Neurologists who hate "dizziness"

This shows the importance of finding the RIGHT neurologist…

forums.studentdoctor.net/showthread.php?t=970773

Pretty sad stuff. If they stopped and read the literature instead of wasting their time posting junk they might actually make a difference.

Good grief! Wow was I lucky to find the lady I did right away.

Never thought I’d say thank goodness for Kaiser!

Whilst trawling through that student doctor forum is really interesting/fun and has taken up at least 2 hours of my day today as has also proven to be massively ADDICTIVE!.. I can’t actually begin to tell you overall how intensley ANGRY that particular thread made me this morning.

I have been stewing on it all day.

I have been stewing on it all day, particularly after typing various amalgamations of “migraine” “dizziness” “vertigo” “headache” etc and hitting search and seeing what they’ve been writing about that…

I strongly advise AGAINST doing this as it WILL wind you up, so I’m not going to link to all the posts, but amongst many many posts basically rendering ANY dizzy patient as basically a pain in the neck who they want to get rid of immediately, check this one out which appears to be referencing some kind of exam question!!?:

http://forums.studentdoctor.net/archive/index.php/t-895890-p-2.html

Aside from moaning about dizzy patients, there are tonnes of posts discussing patients and what could be wrong with them, and I can quite honestly write MAV…MAV…MAV…MAV…across absolutely loads of them. Seriously- the STUDENT DOCTORS are asking each other what the diagnosis should be- I know the answer, and they don’t?! Somethings seriously wrong here… What’s worse, is when the students are talking about themsleves!! I.e “I’ve had dizziness for like, 1 months now… what’s happening to me? I had a big migraine the other day… etc etc”…

The over-riding fact through reading the posts after searching those key words is that they think we’re a pain in the arse, and it’s obvious why- it’s because they don’t have the answers. They don’t know what’s wrong. I’m not sure they have much of an education in general balance disorders, but specifically, it’s because they have absolutely NO UNDERSTANDING of MAV. In fact, some of them don’t even seem to know that dizziness can be a key presenting symptom in migraine. Moreover, they are most certainly definately not aware that this does NOT have to be accompanied by a headache, that the dizziness can present chronically, and that it can come on spontaneously.

In conclusion, it is abunduntly clear that there is ZERO education at the starting level about this condition, in which case, what the hell hope does one have of finding a neurologist who has a knowledge of MAV, or migraine variants, let alone a bloody GP?

In my own humble research of this condition, it seems so many people go misdiagnosed for years. Migraine variants need to be taught about to student doctors- even just 15minutes of a slideshow- I can pop by with a powerpoint presentation if they like :slight_smile:

In all seriousness, I know that’s a student doctor forum and I know it’s not really the ‘done thing’ to jump into forums that have nothing to do with you (directly at least), but I really feel someone should at least educate these people. I am tempted to do this. I am so frustrated and angry by it. Should I?

I swear to god, I have never in all my life wanted to reach through a screen and just shake someone as I did this morning. And I am trying to fricking relax. After reading through this lot, I had to reach for the f*cking beta blockers!

I sit here shaking my head. I mean seriously, what’s the bloody point?! Lets send Dr S down to EVERY medical university! Oh wait- we’d need to clone him first so he could still treat us all :slight_smile:

Can’t help myself…

Here’s a recent post which screams migraine variant, if an EEG comes back with no seizure activity; headache with neuro symptoms | Student Doctor Network

Oh my god, I can’t tear myself away… I’m reading more and more cases of people presenting to A&E/the E.R and hospitals are spending so much time/money/resources on them, to investigate things like stroke, epliepsy, TIA’s etc… and migraine is an after thought or not even a thought.

I know they have to rule out the big stuff, rightly so, but surely if you knew migraine could mimic these symptoms, especially if there is a family history, you’d think about this one first at least while running other tests…I can’t watch anymore! Arghhhhhhhhhh.

I’m on their network now and will be tackling some of this. Not to give them hell but to introduce them to possible answers.

S

OK, I probably shouldn’t do this, but whoever wants to get even more riled up, read some of the posts on the following thread. Lordy. Why the heck did these people become doctors if they don’t want to deal with patients!? Didn’t anyone WARN them that you have to see PATIENTS??

forums.studentdoctor.net/showthread.php?t=870148

Now, as an antidote, go read the posts on the Emergency Medicine forum at that website, particularly this one (“Things I learned from my patients”). You will be laughing your head off after a while (and horrified at how incredibly stupid people can be–I’m talking about the ER patients here–but mostly laughing!). The ER docs are the most hilarious.

forums.studentdoctor.net/showthread.php?t=257985

And another one where dizziness gets dissed: a neuro-otologist will “get dumped on with every ‘dizzy’ patient”" [I especially like how they put “dizzy” in quotation marks, as if dizziness isn’t something real.

forums.studentdoctor.net/showthread.php?t=965042

Did you all know that dizziness is called a “heartsink” symptom by doctors? Because their heart sinks when a patient comes in and says, “Doctor, I’m dizzy.” (No mention of how a PATIENT’s heart sinks when they have a migraine attack or worsening of their condition…)

Google “dizziness heartsink” and see the truth of what I say. With the exception of a few committed, knowledgeable doctors as mentioned on this forum, we the people with dizziness and/or headaches are anathema to the medical world.

