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Old 07-30-2007, 03:47 PM   #1
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Question HELP! New doc, meds, etc

I really need advice. I went to a new neurologist at a Dizzy Clinic. The guy basically thinks there is a strong psychological component. He says I can't possibly be constantly dizzy, have tingling, and had swallowing problems at the beginning of this (this resolved after a couple weeks in the beginning of it all, prob from the virus in my opinion) and that it doesn't make sense neurologically. He is willing to consider a trial of anti-migraine med, but didn't seem to think that is confounding my compensation. In fact he doesn't seem to think there is a compensation problem at all. In fact I don't think he thinks I have any problem physically. He said that yes, I probably had a peripheral vestibular injury, which is seen as a 99% loss with caloric testing, but that that has nothing to do with now.

I know its possible to have anxiety and not know it, but on a conscious level I have had NO anxiety throughout this whole thing. Mild depression on and off yes, or better described as sadness and frustration. But I have a very good handle on that and I am in a good place at this point emotionally.

He prescribed Zoloft. 50mg to start with, he said he would go up to 100mg. I don't know what to do.

He pretty much blew off the vision issues and that despite going through vestibular rehab I have never been able to do the exercises properly because my eyes don't work together. I'm starting vision therapy tomorrow anyway. Certainly couldn't hurt.

But I have no idea what to do regarding the medication. I know many of you have used meds and found them helpful. But if I don't feel like I have anxiety?!? HELP!

Joni

 
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Old 07-30-2007, 05:19 PM   #2
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Re: HELP! New doc, meds, etc

Well.. Its hard to find doctors who understand this illness alltogether.

Either way, you can go on the anti-depressants... They may make you feel alot better... There was a study and an artcile... Ithink posted by Scott which stated that SSRI's actually aid in the compensation process by stimulating the growth of new neurons. So, you may get better coincidentally for a diff reason.. But who cares eh?? You can even tell the doc that a study at northwestern states this.

 
Old 07-30-2007, 09:39 PM   #3
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Re: HELP! New doc, meds, etc

Hi Joni,

>>>The guy basically thinks there is a strong psychological component. He says I can't possibly be constantly dizzy.

That's rubbish of course. I guess he saw the tingling hands and swallowing issues as a sign of anxiety. And it is, but that doesn't mean you are anxious per se. Rather your body is reacting to the dizziness without your mental input. I have had that more times than I care to remember. And this is well-documented in the literature:

For example, a recent study by Staab and Ruckenstein (2007) where they studied 345 men and women found the following:

Chronic dizziness had several common causes, including anxiety disorders, migraine, traumatic brain injuries, and dysautonomia ... BUT ... the high prevalence of secondary anxiety may give a false impression of psychogenicity. 60% of subjects had anxiety with their dizziness and 2/3 of those fell into the category of "Otogenic Chronic Subjective Dizzines (OCSD)".

What do they mean by OCSD?

OCSD: Patients with otogenic CSD have no history of anxiety predating dizziness. They developed CSD and anxiety following a temporary medical conditions that affected their balance systems (eg, vestibular neuronitis, transient ischemic attack, or deconditioning of balance reflexes after prolonged illness).

Also: At least 30% of patients with migraine (they weren't certain how many more might have had vestibular migraine which is not well defined yet) had coexisting anxiety disorders.

Treatment: previous work by this group has found that SSRIs work well for people with CSD but on the other hand it may be that the SSRI was treating MAV in these people (as it has in me). We must remember too that Staab is a psychiatrist so may have a bias towards SSRI treatment. Personally Joni, I'd try a few MAV meds first if I were you and see what happens. If that fails then try the SSRI.

At least you know you're not some out of control anxiety case - that's rubbish.

Best ... Scott

Last edited by studyin; 07-30-2007 at 10:02 PM.

