The Dizzy Specialist, Kosti (2025)

28/03/2025

🤔I read this well known quote recently, and it struck a chord with me, given a recent clinical experience with a patient… 👇

A single mother was referred to my clinic after years of debilitating vertigo. She had been diagnosed with Meniere’s Disease and had seen multiple doctors in both the NHS and private sectors. Nothing helped. She was losing hope. She broke down in tears as she told me how much this was affecting her.

After my comprehensive consultation, detailed examination and basic investigations, it was quite clear that she did not have Meniere’s Disease, but rather Vestibular Migraine.

We started my stepwise preventative management approach and I advised on suitable ‘rescue’ medication. A few months later, she was like a different person.

✅ Fewer episodes

✅ Shorter attacks

✅ Less intense symptoms

She was thriving both professionally and personally. She was immensely grateful, but what most struck a chord with me, was that she told me that her son’s behavior had improved dramatically, which she believed was because she could be more present as a mother. She cried again in that follow-up appointment—but this time, out of happiness.

We must remember that:

✨ Dizziness is more than just a symptom. It can changes lives.

✨ Getting the right diagnosis can change everything for that person.

✨ As healthcare professionals, we don’t just help our patients—we can impact their families and those around them.

“Helping one person might not change the world, but it could change the world for one person.”

Have you ever experienced anything similar. Let me know in the comments.

26/03/2025

🚨 “Dr Shaw, I’ve been told hearing aids will prevent me getting dementia?” 🧠🦻

In my audiovestibular clinic, patients often ask me about hearing loss and dementia. They’ve read headlines or heard it from other professionals - and they want my opinion.

It’s true that some studies and meta-analyses have found a correlation between hearing loss and dementia risk, and there’s emerging evidence of potential benefits from using hearing aids in this regard. But let’s be clear - the relationship is not straightforward, and many confounding factors are at play.

Correlation isn’t causation. So why are patients being told by some that hearing loss causes dementia and that using hearing aids will prevent it? After all, people who use hearing aids can still develop dementia.

As a specialist, at least for the time being, I’m cautious about pushing the hearing loss/dementia narrative too hard. Fear of dementia might grab attention, but it risks overshadowing the real, proven benefits of treating hearing loss:

1️⃣Better communication🗣️

2️⃣Reduced social isolation🤝

3️⃣Overall improved quality of life🌟

We need to be mindful of how we frame our conversations. Awareness is important, but we need to avoid scare tactics. In my opinion, the focus of our conversations should be on empowering patients with practical, immediate benefits - not just distant, unproven possibilities.

“I do stress that hearing aids can be life-changing, but for reasons I can confidently stand behind.”

10/03/2025

🚨 BPPV home treatments - helpful cure or harmful mistake??? This might be controversial, but it needs to be said…

YouTube is NOT a substitute for an accurate diagnosis and quality care. Yet, over the past five years, I’ve seen more and more people being told they “probably” have BPPV (often without a proper test!) and being advised to just Google or YouTube a manoeuvre and try it themselves at home.

⚠️ I am NOT a fan of this. Here are 4 reasons why:

❌ Is it even BPPV? Some causes of positional dizziness are serious and can be life-threatening if misdiagnosed.

❌ If it is BPPV, which side is affected? If you don’t get this right, the manoeuvre won’t work.

❌ Even if you know the side, which canal is involved? It’s not always the posterior canal - using the wrong manoeuvre could be useless… or worse.

❌ Even if you know the side and the canal involved, will the manoeuvre be done correctly? A poorly performed manoeuvre can lead to failed treatment, frustration and a loss of faith and trust. In some cases, it can even turn a simple BPPV into a more complex, multi-canal problem!

💡Bottom line: If a home treatment is to be recommended, it should be done with a clear diagnosis, proper instructions, and patient safety as the TOP PRIORITY.

👉 What do you think? Have you seen cases where DIY treatments made things worse, or experienced this yourself firsthand? Drop your thoughts in the comments!

05/03/2025

🩺 The Most Powerful Medicine Isn’t in a Prescription… 👇

😵‍💫 Dizziness that turns your world upside down. 🔔 Unrelenting tinnitus. 🔇 Hearing loss that isolates you from others.

For so many patients, these are not just symptoms - they reshape daily life. And yet, too often, they’re met with quick prescriptions or dismissive advice.

