Double vision

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This post is not about the group Foreigner or their hit song of the same name. This double vision thing just started and to be honest, it is kinda scary. Both eyes have it. So, I looked it up and here is the information I found. This information is from www.webmd.com.

One of the things that can cause it is migraines, something I get quite frequently lately. Interestingly, myasthenia gravis is another cause and it is one of those possible overlapping diseases that occur in some people who have autoimmune diseases. Interesting to read. Enjoy!

Double Vision (Diplopia)

Double vision, or diplopia, is a symptom to take seriously. Some causes of diplopia are relatively minor, but others need urgent medical attention. WebMD takes a look at the causes, symptoms, and treatments for double vision.

What Causes Double Vision?

Opening your eyes and seeing a single, clear image is something you probably take for granted. But that seemingly automatic process depends on the orchestration of multiple areas of the vision system. They all need to work together seamlessly:

  • The cornea is the clear window into the eye. It does most of the focusing of incoming light.
  • The lens is behind the pupil. It also helps focus light onto the retina.
  • Muscles of the eye — extraocular muscles — rotate the eye.
  • Nerves carry visual information from the eyes to the brain.
  • The brain is where several areas process visual information from the eyes.

Problems with any part of the vision system can lead to double vision. It makes sense to consider the causes of diplopia according to the part of the visual system that has the problem. Double vision is not normal and should be reported promptly.

Cornea problems. Problems with the cornea often cause double vision in one eye only. Covering the affected eye makes the double vision go away. The damaged surface of the eye distorts incoming light, causing double vision. Damage can happen in several ways:

  • Infections of the cornea, such as herpes zoster, or shingles, can distort the cornea.
  • An uncommon complication of LASIK surgery can leave one cornea altered, creating unequal visual images.

Lens problems. Cataracts are the most common problem with the lens that causes double vision. If cataracts are present in both eyes, images from both eyes will be distorted. Cataracts are often correctable with minor surgery.

Muscle problems. If a muscle in one eye is weak, that eye can’t move smoothly with the healthy eye. Gazing in directions controlled by the weak muscle causes double vision. Muscle problems can result from several causes:

  • Myasthenia gravis is an autoimmune illness that blocks the stimulation of muscles by nerves inside the head. The earliest signs are often double vision and drooping eyelids, or ptosis.
  • Graves’ disease is a thyroid condition that weakens the muscles of the eyes. Graves’ disease commonly causes vertical diplopia. With vertical diplopia, one image is on top of the other.

Nerve problems. Several different conditions can damage the nerves and lead to double vision:

  • Multiple sclerosis can affect nerves anywhere in the brain or spinal cord. If the nerves controlling the eyes are damaged, double vision can result.
  • Guillain-Barre syndrome is a nerve condition that causes progressive weakness. Sometimes, the first symptoms occur in the eyes and cause double vision.
  • Uncontrolled diabetes can lead to nerve damage in one of the eyes, causing eye weakness and double vision.

Brain problems. The nerves controlling the eyes connect directly to the brain. Further visual processing takes place inside the brain. Many different causes for double vision originate in the brain. They include:

  • Strokes
  • Aneurysms
  • Increased pressure inside the brain from trauma, bleeding, or infection
  • Brain tumors
  • Migraine headaches 

What Are the Symptoms of Double Vision?

Double vision can occur by itself with no other symptoms. Depending on the cause, other symptoms may be present with double vision, such as:

  • Misalignment of one or both eyes (a “wandering eye” or “cross-eyed” appearance)
  • Pain with eye movements in one or both eyes
  • Pain around the eyes, such as in the temples or eyebrows
  • Headache
  • Nausea
  • Weakness in the eyes or anywhere else
  • Droopy eyelids

How Is Double Vision Diagnosed?

Double vision that’s new or unexplained needs medical attention right away. With so many potentially serious causes for double vision, it’s important to discover the reason without delay.

