148. Navigating Altitude Changes with a Vestibular Disorder

148. Navigating Altitude Changes with a Vestibular Disorder

Heading somewhere with a big elevation change? Good news! Most people living with vestibular disorders actually do really well at altitude. But that doesn’t mean you just show up unprepared and hope for the best. In this episode, I’m breaking down everything you need to know about navigating altitude changes with a vestibular disorder.  From quick pressure shifts like takeoff and landing, to extended stays at higher elevations, I’m sharing what to keep on standby, what to avoid, and why slower adjustments make all the difference. In this episode, we’ll dig into: * Why most people with vestibular disorders actually feel good at altitude * Tools for quick pressure changes like takeoff, landing, and steep elevation drives * The difference between earplanes & WeatherX earplugs * Why slower ascents make a huge difference and how to pace your elevation * Medications to ask your doctor about before travel * Why you most definitely want to rethink alcohol at elevation * What self-care tips still apply at altitude * The research behind nature being great for your nervous system * My thoughts on oxygen bars and vestibular disorders Altitude changes don’t have to derail your trip! With the right prep, the right toolkit, and a slower ascent, you absolutely can enjoy the mountain tops. Links Mentioned: * Vestibular Group Fit (code GROUNDED at checkout for 15% off!): https://thevertigodoctor.com/vestibular-group-fit * WeatherX Earplugs: https://amzn.to/4h7Py7N [https://amzn.to/4h7Py7N] * Earplanes: https://amzn.to/4aQji5b [https://amzn.to/4aQji5b] Free Resources: * ⁠The 4 Steps to Managing Vestibular Migraine: https://thevertigodoctor.myflodesk.com/cb5js0y78n * ⁠The PPPD Management Masterclass⁠: https://thevertigodoctor.myflodesk.com/new-pppd * ⁠What your Partner Should Know About Living with Dizziness⁠: https://thevertigodoctor.myflodesk.com/partnership * ⁠The FREE Mini VGFit Workout⁠: https://thevertigodoctor.myflodesk.com/minifit * ⁠The FREE POTS – safe Workouts⁠: https://thevertigodoctor.myflodesk.com/pots Connect with Dr. Madison (@TheVertigoDoctor): https://instagram.com/thevertigodoctor Work with Dr. Madison: * For 1:1 Vestibular Rehabilitation Therapy, email madison@thevertigodoctor.com * Otherwise, I’ll see ya in Vestibular Group Fit! Connect with Dr. Jenna (@dizzy.rehab.therapist): https://www.instagram.com/dizzy.rehab.therapist/ Learn about the Oak Method: http://thevertigodoctor.com/why-vestibular-group-fit Love what you heard? Consider leaving a review on your favorite podcast platform to help us reach more vestibular warriors like you! This podcast is for informational purposes only and may not be the best fit for you and your personal situation. It shall not be construed as medical advice. The information and education provided here is not intended or implied to supplement or replace professional medical treatment, advice, and/or diagnosis. Always check with your own physician or medical professional before trying or implementing any information read here. Citations 1. “Mountain Vacation? 5 Tips to Cope with Your Altitude Sickness.” Cleveland Clinic, health.clevelandclinic.org/understanding-altitude-sickness-5-best-tips-for-your-next-mountain-trip. ————————————— vertigo and altitude changes, altitude and vertigo, travel and vestibular disorders, vestibular group fit, VGF, living with vestibular disorder, weather & vestibular disorder, change in pressure, inner ear, manage migraine, weatherx earplanes, meniere’s disease, nervous system regulation, chronic dizziness, PPPD

