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Meniere's Disease Snippet

From Audio: Meniere's Disease

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about 35 years ago, when British businessman James Wrath was 24 he noticed his hearing starting to fade in his left ear. It took probably 3 to 4 years for the hearing to be lost completely, But it happened gradually and because it happened gradually, I was able to adjust. Today Wrath is an author as well as a successful consultant whose new book is called Love Mondays. But he had a few bumps on the way when he was 50. What he experienced decades earlier in his left ear attacked his right one. But this time it was much worse. When I lost the hearing in my right ear, it happened literally overnight. It was absolutely catastrophic to me. It was accompanied by some really terrible symptoms. Regular vertigo attacks, which leaves you completely bedridden. I mean, the entire world around you is literally spinning so that you're unable to stand upright. And then with that, you feel terribly, terribly ill on a constant tinnitus in the ears. It really puts you down very badly. It took wrath years to get a hearing, a powerful enough to allow him to function with less than 10% of his hearing in one ear, and he was plagued with attacks of vertigo that came without warning. You really have to write it out. Sometimes the voting of symptoms stay for a few minutes, but I've had them for hours on end. I've had them for 567 hours, and so that you have no other option but to get on to bed and simply lie there and not move. And you just have to write it up. Really? So I'm always weary. I mean, I've had one, for example, a massive vertigo attack right in the middle of a bank. I was talking to a banker, and it just hit me. You vomit because your world is spinning. It's just terrible. The poor customers and the bank thought I was drunk. What wrath really had is Meniere's disease. 10 years disease is commonly diagnosed but is actually quite uncommon. That's Dr David Friedland, professor and vice chair of otolaryngology and communication sciences at the Medical College of Wisconsin. Many primary care physicians have heard of many years disease as a disorder, causing dizziness and associate ID with tinnitus. Tinnitus is a ringing in the ear and years disease has those features. But there are about 50 million people in this country with tinnitus, and there are probably in almost equal amount to experience vertigo or dizziness on some occasions. But just because a person has both of those does not mean they have many years disease. There are many, many other disorders that are much more common that can cause one or both of those symptoms, Freedland says. Many years, disease is a disorder of the inner ear and would be treated completely differently than any of the diseases that it may be mistaken for. So the inner ear has two different chambers containing two different important types of fluid. They're important for the function of both the balance and the auditory system. The inner compartment of that is regulated by a sac called the end of lymphatic sack. We're not really sure if the disorder in mine ears disease is that the end of lymphatic sack produces too much fluid, or that the end of lymphatic sacs fails to absorb enough fluid. In either case, what happens is that center compartment off the inner ear builds up fluid pressure. When the pressure gets high enough, the delicate membrane separating one chamber from another will rupture, and the fluids will mix. And that typically causes an acute attack of vertigo and causes. An acute drop in hearing the vertigo and hearing loss of Meniere's disease occur episodically and attacks. Often occurring clusters then suffers, maybe completely normal for months at a time. Experts believe each attack ends when the membrane between the two chambers of the ear repairs itself within a few hours. After that occurs, typically, the vertigo attack will be over, and the drop in hearing may or may not improve. But the sudden episode will be done over time. Having this occur within the delicate in her ear repeatedly causes damage. So whereas in the early stages people may recover up to a normal baseline with time. Ultimately, this is going to cause damage, and there may be ultimately a progressive loss of hearing and a progressive weakness in the balance system. This is kind of like taking two steps forward and three steps back. You ultimately keep going backwards. Meniere's disease often attacks on Lee one era a time, but as was the case with James Wrath, people who have had it in one ear are at a higher risk of later having it in the other, Freedland says. Allergies sometimes appear to be a trigger, so allergy medication Zahra Common Treatment to start ah, low salt diet and water pills may also help. The inner ear, for interesting reasons, functions almost like the kidney, so things that work on the kidney or a healthy for the kidney can affect the inner ear. So low salt tends to reduce the fluid pressure build up within the inner ear. And the use of a water pill, which is typically used for high blood pressure, can also reduce the fluid pressure within the interior. If those treatments don't work, Friedland says, there are other ways to alter the fluid imbalance and correct the malfunctioning balance system. Surgery can create more room for the sack of the inner ear to expand, reducing the pressure inside, or doctors can install a shunt to drain excess fluid. Those procedures often correct. Hearing loss is well, Ah, second approach is called a blade of therapy. The oblate of methods actually take away the balance function in the ear, so we're kind of killing off the balance self within the inner ear. The goal there is that if the fluid fluctuates within the in their ear, there is no balance system for it to stimulate, and therefore people can't get vertigo, so it doesn't actually changed into these process. It changes the balance system so that it can't be stimulated by the disorder. One of the ways we can do that is with medication called gentamicin. Gentamicin is an antibiotic that is toxic to the balance part of the inner ear. In the clinic, we can inject gentle mizzen behind the ear drum and let it sit there for about 30 minutes. It then soaks into the inner ear, and within about a week it could kill off most of the balance system. That is a very, very effective means of treating many years disease. Because patients typically don't get vertigo after the balance system has been killed off in that manner, surgeons can also cut the nerve to the balance system in one ear. But Friedland admits killing off the balance system has to be considered with caution. There are certain precautions and certain things we want to make sure of. One of those is that we're not dealing with bilateral disease. If we kill the balance system in one ear, the other ear can accommodate for 95% of that function, So most people can actually do quite well if we knock off the balance system in one ear. But if they development years disease in the other ear and it's the Onley, useful ear treatment becomes much more difficult. So a blade of therapies need to be couched in terms of what is the function of the other ear, and is the person going to development years disease in that year? I am much more cautious with a blade of therapies in a very young patient, because I don't know what's gonna happen to the other ear in the next 40 50 or 60 years. Those treatments may seem drastic, but Friedland says vertigo could be completely disabling. If all treatments are considered. He says, Meniere's disease can be successfully treated in almost
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