Filled out paperwork today to get an āappointment offerā from Dr Joel Goebel at Dizziness and Balance Center / Washington University School of Medicine in St Louis.
Excited, anxious and hopeful about meeting him. Did some research and he seems to be very well known and highly regarded. Anyone have experience with him by chance?
No, but itās good to know thereās an expert in that part of the country (I grew up in the KC area).
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Absolutely! I live about 80 miles south of St Louis, so am very thankful to be close to qualified help. So many arenāt.
My appt is set for Dec 4th with Dr Goebel! So anxious to hear his diagnosis since this far itās been BPPV from my primary GP, nerve damage / vestibular dysfunction from my ENT and Vestibular migraines from my ophthalmologist.
Found this great article on Dr Goeble and also found him referenced often by Dr Hain, so Iām feeling optimistic! https://otolaryngology.uams.edu/prosper-meniere-society-2018-international-symposium/
Iāll be very interested to hear what you think of him. If Hain references him, thatās a really good sign.
Last year I investigated traveling to see Dr. Hain. I filled out his online questionnaire and someone from his office called me to say that Dr. Hain reviewed it and said I was a candidate to see him. But then she said that because I am so far away (Florida), that he had given her four names of specialists who he recommended who are closer to me. She gave me the four names and I ended up going to see one of them. He was very good and was flattered when I told him that he had been recommended to me by Dr. Hain!
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That would be an honor indeed! Did you get the answers you were looking for? I will most definitely keep you all updated. I will finally feel like I have the real diagnosis and maybe all three of my physicians were right, who knows. Itās been 10 months now without medication or a real plan, so I promised myself that whatever he suggests, I will actually do!
Yes and no - he provided another piece of the puzzle but not the complete answer (Iām still not sure I have the complete answer but I think Iām close). You can read my story in the āPersonal Diariesā section, titled āThe Manatee Diaries.ā
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I had my appt with Dr Goebel yesterday afternoon. There was no question in his mind that I have vestibular migraine and BPPV. I just wanted to tell you all, that if by chance you are anywhere near St. Louis or willing to travel, Dr Goebel was truly wonderful! I have never felt so confident and comfortable in a dr visit! Increasing the Amitriptyline 10mg a week until I reach 50mg, which is where he feels confident I should be.
I finally have a plan, after a year of diagnosisās with no help. Looking forward to the future now 
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Great. Glad you came out with a diagnosis thatās meaningful to you. Thatās whatās needed. Oh how I would love to have been there to ask how he decided on VM and BPPV. I say this because I was originally diagnosed with BPPV which, fair enough, was the symptoms I was experiencing at the time. Treatment for BPPV is by manoeuvre not by preventatives and that was unfortunate for me because although symptoms changed dramatically, my doctors (local, not specialist consultants), wouldnāt rethink it, and I was āstuckā with it for over a decade. Well my āBPPVā symptoms eventually morphed into VM/MAV but much later the VRT therapist, having wound my condition up still further, again tried to convince me I had both. Hence my comment. Not that it matters to your case at all. You are already on what your expert thinks is the correct medication for the VM. You couldnāt be better placed other than never to have developed it in the first place I suppose. But I will say it seems strange my āBPPVā symptoms seem to have receded in line with the MAV symptoms. Odd given that BPPV is supposedly crystals in the ears that are settled by Epley, Brandt Dorff and other manoeuvres. Helen
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Sorry, but have to say it, itās a very bad habit of medicine to make these ācomorbidā diagnoses. Itās completely obvious to me that they are part of the same condition. About 2/3rd of sufferers with MAV seem to report issues with some positions. Why not just say āMAVā?
But sure ā¦ thereās no consensus on that yet and the science is still somewhat lacking. I get it. But it is still silly.
Anyway. Good youāve got a diagnosis. Now you can focus on just feeling better.
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He doesnāt at all believe that the āeventā on January 9th, when thing started was BPPV. He believes it was Vestibular Migraine from the beginning. He even looked over the caloric testing from my ENT that showed a 79% dysfunction and said he can see how the results were āmisreadā by my ENT, but said after treating tens of thousands of patients, traveling all over the world researching, teaching and collaboratingā¦ heās 100% confident in his diagnosis of MAV. If heās confident, Iām confident! 
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Absolutely. Thatās what you needed. A diagnosis you can believe in. When it comes down to it, providing tests eliminate the ānastiesā, there arenāt many other things involved they would be prepared to operate on, so how it came to occur is much less relevant at this stage than how to control it. Helen
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