VN and migraines - Scott, please respond

Dehydration comes from not drinking enough fluids, or exercising a lot, or being in hot temperatures - you can replace those fluids in a day by just drinking a lot, unless you’re in such bad shape that you need to be hospitalized for IV fluids. You shouldn’t remain “severely” dehydrated from any medication unless it’s a diuretic (“water pill”).

My neurotologist had a little pamphlet to hand out to patients - one part in there was targeted at the many people who are in disbelief when they are diagnosed as having MAV. It said this is a common reaction.

My mother went to her grave convinced that she had “sinus” headaches but I know now that she was actually a migraineur - also, she never got an explanation but I know now why she started getting dizzy spells at the exact same age I did, when the wild hormone swings of perimenopause started and MAV kicked in, as it did with me. I thought for decades that my headaches were just “sinus” headaches too. Sometimes we’re convinced we have the answer, but it’s good to keep an open mind because “the answer” may turn out to have been incorrect.

— Begin quote from “awalkerphoenix”

Best way to describe is if I look at a bright source, then close my eyes, the image stays awhile. I know this is somewhat normal, but mine has been way more pronounced since my attacks started two years ago. I will also see them when eyes are open. Hard to explain, but like I am at home and am looking at the TV and the clock above it, I can kinda see traces of their shape a few inches to the right or left. The image I see if kinda of like a shadow, but whitish purple. Not exact image, maybe like a negative. I also see it when I close my eyes for a few seconds. This really gets heightened when I am doing VRT, like VOR 1 exercises where I am working on my gaze stability.

I saw Dr. Baloh at about month 4 into my problem. He was very quick to dismiss any ear problems and may have mentioned migraine. At the time I think I was already on the Nort, so he might have already been leaning toward migraines…

I know I most likely will not be able to see him again. Would it be safe if I started Celexa through my GP? How does one start and monitor starting a new drug like that?

— End quote

I developed exactly what u r talking about when I got up to a therapeutic dose of amitriptyline. It was so bad I was finding it very difficult to watch tv at night. If I looked at the tvesp if bright colours and then looked at the wall next to it I could still see the image that was on the tv. Also if I look into a bright light like a camera flash the dark spot u c which usually disappears after a few seconds lingers for minutes. I also get speckled vision in dim light. I thought they were all side effects of the ami but my balance and other visual symptoms were I proving. I was changed onto dosulepin as it has less side effects to ami but is essentially the same drug. This enabled me to increase my dose to 75mg from 50 mg and surprisingly the after images and light sensitivity have improved by about 50 per cent. I think as the drug was helping with my dehabilitating balance and visual symptoms the migraine symptoms changed into something more recognisable as migraine.
I wish I had found this site years ago. I have been through hell and kept being told it was uncompensated labs until I got to the point I could barely stand.
Scott you are truly amazing.

Hey Becks,

Sounds like Ami just ratcheted up the migraine symptoms? I had this occur on Cipramil in the end – as in more neck pain, headache and other little weird things … I got sick of waking in the night with a racing heart too.

So glad you got off the “this is years of uncompensated VN or labs” treadmill. Nightmare. Been there, done that and did not buy the t-shirt. :shock: I worry about other forums that perpetuate misinformation like this keeping people unnecessarily unwell for far too long.

S :slight_smile:

As always, I really appreciate the help everyone. I went from a week ago swearing off all drugs, to thinking that is the only thing that will help me. I have some concerns that I hope you guys can help me with.

First of all, as I have stated already, I am absolutely terrified of any kind of AD, as when I came off the Nori, all of these things started. The theory that you guys talk about, that the Nori was suppressing the migraines does make sense, but to me it also makes sense that the Nori really messed with my CNS and eyes, and left these horrible eye symptoms. I have read and talked to countless people who had this same kind of thing happen when coming off an AD, especially a Benzo. Especially the floaters and light sensitivity. So obviously I now have a fear that going on a new drug could make things worse, or maybe better while on it, then worse again if I ever come off. I really do not like the idea of being on a brain altering drug for long term.

