May 29, 2025 • 30 mins
In this episode of The Eye-Q Podcast™, Dr. Rani Banik discusses Idiopathic Intracranial Hypertension (IIH) with her patient Latisha White. They explore Latisha's journey from experiencing mysterious symptoms to receiving a diagnosis and treatment. The conversation highlights the importance of recognizing symptoms, the urgency of proper medical response, and the impact of lifestyle changes on managing IIH. Latisha shares her personal experiences with headaches, treatment options, and the significance of weight management in her recovery.
IN THIS EPISODE YOU WILL LEARN
00:00 – How does the patient journey with IIH begin?
02:03 – What are the symptoms and how is IIH diagnosed?
10:14 – What emergency responses and treatments are used for IIH?
18:48 – How is IIH managed through medication and lifestyle changes?
26:59 – What does recurrence and long-term management of IIH involve?
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6 Natural Ways to Conquer Headaches: https://rudranibanikmd.activehosted.com/f/27
Idiopathic Intracranial Hypertension: https://rudranibanikmd.activehosted.com/f/85
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Dr. Rani’s Instagram: https://www.instagram.com/dr.ranibanik/
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:00):
Idiopathic intracranial hypertension, also known as IIH
for short, is a very common condition I see in my practice
as a neuro ophthalmologist. Many patients with IIH have
mysterious symptoms and signs for months or even years before
they get officially diagnosed. Today, I'm so excited to welcome
to the IQ Podcast, a patient of mine who has been diagnosed with
(00:25):
IIH. And she's going to be talking
about her journey with this condition, how she was
diagnosed, what her work up was and what the treatment entailed,
and how she's doing so well now with this condition, having been
able to manage it and get off medication.
So stay tuned for this week's episode on the IQ Podcast with
me, Doctor Ronnie Bannick. Welcome to the IQ podcast,
(00:48):
hosted by Doctor Ronnie Bannock,America's integrative neuro
ophthalmologist. Get ready to explore the
intricate connections between the brain and the eye through
neuro ophthalmology. Journey with Doctor Ronnie into
the world of integrative ophthalmology, where cutting
edge science meets holistic Wellness.
Discover how to protect and preserve vision through powerful
(01:08):
preventative strategies based onice, smart nutrition, and
lifestyle modifications. Whether you're an eye care
provider or just curious about how to maintain healthy vision
so you can see the world more clearly, join Doctor Ronnie for
exciting and eye opening discussions which will no doubt
raise your IQ. Hello and welcome to another
episode of the IQ Podcast. I'm your host, Doctor Ronnie
(01:31):
Bannick, and in this podcast, you'll gain insights about
vision health and brain health to help you raise your IQ.
Today we're continuing with our series on IIH, also known as
idiopathic intracranial hypertension.
And I'm so honored to welcome tothe IQ Podcast, one of my
patients who's been diagnosed with the condition so that you
(01:53):
all can learn about a patient's perspective with IH.
Welcome to the IQ podcast. Leticia White, we are so glad
that you could join us today. Thank you for having me.
Absolutely. So as I had mentioned in the
introduction, IH can, sometimes we can patients can have
symptoms for a very long time before they're actually
(02:15):
diagnosed or officially diagnosed.
Could you just share with us what are some of the symptoms
that you had? I know that they were going on
for quite some time, but what are some of the initial symptoms
you had and kind of what was thecontext of all of this like when
you were first diagnosed? So like you said, I I believe I
had it a lot longer than I've been.
(02:36):
I thought so. It started out with bad
headaches, headaches that I justcould not shake.
And I spoke to my doctor about it and he prescribed me
something a little stronger thanTylenol or Advil.
And I went back to see him months later and he asked me
about the headaches and they were still there.
(02:59):
They just would not go away. So that was my main.
That was the only symptom I was having, like really bad
headaches. You're not alone because many
people date with IIH. That is the very first symptom.
But can I ask you, did you have headaches prior in your life?
Like for example, did you ever used to get migraine headaches
or any other types of headaches regularly before this episode?
(03:22):
So I did not I I did not have migraines, but I believe the the
symptoms of IIH were happening long before I thought wind of
it. And can you tell us a little bit
about the headache? Like what type of headache was
it? Where was it?
How bad was it? Oh God.
So it just kind of went straight.
(03:43):
Sometimes it would go across my forehead.
On a scale of one to 10, it would be a 10 at at times.
Wow, my. Headaches were really bad.
Really bad. Very severe.
Really bad, but on most days it would be somewhere around A7 or
8. OK.
(04:04):
And also with the headache, did you, did you try, I mean you
mentioned that your doctor gave you some medications, Did you
try other medicines? Did they respond to the
medicines or not really? No, there was only one other
medication. I can't really think of the name
right now, but it was. There was just one other
medication that I tried and it didn't work.
(04:24):
It did not. Work.
And so it sounds like you were having a headache like every day
pretty much. Pretty much.
I thought it was stress, I thought it was the job, I
thought it was everything. I never would have thought that
it could be something like this.Yeah.
And did the headache ever wake you up when you were sleeping?
Like, was it ever that bad that you couldn't sleep because of
(04:45):
it? I had problem going to sleep I
don't think it's ever woken me up from a sleep but going to
sleep definitely. I I just could not get to sleep
the the pain was so bad at times.
Yeah. So again, like you had this
pressure like around here. Yeah.
So now tell us a little bit. You mentioned that you had some
other symptoms. What were some of the other
(05:06):
symptoms that you had with the headache?
So then and I did not connect the two, I started to hear this
little swishing in my ear and obviously I'm not a doctor so I
didn't know that they could be connected, the headache and the
swishing in the air. So that happened and that went
on for a while also without me knowing that it was an issue
(05:29):
like. Weeks.
Months. Like how long?
Did you? Definitely months.
Definitely months. OK.
And what did it sound like? Like, was it like like water,
like an ocean, like a? So sometimes it was like water,
but I remember being outside andI'm thinking, Oh my God, the
(05:51):
wind is so high today. So that and it wasn't the wind.
