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    Hi--Dr. M: Mild symptoms concerning me--almost 1 year post op!
    yanksgirl posted:
    Hi, Dr. M: I need your 'thought's once again. I have had some 'mild, very short episodes of this feeling inside my head that I used to get just prior to a 'vertigo' episode.

    They occur when I lay down in bed, and when I turn on my side to get up, etc. And, on occasion--just while sitting up and really doing nothing (that's usually in a busy area, like a restaurant, etc.)

    The feeling is like 'motion' inside my head' and it immediately makes me feel almost 'faint' and dizzy--and nausea comes on.

    I get shaky and yesterday it happened as we were ordering take out dinner and I had 'looked up' at the menu. Suddenly I felt that movement in my head and my stomach 'turned over' and I was shaky--had to get to a table and sit.

    We got our order right away and my husband pulled the car to the door and the restaurant young man--saw to it I got to the car ok.
    Now, I'm 'anxious' that will occur again of course.

    At the grocery store today I felt so lightheaded and nausea was going on (which has been daily for weeks now--sometimes mild and sometimes really bad), so was glad to get home and sit back.

    It does help when I do that--as always.

    Since my Ent doctor told me I'd have 'no more vertigo' after the shunt surgery, I've felt confident of that, but what could be causing these episodes of 'movement' in my head that feels like a 'spin' is coming on?

    It will be a year in March since the ear surgery. Could it be that the shunt is 'clogged' or that the vertigo is going to recur--or is it something else--and if so, any idea as to what? The doctor said the shunt would 'not clog' because if it did, I'd have 'vertigo', then he followed that with 'you will not have vertigo anymore'!!

    I even stopped in at the Urgent care to get b/p checked and it had 'spiked to 170/66--not really bad, and heart rate was ok too. They do that 'free to walk in patients' and I go there once in awhile to get mine checked.

    Anyway, this extreme nausea and off and on 'near vertigo' feeling has me more anxious again. Have kept on keeping on, but still dealing with this. Very discouraged right now.

    Thought of you this week--as a friend had her shoulder done. She's elderly- in her 80's and so far is doing ok--will start therapy tomorrow.

    I wondered if you have decided on yet another surgery--if so, I wish you the 'best' of results this time. Yanksgirl
    Rod Moser, PA, PhD responded:
    As you know, there are many, many causes of vertigo. We will just assume that these new episodes are really caused by the same 'ol issues as the past. I don't know if your shunt is functional or not. That was a very strong conviction when your ENT said you will never have vertigo again. I am not sure I could ever make a 100% claim like that, so you will need to let him know that "it's back!".

    A person can have a type of vertigo that make you feel like the room is spinning, or a type that makes you feel that YOU are spinning in a room that is stable. Basically, they are the same, it is just how your brain makes the interpretation.

    Have you tried your old medicine regimes again, including the Zofran or meclizine? Did it help?

    WebMD has made some difficult changes in their mission, and one involves this board. Starting next month, I will not be posting hardly at all. I will still be doing the weekly blogs and answering a few WedMD Answers, but this board will be run by the members. I will still jump in from time to time, but I will not be addressing every posting, like I have in the past. I will look for your postings, however, and help when I can.

    Arm surgery likely this summer. Not happy about it, obviously, but what can you do?
    yanksgirl replied to Rod Moser, PA, PhD's response:
    Oh no! Why have they made this sort of change? We need all the help we can get--especially from the dedicated medical personnel like you, who truly are a wonderful source of inspiration and encouragement, and medical advise on this and other boards. You have been absolutely wonderful in your timely responses and help!

    Sure hate to hear this news!

    Thank you for your answer and regarding the Zofran--I can't take it with the A-fib meds I take--they cause serious conflicts. I can take Meclizine-it does help the nausea and head thing--but not alot. I did take it yesterday when the 'near vertigo' happened. It makes me feel even more drugged, but all drugs do. I don't do drugs well at all. I am taking the Valium again--one a day for the inner ear thing. Just doing it on my own, because I know the Ent doctor would say to go back on it, if I called him. I too wonder if he can be 100% certain about 'no vertigo'. Guess that's got me concerned too.
    I've had both types of vertigo--one makes me have to lay down and the other turns me upside down--physically--like a drop attack. Both cause serious 'throwing up'. What I have now is extreme nausea---no throwing up--but it makes me miserable.
    Anyway--I'll sure miss you, Dr. M:
    I do hope your latest surgery will help you---
    Rod Moser, PA, PhD replied to yanksgirl's response:
    I forgot about you A-fib meds. There are other anti-nausea meds, though, like phenergan, so you may want to ask your doctor. Phenergan will make you sleepy, but it does work. It even comes in suppositories if you are unable to hold down the oral meds. Perhaps, not the most pleasant way to administer a drug, but it does bypass the stomach! While I admire the "no vertigo" stance that your ENT has had, that is a difficult statement to make with your extensive history. Perhaps he should have said "considerably less vertigo", and you would not be overly disappointed when these event occur. In the bigger picture, you have done much, much better since the shunt, so hopefully, things will settle down again for another year....or longer.