147. Scaling & Pacing Physical Activity with a Vestibular Disorder

If you’ve ever tried to do too much, crashed hard, and then felt like you were back at square one—this episode is for you. I’m talking about two of the most important concepts we teach in Vestibular Group Fit: scaling and pacing. It cannot be stressed enough how important this is and how much we talk about it in VGF. Scaling and pacing aren’t about doing less forever. They’re about building capacity strategically so you can eventually do MORE without paying for it for days afterward. I’m walking you through real-life examples of how to scale movement, exercise routines, walking, driving, and other daily activities — plus what to do on higher symptom days and post-attack so you can recover faster and get back to living your life. In this episode, we’ll dig into: * What scaling and pacing actually mean and how they’re different * Why you should never increase more than 10% at a time * How to scale things like strength training, walking, and driving * The difference between “immediate” responders and “hangover” responders * Real-life pacing strategies you can add into your day-to-day life * How to scale down on post-attack or high symptom days * The 30-day to 30-minute return to walk program results from VGF * Summer consistency challenge details for Vestibular Group Fit members Whether it’s exercise, grocery shopping, driving, or attending your nephew’s graduation—the same principles apply. Scaling and pacing are skills. As with any skill, it takes time, practice, and a whole lot of grace and patience with yourself. Links Mentioned: * Vestibular Group Fit (code GROUNDED at checkout for 15% off!): https://thevertigodoctor.com/vestibular-group-fit [https://thevertigodoctor.com/vestibular-group-fit] * Inside VGF, we have two helpful lessons: Visualization exercises for return to driving, and a 30-day to 30-minute return to walk program Free Resources: * ⁠The 4 Steps to Managing Vestibular Migraine: https://thevertigodoctor.myflodesk.com/cb5js0y78n * ⁠The PPPD Management Masterclass⁠: https://thevertigodoctor.myflodesk.com/new-pppd * ⁠What your Partner Should Know About Living with Dizziness⁠: https://thevertigodoctor.myflodesk.com/partnership * ⁠The FREE Mini VGFit Workout⁠: https://thevertigodoctor.myflodesk.com/minifit * ⁠The FREE POTS – safe Workouts⁠: https://thevertigodoctor.myflodesk.com/pots Connect with Dr. Madison (@TheVertigoDoctor): https://instagram.com/thevertigodoctor Work with Dr. Madison: * For 1:1 Vestibular Rehabilitation Therapy, email madison@thevertigodoctor.com * Otherwise, I’ll see ya in Vestibular Group Fit! Connect with Dr. Jenna (@dizzy.rehab.therapist): https://www.instagram.com/dizzy.rehab.therapist/ Learn about the Oak Method: http://thevertigodoctor.com/why-vestibular-group-fit Love what you heard? Consider leaving a review on your favorite podcast platform to help us reach more vestibular warriors like you! This podcast is for informational purposes only and may not be the best fit for you and your personal situation. It shall not be construed as medical advice. The information and education provided here is not intended or implied to supplement or replace professional medical treatment, advice, and/or diagnosis. Always check with your own physician or medical professional before trying or implementing any information read here. ---------------------------------------- physical activity intensity, scaling and pacing, activity pacing, scaling physical activity, vestibular disorder management, chronic dizziness, living with vestibular disorder, migraine attacks, nervous system regulation, exercises to improve balance, return to walking, driving with vestibular disorder, vestibular exercises