Now regarding my eyes symptoms, besides the the light sensitivity, or I guess photophobia, even though it is really only sun light and very bright rooms (I feel about 10 times better at night. Street lights, head lights, none of those things bother me). So I want to describe my problems and hopefully get some reassurance that these are actually part of migraines. With a few of them, I can find no information on how they would relate to migraines. I also brought up migraines to my Opthamologist and Neuroopthamologist and both said these symptoms are no associated with migraines. On the other hand, they had no answers for me whatsoever…

  1. Floaters: This is the first thing I noticed about half way through my taper. I went from 100mgs to 0mgs in about 6 or 7 weeks, under doctors orders. They even told me that towards the end to take one 25mg every other day. From what I have learned, both of these methods are terrible ways to come off an AD. Way too fast and alternating days is just bad. Any how,
    within a few weeks of my ween, I started to notice the cell like, crystal clear floaters when looking at the sky. Then the spiderweb, lint looking black ones any time I was outside or near a white wall or bright surface. I kept thinking these would eventually disappear, maybe just a withdrawal symptom from the drugs. I still have them today and they are not much better. They do not give me as much anxiety, but still a nuisance. Now, obviously I have read all there is to know about Vitreous Floaters. I have a feeling my floaters are not “real” ones for a few reasons. One, before this I never had any eye problems at all whatsoever. My vision is perfect. I am too young for “real” floaters, only being 28. I also find it impossible to literally end up with a large amount of floaters over night, for no apparent reason. Another reason I don’t think they are “real” is because my Opthamlogogist looked at my eyes extensively twice in the last year, and can see no floaters. He should be able to see “real” Vitreous Floaters. The same went for the Neuropthamologist. She extensively looked at my eyes for floaters and could see none. They both said my eyes were “perfect”. Can a migraines problem, especially one dealing with bright light issues, make me perceive floaters that are not actually there? In theory, could they disappear if I fix my migraine problem?

  2. Scheerer’s Phenomenon aka Blue field entoptic phenomenon - en.wikipedia.org/wiki/Blue_field … phenomenon

This problem has seemed to only get worse. I didn’t notice it much at first, probably because I was avoiding looking at bright objects to avoid the floaters that were scaring me. A few times when I didn’t have my shades on outside, I noticed them, but just kinda ignored it. Eventually it became hard to ignore. I can now even see those little sparkles and sprites floating around with my polarized shades on. But if I don’t have my shades on I see floaters, have trouble with the bright light, and see these little sprites floating around the sky or any other bright object. I will even see it indoors is a really bright, white wall is being hit with light. In the last 3 months of so I started noticing it on the TV screen, whenever there is a sky or bright white screen on the TV. I just can’t escape it. Now anything you will read will say this is a normal thing for the eye to see. I would say maybe, if you tried really hard, someone could see it after staring for a few minutes. But I don’t see it as normal to see this all the time, every time, especially since I never saw it once or knew what it was before my taper. This is currently the #1 thing that is bothering me. Of course I can’t really find any relation to migraines, unless of course my senses are just really heightened now. I have read that once someone “learns” how to see it, they can’t turn it off. I hope this is not the case… I can’t stand this any longer.

  1. Light Sensitivity: The first few months when the VN hit, about 22 months ago, I noticed I felt strange under sun and fluorescent lights. Just kinda made my head fog worse. It didn’t cause dizziness or make me feel any worse, just was uncomfortable. For this, I was put on the Nori for “possible” migraines, even though we knew for sure I had a very large (73%) vestibular loss. I took it, thinking that it would help with the migraines and help curb my anxiety over all of the problems I now had. I kept thinking it would help with my head fog and some of the balance problems. It really didn’t seem to help with anything. Sun light and fluorescent lights were still a problem, making me feel weird, but I didn’t need sunglasses (like I do now) and had none of the above mentioned eye problems. The only eye problems I had were with motor functions which VRT has really helped (not all the way, but much better than I was a year ago). VOR 1 and VOR 2 as well as Gaze Stability has really helped these problems. It was only AFTER I got off the Nori that the light sensitivity got much, much worse, as well as the above mentioned symptoms. I don’t have episodes where light bothers me, it always does. It also does not make anything worse… I don’t get headaches, nausea or dizziness. I no longer have any dizziness, just off balance and head fog. The light problems never make me feel “worse”, everything is always the same, day to day, I just can’t stand being in sun light or a bright room. It for sure confuses me more. This is another thing many people experience when withdrawing from an AD. I am NOT saying that is what happened to me, but this has been my theory for the past year since mine started right when I got off.

  2. Darkness: I’d say only in the past few months have I had problems with darkly, lit rooms. Pure darkness is fine. Eyes closed is fine. but is there is just a little bit of light I get kind of a grainy vision, a lot like visual snow. I also experience visual snow in the morning upon waking< only through one eye at a time. This grainy, visual snow thing scares me the most since I know some people can get it constantly for life. Since I rarely see it though, it does not cause too much anxiety. I just fear it getting worse, which most of these things seem to be getting. Anyone else experience this? Another possible migraine thing?