    I will be monitoring the community board, but my presence will be considerably less. For you, I will be here, I can assure you. You may have to post a few times in case I miss it, but after more than a dozen years, this transition will be a big change. I try not to question the wisdom of WebMD in these matters. They are a hightly-sucessful business that provides a free service. They have to tighten their belts, re-evaluate these sites, and keep pace with future trends. I am just along for the ride and it has been a good one. Like the weather, we often sit out the storm in hopes of sunnier skies in the future. Again, I am still blogging and "answering", so I am not going out to pasture. It will be nice to "wind down" a bit...maybe take a vacation without tugging the laptop around and looking for a wi-fi site or Internet cafe. When one door closes a bit, others open.....
    yanksgirl replied to Rod Moser, PA, PhD's response:
    Great--I would go in to 'withdrawal' without your help!!

    Just to clarify--I have been having serious bouts of nausea--not 'the throwing up'! I do have the suppositories on hand 'in case' the 'throwing up' would occur'.

    If I could, it might help! It's just really very debilitating to feel that way for long periods of time and you can't eat until is subsides of course.

    Sometimes a cracker or ginger eases it. I keep ginger with me at all times.

    It will suddenly ease and then come back, but especially when I get lightheaded.

    The 'feeling inside my head' that makes me feel vertigo is about to happen, makes me anxious of course. It happened again today while cleaning house.

    I had to lie down awhile--and took 1/2 of a Meclizine and though I'm sleepy, it has helped. The weather here is in' 'winter storm watch' and so that also affects my inner ear as you know.
    Anyway, trying not to get discouraged. I will call my ent doctor if this worsens for sure. Take care---enjoy having more leisure time. yanksgirl
    Rod Moser, PA, PhD replied to yanksgirl's response:
    Just a suggestion....

    If you take the full dose of meclizine, you can counteract some of the sedation with a little bit of caffeine, assuming your cardiologist does not have any objections because of your a-fib.

    The ginger is fine. Are you using the ginger candy (the gelatin-type)?

    I think we have talked about this in the past, but have you used TransDerm-Scop - the seasickness patch that goes behind the ear.

    If you have been advised against using any of these due to your health history, it would be good to talk to the cardiologist and ask speciifically what you can take.
    yanksgirl replied to Rod Moser, PA, PhD's response:
    The full dose of Mec. is 25 mg. and it really puts me to sleep--that's why I take 1/2 dose. However, when I was having bad vertigo, I'd chew the whole tablet and it took care of the nausea and spinning pretty quickly. Remember, my Ent doctor frowns on Meclizine--though many folks with vertigo take it. He says it just masks the symptoms and that Valium is the pill to help control the cause. How do you feel about that?

    As to the scopolomine patch, I used it on a trip years ago and had bad reaction to it. I wore it all the time when on water, land or etc. That may have been the problem--but didn't want to be sick.
    It made me sort of 'out of it' for hours.
    My a-fib is under control now--as of my last appt. I even wore a 24 hr. holter monitor and my heart wasn't in a-fib then. So, since it can come and go--I wonder at times if it's 'back' and that is causing some of this. Just hate to run to the cardio's office all the time.
    Yes, I take the ginger gelatin candy that's coated in sugar.
    Hope that gives you a good picture. yanksgirl
    Rod Moser, PA, PhD replied to yanksgirl's response:
    I don't frown on meclizine; Valium is fine. Perhaps a low-dose of both could may be a bit of trial and error on your part. Yes, when you sedate the inner ear; you sedate the brain, so often you have to choose between vertigo/nausea....and sleep. Past experiences with medication may or may not predict future experiences, but if you have trouble with scopolamine patches, perhaps you could try a low-dose tablet. I don't often recommend that patients experiment, but unless your ENT is willing step in and manage your medication regime, then you have to do what it takes to control your symptoms.

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