But here’s the truth: Medicine isn’t just about medication.

💡As I often say to junior doctors and medical students, “The most powerful medicine a doctor has isn’t in a prescription - it’s in their attention, their words, and their compassion”

The way a doctor speaks can be just as impactful as the treatment they prescribe. A rushed conversation, a lack of empathy, or a dismissive tone can leave patients feeling unheard and hopeless. But when a doctor truly listens, explains, and reassures, it can restore confidence, reduce anxiety, and even improve outcomes.

Because medicine isn’t just treating symptoms - it’s about treating people.

💭How important are empathy and communication to you in medical care?

❔Do you think the way a healthcare professional speaks to a patient can impact their outcome?

💬 Have you ever felt dismissed by a doctor? What made the biggest difference in your care?

Let’s start a conversation. Drop your thoughts in the comments! 👇

03/03/2025

💪 Be migraine ‘TriggerWise’… step 2 of the ‘MigraineSteps’ treatment framework 👨‍⚕️

03/03/2025

🚨 “Dr. Shaw, I LOVE coffee, but I was told I have to cut it out because of my migraines…”
My response? “ABSOLUTELY NOT!!” ☕️❌👇

As someone who personally suffers from migraines and loves coffee, I know how frustrating it can be to hear blanket advice like “Just avoid all triggers.” But that’s NOT the right approach.

Let’s talk about Step 2 of my MigraineSteps: Tiered Treatment Framework - Trigger Avoidance & Reduction.

Migraine triggers are highly individual - what affects one person might not bother another at all. Some more common triggers include:

⚡️ Excessive caffeine
🧀 Tyramines found in aged cheeses, pickled food etc
🍫 Chocolate
🍊 Citrus fruits
🍷 Alcohol
🍜 Additives like MSG

But here’s the key: You don’t have to avoid everything! Managing migraines requires a PRAGMATIC approach.

✅ Keep a simple trigger diary - log what you eat, drink, and experience 48 hours before a migraine.
✅ IDENTIFY PATTERNS - don’t just guess!
✅ If you love something (like coffee!), learn when it’s safe to have and when to avoid it.

For example, if you’re stressed and sleep-deprived, then that’s the time to skip that potential trigger. But on a normal day? It might be totally fine, in moderation!

And here’s something interesting: Coffee isn’t always the enemy! In fact, in some cases, caffeine can actually help relieve a migraine attack in the acute phase - which is why it’s even more important to take a balanced, individualized approach.

Understanding your own migraine triggers is incredibly EMPOWERING - it puts you in control, rather than feeling at the mercy of your symptoms Instead of avoiding everything “just in case”, you can make INFORMED DECISIONS that work for you.

👉 Have you discovered any surprising migraine triggers - or foods you thought were triggers but weren’t? I’d love to hear your thoughts in the comments.

Disclaimer: This post is for medical education purposes only and does not constitute individual clinical advice. Always discuss management options with your treating healthcare professional.

28/02/2025

🚨 The FIRST and MOST POWERFUL step in migraine prevention… and many people overlook it! 🚨

Yesterday, I introduced “MigraineSteps”, my tiered framework for preventing migraine and vestibular migraine attacks - a system I use daily in my clinical practice.

🔹 Let’s expand on Step 1- Lifestyle Modifications.

I cannot emphasize this enough: healthy habits are the foundation of migraine prevention. They don’t just reduce the frequency and severity of attacks - they also improve one’s overall well-being.

To simplify this and maximize results for my patients, I focus on six key areas and coined the term the “MigraineLifestyle Six”.

💡My patients love this approach because it’s clear, structured, and achievable. The memorable name keeps them focused and motivated.

What lifestyle changes have made the biggest difference in your migraine or vertigo management? I’d love to hear your thoughts and experiences in the comments below!

As a passionate advocate for people suffering from dizziness, vertigo, and imbalance, I want to expand awareness and improve care on a larger scale through health education.

📢 If you know someone struggling with Vestibular Migraine, or feel your network could benefit, re-share this post - it could make all the difference! ♻️

Disclaimer: This post is for medical education purposes only and does not constitute individual clinical advice. Always discuss management options with your treating healthcare professional.

