Grounded | The Vestibular Podcast

One thing that a lot of people with vestibular disorders notice is how fatiguing or challenging different tasks become over time. 

What’s happening is your brain is trying to process multiple inputs (or even tasks) at the same time. 

For those with vestibular disorders, it becomes more difficult because your body is trying to process more information—and it’s also now having to work double time to keep you upright.

Multitasking and task switching are a part of daily life, but it comes with costs. And those with vestibular disorders often notice this more but aren’t quite sure how to make it go away.

But this episode is here to help!

In this episode, we’ll dig into:

Why tasks feel manageable alone but become overwhelming when combined

How multitasking and task switching are similar and different

What the “switch cost” is and how it adds up over time for those with vestibular disorders

What percentage of people with vestibular conditions experience cognitive symptoms like brain fog

How the central nervous system and cerebral cortices matter for cognitive symptoms

Why spatial awareness demands extra resources when you have a vestibular disorder

How balance exercises in VRT are designed to gradually scale up task demands

Why errors are actually part of healing with a vestibular condition

Why rest and recovery are essential when you’re adding in more cognitive or physical tasks

Task switching and multitasking are hard for everyone! A vestibular disorder just adds an extra layer—it doesn’t mean things can’t improve, but it does take time, space, and grace.

You’re doing more things than you think and certainly doing more than you take credit for.

Links Mentioned:

Vestibular Group Fit (code GROUNDED at checkout for 15% off!): https://thevertigodoctor.com/vestibular-group-fit

Free Resources:

⁠The 4 Steps to Managing Vestibular Migraine: https://thevertigodoctor.myflodesk.com/cb5js0y78n

⁠The PPPD Management Masterclass⁠: https://thevertigodoctor.myflodesk.com/new-pppd

⁠What your Partner Should Know About Living with Dizziness⁠: https://thevertigodoctor.myflodesk.com/partnership

⁠The FREE Mini VGFit Workout⁠: https://thevertigodoctor.myflodesk.com/minifit

⁠The FREE POTS – safe Workouts⁠: https://thevertigodoctor.myflodesk.com/pots

Connect with Dr. Madison (@TheVertigoDoctor): https://instagram.com/thevertigodoctor

Work with Dr. Madison:

For 1:1 Vestibular Rehabilitation Therapy, email madison@thevertigodoctor.com

Otherwise, I’ll see ya in Vestibular Group Fit!

Connect with Dr. Jenna (@dizzy.rehab.therapist): https://www.instagram.com/dizzy.rehab.therapist/

Learn about the Oak Method: http://thevertigodoctor.com/why-vestibular-group-fit

Love what you heard?
Consider leaving a review on your favorite podcast platform to help us reach more vestibular warriors like you!

This podcast is for informational purposes only and may not be the best fit for you and your personal situation. It shall not be construed as medical advice. The information and education provided here is not intended or implied to supplement or replace professional medical treatment, advice, and/or diagnosis. Always check with your own physician or medical professional before trying or implementing any information read here.

Citations 

McGrath, Kim. “The “Switch Cost” of Multitasking.” Wake Forest News, 16 Apr. 2024, news.wfu.edu/2024/04/16/the-switch-cost-of-multitasking/.

Asuako, P. A. G., Stojan, R., Bock, O., Mack, M., & Voelcker-Rehage, C. (2025). Multitasking: does task-switching add to the effect of dual-tasking on everyday-like driving behavior?. Cognitive research: principles and implications, 10(1), 5. https://doi.org/10.1186/s41235-025-00611-y

Smith, L. J., Wilkinson, D., Bodani, M., & Surenthiran, S. S. (2024). Cognition in vestibular disorders: state of the field, challenges, and priorities for the future. Frontiers in neurology, 15, 1159174. https://doi.org/10.3389/fneur.2024.1159174

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task switching and multitasking, things to help with brain fog, vestibular migraine brain fog, what causes brain fog and dizziness, vestibular disorders, vestibular group fit, living with vestibular migraine, living with chronic dizziness, sensory overload, spatial awareness, cognitive abilities

Heading somewhere with a big elevation change? Good news! Most people living with vestibular disorders actually do really well at altitude. But that doesn’t mean you just show up unprepared and hope for the best.