Interesting it. Was just, I was trying to take a
bike ride and I kept saying to my boyfriend, Oh my God, the
wind is so high. But it was just in my right ear.
It's just like a. Yeah.
(06:14):
So, so that just so people understand that is a symptom
that we call pulse synchronous tinnitus.
Tinnitus is ringing in the ears and many people do have
tinnitus. They have like a high pitched
tinnitus. But this is a very unique kind
of symptom. And I don't know, Letitia, if
this happened to you, but many people will describe it with
their heartbeat, like every timetheir heartbeat they hear like a
(06:38):
kind of what? Definitely, definitely.
Yeah. And we think it's because
there's turbulence in the veins draining the brain, but we'll
get we'll get to that in a little bit.
Any other symptoms that you had in the beginning before you got
the diagnosis? That was it.
It was just the headaches and the swishing in the air.
That was it. Got it.
Got it. And so at what point?
(06:59):
So you were seeing your primary doctor saying, oh, my headaches
are still there. At what point did you go to see
an eye doctor? So so he prescribed another
medication for me and when I went back to see him just on a
regular visit, like a annual, hesays how how would headaches?
(07:20):
And I'm like, oh, they're still there.
He says, I don't like this. I'm going to refer you to an
ophthalmologist. OK, OK, great.
So he said go see an eye doctor and get he.
Said I don't like this. I need you to go and see someone
because these headaches should have stopped by now.
Got it. And were you having any vision
(07:41):
symptoms, like, for example, anyblurring of vision or double
vision or anything like that? No, I didn't have anything like
that. I didn't have any any problems
with my vision. I would have never associated
the headaches with my vision. Like nothing made sense to me.
None of it clicked together. Back then, yeah.
(08:04):
And I have to say, your doctor, your primary was very insightful
because most people, you know, most providers, when they hear
patients with chronic headaches,they they think, oh, this is
probably tension or migraine. But to link it to an eye issue,
he was very, very astute, very insightful to be able to do
that. Yeah.
So also can you just give us thecontext, like, when did this
(08:27):
happen? Like how long ago was it that
you were having these symptoms and you got diagnosed so.
This started back in we. Were just going.
Back after the pandemic, so I want to say it was like, I don't
know if it was 21 or 22 December, I can't remember, but
(08:48):
that's when, that's when the diagnosis came.
Obviously it started long beforethat, but that's when I was
diagnosed. Got it.
OK. And during that time, were you,
you know, working from home? What was it a stressful period
like what was going on in your life around that time?
I know COVID was a unique time for all of us, but what
(09:10):
specifically was going on in your life at that time?
So we had been working from home, from home for a while and
then I remember myself and my staff was back in the office.
It was just like it was very normal, OK?
(09:31):
Nothing really unusual around that time.
No, nothing unusual. OK, OK, All right.
So then what happens? So you you got this appointment
to see the eye doctor and what did they discover?
Yeah. So I go to the eye doctor and
I'm expecting him to say, OK, you need a new prescription for
(09:52):
your glasses. So I get there and he says he
starts to examine my eyes. And he says I need to dilate
your eyes because I need to see what's going on behind your
eyes. And I said OK, And he dilated my
eyes. And within two minutes, he's
like, I need you to go down to New York eye and air.
(10:14):
I need to refer you to someone else.
This is very serious. He wouldn't give me any answers,
but he was like, I just need youto go and see someone else who
could probably help you better. And I said, is everything OK?
And he goes, well, just go down and see them and we'll see what
happens. So he he made it seem very
urgent that he didn't tell you exactly what he didn't tell.
(10:36):
Me exactly. I knew it was urgent, but I
didn't think he met the same dayI thought he was.
He said, my, my, my girls are going to take care of you.
They're going to make sure that when you go, all you have to do
is walk in. So I'm thinking, OK, maybe I'll
be there next week or the week after, but he's like, no, right
now. Like you need to go right now.
(10:58):
Right. It's an emergency.
That's when I started to think, Oh my God, this is serious.
All right, so you got to New York Eye and Air that same day
and walk us through what happened.
What did you experience there? What did the doctors do?
So that's where things got. That's when things became really
scary for me because once they did their examination, I was
(11:22):
told we need to. So they said what they said to
me is what we're seeing is that your optic nerve is swollen and
we need to make sure that this is not a brain tumor.
And I heard nothing else but brain tumor after that.
So and they took really great care of me, I will say that.
So then they decided that they wanted me to do an MRI and it
(11:46):
had to be done today. They called an ambulance to come
and get me to take me over to the hospital.
So everything was moving really,really fast.
It was like, well, I just went to the eye doctor and now here I
am in the ambulance and I'm going to have this MRI done.
And yeah, obviously it wasn't a tumor, but it was really scary.
(12:10):
It is a very scary situation because you don't even link, you
know, having headaches to havingan eye issue, first of all.
And then from there, the eye issue to having a brain issue
and needing an emergency MRII mean, that's kind of mind
boggling for a lot of patients. But you handled it so well.
And I know it's, it's very frightening to think that you
(12:30):
could have a tumor. But as eye doctors like just to
let you know and let our audience know, it is really our
number one priority to make surethat the patient is stable.
And we don't expect there to be a brain tumor.
But that's why we do it as an emergency, because we don't want
to miss a brain tumor. So I mean, I would say in my
experience, over 99.5% of our patients have no brain tumor.
(12:52):
They have nothing like that. But we have to do the scan.
We can't let the patient go because once we see that
swelling of the optic nerves, wehave to make sure it's not a
brain tumor. Right.
Yeah, so, so then what happened?Like so you went to the
hospital, you got the MRI, and then what happened?
Yeah. So then I waited and they told
me that the the MRI was was good, was clear there wouldn't
(13:17):
there was no brain tumor. And yeah, from there I just
started seeing. So the doctor over at New York
Eye and Air, I had to go back tosee him and he prescribed
cetazolamide and I started to take that.
I was taking originally 500 milligrams twice a day.
(13:41):
Definitely helped. Definitely helped.
What the heck I would say. After a week or so I started to
notice the difference. It took a little while, but
after about a week or so I started to notice a difference.
