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-   -   Epley Maneuver - Vertigo (https://www.talkofthevillages.com/forums/medical-health-discussion-94/epley-maneuver-vertigo-344017/)

ton80 09-11-2023 02:36 PM

My Independent Non Expert Viewpoint on Audiologists and Treating Balance Issues
 
To Golfing Eagles and CyberSpring, I offer a hopefully useful summary on audiologists and Balance Issues.

Based on a Google search of various topics, my observation (Non Doctor) follows:

1. Golfing Eagles Post #3 regarding the sequence of diagnosis steps basically matches what Mayo and others recommend.

2. Audiologists are not medical physicians and therefore do not provide medical-based treatment such as surgery or medication. They can help with doing the tests prescribed by a physician.

3. Audiologists and other rehabilitation professionals can help improve your balance and reduce dizziness and bothersome symptoms. Vestibular rehabilitation may include exercises with specific movements of the head, eyes, and/or body. Certain types of dizziness may be treated with repositioning procedures. (Epley maneuver?)

In summary, Audiologists have a role but are not the primary place to start. They can help with the testing and non medical treatment.

golfing eagles 09-11-2023 02:39 PM

Quote:

Originally Posted by Cybersprings (Post 2255563)
I didn't post this as refutation to your point about how many can do it, because it is from Audiology associations and organizations. This is to respond to your point that they wouldn't want to. It looks like, from the top resonses on google, that many will welcome you. several sites state that they may/will refer you to a specialist if they are unable to diagnose or see something beyond their capability (paraphrased).

Again, let's look at the big picture. You are more right than me on this obviously with your very clear steps outlined in one of your posts. I stated earlier a way that you could push the person to the correct medical professional without incorrect statements or denigrating.

You keep trying to keep people healthy and I will continue to push back when you make blanket statements that are unnecessary. People will stay healthy (because of you) and maybe every now and then you will think about what you post and the weight it carries. Win win



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I had already checked out those sites as well. The profession is probably evolving, but my gestalt is still that very few community practicing audiologists would want to take this on.

Now here's an interesting idea: There are other physicians on this site, so I ask them to answer the following if they would.
1) How many times have you referred a vertiginous patient to an audiologist?
2) How many time would you recommend a patient with hip pain see a chiropractor first?

I think the answers will be telling

Cybersprings 09-11-2023 02:42 PM

Quote:

Originally Posted by ton80 (Post 2255565)
To Golfing Eagles and CyberSpring, I offer a hopefully useful summary on audiologists and Balance Issues.

Based on a Google search of various topics, my observation (Non Doctor) follows:

1. Golfing Eagles Post #3 regarding the sequence of diagnosis steps basically matches what Mayo and others recommend.

2. Audiologists are not medical physicians and therefore do not provide medical-based treatment such as surgery or medication. They can help with doing the tests prescribed by a physician.

3. Audiologists and other rehabilitation professionals can help improve your balance and reduce dizziness and bothersome symptoms. Vestibular rehabilitation may include exercises with specific movements of the head, eyes, and/or body. Certain types of dizziness may be treated with repositioning procedures. (Epley maneuver?)

In summary, Audiologists have a role but are not the primary place to start. They can help with the testing and non medical treatment.

ton80, thanks for the post. I did have to chuckle, because I think as you were writing your post backing up Golfing Eagles with Mayo Clinic reference, Golfing Eagles was typing his post saying Mayo is a little out there.

And at the same time, I was writing my post trying to do what you were trying (I think). Your post was much better, but you didn't have any mea culpas to do like I did.:laugh:

I hope Golfing Eagles (and others) can take from my post that I know he is right in his main point. I have been arguing form over function.

Cybersprings 09-11-2023 02:45 PM

Quote:

Originally Posted by golfing eagles (Post 2255568)
I had already checked out those sites as well. The profession is probably evolving, but my gestalt is still that very few community practicing audiologists would want to take this on.

Now here's an interesting idea: There are other physicians on this site, so I ask them to answer the following if they would.
1) How many times have you referred a vertiginous patient to an audiologist?
2) How many time would you recommend a patient with hip pain see a chiropractor first?

