My New Diagnosis: Abdominal Migraine

After 6.5 months of chronic pain that was only improved but not cured by Lyrica, consults with 7 types of doctors, a multitude of tests and an absorbent toll physically, mentally, and financially - I finally have a diagnosis: Abdominal Migraine. 

All of my tests have come back normal from my various specialists except for my pancreas enzyme and platelets that were elevated. I underwent 2 CT scans, abdominal ultrasound, MRCP, 3 MRIs, EEG, sleep deprived EEG, EMG, nerve condition test, and a neuropsych test with all unremarkable results that provided no explanation for my new symptoms and pain. With these normal results, my neurologist came to the conclusion that I likely have abdominal migraine which is a type of migraine. 

My doctor explained that migraine is a chemical imbalance in the brain and depending where at in the brain determines what type of migraine and mine happen to be abdominal. He stated this would explain my trunk pain, chronic nausea, dizziness, scalp sensitivity, hearing sensitivity, headaches, lightheadedness, brain fog, appetite loss, and chest pain. Through our discussions and medical history review, we came to the conclusion that my abdominal migraine started in 2015 after I fell and hit my head. A couple days after the fall, I had a sudden, intense headache that pain medication was unable to treat and after that I've had chronic nausea ever since.

The only medication that's been able to manage my chronic nausea is Compazine, which is an abortive migraine medication to break through migraine symptoms. And Zofran can actually trigger a migraine and hasn't been effective in managing my nausea. To treat my abdominal migraine, he's started me on Amitriptyline which is a preventative migraine medication. 

My doctor explained that abdominal migraine is typically diagnosed among children and often forgotten about for adults often leading to other diagnoses such as IBS. Through our discussions though, this diagnosis makes sense considering all of my accompanying symptoms and the time frame of events. I'm relieved to finally have a diagnosis and a new treatment to pursue for my symptoms. 

It will take 6 weeks for the Amitriptyline to reach it's fully effective state and I've been taking it for 4 weeks now. During the 3rd week, I started noticing periods of time where I was pain free for the first time since these new pains started. I am still requiring the Lyrica in conjunction with the Amitriptyline presently to treat my pain but this may change over time as the Amitriptyline reaches full efficacy levels in my body and dosage may be adjusted. I haven't been experiencing nausea either. I will see my neurologist in another 4 weeks and any medication changes will then be decided upon as he didn't want to make any changes to my Lyrica or Compazine yet. I haven't had any changes to my appetite, although I'm not bothered by that. 

I look forward to my next neurology appointment to see what medication changes may be decided upon and continuing improvement to my symptoms now that a diagnosis has been reached. 

Vertigo and Physical Therapy

I started having chronic nausea in 2015 after my first hospitalization since 2007. My chronic nausea has persisted in spite of a mix of medications and Peppermint Oil. These treatments are helpful in managing my nausea but they do not cure it. A couple years ago, I started noticing visual triggers to my nausea and over time the number of visual triggers began to expand. Strobe lights and the movements of others or objects easily trigger my nausea. It was then that I was diagnosed with Vertigo that was worsening my nausea. I rarely felt dizzy but at times the room would spin and I felt unsafe to drive until the dizziness dissipated. A friend recommended physical therapy to me in an effort to help reduce the Vertigo and so my GI specialist sent me to a local physical therapy center.

Although the Vertigo was the primary focus of my physical therapy, my therapist also wanted to include core strength and range of motion for my neck as additional goals. My core remains weak after 7 abdominal surgeries and I have chronic neck pain with limited range of motion due to degeneration in my neck. My therapist explained that my limited movement had not only contributed to the development of Vertigo but was also worsening my symptoms.

A common cause of Vertigo is Benign Paroxysmal Positional Vertigo (BPPV) that occurs when tiny calcium particles become dislodged and enter the inner ear. My therapist explained that my limited head and neck movements were creating these particles and caused them to wrongfully enter my inner ear resulting in my dizziness and nausea. 

Not only does Vertigo cause dizziness and nausea but other symptoms may include balance issues, abnormal or jerking eye movements, headache, sweating, ringing of the ears or hearing loss.

The physical therapist completed an evaluation of my Vertigo symptoms and found that I also presented with the abnormal, jerking eye movements. The evaluation included a dizziness questionnaire and movements of my head to try to invoke nausea or dizziness. She would later use the technique to determine the presence of jerky eye movements to help determine the effectiveness of physical therapy on my Vertigo. My physical therapist also performed whole body movements on myself to help move the calcium particles in my inner ear into the correct locations. 

VOR Exercise

I completed 8 sessions of physical therapy before being released. I completed several different exercises to improve my balance which would also help reduce my Vertigo. I started with single leg stances on each leg. First, these were completed with my eyes open and then as I progressed it was changed to eyes open, moving my head in all four directions, and finally using a bosu ball. In addition to completing single leg stances on the bosu ball, I also had to turn the bosu ball upside down and complete squats on it. This was like doing squats on a see-saw. I also did an exercise called Vestibular Ocular Reflex (VOR) that is completed by keeping my eyes on a fixed object in front of my face and moving my head from left to right while maintaining my focus on the object. This exercise helps to recalibrate the eye, inner ear, and brain. The remainder of my exercises focused on core strengthening and on stretching my neck to improve my range of motion thereby reducing the development of these calcium particles and their risk of entering my inner ear.

After a month of physical therapy, my therapist felt as though I had reached the maximum level of benefit physical therapy could provide me and I should continue my exercises on my own at home indefinitely. I'm hesitant to say that my Vertigo is cured. However, I have noticed less use of my Vertigo medication and increased ability to tolerate visual triggers for longer periods after the completion of physical therapy. 

