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May 9, 2016 10:42 PM   Subscribe

I've been having debilitating vertigo and nausea. I can't function or deal. Hope me?

I have pretty severe POTS and this may be migraine related but no headaches.

I keep getting debilitating episodes of severe nausea and vertigo plus light and sound sensitivity.

This week has been hell since Wednesday and included a trip to the ER on Friday, with 3 doses of Zofran and one of meclizine barely helping (plus a heart rate of 140 and a flushed chest). It's been non stop spinning and nausea and I literally can't take it.

I've tried meclizine and I use Zofran when I absolutely have to. I have Ativan but it can make me fuzzy and very sleepy and out of it which makes my skin crawl.

Should I try that? Can I take it with meclizine?

I take allergy meds and Prilosec.

I'm super sensitive to meds and get stomach problems. I have a horrible phobia of vomiting which isn't helping bit any "just get over it" advice is not going to help or welcome.

What else should I try?
I can barely eat anything let alone move.

I have an appointment with my GP next Wed and will be calling every morning she's in for a same day appointment. But she's only part time. I can head to a walk in clinic if I have to get something RX.

I thought I had the vertigo sorted when I cut out chocolate and it got amazingly better but a few weeks ago I got a severe migraine thing(? No headache) and that set it off and it's now been waves on and off since Wed.

Sorry if this isn't cohesive or if I left something out I can barely think. You are not my doctor etc.
posted by SockWombat to Health & Fitness (30 answers total) 1 user marked this as a favorite
This sounds absolutely like a migraine. But once you have neurological involvement you need to see a doctor sooner rather than later.
posted by feckless fecal fear mongering at 11:00 PM on May 9, 2016 [1 favorite]

Just to update I've been to my doctor, and ENT, and neurologist, a POTS specialist, and has 2 MRIs among a million other things. The next thing to check is a mast cell thing and while I don't doubt that it's possibly migraines what should I do now?
posted by SockWombat at 11:09 PM on May 9, 2016

I have pretty bad vertigo - very related to allergies. Allergy meds don't help much, but allergy shots have. I was going 3x/week to get up to full dose. Now I'm back down to once a week.

On the phone, so can't link - but I get Vertisil on Amazon, taken 2x/day and it's like a miracle. Passed it by all my docs and got the ok. There's nothing particularly special in it - but is a big help.

I was so desperate at one point that I just searched "vertigo" on Amazon and this was highly rated. I've tried just about everything else, but nothing works as well. Meclizine didn't do anything.

(I've also wondered if it's migrainey.)
posted by crankyrogalsky at 11:10 PM on May 9, 2016

Have you seen a cardiologist?
posted by discopolo at 11:26 PM on May 9, 2016 [1 favorite]

Could it be benign paroxysmal positional vertigo? Per that article, BPPV is sometimes overlooked when docs jump straight to imaging and whatnot. If so, there may be a crazy easy fix you can try yourself.
posted by mumkin at 11:34 PM on May 9, 2016 [5 favorites]

You don't say anything about medicine for the POTS. If you're not taking anything for that, I really think you should. POTS can mess you up in all kinds of ways, it's hell on your system. I take Atenolol which doesn't eliminate my POTS but makes it a livable situation.

I'd say ask your doctor about POTS, allergies and migraines. Obviously it could be many other things, but I have a hunch it's one of those. It's also possible (although less likely) that this is anxiety, or that you have something physically wrong and you're getting anxious and that's making the symptoms worse. Do whatever you can to relax, and maybe ask your doctor about an anti-anxiety medication. Just having something that makes you not care for a while could be a huge relief right now.

Back in the 90s I had months and months of nausea and dizziness (back in the 90s I had everything), so I really feel for you here. In my case the nausea was from mono and the dizziness was probably an allergy thing, but we never did get it 100% sorted. Eventually it just got better. Like you I became a puke-phobe, spending so long on the brink of puking and never quite getting there. But I kept reminding myself that the scariest part is waiting to puke. Once you finally puke it's usually a relief, and you feel better after.

Whatever is going on with you, you'll either get it diagnosed and treated or it'll go away eventually. You won't feel nauseated and dizzy forever!
posted by Ursula Hitler at 12:46 AM on May 10, 2016

What else should I try?

I found marijuana is a very powerful and fast-acting fix for my migraine-induced nausea. Takes effect in under 5 minutes for me. You definitely want to smoke it, not eat it for this.
posted by ryanrs at 12:48 AM on May 10, 2016

Could it be a virus and unrelated to the other stuff?
posted by kitten magic at 4:16 AM on May 10, 2016

I had a virus like that once and it was hideous. I couldn't move so my diagnosis was retrospective but my GP said that was a thing.

I wish you a speedy recovery, whatever it is. You deserve all the sympathy.
posted by kitten magic at 4:19 AM on May 10, 2016

I found marijuana is a very powerful and fast-acting fix for my migraine-induced nausea.