146. The Importance of Nutrition in Vestibular Disorders

I recently got a certificate in functional nutrition and I have thoughts. Starting with the fact that staying hydrated and fueling your body with nutrients will be—not can be, will be—a game-changer for your vestibular disorder. In this episode, I’m breaking down something that comes up over and over again in Vestibular Group Fit: how much what you eat (and drink!) actually matters when you have a vestibular disorder. This isn’t about going on a perfect diet or never eating processed foods again. It’s about understanding how blood sugar regulation, hydration, inflammation, gut health, and hormones are all connected to your dizziness. And what small, manageable steps you can take to start feeling better. In this episode, we’ll dig into: * Why diet & hydration are foundational basics for managing a vestibular disorder * How blood sugar crashes — including overnight ones — can trigger dizziness & attacks * Why skipping meals is practically a guaranteed migraine trigger * The role of key nutrients like iron, vitamin D & B vitamins in managing chronic dizziness * How inflammation connects to vestibular disorders — and how food either fuels or fights it * Perimenopause & menopause: how hormonal changes affect metabolism, muscle mass, insulin sensitivity & dizziness * Endocrine-disrupting chemicals (plastics, pesticides, PFAs) & how low-tox swaps can make a real difference * Why your gut microbiome might be the reason your medications aren’t working * Practical, accessible ways to start improving your nutrition without overhauling everything at once You don’t have to eat perfectly! You just have to start somewhere because the better your nutrition and hydration are, the better you will feel. Links Mentioned: * Vestibular Group Fit (code GROUNDED at checkout for 15% off!): https://thevertigodoctor.com/vestibular-group-fit * Optimal Bloodwork Link: https://thevertigodoctor.myflodesk.com/yt2ko79vaq [https://thevertigodoctor.myflodesk.com/yt2ko79vaq]  * Detoxify by Alli Cohen: https://www.amazon.com/dp/1668033534/ref=cm_sw_r_as_gl_api_gl_i_TYFM23HJFGM1JPQW5671?linkCode=ml1&tag=thevertigodoc-20&linkId=1700598d13c22416e1837eb71940139d [https://www.amazon.com/dp/1668033534/ref=cm_sw_r_as_gl_api_gl_i_TYFM23HJFGM1JPQW5671?linkCode=ml1&tag=thevertigodoc-20&linkId=1700598d13c22416e1837eb71940139d]  * EWG Dirty Dozen list: https://www.ewg.org/foodnews/dirty-dozen.php [https://www.ewg.org/foodnews/dirty-dozen.php] Free Resources: * ⁠The 4 Steps to Managing Vestibular Migraine: https://thevertigodoctor.myflodesk.com/cb5js0y78n * ⁠The PPPD Management Masterclass⁠: https://thevertigodoctor.myflodesk.com/new-pppd * ⁠What your Partner Should Know About Living with Dizziness⁠: https://thevertigodoctor.myflodesk.com/partnership * ⁠The FREE Mini VGFit Workout⁠: https://thevertigodoctor.myflodesk.com/minifit * ⁠The FREE POTS – safe Workouts⁠: https://thevertigodoctor.myflodesk.com/pots Connect with Dr. Madison (@TheVertigoDoctor): https://instagram.com/thevertigodoctor Work with Dr. Madison: * For 1:1 Vestibular Rehabilitation Therapy, email madison@thevertigodoctor.com * Otherwise, I’ll see ya in Vestibular Group Fit! Connect with Dr. Jenna (@dizzy.rehab.therapist): https://www.instagram.com/dizzy.rehab.therapist/ Learn about the Oak Method: http://thevertigodoctor.com/why-vestibular-group-fit Love what you heard? Consider leaving a review on your favorite podcast platform to help us reach more vestibular warriors like you! This podcast is for informational purposes only and may not be the best fit for you and your personal situation. It shall not be construed as medical advice. The information and education provided here is not intended or implied to supplement or replace professional medical treatment, advice, and/or diagnosis. Always check with your own physician or medical professional before trying or implementing any information read here. Citations 1. Patelarou, E., & Giakoumidakis, K. (2025). Nutrition and Quality of Life for Patients with Chronic Disease. Nutrients, 17(13), 2170. https://doi.org/10.3390/nu17132170 [https://doi.org/10.3390/nu17132170] 2. Paramasivam, A., Murugan, R., Jeraud, M., Dakkumadugula, A., Periyasamy, R., & Arjunan, S. (2024). Additives in Processed Foods as a Potential Source of Endocrine-Disrupting Chemicals: A Review. Journal of xenobiotics, 14(4), 1697–1710. https://doi.org/10.3390/jox14040090 [https://doi.org/10.3390/jox14040090] 3. Erdélyi, A., Pálfi, E., Tűű, L., Nas, K., Szűcs, Z., Török, M., Jakab, A., & Várbíró, S. (2023). The Importance of Nutrition in Menopause and Perimenopause-A Review. Nutrients, 16(1), 27. https://doi.org/10.3390/nu16010027 [https://doi.org/10.3390/nu16010027] 4. Yu, X., Pu, H., & Voss, M. (2024). Overview of anti-inflammatory diets and their promising effects on non-communicable diseases. The British journal of nutrition, 132(7), 898–918. https://doi.org/10.1017/S0007114524001405 [https://doi.org/10.1017/S0007114524001405] 5. Kang, H. S., Kim, S. Y., Kim, J. H., Kim, E. S., Choi, H. G., Lim, H., Kim, J. H., Park, H. Y., Kim, N. Y., Hong, S., Choi, K. C., & Kwon, M. J. (2022). Association between Migraines and Prior Proton Pump Inhibitor Use: A Nested Case-Control Study Using a National Health Screening Cohort. Pharmaceuticals (Basel, Switzerland), 15(11), 1385. https://doi.org/10.3390/ph15111385 6. Zhang P. (2022). Influence of Foods and Nutrition on the Gut Microbiome and Implications for Intestinal Health. International journal of molecular sciences, 23(17), 9588. https://doi.org/10.3390/ijms23179588 [https://doi.org/10.3390/ijms23179588] ---------------------------------------- importance of nutrition, functional nutrition, nutrition and lifestyle, living with vestibular migraine, diet and nutrition, treatment for vestibular disorders, diet for vestibular migraine, food and diet for vestibular disorder, migraine management, chronic dizziness, PPPD, vestibular group fit