Now at one point I did have to do the do a lumbar puncture.
(14:03):
Tell, tell us about that experience.
I know it's it's something no patient ever looks forward to,
but it's so important for the diagnosis.
So tell us, like what happened with the lumbar puncture?
So the lumbar puncture was, it was scheduled and I went in and
I had that done. I will say it wasn't as bad as I
(14:24):
thought it would be. So building up to going is much
more scarier than it really is. And I got there and the doctor
was great and he did it and everything was fine.
But after an entire week after Ihad the worst headache of my
entire life and I was told that it was something has something
(14:45):
to do with the needle going intoyour spine and air or something
going in and that that that could happen.
But once that was over, everything was things were
great. Yeah.
So I'm just going to add a little bit of contest for our
audience. So the Spinal Tap or lumbar
puncture is when there's a needle put into the back, into
(15:07):
the lower back. And the goal, the real purpose
of it is to measure the pressure, measure the pressure
in the fluid around the brain, which is typically high in IAH.
But it's also to make sure that patients don't have other
reasons for having high pressurein the brain, for example, an
infection or inflammation or cancer.
There's many reasons why we do aSpinal Tap.
(15:29):
So it's not, we tell our patients, it really is
mandatory. It's not something optional.
We everybody with suspected IIH should have a Spinal Tap.
So that's why we put our patients through it.
So I'm sorry you went through that, but it was really
important as part of the workout, survived it and you
know, the, the headache you had afterwards.
I'll just share something with the with the audience.
(15:52):
So I believe your pressure, I don't have your notes in front
of me, but I believe it was 30, something like 36 or 37.
So just so you know, everyone knows normal pressure is up to
about 25 S Your pressure was high.
So imagine somebody has high pressure in the brain, their
pressure is 37. They get the Spinal Tap and all
of a sudden the pressure is lowered down to like 15.
(16:14):
Your brain is not used to 15. Your brain is used to 37.
So that's why many patients get what we call a low pressure
headache and that's what you experienced because of that
sudden drop. And sometimes what can happen
is, you know, the needle goes into the spine, into the spinal
fluid area. Sometimes there's a tiny little
kind of a leak at where the needle went in from the needle
(16:35):
track. And so the pressure, instead of
going right back up to 37, again, it stays low.
And again, your brain is not used to that low pressure.
So we call that a low pressure headache and usually it goes
away within three to five days, but it can happen and it is a
different type of headache, right like it.
Is it is so the only thing that would take that headache away
(16:56):
was literally laying on my back.Yes, and it is positional and
you know, sometimes patients, they respond to painkillers or
caffeine can get rid of that headache.
But sometimes we just have to wait and wait a few days and
sometimes even need a blood patch to close up any small leak
that may be there. So it's not leaking anymore.
(17:16):
Yeah, I'm so sorry you went through that.
But it it is common for many patients to get that type of low
pressure headache. Well, it's been such an
interesting discussion. Leticia, and I really appreciate
your sharing your experiences. We're going to take a very, very
short break and then we'll be right back with more on the IQ
Podcast. So stay tuned.
You've been listening to the IQ Podcast with me, Doctor Ronnie
(17:39):
Bannick. We're going to take a short
break and then we'll be right back with more insights to help
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(18:43):
your migraine naturally. Welcome back everyone, to the IQ
Podcast. Today we're chatting about IIH
with one of my patients, LeticiaWhite.
And so Leticia, and now I want to talk to you about the
treatment. You mentioned that the doctor
started you on this medicine called acetazolamide.
(19:05):
We also call it Diamox sometimes, depending on the
brand. Tell us about what happened with
this medicine. So I when I started taking the
medicine, like I said, it took about a week or so to start
working and I started to notice that the headaches didn't come
as much as they were coming. I even noticed that the swishing
(19:29):
in my ear, although I still had it sometimes I did not.
I, I took 500 milligrams every day.
It helped me. It helped me lose weight.
Actually, I started, I changed my diet and I was taking the
medication and my my weight dropped down.
(19:49):
I lost about 20 lbs and then everything just went away.
Wow, that was the first talk a little bit.
Can we talk a little bit more about weight?
You know, we know as medical professionals that weight is a
risk factor for IAH. It's not the only risk factor,
but it's one of the risk factors.
And well before all of these symptoms ever started, had you
(20:10):
gained weight or, or lost weightor you were stable?
Like what was your weight before?
You got, I gained weight becauseI was always really the end and
I might have gained about 2030 lbs and I'm pretty sure that's
what that's around the time whenthe headaches began.
(20:34):
I definitely gained a lot of weight.
Yeah, we hear that a lot from our IIAH patients, particularly
women, women who are kind of, you know, in the menstrual
period in their lives. Weight gain, usually it's in the
range of like 15 to 20 lbs is what we hear and usually like 6
months before the symptoms start.
(20:55):
So, so it is common and unfortunately we don't know why.
We really don't understand why weight plays such a role in I I
age, you know, how does it contribute to the pressure being
high in the brain? We still don't understand that.
But for many patients, it is a major risk factor.
And on the flip side, it's something that is modifiable,
(21:15):
meaning that you can do things to to turn it around, right.
So what did you do, Leticia? So that was the first time and I
did, I lost, I lost 20 lbs. I changed my diet and I started
to work out and I took the medication and I dropped down 20
lbs and everything just stopped.No more headaches, no more
(21:37):
swishing, everything is fine. And then I got comfortable and I
gained the weight back. OK.
The weight did come back. It did come back in.
It did come back. So how much weight when you
were, when you had gained the weight back about, at what point
did it come back? Like was it immediate or was it
only if you gained back like whatever you had lost?
(22:00):
Like when did it come back, the symptoms?
So I dropped down 20 lbs. I picked back up all of the 20
lbs and it was like right, Just right after that it came back.
It. It came right back as soon as I
gained the weight back and then I started taking the medication
(22:23):
again. I see.
You can I sorry to interrupt you.