In this episode, I’m breaking down everything you need to know about navigating altitude changes with a vestibular disorder. 

From quick pressure shifts like takeoff and landing, to extended stays at higher elevations, I’m sharing what to keep on standby, what to avoid, and why slower adjustments make all the difference.

In this episode, we’ll dig into:

Why most people with vestibular disorders actually feel good at altitude

Tools for quick pressure changes like takeoff, landing, and steep elevation drives

The difference between earplanes & WeatherX earplugs

Why slower ascents make a huge difference and how to pace your elevation

Medications to ask your doctor about before travel

Why you most definitely want to rethink alcohol at elevation

What self-care tips still apply at altitude

The research behind nature being great for your nervous system

My thoughts on oxygen bars and vestibular disorders

Altitude changes don’t have to derail your trip! With the right prep, the right toolkit, and a slower ascent, you absolutely can enjoy the mountain tops.

Links Mentioned:

Vestibular Group Fit (code GROUNDED at checkout for 15% off!): https://thevertigodoctor.com/vestibular-group-fit

WeatherX Earplugs: https://amzn.to/4h7Py7N

Earplanes: https://amzn.to/4aQji5b

Free Resources:

⁠The 4 Steps to Managing Vestibular Migraine: https://thevertigodoctor.myflodesk.com/cb5js0y78n

⁠The PPPD Management Masterclass⁠: https://thevertigodoctor.myflodesk.com/new-pppd

⁠What your Partner Should Know About Living with Dizziness⁠: https://thevertigodoctor.myflodesk.com/partnership

⁠The FREE Mini VGFit Workout⁠: https://thevertigodoctor.myflodesk.com/minifit

⁠The FREE POTS – safe Workouts⁠: https://thevertigodoctor.myflodesk.com/pots

Connect with Dr. Madison (@TheVertigoDoctor): https://instagram.com/thevertigodoctor

Work with Dr. Madison:

For 1:1 Vestibular Rehabilitation Therapy, email madison@thevertigodoctor.com

Otherwise, I’ll see ya in Vestibular Group Fit!

Connect with Dr. Jenna (@dizzy.rehab.therapist): https://www.instagram.com/dizzy.rehab.therapist/

Learn about the Oak Method: http://thevertigodoctor.com/why-vestibular-group-fit

Love what you heard?
Consider leaving a review on your favorite podcast platform to help us reach more vestibular warriors like you!

This podcast is for informational purposes only and may not be the best fit for you and your personal situation. It shall not be construed as medical advice. The information and education provided here is not intended or implied to supplement or replace professional medical treatment, advice, and/or diagnosis. Always check with your own physician or medical professional before trying or implementing any information read here.

Citations

“Mountain Vacation? 5 Tips to Cope with Your Altitude Sickness.” Cleveland Clinic, health.clevelandclinic.org/understanding-altitude-sickness-5-best-tips-for-your-next-mountain-trip.

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vertigo and altitude changes, altitude and vertigo, travel and vestibular disorders, vestibular group fit, VGF, living with vestibular disorder, weather & vestibular disorder, change in pressure, inner ear, manage migraine, weatherx earplanes, meniere’s disease, nervous system regulation, chronic dizziness, PPPD

If you’ve ever tried to do too much, crashed hard, and then felt like you were back at square one—this episode is for you. I’m talking about two of the most important concepts we teach in Vestibular Group Fit: scaling and pacing.

It cannot be stressed enough how important this is and how much we talk about it in VGF.

Scaling and pacing aren’t about doing less forever. They’re about building capacity strategically so you can eventually do MORE without paying for it for days afterward.

I’m walking you through real-life examples of how to scale movement, exercise routines, walking, driving, and other daily activities — plus what to do on higher symptom days and post-attack so you can recover faster and get back to living your life.