Your doctor will most likely use multiple methods to diagnose the cause for double vision. Blood tests, a physical exam, and possibly imaging studies like computed tomography (CT) or magnetic resonance imaging (MRI) are frequently used.

One of the most effective tools in diagnosing diplopia, though, is the information you can provide. You can make the diagnosis for double vision more accurate by answering several questions beforehand.

  • When did the double vision start?
  • Have you hit your head, fallen, or been unconscious?
  • Were you in a car accident?
  • Is the double vision worse at the end of the day or when you’re tired?
  • Have you had any other symptoms besides double vision?
  • Do you tend to tilt your head to one side? Look at old pictures, or ask family — you may not even be aware of the habit.

Now, focus on something unmoving in your field of vision — a window or a tree.

  • Are the two objects side by side, or is one on top of the other? Or are they slightly diagonal? Which one is higher or lower?
  • Are both images clear but simply unaligned with each other? Or is one image blurry and the other clear?
  • Cover one eye, then uncover it and cover the other. Does covering either eye make the double vision go away?
  • Pretend your field of vision is a clock face. Move your eyes around the clock, from noon to six and up to 12 again. Is your double vision worse at any clock position? Does any position make your double vision improve?
  • Tilt your head to the right, then to the left. Do any of these positions improve the double vision, or make it worse?

How Is Double Vision Treated?

With double vision, the most important step is to identify and treat the underlying cause. In some cases, double vision can be improved by managing or correcting its cause.

  • If weak eye muscles are the cause, or if a muscle has been pinched as a result of injury, surgery may help.
  • Myasthenia gravis can be treated with medications.
  • Graves’ disease is often curable with surgery or medical therapy.
  • Blood sugar in diabetes can be controlled with medicines and/or insulin.

If double vision can’t be reversed, treatments can help people live with double vision. Sometimes, this requires wearing an eye patch or special contact lens to minimize the effect of double vision.

Topamax for migraines

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This is yet another new medication my neurologist prescribed for me. I have found that researching medications is helpful to see how it affects me and why it is prescribed in the first place. This information I found on the website, www.healthcentral.com. Let me know if you have taken this and if it worked for you. Thanks!

Topamax

Learn more about the side effects, dosage, and details of Topamax, one of only four medications approved by the FDA for the prevention of Migraines.

Topamax (Topiramate)

by Teri Robert, MyMigraineConnection Lead Expert

Read Teri Robert’s SharePosts

Topiramate is a neuronal stabilizing agent (aka anticonvulsant medication) that has proven effective as a Migraine preventive for some patients. It is one of only a few medications to have been approved by the FDA for Migraine prevention. As with other drugs in this category, patients should start at a low dosage and slowly taper up to therapeutic levels. The daily dose should be taken in two divides doses approximately 12 hours apart. If discontinuing this medication, it is essential to slowly taper off rather than discontinuing abruptly.

 

Type of medication: Rx, preventive, neuronal stabilizing agent (anticonvulsant )

 

Special Notes:

  • At the Migraine Trust’s 14th biennial International Research Symposium, noted Migraine specialist Dr. Stephen Silberstein noted:
    • The best results were achieved at a dosage of 100 or 200 milligrams of topiramate per day, a lower dosage than that used to treat epilepsy.
    • The most commonly experience side effects were nausea and tingling of the extremities.
    • “What was amazing in this trial was the effect on weight. The patients who got topiramate lost, on average, 3.8 percent of their body weight.”
  • In an interview with Teri Robert, Dr. Silberstein elaborated:
    • “The key to success with Topamax is a very slow titration up to the therapeutic dose. Patients should begin taking only 15 mg, once a day, and taper up slowly from there, being sure to take it in a split dose.”
    • “The effective dosages are lower than you might think. Many patients achieve good results at only 50 mg per day.”