27/02/2025

😩Is the ’right’ medical treatment still not working…??? This could be why👇

I see and treat a lot of people suffering with dizziness, through my work as a Consultant Audiovestibular Physician, referred directly from primary care. I also receive a lot of second opinion referrals from consultant colleagues across the country.

Here is one thing I see which explains why people receiving, what seems to be, the ‘right treatment’, do not get better, and in fact sometimes get worse…

They receive the right treatment methods, but in the WRONG order. 🧐

Let’s take Vestibular Migraine (VM) and Persistent Postural Perceptual Dizziness (PPPD). VM can lead into PPPD for some. If this happens, then it is really important to optimize preventative (prophylactic) Migraine management, BEFORE starting intense Vestibular Rehabilitation (VR). If intense VR is started too soon, then it will make migrainous symptoms worse and the person will not be able to engage with the VR. For others, as VR is intensified, migrainous symptoms worsen, but Migraine management is never stepped up. Unfortunately, I’ve seen so many patients who have LOST FAITH IN REHABILITATION because of this.

Part of patient-centered care is providing the right treatment methods, but it has to be in the right order, for each individual person. Everyone is different, and there is never a one size fits all.

This is true across medicine, but is particularly the case for vestibular medicine.

Is this something you have also come across?

migraine

27/02/2025

🚨 Struggling with Vestibular Migraine? Here’s the framework I use to help my patients take control! 🚨

Vestibular Migraine (VM) is one of the most common yet misdiagnosed causes of vertigo. It affects around 3% of adults, and for some can be completely life-altering - impacting work, relationships, and daily activities.

🔹 Misdiagnosis is a huge problem - many patients are mistakenly told they have BPPV, Labyrinthitis, or Meniere’s Disease.

🔹 The good news? VM CAN be managed effectively. While there’s no outright ‘cure’, the right approach can drastically reduce symptoms and improve quality of life.

🔹 The key? An accurate diagnosis and a structured treatment plan.

↗️ I use a Stepwise Framework Approach to preventing and managing symptoms, which I call ‘MigraineSteps’, and my patients love the infographic included in this post which illustrates the Framework.

📌 People start at the bottom and move up the framework as needed, creating a clear path to fewer attacks and better control.

📲 Follow me for more posts on dizziness, vertigo, and migraine management - I’ll be expanding on each step of MigraineSteps over the coming weeks.

This information needs to reach more people! If you know someone struggling with Vestibular Migraine or feel your network could benefit, feel free to re-share this post, it could make all the difference ♻️

26/03/2024

Children and teenagers can get dizzy too!!

The most common cause of vertigo in the paediatric population is Vestibular Migraine of Childhood. Swipe through to get the basic facts 👉.

There are many other possible causes of dizziness in children, so make sure an appropriately trained professional makes the diagnosis.

DISCLAIMER: This post is meant for medical education purposes ONLY and does not constitute individual clinical advice. Always seek medical advice from your treating doctor, when managing health conditions. If you would like to arrange for a private medical consultation with Dr Shaw, Consultant Audiovestibular Physician, then information on booking an appointment can be found at TheDizzySpecialist.com. Face to face and virtual consultations available.

12/03/2024

🚢 ‘Sea legs’… 🌊

Experiencing non-spinning vertigo (swaying, rocking, etc) when coming off of a boat or other mode of transport is very common and usually settles within seconds to minutes. However for some people it lasts days and even months. This condition is termed Mal de Débarquement Syndrome (MdDS). Swipe through to get the key facts 👉.

DISCLAIMER: This post is meant for medical education purposes ONLY and does not constitute individual clinical advice. Always seek medical advice from your treating doctor, when managing health conditions. If you would like to arrange for a private medical consultation with Dr Shaw, Consultant Audiovestibular Physician, then information on booking an appointment can be found at TheDizzySpecialist.com. Face to face and virtual consultations available.

07/03/2024

Want to learn more about Vestibular Function Tests? Have these been recommended to investigate your dizziness and / or imbalance?

Swipe through for a breakdown of these tests, why they are done, and what to expect…

DISCLAIMER: This post is meant for medical education purposes ONLY and does not constitute individual clinical advice. Always seek medical advice from your treating doctor, when managing health conditions. If you would like to arrange for a private medical consultation with Dr Shaw, Consultant Audiovestibular Physician, then information on booking an appointment can be found at TheDizzySpecialist.com. Face to face and virtual consultations available.

The Dizzy Specialist

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