I think the answers will be telling

I think you missed my point in the middle just before the list of sites.
The response to your survey could hammer in the point, but I really have already conceded it.

golfing eagles 09-11-2023 02:55 PM

Quote:

Originally Posted by Cybersprings (Post 2255570)
I think youh missed my point in the middle just before the list of sites.
The response to your survey could hammer in the point, but I really have already conceded it.

My bad. I’m still recovering from COVID and not 100%

Cybersprings 09-11-2023 02:57 PM

Quote:

Originally Posted by golfing eagles (Post 2255572)
My bad. I’m still recovering from COVID and not 100%

I am sorry to hear that. I hope you feel better soon.
By the way, my chiropractor has a great adjustment to prevent COVID. Let me know if you need his name or a referral.

golfing eagles 09-11-2023 03:01 PM

Quote:

Originally Posted by Cybersprings (Post 2255573)
I am sorry to hear that. I hope you feel better soon.
By the way, my chiropractor has a great adjustment to prevent COVID. Let me know if you need his name or a referral.

Thanks, but I have a voodoo witch doctor on speed dial 😂😂😂

blueash 09-11-2023 03:33 PM

Ok, I'll bite. Dr google can give you a very good idea of the symptoms of benign paroxysmal positional vertigo. Why even the Mayo Clinic gives you pretty much all you need to determine if your dizziness fits that diagnosis
https://www.mayoclinic.org/diseases-...s/syc-20370055
Many other sites will also walk you through the presentation of BPPV.

If your story fits that diagnosis, yes self diagnosis. And you don't have any of the other worrisome accompanying symptoms... I have no problem with you going to you tube and seeing how to do at home Epleys for a few days to see if you get relief.

Every patient does not need an MRI for every symptom. If all you have is BPPV and a couple days of home therapy works... go on with your life without seeing a doctor or having an MRI.

Now, having said that, in our age group a percentage of persons will have unexpected findings on the MRI, up to and including brain tumors.

golfing eagles 09-11-2023 03:47 PM

Quote:

Originally Posted by blueash (Post 2255584)
Ok, I'll bite. Dr google can give you a very good idea of the symptoms of benign paroxysmal positional vertigo. Why even the Mayo Clinic gives you pretty much all you need to determine if your dizziness fits that diagnosis
https://www.mayoclinic.org/diseases-...s/syc-20370055
Many other sites will also walk you through the presentation of BPPV.

If your story fits that diagnosis, yes self diagnosis. And you don't have any of the other worrisome accompanying symptoms... I have no problem with you going to you tube and seeing how to do at home Epleys for a few days to see if you get relief.

Every patient does not need an MRI for every symptom. If all you have is BPPV and a couple days of home therapy works... go on with your life without seeing a doctor or having an MRI.

Now, having said that, in our age group a percentage of persons will have unexpected findings on the MRI, up to and including brain tumors.

Good answer!

rogerk 09-11-2023 05:06 PM

It can work if done correctly AND depending on the cause of the vertigo. There is a great Doctor in Celebration Florida. The practice is: Vertigo and Balance Treatment, Florida Ear and Balance - (321) 939-3000

They virtually eliminated my vertigo. It is not the most fun treatment but it utilizes the Eply Chair to correctly identify and treat most causes of Vertigo. It works and is not fake science.

This is the only location in the Southeast that has an Eply chair. Call them and draw your own conclusions.

mtdjed 09-11-2023 07:16 PM

Unbelievable how two people hijack a forum. Your first posts said everything you needed to say. The rest is purely self-serving.

mtdjed 09-11-2023 09:38 PM

Quote:

Originally Posted by golfing eagles (Post 2255572)
My bad. I’m still recovering from COVID and not 100%

Quote:

Originally Posted by mtdjed (Post 2255653)
Unbelievable how two people hijack a forum. Your first posts said everything you needed to say. The rest is purely self-serving.

Golfing Eagles. Sorry for your COVID. I just had my first Covid after a European River Cruise. Fortunately, I did not get it on the cruise and secondly fortunate that I tested for it early, got Paxlovid and had no major symptoms.