 

Precautions:

  • Seek immediate medical attention if you experience blurred vision, changes in vision, or pain in or around the eyes during treatment with topiramate. These may be early signs of a serious side effect.
  • Do not stop taking topiramate without first talking to your doctor, even if your symptoms have improved. It is important to continue taking topiramate to prevent seizures from recurring.
  • Carry or wear a medical identification tag to let others know that you are taking topiramate in the case of an emergency.

Migraine medication Frova

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This is one of the new meds my neurologist prescribed for me. I found this imformation on the webite, www.migraines.org. Many of us with lupus also suffer from migraines as well. I am not aware of anything linking the two specifically, but if you know of an article or study that has linked these two, feel free to let me know and I will post it here. Thanks and enjoy reading…

Drug Profiles:
FROVA
® (frovatriptan succinate tablets)

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CAUTION: Federal law prohibits dispensing without prescription.

What is Frova®?
Frova (frovatriptan) is an abortive medication used for the treatment of Migraine attacks in adults. It is one of the Triptan group of drugs which also includes Imitrex (sumatriptan), Amerge (naratriptan), Maxalt (rizatriptan), Zomig (zolmitriptan), and Axert (almotriptan).

   
Description
Frovatriptan (froe-va-TRIP-tan) is used to treat Migraine attacks. Many people find that their Migraine symptoms go away completely after they take frovatriptan. Other people find that their symptoms are reduced, and that they are able to go back to their normal activities even though their Migraines are not completely gone. Frovatriptan often relieves many symptoms that occur together with the pain of a Migraine, such as nausea, vomiting, sensitivity to light, and sensitivity to sound.

Frovatriptan is not an ordinary pain reliever. It will not relieve any kind of pain other than Migraine. This medicine is usually used for people whose Migraines are not relieved by acetaminophen, aspirin, or other pain relievers.

Frovatriptan may cause serious side effects in some people, especially people who have heart or blood vessel disease. Be sure that you discuss with your doctor the risks of using this medicine as well as the good that it can do.

Frovatriptan is available only with your doctor’s prescription.Before Using This Medicine
In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For frovatriptan, the following should be considered:

Allergies-
Tell your doctor if you have ever had any unusual or allergic reaction to frovatriptan. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy-
Frovatriptan has not been studied in pregnant women. However, in some animal studies, frovatriptan caused harmful effects to the fetus. These unwanted effects usually occurred when frovatriptan was given in amounts that were large enough to cause harmful effects in the mother.

Breast-feeding-
It is not known whether frovatriptan passes into human breast milk. Although most medicines pass into breast milk in small amounts, many of them may be used safely while breast-feeding. Mothers who are taking this medicine and who wish to breast-feed should discuss this with their doctor.

Children-
Studies on this medicine have been done only in patients 18 years of age and older, and there is no specific information comparing use of frovatriptan in children with use in other age groups.

Older adults-
Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults. Although there is no specific information comparing use of frovatriptan in the elderly with use in other age groups, this medicine is not expected to cause different side effects or problems in older people than it does in younger adults.

Other medicines-
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary.

Do not take frovatriptan if you have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), tranylcypromine (Parnate), or phenelzine (Nardil) within the last 14 days. The combination could cause seizures, nausea, vomiting, sweating, flushing, and dizziness.

Do not take frovatriptan if you:

  • have taken an ergot-based medication within the last 24 hours–ergot-based medicines include methysergide (Sansert), ergotamine (Ergostat, Ergomar, others) dihydroergotamine (D.H.E. 45, Migranal Nasal Spray), and ergotamine combination products (Bellergal-S, Cafergot, Ercaf, Wigraine, Cafatine, Cafatine-PB, Cafetrate)
  • have taken another serotonin receptor agonist within the last 24 hours – these include frovatriptan (Frova), naratriptan (Amerge), rizatriptan (Maxalt, Maxalt-MLT), sumatriptan (Imitrex), and zolmitriptan (Zomig, Zomig-ZMT); or
  • have taken ketoconazole (Nizoral), itraconazole (Sporanox), ritonavir (Norvir), or erythromycin (E-Mycin, others) in the last 7 days.

