Menieres Disease - How To Cope

How To Cope

In 1861, French physician prosper Meniere described a condition that now bears his name. Meniere's disease is a disorder of the inner ear that causes episodes of vertigo , tinnitus , a feeling of fullness or pressure in the ear, and fluctuating hearing loss.

What Is Meniere's Disease

A typical attack of Meniere's disease may be preceded by fullness or aching in one or both ears. Hearing fluctuation or tinnitus (ringing or sounds in the ears) may also precede an attack. A Meniere's episode generally involves severe vertigo (spinning), imbalance, nausea, and vomiting. The average attack lasts two to four hours. After a severe attack, most people find that they are extremely exhausted and must sleep for several hours.

In some people, Meniere's episodes may occur in clusters; that is, several attacks may occur within a short time. In other cases, weeks, months, or even years may pass between episodes. Between the acute attacks, most people are free of symptoms or note only mild imbalance and tinnitus.

In 75 percent of the cases, Meniere's disease is confined to one ear, while in the other 25 percent, both ears are involved. In most cases, a progressive hearing loss occurs in the affected ear(s). Although an acute attack can be incapacitating, the disease itself is not fatal.

What Causes It

An acute attack of Meniere's disease is believed to result from fluctuating pressure of a fluid (endolymph) within the inner ear. The underlying cause of Meniere's disease is unknown.

How Do I Manage an Acute Attack

During an acute attack, lie down on a firm surface. Stay as motionless as possible and keep your eyes open and fixed on a stationary object. Do not try to drink or sip water, because you may vomit. Stay like this until the severe vertigo (spinning) passes, then get up SLOWLY. After the attack subsides, you'll probably feel very tired and need to sleep for several hours.

If vomiting persists and you are unable to take fluids for longer than 24 hours (12 hours for children), call your doctor. Your doctor can prescribe nausea medication or may wish to see you.

What Can Be Done to Reduce the Symptoms

Between attacks, different medications may be prescribed to help regulate the fluid pressure in your inner ear, thereby reducing the severity and frequency of the Meniere's episodes. A hydrops diet regimen will probably be recommended. This is an important part of treatment for virtually all patients with Meniere's disease. Experience has shown that STRICT adherence to this dietary regimen will result in significant improvement in most patients.

More information about diet can be found at this web site on the page titled " Hydrops and Meniere's Diet Suggestions. " If you would like even more information about your diet, call your physician or your local hospital's dietary department.

The purpose of treatment between attacks is to prevent or reduce the number of episodes and to decrease the chances of further hearing loss. A permanent tinnitus (ringing in the ears) or a progressive hearing loss may be the consequence of long-term Meniere's disease.

In cases that are very severe and that do not respond to medication or diet regimens, your physician may recommend surgery (possibly including instillation of gentamicin or other substances) to relieve the pressure on the inner ear or to block the transmission of information from the affected ear to the brain. A doctor specializing in ear surgery (an otologist or neuro-otologist) can advise you about the types of surgery available and under what conditions they are prescribed.

How Can I Cope with My Symptoms

Strict adherence to the diet regimen is difficult and may require changes in lifelong eating patterns. Explain to your family and friends how important it is that you maintain your diet; solicit their help.

Also, because the acute symptoms of Meniere's disease are episodic, it is important to explain to your family and friends what might happen when you have an attack. Then, if the symptoms occur when they are present, they will understand and not be overly frightened.

You may be able to protect yourself from injury if you feel that an attack is about to begin. Some attacks may occur during the night, so be sure you have a night light on; you'll be relying more on vision to help maintain your balance. You will want to make sure that the path to the bathroom is free of throw rugs, furniture, or other obstructions.

As you learn more about your disease, you will understand the symptoms and be more successful in coping with them.

A full-length book, Meniere's Disease:What You Need to Know, is available from VEDA.

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