Dr. Alan Desmond 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. In 2015, he received the Presidents Award from the American Academy of Audiology.

1 Comment

  1. Alan,
    Very nice and informative blog topic. In our center we do the same sort of thing with an informational piece, map, and expectations. I like your letter very much. You are quite correct of the many times patients stop taking the diabetic meds prior to the VNG.
    I look forwrad to the part 2.
    Good job Alan!

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