Sunday, November 19, 2017

My husband's story of his Meniere's disease and how he manages it!

My Meniere’s Disease story

            Early fall 1999.  It was a hot, sunny day in southern Arizona.  We were out of town on a job installing equipment in a cell tower shelter for Nextel.  During the long drive into the mountainous area north of Douglas  suddenly the straight highway appeared to slowly curve to the left, then straighten, then curve, then straighten.  As I was driving this was pretty unsettling.  I knew that the road was still straight, but my eyes and correlating brain area didn’t agree.  I pulled over and let my co-worker drive and I leaned my seat back, closed my eyes and dozed for an hour or so.  When I woke up I was fine and had no idea what had just happened.  My ear felt “clogged” but I figured that it was from the extended, loud driving experience in a heavily loaded, open work van, and the droning cooling fans on the equipment in the cell site shelter.

            A few weeks later I found myself in a room kept at 65°  making fiber optic terminations.  The room was full of racks upon racks of computer equipment cooled with moderately loud axial fans.  As I went through the steps of stripping the fiber, putting hot-melt connectors in the heater, inserting the fiber and letting it cool to be cleaved then polished the room slowly started to seem to rotate.  At first I was able to continue.  I was the only one in our company that had been to the week-long training on fiber optic handling and termination, so there was a lot of pressure on me to do the job and do it right.  No one could come and replace me.  So I walked down the hall to get a drink and ended up leaning against the wall as I walked  to keep from falling over.  I managed to get a drink and make it back to the room.  Then things got worse.  The room started to spin violently in a counter clock-wise direction.  My vision told me the room would quickly spin about ¼ turn counter-clockwise then sort of reset back to straight then spin again in rapid succession.  I have never done well on any sort of spinning or twirling ride at amusement parks, so this was terrible for me.  Very quickly I became nauseated, then vastly more nauseated.  I threw up over and over until my stomach was trying to get rid of even the memory of my breakfast.  All I could do was huddle in the fetal position on the floor and not open my eyes or move.  My neural system began to freak out.  I had cold sweats and then my muscles began to feel as if electricity was coursing through them, causing them to vibrate at about 10 hertz.  All I could do was lie there and pray I would pass out and it would end, which of course I didn’t. 

            After what seemed a long time someone finally happened by and found me.  I could barely speak.  After a quick ambulance ride to the hospital and some sort of injection I slowly felt the spinning (I later learned it is appropriately called ”Severe Rotational Vertigo”) subside.  The shock to my body and brain didn’t go away for a couple of days.  I was to learn that this is a typical aftereffect.  I felt lightheaded, tired, and my stomach had a constant, dull pain. As my concerned wife drove me home, whatever the injection was that I had been given made me feel like I couldn’t hold still and I was going to jump out of my skin.  I had to force myself to exist through it, not minute to minute but second to second.  I suspect it was a combination of the injection and the neural trauma.  I haven’t experienced that sensation since.

            The ER doctor suspected it was an inner ear issue and sent me to an Ear, Nose and Throat (ENT) specialist.  He talked with me, looked in my ears, and did a couple of simple tests and told me I had something called Meniere’s Disease.  He prescribed a medication for the nausea and a diuretic (water pill)  and sent me on my way.  No talk of causes, helpful dietary changes, or anything.  Now, I can’t blame him for not guessing at causes.  After much research I have discovered that many believe Meniere’s shouldn’t be called a “disease” but rather a “syndrome”.  Disease indicates that it is understood and has a known cause and treatment.  This is definitely not the case with Meniere’s.  Syndrome indicates a known set of symptoms and an indeterminate cause or treatment.  This is the case with Meniere’s.  I experience (and every website and doctor concurs)  fullness or pressure in the inner ear (i.e. That “clogged” feeling), loss of hearing (which is degenerative, progressive, and permanent), tinnitus (a low roar and/or high-pitched ringing), and rotational vertigo.  Everyone has triggers, and they are usually quite varied.  Things that trigger one person’s symptoms are totally different for another person.  But one thing we all have in common; when a  rotational vertigo attack hits we need a dark, quiet place to lie down, close our eyes, and not move.  Usually that is in our bed with the shades drawn, lights out, and no one talk to us or jiggle the bed.  You may well discover that it helps to lie down on one side or the other, or on your back, with or without a pillow.  You see, your balance receptor thinks you are in motion, and if you can make gravity agree with what your ear thinks is happening it really helps.  Also, when your ear is feeling that “fullness” and your hearing ability in that ear has dropped you may find an ear plug helps.  Moderately loud sounds can become irritating, and loud noises can actually be painful.  Looking at screens on small electronic devices or a computer screen can make you start to feel dizzy.  Leaning forward and looking down repeatedly to load the dishwasher or do the dishes can bring on vertigo if you are already close.  Only use that last excuse on your spouse if it is true!