Had you come off the medication during that time when you gained
the? So I was told I no longer needed
to take the medication because Ihad lost the weight and
everything was going fine and ifI needed it then I could take it
and but for now I did not need to take the medication anymore
(22:45):
and I didn't. And then I gained the weight
back and it came back. And you knew, right?
You, you could tell right away, right?
Away I knew right away so one day I would just happen to be
laying across my bed and I hearda swishing in my ear and I'm
like Oh no and so. That was very they were telling
(23:07):
the sign right was swishing in the ear.
Many patients. Well, you know it's interesting
you say that Leticia. Many patients before they
actually develop the headaches, they will hear the swishing
first. That will be like the first
thing that they where they know,OK, there's a red flag it's
coming back. Right.
So that's the red flag for me, like the swishing in my ear like
(23:29):
for now, now like after the first time, because I didn't
really have a headache as much this time.
And maybe in the beginning the swishing started 1st and maybe
it just didn't register the headaches did.
But this, I mean, after I lost the weight and I gained it back,
(23:50):
I heard that swishing and I justthought, Oh no.
But you know, Leticia, you handled it very well the first
time, right? You got it to go into remission.
So you had a really great outcome the first time.
So how did you handle it when you had this recurrence?
What did you do? So when it came back, I started
to take the medication again. Not I, I, well, I was told that
(24:13):
I only needed to take 500 milligrams.
After a while, I was down to 500milligrams a day.
So I immediately started taking it again and I started watching
what I was eating and I started to walk a little more and I
managed to drop down enough weight that like it's not, it's,
I don't want to say it's gone, but it's definitely in remission
(24:35):
right now. So I'm not having any symptoms.
Amazing and I think the last time I saw you, I think it was a
few weeks ago, we had you come off the medicine, right.
So you stopped the medicine and how are you doing now?
I'm. Doing great and this time I'm
not going to pick back up the weight.
OK. All right, all right.
If that's an incentive to not gain weight, that's that's
(24:57):
great. I wanted to just let our
listeners know, you know, when we counsel patients about weight
and IIH, first of all, not everyone has gained weight or is
overweight. And if somebody has not gained
weight or is overweight, we lookfor other reasons for why they
may have high pressure in the brain.
So we always investigate other things.
But if weight we think does playa role, we typically tell our
(25:18):
patients, whatever weight you'reat, your maximum weight, we
usually recommend losing about 6to 10% of that weight.
So I'll give you an example. If somebody weighs like 200 lbs,
we usually recommend that they go down to, you know, lose like
15 to 20 lbs. So they can go down to like one
85180. That would be their target
(25:39):
weight. So it's not like we're asking
people to lose 50 lbs or more. It's really even like small
amounts of weight loss can make all the difference.
So for you, you're, you're kind of Mark, it was kind of like
1520 lbs. That's kind of where you're at
with your your target. So I've already lost 15 lbs and
I plan on even though I'm not having any symptoms, I do plan
(26:02):
on trying to go down at least another 10 lbs.
OK, amazing. Yeah.
Yeah. And in most of our patients with
IIH, when people lose the weight, they tend to have not
just resolution of all their symptoms, but their swelling
goes away. So I'll just share something
also with the audience. When Tisha first came in, in the
(26:24):
first episode, her swelling was a grade 3.
So we graded on a scale from zero to 5, five being the worst
that it could be. And her swelling was a three.
And then gradually it went down.It went down to like 0 to one.
That's, I think when we had taken you off the medication and
then when you came back again the second time, it wasn't 3
(26:44):
again. It wasn't that bad.
It was more like 1 to 2. And most recently when I saw
you, it was back down to 0. So it can fluctuate, swelling
fluctuates, and it really is very sensitive to weight loss
for whatever reason. Yeah.
Yeah. All right.
Well, I'm so glad to see you're doing so well and off
(27:06):
medications, not having any of that, those symptoms anymore,
not having any vision. Issues.
No swelling. So I'm really so impressed by
your persistence with this condition.
I know it can be challenging andfrightening.
Leticia, is there any kind of last words that you'd like to
leave our audience with about IIH?
(27:27):
Maybe some words of wisdom for patients who may be suffering or
who've been recently diagnosed. So I'll tell you this, my
daughter has a friend whose mom was having really bad headaches
and she was, she was just havingreally bad headaches.
(27:48):
And my daughter said to me, mom,Caitlin's mom is really safe.
She had to go to the emergency room.
She's having these bad headachesand she can't, can't kick it.
And I immediately told her, tellher mother to have her eyes
examined. And I told her to tell her.
I said tell your tell your friend my story so that her
mother can know what to say whenshe get there because we don't
(28:12):
know. I just.
Pass on what happened to me. And, you know, so now her mother
has an she has an appointment with an ophthalmologist and
she's going to have her eyes examined and see what happens
from there because the emergencyroom couldn't tell her anything.
Oh, yeah, yeah, I would echo that.
I mean, I think your point is soimportant when the headaches are
(28:33):
not, you know, daily headaches are not normal.
People should not get headaches like that every single day.
And when you're kind of, you know, living life like that,
it's, it's really not enjoyable to live with a daily headache
that's severe. It's hard.
Yeah, so go see an eye doctor. Just get it checked out if
you're someone who's been, you know, diagnosed with just
(28:54):
headache or tension or something.
But get checked out so you know that it's not IIH.
And on the flip side, the good news is people tend to have a
really good outcome with IIH. You know, most people do really
well like you did. So it's a scary diagnosis to go
through the process. But ultimately, most people, I
(29:15):
mean, there's a small percentage, about 5 to 10% of
people who don't do as well. And maybe they've had it for too
long. They've already lost some
vision. They have some visual deficits.
But the vast majority of people,over 90% of people do really,
really well if we can catch it in time.
So, yeah, well, thank you for sharing.
(29:36):
Yeah, I know you, you did the right thing.
You got the care in a in a timely fashion, which is really
important. And now you're doing great,
right? It's almost like you never
happened, right? Yeah, I'm just glad I had the
right team. All right, well, it was a
pleasure chatting with you today, Latisha.
(29:56):
I really appreciate your insights and sharing your
experiences. I'm sure you're going to help so
many people who are listening tothis podcast and people who are
really. Afraid.
