Thursday, February 18, 2010

My diagnosis (finally...sort of)

Had my follow-up with the Otolaryngology specialists earlier today. The general consensus is that I am having vestibular migraines without headaches. Not a 100% certain diagnosis, but somewhere in the 90% certain category.

Now the fun part really starts - trying to find the trigger(s). I may never find it, which means taking some type of medication from now on. I also get to try out different types of medications (if needed). For the time being, I'm sticking with my current medication. I've gotten the OK to up my dosage another 10mg if needed. I go back in 8 weeks or if my meds don't seem to be working (i.e. blocking or stopping the episodes). In that 8 week span, C and I will be making a trip, so they are very interested to see how I do on on the planes and immediately afterward. They are also interested to see how I do in the environment I'll be in (in keeping with my tradition of not disclosing info about trips I take until I return, the destination will remain a mystery until I get back to post about it).

The real bummer is that starting tomorrow, they want me to cut out (as much as possible):
  • chocolate
  • caffeine
  • wine, especially red
  • cheese
  • MSG

On a positive note, they told me that the vast majority of people who have this rarely, if ever, have headaches. I've been trying to remember when I last had a headache and discounting an after several glasses of wine one back in September, I can't recall one. So I have that going for me....


Stephanie said...

Everyone can feel free to marvel that "migraine without headache" was my first guess on your Oct. 1 post.

Scooter said...

I guess we have to address Steph as "Dr." now.

I know it can't be any fun but at least those are all things you can do without. I'm trying for most of them myself.

Stephanie said...

It seems like it would work better to eat a lot of each thing (one thing per day) to see what triggers an episode, rather than avoiding things and not know if not having an episode is meaningful. Since I'm the doctor, I think you should listen to me. Also, YOGA.

Scooter said...

What the heck is wrong with cheese? The others I get. Caffeine, sulfites. Just thinking about MSG makes my head hurt. I like the doc's advice if a daily intentional overdose won't do any real damage.

Stephanie said...

Tyramine-triggered migraine
One of the first reports of the relation of tyramine to the migraine attack was that of Dr Edda Hanington (British Medical Journal, 2:550, 1967) who observed a headache reaction to cheese eaten by patients treated for depression with certain drugs. The drugs, monoamine oxidase (MAO) inhibitors, inhibit an enzyme that normally metabolizes tyramine, the migraine provoking chemical found in cheese and other foods. MAO inhibitors taken in chance combination with a meal of cheese can also cause an acute rise in blood pressure by releasing the neurotransmitter norepinephrine, another reason for headache symptoms. It is postulated that patients with dietary migraine are sensitive to tyramine-containing foods because of an inherent deficiency of MAO in their liver and blood, and an inability to metabolize tyramine. The elimination of the offending food and chemical from the diet should prevent or lessen the number and severity of migraine attacks.

Scooter said...

Simply study one's little red book and eat all the cheese one desires.