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    Old 11-11-2005, 01:38 PM   #1
    Lauren29
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    anxiety vs. a real inner ear problem

    Hi everyone! thank you so much for the responses to my questions...I really appriciate it so much. My biggest obstacle now.....is the diagnosis of anxiety. My dad's cousin is an ear doctor and he has called him and told him about all of my symptoms and my tests all coming out normal....he says that this is none other than just anxiety. I feel that this is very real to me and something is definately wrong....I wake up every day feeling dizzy and w/ this gosh awful brain fog that just makes me feel not normal....so this is all that anyone thinks it is (anxiety)...and my parents are just dismissing it as that and saying for me just to relax. I am so confused as what to do b/c ear doctors can not help me....but I still have found no releif. All of my symptoms match up w/ everyone of this boards exactly...except that I did not start this w/ a cold or flu. I have an appt. at the Mayo clinic in a week in a half. I just don't want to walk away from there w/ no answer either...or i am at the end of my rope. thank you so much for listening.....this site is a god send. -Lauren

     
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    Old 11-11-2005, 04:48 PM   #2
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    Re: anxiety vs. a real inner ear problem

    Hello,

    Just to say I got tagged with the anxiety diagnosis initially by 2 Ear Nose and Throat docs. ENT's are required to do no further training in the inner ear, a handful know what they're talking about. The rest don't. Mine didn't know that despite not having true vertigo in the first 8 months, it is still possible to have a vestibular disorder. When I was seen by a neurotologist, they knew I had a vestibular disorder straight away, they'd see it all before.
    Like you, initially I just had terrible brain fog and dizziness. Not getting a diagnosis made it all worse, or should I say getting a false anxiety diagnosis made it worse.

    Three years in I am loads better - living a normal (ish) life again. In the end I was diagnosed with migraine associated vertigo with possible vestibular damage (vestibular neuritis) The initial diagnosis was vestibular neuritis. You could have VN or you could have MAV. It's difficult to say as the symptoms can be so similiar. I'm in England so I'm not familiar with the mayo clinic, the advice I always give is see a neurotologist, not an ENT. So if the mayo clinic doesn't provide you with answers seek out a neurotologist. It took me my GP and 2 ENT's, both consultants, who all missed the problem and thought I was exagerrarting, before I got answers.

    I knew I wasn't suffering from anxiety, aside from the anxiety having a vestibular disorder caused. I knew it as sure as I knew that grass is green. The brain fog was so violent, the dizziness so severe. Trust your instincts,

    best,
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    Old 11-11-2005, 05:17 PM   #3
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    Re: anxiety vs. a real inner ear problem

    hbep:

    Did your condition clear up on its own or did you have medicine / therapy?

     
    Old 11-11-2005, 05:22 PM   #4
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    Re: anxiety vs. a real inner ear problem

    Hi Lauren,

    I am running out the door at the moment and cannot give you a full response just now but I am in complete agreement with hbep - your doc has no idea what he is talking about telling you "it's simply anxiety". In fact, this sort of thing really &^$%#% me when someone like yourself is told this. Ignorance in this department is very large unfortunately.

    Your anxiety is real and is part and parcel of having an inner ear problem - it is not just some psychological problem.

    Hang in there...more to come later (ie. solid information from the literature to arm yourself against ignorant doctors).

    Scott

    Last edited by studyin; 11-11-2005 at 05:25 PM.

     
    Old 11-11-2005, 06:38 PM   #5
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    Cool Re: anxiety vs. a real inner ear problem

    Hi Lauren

    Agree with Hbep & Scott---totally!!

    Scott has a good and personal handle on this---and as he said he will get back to u....

    ..."he says that this is none other than just anxiety"...

    What an "idiot"!!!

    From a previous posting:

    Below is only a very-very small part of a presentation on---


    COGNITIVE ASPECTS OF VESTIBULAR DISORDERS

    ---which is basically what you are fighting to regain when your vestibular system screws up-----

    (given at the--- VEDA Conference - Portland, Oregon)


    ......"PRACTICAL RAMIFICATIONS:

    Let's start with personal life, your home, your shopping, your social interactions, your family responsibilities. The above difficulties I've spoken of wreak havoc with your ability to function in any normal personal setting, from planning a menu to organizing your day's do list, to tracking your children's conversation...........


    .......Finally psychiatric complications such as depression and anxiety are almost too obvious to mention. After this kind of alteration of your most basic habits of thought, it's hard to conceive of not experiencing anxiety, depression, and disappointment with yourself..............

