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I was able to move my neurologist appt. to tomorrow!! What should I ask him?

Hi, all! I fell getting out of bed yesterday because I was dizzy. Because this has been going on for months, I am usually pretty careful about getting up too fast, but I am usually disoriented first thing in the morning and it was dark. Luckily, I just went down on hands and knees and wasn’t hurt. It did scare me a bit and I called in to work (again). I have no time on the books so my paycheck has suffered the past few months. My job suggested I call the neuro to see if they could get me in on an emergency basis which I doubted would happen since I am a new patient that they haven’t seen before, but I lucked out that someone had just cancelled so I don’t have to wait two weeks anymore. It’s a bonus that it’s the last appointment of the day, so I won’t have to take off for very long without pay. I have filled out all the paperwork, I have a copy of my recent brain MRI and an older lumbar MRI, I made a list of my older symptoms and my newer symptoms, wrote down all my medications, made a copy of my recent bloodwork–I AM READY!! Even so, I will probably be nervous and worried he will make me come back for multiple expensive visits and not diagnose me for a long time. What advice can anyone give me? What should I ask and what should I tell? I just want some kind of frickin’ medication that will at least help me function somewhat. I know even if he does diagnose me and prescribe something, it’s not going to be a magic pill that works overnight or will even work at all. I see lots of people go through dozens of medication and still may not find the right one, but at least it will be progress. Let me know your thoughts, please!!

I don’t know where to start. Oh no! I’m so sorry you fell and am relieved you didn’t hurt yourself. I’ve fallen. Scrapes, bruises, destroyed ego. Not fun. Scary, too.

I’d start by asking if they’ve ever dealt with VM. I’ve been thru five neurologists, though two were something else first and neurology second. The first guy had no clue. The second was willing to learn but the head of the headache clinic wasn’t interested because I don’t fit the classic migraine profile. The current one has several VM patients. She understands VM, though even she focuses on headaches and I have to remind her there’s more to it. So the question is whether they’ve dealt with VM and if not are they willing to learn. Even if the answer is no, they’re going to start with the same types of meds.

I’d ask about the meds they use most frequently. Most preventative meds are the same for classic migraine as for VM but each doctor has their favorites. I’d ask why they chose this med. What makes this one more suited to my case than others?

I’d ask about how to contact them. My neurologist knows I know my stuff, maybe as well as she does on certain things. Therefore she doesn’t give me grief when I want to try new things. The question here is how do we course correct if it turns out I need a different med or dose.

I’d ask what their goals are. How do they measure success? What level and type of relief over what timeframe?

Most of the hard issues are things we can help with here. We’re not doctors but between us we’ve tried and experienced everything. So the important issue tomorrow is establishing your credibility and the doctor’s experience and attitude and walking out with a script for one of the frontline meds. It’s also important they understand you have limited means so additional testing should be avoided unless it results in a direct change in the treatment plan.

Good luck!!

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@flutters That sounds like a plan! Thank you! After visiting the ENT and the first thing she said was VM and/or BPPV, then doing research, I was kind of surprised that she knew about it. I’ve read so many stories on here about people going for years, even over a decade without an actual diagnosis because the dr has never heard of it and I hope I am not one of them. I am no doctor and I may very well be a hypochondriac, but I research and read (I am OCD also) to the point where sometimes I feel I know more than the dr’s. LOL I mean, I suppose there is a possibility that I have something besides VM, but it seems doubtful based on what the ENT said and the research I have done. Do you know what meds are typically diagnosed in the beginning? I’ve read some horror stores (Topamax) and I really don’t want something that the side effects are worse than my symptoms. I will make it clear to the dr that I don’t want unnecessary tests and I have the results of several that are recent, so I hope that won’t be an issue. I have money in savings if it’s something he firmly believes I need and I still have a little left on my FSA.I will let you know what I find out tonight. Who’d a thunk I would be this excited over a dr’s appointment? LOL

When you’re suffering any hope is exciting.

Most of the front line meds are those found in our big med poll.

By the way, I forgot to mention that I’ve been on Cymbalta for years. I have seen it mentioned by several people here and on other sites regarding VM. I don’t know what it’s supposed to do to help VM or if it’s just for the depression brought on by having VM, but I already had depression before this. My depression isn’t that bad right now compared to any other time, but my anxiety is pretty great, but it always is.

Nobody knows why antidepressants work for VM. Amitriptyline is a first line drug. So is Effexor. Both are antidepressants. Maybe mention today you need to try a different drug class.

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From all I have read Cymbalta only seems to work at high doses for VM. Guess that’s why it’s not considered as early choice.