ICU – “I See You” Podcast
PPPD
Listen Now
Available wherever you get your podcasts.
Persistent Postural Perceptual Dizziness. That’s a mouthful! No wonder we call it PPPD! This relatively new vestibular diagnosis helps explain why some people continue to experience vestibular symptoms despite normal test results. PPPD typically starts shortly after an event that causes acute vertigo, dizziness, or some other disruption of balance, but it may also occur for unknown reasons. PPPD causes dizziness without vertigo and fluctuating unsteadiness provoked by environmental or social stimuli, such as crowded places. Some critics question whether this is a “garbage” diagnosis for people with unexplained vestibular-like symptoms. In a separate interview with Professor Jon Stone, we learn that this is not the case, and indeed, that PPPD can co-exist with other vestibular disorders. This episode of the ICU Podcast features a patient who struggles with PPPD and a physical therapist who treats this complex condition.
Guests
Susan Blount is a college professor, publishing and media executive, and certified health and wellness coach who has dedicated her career to education and well-being. After developing Persistent Postural Perceptual Dizziness (PPPD) following a trip to Alaska, she faced life-changing challenges. Yet, through vestibular rehab, cognitive behavioral therapy, and a commitment to strength training, she has redefined what it means to live fully. Now, Susan empowers others with the message that being both healthy and chronically ill is possible. With the support of the VeDA community, she continues to navigate life with resilience, purpose, and joy.
Dr. Megan Daly is an experienced Vestibular Physical Therapist and Health Coach. She has her own physical therapy and coaching practice, helping people to address the root cause of their symptoms, navigate the healthcare system, and modify their lifestyle. She also runs Dizzy Coaches, a vestibular mentoring program for clinicians of all levels. She helps patients with dizziness, migraines, concussions, and balance issues manage their conditions so they can have fewer dizzy days. She has experienced many vestibular conditions personally and brings this empathy to all her patient interactions.
Hosts
Cynthia Ryan, Executive Director of the Vestibular Disorders Association (VeDA)
Kimberly Warner, Founder and Director of Unfixed Media
This podcast is a co-production of the Vestibular Disorders Association (VeDA) and Unfixed Media.
Summary
The podcast explores the complex vestibular disorder known as Triple PD (Persistent Postural-Perceptual Dizziness), featuring two key guests: Susan Blount, a patient living with the condition, and Dr. Megan Daly, a vestibular physical therapist.
Susan shared her challenging journey with PPPD, which began after a series of health complications. Following an upper respiratory infection and hearing loss, she experienced a dramatic onset of dizziness during a return flight from Alaska. Her symptoms included vertigo, brain fog, and extreme sensitivity to environmental stimuli like sounds and lights. Initially struggling to find answers, Susan underwent numerous medical tests and treatments, including vestibular therapy, cognitive behavioral therapy, and medication.
Dr. Daly explained that PPPD is a unique vestibular diagnosis characterized by persistent non-spinning dizziness that differs from other vestibular disorders. Unlike conditions like Benign Paroxysmal Positional Vertigo (BPPV) or vestibular migraine, PPPD creates a constant sense of unsteadiness provoked by environmental stimuli. Importantly, patients can have PPPD alongside other vestibular conditions. The treatment approach for PPPD typically involves a three-pronged strategy:
- Medication (often low-dose anti-anxiety medications)
- Cognitive Behavioral Therapy
- Vestibular Rehabilitation
Susan’s rehabilitation centered on transforming her relationship with dizziness. Instead of concentrating on her symptoms, she learned to shift her focus toward living fully. She adopted strategies such as morning walks, using preparatory techniques before entering challenging environments, and maintaining a positive outlook.
Dr. Daly described vestibular rehabilitation for PPPD as a nuanced process involving:
- Habituation: Gradually exposing patients to movements that trigger symptoms
- Meaningful exercises tailored to the patient’s personal goals
- Sensory system retraining
- Visual input management
- Real-world environment adaptation
Both guests addressed common misconceptions about PPPD. Some critics call it a “garbage diagnosis” for unexplained symptoms, but the podcast emphasized its legitimacy.
The diagnosis helps patients understand their condition and develop effective management strategies. Susan’s key message was about resilience and adaptation. Despite significant life changes, she discovered personal growth through her journey. She learned to grieve her previous lifestyle while embracing new possibilities, ultimately finding strength in her transformed perspective.
Dr. Daly offered hope to those struggling with vestibular disorders, emphasizing that while complete resolution might not always be achievable, patients can learn to manage their symptoms and regain their quality of life. The podcast concluded with encouraging words: patients are not alone, hope exists, and with proper education, professional support, and peer networks, individuals can navigate the challenges of PPPD.
Key takeaways include:
- PPPD is a legitimate vestibular disorder
- Comprehensive, personalized treatment is crucial
- Mindset and adaptive strategies play significant roles in management
- Professional support and patient education are essential
The conversation offered a compassionate and informative exploration of a complex medical condition, providing valuable insights and hope to those experiencing persistent dizziness.
A full transcript is available on YouTube (scroll below the description and click “Show Transcript”).