Yeah. So I really appreciate your time
and thank you all for joining usfor the IQ Podcast.
I look forward to seeing you allnext time.
So stay tuned. Thank you for tuning in to the
(30:18):
IQ Podcast. We hope you enjoyed today's
episode and learn something new to help elevate your IQ.
If you loved what you heard, don't forget to subscribe, leave
a review and share the podcast with your friends.
Stay connected with Doctor Ronnie Bannock for more eye
opening insights on eye health, nutrition and lifestyle.
Until next time, keep your vision clear and your IQ sharp.
Idiopathic intracranial hypertension, also known as IIH
for short, is a very common condition I see in my practice
as a neuro ophthalmologist. Many patients with IIH have
mysterious symptoms and signs for months or even years before
they get officially diagnosed. Today, I'm so excited to welcome
to the IQ Podcast, a patient of mine who has been diagnosed with
(00:25):
IIH. And she's going to be talking
about her journey with this condition, how she was
diagnosed, what her work up was and what the treatment entailed,
and how she's doing so well now with this condition, having been
able to manage it and get off medication.
So stay tuned for this week's episode on the IQ Podcast with
me, Doctor Ronnie Bannick. Welcome to the IQ podcast,
(00:48):
hosted by Doctor Ronnie Bannock,America's integrative neuro
ophthalmologist. Get ready to explore the
intricate connections between the brain and the eye through
neuro ophthalmology. Journey with Doctor Ronnie into
the world of integrative ophthalmology, where cutting
edge science meets holistic Wellness.
Discover how to protect and preserve vision through powerful
(01:08):
preventative strategies based onice, smart nutrition, and
lifestyle modifications. Whether you're an eye care
provider or just curious about how to maintain healthy vision
so you can see the world more clearly, join Doctor Ronnie for
exciting and eye opening discussions which will no doubt
raise your IQ. Hello and welcome to another
episode of the IQ Podcast. I'm your host, Doctor Ronnie
(01:31):
Bannick, and in this podcast, you'll gain insights about
vision health and brain health to help you raise your IQ.
Today we're continuing with our series on IIH, also known as
idiopathic intracranial hypertension.
And I'm so honored to welcome tothe IQ Podcast, one of my
patients who's been diagnosed with the condition so that you
(01:53):
all can learn about a patient's perspective with IH.
Welcome to the IQ podcast. Leticia White, we are so glad
that you could join us today. Thank you for having me.
Absolutely. So as I had mentioned in the
introduction, IH can, sometimes we can patients can have
symptoms for a very long time before they're actually
(02:15):
diagnosed or officially diagnosed.
Could you just share with us what are some of the symptoms
that you had? I know that they were going on
for quite some time, but what are some of the initial symptoms
you had and kind of what was thecontext of all of this like when
you were first diagnosed? So like you said, I I believe I
had it a lot longer than I've been.
(02:36):
I thought so. It started out with bad
headaches, headaches that I justcould not shake.
And I spoke to my doctor about it and he prescribed me
something a little stronger thanTylenol or Advil.
And I went back to see him months later and he asked me
about the headaches and they were still there.
(02:59):
They just would not go away. So that was my main.
That was the only symptom I was having, like really bad
headaches. You're not alone because many
people date with IIH. That is the very first symptom.
But can I ask you, did you have headaches prior in your life?
Like for example, did you ever used to get migraine headaches
or any other types of headaches regularly before this episode?
(03:22):
So I did not I I did not have migraines, but I believe the the
symptoms of IIH were happening long before I thought wind of
it. And can you tell us a little bit
about the headache? Like what type of headache was
it? Where was it?
How bad was it? Oh God.
So it just kind of went straight.
(03:43):
Sometimes it would go across my forehead.
On a scale of one to 10, it would be a 10 at at times.
Wow, my. Headaches were really bad.
Really bad. Very severe.
Really bad, but on most days it would be somewhere around A7 or
8. OK.
(04:04):
And also with the headache, did you, did you try, I mean you
mentioned that your doctor gave you some medications, Did you
try other medicines? Did they respond to the
medicines or not really? No, there was only one other
medication. I can't really think of the name
right now, but it was. There was just one other
medication that I tried and it didn't work.
(04:24):
It did not. Work.
And so it sounds like you were having a headache like every day
pretty much. Pretty much.
I thought it was stress, I thought it was the job, I
thought it was everything. I never would have thought that
it could be something like this.Yeah.
And did the headache ever wake you up when you were sleeping?
Like, was it ever that bad that you couldn't sleep because of
(04:45):
it? I had problem going to sleep I
don't think it's ever woken me up from a sleep but going to
sleep definitely. I I just could not get to sleep
the the pain was so bad at times.
Yeah. So again, like you had this
pressure like around here. Yeah.
So now tell us a little bit. You mentioned that you had some
other symptoms. What were some of the other
(05:06):
symptoms that you had with the headache?
So then and I did not connect the two, I started to hear this
little swishing in my ear and obviously I'm not a doctor so I
didn't know that they could be connected, the headache and the
swishing in the air. So that happened and that went
on for a while also without me knowing that it was an issue
(05:29):
like. Weeks.
Months. Like how long?
Did you? Definitely months.
Definitely months. OK.
And what did it sound like? Like, was it like like water,
like an ocean, like a? So sometimes it was like water,
but I remember being outside andI'm thinking, Oh my God, the
(05:51):
wind is so high today. So that and it wasn't the wind.
Interesting it. Was just, I was trying to take a
bike ride and I kept saying to my boyfriend, Oh my God, the
wind is so high. But it was just in my right ear.
It's just like a. Yeah.
(06:14):
So, so that just so people understand that is a symptom
that we call pulse synchronous tinnitus.
Tinnitus is ringing in the ears and many people do have
tinnitus. They have like a high pitched
tinnitus. But this is a very unique kind
of symptom. And I don't know, Letitia, if
this happened to you, but many people will describe it with
their heartbeat, like every timetheir heartbeat they hear like a
(06:38):
kind of what? Definitely, definitely.