Taking a serotonin receptor agonist with any of the medicines listed above may be dangerous.

Before taking frovatriptan, tell your doctor if you are taking a selective serotonin reuptake inhibitor (SSRI) such as citalopram (Celexa), fluoxetine (Prozac), fluvoxamine (Luvox), paroxetine (Paxil), or sertraline (Zoloft). You may not be able to take frovatriptan, or you may require a dosage adjustment or special monitoring during treatment if you are taking any of the medicines listed.

Drugs other than those listed here may also interact with frovatriptan. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including herbal products.

Other medical problems-
The presence of other medical problems may affect the use of frovatriptan. Make sure you tell your doctor if you have any other medical problems, especially:

  • Uncontrolled high blood pressure—Use of frovatriptan may cause this condition to become worse.
  • Coronary artery disease
  • Heart attack (recent)
    Heart disease or Risk factors for coronary artery disease such as high cholesterol, family history, diabetes, obesity, women after menopause and men over 40 years of age—Use of frovatriptan may cause problems in patients with these risk factors.
  • Blood vessel disease, especially in the intestines and fingers—Use of frovatriptan may cause these conditions to become worse.
  • Bleeding in the brain or Stroke (or history of)—Use of frovatriptan may increase the chance of having a stroke

Proper Use of This Medicine
Do not use frovatriptan for an episode that is different from your usual Migraines

To relieve your Migraine as soon as possible, use frovatriptan as soon as the pain begins. Even if you get warning signals of a coming Migraine (an aura), you should wait until the pain starts before using frovatriptan. Using frovatriptan during the aura probably will not prevent the pain from occurring. However, even if you do not use frovatriptan until your Migraine has been present for several hours, the medicine will still work.

Lying down in a quiet, dark room for a while after you use this medicine may help relieve your Migraine.

If you feel much better after a dose of frovatriptan, but your Migraine comes back or gets worse after 2 or more hours, you may use one additional dose of frovatriptan

Your doctor may direct you to take another medicine to help prevent Migraines. It is important that you follow your doctor’s directions, even if your Migraines continue to occur. Migraine-preventing medicines may take several weeks to start working. Even after they do start working, your Migraines may not go away completely. However, your Migraines should occur less often, and they should be less severe and easier to relieve. This can reduce the amount of frovatriptan or pain relievers that you need. If you do not notice any improvement after several weeks of Migraine-preventing treatment, check with your doctor.

Dosing-
The dose of frovatriptan will be different for different patients. Follow your doctor’s orders or the directions on the label. The following information includes only the average doses of frovatriptan. If your dose is different, do not change it unless your doctor tells you to do so.

  • Adults—Take one tablet (2.5 mg (milligrams) anytime after the start of your migraine headache. You may take a second tablet if your headache comes back after relief from the 1st dose. You should wait at least 2 hours between doses. Do not take more than 3 tablets in a 24 hour period. 
  • Children—Use and dose must be determined by your doctor.

Storage-
To store this medicine:

  • Keep out of the reach of children since overdose is especially dangerous in children.
  • Store away from heat and direct light.
  • Do not store in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down.
  • Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.

Precautions While Using This Medicine
Drinking alcoholic beverages can make Migraines worse or cause new Migraines to occur. People who suffer from severe Migraines should probably avoid alcoholic beverages, especially during an attack.

Some people feel drowsy or dizzy during or after a Migraine, or after taking frovatriptan to relieve a Migraine. As long as you are feeling drowsy or dizzy, do not drive, use machines, or do anything else that could be dangerous if you are dizzy or are not alert.

Side Effects of This Medicine
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

  • Less common: Chest pain

Other side effects may occur that usually do not need medical attention. Some of these effects, such as nausea, vomiting, drowsiness, dizziness, and general feeling of illness or tiredness, often occur during or after a Migraine, even when frovatriptan has not been used. Most of the side effects caused by frovatriptan go away within a short time (less than 2 hours). However, check with your doctor if these side effects continue or are bothersome.

