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Dizzy and Disoriented, With No Cure in Sight

It started in 2010 when I smoked pot for the first time since college. It was cheap, gristly weed I’d had in my freezer for nearly six years, but four hours after taking one hit I was still so dizzy I couldn’t stand up without holding on to the furniture. The next day I was still dizzy, and the next, and the next, but it tapered off gradually until about a month later I was mostly fine.

Over the following year I got married, started teaching seventh and eighth grade, and began work on a novel. Every week or so the disequilibrium sneaked up on me. The feeling was one of disorientation as much as dizziness, with some cloudy vision, light nausea and the sensation of being overwhelmed by my surroundings. During one eighth-grade English class, when I turned around to write on the blackboard, I stumbled and couldn’t stabilize myself. I fell in front of my students and was too disoriented to stand. My students stared at me slumped on the floor until I mustered enough focus to climb up to a chair and did my best to laugh it off.

I was only 29, but my father had had a benign brain tumor around the same age, so I had a brain scan. My brain appeared to be fine. A neurologist recommended I see an ear, nose and throat specialist. A technician flooded my ear canal with water to see if my acoustic nerve reacted properly. The doctor suspected either benign positional vertigo (dizziness caused by a small piece of bonelike calcium stuck in the inner ear) or Ménière’s disease (which leads to dizziness from pressure).

Unfortunately, the test showed my inner ear was most likely fine. But just as the marijuana had triggered the dizziness the year before, the test itself catalyzed the dizziness now. In spite of the negative results, doctors still believed I had an inner ear problem. They prescribed exercises to unblock crystals, and salt pills and then prednisone to fight Ménière’s disease.

All this took months, and I continued to be dizzy, all day, every day. It felt as though I woke up every morning having already drunk a dozen beers — some days, depending on how active and stressful my day was, it felt like much more. Most days ended with me in tears. Teaching was nearly impossible; I was unable to write because of blurry vision, and my wife became a caretaker more than a partner; I became addicted to message boards for dizziness, vertigo, benign positional vertigo and Ménière’s disease. Anonymous posters described how their medications didn’t work and their doctors couldn’t cure them. They couldn’t keep their jobs; their friends didn’t understand them; and their spouses left or tried to be supportive, but eventually both suffered.

Finally, my doctor recommended a new neurologist who performed some simple tests and casually gave me a diagnosis of vestibular migraines, a condition that didn’t exist in medical journals 20 years ago.

Apparently, instead of causing severe pain, my migraines manifest as constant dizziness. I began taking Klonopin daily. It immediately mitigated the symptoms, but Klonopin can be addictive. My eyes started to twitch after a few weeks on it, so my doctor looked for another option. After living for two years with incessant dizziness, I settled on a combination of Lexapro and Serzone, both antidepressants, that began to work. In 2013, I could teach and began to write my novel again. I could enjoy life with my wife. We had our first son. I was free.

But there was a downside. A known side effect of the treatment is nightmares. Night after night, I woke up from a tortured dream during which I fought someone off from attacking my wife and baby, or suffered the devastation of them leaving me. I couldn’t sleep for more than a few hours at a time (and still can’t), and neither could my family. Still, compared to the dizziness, it was a trade worth making. I was tired but still able to finish and sell my novel and to teach, and we had our second son.

After nearly three years of being symptom free, I became greedy. Was there a way to live without the dizziness and the nightmares? I thought it might be worth cutting down on the medication to see. In January, I went to half the amount of medication, and I was fine. So I went to a quarter of the amount, and I was fine. So I went off it entirely.

The dizziness came back more viciously than ever. This wasn’t troubling at first; I merely went back on the antidepressants. When they didn’t work after a couple weeks, I grew anxious. But my doctor told me that sometimes the drugs take as long as a month to work. When they were still ineffective after two months, I began to despair. A neurologist explained that sometimes medication doesn’t work a second time — sometimes brain chemistries change, or medications stop proving effective for reasons doctors don’t understand.

So now, we are searching again. It has been five months of dizziness. I am 35 now, doing my best to fight my way through parenting, teaching and working on my book. I am relying on my wife. My neurologist has started me on verapamil, a blood pressure medication, which has been shown to be effective for some migraine sufferers, but is not working for me.

I am pretending for as long as I can, at least in front of my 3-year-old. “Daddy no feel so good?” he says when I brace myself on a chair on my way to the kitchen to reheat his dinner. I’ve begun to see a psychologist who specializes in pain and palliative care to provide techniques to help me get through the day. I am waiting, terrified, to see if this medication, or the next one, will rescue me.

Brian Platzer (@BPlatzer) has written for New Republic, Salon and other publications. His debut novel is to be published in 2017.

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A version of this article appears in print on 06/14/2016, on page D 4 of the NewYork edition with the headline: Dizziness With No End.

A diagnosis of vestibular migraine forced the author to choose between living with disabling dizziness or a treatment that triggered disabling nightmares.

CASE STUDIES: CANNABIS AND VERTIGO

We are all very familiar with both CBD rich and THC rich medicines helping a lot with nausea. In recent months I have seen a number of patients with vertigo from different etiologies. A few have been related to inner ear issues, a few have been associated with local cancers and a few were a part of a systemic neurological disorder.

They seem to share one thing in common; they all seem to respond to CBD in doses of 6 mg per 24 hours.

I feel comfortable thinking about Vertigo the same way I think of nausea. Both CBD and THC are effective in treating both nausea and vomiting; not all that surprising as they are so frequently related.

So, if you Diagnose Vertigo, think cannabinoids

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