Initial Consult
The primary objective of an Initial Consult is to conduct a very thorough case history review and perform some simple, but valuable, bedside screening tests that help determine whether more advance diagnostic testing may be required. It also includes a BPPV assessment and repositioning maneuvers, if required. There is not typically enough time during an Initial Consult to conduct any advanced diagnostic testing, but it is often possible to gather enough information to form a reasonable impression of what may or may not be causing your symptoms and create a coherent plan going forward.
Should it be determined that you do in fact require more advanced diagnostic testing, a custom follow-up appointment can be booked to perform the specific tests you require. The length and cost of such follow-up appointments will depend upon which particular tests are required, and how much clinic time must be booked. Having said that, even if you end up requiring the full comprehensive test battery, the total cost of your Initial Consult + Subsequent Diagnostic Testing will not exceed that of a 3hr Comprehensive Assessment in the vast majority of cases. There can be rare exceptions when dealing with extrordinarily complex cases, or multiple co-occuring conditions, but it is uncommon. If it is determined that you require a Subsequent Diagnostic Testing appointment that would result in the total cost exceeding that of a comprehensive assessment, it would be thoroughly disucussed with you beforehand, and you always have the option to decline.
If you would like to avoid having to return for f/u testing should it be required, you may want to consider booking a full 3hr comprehensive assessment, during which all required testing can typically be completed in a single appointment.
Appointment length: 60min / 1hr
Cost: $300
Some important information on BPPV/Ear Crystals:
Many people have been told, or even “diagnosed” with BPPV(often referred to as something along the lines of crystals in their ears), and that they just need a quick maneuver to get them out, or back in place. While BPPV certainly is common, and we absolutely love helping people who have it, the reality is that we have literally seen hundreds patients who have been definitively MISdiagnosed with BPPV when the actual source of their vertigo/dizziness/imbalance was something entirely different, which cannot be corrected with simple maneuvers. Unfortunately, there seems to be a profound lack of understanding and awareness surrounding the wide range of vestibular disorders that can cause dizziness/vertigo-type symptoms, and how to differentiate BPPV from everything else that might be causing them. “Vertigo” is NOT a diagnosis – it is a symptom. BPPV is one potential cause for the symptom of vertigo, but it is only one potential cause. Because of this confusion, we no longer offer short duration “quick fix” BPPV appointments, even if you’ve been “diagnosed” with BPPV by a doctor or other health care provider. We know they are absolutely well-intentioned, but our experience as a dedicated vestibular clinic is that the vast majority of patients who have been referred to us for a quick BPPV “fix”, do not actually have BPPV. Or, it is not the sole underlying cause of their symptoms, and is actually a secondary complication of a larger underlying issue. In any case, the point of this extensive explanation is that even if you believe you just have BPPV (or have even been “diagnosed” with it), you still need to book an Initial Consult so that we can properly assess you and ensure that is in fact what you’re dealing with. If it is, that’s fantastic news and we will absolutely perform the necessary corrective maneuvers to resolve it as part of that appointment. The added benefit is that you will also receive peace of mind that you have been thoroughly assessed by a dedicated vestibular specialist for any other potential underlying problems. If you would like to learn more about the key features and common misconceptions regarding BPPV, please refer to the “BPPV Self-Assessment Tool” located on our “Helpful Resources” page.
Comprehensive Assessment
A Comprehensive Assessment is effectively an Initial Consult plus any additional advanced diagnostic testing that is indicated by your symptoms and history, in a single appointment. It allows us to immediately perform the full battery of powerful objective testing we have at our disposal, and provides the best possible chance of definitively determining the root cause(s) of your symptoms. This ultimately allows us to make the most well-informed and appropriate treatment recommendations going forward. In many cases, this includes identifying issues that require other specialty referrals (ex. ENT or Neurology), or specific imaging (ex. brain MRI or head CT), which we are happy to help you acquire by providing specific written recommendations to your GP, supported by objective data. These types of referral/requisition recommendations may not be possible based on an Initial Consult alone, since they often require objective test findings to justify their need and ensure they are accepted. If one of the reasons you are seeking assessment is to obtain a difficult to acquire specialty referral or image requisition, then it would make the most sense to book a Comprehensive Assessment as opposed to an Initial Consult. Likewise, if you are travelling a significant distance to see us, or would just like to avoid having to return for additional follow-up testing for any reason, it is also highly recommended that you book a Comprehensive Assessment.
Appointment length: 180min / 3hrs
Cost: $995
*Please read if you are travelling from out of town: Due to the fact that we are one of the only private clinics in Canada that provides such an extensive battery of advanced diagnostic vestibular testing, patients often travel long distances to see us. While it is rare that we require more than a 3hr appointment to complete all of the testing that is indicated by your symptoms and history, there are some exceptions when dealing with extrordinarily complex cases, or multiple co-occuring conditions. If you are travelling to see us, and have a complex or extensive/long-standing history, or multiple co-occuring conditions, it is highly recommended that you also book a brief phone consult with the audiologist prior to your trip. This ensures that extra time can be booked for your Comprehensive Assessment if it is likely to be required. Extra time is billed at the standard clinic rate of $300/hr, but it is far better than the unexpected cost of an unplanned return trip.