Obviously, you know a lot about Vertigo. One of my questions is whether you ever had severe Vertigo?

margaretmattson 09-12-2023 04:32 AM

Quote:

Originally Posted by golfing eagles (Post 2255523)
No offense, and I'm really not looking for a p!$$!ng match, but please point out a statement that is "categorically wrong". Some may be exaggerations to make a point, but overall they are accurate. You cannot hunt for rare exceptions and hold that up as a standard. I think I have been pretty consistent---I acknowledged referring patients to chiropractors and other ancillary services when appropriate, but pretty harshly warn against getting evaluated by those fringe practitioners first. Sorry if I ruffle some feathers, but the public sometimes just doesn't "get it". There are a lot of quacks and snake oil salesmen out there, and if I can do some small part to protect the innocent, I'm going to take it.

As far as "having a degree and being retired" goes, I think my career is a bit more than that. For all anyone knows, when they play Dr. Google they may be quoting me from the content that I myself have written. When they need inpatient medical care, they may be receiving treatment under protocols that I have written. So, consider it arrogant if you will, but I feel obligated to utilize my extensive knowledge to benefit others, within certain constraints of law and ethics. And yes, sometimes I get overzealous.

I thank you for taking the time to educate people on this forum. I do not place emotions into your words and find each of your posts thorough. Why people want to argue with an expert is beyond me. Everyone is entitled to get a second opinion. That second opinion should NOT be a layperson who googles something and decides. "Hey, I am now an expert!" How many times have we been told DO NOT TRUST THE INTERNET? If you doubt what GE says, get a second opinion from a MEDICAL DOCTOR.

BTW: I find you bedside manner fine. I would rather have a doctor who is engaged in each of his patients and will be harsh when necessary. Who wants a doctor that holds your hand and tells you only what you want to hear? And says, Oh! You googled I was wrong? My bad! Thanks for updating me. Good luck recovering with a doctor like that!

Please THINK before you go against an expert. Any layperson can find the answer they WANT on the internet. It doesn't mean it is the correct one.

golfing eagles 09-12-2023 06:42 AM

Quote:

Originally Posted by mtdjed (Post 2255675)
Golfing Eagles. Sorry for your COVID. I just had my first Covid after a European River Cruise. Fortunately, I did not get it on the cruise and secondly fortunate that I tested for it early, got Paxlovid and had no major symptoms.

Obviously, you know a lot about Vertigo. One of my questions is whether you ever had severe Vertigo?

Thanks, finally improving, today is day #9, but I didn't start Paxlovid (for what it's worth) until day 4. The absolute worst was such a severe sore throat that I could only swallow with intense pain. Now just down to fatigue. Still very hard to assess the efficacy of Paxlovid, the success rate is all over the board. I have to admit it was a bit disconcerting when my pulse ox dropped to 84%, but I question the accuracy of that reading since I didn't have any dyspnea. Hope you are getting over it as well.

No, I never had vertigo. Unfortunately, it is difficult to treat when it has an element of chronicity. You can try Epley maneuvers and pump the patient full of meclizine, but it usually recurs. More often I have seen the acute form----acute viral labyrinthitis. Almost anyone can diagnose it---you literally are fine one second and falling to the floor the next. It's more severe than the chronic variety, but also self limited. Best not to get either in the first place.

golfing eagles 09-12-2023 07:01 AM

Quote:

Originally Posted by margaretmattson (Post 2255680)
I thank you for taking the time to educate people on this forum. I do not place emotions into your words and find each of your posts thorough. Why people want to argue with an expert is beyond me. Everyone is entitled to get a second opinion. That second opinion should NOT be a layperson who googles something and decides. "Hey, I am now an expert!" How many times have we been told DO NOT TRUST THE INTERNET? If you doubt what GE says, get a second opinion from a MEDICAL DOCTOR.