Yeah. And we think it's because
there's turbulence in the veins draining the brain, but we'll
get we'll get to that in a little bit.
Any other symptoms that you had in the beginning before you got
the diagnosis? That was it.
It was just the headaches and the swishing in the air.
That was it. Got it.
Got it. And so at what point?
(06:59):
So you were seeing your primary doctor saying, oh, my headaches
are still there. At what point did you go to see
an eye doctor? So so he prescribed another
medication for me and when I went back to see him just on a
regular visit, like a annual, hesays how how would headaches?
(07:20):
And I'm like, oh, they're still there.
He says, I don't like this. I'm going to refer you to an
ophthalmologist. OK, OK, great.
So he said go see an eye doctor and get he.
Said I don't like this. I need you to go and see someone
because these headaches should have stopped by now.
Got it. And were you having any vision
(07:41):
symptoms, like, for example, anyblurring of vision or double
vision or anything like that? No, I didn't have anything like
that. I didn't have any any problems
with my vision. I would have never associated
the headaches with my vision. Like nothing made sense to me.
None of it clicked together. Back then, yeah.
(08:04):
And I have to say, your doctor, your primary was very insightful
because most people, you know, most providers, when they hear
patients with chronic headaches,they they think, oh, this is
probably tension or migraine. But to link it to an eye issue,
he was very, very astute, very insightful to be able to do
that. Yeah.
So also can you just give us thecontext, like, when did this
(08:27):
happen? Like how long ago was it that
you were having these symptoms and you got diagnosed so.
This started back in we. Were just going.
Back after the pandemic, so I want to say it was like, I don't
know if it was 21 or 22 December, I can't remember, but
(08:48):
that's when, that's when the diagnosis came.
Obviously it started long beforethat, but that's when I was
diagnosed. Got it.
OK. And during that time, were you,
you know, working from home? What was it a stressful period
like what was going on in your life around that time?
I know COVID was a unique time for all of us, but what
(09:10):
specifically was going on in your life at that time?
So we had been working from home, from home for a while and
then I remember myself and my staff was back in the office.
It was just like it was very normal, OK?
(09:31):
Nothing really unusual around that time.
No, nothing unusual. OK, OK, All right.
So then what happens? So you you got this appointment
to see the eye doctor and what did they discover?
Yeah. So I go to the eye doctor and
I'm expecting him to say, OK, you need a new prescription for
(09:52):
your glasses. So I get there and he says he
starts to examine my eyes. And he says I need to dilate
your eyes because I need to see what's going on behind your
eyes. And I said OK, And he dilated my
eyes. And within two minutes, he's
like, I need you to go down to New York eye and air.
(10:14):
I need to refer you to someone else.
This is very serious. He wouldn't give me any answers,
but he was like, I just need youto go and see someone else who
could probably help you better. And I said, is everything OK?
And he goes, well, just go down and see them and we'll see what
happens. So he he made it seem very
urgent that he didn't tell you exactly what he didn't tell.
(10:36):
Me exactly. I knew it was urgent, but I
didn't think he met the same dayI thought he was.
He said, my, my, my girls are going to take care of you.
They're going to make sure that when you go, all you have to do
is walk in. So I'm thinking, OK, maybe I'll
be there next week or the week after, but he's like, no, right
now. Like you need to go right now.
(10:58):
Right. It's an emergency.
That's when I started to think, Oh my God, this is serious.
All right, so you got to New York Eye and Air that same day
and walk us through what happened.
What did you experience there? What did the doctors do?
So that's where things got. That's when things became really
scary for me because once they did their examination, I was
(11:22):
told we need to. So they said what they said to
me is what we're seeing is that your optic nerve is swollen and
we need to make sure that this is not a brain tumor.
And I heard nothing else but brain tumor after that.
So and they took really great care of me, I will say that.
So then they decided that they wanted me to do an MRI and it
(11:46):
had to be done today. They called an ambulance to come
and get me to take me over to the hospital.
So everything was moving really,really fast.
It was like, well, I just went to the eye doctor and now here I
am in the ambulance and I'm going to have this MRI done.
And yeah, obviously it wasn't a tumor, but it was really scary.
(12:10):
It is a very scary situation because you don't even link, you
know, having headaches to havingan eye issue, first of all.
And then from there, the eye issue to having a brain issue
and needing an emergency MRII mean, that's kind of mind
boggling for a lot of patients. But you handled it so well.
And I know it's, it's very frightening to think that you
(12:30):
could have a tumor. But as eye doctors like just to
let you know and let our audience know, it is really our
number one priority to make surethat the patient is stable.
And we don't expect there to be a brain tumor.
But that's why we do it as an emergency, because we don't want
to miss a brain tumor. So I mean, I would say in my
experience, over 99.5% of our patients have no brain tumor.
(12:52):
They have nothing like that. But we have to do the scan.
We can't let the patient go because once we see that
swelling of the optic nerves, wehave to make sure it's not a
brain tumor. Right.
Yeah, so, so then what happened?Like so you went to the
hospital, you got the MRI, and then what happened?
Yeah. So then I waited and they told
me that the the MRI was was good, was clear there wouldn't
(13:17):
there was no brain tumor. And yeah, from there I just
started seeing. So the doctor over at New York
Eye and Air, I had to go back tosee him and he prescribed
cetazolamide and I started to take that.
I was taking originally 500 milligrams twice a day.
(13:41):
Definitely helped. Definitely helped.
What the heck I would say. After a week or so I started to
notice the difference. It took a little while, but
after about a week or so I started to notice a difference.
Now at one point I did have to do the do a lumbar puncture.
(14:03):
Tell, tell us about that experience.
I know it's it's something no patient ever looks forward to,
but it's so important for the diagnosis.
So tell us, like what happened with the lumbar puncture?
So the lumbar puncture was, it was scheduled and I went in and
I had that done. I will say it wasn't as bad as I
(14:24):
thought it would be. So building up to going is much
more scarier than it really is. And I got there and the doctor
was great and he did it and everything was fine.
But after an entire week after Ihad the worst headache of my
entire life and I was told that it was something has something
(14:45):
to do with the needle going intoyour spine and air or something
going in and that that that could happen.
