Canalith
Canalith
Dizziness appointments are unusually dependent on what you bring to them. Much of the time the examination is normal — episodes come and go, and you are unlikely to have one in the room — so the history you can give does a great deal of the work. An hour of preparation is the difference between a consultation that narrows things down and one that ends with "keep a diary and come back in three months".
The single most useful thing you can carry in is a one-page summary of your episodes. Not eight weeks of entries — nobody has time to read those — but a page that says:
Keep the full log behind the summary. If you have not been keeping one, start now even if the appointment is next week — two weeks of accurate entries beats a year of recollection. Our companion guide covers capturing an episode while it is happening, and the blog covers what belongs in the diary.
Gather, in one folder or one album on your phone: previous clinic letters, hearing test results, imaging reports, and discharge notes from any emergency visit for dizziness. Different departments may not share records as fully as you expect.
Then write a complete medication list: everything prescribed, over the counter and supplement, with doses and roughly when each started, plus anything stopped recently. Dizziness is a recognised side effect of a good number of common medicines, and the timing of a change is invisible without a list. If you take anything to suppress the dizziness itself, note how often — the clinic may ask you to pause it before testing.
Expect the consultation to be dominated by questions. Think your answers through in advance; these carry the most weight.
What kind of dizziness. A true sense of spinning is a different complaint from lightheadedness, from floating, from being about to faint, and from visual unsteadiness. Try to describe it without using the word "dizzy" — whether the room moved, whether you moved, whether the floor felt uncertain.
The timing. How long each episode lasts, and how long the problem has been going on. Brief spells, spells of hours, and continuous unsteadiness for days point in very different directions.
The triggers. Whether a change of head position reliably provokes it, and which movements. Also whether standing up quickly, busy visual environments, loud sounds, exertion or straining set it off.
The ears. Hearing loss or change, in which ear, whether it fluctuates. Ringing, fullness or pressure, discharge, ear pain. Whether these track with the episodes or are constant.
Headache and migraine. Whether you get migraine now or have in the past, whether headaches accompany episodes, and whether light or sound sensitivity comes with them. People often omit this because they think of it as a separate problem; it is routinely relevant.
Events and background. Head injury, whiplash, ear surgery, ear infections, recent viral illness, any known neurological or cardiac condition, and family history of hearing loss or migraine.
Falls, near-falls and anxiety. Say plainly whether you have fallen, whether you have stopped driving, and whether fear of an episode has changed what you do. It shapes what help is offered.
Do not plan to drive yourself. Testing may provoke symptoms, and you may feel unsteady for some hours afterwards.
Ask when you book whether anything should be paused beforehand — some clinics ask you to avoid dizziness-suppressing medication, alcohol or caffeine before vestibular testing, and it is easier to know in advance than to have the appointment cut short.
Skip eye make-up if there is any chance of goggle-based eye recording, and bring your glasses.
Dress for lying down and being moved about on a couch, and mention any neck, back or shoulder problem, recent surgery or limited mobility before testing begins.
Bring someone if you can. A second person catches half of what is said, and can describe what your episodes look like from outside.
Eat something light beforehand. An empty stomach makes provoked nausea worse; a heavy meal is no better.
A good deal of the examination is watching your eyes. You may be sat, laid back quickly, turned to one side and held there while the clinician observes; goggles or an infrared camera may be used because some eye movements are hard to see otherwise. You may also be asked to walk, stand with your feet together, or have your hearing checked.
Two things are worth knowing. The point of the positional tests is often to provoke your symptoms briefly — that is the finding. It is unpleasant for a short time and then it passes; say so if you need a moment, but keep your eyes open when asked, because closing them hides the very thing being looked for. And mention neck, back or circulation problems first; there are alternatives when a standard position is not safe for you.
A normal examination is a useful result, not a wasted appointment, and a single visit does not always end in a firm diagnosis.
Write these down beforehand and tick them off.
Consultations evaporate. In the waiting room afterwards, record the working diagnosis, any exercise prescribed with its side and repetitions, medication started or stopped, the red flags you were told about, what tests were requested, and when you are being seen again. Then keep logging — a diary is most valuable in the weeks after a change, because that is what tells you whether it did anything. While you wait, our guide to making your home safer during an episode covers what to change.
Canalith was built to produce exactly the page described above. It keeps the diary, records the barometric pressure and weather at each episode, shows the frequencies in your own log, follows along with the exercise your clinician prescribed and taught you, and exports a one-page PDF or a CSV. Everything stays on your phone. It does not diagnose or treat anything. It is not on the App Store yet — join the waitlist.
This guide is about preparing for an appointment. It is not medical advice and does not replace an examination, and nothing here describes how to perform a repositioning manoeuvre — only a clinician who has examined you should prescribe and teach one. See a clinician about new or recurring vertigo. Treat it as urgent — emergency care, the same day, rather than waiting for a scheduled appointment — if vertigo comes on suddenly together with any of: double vision, weakness or numbness on one side, trouble speaking or swallowing, a severe or unusual headache, difficulty walking or standing, new hearing loss in one ear, chest pain, or fainting.