    ..........Could it be that since you're constantly fighting the mismatch from your visual input and your disordered balance system that a very basic mechanism -- a mechanism that was developed as you learned to sit and crawl and that influenced how you later manipulated objects and then walked and spoke and thought, a mechanism that's taken for granted and built into very fundamental habits -- could it be that something that fundamental is being distorted? That the vestibular and visual disturbance interferes with nuclei functioning within the brain stem and thus interferes with your sequencing of information and impairs and reduces your channeling capacity?................


    ..............Question: Do you have any help for family members?..........

    ............Answer: A vestibular dysfunction affects the whole family because it affects the patient's total life. Family members need help and understanding almost as much as the patient him- or herself..............."

    Post Located at:

    http://www.healthboards.com/boards/showthread.php?t=66143&page=2


     
    Old 11-12-2005, 01:09 AM   #6
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    Re: anxiety vs. a real inner ear problem

    Hi 6Blues,

    I did have treatment. I did months of VRT. I changed my diet to a migraine diet. I kept active. I also used an NTI as I was diagnosed with MPD (myofascial pain dysfunction) on account of clenching my teeth. The latter is a migraine trigger. Unfortunately I will never know which of these things was most instrumental in helping me to the point where I am now. It's impossible to prove that any of them were the thing that did it. I'm guessing they all helped - attacking the problem from all angles. Who knows, maybe Id've just improved anyway, even if a condition is caused by migraine - migraine works in cycles and can lessen in severity over time.

    I tried migraine drugs but so far the ones I tried caused worse side effects than the condition.

    I am not fully recovered - although within strict perameters - changed diet, getting enough sleep, less stress - amongst other things - I live a much more normal life. I may trial another migraine drug but am not keen as my next option is ant-seizure meds and the prospect of those doesn't fill me with joy.

    Unlike people who have a straighforward case of VN, for me it isn't a straighforward matter of compensating for the original vestibular injury.as my conditon is by nature unstable. To get my condition completely under control I would have to somehow completely control the migraine.

    I read another of your posts. When you said ...then I started getting the dizzies, lost my sense of balance, had some facial numbness, oscillopsia, memory problems, trouble speaking, etc. I was curious that no one had mooted migraine as a possibility. Especially with the facial numbness as part of the package. This can be a classic migraine sign- particularly in tandem with all the other stuff you have going on. You don't need to experience visyal auras or headache for this diagnosis. (That is simply the description of migraine people are most familiar with.) Migraine is simply an expansion and contraction of blood vessels - headache is only one manifestation of it. I'd recommend a look at the book 'Heal your headache' by David Buccholz and an article on migraine associated vertigo by Robert A Battista. Search online with his name and you should find it.

    Glad you're going to Uni of Penn - sure they will sort out some answers for you,

    best,
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    Last edited by hbep; 11-12-2005 at 01:26 AM.

     
    Old 11-12-2005, 09:54 AM   #7
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    Re: anxiety vs. a real inner ear problem

    lauren29:

    I used to be the type of person who could handle anything with ease and I was really easy going. Now, I find that the smallest little problem causes me to freak out.

    If my car battery dies, I just sit around crying about it instead of asking my neighbor for a jump. I can start to cry now over the smallest things. I work from home (thank God) but once this past summer, I was asked to drive in to the office for a meeting. I got scared at the thought. I made up a lie about a doctors appointment so I could get out of it. I would never have done something like that!

    I think my freak outs are related to not feeling confident anymore. I'll read more about the cognitive info Subs30 provided.

    hbep: Thanks for the info. I'll be sure to look into it.

     
    Old 11-12-2005, 02:41 PM   #8
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    Re: anxiety vs. a real inner ear problem

    Many doctors are earning big bucks because of me, but I still have no diagnosis.

    Keep fainting all the time... feel like killing myself...

     
    Old 11-12-2005, 11:43 PM   #9
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    Re: anxiety vs. a real inner ear problem

    BigK, I read your previous posts. Can you give anymore details about what kind of doctors you've seen and what they've said? Have you discussed the migraine situation with them?

    In regards to the anxiety diagnosis everybody is talking about, I think the problem everybody has with it is that it is kind of a throw away diagnosis. There is no way to show with these kinds of disorders that it isn't anxiety, so there's no way to remove that label as long as everybody continues to believe it.

     
    Old 11-13-2005, 10:32 PM   #10
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    Re: anxiety vs. a real inner ear problem

    Hi Lauren,

    Here's a few articles that I have picked up over the last 2 years shedding some light on anxiety. For me, labyrinthitis wasn't so much a dizzy problem (although the dizziness was very nasty) as it was a massive assault on my central nervous sytem creating all kinds of hassles - namely relentless and sometimes severe anxiety followed by equally disturbing rounds of depression that would last for half a day.

