Obviously, the answer is one that is successful at treating patients with balance and dizziness type disorders.  Our office has been sub-specialized in seeing patients with balance problems and fall risk, in particular vertigo and dizziness for some time now.  It is well known that the simplest treatments for vertigo are the most useful, yet we continue to see patients inappropriately medicated with vestibular suppressant therapy, anti-anxiety drugs, and on and on.  The history of these patients typically includes that of a small fortune spent on diagnostic testing, which could have been avoided with appropriate clinical examination and management early on.  The last statistic I read in the medical literature estimated that almost 99% of the MRI’s performed on patients referred with vertigo are normal.  That’s a heck of a lot of money spent for a very small return, certainly not what I would consider an ideal use of the diagnostic dollar.  One of the main problems that I see everyday is that patients are first seen by their primary care provider, which is now the way with insurance HMO’s.  Being generalists, patients are managed such to rule out more threatening diagnostic entity’s, typically by imaging, (MRI).  Since treatment for patients with vertigo and dizziness typically responds very quickly in our office, it would seem this course of action to be a much more sensible initial management plan in the multitude of cases where no life threatening problems are suspected.  If no resolve is evident via this course, or, if on examination suspicion of more threatening diagnostic entities exists, then imaging can be performed.  This plan only delays potential imaging by maybe one week, certainly not enough to have missed the boat, especially, in light of the statistic of 99% of these tests returning as normal.  The one most important factor related to all of this is the initial examination.  The examiner should be so trained that it becomes readily apparent during the examination as to the urgency of specialized studies such as MRI, or not. In the latter, it should not be the next thing done.  Further, all patients need to be evaluated for fall risk.  Those with established fall risk should be managed with fall prevention and rehabilitative therapies congruent with their needs.  We see this as being overlooked more often than not. Our office currently is compliant with JCAHO goal and requirement re: falls-risk identification, assessment and prevention, effective 2005.   Simply put, everyone who walks through our office gets a balance screening test, which we perform free of charge as a community service.  If you or someone you know is suffering with balance loss or dizziness, we would strongly recommend going to our What Patients Had To Say page.  Or, simply call our office directly at (732) 229-5250.

Pretty much everyone knows at least one person who has fallen.  The fall may have been purely accidental, such as a slip and fall, or the fall may have been related to dizziness.  More than one in three people age 65 years or older falls each year. The risk of falling and thus fall-related injuries rises proportionally with age.  Each year, more than 1.6 million elderly go to US emergency departments for fall-related injuries. Among older adults, falls are the number one cause of fractures, hospital admissions for trauma, and accidental injury deaths. Fractures caused by falls can lead to hospital stays and oftentimes to long term disability. With this comes loss of independence.  Most often, fall-related fractures are at the arm, hand, ankle, spine, pelvis or hip.  Hip fractures are amongst the most serious type of fall injury.  They are a leading cause of loss of independence, particularly in the elderly.  Only 50% of the elderly hospitalized for a broken hip return home or are capable of living on their own after the injury.  There is high morbidity associated with hip fractures, mostly from complications.

Most people develop a fear of falling which increase with age.  This can become even more overwhelming for those with a previous fall.  As such, many will avoid activities of daily living such as walking, shopping, or taking part in social activities.

Many individuals have deceived themselves into thinking that they are not at risk of fall simply because they have never fallen, or because they do not feel imbalanced.  This could not be further from the truth.  You see, the problem with risk of fall is that by the time that you can tell that you have a problem; the problem has already gotten severe.  It is for this reason that the hospital administration mandated fall risk analysis in 2004.  My office checks dozens of patients weekly for risk of fall.  Most know they have a problem going into the test as that is why they are in my office in the first place.  Many others however feel confident that they will score high and are surprised when they do not.

If you are worried about falling, our office offers a simple 20 second test to assess your overall stability, and thus your risk of fall.  The test is accurate and currently the standard used to evaluate fall risk.  My office offers this testing free as a community service.  We will also send a copy of the report back to your doctor, so that they know both that you have been tested and whether or not you are high risk.  Those who are high risk will be accepted as patients and treated appropriately.  Of those treated, most will have reduced their risk to normal; the remainder will have improved by at least one or two categories.

Because of the human aging process, changes occur around the sixth decade that lead to diminished balance ability and thus an increased risk of fall.  These detrimental changes can be easily fixed with some simple exercises.  Since most people don’t ever get checked, they don’t ever fix these detrimental changes and fall risk just continues to rise with age.

Even though detrimental changes occur as an inevitable part of human aging, falls are not an inevitable part of human aging.  Getting rid of your risk of falling, as well as your fear of falling can help you to stay active, maintain your physical health, and prevent future falls.  Call our office today for more information on falls, fall risk screening, or balance/dizziness problems in general.  More information can be found on the main pages of this website, (www.dcneuro.net).

A simple thing like tripping on a carpet or slipping on a wet floor can change your life in a heartbeat.  Like the thousands of people who fall each year, you may suffer a broken bone. Broken bones are no picnic, and for older people, a broken bone can be the start of more serious health problems.

Sometimes falls are truly accidental.  Much more often however, falls can be attributable to deteriorating eyesight and hearing, weakened muscles, reflexes not being as sharp as they used to be, and in particular, increased visual reliance, a phenomena associated with aging. Most drugs will cause a reduced reaction time.  In fact meclizine, (aka Antivert), is notorious for this, and, it is the most frequently prescribed drug therapy for dizziness!  Many other disorders can play a role, such as diabetes, heart disease, etc.

Now let’s consider osteoporosis, an aspect of aging which makes bones weak and more likely to break easily. Women tend to suffer from this more than men.  Having osteoporosis can mean that even a minor fall might cause considerable damage.

By all means, my motive here is not to have a fear of falling prevent you from being active. In fact, quite contrary, having an active lifestyle is one of the most important things we can do for ourselves as we age.  There are simple ways you can prevent falls.  Most of the time, falls and accidents don’t “just happen.” Here are a few hints that will help you avoid falls and broken bones:

• Get checked regularly for osteoporosis. Ask your doctor about a bone density test, which shows if your bones are weak.
• Stay physically active. Plan an exercise program that is right for you. Regular exercise makes you stronger and improves muscle strength as well as joint integrity.
• Have your eyes and hearing tested frequently. Deterioration in sight and hearing increases risk of fall. Wear your glasses when you are supposed to, and keep them clean.  Dirty glasses cause illusions which can cause sudden balance loss.
• Ask your pharmacist about the side effects of any medicine that you take. The #1 side affect of most drugs, even those prescribed for dizziness, is dizziness.
• Get enough sleep. If you are sleepy, you are more likely to fall. Don’t perform high risk activities if you are overtired.
• Limit the amount of alcohol you drink. Even a small amount can affect your reaction time and cause a fall.  Keep this in mind if you are drinking alcohol of any type, and do not perform high risk activities.
• If you feel faint on standing up, tell your doctor.  You may be hypotense, or, overmedicated for high blood pressure.  If you take meds for your pressure, you should be monitoring your pressure yourself with a home unit daily, and at the same time.  Keep a log to show your doctor.
• Perhaps the best thing you can do is getting screened for risk of fall regularly.  My office offers this service free of charge as a community service.