Unfortunately pot can accelerate your heartbeat. If the OP is suffering from uncontrolled POTS, pot's probably not an ideal drug. (But, it could be worth asking your doctor about it and experimenting with a very low dose.)
posted by Ursula Hitler at 4:30 AM on May 10, 2016

Don't start mixing and matching prescription meds. *Definitely* don't combine prescription meds with pot or alcohol. Honestly if this is so painful right now, go back to the ER. You should be in impatient until they find a treatment that works for you. Trying to MacGuiver your neurological problems is not very smart.
posted by deathpanels at 5:39 AM on May 10, 2016 [2 favorites]

My first thought was what mumkin said - inner ear crystals, unrelated to your other symptoms. Give that crazy easy fix a try.
posted by Dashy at 5:43 AM on May 10, 2016

My boyfriend is prone to vertigo whenever he gets seriously sick and a dose of pharmacist-recommended Benadryl fixed him in about 30 minutes last time. We wish we had known about that years ago when he had his first episode. Here is a reference. Dramamine was also recommended.

I would check in with your doctor to see if there were any contraindications, and I really hope you feel well soon!
posted by missmobtown at 6:00 AM on May 10, 2016

I'm an audiologist not yours etc.

This does not at all sound to me like BPPV. BPPV for one is positional, and is always caused by moving into some particular position. Secondly, because BPPV is caused by an inertia response, it fades relatively quickly, and rarely lasts more than a couple minutes.

This sounds to me to be migraine related, which can be very frustrating. I too recommend seeing a neurologist.
posted by Lutoslawski at 6:06 AM on May 10, 2016 [1 favorite]

I would go back to the ER. When it's hard to move and eat and exist, the ER exists to get you back to at least comfortable. I don't think it is reasonable for you to try to love like this for eight days. The ER has access to multiple doctors and drugs and tests to try and fix this. If it were me, I'd go a few hours before shift change so you can pick two doctors minds on this.
posted by Kalmya at 6:08 AM on May 10, 2016

And on the infection note, while not impossible, repeated episodes sans any other infection symptoms also strikes me as being a central problem rather than an inner ear infection.
posted by Lutoslawski at 6:08 AM on May 10, 2016

You might want to check the symptoms for Labyrinthitis (inner ear infections) to see how closely they match. I had a viral inner ear infection that turned into Labyrinthitis and some of the symptoms match. I also had horrible headaches, probably from the fatigue of trying to stand up straight even as it felt like gravity was pulling me to the ground. It felt like being on the Gravitron for 3 weeks.

As far as I can tell, there is no cure for Labyrinthitis. Acute symptoms usually last 3 weeks and full recovery is usually within 8. Avoid reading testimonials if you are prone to anxiety. At the crux of it, I had to take a week off work. I stayed home resting on the couch, which was the only way to avoid fatigue from the symptoms.
posted by Milau at 7:01 AM on May 10, 2016 [1 favorite]

Similar to the Foster Manoeuvre mumkin linked there's an Epley Manoeuvre which you do mostly lying down on your back.
posted by lucidium at 7:06 AM on May 10, 2016 [1 favorite]

This isn't immediate, but ask about glasses and visual physical therapy if it turns out to be migraine-based. After terrible vertigo for more than a year, a special pair of glasses (that look much like normal glasses just very slightly tinted pink) and physical therapy that's basically a series of vision tests have made a huge difference for someone in my family.
posted by snaw at 8:30 AM on May 10, 2016

Please be careful TRYING the Epley Manoeuvre - I'm saying this as a fellow emitophobe. It can be very intense. A professional can do it safely and quickly.
posted by Dressed to Kill at 9:54 AM on May 10, 2016

This sounds a lot like Meniere's Disease, an infection of the inner ear. My close friend had it in one of her ears. It's fairly rare, but it really does sound like it.
posted by primate moon at 2:32 PM on May 10, 2016 [1 favorite]

Just to update I've been to my doctor, and ENT, and neurologist, a POTS specialist, and has 2 MRIs among a million other things. The next thing to check is a mast cell thing and while I don't doubt that it's possibly migraines what should I do now?

Short answer: Make an appointment with your doctor today!

Less short answer: I, too, have pretty severe POTS, migraines, and CS to boot. I even went to the Mayo to have stuff figured out, but I *still* have been going to back to my doctor to figure more things out. Maybe go back to ENT?
posted by TinWhistle at 2:46 PM on May 10, 2016

I've dealt with something along these lines. The doctor's visits are beyond frustrating but eventually I expect you'll find someone who can help you.

Nthing that it sounds migraine related. Are there any migraine specialists or headache clinics near you? I found that the more specific I got with doctors - a guy who specialized in vertigo! in migraines! in neurological balance disorders! - the easier it was to start ruling things out. I lived in a big metropolitan area at the time, though, which gave me a few more options.

