Preparing For Your Appointment

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In many cases, patients diagnosed with MdDS by a neurologist are prescribed benzodiazepines such as Valium. One of the actions of benzo-medication is suppression of the vestibular periphery organ located in the inner ear. This makes some patients feel better. Intact function of the vestibular periphery, however, is crucial for the success of our treatment. Therefore, we highly recommend stopping taking any benzo-medication 3 weeks prior to treatment. This may substantially elevate your symptoms. Our treatment may not be effective if you do not stop benzo-medication three weeks prior to your treatment. You should contact your physician, who prescribed you the medication and work out a plan to taper off these medications to avoid withdrawal effects. We recommend bringing this medication with you at the time of treatment. To reduce the possibility for your symptoms to be re-triggered by your transportation home, we recommend taking one tablet of benso-medication half an hour prior to a flight (or taking a train, or driving) home. Other medications prescribed by your physician for anxiety, depression, or any other medical conditions or multivitamins have no effect on the treatment and can be taken as prescribed. If you, for whatever reason, cannot stop benso-medication, you should discuss it with Dr. Yakushin (sergei.yakushin@mssm.edu).

We do not recommend exercises on a treadmill or elliptical machines. Cyclic movements on stationary machines give a false sensation of motion. This can potentially elevate your symptoms or re-trigger them after treatment. For these reasons, we recommend avoiding these exercises until you are MdDS-symptom-free. Other gym exercises such as swimming (not rafting) in a pool, over ground running, or bicycle riding are OK.

Please arrive to New York City at least 1 day prior to your treatment. Please arrive at the vicinity of Mount Sinai at least 1 hour prior to treatment.

• The majority of MdDS patients are very sensitive to motion. Therefore, transportation is an important issue since it can potentially increase the severity of some symptoms. It is very important to determine the baseline severity of your symptoms, such as the magnitude and frequency of the rocking, swaying, and bobbing while sitting, standing, walking, or lying down. Thus, any prolonged motion prior to treatment can complicate the treatment.
• If you are driving to New York City for treatment, we recommend avoiding sudden stops and accelerations. While driving, sit upright in the front seat, looking forward. As much as possible, avoid looking in side windows. Some people feel better when they are driving rather than being a passengers in a car due to the motion sickness that is frequently associated with MdDS. However, it is important that patients have a sufficient rest prior to the treatment. Therefore, you should decide for yourself whether it is better for you to drive or be a passenger.
• No cruise, ferry or boat riding is recommended for MdDS patients. Some of our patients have several episodes of MdDS. Reoccurring MdDS are longer in duration and stronger each time when induced. Thus, even when you are symptom free, there is a chance that MdDS will be re-triggered by a cruise.

For the success of our treatment it is critical to obtain several of your parameters accurately. Previous motion due to prolonged transportation, however, can affect the accuracy of our measurements. For this reason, we recommend that if you are arriving from a different state or country, than you arrive in New York City two days prior to treatment. During the treatment, we recommend that you stay within walking distance from Mount Sinai. If you are accepted for treatment, Ms. Schantell Simon will send you a list of reasonably-priced accommodations not far from our lab.

To test whether treatment is successful, we ask our patients to perform certain activities, which typically trigger MdDS symptoms, such as going to crowded places, grocery stores, Broadway shows, etc. Since we do not know how you will respond to these triggers, we recommend that if you would like to see some Broadway shows, you purchase tickets for the first two days of treatment.

You can use all types of transportation during treatment, except ferries or boats.