Continuing the discussion from More headaches on 150mg effexor… Need a steer please:
I’ve seen many references to ‘crystal clear headache days’ on here going back as far as 2007. I first came across the term, coined by Dr Silver of The Walton Centre, years ago when investigating Preventative Medicines the aim of which he wrote
is to achieve 28 or more ‘brilliantly crystal clear headache-free’ days per month.
As a person whose main MAV symptom has, so far, always been vertigo/dizziness and who always claimed no headache years of attacks past before I realised that since their severity had increased to an extent they would confine me to bed for a week at a time that the presence/absence of rear head pressure was a deciding factor in my debility. Slight rear head pressure might mean I could stand up and walk, excessive head pressure always meant no way. I remember the first time I met the VRT person offering symptoms of 24/7 dizziness and rear head pressure. She smiled without recognition or response. I remember thinking how odd it was have such head pressure when supposedly I’d had labyrinthitis at some undisclosed time in the past that Had obviously slipped my memory and never got recorded in my medical notes (ENT explanation when he couldn’t find anything wrong with me and it wasn’t Menieres).
I’ve long since come to recognise a rear head pressure day is a bad day, a pressure free day a good one. The head pressure became more and more obvious once other symptoms were controlled by meds. It hung on and on but caffeine restriction reduced it considerably but it’s always linked with worse/bad balance days.
I was told my symptoms were ‘migrainous’ and as the same preventatives are used for straight migraine and MAV to try migraine preventatives. Nobody medical seems to be able to reach an conclusion as to whether 24/7 dizziness is or isn’t a substitute for a migraine headache and the same drugs are used for both I think the choice of drug used may depend on the presence/absence of headache aka ‘head pressure’. Propranolol is excellent at controlling migraine attacks but not so hot with vestibular issues. Dr Hain states Effexor is brilliant for visual vertigo and so on. Beyond that I suppose choice order depends on the consultant’s personal opinion. Whichever way it goes I’ve found success for me relies on ‘crystal clear rear head pressure free days’ just as much as it would with a classic migraineur. When I experience a head pressure free day my head sits comfortably on my neck, my neck muscles are completely free and I can look from side to side perfectly naturally and my balance is OK cos ‘underneath’ it’s not damaged. Helen