Migraine and My New Love/Hate Relationship with Flying

Another_Airplane!_(4676723312)
Attribution: Photographs by xlibber

Like most ENFPs, I love to travel. The novelty of a new place (with its new sights, new people, new smells, and new adventures) never gets old. Yes, every big city is similar in many ways to every other big city (just as most small towns are similar in certain ways), but the differences between them – no matter how small – thrill me. I am happiest, in fact, when I have a trip scheduled for sometime in the next six months. As long as I know I am going somewhere soon, the normalcy of my everyday routine doesn’t get me down.

You can understand my disappointment, then, when I realized that I may soon have to change either the frequency at which I travel or the way in which I do it. Flying, it turns out, makes me dizzy, dizzy, dizzy. I’m talking days of dizziness. Weeks of constant vertigo. And it took me until this year to realize it.

Earlier this year, I flew to Philadelphia for a four-day trip. Though I was slightly dizzy the day we arrived, the vertigo quickly dissipated and I had a wonderful time at my conference and touring the city. Once I arrived home, however, I had the worst vertigo of my life, and it lasted for three weeks. 

Once it eased, I wrote it off as an anomaly. (As I am wont to do with most of my weird migraine symptoms.) Until, that is, I traveled to San Diego last week for another conference.

Once again, the flight there wasn’t too big of a problem. Though I almost passed out from vertigo at one point during the first day,  a two-hour lunch break in bed restored me for the rest of the trip. Arriving home, however, was an entirely different matter.

It’s been five days, and the room is still spinning. I ran into a couch on the way to the kitchen this morning, and I had to cancel a doctors appointment because I couldn’t trust myself to drive. I’ve been working primarily in bed instead of at my desk all week, and I haven’t been to the gym once.

I’m also about to leave on another trip, this time for five days to Florida.

I haven’t had two long-distance trips so close together since my vertigo worsened, and I’m truly wondering how it will go. Apparently, vertigo after flying isn’t uncommon for those of us with vestibular migraine and/or migraine associated vertigo, but I’d certainly never heard of it before. Now, all I can do is refill my Valium (which my neurologist gave me for vestibular symptoms) and hope for the best. Oh, and make a promise to myself to never again schedule back-to-back air travel, of course.

 

 

 

Propranolol for #Migraine and #Anxiety: The Good, The Bad, and the Ugly

About nine months ago, my psychiatrist put me on the drug Propranolol for anxiety. Propranolol is a beta-blocker drug primarily used to treat high blood pressure, chest pain, and other circulatory disorders. It’s also often used off label for the treatment of anxiety and for migraine prevention. So I figured, why not? If it could treat both my conditions at once, I’d give it a definite try.

But I did have questions:

  1. Would it work for my migraine disease when the other beta-blockers I’d been given for migraine prevention did absolutely nothing?
  2. Would it be safe to take when my normal blood pressure is already so low?

The answers, it turned out, were yes and yes, but not really.

The Good News: 10 mg of Propranolol three times a day did more to manage my general anxiety than any other drug I’ve ever tried except Klonopin, Xanax, and Valium, which are truly more effective for my panic attacks than my overall anxiety anyway. It also had a positive impact, albeit it a slight one, on the frequency and severity of the head pain that accompanies my migraine attacks.

The Bad News: If I skipped a dose, I felt it. Almost immediately. And it was not pleasant. Shaky hands, racing heart, queasiness, and a general feeling of something being not right that quickly transformed into a panic attack if I didn’t get that dose quickly.

The Ugly: While it did seem to reduce the symptom of head pain associated with my migraine attacks, after about three months, it increased my migraine-associated vertigo to such a degree I eventually had to stop taking it. (You can read about my level of disability from vertigo in one of my posts for Migraine.com: “Waiting for My Sea Legs: A Story of Vestibular Migraine.”) I tried to hang on to see if that symptom would eventually disappear, but after months of barely being able to walk, I had to say enough was enough. I did try experimenting, with my doctor’s approval, with decreasing my dose and then the dosing frequency, but that only gave me more of the withdrawal symptoms described above.

I imagine that someone with comorbid anxiety and migraine disease who either doesn’t have low blood pressure or doesn’t live with severe vertigo may have a much better experience with this drug than I did. My migraine disease is so complicated, with its crazy auras and brainstem symptoms, that it’s been impossible so far to find a medication that treats one aspect of the disease without worsening another. That may not be the case for others.

I’m curious: Have any of you readers tried Propranolol for migraine or anxiety? What was your experience?