Virtual Consult (Phone/video call)
If you’re still not sure what type of appointment to book after having read the above descriptions, are travelling a long distance to come see us (also see above), or just want to speak directly with the audiologist for any reason, you can book a 15 minute virtual consult that can be conducted over the phone or by video chat. Please note that this is a relatively brief consult (15 min), which is not an adequate amount of time to conduct a detailed/in-depth review of your symptoms and history. It is primarily just to determine if you would be a good candidate for an in-clinic assessment, and what type of appointment would be most appropriate. The audiologist cannot perform any testing, diagnose you, or provide treatment over the phone. Although there isn’t enough time for an extensive history review during a Phone/Video Consult, when you book one it does allow you to fill out an extensive “Balance and Dizziness Medical History” form, which the audiologist will review prior to your call, if you complete it.
Appointment length: 15min (Virtual, via phone or video call – Not an in-clinic appointment)
Cost: $50
Vestibular Rehabilitation Therapy (VRT)
VRT sessions at Alberta Balance Centre are individualized to your specific needs, and are based on an extensive diagnostic assessment to determine exactly what aspects of your vestibular system require rehabilitation. VRT is not just a universal handful of exercises that treat all problems equally. There are literally hundreds of different exercises that fall under the VRT umbrella, and specific problems require the appropriate selection of specific exercises. For that reason, prior assessement is absolutely essential before booking a VRT session. Otherwise, we don’t actually know what it is we’re trying to treat! We have heard countless stories of people being told to just go get some vestibular therapy without having had any sort of formal diagnostic assessment to determine if they even have a vestibular problem. Even if it has already been determined that you do likely have a vestibular problem, there are very few clinics in Canada that have the necessary diagnostic equipment and expertise to precisely determine what that problem is. Since there are a multitude of different vestibular issues requiring different treatment approaches, a detailed diagnostic assessment is absolutely critical.
It is true that many paramedical clinics (ex. physio, chiro, osteo, massage etc.) offer vestibular rehab without any formal diagnostic testing, but we are a far more specialized vestibular clinic, completely dedicated to precision diagnostics and carefully crafted, evidence-based rehab plans for specific vestibular issues. We pride ourselves on providing more targeted and effective VRT programs than most other clinics are able to. That isn’t meant to be a criticism. It’s simply a reflection of the fact that they aren’t dedicated vestibular clinics, and don’t have access to the same advanced diagnostic testing. We are able to remove the guess work and create plans that target very specific impairments based on objective data, as opposed to giving you a multitude of different exercises and just hoping that some of them address the underlying issue. In addition to all of the objective diagnostics, we also utilize numerous clinically validated functional assessments and formal outcome measures when creating individual VRT plans. This allows us to formally measure your progress over time to ensure we are actaully achieving our rehab goals, or make adjustments to your program if progress is less than expected.
VRT sessions can only be booked by existing patients who have already had an assessment at our clinic. Because effective VRT is a process of rehabilitation that often occurs over a longer period of time, most plans involve at least 3 sessions spaced out over a period of approximately 2 months (Ex. Initial session + 1 month f/u + Final session approx. 1 month later). Programs can obviously vary since they are highly individualized, but this is the most common structure. For that reason, we have decided to offer pre-paid 3-session VRT packages at a discounted rate compared to paying for 3 single/stand-alone sessions. With pre-paid packages, you get 3 sessions for the same cost as 2 individually purchased single sessions. If you complete your 3 pre-paid sessions and still require/want more, we will provide additional single sessions at a reduced rate so you don’t have to purchase another package.
Appointment length: 45 min
Cost:
Single/Stand-Alone session: $225
Pre-paid 3-Session VRT package: $450
Individual/Stand-Alone Tests
While we can perform individual tests in isolation under certain circumstances, they cannot be booked without first having had an initial consult. The cost for performing individual/stand-alone tests depends on which specific test(s) is/are being requested, and the estimated amount of clinic time required to complete them.
EXISTING PATIENTS ONLY appointments
We offer a variety of appointments for patients who have already been to the clinic for an Initial Consult or Comprehensive Assessment. These can be viewed on the online booking page and include:
- Subsequent Diagnostic Testing
- Vestibular Rehabilitation Therapy (VRT) Sessions
- General follow-up
- Complimentary f/u phone or video calls with the audiologist
*Please do not book any “EXISTING PATIENT ONLY” appointments if you have not already had an in-clinic assessment. It is not a loophole that allows you to book treatment without having had an assessment, or a reduced-rate/free consult. If you book an “EXISTING PATIENTS ONLY” appointment without having had a previous assessment at our clinic, it will be promptly canceled without notice. Please see the above VRT section for a detailed explanation of why you can’t just book a treatment session without an assessment*