Thank God for this site and for those few good doctors out there!!

Nancy

Missmoss, I understand your frustration; it’s horrible reading, really (not for before bedtime, you won’t sleep), but having myself gone through psychological hell with many years of undiagnosed neurological symptoms and being essentially told many variations of “I don’t know what’s wrong and I’m not going to do anything further to find out, you’re just paying too much attention to your symptoms,” being “diagnosed” with “medical student’s disease,” anxiety, etc. (after having been first told I had MS, and with no history of anxiety or any psychiatric problem in my previous 42 years of life)–after that, you really begin to understand how little most doctors are paying attention and concerned to get a diagnosis–and the right one. And how uninformed and uninterested many of them are.

Of course there are many exceptions, but as a general rule the doctors are seeing thousands of patients, and even the well-intentioned ones just don’t have time to diagnose difficult cases–nor explain properly to patients why they can’t. They often see a couple dozen patients PER DAY! You are just a speck on their schedule.

No disrespect to the many fine doctors who do their best under what seem to me incredibly difficult circumstances and pressures of all kinds, and to the few who are really exceptional, but honestly it’s mostly up to us these days to figure things out for ourselves. A large percentage of doctors (I remember reading once) would NOT go into medicine again and only stay in it to pay off their huge debts. That is really sad. Students aspiring to go into medicine should really be given the rude awakening BEFORE they start medical school!

Nancy, sadder but wiser (and now unable to walk more than one block without my walking sticks… used to walk 2 miles really fast…but who cares?)

Thanks Scott- I was going to ask you to but didn’t know if you’d think it was the right thing or not.

Looking forward to seeing it!

Hi Nancy, I agree with you- it seems largely up to us to find out whats wrong- and thank god for the internet in this day and age- prior to that, things must have been impossible. It’s worrying to think that even just 100 years ago, people with migraine were declared ‘looney’ and actually, I do wonder if we’ve progressed much further at times…

I do think that our condition is a particularly easy one for them to not give a stuff about because it is not a life threatening one. Such as seizure sufferers. There is no desire to come up with a solution/cure for us. But if they were better informed, they could more easily fix, and therefore might be more encouraged to try to treat us.

Hmm… At least WE know it’s not ‘just in our heads’.

I’m sorry to hear you have such trouble walking… I’ve just read through your first post on this forum. Wow- what a story and such a terribly long time to be suffering without 1 medical professional actually listening to you and agreeing migraine was a viable cause and agree to work with you on it. Unbelievable, I am truely gobsmacked and so sorry to hear how much you’ve been through. Where are you at with things to date? Can you get anyone to work with you on any of the more commonly prescribed drugs we know about like Topirimate or Nortriptyline, or something similar?

MMx

x

The sad thing is how many qualified neurologists have exactly the same attitude. Sometimes I’d like to give this shit to them for a week and then see what they have to say :smiley:

Seriously though someone needs to point these people to the numerous peer-reviewed journal articles describing the symptoms and presentation of MAV.

Yowsa, what a bunch of turkeys, eh? :roll: They seem almost smug in their ignorance. Keeping in mind these are student doctors (I hope they are anyway, they have A LOT to learn) the Dunning Kruger effect does seem at play. That is, in their ignorance they vastly over estimate their own knowledge.

What I find genuinely perplexing though is the ignorance of the medical community in general towards migraine. ‘Dizziness’ is not unheard of or undocumented as a symptom of migraine at all. I’m thumbing through my copy of Oliver Sacks’ book Migraine. Oliver Sacks - the world famouls neurologist (and migraineur) who wrote The Man Who Mistook His Wife for a Hat and Awakenings. He wrote Migraine in 1970. That’s right, 42 years ago. He updated it in 1985. He references literature and case studies that in some cases are hundreds of years old, covering the crazy gamut of migraine symptoms. Sacks has also just published a new book (a best seller) Hallucinations, with an entire chapter devoted to migraine.