  • More common: dizziness 
  • Less common: Acid or sour stomach, belching, heartburn, indigestion, stomach discomfort, upset or pain; dry mouth; fatigue, such as unusual tiredness or weakness; flushing, such as feeling of warmth, redness of the face, neck, arms and occasionally upper chest; headache; hot or cold sensation; nausea; skeletal pain, such as pain in bones; tingling, burning, or prickly sensations; sleepiness or unusual drowsiness. 

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.

10.01.2010 neuro visit

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Today I went to see my neurologist for a re check and other issues. He is a relatively new doctor on my list, so I am still seeing how he reacts to me. I have been pleasantly surprised so far that he is not only very personable but knows his stuff too. He also has passed my test for researching my issues and passed with flying colors.

On to the visit.  We discussed the periphreal neuropathy in my feet and hands and it was decided that I should start upping my dosage of neurontin as slowly as I feel comfortable doing it. My feet are also turning purple (as I have discussed before on here) and so he checked them and said I have slow capillary refill so he is ordering a vascular study of my legs and feet. I also need to have new bloodwork (oh yippee).

Now onto the migraine situation. I am on midrin, an older migraine medication that treats the headache when it occurs. I have taken it for years now to help with these awful migraines. It has done the job pretty well, although I have breakthrough pain at times. After discussing this, my neurologist suggested we try topomax instead. He said that it helps to prevent them from starting and that we should see how it works. It also has a quality similar to neurontin but in smaller quantity for the neuropathy as well so it would help a little in thaat department as well. I do have to watch for kidney stones, since I am prone to them and this medication can cause them. I know how they feel so I hope to keep the stones at bay.

If anyone out there has used topomax, please let me know how it works for you. I am always curious to find out from others how a medication helps them. Since this is a new one for me, I will be interested in hearing from anyone on it.

Now, I am off to the campground for a night or two to digest this latest development in my care and research it as well. I am sure I will be posting the results here. In the meantime, thanks for all the support I get from you all. It really does help me to cope with all the manifestations of the wolf.

Repeat performer worthy of it

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This is a repeat perfomance of a blog I posted a few weeks ago, but it bears repeating because it is a topic all of us with chronic diseases have to deal with on a daily basis. I did add more to it so it is not entirely the same post as before. Please read and understand us better… thanks!

It is just another day here in my life. I have had a difficult week. This flare is really causing me pain in my joints and in my head. I have gotten out and tried to do some things this week but the heat is also my enemy. Yeah, I know, I gripe all the time. For you normal people, it would seem that way. For those of us with these diseases though, griping is our way of letting the anger go, the anger that we have these diseases, they are incurable, and we have to live with them.

This anger we feel, because some people misunderstand our pain for laziness, and think we want to get the attention. That is not true at all! We are genuinely ill and with no cure, we are facing the rest of our lives with uncertainty. The wars raging on the inside of our bodies are not visible on the outside but they are still there, causing pain and discomfort.

So, do not judge us, please try to understand us. We cannot “buck up” and overcome our fatigue, pain and disease. If we do that, we are setting ourselves up for a backlash from our bodies. To a degree we can buck up, but the results are often days of pain following. We have had to learn to listen to our bodies cues, and if it says rest, we rest. If we are able to participate, we do that as well. We make plans knowing that we may or may not be able to follow through with them.

So please, try to understand and do not pressure us to do things or think we are less because we cannot do certain things on certain days. We feel bad enough without judgment from others. You see, stress can tilt the cart over even faster because we are made to feel inferior. Please listen, read and try to use empathy when dealing with us. We want to do the things others can do! We wish we could do things when we want to do them! It just is not possible to do it all the time.

We kick ourselves enough for our own inadequacies, we do not need another person kicking us too.  Thanks for taking the time to read this and hopefully understand a little better why I may not do all things YOU think I should and can do.