            So what had brought this on for me?  Luckily I have a cousin who was in the middle of his residency to become a doctor and he looked to the significant resources available to him for answers.  One of the things he told me was that Meniere’s can be brought on by an increase of blood flow in the cranium that occasions an increase of flow in the inner ear.  While this cause is considered rare and even controversial it made me think about things that I had be doing that were new and different.  What immediately came to mind was a hair cream that I had been using that was “all natural” and therefore “safe” since it didn’t use chemicals but rather stimulating herbs and plant oils.  It turned out for me that these compounds, especially essential oils are my worst and most fast-acting trigger.  Unfortunately, discontinuing using them and avoiding all possible contact with them doesn’t make Meniere’s Syndrome go away.  Once it is initiated it is pretty much something you deal with for the rest of mortality. 

             Now, don’t let this be over-discouraging!  Some people experience vertigo daily, some go weeks, months, or even years without it.  Most get it in only one ear, but some unfortunates get it in both ears.  For those with extreme, untreatable Meniere’s there are surgical options that are drastic, but better than the alternative.  The trick is figuring out your trigger(s).  Everyone has them, and they are very different.  Some can’t have wind blowing across their ears, some can’t have any sugar, some get really bad anytime the weather changes (barometric pressure), and the list goes on and on.

 And then there is a list of things that pretty much apply to everyone with Meniere’s Syndrome.  These are things that all informational websites and good ENT doctors will tell you:  Avoid alcohol, tobacco, coffee, caffeine, chocolate, stress, get plenty of sleep, and eat a low sodium diet.  Most of those you can control, but when you feel your ear getting more pressurized, the roaring in your ear increases, and your hearing decreases, and you know that the world is going to spin soon, your stress level goes up no matter what you try to do!

            So here is what I eventually discovered over the years that has helped me, and I am confident it will help most people who suffer from Meniere’s.

1-  Meclizine.  You can buy it over the counter, but it is much cheaper by prescription.  For most people a 25 mg capsule is best.  It doesn’t treat the problem.  It does mask small attacks, and it makes bad attacks much smaller.  And it helps with the nausea during an attack.  While you are figuring things out this will help you not have the terrible rotational vertigo attacks, or at least take the edge off of them.  You take 1 every 24 hours.  Try not to take it unless you are feeling unsteady and fear an attack is likely coming on.  I have taken it for weeks at a time and experienced no serious side effects, just relief from the vertigo.  It can make you feel slightly lightheaded and “almost unsteady”. I know quite a few people who have taken it every day for years without any bad side effects, but it is much better if you can figure out how to control Meniere’s without it.  When I once tried 50 Mg (2 capsules) at the same time it knocked me down and made me so drowsy I couldn’t get out of bed for most of the day.  Some people get some of that effect from just 25 Mg.

2-  Drink plenty of waterAbsolutely stop drinking soda pop, energy drinks, V8 vegetable juice (it has an atrocious amount of sodium in it!), even be sparing drinking milk (130 mg sodium per 8 oz. Cup)  You can drink some real fruit juice, but mostly drink just water, at least ½ gallon per day even in the winter.  I finally made the connection that my symptoms went away in the summer when I was working out in the heat every day and drinking lots of water and sweating out the excess sodium (notice I don’t just say “salt”).  In the wintertime I would drink very little water and wasn’t sweating and my symptoms would return.  I can’t stress this point enough.  My overall health increased as soon as I started doing this.  I used to suffer from a painful, inflamed hip joint that even in my late 20’s would often become so painful that I could hardly walk.  A good chiropractor told me what I just told you about drinking water and avoiding pop and such and unfortunately I didn’t try it for about 8 years.  When I finally did (because of my Meniere’s) my hip basically healed.  At my current age of 45 I have no pain or effects in my hip joint or any of my joints, and I have recently hiked 22 miles up, across, and back down Pine Valley mountain in one day with no problem in my hip.  I consider it pretty much a miracle.  I am reminded of something the councilor’s at Thunder Ridge Scout Camp would have us chant regularly, “What do we want?-Clear Pee!-How do we get it? Drink more water!”  If your urine is dark you aren’t drinking enough water;  you want clear or nearly clear urine.