BTW: I find you bedside manner fine. I would rather have a doctor who is engaged in each of his patients and will be harsh when necessary. Who wants a doctor that holds your hand and tells you only what you want to hear? And says, Oh! You googled I was wrong? My bad! Thanks for updating me. Good luck recovering with a doctor like that!

Please THINK before you go against an expert. Any layperson can find the answer they WANT on the internet. It doesn't mean it is the correct one.

Thanks, but I'm no saint. I often post responses in an insulting manner, usually intentional for shock value, but also occasionally in anger in response to those who are determined to prove they are idiots.

There is an allure and false air of authority to the internet. It seduces otherwise rational individuals into believing that their 5 minute google search makes them an expert. They fail to realize that much of the content is unverified, and that which is from a legitimate site is often "dumbed down" to the point of losing its true meaning as to make it more understandable to the average person. It is not written for professionals.

Medicine frequently does not follow the rules of common sense and logic, some things are opposite from what one might expect. It is almost impossible to understand medicine without knowing some underlying principles. Then, there is always the difference between what the academicians think and write and what actually is done in the real world.

Most here on this site mean well, but I agree there are some that want to argue with an expert. Arguing an opinion is one thing, fine. Arguing medical facts, well, that generally turns out embarrassing, even if that person doesn't realize it. But like I said, I'm no saint and I'm happy to call them out.

deborahcme 09-12-2023 07:25 AM

I had a vertigo attack about two years ago. I would not have described it as dizziness. It was full on not being able to walk with safety as the room felt like it was spinning around me. Even when lying down, I felt like the bed was tilting crazily and would soon dump me on the floor! Husband took me to ER who referred me to Ear Nose and Throat doctor. After doing a few diagnostic tests, they determined that I did have vertigo and not some other neurological condition. They performed the Epley procedure and taught me how to do it myself in case vertigo returned. It has not. That said, if it does, I'd still err on the side of caution and seek additional testing.

neilbcox 09-12-2023 07:42 AM

Audiologist needed
 
Quote:

Originally Posted by hawk1021 (Post 2255116)
My Husband suffers from dizziness constantly someone said something about the Epley Maneuver. Has anyone done this before ? Did it work ? and if so can you recommend a doctor down here in the villages area.

Have a doctor of audiology check it out. The Villages Healthcare has several.

Cybersprings 09-12-2023 08:01 AM

Quote:

Originally Posted by neilbcox (Post 2255751)
Have a doctor of audiology check it out. The Villages Healthcare has several.

I am not sure if this was meant to be funny or not.
If it was humor, it is very funny.
If it is not an attempt at humor, I am going to guess that you posted after reading the initial post without reading the the whole thread (the one I hijacked).
If that is the case, I would go back and read the whole thread for some great entertainment, and see why I say it was very funny (truly not intended as an insult).

For Golfing Eagles....round 2???

Cybersprings 09-12-2023 08:06 AM

Quote:

Originally Posted by margaretmattson (Post 2255680)
I thank you for taking the time to educate people on this forum. I do not place emotions into your words and find each of your posts thorough. Why people want to argue with an expert is beyond me. Everyone is entitled to get a second opinion. That second opinion should NOT be a layperson who googles something and decides. "Hey, I am now an expert!" How many times have we been told DO NOT TRUST THE INTERNET? If you doubt what GE says, get a second opinion from a MEDICAL DOCTOR.

BTW: I find you bedside manner fine. I would rather have a doctor who is engaged in each of his patients and will be harsh when necessary. Who wants a doctor that holds your hand and tells you only what you want to hear? And says, Oh! You googled I was wrong? My bad! Thanks for updating me. Good luck recovering with a doctor like that!

Please THINK before you go against an expert. Any layperson can find the answer they WANT on the internet. It doesn't mean it is the correct one.

I never once argued with his point regarding what the person should do.
I never thought nor in any way claimed that I was an expert.
Since I hijacked the thread, you have lots of content to use. Please point out a single statement I made that was not 100 % correct.
I will wait....

golfing eagles 09-12-2023 08:21 AM

Quote:

Originally Posted by Cybersprings (Post 2255761)
I am not sure if this was meant to be funny or not.
If it was humor, it is very funny.
If it is not an attempt at humor, I am going to guess that you posted after reading the initial post without reading the the whole thread (the one I hijacked).
If that is the case, I would go back and read the whole thread for some great entertainment, and see why I say it was very funny (truly not intended as an insult).

