Vision Disturbances and Migraines

[Guest]

I have found some info but not alot on migraines and vision loss post-op.

Seems to not be very uncommon for frequencies to increase after surgery. Before surgery I used to get a vision disturbances followed by a migraine headache about 30 min later that would last about 2 hours around every other month. Fast forward to the present, and post-op I expect to have 1-2 a week. Post-op vision in my left eye just seems to be blurry most of the time unless i concentrate on it... no idea what that might mean but i do wear contacts. February 15, 2018 at 23 years old I had open heart surgery, replaced my bicuspid aortic valve with a St. Jude Mechanical valve and had the aortic root and ascending aorta replaced with a Dacron graft. I take 81mg aspirin (once a day), metropolol (twice a day) and coumadin (once a day but dose changes depending on the day).

Since im on coumadin I am limited on migraine meds I can take when I first get the vision disturbances. Most migraine meds (at least that I have read) are made up of aspirin, acetaminophen and caffeine. Since I am not supposed to take more aspirin than I already do, I usually just take Tylenol immediately if I get vision disturbances and try to follow the Tylenol with something with caffeine (coffee, redbull, etc.) depends on what is faster to go buy. Typically if I get caffeine and tylenol in my system fast enough before the vision disturbances go away then I will have a minor headache.

Although I have found a way that I can exist with these migraines, I am still looking to see if anyone has any insight or recommendations. General doc recommended some sort of anti-depressant that "might have the possibility of preventing migraines" or increasing my dose of metropolol which would drop my heart rate below 60. The doc did state that its probably not the smartest idea on the low heart rate thing, and I agree. Anti-depressants just seem like a cop-out to me from doctors when they dont want to dig deeper, and I wont take them. A friend mentioned CBD oil but idk on that or how it reacts with coumadin.

Any recommendations or insights on what other people have discovered?

Anyone else have similar experiences with vision loss and migraines after surgery?

 

[DachsieMom]

Yes, same exact thing. I never had a headache in my life until surgery (might have had one right before surgery...same week...but I don't recall). Immediately after surely, I had 3 migraines a week. If I took Tylenol immediately, they went away quickly. Now, I have one every few months. I generally have one if I exercise very hard. My doctor thought it might be hormonal, as I was 42 at the time of surgery (45 now). Same symptoms - visual aura, followed by headache and nausea unless I take Tylenol. I am not on meta pro lol but take Coumadin and aspirin. St Jude mechanical with Dacron graft.

 

[Zoltania]

A lot of people have posted here about getting optical migraines (just the visual aura, without the headache) for the first time after surgery, or getting them more frequently. I had gotten one or two a year for nearly 20 years before my surgery, but they became more frequent afterward, and now I get one or two a month. Fortunately there is no associated pain, and they go away in about 20 minutes. I mentioned it to my cardiologist and he had not heard of this phenomenon.

Sorry I don't have any suggestions for dealing with the headache. I know that migraines can be brutal.

 

[user 16827]

yep happens a lot to me post surgery, i also find i get one after hard exercise, exercise is a catalyst for me

i link mine to stimulants especially coffee + hard exercise

having to take warfarin i'm really not a fan of other drugs too so i found that chelated Magnesium
taken daily is a big help

 

[mrfox]

I had a visual disturbance yesterday (2 weeks post surgery here) which freaked me out, thought it might be a TIA.. but visual migraine of also a possibility

 

[Zoltania]

The first time I had an optical migraine I took myself to the ER because I thought I was having a retinal detachment. I know someone else who did the same thing because she thought she was having a stroke.

The visual disturbance pattern of an optical migraine is pretty classic. I've even seen drawings people have made of the patterns they see, and they look like mine. What I see is a small crescent-shaped area filled with flickering zigzags which grows larger and larger for about 20 minutes until it vanishes. mrfox, if that's what you saw too, I bet it was not a TIA.

 

[Paleowoman]

I've even seen drawings people have made of the patterns they see, and they look like mine. What I see is a small crescent-shaped area filled with flickering zigzags which grows larger and larger for about 20 minutes until it vanishes. mrfox, if that's what you saw too, I bet it was not a TIA.

Here's a Youtube video of what one looks like: https://www.youtube.com/watch?v=G8P_ZTJqv8g

I've had these ever since the day after AVR. They're getting less frequent now. They always last around 20 minutes long. I sometimes get them during the night, I will wake up with one going and can tell how long it's been going from the size it's reaching ! I also get episodes of double vision which are much more disconcerting. No headaches though.