145. How to Prepare to Start a New Vestibular Medication

If you’ve ever started a new medication and immediately felt worse—you’re not broken, and you’re definitely not alone.  In this episode, I’m diving into one of the most common and most frustrating experiences in the vestibular world: medication sensitivity. And more importantly, what to actually do about it. I’m breaking down why so many people with vestibular disorders struggle to tolerate new medications, how to wean on and off gradually to give yourself the best shot at success, and why going slow is actually the fastest way to feel better. We’re also talking about the nocebo effect—because what you expect from a medication can literally shape what you experience. Plus, I’m making a case for the most underutilized resource in your healthcare team: your pharmacist. Seriously, use them. They know things your doctor might miss. In this episode, we’ll dig into: * Why medication sensitivity is SO common in the vestibular community * The case for weaning onto medications gradually * What compounding pharmacies are & how they can be a game changer for hypersensitive people * Why you need to understand the nocebo effect before starting a new medication * How to tell the difference between “dizziness as a side effect” vs your chronic dizziness * How to set yourself up for success when starting a new medication * A tool you can use to take the guesswork out of medications Starting a new medication doesn’t feel like as much of a gamble when you know how to prepare, advocate for yourself, and you go slow. Following these tips, you give yourself the very best shot at finally feeling better. Related Episodes: * How to Wean Off Your Preventative Medications: https://thevertigodoctor.com/podcast/54-how-to-wean-off-your-preventative-medications/ [https://thevertigodoctor.com/podcast/54-how-to-wean-off-your-preventative-medications/] Links Mentioned: * Vestibular Group Fit (code GROUNDED at checkout for 15% off!): https://thevertigodoctor.com/vestibular-group-fit * Golden Genetics (mention Dr. Madison for a discount!): https://www.goldengeneticshealth.com/ [https://www.goldengeneticshealth.com/] Free Resources: * ⁠The 4 Steps to Managing Vestibular Migraine: https://thevertigodoctor.myflodesk.com/cb5js0y78n * ⁠The PPPD Management Masterclass⁠: https://thevertigodoctor.myflodesk.com/new-pppd * ⁠What your Partner Should Know About Living with Dizziness⁠: https://thevertigodoctor.myflodesk.com/partnership * ⁠The FREE Mini VGFit Workout⁠: https://thevertigodoctor.myflodesk.com/minifit * ⁠The FREE POTS – safe Workouts⁠: https://thevertigodoctor.myflodesk.com/pots Connect with Dr. Madison (@TheVertigoDoctor): https://instagram.com/thevertigodoctor Work with Dr. Madison: * For 1:1 Vestibular Rehabilitation Therapy, email madison@thevertigodoctor.com * Otherwise, I’ll see ya in Vestibular Group Fit! Connect with Dr. Jenna (@dizzy.rehab.therapist): https://www.instagram.com/dizzy.rehab.therapist/ Learn about the Oak Method: http://thevertigodoctor.com/why-vestibular-group-fit Love what you heard? Consider leaving a review on your favorite podcast platform to help us reach more vestibular warriors like you! This podcast is for informational purposes only and may not be the best fit for you and your personal situation. It shall not be construed as medical advice. The information and education provided here is not intended or implied to supplement or replace professional medical treatment, advice, and/or diagnosis. Always check with your own physician or medical professional before trying or implementing any information read here. ————————————— vestibular medication, medication for vestibular disorder, placebo and nocebo effect, side effects, vestibular migraine, VM, vestibular disorders, chronic dizziness, mindset and the nocebo effect, increased anxiety and depression, nervous system and dizziness, vestibular group fit, migraine management, compounding pharmacies

