Meniere disease is a diagnostic term that is given after prolonged medical evaluation and follow up tests.
There is a common fear of ENT specialist and the patient: both consider the diagnosis of Meniere Disease as a pessimistic message.
I do not hesitate to discuss this possibility directly with my patients because I am convinced that in most of the patients with Meniere Disease there is cure.
My data include 3 sources: (1) Statistical analysis of reduction in the symptoms in Israeli soldiers. (2) Statistical analysis of reduction in the symptoms in patients who were treated in the out-patient clinic of "Hadassah Hospital". (3) Follow up of my patients.
Here you can read more about my medical approach.
Most of the sufferers of Meniere disease are coming for treatment in order to be cured from their vertigo or dizziness.
When I start the treatment and the patient have both vertigo and tinnitus, the vertigo responds to the treatment long time before the tinnitus.
The tinnitus is also a very annoying symptoms, but it does not include a fear of falling, nausea or vomiting. A tinnitus patient can go out of his home by himself.
Many of the tinnitus patients complain of having severe hyperacusis (sensitivity to loud noises) and the noises in the street of a town are very irritating for them.
When the disease is starting, there are patients who experience symptoms in the equilibrium system. If the tinnitus is the dominant symptom, the sufferers complain of attacks of continuous sound, that is a "subjective tinnitus".
A combination of increased volume of a subjective tinnitus together with significant hearing loss is a common complaint.
The hearing loss is indication for referral to the Emergency Department of a hospital. For a new patient with hearing loss, admission and complete workup should be performed together with attempts to treat the hearing loss. The management is dependent on the underlying theory regarding the hearing loss.
When the treatment is directed to possible infection or inflammation, the main medication is steroids. In a case of suspected ischemia or ineffective circulation, anti coagulants and intravenous plasma expanders are used.
There are attempts to use a Hyper-baric-chamber. The theory sounds good, but it is still experimental.
If the tinnitus is mainly a pulsating sound, it is not part of Meniere Disease.
The specialist of Ear Nose and Throat should decide what is the source of the tinnitus:
(1) Turbulent blood flow near the auditory system. Irregularity of the internal part of an artery due to cholesterol plaques or vascular malformations can be the origin of the tinnitus.
(2) Abnormal contraction of muscle close to the middle ear or inner ear, such as Platal Myoclonus.
Sensation of plugged ears (or fullness in the ears) can happen at any stage of the disease. This symptom may come and go away. It can be uni-lateral (one ear) or bi-lateral (two ears).
Hearing loss may fluctuate and be asymmetric. The side with the tinnitus and the "plugged ear" is more susceptible to the hearing loss.
"Fullness in the ears" may occur in other medical conditions such as Infectious Otitis Media, Serous Otitis Media, Fluids in the middle ear, Dysfunction of the Eustachian tube and Baro-trauma.
Although Dr. Prosper Meniere did not include the emotional part of the disease in his basic criteria for establishing the diagnosis, this part of Meniere disease is known as an essential part for completing the diagnosis.
A Comprehensive Medical Approach should include a good management of the biological and the psychological aspect of the disease.
Anxiety, depression, irritability, inability to enjoy hobbies, restriction of social activity and divorce are common symptoms of the emotional aspect. Many patients are telling about suicidal thoughts, but scientific data about the rate of suicidal acts can not be found.
Mrs Shalev Shoshana suffered from tinnitus (without vertigo or plugged ears) and was cured.
Later she was diagnosed as a Breast Cancer patient and underwent surgery radiotherapy and chemotherapy.
In her video she say that the recurrence of her tinnitus is "more frightening" than the relapse of the Breast Cancer.
The time table for cure is unpredictable. Who are the patients with the highest probability to be cured? It is also unknown.
What I can say about patients that were cured is that they had high motivation that remained even after all their symptoms disappeared. There are patients like Mr. Donohue Tim who responded to the treatment after one month, but this is a rare event (about 5%).
The last part of the treatment: the decision of discontinuation of the treatment after you are cured, is the hardest part of the treatment process.
Mrs. Halio Rivka came to my clinic in the days that the metabolic approach was a new concept. In order to avoid mistakes we consulted the top experts in the specific field of metabolism that was relevant to her medical problem.
She was a very cooperative patient, but the fact that it was a new field of medicine was responsible to the delay in her recovery. Today she feels good, and is very happy with the results of her treatment. her story is very typical to Meniere Disease patient.
Other patients are: Dr. Arie Yagoda, Mr. Van Romondt Mark, Mr. Cohen Yacov, Mrs. Shachar Lidia and Mrs. Anatt Cohen.