In this episode, we’ll dig into:

What scaling and pacing actually mean and how they’re different

Why you should never increase more than 10% at a time

How to scale things like strength training, walking, and driving

The difference between “immediate” responders and “hangover” responders

Real-life pacing strategies you can add into your day-to-day life

How to scale down on post-attack or high symptom days

The 30-day to 30-minute return to walk program results from VGF

Summer consistency challenge details for Vestibular Group Fit members

Whether it’s exercise, grocery shopping, driving, or attending your nephew’s graduation—the same principles apply. Scaling and pacing are skills. As with any skill, it takes time, practice, and a whole lot of grace and patience with yourself.

Links Mentioned:

Vestibular Group Fit (code GROUNDED at checkout for 15% off!): https://thevertigodoctor.com/vestibular-group-fit

Inside VGF, we have two helpful lessons: Visualization exercises for return to driving, and a 30-day to 30-minute return to walk program

Free Resources:

⁠The 4 Steps to Managing Vestibular Migraine: https://thevertigodoctor.myflodesk.com/cb5js0y78n

⁠The PPPD Management Masterclass⁠: https://thevertigodoctor.myflodesk.com/new-pppd

⁠What your Partner Should Know About Living with Dizziness⁠: https://thevertigodoctor.myflodesk.com/partnership

⁠The FREE Mini VGFit Workout⁠: https://thevertigodoctor.myflodesk.com/minifit

⁠The FREE POTS – safe Workouts⁠: https://thevertigodoctor.myflodesk.com/pots

Connect with Dr. Madison (@TheVertigoDoctor): https://instagram.com/thevertigodoctor

Work with Dr. Madison:

For 1:1 Vestibular Rehabilitation Therapy, email madison@thevertigodoctor.com

Otherwise, I’ll see ya in Vestibular Group Fit!

Connect with Dr. Jenna (@dizzy.rehab.therapist): https://www.instagram.com/dizzy.rehab.therapist/

Learn about the Oak Method: http://thevertigodoctor.com/why-vestibular-group-fit

Love what you heard?
Consider leaving a review on your favorite podcast platform to help us reach more vestibular warriors like you!

This podcast is for informational purposes only and may not be the best fit for you and your personal situation. It shall not be construed as medical advice. The information and education provided here is not intended or implied to supplement or replace professional medical treatment, advice, and/or diagnosis. Always check with your own physician or medical professional before trying or implementing any information read here.

physical activity intensity, scaling and pacing, activity pacing, scaling physical activity, vestibular disorder management, chronic dizziness, living with vestibular disorder, migraine attacks, nervous system regulation, exercises to improve balance, return to walking, driving with vestibular disorder, vestibular exercises

I recently got a certificate in functional nutrition and I have thoughts. Starting with the fact that staying hydrated and fueling your body with nutrients will be—not can be, will be—a game-changer for your vestibular disorder.

In this episode, I’m breaking down something that comes up over and over again in Vestibular Group Fit: how much what you eat (and drink!) actually matters when you have a vestibular disorder.

This isn’t about going on a perfect diet or never eating processed foods again. It’s about understanding how blood sugar regulation, hydration, inflammation, gut health, and hormones are all connected to your dizziness. And what small, manageable steps you can take to start feeling better.

In this episode, we’ll dig into:

Why diet & hydration are foundational basics for managing a vestibular disorder

How blood sugar crashes — including overnight ones — can trigger dizziness & attacks

Why skipping meals is practically a guaranteed migraine trigger

The role of key nutrients like iron, vitamin D & B vitamins in managing chronic dizziness

How inflammation connects to vestibular disorders — and how food either fuels or fights it

Perimenopause & menopause: how hormonal changes affect metabolism, muscle mass, insulin sensitivity & dizziness

Endocrine-disrupting chemicals (plastics, pesticides, PFAs) & how low-tox swaps can make a real difference

Why your gut microbiome might be the reason your medications aren’t working

Practical, accessible ways to start improving your nutrition without overhauling everything at once

You don’t have to eat perfectly! You just have to start somewhere because the better your nutrition and hydration are, the better you will feel.