From Migraine:

’ Milder states of ‘lightheadedness’ occur with notable frequency. Selby and Lance (1960), in a clinical study of 500 patients with migraine of all types, found that “some 72 per cent complained of a sensation of dizziness, lightheadedness and unsteadiness…”

and

‘Hallucinations of motion may take two forms. Rarely, there may be what Gowerss has termed a “motor sensation”, e.g. the feeling that the limb has moved, or the body has adopted a new posture, when in fact there has been no such movement. Far commoner, and perhaps the most intolerable of all aura symptoms, is intense sudden vertigo accompanied by staggering, overwhelming nausea, and frequently vomiting.’

That so many in the medical fraternity, including students (whom one would hope are learning the most up to date information) maintain such a narrow view of migraine (and fail to make the connection between vertigo/dizziness/lightheadedness/false motion and migraine) is staggeringly disappointing.

I’m reminded of Edvard Munch’s painting “The Scream” - all of this makes me feel like screaming, but it feels like no sound comes out because these Bozos just don’t (won’t) hear. Facts? What facts. Their minds are made up, so don’t bother them with facts.

I’ve read The Man Who Mistook His Wife For A Hat- fascinating stuff.
Ordered Migraine just before Xmas and Amazon buggered up my order- really looking forward to getting my hands on it soon.

Oliver Sacks is The Man!

Missmoss: You hit the nail on the head–doctors are just not too interested in things that are not a threat to life or limb. They rule out cancer, brain tumor, heart problem, and BOOM! the patient is discarded because nothing really bad is going to happen. And trying to treat migraine patients can be a long and difficult process, not just a quick fix with one or two visits. So most doctors (except the few MAV specialists) will try to avoid you. Same with pain, fibromyalgia, name any one of probably 100 other chronic conditions!

I like your comment wondering if things have progressed much in the last 100 years as far as migraine patients being thought “looney”. :slight_smile: Doctors who are lazy and uninformed now use words that are a bit nicer and more accurate, but just as effective in dismissing the patient.

Your point is also a GREAT one that if doctors were better informed about migraine, they would be more willing and able to treat patients correctly instead of making that crosswise “stay away from me!!” sign.

As for where I’m at now, I’m actually doing pretty well in the dizziness department; it’s so low-level and soooo familiar that, except for a rare day of worse dizziness, I’ve learned to just deal with it by not moving too fast until afternoons (when I feel better) and trying to keep sleep as even as possible. My Strattera sufficiently fixes the dizziness-induced concentration problem, which was always the WORST thing for me. I did explore some possibilities (B-2, nortriptyline, atenolol, verapamil) with my PCP a few years ago, but nothing really came of that. It’s really the other problems (fatigue and walking) that are bad now. But I just can’t approach a neurologist again. I will probably ask my PCP to send me to PT (after I lose some weight).

I know I am very lucky… most people here have much worse dizziness than I ever had, not to mention headache. My heart really goes out to you.

Nancy

I actually got my first ever letter of dismissal from a neurologist I saw only once; didn’t even know they sent these. It was sent by certified mail and indicated that he wouldn’t be treating patients and encouraged me to find another doctor. I tore it up, threw it away, and found a better doctor who wasn’t dismissive of my symptoms. Unbelievable, but true!

Actually, these are NOT student doctors (at least not in the links I posted); they are from the “Physician/Resident” forums, in other words, practicing doctors with varying degrees of experience. The overall site is called “Student Doctor Network,” but it encompasses much more.

Even if doctors are misinformed or ignorant through no fault of their own (they were never exposed to the migraine-dizziness connection nor its prevalence), what is inexcusable is when they AREN’T WILLING TO LEARN–the “my mind’s made up, don’t confuse me with the facts” mentality that some doctors have (as Mary Alice pointed out!). I’ve seen some people post here whose doctors have been grateful and taken seriously the info their patient has given them, but some just don’t care.

I have been a “victim” of careless and/or willful ignorance in other areas of ENT and neurology. (Besides the too-long-ignored sudden hearing loss, it was mainly one clownish neurologist who was a perfect example of that smug, stupid, totally stubborn ignorance–and was too dumb to know it!)

MOST doctors are well-meaning, and will listen initially and make an effort to some extent, but few will really stick with you and care about getting things right in the end. And if you persist in seeking help for unresolved symptoms, you can be labeled as the infamous “difficult patient.”

Victoria and Andrew, yes, it’s incredible that so much has been published, so much is known about the relationship between dizziness and migraine, and the many different manifestations of migraine, and yet so many doctors still have either never heard of it or don’t take it seriously.

However, I do believe that younger doctors TEND to be more open-minded, interested, and up-to-date than lots of older ones. It’s like checking the date on items at the supermarket–get something fresh! or else choose a famous brand (Hain, Surenthiran, etc.) that you know will be good. :slight_smile:

Nancy

Lisa… gosh, that must have been sooo disheartening. Glad you found another doctor.