 
Old 07-30-2007, 10:13 PM   #4
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Re: HELP! New doc, meds, etc

Joni,
That's crap. this is not a psychological issue. this doctor was not listening to you and he just doesn't have the experience to know that this can come from inner ear problems. Being dizzy for 7 weeks straight will cause any well adjusted person to become a bit depressed, anxious, and ****** off. You have a 99% loss? In one ear? if you have a loss of function in one ear it absolutely has everything to do with why you feel dizzy. I was dizzy for 6 months before things got better. So 7 weeks even though it feels like forever, is by no means a long time.

I'm sorry you found a doctor who is so insensitive and has such a lack of experience. Keep looking for a doctor who is educated in these problems. good luck

Last edited by joy78; 07-30-2007 at 10:14 PM.

 
Old 07-31-2007, 02:02 AM   #5
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Re: HELP! New doc, meds, etc

Hi Joni - how long have you been dizzy all up? I thought it was a long time and not 7 weeks. If 7 weeks then it would likely be premature to start a MAV med or an SSRI.

Scott

 
Old 07-31-2007, 03:42 AM   #6
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Re: HELP! New doc, meds, etc

Its been 17 months. I'm definitely much better than at the beginning too. But not anywhere near normal.

The doctor was willing to try anti-migraine meds as a trial. I think he wanted to start with the SSRI because he believes its more psych but would also address migraine? He mentioned Topamax as another option if this doesn't work.

I woke up this morning still upset about it all. I don't want to alter my mood. I am happy with my current state of mind. I'm in a good place and coping really well. I'm waking up ever morning, doing a wellness meditataion, working out, I'm doing the vestibular exercises, eating well, I'm starting vision therapy today.

I don't know. My two theories were 1)my longstanding vision problems were blocking compensation 2)possible MAV. Maybe I will continue to focus on the first, since I've thought that was an issue since the beginning of this all. But if the meds would help compensation??? Then maybe its worth a try. Is there a better med to start with if it is MAV?

Joni

 
Old 07-31-2007, 05:55 AM   #7
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Re: HELP! New doc, meds, etc

JoniMicelle, your vision problems could be very welll holding up your compensation. It did for Subs. I pray for the vision therapy will help you get to 100%. You might have found your answer!!!

Cathy

 
Old 07-31-2007, 01:10 PM   #8
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Talking Re: HELP! New doc, meds, etc

Quote:
Originally Posted by JoniMichelle View Post
Its been 17 months. I'm definitely much better than at the beginning too. But not anywhere near normal.

The doctor was willing to try anti-migraine meds as a trial. I think he wanted to start with the SSRI because he believes its more psych but would also address migraine? He mentioned Topamax as another option if this doesn't work.

I woke up this morning still upset about it all. I don't want to alter my mood. I am happy with my current state of mind. I'm in a good place and coping really well. I'm waking up ever morning, doing a wellness meditataion, working out, I'm doing the vestibular exercises, eating well, I'm starting vision therapy today.

I don't know. My two theories were 1)my longstanding vision problems were blocking compensation 2)possible MAV. Maybe I will continue to focus on the first, since I've thought that was an issue since the beginning of this all. But if the meds would help compensation??? Then maybe its worth a try. Is there a better med to start with if it is MAV?

Joni
Hi Joni

Not likely its ..."its more psych"....

Agree with Scott.... and u-----sure sounds like vision....vision therapy--should help...

Now that u know (from the Neuro-Ophthalmologist)---physically ur eyes are functioning---correctly.....

Vision Therapy---highlighting Muti-Sensory Integration---(focused on ur vision)---I would think would help---take time---but help!


 
Old 07-31-2007, 07:30 PM   #9
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Re: HELP! New doc, meds, etc

Thank you all so much. I had my first vision therapy appointment tonight. I've decided to hold off on any meds. I can always return to that option in the future if need be.

 
Old 08-01-2007, 05:13 PM   #10
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Re: HELP! New doc, meds, etc

Quote:
Originally Posted by JoniMichelle View Post
Thank you all so much. I had my first vision therapy appointment tonight. I've decided to hold off on any meds. I can always return to that option in the future if need be.
where do you go for this kind of therapy? it sounds like it would be helpful. is it completely different from the vestibular rehab therapy exercises?
wish you all the best!

