Update from my last post before my AVR in Aug '08. OK, as long as this thread is still alive, since my surgery a little over 3.5 years ago, I virtually never get migraines with pain, but what I do get is very frequent migraine related symptoms that include aura, double vision, dizziness, numbness in a part of my mouth (very rarely and for no more than 30 - 60 sec). I saw a neurologist a year ago about these symptoms and because I get them often several times a day, the medications typically prescribed to treat the symptoms were out of the question. You just can't take that stuff that frequently and expect your body to function. So he put me an anti seizure medication Zonisamide (Zonagran) and it has cut down on the frequency and length of the symptoms. Since I have not been happy with that neurologist (another story for another day), I just saw a new one, who pointed out to me that a possible trigger for my migraines might be the Nexium (40Mg) I've been taking since, oh, around the time of my Aortic Valve Replacement surgery and the timing of which seems to at least coincide with the increase in the increase in my migraine frequency. I'm not totally convinced this is the trigger, especially since so many of us BAV'ers seem to have suffer from migraines; however, if it helps me reduce the frequency, I'm all for it. So, what I learned, for any of you who may also have a GERD problem, is that Nexium is the worst offender, among the Proton Pump Inhibitor (PPI) group of acid reducer drugs in triggering migraines. Who knew?? Would have been nice if my first neurologist had looked at the bigger picture and at least considered this possibility. So, I just today switched to a less potent PPI Lonasopril(sp?) 15mg to see if my migraine symptoms reduce. We shall see. If that doesn't work. The next step will be to try Topomax, which has proven more effective as a migraine preventer among the anti-seizure drugs used off-label.