  3. Dehydration and Dry Eyes: In response to the above post, I realize what dehydration is. You seriously think I don’t try to rehydrate myself? I have been drinking nothing but water, Gatorade and coconut water to try and rehydrate, but I am always thirsty with dry mouth, dry lips and dry eyes. I have had this ever since my taper too, and of course assumed it was withdrawal. My doctor actually commented on my blood work and said it showed I was dehydrated. I am not sure what else I can besides keep drinking…

So I hope this all makes sense and you guys can understand why I am so distraught over all of this. This last year, dealing with the eye stuff, has actually been worse than the first year dealing with the dizzy stuff. If getting off the Nori caused all these problems, does that mean it was working? Was I not feeling better while on it because I was not doing proper VRT yet? I know the VRT has been helping a lot, but right now besides all the eye problems, the only other things I am dealing with is brain fog and the fact that I wake up every morning feeling like I was hit by a truck. No more dizzy spells, head pressure, rarely get the neck and shoulder soreness. I know I still need VRT because my balance is off and my eye gaze and head turns are still “off”. I still have this awful clicking and crunching noise in my ears every time I swallow which all started when the VN was hitting me at the beginning, so I assume it is just damage to my E Tubes and will never improve. I was also diagnosed last week with Chronic Sinusitis (CAT Scan), so was going to start antibiotics for about 6 to 8 weeks per my GP. This same GP I was going to ask about the Celexa. Is it bad to start both these drugs at the same time? Is it safe to have a GP, who probably knows nothing about migraines, prescribe me AD’s? How will I know how to start and when to increase? How do I know if I should use Celexa and not the Nori again? So many questions I have and I am so terrified that things will just get worse…

Sorry for the long post, I had a lot on my mind this weekend.

I also wanted to reiterate how none of these come in episodes. They are all constant. This is a reason why I cannot find a trigger. Can VN alone be a trigger? I have not been on any diet the last year or so (besides staying away from obvious ones like caffeine and red wine, but have been drinking alcohol and eating chocolate, none of which make me feel much worse. Alcohol of course increases the head fog…) I am back on the migraine diet now, but not sure how much it will help. Is it safe to assume that only drugs can help at this point?

I read through your post, but I am going to give a simple answer because that is all that is needed. The Nori DID NOT cause CNS damage. Stop reading forums about other peoples negative responses to antidepressants because you do not know about their medical history, and most of them have no diagnosis. Therefore that information is useless and does not apply to you.

Secondly, as has already been stated, all your visual symptoms can be caused by MAV. Almost all MAV patients will complain of visual symptoms, anything from light sensativity, to visual floaters/snow, trouble focusing eyes, etc… I have seen many people here describe exactly what you describe.

I also have clicking sounds in my left ear, this is not uncommon with MAV. They dont know why MAV can cause that, but it does. This is not a result of VN, absolutely impossible.

A GP can prescribe an antidepressant safely, I already told you about the dosage, maybe Scott can verify that this information was correct. I wouldnt try Nori again because you gave it a good try before. All antidepressants work slightly differently because each one hits the chemicals in the brain slightly differently.

I dont have any dietary triggers either, so for people like us, only medication can break this chronic phase. Sometimes it will spontaneously resolve, but there is no reason to wait it out if I can use medications to stop this.

I feel that you are analyzing this too much. I understand why you are doing this, and Im guilty of it too, but over analyzing is not going to change anything. You either have MAV or dont, so get started with medication therapy for diagnostic and therapeutic purposes immediately. This is the only way to get to real answers, and I think you will be pleasantly surprised.

Alright, alright, I am getting it. It’s just so hard to not over analyze because as you guys know, this shit just takes over your while life. Right when I thought things were getting better (when I tapered off Nori) was when everything went to hell. I will get a prescription on Friday. I jut want to make sure I do everything right. Anyone have feelings on starting an antibiotic at the same time?

One things that does have my anxiety through the roof at the moment is diet. I’m almost scared to eat anything causing me to be hungry…talk about a trigger! Thanks for the reply, I will keep you guys updated.

It’s just so hard to not over analyze because as you guys know, this shit just takes over your while life.

You can choose to stop doing this. You’re at the right place to get answers for one so that problem is solved. No one here will tell you to have a coffee enema or take seaweed and rice powder to get well. So breathe a sigh of relief on that.