Links Mentioned:

Vestibular Group Fit (code GROUNDED at checkout for 15% off!): https://thevertigodoctor.com/vestibular-group-fit

Optimal Bloodwork Link: https://thevertigodoctor.myflodesk.com/yt2ko79vaq 

Detoxify by Alli Cohen: https://www.amazon.com/dp/1668033534/ref=cm_sw_r_as_gl_api_gl_i_TYFM23HJFGM1JPQW5671?linkCode=ml1&tag=thevertigodoc-20&linkId=1700598d13c22416e1837eb71940139d 

EWG Dirty Dozen list: https://www.ewg.org/foodnews/dirty-dozen.php

Free Resources:

⁠The 4 Steps to Managing Vestibular Migraine: https://thevertigodoctor.myflodesk.com/cb5js0y78n

⁠The PPPD Management Masterclass⁠: https://thevertigodoctor.myflodesk.com/new-pppd

⁠What your Partner Should Know About Living with Dizziness⁠: https://thevertigodoctor.myflodesk.com/partnership

⁠The FREE Mini VGFit Workout⁠: https://thevertigodoctor.myflodesk.com/minifit

⁠The FREE POTS – safe Workouts⁠: https://thevertigodoctor.myflodesk.com/pots

Connect with Dr. Madison (@TheVertigoDoctor): https://instagram.com/thevertigodoctor

Work with Dr. Madison:

For 1:1 Vestibular Rehabilitation Therapy, email madison@thevertigodoctor.com

Otherwise, I’ll see ya in Vestibular Group Fit!

Connect with Dr. Jenna (@dizzy.rehab.therapist): https://www.instagram.com/dizzy.rehab.therapist/

Learn about the Oak Method: http://thevertigodoctor.com/why-vestibular-group-fit

Love what you heard?
Consider leaving a review on your favorite podcast platform to help us reach more vestibular warriors like you!

This podcast is for informational purposes only and may not be the best fit for you and your personal situation. It shall not be construed as medical advice. The information and education provided here is not intended or implied to supplement or replace professional medical treatment, advice, and/or diagnosis. Always check with your own physician or medical professional before trying or implementing any information read here.

Citations

Patelarou, E., & Giakoumidakis, K. (2025). Nutrition and Quality of Life for Patients with Chronic Disease. Nutrients, 17(13), 2170. https://doi.org/10.3390/nu17132170

Paramasivam, A., Murugan, R., Jeraud, M., Dakkumadugula, A., Periyasamy, R., & Arjunan, S. (2024). Additives in Processed Foods as a Potential Source of Endocrine-Disrupting Chemicals: A Review. Journal of xenobiotics, 14(4), 1697–1710. https://doi.org/10.3390/jox14040090

Erdélyi, A., Pálfi, E., Tűű, L., Nas, K., Szűcs, Z., Török, M., Jakab, A., & Várbíró, S. (2023). The Importance of Nutrition in Menopause and Perimenopause-A Review. Nutrients, 16(1), 27. https://doi.org/10.3390/nu16010027

Yu, X., Pu, H., & Voss, M. (2024). Overview of anti-inflammatory diets and their promising effects on non-communicable diseases. The British journal of nutrition, 132(7), 898–918. https://doi.org/10.1017/S0007114524001405

Kang, H. S., Kim, S. Y., Kim, J. H., Kim, E. S., Choi, H. G., Lim, H., Kim, J. H., Park, H. Y., Kim, N. Y., Hong, S., Choi, K. C., & Kwon, M. J. (2022). Association between Migraines and Prior Proton Pump Inhibitor Use: A Nested Case-Control Study Using a National Health Screening Cohort. Pharmaceuticals (Basel, Switzerland), 15(11), 1385. https://doi.org/10.3390/ph15111385