But once that was over, everything was things were
great. Yeah.
So I'm just going to add a little bit of contest for our
audience. So the Spinal Tap or lumbar
puncture is when there's a needle put into the back, into
(15:07):
the lower back. And the goal, the real purpose
of it is to measure the pressure, measure the pressure
in the fluid around the brain, which is typically high in IAH.
But it's also to make sure that patients don't have other
reasons for having high pressurein the brain, for example, an
infection or inflammation or cancer.
There's many reasons why we do aSpinal Tap.
(15:29):
So it's not, we tell our patients, it really is
mandatory. It's not something optional.
We everybody with suspected IIH should have a Spinal Tap.
So that's why we put our patients through it.
So I'm sorry you went through that, but it was really
important as part of the workout, survived it and you
know, the, the headache you had afterwards.
I'll just share something with the with the audience.
(15:52):
So I believe your pressure, I don't have your notes in front
of me, but I believe it was 30, something like 36 or 37.
So just so you know, everyone knows normal pressure is up to
about 25 S Your pressure was high.
So imagine somebody has high pressure in the brain, their
pressure is 37. They get the Spinal Tap and all
of a sudden the pressure is lowered down to like 15.
(16:14):
Your brain is not used to 15. Your brain is used to 37.
So that's why many patients get what we call a low pressure
headache and that's what you experienced because of that
sudden drop. And sometimes what can happen
is, you know, the needle goes into the spine, into the spinal
fluid area. Sometimes there's a tiny little
kind of a leak at where the needle went in from the needle
(16:35):
track. And so the pressure, instead of
going right back up to 37, again, it stays low.
And again, your brain is not used to that low pressure.
So we call that a low pressure headache and usually it goes
away within three to five days, but it can happen and it is a
different type of headache, right like it.
Is it is so the only thing that would take that headache away
(16:56):
was literally laying on my back.Yes, and it is positional and
you know, sometimes patients, they respond to painkillers or
caffeine can get rid of that headache.
But sometimes we just have to wait and wait a few days and
sometimes even need a blood patch to close up any small leak
that may be there. So it's not leaking anymore.
(17:16):
Yeah, I'm so sorry you went through that.
But it it is common for many patients to get that type of low
pressure headache. Well, it's been such an
interesting discussion. Leticia, and I really appreciate
your sharing your experiences. We're going to take a very, very
short break and then we'll be right back with more on the IQ
Podcast. So stay tuned.
You've been listening to the IQ Podcast with me, Doctor Ronnie
(17:39):
Bannick. We're going to take a short
break and then we'll be right back with more insights to help
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(18:43):
your migraine naturally. Welcome back everyone, to the IQ
Podcast. Today we're chatting about IIH
with one of my patients, LeticiaWhite.
And so Leticia, and now I want to talk to you about the
treatment. You mentioned that the doctor
started you on this medicine called acetazolamide.
(19:05):
We also call it Diamox sometimes, depending on the
brand. Tell us about what happened with
this medicine. So I when I started taking the
medicine, like I said, it took about a week or so to start
working and I started to notice that the headaches didn't come
as much as they were coming. I even noticed that the swishing
(19:29):
in my ear, although I still had it sometimes I did not.
I, I took 500 milligrams every day.
It helped me. It helped me lose weight.
Actually, I started, I changed my diet and I was taking the
medication and my my weight dropped down.
(19:49):
I lost about 20 lbs and then everything just went away.
Wow, that was the first talk a little bit.
Can we talk a little bit more about weight?
You know, we know as medical professionals that weight is a
risk factor for IAH. It's not the only risk factor,
but it's one of the risk factors.
And well before all of these symptoms ever started, had you
(20:10):
gained weight or, or lost weightor you were stable?
Like what was your weight before?
You got, I gained weight becauseI was always really the end and
I might have gained about 2030 lbs and I'm pretty sure that's
what that's around the time whenthe headaches began.
(20:34):
I definitely gained a lot of weight.
Yeah, we hear that a lot from our IIAH patients, particularly
women, women who are kind of, you know, in the menstrual
period in their lives. Weight gain, usually it's in the
range of like 15 to 20 lbs is what we hear and usually like 6
months before the symptoms start.
(20:55):
So, so it is common and unfortunately we don't know why.
We really don't understand why weight plays such a role in I I
age, you know, how does it contribute to the pressure being
high in the brain? We still don't understand that.
But for many patients, it is a major risk factor.
And on the flip side, it's something that is modifiable,
(21:15):
meaning that you can do things to to turn it around, right.
So what did you do, Leticia? So that was the first time and I
did, I lost, I lost 20 lbs. I changed my diet and I started
to work out and I took the medication and I dropped down 20
lbs and everything just stopped.No more headaches, no more
(21:37):
swishing, everything is fine. And then I got comfortable and I
gained the weight back. OK.
The weight did come back. It did come back in.
It did come back. So how much weight when you
were, when you had gained the weight back about, at what point
did it come back? Like was it immediate or was it
only if you gained back like whatever you had lost?
(22:00):
Like when did it come back, the symptoms?
So I dropped down 20 lbs. I picked back up all of the 20
lbs and it was like right, Just right after that it came back.
It. It came right back as soon as I
gained the weight back and then I started taking the medication
(22:23):
again. I see.
You can I sorry to interrupt you.
Had you come off the medication during that time when you gained
the? So I was told I no longer needed
to take the medication because Ihad lost the weight and
everything was going fine and ifI needed it then I could take it
and but for now I did not need to take the medication anymore
(22:45):
and I didn't. And then I gained the weight
back and it came back. And you knew, right?
You, you could tell right away, right?
Away I knew right away so one day I would just happen to be
laying across my bed and I hearda swishing in my ear and I'm
like Oh no and so. That was very they were telling
(23:07):
the sign right was swishing in the ear.
Many patients. Well, you know it's interesting
you say that Leticia. Many patients before they
actually develop the headaches, they will hear the swishing
first. That will be like the first
thing that they where they know,OK, there's a red flag it's
coming back. Right.