144. How to Pick the Right Shoes for Balance Problems

Today, we’re talking shoes. Specifically, the best shoes for you if you have chronic dizziness or balance problems. (If you caught my viral Hoka video back in April, you already know I have thoughts.) But I need you to know this… it was never really about Hoka. It’s about understanding what’s actually going on with your shoes when you have a vestibular disorder and why that matters more than any brand name ever will. I’m breaking down the anatomy of a shoe (from toe box to heel drop) so you can stop Googling “best shoe for dizziness” and just know what to look for. Because the best shoe is the one that works for your feet, your symptoms, and your life. Full stop. In this episode, we’ll dig into: * The big takeaway from my viral Hokas video * Why there’s no single “best shoe” for vestibular disorders * The key parts of shoe anatomy every vestibular warrior should know * How conditions like peripheral neuropathy, plantar fasciitis, or a toe fusion change what YOU need in a shoe * The best places to shop for shoes when you have a vestibular disorder * Why heel-to-toe walking matters for fall prevention Your shoes are touching the ground so YOU don’t have to think about it, so let’s make sure they’re actually working how they need to for you. If you have questions about this or you want support as you explore the best possible shoe for you, join us in Vestibular Group Fit [https://thevertigodoctor.com/vestibular-group-fit] (use code GROUNDED)! Links Mentioned: * Vestibular Group Fit (code GROUNDED at checkout for 15% off!): https://thevertigodoctor.com/vestibular-group-fit [https://thevertigodoctor.com/vestibular-group-fit] * The viral Hoka video: https://www.instagram.com/p/DXWzgM9BKc-/ [https://www.instagram.com/p/DXWzgM9BKc-/] * Recommended shoes link: https://liketk.it/67x4j [https://liketk.it/67x4j] Free Resources: * ⁠The 4 Steps to Managing Vestibular Migraine: https://thevertigodoctor.myflodesk.com/cb5js0y78n * ⁠The PPPD Management Masterclass⁠: https://thevertigodoctor.myflodesk.com/new-pppd * ⁠What your Partner Should Know About Living with Dizziness⁠: https://thevertigodoctor.myflodesk.com/partnership * ⁠The FREE Mini VGFit Workout⁠: https://thevertigodoctor.myflodesk.com/minifit * ⁠The FREE POTS – safe Workouts⁠: https://thevertigodoctor.myflodesk.com/pots Connect with Dr. Madison (@TheVertigoDoctor): https://instagram.com/thevertigodoctor Work with Dr. Madison: * For 1:1 Vestibular Rehabilitation Therapy, email madison@thevertigodoctor.com * Otherwise, I’ll see ya in Vestibular Group Fit! Connect with Dr. Jenna (@dizzy.rehab.therapist): https://www.instagram.com/dizzy.rehab.therapist/ Learn about the Oak Method: http://thevertigodoctor.com/why-vestibular-group-fit Citation Jellema, A. H., Huysmans, T., Hartholt, K., & van der Cammen, T. J. M. (2019). Shoe design for older adults: Evidence from a systematic review on the elements of optimal footwear. Maturitas, 127, 64–81. https://doi.org/10.1016/j.maturitas.2019.06.002 [https://doi.org/10.1016/j.maturitas.2019.06.002] Love what you heard? Consider leaving a review on your favorite podcast platform to help us reach more vestibular warriors like you! This podcast is for informational purposes only and may not be the best fit for you and your personal situation. It shall not be construed as medical advice. The information and education provided here is not intended or implied to supplement or replace professional medical treatment, advice, and/or diagnosis. Always check with your own physician or medical professional before trying or implementing any information read here. ————————————— shoes for balance problems, exercises for vestibular disorders, living with vestibular migraine, vertigo, bppv, pppd, guidelines of physical activity, anxiety and depression, chronic dizziness, balance issues, anatomy of a shoe, toe box, rocker angle, sole firmness, cushioning, tread, heel bevel, heel drop