    An article by A Bronstein - surprisingly cluey about the psychological component of vestibular problems.

    Visual and psychological aspects of vestibular disease
    Adolfo M. Bronstein, Current Opinion in Neurology 2002, 15:1-3.

    Quote:
    Clinicians need not be reminded of the close association present between anxiety and vestibular disease. Why is it that patients with a seemingly identical vestibular lesion, for example, a viral vestibular neuritis, can differ so much in follow up - some returning to a full normal life in 3-4 weeks, others handicapped for months or years?

    The fact that a patient may have additional anxiety or phobic symptoms should not prompt the clinician to think that all symptoms in that patient are psychological. Indeed, some of the psychological symptoms may be secondary to the long-term experience of disorientation and dizziness, which in turn would confirm the patient's negative beliefs about his or her illness.
    The last paragraph is obvious to many of us - that the vestibular disease *initiates* the anxiety problem.

    And this:

    Dizziness and panic disorder: a review of the association between vestibular dysfunction and anxiety.Simon et al. Annals of Clinical Psychiatry1998.

    Quote:
    There are 3 models proposed:

    Psychosomatic model: describes vestibular dysfunction as a consequence of anxiety. Hyperventilation and hyperarousal increase vestibulo-ocular reflex sensitivity, even among normals who hyperventilate. No studies have examined vestibular dysfunction during a panic attack.

    Somatopsychic model: proposes that cases of panic disorder are triggered by misinterpreted internal stimuli (eg. stimuli from vestibuar dysfunction), that are interpreted as signifying imminent physical danger. Heightened sensitivity to vestibular sensations leads to increased anxiety and, through conditioning, drives the development of panic disorder.

    Network alarm theory: derives from pharmacological challenge studies and other laboratory assessments of panic that suggest involvement of noradrenergic, serotonergic, and other connected neuronal systems. According to this theory, panic can be triggered by stimuli that set off a false alarm via afferents to the locus ceruleus, which then triggers the neuronal network. This network is thought to mediate anxiety and includes limbic, midbrain and prefrontal areas. Vestibular dysfunction in the setting of increased locus ceruleus sensitivity may be one potential trigger. The network alarm model contributes to a neuropsychiatric explanation for the somatopsychic model.
    The last two models support labyrinthitis or other inner ear problems potentially driving anxiety and resultant panic attacks.

    And:

    Neural substrates linking balance control and anxiety.
    CD Balaban
    Physiology & Behavior 77 (2002) 469– 475.
    Quote:
    Growing clinical and basic scientific evidence indicates that vestibular and other information regarding balance control also exert a significant influence on ascending pathways that are involved in anxiety. These pathways may provide an explanation for the extensive comorbidity between balance disorders and anxiety disorders, which was noted since antiquity. These balance–anxiety linkages appear to involve integrated activity of at least three neural circuits: (i) a vestibulo-parabrachial nucleus (PBN) network, (ii) a coeruleo-vestibular network, and (iii) a raphe nuclear–vestibular network.
    So there you go - anxiety stemming from balance problems has been known for centuries. Ask your doc where he's been all this time .

    Other articles you can chase down in this area are:

    Clark DB, Hirsch BE, Smith MG, Furman JMR, Jacob RG:
    Panic in otolaryngology patients presenting with dizziness or
    hearing loss
    . Am J Psychiatry 1994; 151:1223-1225

    Jacob R: Panic disorder and the vestibular system. Psychiatr
    Clin North Am 1988; ll(2):361-374

    Jacob RG, Furman JMR, Clark DB, Durrani JD: Vestibular
    symptoms, panic and phobia: Overlap and possible relationships
    .
    Ann Clin Psychiatry 1992; 4:163-174

    Pratt R, McKenzie W: Anxiety states following vestibular disorders.
    Lancet 1958; 16:347-349

    So don't listen to any doctor tell you it's all in your head Lauren. Be good if you could print all of this material off and send it to that so-called medical practioner to give him a reality check.

    Best...Scott

     
    Old 12-04-2005, 02:47 PM   #11
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    Re: anxiety vs. a real inner ear problem

    Quote:
    Originally Posted by coryb
    BigK, I read your previous posts. Can you give anymore details about what kind of doctors you've seen and what they've said? Have you discussed the migraine situation with them?

