September 16, 2008
Dizziness and Ear-Ringing Point to Meniere’s
DEAR DR. DONOHUE: I would like information on Meniere's disease. What caused it to happen to me? Is there a cure for it? - V.C.
ANSWER: Meniere's (main-YAIRS) disease consists of a quartet of symptoms: fluctuating deafness, dizziness, tinnitus (ear noises, like ringing) and ear fullness. All of them need not be present at the same time, and they occur in episodes. The times between episodes are free of symptoms. However, with the passage of time, the symptom-free periods become shorter, and the times with symptoms become longer and longer, until they're present all the time.
The cause is an accumulation of fluid in the inner ear, but no one knows for sure why that happens. Infections, head trauma and a misfiring immune system are possible reasons, but to most Meniere's patients, none of these applies.
Treatments in your grasp include a low-salt diet - a very, very low-salt diet. Water pills can remove the fluid from the inner ear. Meclizine is a dizziness medicine that helps some, and there are nausea medicines for the nausea that often comes with dizziness.
If medicines don't bring relief and if symptoms are intolerable, injections of the antibiotic gentamicin directly into the ear can abolish symptoms. A shunt can be placed in the inner ear that drains liquid from it. The nerve involved with dizziness can be cut, which ends that aspect Meniere's.
The Meniett device, not universally endorsed by all, generates low pressure waves that push fluid out of the inner ear. A doctor first has to insert a tube in the eardrum so the waves can travel to the inner ear.
I haven't included all possible treatments, but an ear, nose and throat doctor can suggest the one best suited to your needs.
DEAR DR. DONOHUE: My 37-year-old daughter has Addison's disease. Many doctors saw her when she was hospitalized a year ago. She had to go back to the hospital because of stomach upset, back pain and dehydration. Her skin has darkened. She was told she would be fine after she started steroids. This hasn't happened. She is constantly sick. Do you have any good news? - L.K.
ANSWER: With Addison's disease, the adrenal glands have stopped producing their many hormones. Those hormones include cortisone and aldosterone. Cortisone gives us energy, combats inflammation and figures into many of the body's most important functions. Aldosterone is essential for blood pressure maintenance. Without adrenal gland hormones, the skin darkens, especially the elbow skin and the creases in the hands.
Treatment is straightforward: Replace the missing hormones. Maybe the dosage of her hormone medicines needs revision. If she's hasn't shortly turned the corner, she should get a second opinion from an endocrinologist, a specialist in this kind of illness.
Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853- 6475. Readers may also order health newsletters from www.rbmamall.com. DEAR DR. DONOHUE: Why are people becoming such germophobes? When I go to the grocery store, there are disinfecting wipes to use on your cart. Why? Because someone has touched it before you? Come on. As a kid, we actually played outside. We rode bikes, climbed trees, played ball, went hiking in the woods and, when we went home for lunch, we just grabbed a sandwich and took it outside to eat. My house is clean, but I don't run around disinfecting everything. - N.C.
ANSWER: You have a point. People can get carried away in an attempt to live in a germ-free cocoon. Exposure to germs keeps the immune system healthy and acts like a vaccination for many of the common bacteria and viruses found in the environment. We are stronger than we give ourselves credit for.
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