            Drinking water brought about a lessening of symptoms for me in only a few days.
3-  Stop eating processed foods, sweet or salty.  The list of bad things is lengthy, but here are a few for starters.  Do not consume:

             msg (monosodium glutamate),
             Fast food, period!  Most restaurant food.  Especially Chinese food.
            Junk food.  Chips, candy bars, Oreos, candy, etc...
corn syrup, high-fructose corn syrup (this is what Karo is made of),
cheap fats found in restaurant fryers (olive oil, real coconut oil, and the like are ok) and in butter substitutes (real butter is ok in small amounts, but it has 90 mg of sodium per tablespoon),
V8 vegetable juice, bacon, ham, sausage,  lunch meat, pepperoni, jerky, and Canadian bacon (they are loaded not only with salt but also sodium nitrite and sodium nitrate),
I personally have found it very beneficial to replace white salt with Real Salt and Pink Himalayan Crystal Salt.  I understand that you body treats cheap, stripped, bleached white salt as a toxin and dedicates water molecules to isolate it and try to eliminate it.  I have had less problems with the salt in its natural state with the accompanying trace minerals.  One of the reason given by the medical field as to why you need to lower your sodium intake is that is causes water retention and contributes to the “endolymphatic hydrops”.  Endolymphatic hydrops basically means your inner ear, where the hearing and balance takes place, gets too full and over pressurized with fluid, causing Meniere’s symptoms.  The purpose of the diuretic (water pill) is to try to get your body to release more water and sodium than it normally does, which will hopefully relieve the over fullness of fluid in the inner ear.  I personally have tried the diuretic multiple times and it doesn’t help me, but rather makes me feel lousy in multiple ways.  Some people have better results.  Drinking lots of water flushes out my excess toxins and sodium, and fulfils what the doctors are trying to accomplish with the diuretic.  Eating less of these toxins is indispensable too.

4-  Lower you sodium intake.  It is recommended that most people intake about 2000 Mg (milligrams ) of sodium per day.  Most people get 3500Mg or more, easily.   You may well need to try to only take in 1000-1200 Mg which is still generally safe (I do an average of 600-800 per day, but only do that if your doctor is cool with it).  There is a reason  I don’t say “Salt”.  Salt (sodium chloride, NaCl) is only one source of sodium.  An egg, still in the shell contains about 65-70 mg, so does 4 oz. of natural chicken or beef.  Most chicken has added broth which means 150Mg of sodium or more per 4 oz.  You have to learn to read labels.  A basic rule is you have to prepare food from scratch.  If it is processed or already made, it has too much sodium, and bad sodium (chemical preservatives).  1/4 teaspoon of cheap white salt has 590 Mg sodium, The Spice Lab Himalayan Pink Salt from Costco has 420 Mg sodium per ¼ teaspoon.  Some sea salts have 570 Mg Sodium per ¼ teaspoon.  So even all salts are not created equal!  Baking soda has 300 Mg per ¼ tsp, and baking powder 180 Mg per ¼ tsp.  Canned anything.  Especially beans, chili con carne, cream of mushroom or chicken or celery soup, canned Mexican sauces (enchilada sauce for example), soy sauce.  Again, read the labels.

I mentioned fast food and restaurant food.  This is especially true for Chinese food.  It is, without exception, full of sodium.  They use lots of MSG, and even the sushi has sodium-based preservatives in it.  What happens is it may not taste “salty” but it is deceptively loading you up with sodium.  My wife started making bread for us with less salt.  From the store it can have 120-180 Mg sodium per slice or more.  Flour tortillas have 350- 550 Mg or more, but corn tortillas can be found with only 10-25 Mg for 2 tortillas.  Most cheese has 150 Mg or more per 1 oz., but Swiss cheese can be found with 35-40 Mg per 1 oz.  Even granola bars and Clif bars have 180-250 Mg.  Dairy products all have sodium in them. 

We created our own cookbook of modified or just plain made-up recipes with lower sodium recipes, and desserts with way less sugar in them.  We learned to use 50-80% whole grains in our flour; even in cookies, pies, cakes and muffins, as well as biscuits, waffles, pancakes, German oven pancakes, etc...  We learned that by creating a multi-grain mix we could improve the taste so it wasn’t so overpoweringly “wheaty”.  Most dessert recipes call for 1 cup of sugar per 1 cup of flour.  We generally do ½ cup sugar for 4 cups of flour, and add honey to help sweeten things.  You learn by trial and error how much you can use before things start to taste too “honeyey”.  It is surprising how quickly things come to taste satisfyingly sweet even though they contain 50-75% less sugar.  This is good for most Meniere’s sufferers symptoms, and for everyone’s physical and dental health (most of our seven kids have NEVER had a cavity).

