What to Expect During Your Balance Clinic Visit

Dizziness and imbalance are complex symptoms that require thorough evaluation, and will normally not be cured in one doctor's visit. Here are some guidelines of what you can expect to happen during your visit to the Iowa Ear Center Balance Clinic:

First Appointment

Your first appointment will be an initial consultation, normally with both Dr. Matthew Carfrae and Trisha Hittenmiller, ARNP MSN. Patients being seen on shorter notice may have their first visit with Trisha Hittenmiller ARNP and meet Dr. Matthew Carfrae at a subsequent visit. By having both Dr. Carfrae and Trisha Hittenmiller, ARNP see you as a team, we are better able to form an individualized plan of care.

You will have an audiogram performed by one of our audiologists. If you have had previous audiograms elsewhere, please bring them along as our clinicians will need to compare your results for a complete assessment of your symptoms. 

We will always need to obtain our own audiogram at Iowa Ear Center.  This is very important information for diagnosing inner ear problems. Specifically, our providers are able to exclude or consider diagnoses with by comparing audiograms.

You can expect us to review your history of past and current symptoms. 

Diagnostic testing will be ordered for further investigation into what may be going on.  This may include: MRI, CT, and/or vestibular testing dependent upon the situation.

The most important thing to understand is that your first appointment will be a consultation and it is rare to come to a definitive diagnosis on the first visit.  

On average, all vestibular and imbalance patients will have anywhere from 2-4 appointments before a diagnosis is formulated. Diagnosing vestibular conditions is a process that takes place over time. Inner ear disorder diagnoses are more based off the personal description of symptoms past and present. 

With diagnostic testing, we are excluding more acute conditions.  Diagnostics seldom show the specific pathology of the inner problem.  Therefore, it is important to understand that some of these conditions are grey areas; not black and white.  For example, you could obtain a chest x-ray to diagnose pneumonia.  With vestibular disorders, this is not the case. 

You can expect for a referral to vestibular therapy to be made during your first appointment.

Second Appointment

You can expect to see Trisha Hittenmiller, ARNP for all follow-up appointments as we complete the workup process. Dr. Matthew Carfrae is primarily a surgeon, and surgery is not commonly appropriate for most patients living with dizziness or imbalance. If Trisha Hittenmiller ARNP believes further consultation with Dr. Carfrae is appropriate, she will make sure that is done.

We may need to obtain a repeat audiogram, dependent upon intake from first appointment. This helps our clinicians evaluate the stability of some of your symptoms.

We will review recently obtained diagnostic testing with you, as well as interventions recommended at your previous appointment. We may also discuss if more diagnostic tests are warranted. At this point in the process, there is some potential for a “possible” diagnosis and treatment.

Third Appointment

You can expect us to review how previously recommended interventions are working, as well as your current symptoms. Depending upon your response to therapy, it is possible that your plan of care may change course. 

Working Together for Your Success

Iowa Ear Center Vestibular & Balance Clinic staff want you succeed in your course of treatment, so that you can get back to feeling more like yourself. This requires a cooperative relationship between providers and patient as we work together to diagnose the problem and treat your symptoms in the least invasive way possible.