For Golfing Eagles....round 2???

If you insist, but why do you want to dig yourself an even deeper hole?

Cybersprings 09-12-2023 08:30 AM

Quote:

Originally Posted by golfing eagles (Post 2255777)
If you insist, but why do you want to dig yourself an even deeper hole?

///

golfing eagles 09-12-2023 08:43 AM

Quote:

Originally Posted by Cybersprings (Post 2255780)
I was trying to be humorous and get along.
I am sorry that got missed in translation.
As far as digging an even deeper hole, same request for you as MM: you have a lot of content in this thread to use, please point to any statement(s) I made that were not 100% accurate.
I will wait....

So was I :1rotfl::1rotfl::1rotfl:

margaretmattson 09-12-2023 08:57 AM

Quote:

Originally Posted by Cybersprings (Post 2255764)
I never once argued with his point regarding what the person should do.
I never thought nor in any way claimed that I was an expert.
Since I hijacked the thread, you have lots of content to use. Please point out a single statement I made that was not 100 % correct.
I will wait....

I read the entire thread. There were several people who argued with GE. My post is a general statement that is not directed to anyone specific. My ideology is this: Dont trust what you read on the internet when your life is in danger. I can see hundreds of ways that can go wrong. Go to a medical doctor and get a MEDICAL diagnosis.

Cybersprings 09-12-2023 09:14 AM

Quote:

Originally Posted by golfing eagles (Post 2255783)
So was I :1rotfl::1rotfl::1rotfl:

In that case, my apologies. I will delete my previous post.
I hope you are feeling better Doc.

golfing eagles 09-12-2023 09:23 AM

Quote:

Originally Posted by Cybersprings (Post 2255794)
In that case, my apologies. I will delete my previous post.
I hope you are feeling better Doc.

No need---this is simply play time, nothing serious going on except for medical content.

Cybersprings 09-12-2023 09:28 AM

Quote:

Originally Posted by margaretmattson (Post 2255789)
I read the entire thread. There were several people who argued with GE. My post is a general statement that is not directed to anyone specific. My ideology is this: Dont trust what you read on the internet when your life is in danger. I can see hundreds of ways that can go wrong. Go to a medical doctor and get a MEDICAL diagnosis.

I agree with your ideology 100% (not that that really makes a difference).

Not sure the OP's life is in danger, but your point is still valid.

No one else argued with GE. Lots of people posted their experiences and some recommendations, but from reading them, those with recommendations hadn't appeared to have read the whole thread before posting, which is very often the case and is not intended to insult them (many people just want to jump in and help, and didn't know the Doc had already laid out an excellent recommendation).
So, really the only person your post could have reasonably applied to is me. I argued in many posts with him (never about his advice).
So again, I ask for any thing I said that was not 100% accurate.
If you cannot provide any example, your post to which I responded has no value and is just plain wrong. If you want to say something along the lines of "I wish people would stop nitpicking statements people/experts make when their primary point is so on target" then I would have to drop my head and take my lumps. Or "some people should read the entire thread before providing recommendations because an expert may have already provided the right answer, that would be reasonable (but would not apply to the people who gave personal experience without providing recommendations).

But to insinuate that I or anyone else claimed to be an expert and argued with the expert and got anything wrong would be complete non-sense, at least as far as this thread goes.

margaretmattson 09-12-2023 09:34 AM

Quote:

Originally Posted by Cybersprings (Post 2255798)
I agree with your ideology 100% (not that that really makes a difference).

Not sure the OP's life is in danger, but your point is still valid.