Now, you will need to determine how drastic you need to be in avoiding all of this stuff.  In my experience it changes.  About 8 years ago I started drinking lots of water and stopped the pop.  I occasionally had some junk food, used some canned food to make dinner, and ate out occasionally at Wendy’s or a nice restaurant.  I completely got rid of all of my symptoms for 5 years.  My hearing returned to about 70% of perfect (every time you have an extended bout of this you lose a little bit more of your hearing in the affected ear, permanently.  However, when it goes down to say 30% during a bad spell it will return to almost as good as it was before when the spell goes away).  I was tickled to say the least.  Then after 5 years of no problems we were visiting family down in Mesa and I forgot my usual toothpaste and without thinking I used my wife’s.  Her’s was an all natural toothpaste flavored with real spearmint oil.  My Meniere’s was back full force in less than 36 hours.  I had horrible bouts of severe rotational vertigo every 2-3 weeks, even though it was summer time.  It took nearly a year for the symptoms to lessen and for the vertigo spells to go away.  That is the bad thing about Meniere’s disease.  One slip up can take months to undo.

 I did pretty well for the next couple of years until I ate too much prepared, high-sodium food, nearly every day, for a two-week period.  The vertigo came back with a vengeance for 8 months.  The vertigo was so constant and debilitating that time that I finally was forced to seek serious, professional medical help.  I would have vertigo up to 5 days a week, sometimes 3 times a day, and for hours at a time.  I went to a Meniere’s specialist and talked about options.  The first thing that a good doctor will do it put you through a battery of tests, including an MRI and hearing and balance tests.  They will blow air into your ears, turn you all different ways, make you look at moving, blinking dots inside of blackout goggles, and myriad other things.  The point of all that is to determine if you really have Meniere’s.  There are other things that can cause the same symptoms, and they can do something about those other things.

With Meniere’s however, they can only throw things at it and see if anything sticks.  If something they try can lower your symptoms even 20% it is considered a success of sorts.  There is a good ENT center in Northern Utah.  I ended up seeing doctor Eric Slattery in their Draper clinic.  They have one of the better pages on Meniere’s Disease and treatment found at http://entcenterutah.com/menieres-disease-services/  .  This is one of the better explanations of symptoms and optional treatments available if you can’t control it with diet and lifestyle.  One surgery they don’t list, and one that has reportedly had decent success is where they remove some of the bone next to the inner ear allowing the fluid sac to expand into that space and lessen the pressure.  I haven’t had to progress that far.  They start with the less-invasive treatments first, then work up to more serious ones if they need to.  They can even sever the nerve that is carrying the misinformation from your inner ear to the brain if necessary, but that is drastic and irreversible, and  it is brain surgery.  One nick in the wrong place and bad things can happen.  There is also a clinic in Saint George that seemed pretty good. I think it was the Hearing and Balance Center.  I went there to have some of the testing done, but didn’t see a doctor specifically for Meniere’s consultation.
What I have had done was the Prednisone (steroid) treatment.  First we tried the injection.  That didn’t go well for me (for some people it does).  I began to have “drop attacks”, where you go from normal to full severe rotational vertigo in the blink of an eye. It would last for 10-15 seconds, then pretty much fade away.  Normally I feel the vertigo coming on 30 minutes or even hours beforehand.  And when the attacks come they start slow and gradually build to full out attacks.  This means driving hadn’t been dangerous for me.  Now I didn’t know what to expect.  After talking to my doctor I tried an oral dose of Prednisone instead.  It consisted of starting with a very high dosage for a few days, then a medium dosage for a few days, then a low dosage for a few days.  The first few days were rough.  The higher dosage basically put me out of commission for a week.  I felt groggy, light-headed, and had some vertigo and lack of appetite.  That slowly faded away.  After the full regimen my vertigo attacks started becoming less and less frequent and severe.  I think that the Prednisone helped.  I also hope I never need it again.


There have days when I have found myself in the middle of yet another horrible, repeating attack, and I was ready to go into surgery and have the nerve from my left ear severed and be done with it.  Prayer, faith and an understanding of God’s plan were the only thing that got me through it.  Meniere’s Syndrome has caused me to make diet and lifestyle changes that few could make.  I know people who are overweight, have diabetes, blown knees, and can only get around in a wheelchair and they still won’t kick the junk food and pop.  I have been able to give all that up and more.  Meniere’s is a pretty serious motivator.

For breakfast, I have found that having a meal replacement shake is a great way to start out my day. I use the Garden of Life meal replacement shake, Vanilla or Lightly Sweet. Both are both good. I find them cheapest on eBay. I put in lots of different frozen fruits: peaches, apricot, pineapple, mango, strawberries, wild blueberries, mixed berries from Costco and a fresh banana. I also add 1/2 tsp beet juice powder and a handful of raw spinach and a couple of leaves of kale from the garden. I eat a lot of green salads with lots of different vegetables added and make a vinaigrette without salt. I've learned to cooked and eat vegetables with just a dash of salt. It is Nov 2017 and I have gone a year now without having a vertigo attack by eating a clean diet. 

No comments:

Post a Comment