Right when I thought things were getting better (when I tapered off Nori) was when everything went to hell.

You have to accept that the mantra you’ve been running through your head on this for months will have to come unstuck. You made this observation and have assumed correlation = causation. I think Darren’s advice of going back on Nori is a good angle when I think about it. I bet you’re light sensitivity will vanish again on it – maybe even the floaters and weird visual stuff. That would be the evidence you need to put finally put this to bed.

Anyone have feelings on starting an antibiotic at the same time?

Why do you need an antibiotic? If you have an infection, get rid of that first. Don’t start on two meds at the same time because if the AB causes you side effects, you’ll think it’s the Nori.

One things that does have my anxiety through the roof at the moment is diet. I’m almost scared to eat anything causing me to be hungry…talk about a trigger! Thanks for the reply, I will keep you guys updated.

Your anxiety is almost certainly a big factor in ALL of this. Now that you’re getting the facts straight on all of this, I’m hoping you can relax now and get on with treatment. Eat fresh foods and avoid junk while you are sorting this out.

Good luck, you’ll get there. S 8)

Well, at the time I started Nori, I think the smallest they had was 25mg, but I have no idea if that is a lot or not. If the Nori maybe helped with the visual stuff before, but no the head fog, what does that say? Was my head cloudy back then because I had not done any legitimate VRT? I don’t mind trying Celexa out either. Just want whatever is best. I thought Nori, a TCA, was older and maybe more prone to side effects? I don’t recall having any at the time I was on it. I just want to be prepared to tell the doctor what I want on Friday since I do not have much time for doctor visits. I will also ask her for a referral to a Neurologist. The one I saw before ONLY used Topamax which I did not like. Would I be better off with a Neurooto?

The reason for the antibiotics is the CAT SCan showed that I have chronic sinusitis and both of my nasal passages are enflamed and swollen. Ever since the VN hit me two years ago, my sinuses haven’t been the same. This has always been a minor worry for me compared to everything else the last two years. I got real sick back in November so the doc wanted me to get the CAT Scan for my passages. I only talked to him on the phone a few minutes and he said first step was antibiotics to kill off any infection that has been causing this. This is low priority compared to the other stuff, but I would like to clear this up. I will let him know that my #1 concern is the migraines and getting meds for that. The appointment is supposed to be for the sinuses, but maybe I can work on more natural ways of clearing them up. He made it seem pretty bad, I have no idea. I have just been wondering how much that could be affecting my head and ears…

I have been eating nothing but healthy the last year, but even more healthy now. It’s just that the things I eat every day are on some lists as triggers. I miss my nuts and milk!

Thank again

I think it’s pointless for you to see another neurologist and throw more money away. You’ve already seen the best in the world on this. Baloh himself says not to waste your time chasing specialists around hoping for some magic solution that all the others missed. If there was a migraine cure, Baloh would know it.

Some meds knock out all symptoms while some take out only a few. OR you may be fuelling your headfog with a food trigger that you have not yet discovered. If you keep fuelling the trigger load, the meds won’t necessarily work on that. For example, even though I am on an SSRI and a benzo as required it is IMPERATIVE that I live the lifestyle and don’t fill my face with triggers otherwise I end up flat on my back and a fogged out head.

You could get Nori and start at 12.5 mg and ease up slowly. I would do this to see if the light sensitivity vanishes. If it does, there’s your answer. If you are still not satisfied with Nori, then swap to Celexa and keep doing VRT if you think you need it. Another neuologist won’t add anything you don’t already know.

As far as triggers go, take out the big 5 to start and see how you go. Milk is not a common trigger.

I just wonder if the Nort didn’t help with the head fog the first time, if I should just go with the Celexa… Is there any possibility that I still felt the fog during the Nori because I was still compensating/not doing VRT?

I’d rather use that med that knocks out all of the symptoms, not just a few!

What are the big 5? Caffeine, chocolate, cheese, red wine and nuts?

I am not an expert on the diet, but I’d say that the triggers you mentioned are a good place to draw the line. I still eat cheese because its really hard to cut that one out… But I dont know if thats a bad idea lol.