So that's the red flag for me, like the swishing in my ear like
(23:29):
for now, now like after the first time, because I didn't
really have a headache as much this time.
And maybe in the beginning the swishing started 1st and maybe
it just didn't register the headaches did.
But this, I mean, after I lost the weight and I gained it back,
(23:50):
I heard that swishing and I justthought, Oh no.
But you know, Leticia, you handled it very well the first
time, right? You got it to go into remission.
So you had a really great outcome the first time.
So how did you handle it when you had this recurrence?
What did you do? So when it came back, I started
to take the medication again. Not I, I, well, I was told that
(24:13):
I only needed to take 500 milligrams.
After a while, I was down to 500milligrams a day.
So I immediately started taking it again and I started watching
what I was eating and I started to walk a little more and I
managed to drop down enough weight that like it's not, it's,
I don't want to say it's gone, but it's definitely in remission
(24:35):
right now. So I'm not having any symptoms.
Amazing and I think the last time I saw you, I think it was a
few weeks ago, we had you come off the medicine, right.
So you stopped the medicine and how are you doing now?
I'm. Doing great and this time I'm
not going to pick back up the weight.
OK. All right, all right.
If that's an incentive to not gain weight, that's that's
(24:57):
great. I wanted to just let our
listeners know, you know, when we counsel patients about weight
and IIH, first of all, not everyone has gained weight or is
overweight. And if somebody has not gained
weight or is overweight, we lookfor other reasons for why they
may have high pressure in the brain.
So we always investigate other things.
But if weight we think does playa role, we typically tell our
(25:18):
patients, whatever weight you'reat, your maximum weight, we
usually recommend losing about 6to 10% of that weight.
So I'll give you an example. If somebody weighs like 200 lbs,
we usually recommend that they go down to, you know, lose like
15 to 20 lbs. So they can go down to like one
85180. That would be their target
(25:39):
weight. So it's not like we're asking
people to lose 50 lbs or more. It's really even like small
amounts of weight loss can make all the difference.
So for you, you're, you're kind of Mark, it was kind of like
1520 lbs. That's kind of where you're at
with your your target. So I've already lost 15 lbs and
I plan on even though I'm not having any symptoms, I do plan
(26:02):
on trying to go down at least another 10 lbs.
OK, amazing. Yeah.
Yeah. And in most of our patients with
IIH, when people lose the weight, they tend to have not
just resolution of all their symptoms, but their swelling
goes away. So I'll just share something
also with the audience. When Tisha first came in, in the
(26:24):
first episode, her swelling was a grade 3.
So we graded on a scale from zero to 5, five being the worst
that it could be. And her swelling was a three.
And then gradually it went down.It went down to like 0 to one.
That's, I think when we had taken you off the medication and
then when you came back again the second time, it wasn't 3
(26:44):
again. It wasn't that bad.
It was more like 1 to 2. And most recently when I saw
you, it was back down to 0. So it can fluctuate, swelling
fluctuates, and it really is very sensitive to weight loss
for whatever reason. Yeah.
Yeah. All right.
Well, I'm so glad to see you're doing so well and off
(27:06):
medications, not having any of that, those symptoms anymore,
not having any vision. Issues.
No swelling. So I'm really so impressed by
your persistence with this condition.
I know it can be challenging andfrightening.
Leticia, is there any kind of last words that you'd like to
leave our audience with about IIH?
(27:27):
Maybe some words of wisdom for patients who may be suffering or
who've been recently diagnosed. So I'll tell you this, my
daughter has a friend whose mom was having really bad headaches
and she was, she was just havingreally bad headaches.
(27:48):
And my daughter said to me, mom,Caitlin's mom is really safe.
She had to go to the emergency room.
She's having these bad headachesand she can't, can't kick it.
And I immediately told her, tellher mother to have her eyes
examined. And I told her to tell her.
I said tell your tell your friend my story so that her
mother can know what to say whenshe get there because we don't
(28:12):
know. I just.
Pass on what happened to me. And, you know, so now her mother
has an she has an appointment with an ophthalmologist and
she's going to have her eyes examined and see what happens
from there because the emergencyroom couldn't tell her anything.
Oh, yeah, yeah, I would echo that.
I mean, I think your point is soimportant when the headaches are
(28:33):
not, you know, daily headaches are not normal.
People should not get headaches like that every single day.
And when you're kind of, you know, living life like that,
it's, it's really not enjoyable to live with a daily headache
that's severe. It's hard.
Yeah, so go see an eye doctor. Just get it checked out if
you're someone who's been, you know, diagnosed with just
(28:54):
headache or tension or something.
But get checked out so you know that it's not IIH.
And on the flip side, the good news is people tend to have a
really good outcome with IIH. You know, most people do really
well like you did. So it's a scary diagnosis to go
through the process. But ultimately, most people, I
(29:15):
mean, there's a small percentage, about 5 to 10% of
people who don't do as well. And maybe they've had it for too
long. They've already lost some
vision. They have some visual deficits.
But the vast majority of people,over 90% of people do really,
really well if we can catch it in time.
So, yeah, well, thank you for sharing.
(29:36):
Yeah, I know you, you did the right thing.
You got the care in a in a timely fashion, which is really
important. And now you're doing great,
right? It's almost like you never
happened, right? Yeah, I'm just glad I had the
right team. All right, well, it was a
pleasure chatting with you today, Latisha.
(29:56):
I really appreciate your insights and sharing your
experiences. I'm sure you're going to help so
many people who are listening tothis podcast and people who are
really. Afraid.
Yeah. So I really appreciate your time
and thank you all for joining usfor the IQ Podcast.
I look forward to seeing you allnext time.
So stay tuned. Thank you for tuning in to the
(30:18):
IQ Podcast. We hope you enjoyed today's
episode and learn something new to help elevate your IQ.
If you loved what you heard, don't forget to subscribe, leave
a review and share the podcast with your friends.
Stay connected with Doctor Ronnie Bannock for more eye
opening insights on eye health, nutrition and lifestyle.
Until next time, keep your vision clear and your IQ sharp.
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