Zhang P. (2022). Influence of Foods and Nutrition on the Gut Microbiome and Implications for Intestinal Health. International journal of molecular sciences, 23(17), 9588. https://doi.org/10.3390/ijms23179588

importance of nutrition, functional nutrition, nutrition and lifestyle, living with vestibular migraine, diet and nutrition, treatment for vestibular disorders, diet for vestibular migraine, food and diet for vestibular disorder, migraine management, chronic dizziness, PPPD, vestibular group fit

If you’ve ever started a new medication and immediately felt worse—you’re not broken, and you’re definitely not alone. 

In this episode, I’m diving into one of the most common and most frustrating experiences in the vestibular world: medication sensitivity. And more importantly, what to actually do about it.

I’m breaking down why so many people with vestibular disorders struggle to tolerate new medications, how to wean on and off gradually to give yourself the best shot at success, and why going slow is actually the fastest way to feel better. We’re also talking about the nocebo effect—because what you expect from a medication can literally shape what you experience.

Plus, I’m making a case for the most underutilized resource in your healthcare team: your pharmacist. Seriously, use them. They know things your doctor might miss.

In this episode, we’ll dig into:

Why medication sensitivity is SO common in the vestibular community

The case for weaning onto medications gradually

What compounding pharmacies are & how they can be a game changer for hypersensitive people

Why you need to understand the nocebo effect before starting a new medication

How to tell the difference between “dizziness as a side effect” vs your chronic dizziness

How to set yourself up for success when starting a new medication

A tool you can use to take the guesswork out of medications

Starting a new medication doesn’t feel like as much of a gamble when you know how to prepare, advocate for yourself, and you go slow. Following these tips, you give yourself the very best shot at finally feeling better.

Related Episodes:

How to Wean Off Your Preventative Medications: https://thevertigodoctor.com/podcast/54-how-to-wean-off-your-preventative-medications/

Links Mentioned:

Vestibular Group Fit (code GROUNDED at checkout for 15% off!): https://thevertigodoctor.com/vestibular-group-fit

Golden Genetics (mention Dr. Madison for a discount!): https://www.goldengeneticshealth.com/

Free Resources:

⁠The 4 Steps to Managing Vestibular Migraine: https://thevertigodoctor.myflodesk.com/cb5js0y78n

⁠The PPPD Management Masterclass⁠: https://thevertigodoctor.myflodesk.com/new-pppd

⁠What your Partner Should Know About Living with Dizziness⁠: https://thevertigodoctor.myflodesk.com/partnership

⁠The FREE Mini VGFit Workout⁠: https://thevertigodoctor.myflodesk.com/minifit

⁠The FREE POTS – safe Workouts⁠: https://thevertigodoctor.myflodesk.com/pots

Connect with Dr. Madison (@TheVertigoDoctor): https://instagram.com/thevertigodoctor

Work with Dr. Madison:

For 1:1 Vestibular Rehabilitation Therapy, email madison@thevertigodoctor.com

Otherwise, I’ll see ya in Vestibular Group Fit!

Connect with Dr. Jenna (@dizzy.rehab.therapist): https://www.instagram.com/dizzy.rehab.therapist/

Learn about the Oak Method: http://thevertigodoctor.com/why-vestibular-group-fit

Love what you heard?
Consider leaving a review on your favorite podcast platform to help us reach more vestibular warriors like you!

This podcast is for informational purposes only and may not be the best fit for you and your personal situation. It shall not be construed as medical advice. The information and education provided here is not intended or implied to supplement or replace professional medical treatment, advice, and/or diagnosis. Always check with your own physician or medical professional before trying or implementing any information read here.

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vestibular medication, medication for vestibular disorder, placebo and nocebo effect, side effects, vestibular migraine, VM, vestibular disorders, chronic dizziness, mindset and the nocebo effect, increased anxiety and depression, nervous system and dizziness, vestibular group fit, migraine management, compounding pharmacies