Dr appt today....new advice

Hi All,

Today I had my appt. with my family md (who is awesome). He has been my dr for like 10 years. Anyways, I went to him 2 weeks ago in tears, anxious, fidgety, a complete mess. He suggested “talking to someone” and said I have situational anxiety. Well, he wanted me to talk to this female psych. but she was booked so I went to this man twice who cut my sessions short and charged full price. So, tonight (after a nurse friend called in a favor) I will see the female psych who my doc wanted me to see in the first place.

About the appt…well, he thinks I should really stop playing with my verapamil so much, stay at an increase and that will be enough to hopefully burnout the mav. I did get better on about 1/2 - 3/4 roughly before. He thinks I was having heart palpitations from anxiety not the Verapamil. He said Verapamil can cause those but unlikely. They actually prescribe Verapamil for heart palpiatations.

He is very leary about me starting Celexa now or any antidepressants. I told him Hain’s ordered me Celexa. He said he would prefer me to hold off because of the terrible, paradoxyl reactions I have had on ssri’s. He also thinks if the Verapamil cuts some of the mav symptoms, my anxiety will drop off some and I can work on the rest with the psych. He said he is all for antidepressants but not now in my case. He said he thinks by me getting all this different advice from these drs adds to my anxiety. I just need to stick with something and not be “all over the place”.

so, back up on the Verapamil, I guess. I am pretty dizzy today but my period keeps starting and stopping. My cycles are all screwed up. My dr said it is all the stress causing it. That is probably making my mav worse.

That is the newest info.

Nance

Hi Nance,

Sounds like a plan. See how you go with this for a while. It sounds like the doc plus new psych might help you to kill this off without having to resort to an SSRI which would be great.

I am still surprised by the doc saying that because you had a bad time on one or two SSRIs that you would likely have a bad time on the other ones. I don’t think that is true. I would just hate for you to close the door on a potentially effective treatment – throwing the baby out with the bath water as they say.

Really hope this current strategy works.

Best … Scott :slight_smile:

Hi Nance,
While I absolutely agree with your plan of sticking with one doctor, I really hope you are sticking with the correct doctor. Many of you may not know this but neurologists are boarded in both neurology and psychiatry (as are psychiatrists), so both are VERY knowledgable about all the meds we take for migraine as well as the emotional aspects surrouding this dreaded illness. With regards to your palpitations, I strongly enourage you to get this checked out by a cardiologist as so many doctors mistakenly in young pre-menopausal women dismiss heart related complaints as anxiety. I especially urge you to go for further evaluation if you have any history of palpitations before these recent stressful events.
I wish you the best of luck and we are all pulling for ya!
Keep us posted!!!
lisa

Nance - thanks for updating us. I think what Lisa said is 100% correct. I’m sure it’s nothing, but you always want to err on the side of safety when it comes to anything cardio. It certainly cannot hurt to check it out with a cardiologist. Btw - when I was on verapamil, I had a heightened awareness of my heart beating, which is a side effect of the med. Dr. Bucholtz writes about it in his book. I was also glad to hear that your internist agreed that you need meds to combat this illness, and did not just write everything off to anxiety. All the best to you. Please keep us updated.

In me, it is SO hormone connected. But I’m glad I did have the heart checked out because I do feel reassured now that I know for sure it’s OK. I had that increased awareness of heartbeat thing (boy, that IS a strange sensation!!), and got EKG, echo stress test, 24 hour holter monitor - all this was after I felt I was going to pass out for no reason. Turns out I was having migraine aura (tunnel vision) at the same time as a brand new, never had it before, severe episode of Migraine-Associated Dizziness! Which all happened about 3 weeks after I had to postpone a mammogram for the first time in my life: I was so sore, I thought I was ready to start nursing (lots of people think perimenopause is when your estrogen only drops - HA! - I’m sure I had an estrogen spike, and THEN a rapid drop from some ridiculously high estrogen level that triggered all the fun that I’ve been going through for the past year).

Nance, I will keep my fingers crossed for you that the Verapamil will work for you again - it did before, but with circumstances being more challenging now, a breakthrough isn’t really unexpected. I don’t think any medication can hold this off through everything. But you’ve had success with this med - you stand a very good chance that it will work again.

My MAV is also a result of fluctuating hormones. Hormones can fluctuate many times in one day. So even if I feel ok in the morning, I could feel horrible, dizzy, off balance, ringing ears … within a hour. I never know how I am going to feel. That’s one reason I dont want to try meds. I am afraid I would get the dosage correct and then my hormones would fluctuate and undo all the good meds can do. I choose diet and lifestyle changes. It does help to a point but I am just waiting for my hormones to settle down. I always know I will have a bad time when my ovaries are bothering me. Hormones run my whole life at this point.