Yea, that has been my biggest concern. When I did the diet a year ago, I read the David Bucholz book and pretty much cut out everything that could possibly be a trigger. It never helped with any of the symptoms. I LOVE cheese, but I can avoid that. It is just crazy that when you look around for different diets you will find that just about anything can be one. The hard thing for is that I never feel any worse after anything, so I can never tell. I feel the worst when I am hungry! =)

That is why I was asking if just the VN damage alone is enough of a trigger, because everything has always been pretty constant. Everything just got worse once I was on no preventative.

— Begin quote from “awalkerphoenix”

I’d rather use that med that knocks out all of the symptoms, not just a few!

— End quote

If there was one, we’d all be on it.

Everyone’s brains are different - what works for me may not work for you. And you may not ever reach 100% wellness again. I would say that when I’m well it’s 90-95%. That’s an excellent result. Learn to not let the low level symptoms worry you.

Also learn to not let low level side effects from meds bug you. If the good outweighs the bad (and the bad is just ‘annoying’)that is a great result.

I would avoid the Buccholtz diet stuff for now (it’s too complex) and start by avoiding:

Chocolate
Cheese
ALL caffeine (no coffee, tea, or soft drinks like Coke)
Alcohol
Nuts
Anything with nitrites, sulfites or MSG (crappy sauces in jars, cheap Asian foods, deli meats and anything aged)

Exercise every day – do at least 30 minutes of purposeful aerobic exercise where you get your heart rate up. You don’t have to be gasping for air, just get the heart rate up.

Go to sleep every day and wake every day at the same time.

Start accepting your situation as in what has happened and what is happening. Do not confuse this with not taking action however. The key is to lose the resistance to it all because resistance = anxiety = symptoms get worse.

Do your symptoms wax and wane or is it just one solid sameness all day, every day? Any neck pain if you stick your fingers in there? What’s it like at the base of your skull, mid way down the neck or at the shoulders? Any tension in there at all?

S

They don’t ever wax and wane. This is why i never bought into the migraine things and another reason why i cannot find a trigger. Nothing ever makes me feel worse. Again, after some alcohol i get a little more brain fog, but dont most people when they drink? I for sure never feel better. Mornings are always the worst. Like I didn’t get any sleep even though I get about 7 to 8 a night. I always feel better at night, either because I am warmed up or the sun is down. I always feel tired and worse when tired. Always yawning. My neck and shoulders were great for about 8 months or so, only recently worse because I have started some new VRT exercises plus have started playing tennis and basketball again since I have avoided most sports for two years. The neck and shoulders were a big deal in the beginning but got much better the last year. I am really tender a t the base of skull at the moment. For sure tension. Went and got a massage yesterday!

I am thinking I might just try the Celexa since I already tried the nori? Even though they nori may have helped my eyes?

Two things stand out here: light sensitivity coupled with neck pain/ tension. If you read any of the leading research in this field right now and pay attention to expert opinion you’ll see that any “tension type headache” as it has been known should not be associated with photo or phonophobia. If it is – they are both there – you have migraine. Migraine frequently hits the neck area.

Have you had a physiotherapist examine your neck to make sure there aren’t any spasmed muscles in there? This was the MAIN cause of my head fog in the past. It didn’t necessarily hurt either until the physio got stuck into it and then I couldn’t believe how sore it was in some areas. Once loosened released and loosened up it was like a veil was lifted from my head and clarity returned.

Note, a regular massage will not undo these knots I’m talking about if it’s there. I’d get this checked out by a physio to rule it out. Even on a med, if I have this neck stuff going on, I will be brain fogged out of my mind.

You could start on Celexa but it would be an interesting test to watch if Nori killed the light sensitivity for you and thus prove to you what that the light thing was migraine-related and nothing more.

S

My sister is a PT, I will have her check it this weekend. Just tell her to look for spamming muscles? When my neck wasn’t bothering me so much, pain wise, the fog was still there. I haven’t had a clear day in almost two years.

When I was on the Nori, at it’s peak, I still felt weird under fluorescent and sun light, but not really afraid of it if that makes sense. It was a nuisance, but not an avoid at all costs like it is now. The neuroto noticed this when examining me which is why he put me on Nori in the first place. I don’t think it ever cured it, but at the same time I was more worried about my balance and brain fog back then. Once I came off and the floaters appeared, all hell broke loose light sensitive style. There is a chance the nori will make these symptoms go away, but I dont recall it ever making me feel 100% under fluorescents. Under sunlight, then and now, I just fel a little more off, but I think that is because there is so much out there to stimulate my vestibular system, as well as migraine. Hopefully by Friday I will have an idea which drug to ask for since my GP will be no help…

Thanks for all your help Scott.