If you suffer from Vertigo, I would highly recommend requesting physical therapy as part of your treatment plan for the Vertigo. 

No, My Food Choices Aren't The Problem

I have a long history of chronic pain caused by eating and no, it isn't my food choices that are the culprit. I appreciate others being concerned about my well-being but unsought advice gets to be tiresome, particularly when I've been dealing with my health issues since I was 9 and the particular issue of pain when I eat since I was 15. I think I have a good understanding of my own health issues and symptoms.


A lot of people are quick to tell me "It's what you ate", "You shouldn't eat so much" or "You have an allergy, try this diet". I have been tested for food allergies and intolerances, they were all negative. And the pain happens with everything I eat and even a gulp of water is enough to cause excruciating pain and stomach cramps at times. The only things that sometimes don't cause me pain are saltines, tamales, and Arby's Roast Beef Sandwiches and even then I'm sure if I ate enough of them, they would cause pain too. Sure, over eating causes me pain but the pain is just worsened by quantity. Even small meals or snacks cause me pain and discomfort. Reducing my intake of filling foods such as pasta, rice, and bread do help to reduce my pain but I still have pain regardless. I have some level of discomfort with everything I eat - it just varies on severity. And there are times that I can eat something and have one level of pain and eat it again the next day and the pain level is something different.


I started experiencing excruciating pain every time I ate after I had my ostomy reversed via a straight pull thru. I required another surgery within a year to remove adhesions that were causing a stricture of my small intestine. It took several years after this last surgery in 2002 before my body was better able to tolerate food. The pain never fully went away although it did significantly lessen - that is until 2015. With my hospitalization in 2015, I started having chronic pain and nausea when I eat and the nausea occurs sporadically throughout the day and night as well. Additionally, my adhesions now cause me a higher risk of intestinal blockage and now I'm unable to eat raw or undercooked vegetables or I will have a blockage. This makes it harder to eat light, healthy foods in an attempt to further reduce my pain.


Since 2015, I've undergone various procedures and tests and the conclusion is that my chronic pain and nausea are a result of my adhesions worsening again. They're just not to the point of requiring surgery. During a period of testing in 2017, it was discovered that I had C-Diff and that was the cause of worsening my GI symptoms as my stomach and intestine were inflamed and irritated from the infection that was wreaking havoc on my body. I remember during this time I was being told by others to "try this diet, you have food allergies". I held off from trying the diets these individuals suggested because I wanted to give all the testing I was completing a chance to identify a source and for treatments to be tried before I changed my diet. I'm glad I didn't jump on the diet bandwagon as it turned out my weight loss and severe pain were actually due to the infection I didn't realize I had.


I'm glad to hear that certain diets have really helped others and I wish everyone the best of luck but a diet isn't always the answer for everyone's health issues. It certainly isn't the answer for my symptoms.

Life with Chronic Nausea

Nausea is easy to understand, right? It's simply of feeling of sickness with the inclination to vomit. Seems pretty straight forward. Not so much for me though, at least not my chronic nausea.

For me, chronic nausea is something different than just the inclination to vomit. It's different from nausea that can accompany a stomach virus, food poisoning, or over indulging on alcohol. I don't typically even vomit from my chronic nausea. My mouth doesn't start to salivate in preparation for the impending upchuck, I don't start heaving, I don't have to stop talking or risk vomitting. None of the usual signs I experience when I'm inclined to vomit. No, typically if I were to vomit from my chronic nausea, it's because I forced myself not because my body forced me. Although, frequently I wish I would vomit when I'm nauseated as I believe it would help provide relief. This is a predicament I find myself struggling with regularly and unfortunately, not new to me.

Instead of the typical response to nausea, my whole body reacts to my chronic nausea. My nausea has various triggers and although I can usually predict when the nausea will hit based on my behaviors, it is not always known to expect it crashing in upon me. Ingesting food or liquid often triggers the nausea as it fills my stomach and causes discomfort or if I become overheated I will become nauseated. Other times physical or visual motions will send me overboard. The slightly shaking is too much for my stomach and at times even the movement of a computer mouse or the scrolling of a computer screen will act as a trigger. And even with these triggers, there are times that I will simply awake nauseated. But whatever the reason for it, it always feels the same.

Typical nausea that subsides upon the expultation of the irritating source, I would welcome that. But that is not my experience. I can usually feel the nausea crashing over my body like the waves of a tide. I feel like complete and utter rubbish when the nausea hits. My body has a generalized, overwhelming sickness to it; my stomach hurts and feels uneasy, I feel full and bloated. On particularly worse occasions my head will slightly hurt and if I close my eyes to rest, I feel as though the room is spinning about me. I feel as though if I could just vomit or empty my bowel, I would feel better. I have the urge to lie down in a ball and hold onto my stomach. At times it becomes too much and the tears fill my eyes as I'm overcome with frustration at my physical status.


I regularly utilize my anti-nausea remedies- Compazine and Phenergan tablets, peppermint candies, and Peppermint Oil. I even have Phenergan gel as well. But nothing makes the nausea dissipate immediately, it's a gradual overthrowing of the nausea. And in the meantime, I'm left wanting to make myself vomit in an effort to make it stop yet knowing that it's not healthy to make ourselves vomit.

The chronic nausea is there with me, almost every day without warning, it is never cured. It's simply managed and so I must continue functioning in spite of the discomfort. I can't stop living my life or completing my responsibilities over nausea. In spite of my efforts to fight through the nausea, there are times that it is simply too overwhelming and all I can manage is to rest. But it sure would be nice to return to my pre-chronic nausea days.