setbacks are common and because antivirals have never done a good enough job for anyone with HSV, not only with MM. There are situations that wake up that sucker even while on antivirals. The tricky part is to figure out what triggered the setback. If none of the triggers of MM were present than it could very well be MAV. But there are definite ways to tell the difference between MM and MAV..please see my post with the comparison chart I posted a few days ago. If one does not have any MAV symptoms then I would say it is an MM setback. This is why I feel taking many treatments at same time when not giving any one of them a chance by themselves to see if it works or not is not a great idea. I am not saying taking more than 1 treatment is bad, but I feel it is helpful only after taking one at a time for a long enough to time determine if its helping or not, or partially helping etc etc. and then deciding if you need to add something else to get better symptom control.
forgot to add @gardengal it's not necessarily one or the other MM or MAV. Its very common for us to have both.
I started JOH in February and haven't had a major attack since around that time, I don't actually remember exactly when the last one was. My issues lately have been balance issues, nausea, and then last week I did have a minor attack. The chair next to my bed was slowly turning. Not the zipping by that it would have done if it had been a major attack, but still not much fun.
I don't know if this would be helpful to anyone But my son now 21 has suffered from Mav since he was a small child. Extreme Migraines with horrible vertigo which lasted Days at a time, damp weather was always a trigger We took him all over to help him and it got Worse he started having hallucinations and Hearing disturbancing . At this point his Dr explained that he has extreme migraines Due to allergies causing sinus problems. He put him on singulair with Zyrtec daily and insisted I not take him off to give it 6 weeks It has now been 12 years he is doing great Recently he tried stopping the singulair Only to see he still needs it. I never knew It was mav until this forum mentioned It and i seen the connection .seeing How singulair helped my son maybe it's worth A try for those with mav good luck