No one else argued with GE. Lots of people posted their experiences and some recommendations, but from reading them, those with recommendations hadn't appeared to have read the whole thread before posting, which is very often the case and is not intended to insult them (many people just want to jump in and help, and didn't know the Doc had already laid out an excellent recommendation).
So, really the only person your post could have reasonably applied to is me. I argued in many posts with him (never about his advice).
So again, I ask for any thing I said that was not 100% accurate.
If you cannot provide any example, your post to which I responded has no value and is just plain wrong. If you want to say something along the lines of "I wish people would stop nitpicking statements people/experts make when their primary point is so on target" then I would have to drop my head and take my lumps. Or "some people should read the entire thread before providing recommendations because an expert may have already provided the right answer, that would be reasonable (but would not apply to the people who gave personal experience without providing recommendations).

But to insinuate that I or anyone else claimed to be an expert and argued with the expert and got anything wrong would be complete non-sense, at least as far as this thread goes.

I will be more careful in the wording of my posts. I only meant to make a general statement (As explained above) I never meant harm.

Cybersprings 09-12-2023 09:38 AM

Quote:

Originally Posted by margaretmattson (Post 2255799)
I will be more careful in the wording of my posts. I only meant to make a general statement (As explained above) I never meant harm.

Thanks for your post. No real (or otherwise) harm was done. As the Doc said in his post, nothing serious is really going on here.
I apologize that my post came across so snarky.

scooterstang 09-12-2023 09:43 AM

While in the service. I went to the base pool that had a 3 miter diving board. I was in the middle of a back flip when I heard my last name called out and dumb me cranked my head towards the voice, and Bam my right ear hit the water flat and busted my tympanic membrane. I was in terrible pain and things were super loud. I went to Wilford hall medical clinic in San Antonio and they diagnosed my issue. They said the membrane would grow back but there would be scar tissue and most likely I would loose a lot of hearing in that ear! I might also get vertigo real bad. I have only had vertigo a few times since then but I am super glad that it is not a more regular thing because it puts you down and is the worse feeling. I have never heard of the Epley proceedure before today(guess back in 78 it wasn't a thing)

Aviva 09-12-2023 10:13 AM

Vestibular physiotherapist
 
It took me awhile to get to the right type of specialist to find me the right person to treat vertigo. A vestibular physiotherapist is trained to assess your inner ear organs with positional testing which puts your head in different angles to try reproduce your vertigo while carefully noting the related nystagmus or patterns of eye reflexes.
I have Left Particle Vetigo so for me the Epley Maneuver works wonders. I know there are ways to do it yourself but I prefer the Vestibular Physiotherapist do it while he is monitoring my eyes so he can know the particles have moved away. Its been a game changer for me.

Quote:

Originally Posted by hawk1021 (Post 2255116)
My Husband suffers from dizziness constantly someone said something about the Epley Maneuver. Has anyone done this before ? Did it work ? and if so can you recommend a doctor down here in the villages area.


bp243 09-12-2023 10:45 AM

Quote:

Originally Posted by golfing eagles (Post 2255523)
No offense, and I'm really not looking for a p!$$!ng match, but please point out a statement that is "categorically wrong". Some may be exaggerations to make a point, but overall they are accurate. You cannot hunt for rare exceptions and hold that up as a standard. I think I have been pretty consistent---I acknowledged referring patients to chiropractors and other ancillary services when appropriate, but pretty harshly warn against getting evaluated by those fringe practitioners first. Sorry if I ruffle some feathers, but the public sometimes just doesn't "get it". There are a lot of quacks and snake oil salesmen out there, and if I can do some small part to protect the innocent, I'm going to take it.

As far as "having a degree and being retired" goes, I think my career is a bit more than that. For all anyone knows, when they play Dr. Google they may be quoting me from the content that I myself have written. When they need inpatient medical care, they may be receiving treatment under protocols that I have written. So, consider it arrogant if you will, but I feel obligated to utilize my extensive knowledge to benefit others, within certain constraints of law and ethics. And yes, sometimes I get overzealous.

Thank you for taking the time to share your knowledge and, in particular, your compassion for helping others. Your thoughts are appreciated. My vertigo issues occur when tracking movement over an extended period like scrolling on the Internet or watching a video with lots of movement. Is that something that I live with or is there a specialist to recommend who might best evaluate that issue?


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