 

[Warrick]

I use to have these visual migraines about once a week before surgery, since surgery I think I've had no more than 1/2 a dozen.
I figured the reduction may be due to the fact that I have a PFO (patent foramen ovale) and now that I'm anticoagulated that cross leakage isn't clotting like it did and causing them.
Just a hunch but from what I've read it seems to fit.
I find that if I can get 4 x 500mg paracetamol taken at the onset of the blurring I don't get the usual headache 20 minutes later

 

[ottagal]

I, too have had the migraines with the classic visual disturbances as described and the aura. I was referred to a neurologist and she actually recommended a combination of Magnesium and B2 supplements. She told me that the evidence was limited, but she did read a few studies that showed benefit. I am not suggesting this in your case, but thought I would share what the neurologist told me.

I also found an article on WebMD on vitamin supplementation: .
I found this on webMD:

https://www.webmd.com/migraines-headaches/features/prevention-future-of-migraine-therapy#1

"For those who can't take medications or aren't happy with them, a few supplements also show promise for preventing migraine headaches. "In my own practice, I recommend these if there are at least two well-controlled clinical trials showing benefit," says Sarah DeRossett, MD, a neurologist and migraine specialist in Atlanta. "Magnesium, riboflavin (vitamin B-2), and coenzyme Q10 all fit those criteria."

 

[cldlhd]

A lot of people have posted here about getting optical migraines (just the visual aura, without the headache) for the first time after surgery, or getting them more frequently. I had gotten one or two a year for nearly 20 years before my surgery, but they became more frequent afterward, and now I get one or two a month. Fortunately there is no associated pain, and they go away in about 20 minutes. I mentioned it to my cardiologist and he had not heard of this phenomenon.

Sorry I don't have any suggestions for dealing with the headache. I know that migraines can be brutal.

I used to get one or two auras a year followed by a bad migraine. Post surgery I get 2 or 3 auras a month but no migraine afterwards. Sometimes I feel a little blah after but that's about it.
The cardiac team said they've never heard of it. The neurologist right down the hall said he sees it all the time after heart surgery....

 

[epstns]

In addition to the optical migraines, I've also had some other odd visual disturbances since surgery. Occasionally I find that although I can see clearly, I cannot focus both eyes on the same point. If I cover one eye, all is clear. Cover the other eye, clear there too. But I cannot resolve both images into normal binocular vision. This usually lasts perhaps 15 or 30 seconds, usually resolving if I simply rest my eyes for a few seconds, then focus on something off in the mid-distance. My eye doc doesn't have an answer for me. I just deal with it.

 

[cldlhd]

In addition to the optical migraines, I've also had some other odd visual disturbances since surgery. Occasionally I find that although I can see clearly, I cannot focus both eyes on the same point. If I cover one eye, all is clear. Cover the other eye, clear there too. But I cannot resolve both images into normal binocular vision. This usually lasts perhaps 15 or 30 seconds, usually resolving if I simply rest my eyes for a few seconds, then focus on something off in the mid-distance. My eye doc doesn't have an answer for me. I just deal with it.

Interesting, I've had a sort of cross eye vision once in awhile post surgery but I do the same. I sit down and close my eyes and it , thankfully, goes away.

 

[Paleowoman]

In addition to the optical migraines, I've also had some other odd visual disturbances since surgery. Occasionally I find that although I can see clearly, I cannot focus both eyes on the same point. If I cover one eye, all is clear. Cover the other eye, clear there too. But I cannot resolve both images into normal binocular vision. This usually lasts perhaps 15 or 30 seconds, .

I wonder if that is similar to what I am describing as double vision - each eye sees things at a different angle so it's like two images, whereas normally we combine the two images into one. I find when this happens I feel I'm going to fall over but it's not dizziness. I just shut my eyes and after a short while everythig is normal agan.

 

[DDT77]

I wonder if that is similar to what I am describing as double vision - each eye sees things at a different angle so it's like two images, whereas normally we combine the two images into one. I find when this happens I feel I'm going to fall over but it's not dizziness. I just shut my eyes and after a short while everythig is normal agan.

Same here, noticeable tilt (usually on left side) and offset of visual field. Happened often (daily) after surgery, but less frequent (every few weeks) now seven months post OHS. Seem to be able to feel it coming on, similar to what migraines were like.