 
Old 08-01-2007, 07:19 PM   #11
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Re: HELP! New doc, meds, etc

Quote:
Originally Posted by alexiwildchild View Post
where do you go for this kind of therapy? it sounds like it would be helpful. is it completely different from the vestibular rehab therapy exercises?
wish you all the best!
Its done my developmental/behavioral optometrists and they often work with vision therapists or do it themselves. Some types of vision training also may be done by occupational therapists in rehab settings.

Subs- my eyes actually aren't functioning properly, separate from the vestibular system. My eyes over-converge, I suppress the left eye, and I have almost no binocular vision, no 3-d vision, no depth perception. So then put a broken visual system with a broken vestibular system and how can it compensate! I wonder if my vestibualr system has been compensating for my poor vision system all these years?!?

Joni

 
Old 08-01-2007, 07:28 PM   #12
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Talking Re: HELP! New doc, meds, etc

Quote:
Originally Posted by JoniMichelle View Post
Its done my developmental/behavioral optometrists and they often work with vision therapists or do it themselves. Some types of vision training also may be done by occupational therapists in rehab settings.

Subs- my eyes actually aren't functioning properly, separate from the vestibular system. My eyes over-converge, I suppress the left eye, and I have almost no binocular vision, no 3-d vision, no depth perception. So then put a broken visual system with a broken vestibular system and how can it compensate! I wonder if my vestibualr system has been compensating for my poor vision system all these years?!?

Joni
Hi Joni

Exactly what I had before the vestibular injury---no binocular vision---no depth perception---no 3-d...

Yes ur brain has been compensating for ur(and my) vision problems---before this happened....for all those years...

And yes---it will do it again---but it takes longer---longer.....the vision training...will help....

Nice going---u---nailed it!!!

And with time/vision training----like me---u'll be good as new----again!!


Last edited by Subs30; 08-01-2007 at 07:45 PM.

 
Old 08-01-2007, 10:21 PM   #13
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Re: HELP! New doc, meds, etc

Thanks Subs! I'm feeling really good about it all. The vision excercises knocked me out this evening, especially after a really busy 9 hour sensory-filled work day. I took that as a good sign!

 
Old 08-12-2007, 04:11 PM   #14
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Re: HELP! New doc, meds, etc

JoniMichelle,

Hi, I'm sorry you have probably mentioned this before but how did you find out you had vision problems also? Did an opthamologist find it during an exam? Also, what are the vision exercises like? How are you feeling since you started these new exercises? Thanks so much!

 
Old 08-12-2007, 07:04 PM   #15
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Re: HELP! New doc, meds, etc

Quote:
Originally Posted by Floridagirl77 View Post
JoniMichelle,

Hi, I'm sorry you have probably mentioned this before but how did you find out you had vision problems also? Did an opthamologist find it during an exam? Also, what are the vision exercises like? How are you feeling since you started these new exercises? Thanks so much!
From the start of the whole dizzy thing one of my biggest problems was my eyes switching dominance (like as if you closed left eye, then switched, over and over) and my eyes would dart all over because I couldn't focus.

I knew my eyes never worked together because as a child i had surgery for crossed eyes, had vision therapy when I was a kid for seeing double and other eye related issues once I started school, and had been told that my eyes still didn't work together.

The neuro-otologist that diagnosed me said he didn't know how my eyes would affect my recovery. The 2 PTs I saw were clueless about how my eyes impacted me, but I wasn't getting better.

I saw a development optometrist, they look at eye function rather than only eyesight (mosrt optometrists) or medically eye health (opthomologist) who looked closely at my eye function. She's treating the eyes not working together and I'm continuing with the vestibular rehab on my own. The exercises are very specific using lens and other tools to get the eyes to focus and relax rapidly, and to get them to work together.

 
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