Hi Joan,
I was just wondering, which meds are you specifically worried about affecting your hormone levels? Outside of the birth control pills, I am not really aware of meds directly affecting the female hormones. I think what meds could do is raise your threshold, so that your fluctuating hormones would not cause you to have MAV symptoms, or at least that is the theory behind taking medication to treat MAV.
Best,
Lisa

In my opinion - if female hormones had a direct impact on male sexual functioning (like ED), our hormone problems would have been researched in depth a long time ago and we’d have lots of good options for monitoring it and treating it (even given the fluctuations throughout the day). A patch or something, with a smart chip in it…

:oops:

Maybe we’ll get lucky and that research will happen anyway. I can dream, can’t I?

— Begin quote from “nance”

Hi All,

Today I had my appt. with my family md (who is awesome). He has been my dr for like 10 years. Anyways, I went to him 2 weeks ago in tears, anxious, fidgety, a complete mess. He suggested “talking to someone” and said I have situational anxiety. Well, he wanted me to talk to this female psych. but she was booked so I went to this man twice who cut my sessions short and charged full price. So, tonight (after a nurse friend called in a favor) I will see the female psych who my doc wanted me to see in the first place.

About the appt…well, he thinks I should really stop playing with my verapamil so much, stay at an increase and that will be enough to hopefully burnout the mav. I did get better on about 1/2 - 3/4 roughly before. He thinks I was having heart palpitations from anxiety not the Verapamil. He said Verapamil can cause those but unlikely. They actually prescribe Verapamil for heart palpiatations.

He is very leary about me starting Celexa now or any antidepressants. I told him Hain’s ordered me Celexa. He said he would prefer me to hold off because of the terrible, paradoxyl reactions I have had on ssri’s. He also thinks if the Verapamil cuts some of the mav symptoms, my anxiety will drop off some and I can work on the rest with the psych. He said he is all for antidepressants but not now in my case. He said he thinks by me getting all this different advice from these drs adds to my anxiety. I just need to stick with something and not be “all over the place”.

so, back up on the Verapamil, I guess. I am pretty dizzy today but my period keeps starting and stopping. My cycles are all screwed up. My dr said it is all the stress causing it. That is probably making my mav worse.

That is the newest info.

Nance

— End quote

I agree I would have the heart palpations checked out just to make sure they are related to your anxiety and not something else. Sometimes I feel like the doctors are too fast to write things off to anxiety , not to say that may not be the cause but better safe to me.

If you could take a benzo just to get through this rough patch do you think that would be an option? At least until you have had a couple of session with the female doctor and until the Verapmil has time to work. A antidepressant may be an option once you can settle back to a baseline. Some of us just have a harder time on the med merry go round. The side effects can be as bad as the disease, not to say that they do not work but it is a long journey sometimes that is very hard to deal with on a daily bases.

Sometimes it just seems as though it is a vicious cycle, mav, anxiety, anxiety , mav, hormones which causes what and how do you know…

Keep your chin up, keep thinking one day at a time, one moment at a time…

Having someone to vent with will help, we are always here too…

Hang in there better days are ahead …
Hugs
Timeless

Nance,

I have not posted on the forum in awhile and I just recently caught up with all that has been going on with you. It really sounds like your doctor is a good guy and he knows what’s best for you. I’ll tell you, I often look back to when my MAV started in May 08 and I can recall several stressful events that were taking place around that time. I know that all that anxiety may have pushed me and my migraines over the edge and started the whole vicious cycle. I started off anxious, which seemed to kick the MAV into high gear, which made me more anxious, which made the MAV worse and so it went for 10 months. It sounds like things got kicked up again for you and your sensitive brain (like all of ours) just needs some time to calm down again. You’ll get there again Nance. You’re doing all the right things to get things back on track…it will happen:) Hang in there!!

:smiley: Colleen

Lisa: I am not worried about the meds effecting my hormone levels but my hormone levels effecting my threshold level and I would have to keep adjusting any medication level and my threshold would fluctuate on a daily or even hourly basis.

Joan

Hi Joan,
The idea behind taking meds to treat MAV is to raise your threshold level for any stress, whether it be anxiety, hormone levels, excessive exercise, possibly a fun night out :lol:, etc. so that we can live as normal lives as possible. The meds theoretically should protect how your body reacts to your daily fluctuating hormone levels and therefore your drastic changes in dizziness should not feels so drastic. For example, I always feels so much worse the week before my period, but as I have been on meds (I am still sub-therapeutic keep in mind) I am noticing that although I still decompensate, I do not decompensate as much that week. I am hopeful that once I find the right dose and/or meds I will no longer decompensate at all. Does this make sense?
lisa