Very little aura soon after surgery, but now back to bi-weekly frequency, but now without the other stuff that usually accompanied migraines. Hydration seems helps to mitigate this post OHS feature...

 

[pellicle]

in my own case I've had "optical migraines" for my living memory (although I don't recall them before my surgery at 10 years old).

These are classical migraine pattern which starts as a small dot (even with eyes closed) that looks at first as if you've glanced briefly at a light bulb fillament (such are perhaps only in history or 3rd world countries now) and has a flickering look to it. It grows and gradually those "flickerings" resolve to be visible as small geometric patterns not unlike this artists rendition:

I do not get double vision with this

 

[pellicle]

perhaps also like this when they don't move to one side (as for me they usually do as they enlarge and go "out of vision"

 

[lilyofthewest]

As I've posted before these descriptions are exactly like my experiences. Thankfully as time has gone by the occurrences have decreased. Have always had migraines but never these eye disturbances. But 3 different cardiologists told me they never heard of such a thing...same as some here are reporting. Sooo… given the obvious frequency, how in the world can the cardio drs. keep saying they've never heard of them???? Why should people have to keep going through being freaked out, like I did, on first occurrence due to Dr ignorance? I certainly warned my brother who just went through the surgery, the third of us 6 siblings to need a bicuspid valve replaced. And shouldn't there be some research done to find the cause of such a common after effect? Thanks all and sorry for the rant.

 

[pellicle]

Hi

.... But 3 different cardiologists told me they never heard of such a thing...same as some here are reporting.

this was taken at a recent conference of Cardiologists during the presentation of data on correlation between migraine and heart issues:

although it could have been on warfarin management and INR interpretation ... I can't recall

 

[harrietW]

Just thought I would add my two cents. My surgery was January 2016 I experience terrible migraine headaches and vision problems for the past two and a half years I have many other issues including internal bleeding / angiodysplasia approximately 100 transfusions in the past two and a half years. In May I had 7/8 transfusions three trips to emerge and I was cut off warfarin cold turkey for 3 weeks. During that timeframe I had an increase in migraines and an increase in vision problems. Many times I thought I was going blind completely so three weeks later they put me back on warfarin and the same day they decreased my metoprolol. I was taking 50 mg morning and night I am now on 25 mg of metoprolol twice a day so morning and night I haven't had any vision problems and my headaches have gone away. So I'm going to suggest for me the decreasing my metoprolol intake has stop the migraines and stop the vision problems I have extremely low blood blood pressure as is. The other thing that I realized from the moment I woke up from open heart surgery and started on all the meds that they give you I became very itchy I wanted to literally rip my skin off I couldn't stand it so for two and a half years I have been taking reactine to stop the itch or relieve the itch but after decreasing my metoprolol 25 mg the itch is gone so no more headaches no more vision problems and no more itch I'm very grateful. And all that time I thought it was the warfarin and it clearly was not.
Hope that helps that has been my experience.
Best of luck

 

[pellicle]

Hi

...I was cut off warfarin cold turkey for 3 weeks.

actually going off warfarin "cold turkey" is actually pretty normal (unless you have some prior issues with clots causing strokes, you on the other hand have the opposite). I go "cold turkey" when I have a procedure (like that colonoscopy) ... unlike many drugs there is really no effect except that "normal" coagulation is restored. Its what people would do in preparation for a surgery.

... The other thing that I realized from the moment I woke up from open heart surgery and started on all the meds that they give you I became very itchy I wanted to literally rip my skin off I couldn't stand it so for two and a half years I have been taking reactine to stop the itch or relieve the itch but after decreasing my metoprolol 25 mg the itch is gone so no more headaches no more vision problems and no more itch I'm very grateful. And all that time I thought it was the warfarin and it clearly was not.

I've noticed that warfarin gets blamed first for almost everything, but the detailed analysis is that its seldom responsible for more than what it does ... interfering with clotting. I'd call it one of the more well understood drugs (with like what 60 years of therapeutic administration data) and in only the rarest of cases is any problem with it not linked to the dopes administering and monitoring INR.

I'm just putting this here because there is a lot of "nervous fear" out there which IMO needs to be quelled with a little "evidence based analysis".

Its interesting that metoprolol was your causal agent ... myself I hated being on it because it made me sluggish and tired.