Dr. Rauch this Tuesday

I am happy to be going to Dr. Rauch in a few days. I’m not sure how much he can do for me during pregnancy, but I am still eager to meet w/ him. I know we asked him many questions via the forum already. Is there anything more that people want to know? I know that I am quite curious to find out why he doesn’t prescribe SSRIs for MAV. Is he just not using them because he found success with other drugs or doesn’t believe that SSRIs help. I am particularly curious as I know that Zoloft is fairly safe during pregnancy.

Hi Lisa, I hope that the appointment goes well. I too am very interested in the SSRI question. I would also be interested in his view about whether migraine has an impact on glucose levels. I think it is fairly well documented about glucose impacting migraines but I am not sure about the reverse. I have been really struggling with reactive hypoglycemia this past week and going back over all of my journals it has undeniably gotten much worse since my MAV crash over a year ago. I wish you the best and hope that he can provide some assistance during your pregnancy and beyond. Ben

Hi Lisa,
I hope you visit goes well! This is a time of celebration for you it would be so nice for you to enjoy it. I wonder if you could ask the doc if physical injuries to the neck and shoulder muscles could lead to MAV, I was never like this until my neck and shoulders tightened up so much. I don’t know if the dizzies caused the tightness or the disc problems or if it’s the other way around, but i do know the tighter my neck and shoulders are the worse the dizzies and headaches are.
I’ll be thinking of you.
Tammy

— Begin quote from “MAVLisa”

I am happy to be going to Dr. Rauch in a few days. I’m not sure how much he can do for me during pregnancy, but I am still eager to meet w/ him. I know we asked him many questions via the forum already. Is there anything more that people want to know? I know that I am quite curious to find out why he doesn’t prescribe SSRIs for MAV. Is he just not using them because he found success with other drugs or doesn’t believe that SSRIs help. I am particularly curious as I know that Zoloft is fairly safe during pregnancy.

— End quote

Lisa it is very kind of you to get questions from folks to take to your appt. However since I would think a doctors time may be limited I would think it would be best to focus on your circumstance directly and get the questions in if they apply to you. I hope that does not come across wrong but I have found that doctors seem to respond better to direct questions about the patients situation as opposed to general questions that may not apply to the patient directly…does that make sense…in other words overload of questions may not be specific enough to your own circumstance.

Maybe if we have more questions we could ask Scott to send them to him again to answer and post on the forum to make sure you get the most time spent with him addressing your circumstance directly.

Timeless - You are definitely correct. I figured that there might be several questions that overlap with my specific circumstances as well. Thank you for thinking of me

Lisa,

Have you been to Mass Eye and Ear before? Their valet parking is the best deal in Boston so let them park and get your car for 12.00 if you will have it there. I’m not sure where you are traveling from.

Boston used to be my favorite city to visit, miss doing those things especially since I have a son who moved there and another who lives there part-time. Oh well, one more pity party isn’t going to help.

Best of luck with your appointment, hope you get some answers.
Sally

Thanks for the advice, Sally. $12 is a great price. Does Mass eye and ear have valet? was there over a year ago to see Dr. Priesol. I just moved from NY to Connecticut in July, so I think I’m about 1 hr 45 min from boston. Boston is a great city. Wish I was better, too, so I could actually enjoy it. One day we will be.

Hope your visit finds you some answers …

Yes, MEEI has valet. Just weave your way through the Mass General traffic, pull up in front of MEEI. Someone will run out to pack your car.

Best of luck to you.
Sal

— Begin quote from “MAVLisa”

I know that I am quite curious to find out why he doesn’t prescribe SSRIs for MAV.

— End quote

Hi Lisa,

I think you’ll find that he doesn’t use them a lot (if at all) because he doesn’t have much experience with them as a treatment option and has seen good results with meds such as nortriptyline and some of the other more well-known migraine meds. Moreover, there isn’t (as yet) much in the way of evidence in the science literature for SSRIs and migraine in general although I think it would pan out differently for people with MAV. I think the SSRIs work on the dizziness in some way, thus reducing stress … the modulating effect on serotonin must be key. Dr Tusa’s group are working on such a study now – ie, SSRI treatment (Paxil) and MAV.