Something you might consider is physical therapy, again with someone who specializes in vertigo. Ultimately that was the thing that helped me - vestibular rehabilitation therapy.
posted by fast ein Maedchen at 4:05 PM on May 10, 2016

Get yourself to a good acupuncturist. It's amazing how they can often sort out complex stuff like this. And/or go to a Physical Therapist who specializes in vertigo. If it were me I'd do both.
And take a hard look at my diet in terms of allergies/food reactions.
posted by Otterone at 4:39 PM on May 10, 2016

Like I said, I do have a doctor's appointment for next Wednesday and will be calling on the days she's in to try to get a same-day appointment. I really trust my doctor.

But, are there any other meds OTC that I can take? Will Ativan+Meclizine be bad news? The Meclizine doesn't seem to make me drowsy. Any meds to mention to my doctor?

Yes I have seen a cardiologist (two holters, an echo, and the POTS specialist IS the cardiologist who deals with this condition in my area.) They mentioned Meniere's but when I dropped my salt intake there was no difference - and low salt is the opposite treatment for POTS. Plus light+sound sensitivity isn't present in that. Again, things got better when I stopped chocolate which leads me to think migraines but then it came back. (I'm very aware of my food, no wheat, no dairy.) Don't think it's BPPV.

I think I have a migraine medication around here somewhere but I've never taken it and since I'm not SURE that it's migraines, and since I have a sensitive system I'm not too keen to track them down and take them. It keeps coming in waves every day.

Also, thank you for suggestions for physical therapy, however I am literally homebound with my illness. So that's not in the cards for right now. I'm literally just trying to cope until I can get into my doctor and get some sort of treatment going on.
posted by SockWombat at 6:13 PM on May 10, 2016

I'm throwing this out there just in case -- do you wear glasses, and have you gotten a new prescription or new glasses in the last few months? I had horrible vertigo that my doc couldn't figure out. After months of hell, I finally deduced that it was due to chronic eyestrain from a pair of improperly fitted glasses. Switching to contacts fixed most of it, but I still get dizzy if I strain my eyes. It's also too easy to trigger in other ways now -- dehydration, exhaustion, etc., so I'm more careful about those things than I used to be. It's basically like getting a migraine without the headache.

Every time I run into someone with vertigo problems, I mention my experience. Just in case.
posted by QuickedWeen at 7:10 PM on May 10, 2016

I'm not a doctor, this is not medical advice. I suffer from a similar condition which I've been working to try and fix for the last 6 months with a bunch of specialists. When things are really bad I take meclizine and ativan together and it reduces my symptoms enough that I can function. I think my diagnosis is headed towards vestibular migraines and I've been in physical therapy too which can really trigger my symptoms but has helped overall build up my tolerance to things. Good luck.
posted by OsoMeaty at 5:11 AM on May 11, 2016

Do you have low frequency fluctuating hearing loss and roaring tinnitus preceding your vertigo? If no, it isn't Meniere's.

Do you have hearing loss? If no, it isn't labyrinthitis.

People really need to stop giving random diagnoses in these threads. Ativan and meclizine is probably fine together, just don't overdo it on either.

I'm glad you're seeing a doctor. Vertigo can be really terrible, and outside of a one or two causes there are no great treatments for it.
posted by Lutoslawski at 9:13 AM on May 11, 2016

Not all Meniere's has roaring tinnitus and fluctuating hearing loss, and not all labyrinthitis has hearing loss. I wish medicine were that clear cut.

I still wonder if Meniere's is possible considering what you've said. I am a doctor but I am not an ENT (and this is not medical advice), I see patients with vertigo frequently. My husband has Meniere's disease and knock on wood, he has not had an attack of it since he went on hydrochlorothiazide daily (a diuretic). Reducing salt in your diet is not always enough - it wasn't for him. Unfortunately, a diuretic may not do well with your POTS. There are a few potential treatments for Meniere's, so it could be worth re-discussing with your ENT.

Vertigo is a miserable thing. Usually if you're failing meclizine, the plan B I use is diazepam (Valium), which is a similar drug to Ativan but it's longer acting. The problem with combining the two is that both drugs tend to cause drowsiness - and so do other medications noted above that can help, such as antihistamines (Dramamine, Benadryl). Please be very cautious when combining sedating meds. Also be careful, if you're using that much Zofran, I hear it can be very constipating.
posted by treehorn+bunny at 3:20 AM on May 12, 2016

Re: migraines - one thing to add is that I often see migraine sufferers come in with migraines plus another problem that is related to dehydration. In other words, they have one problem that causes dehydration, and that triggers their migraine too. It may not be impossible that all your symptoms could be POTS and/or migraine related, but it isn't typical for migraines to present with severe intractable vertigo as their primary symptom, certainly.
posted by treehorn+bunny at 3:24 AM on May 12, 2016

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