As many of you have read in my posts, I have mentioned a few times that I suffer from vertigo since about 2015. After chasing the root cause over several years, it was determined not to be vertigo. In 2019 my ENT ruled out vertigo; I was referred to a neurologist, who ordered an MRI, MRA, and CT scans. He was leaning towards vestibular migraines initially but wanted to be sure it wasn’t more.
The doctor reading the scans initially called me directly as my neurologist couldn’t be reached. They found a dissection in an artery feeding my brain. She asked if someone could drive me to the ER or whether she should call 911 as I was at risk of having a stroke. Luckily, my wife was home and drove me to the ER. They were not able to do a CTA that night due to the MRA dye still being in my system from earlier in the day and my shellfish reactions ruling out iodine. They prescribed Plavix that night to prevent clotting. A few weeks later I had my CTA and it was not just a restricted blood flow as he originally thought; during the initial tests, it was determined that it was a 100% blockage of my right vertebral artery.
Vertigo or Stroke?
Therefore, it is believed that the several hundred vertigo episodes I encountered over almost 5 years were most likely mini-strokes. It is scary to think of all the places I have visited in the last 5 years and that I could have had a fatal stroke at any time. My neurologist stated it was inoperable due to the location. I was not willing to take that as a final answer. Therefore, I scheduled an appointment with a top vascular surgeon in Atlanta. Sadly, he agreed it was riskier to perform the surgery than to treat the symptoms. This is from a surgeon who has performed hundreds of these surgeries.
The surgeon stated that he would only consider the surgery if I had a fall-down stroke. Luckily, since last October I have been on an anticoagulant and have not had another episode. My neurologist has wanted me to have an MRI scan since February 2020. Due to now being in the high-risk category for COVID-19 and the scan not being a required procedure, this has been temporarily put on hold.
Unfortunately, this could have been caught much earlier. I have been to the doctor multiple times over the past 5 years and they never thought to test for neurological or vascular issues. It had been treated as an ear infection most of the time. My great ENT was able to rule out my ears in the first visit.
My Vertigo Symptoms
I experienced vertigo-like symptoms that involved balance issues, spinning vision, nausea, and a stiff neck. The damage to the artery is most likely due to the stiff neck I have experienced since at least 2005. I would pop my neck as it felt like I had fallen asleep on a plane and had a stiff neck after waking up. The doctors asked if I had any chiropractic work done as that could cause a tear in the artery that would restrict the blood flow. I hadn’t, so it must be due to my DIY chiropractic work of popping my neck. My vision was like a kaleidoscope with spinning around the edges and a clear area in the middle. If you are having intermittent vertigo issues with similar symptoms, get a neurologist to perform an MRA and CTA to rule out a blockage. I wish I had known earlier.
Vertigo Episode in South Africa
During our trip to South Africa in 2019, I experienced a serious episode at the wedding reception. I had a few drinks before I started to feel bad. It was assumed by all that I was under the influence. In fact, I was having a mini-stroke most likely. Below is what I looked like at the time as people thought it was funny to see a drunk guy that early in the evening. My response is quite visible to the person taking the picture. After a few hours, I recovered and was the designated driver. I never thought that it was a mini-stroke at the time, just another annoying vertigo episode. If I had been drunk, this would have been an embarrassing photo.
Will I Travel Again?
Yes, I look forward to the COVID-19 travel bans being lifted once it is safe to travel again. At that time we will continue to see the world and complete the trip we had to cancel due to COVID-19. However, I plan to buy travel insurance going forward. This is due to my health issues, and the potential for COVID or other infections is a large concern.
Why Did I Write About This on my Travel Blog?
This is to be an FYI of sorts. Don’t ignore vertigo symptoms or assume they are always related to your ears. After finding the source of the issue, a little research showed it is quite common to be misdiagnosed. Some people were not lucky enough to have it diagnosed correctly before a fatal stroke occurred. The possibility of a stroke scares me as my father passed away at 48 after having a stroke 2 years earlier.
In October 2019 I took about a month off work to handle the doctor appointments and to reduce stress. Upon my return to work in November, I asked to be converted to a part-time employee or to have reduced hours as a contractor. After 4 months, I had not received a response and decided to leave my job to reduce stress. My last day was in February, just before the world went crazy with the COVID-19 outbreak.
UPDATE August 16, 2020:
Due to changing insurance after leaving my job in February, it has been an uphill battle with the new insurance over the needed MRI. They had a peer to peer review with my neurologist. The insurance company wanted me to do 4 weeks of physical therapy for my neck issues. I went for a couple of sessions and realized that it would be more cost-effective and faster for me to pay for the MRI out of pocket. The MRI was $525, 8 sessions of PT would have been $800. I had the MRO last week and I am awaiting the results.
When I last saw my neurologist, he asked if I had any TIA (transient ischemic attack) events since he last saw me. Luckily, I have been TIA free since starting the medication last October. However, I did have a couple of episodes that were very mild where I had blurred vision. None of the other symptoms that I previously encountered were present though.
UPDATE September 2, 2020:
I had an appointment with my Neurologist yesterday and received the results of my MRI. The MRI shows that I have degenerative disk disease in 3 places on my neck. Luckily, there is no sign of spinal damage. This is similar to bone spurs that are filing the void after my vertebrae shifted due to the excessive neck popping over the years. At the moment, there is not much that can be done other than possibly physical therapy. My Neurologist is scheduling another CTA in the coming months to see if there are any further issues from a vascular standpoint.
UPDATE January 12, 2021:
I had my CTA at the end of October. During my follow-up appointment with my Neurologist, I learned that the blockage has not increased. However, the other vessels in the affected area have recovered about 10% of the blood flow. This does not mean that they can recover all of the flow, they are only providing some of the needed blood. Due to this, the issue will still be with me for the rest of my life. I need to continue with the Plavix to prevent any future blockage.
I will continue to update this post as more info is available.