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Imagine feeling that drunken-buzzed sensation (minus the alcohol) every day, all day. That’s been my life for the past few years, thanks to Migraine Associated Vertigo (MAV).
I’m not exactly sure when I first started feeling strange, but I can trace it back to 2011, when I was interning in Toronto. After I graduated college, I was living in the city by myself and interning at a local magazine.
Toward the end of my internship, reality set in and I realized that soon I would be moving back home to Atlanta, jobless and without a plan for my next step. I began to experience vertigo a few times a week. There was never a pattern but once I felt so dizzy that I left my internship because I couldn’t stand to look at the computer screen any longer. Trying to type an article felt like I was working on a boat in the middle of an ocean.
I thought it was stress —the transition of leaving college for the real world taking a harsh toll on me.
One morning, as I was getting ready for work, I suddenly started to feel nauseous. My vision went from blurry to blotchy to black and I broke out into a cold sweat. Scared of what was happening, I ran out of the bathroom to the couch and lay there until I regained my sight and stopped sweating.
I was so frightened that I went to a walk-in clinic, and the doctor confirmed what I thought: stress. I aimed to take it easy for my last few weeks but the vertigo still continued on and off, finally subsiding once I moved home.
A few months later I moved to New York, where I landed a job and established a routine until the vertigo slowly crept back into my life.
I vividly remember the fall of 2012, just after Hurricane Sandy hit. Many of the trains were still down, which caused the train cars to be extra crowded during my morning commute. Holding on to a center pole and crammed next to hundreds of my fellow commuters, I started to feel that familiar nauseous sensation.
Crossing the Williamsburg Bridge into the city, my vision went blurry and then black. I woke up sitting in a seat on the train sweating profusely — someone had put me there — and my purse a few feet away on the floor. Panicking, I got off the train and sat at Essex street station in an attempt to recover from what just happened.
This time, I was scared and desperately wanted to figure this out. No one wants to loose consciousness, especially on the subway, and I didn’t want this to happen again. I didn’t know where to begin finding a doctor or how vertigo was even treated. I picked up some Dramamine at the pharmacy in a failed attempt to tame the vertigo, but that only ended up making me extremely drowsy.
I settled on trying my luck with a General Practitioner — you have to start somewhere. Among a few other tests, the General Practitioner ran an EKG, which luckily came out clear. They diagnosed me with syncope, something apparently common in young women in their 20s. I felt like a 21st century damsel in distress. Fainting, OK, I have a fainting condition, and of course, there is no treatment.
The doctor explained that the incident on the subway was caused by insufficient flow of blood to the brain, and she recommended I sit down on the train whenever possible. She noted that the vertigo wasn’t the cause of the fainting, but that vertigo is a symptom of something else. But what?
From that point I had varying degrees of anxiety accompanied by that buzzed feeling every time I got on the subway in the morning. But how else was I going to get to work? Making it to work every morning soon became an accomplishment, something I completed with great relief. I continued having regular vertigo a few times a week, and then a new issue arose: migraines.
For about six months, I gradually experienced anywhere from one to five headaches a week, topped off with at least one migraine. I tried different pain meds including Tylenol, Advil, Motrin, Aleve and Excedrin Migraine almost daily, to no avail. And on the days that I wasn’t experiencing pain, I had vertigo.
I finally hit my breaking point when I was confined to my apartment every weekend nursing a debilitating migraine. I decided to find a neurologist, as I was desperate to get rid of the headaches and vertigo -- not realizing they were linked. I was put on a daily preventative medication, propranolol, a beta-blocker often prescribed to migraine patients, and Imitrex, for those instances when I needed pain medicine.
For the first month, I felt rejuvenated; my headaches and migraines decreased immensely and I was vertigo-free for the first time in two years. I was positive that this was the cure, until I experienced the migraine-to-end-all-migraines. This migraine opened the proverbial floodgates, and my vertigo came back in full force.
I experienced it every weekend for hours on end, and occasionally throughout the week. It was worse in the summer as I was always scared I would fall or pass out in the heat. My doctor was sympathetic but more or less offered me no alternatives, and ordered an MRI to be sure my brain and inner ear were clear. Once the MRI came back clean she suggested vestibular rehab, stating that my vertigo was likely linked to the migraines, but the vestibular rehab might offer a solution.
I left feeling extremely disheartened, but at the same time determined to figure this out; I'd had close to two frustrating years with vertigo. I put a tremendous amount of effort into finding a vestibular rehab center and getting an appointment as soon as possible.
After six sessions of up and down improvement I left feeling more upset than when I started. The vestibular therapist diagnosed me with Migraine Associated Vertigo (MAV) and was sorry he could not be of more help.
Vestibular therapy helps those with Benign Paroxysmal Positional Vertigo (BPPV), a type of vertigo caused by the inner ear. He did offer me the name of a neurologist with whom many of his patients had had success. I eagerly took down the contact information and was determined yet again to solve the vertigo problem with a new neurologist — one who was hopefully open to figuring out my ever-challenging case.
When I finally got to see the new neurologist — it’s tough to get an appointment with a specialist in New York, it can take weeks to months — she went through all of my medical records, re-ordered my blood tests and we started fresh.
With my migraines and headaches under control, but still plagued with persistent vertigo, she told me that she would never run out of ideas for me. That was what I needed to hear. She wasn’t going to give up.
Throughout the course of that year I experienced possibly the most frequent amount of vertigo I'd ever had -- almost every day, all day. Working was difficult, concentrating took effort, and the ever-present feeling of imbalance weighed me down.
I tried many different medications in various doses and nothing helped. It was like solving a complex code, trying different combinations of everything. I experimented with my diet, did constant Internet research, took various vitamins, and tried acupuncture but wasn’t seeing any results.
Each time I went back to the neurologist, the doctor was understanding and thoughtful, and took a logical approach to solving the issue. Having a doctor that is positive and hopeful can make all the difference. I held on to her assurance of never running out of ideas.
About a year later, I think we’ve finally found the right combination of medicine: sertraline 100 mg + nortriptyline 30 mg, in case you wanted to know. Battling over three years with vertigo has made me appreciate my health much more than the average 25 year old. I now cherish each day that I am headache-and-vertigo-free.