Scott

— Begin quote from “scott”

— Begin quote from “MAVLisa”

I know that I am quite curious to find out why he doesn’t prescribe SSRIs for MAV.

— End quote

Hi Lisa,

I think you’ll find that he doesn’t use them a lot (if at all) because he doesn’t have much experience with them as a treatment option and has seen good results with meds such as nortriptyline and some of the other more well-known migraine meds. Moreover, there isn’t (as yet) much in the way of evidence in the science literature for SSRIs and migraine in general although I think it would pan out differently for people with MAV. I think the SSRIs work on the dizziness in some way, thus reducing stress … the modulating effect on serotonin must be key. Dr Tusa’s group are working on such a study now – ie, SSRI treatment (Paxil) and MAV.

Scott

— End quote

I am surprised to hear that Dr Tusa group is working on that he did not mention anything about it when I saw him last month.

— Begin quote from “Timeless”

I am surprised to hear that Dr Tusa group is working on that he did not mention anything about it when I saw him last month.

— End quote

It’s early days – they’re just putting together a grant. It’ll get done sooner or later … unfortunately it all requires money. S

Hi Lisa,

Timeless is right, you should focus on your situation! I’ll get my answers in good time, you focus on you and the baby.

Tammy

Thanks Tammy.
So great to hear that there is going to be research on SSRIs and this condition. I know it can take a long time, though.

Lisa: I am just curious, is there a reason you are switching from Dr. Priesol to Dr. Rauch? I see Dr. Priesol and like him and he seems to have the same treatment plans as Dr. Rauch. Also, definately use the valet parking. I have gotten into the cramped parking lot on Storrow Drive only to find no parking spaces left and it is very difficult to back up or turn around to get out.
Hope your appointment goes well.

Joan

Joan - Thanks for the advice. Will definitely use the valet. What had happened was I traveled to see Dr. Priesol when I was still living in NY (I moved to CT a few months ago). I did like Priesol. He seemed very intelligent and aware of this illness. However, at the same time, I was on a wait list to see Dr. Newman in NY - much more convenient. I ended up seeing Dr. Newman and stuck with him as I liked him too and he was much closer. He ended up immediately taking me off of Nortriptyline, which I now regret as it could have been the drug for me. Now that I moved and am closer to Boston (and stopped seeing Dr. Newman awhile ago for various reasons) I decided to go back to MAss eye and ear, and decided to make the appt with Dr. Rauch as he’s been so active on this forum and I am interested to see what he has to say. I’m sure you mentioned, but I forget. What did Dr. Priesol decide to do for your treatment. do you live right in Boston?

Lisa,

Good luck with your appointment. I’m glad you are going to see Dr. Rauch. Congratulations on your pregnancy! I’m so happy for you!

Marci :smiley:

Lisa: Dr. Priesol wanted me to try to migraine diet for 2 months before discussing meds. It took a month or so but it did make me feel better, so when I went back for my follow-up in 2 months he told me if I wanted to try any meds he would start me on Nortriptyline but I said I wanted to try without meds for now. Right now I follow the migraine diet, exercise and yoga and feel about 75% - 80% better. I can work, go shopping, etc. although it is very uncomfortable at times, I do get through it. Dr. Priesol told me if I wanted to try the meds to just give him a call and he would call in the prescription for Nortriptyline and he would have me try it for 4-6 weeks. He said it takes 4-6 to change your brain chemistry and start to feel better. So far I have not wanted to try meds as with everyone here, I am very med sensative and hate the side effects. I did try Lexapro once a few years ago and spent the whole first day, throwing up and dry heaving … not for me.
Good luck with Dr. Rauch, when I was in to see Dr. Priesol in June he was telling me they are doing a study on women with vertigo/imbalance, he was going to recommend me for the study but one of my ENG tests was abnormal … I think it was the caloric test where they put warm then cold air into your ears to create the vertigo and he didn’t want to put me having that test re-done.
By the way, I live just south of Boston in Braintree. I found Dr. Priesol by calling MEEI and asking for a someone who treats balance disorders. I think Dr. Priesol has more office hours and is more accessible then Dr. Rauch so I could get an appointment sooner with Priesol then Rauch.
Good luck at your appointment, I will be thinking of you. Let us know how it goes.