    In regards to the anxiety diagnosis everybody is talking about, I think the problem everybody has with it is that it is kind of a throw away diagnosis. There is no way to show with these kinds of disorders that it isn't anxiety, so there's no way to remove that label as long as everybody continues to believe it.
    Over the last 7 years, I've probably seen 20+ med professionals about this. The first CYCLE was 7 years ago when the symmtoms hit hard and was ruining highschool for me. General prac. sent me off to neuro and allergist. Neuro sent me for CT, allergist found allergies to dust mites and ragweed. CT showed nothing. Nobody believed me basically. The cycle finally ended when the neuro implied that I might be overexaggerating the symtoms or lying or that I was just depressed. Mom gave me hell for making this whole thing up, and she's not a rational thinker... that's why I was skipping school and not telling her about it (which is why my highschool eventually kicked me out because the medical tests found nothing).

    Since then symptoms kept coming back (well, they kept lessening and coming back worse, never really free from it). I keep mentioning the symptoms to doctors, but never make too much of a big deal out of it because I remembered how it ended the first time. Doctors always prescribed me stuff for vertigo, or tylenol, etc. I remember a walk-in clinic doctor even JOKING about how my BRAINFOG could just be genetically deficient intelligence (he was laughing too).

    Well about 7 months ago, the symptoms just became UNBEARABLE. And then it slowly subsided in the summer. I entered university (finally made it) this semptember and was getting 90s when BOOM, unberable. Dizziness, eye pain, head fullness, blurriness, clogged ears, ear pain, fever, weakness, lowered IQ, head fog, etc. etc. I decided to start a serious medical CYCLE once again but this time use my own research to aid the docs.

    So I've been to a walk-in clinic 3 times in the last 2 months. First time the guy looked in my ear and nose and said he couldn't see any infection (even though I was complaining about having clogged ears!!). Prescribed me Flonase and told me to relax and it will go away.

    Didn't go away! Went back to the clinic, a different doctor. She was AMAZING, because she actually said "I have no clue, I have to send you to experts" (We need more doctors like this, who don't guess if they don't know what's going on). So I went to the ENT and he examined my sinuses and said it looked infected and that I probably have sleep apnea too. And he said he needed to see a CT before he can make better diagnoses and further examinations. So I'm waiting on my CT appointment (2 weeks from now).

    Since the ENT appointment I have also been to the emergency room once because I was fainting several times and had severe blurriness/eyepain. They ran blood tests and EKG and said I was fine (blood tests showed no infection). They also did tests to see if I had a stroke. Finally the doctor told me to eat 6 good meals a day and not to stand up fast after sitting.

    I also went to the optometrist, who found no eye disease.

    I also went to my family doctor recently (dont' go to him much, because I tried telling him about these symtomps before and he always dismissed them as nothing). Told him about waht happened, he stuck the thing in my ears and nose and said I was fine. He said it's probably depression or something and told me to relax and continue flonase.

    So here I am waiting on ENT (after seeing CT scan results) to finally put me out of this misery.

    I've left out many many things here, as I've even seen many other doctors too (GPs mostly). I even saw a French doctor this summer who prescribed me some vertigo related medicine which is unfortunately not available in Canada (doesn't matter, because the samples didn't work very well this summer).

    Basically, the only thing that really gets me is the WEAKNESS. I can manage the brain fog (lowered IQ, but factor work isn't too bad), and head aches, but it's the WEAKNESS and DIZZINESS that makes be utterly useless as a human being.........

    Ohh another thing, my facial structure has been abnormally changing over the last 4-5 years. It's very noticeable to me and my family, and now I look much different than my family members. Nobody else in my family has these symtomps (swelling, etc.) so maybe it's the constant swelling that has reshaped my forehead/face/nose structure. I think it is because when I have these swelling attacks, my face does temporarily get deformed and enlraged (very visible to others), so many years of this could have permanently shaped it. Anyways I don't care about this, I just want this constant weakness and dizziness to go away so I can at least live my life semi-productively (factory work, volunteer work, charity work, etc.).

     
    Old 12-04-2005, 03:27 PM   #12
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    Re: anxiety vs. a real inner ear problem

    Wow that is very serious. The doctor basically just brushed off the fainting as just being depression? That is horrible. Well, I know you won't get any such judgements from the people on this board. It is very obvious that this is a serious problem. And as many of us have experienced the same sort of thing with doctors and family, we know they like to imagine that nothing is wrong so they can make themselves feel better. But I haven't seen anything so overtly bad as your situation.

    As far as what could be causing your situation, I am not very educated on things outside of certain inner ear diseases and a few neurological diseases. The only things I know of that can cause the facial swelling you describe would be allergies and perhaps kidney disease. And I don't think that allergies could cause fainting. I'm sure there are many other possibilities, but I don't know what they are.

    Anyways, please stay in touch, somebody needs to help you! I hope that others can provide more insight that I can.

    Cory

     
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