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Ear Pressure and Meniere's Disease
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sadeargirl posted:
In December, I had a terrible sinus cold. I did not go to the doctor for it, as I usually wait them out and treat them at home without complications. I experienced ear pressure more severely than I had before, but assumed it would go away after the cold was finished. In January, I was put on Prednesone due to ear congestion and pain even though my doctor said my ears looked good from the outside. The pain went away, however, the pressure got worse and I felt I was unable to hear as well. In February, I went to a new doctor who put me on an antibiotic and Flonase. In March, I returned to the same doctor, got a different antibiotic, had an x-ray which he said showed severe sinus congestion (even though I was not experiencing any cold symptoms/sinus pain), gave me a different antibiotic and referred me to a specialist. In between this appointment and going to the specialist, I was put on two different antibiotics for a cat bite and a proceedure I had done. From January - May I experienced severe ear pressure that would come and go, remain constant for days at a time, and move from ear to ear. Ear candles provided some relief but only when the pressure was very severe. I definitely was not hearing well when the pressure was severe.I finally saw an ENT in late May who did not do any x-rays, did non-invasive tests of some sort with various small tools that were touched to my teeth, nose, and ears, and came to the conclusion that my ear pressure could be caused either by me taking Fastin (Phentermine) or it was Meniere's Disease. I hadn't started taking Fastin until late February, but the ENT said it could have been a coincidence that I happened to have an ear infection prior to that. He also put me on a low sodium diet in case it is Meniere's Disease. I have been off Fastin for one week, and my ear pressure is exactly the same (off and on, switching which ear is more severe). I have not started a low sodium diet because I want to see if Fastin is the culprit before I add another factor. I can not find any indications of Fastin causing this side effect online. I also feel that the doctor skipped ahead to Meniere's Disease without doing much testing for anything less serious. Any suggestions????? Not only is the ear pressure/hearing loss driving me crazy, but now I am anxious that I have Meniere's Disease. In between doctor's visits, I did try OTC ear drops, decongestants, nasals sprays, ear candles, and different methods of "popping" ears naturally (steam, heat, with fingers). I am seeing an allergy specialist next week because I'm not happy with my ENT (I will be driving at least 1 1/2 hours to see someone else) and I thought he could have some insight. Any ideas?
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sadeargirl responded:
How did I forget one of the most important parts of my saga??? For the past month, I have also had terrible vertigo, especially when I am driving. It only occurs when my ear congestion is severe, and may last for most of the day. I can control it at times with Dramamine but I have found that .5mg Ativan takes the dizziness away completely (and my ENT confirmed it can be used for dizziness).
 
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Rod Moser, PA, PhD responded:
M?ni?re's disease affects over 2 million people in the United States. It is most frequently seen in adults 20 to 60 years of age with no gender predilection.

M?ni?re's disease is a medical condition of the inner ear characterized by episodes of debilitating vertigo (dizziness), tinnitus (ringing in the ears), and intermittent (and often progressive) hearing loss — often referred to as the "triad of symptoms". Many patients may complain of a sensation of "fullness" in the affected ear, and nausea and vomiting are also quite common. Usually these symptoms appear together, although it is not uncommon for ringing or hearing loss to precede the onset of dizziness.

Because the problems is in the inner ear, things like ear drops, antibiotics, nasal sprays, and ear candles are absolutely worthless. Of course, in my opinion, ear candles are always worthless for any ear problem and should never be used. Things like "popping the ears" are for middle ear problems, so this would also not help the fullness from an inner ear disorder.

The onset of vertigo is usually sudden (called "attacks") and often disabling. M?ni?re's disease attacks, while unpredictable, are usually short-lived and self-limiting. The vertigo may last minutes or hours but rarely lasts longer than 24 to 48 hours. Persistent vertigo lasting longer than this suggests a diagnosis other than M?ni?re's disease. Patients frequently are well between attacks.

You have some, not all, of the symptoms of Menieres. This is called atypical Menieres. The diagnosis is made clinically -- based on examination findings and a few office tests. There are no other special tests to make the diagnosis.

I have no way of diagnosing you over the Internet based on symptoms alone, so if you feel a second opinion to prove or disprove the Menieres diagnosis, than that 1.5 hour drive may be worth it.
 
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sadeargirl replied to Rod Moser, PA, PhD's response:
I wanted to give an update in case anyone else is having similar problems. I went to my allergy specialist, and he feels my problems could possibly be allergy related. I CLEANED my house from top to bottom, vacuumed out the ducts, the whole works! I started having less pressure in my ears, but it has gone back and forth before. My allergy doctor put me on Q-Nasal, and has a few back up plans/tests if this doesn't get rid of it. It has been over a week since I started going in the allergy direction, and I feel the best I have since December! Obviously, this won't apply to everyone, but don't rule allergies out!!!!
 
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mayacoleman replied to sadeargirl's response:
Hi-
I'd add that it's important not to rule out food sensitivities/intolerances either. Apparently a subset of people with Meniere's symptoms (between 8-16%) have an underlying autoimmune issue, and in my case I was having a systemic immune response to certain elements of my diet. I have cleared up all of my Meniere's symptoms (along with a long list of other physical symptoms, including persistent congestion and upper respiratory infections) by basically going on a "paleo" diet. I have more information on my website www.managemenieres.com about what that kind of diet looks like if you're interested. I'm glad to hear things are moving in the right direction with your allergy specialist!
-Maya
 
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sadeargirl replied to mayacoleman's response:
Hi! Thank you for the input and I will look into the paleo diet. I truly do not believe I have Meniere's. I have read over and over that the only way to diagnose Meniere's is to rule everything else out, and my ENT did not rule anything out. I am still feeling great on the new nasal spray and treating it as allergies, and it has been almost one month now. This is the longest I have gone without ear pressure. I'm not sure why my ENT chose not to run any tests, take an x-ray, CT scan, scope in the nose...something! I know of several other people who suffered from similar symptoms, and their ENT was much more thorough with testing. If I continue to do well with the nasal spray, my allergy doctor wants to do extensive allergy testing to find out what the allergen is. I am more than happy to do any testing he feels is necessary. I agree it could be a food sensitivity/allergy, and will definitely let him know I would like to look into that along with other allergy possibilities. Thanks again!
 
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Rod Moser, PA, PhD replied to sadeargirl's response:
The Menieres diagnosis is in question, especially if you seem to be favorably responding to allergy management. There are very few diagnostic tests for Menieres, and nothing that would be definitive. Menieres is a "clinical diagnosis" - based on signs and symptoms, not something ath a lab test or CT would show.

I am pleased that you are better....
 
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GBonnough50 replied to Rod Moser, PA, PhD's response:
I have wondered about some of the same things myself. I developed vertigo, imbalance, dizziness, ear pressure and pain starting last fall. It has gotten better at times, but never completely went away. I have had Z-paks, IV Rocephin, IV Ancef, Augmentin several times, different nosespray and nothing seems to get rid of it. It even turned into a full-blown infection over the summer. I have had inner workup, which did show some weakness on the side that was hurting so bad and is still giving me issues. I have tried Qnasl the last couple days as well. I feel that some of my issues my also be allergy, both to food and inhalants. I know our duct work smells both when the heater kicks on and during the summer when the air was running. I have tried to have some allergy testing, but no luck with it and I do not feel that it was very reliable since every single test showed no reaction and I know I react to many, many things, especially dust and mold, so this makes absolutely no sense to me. I also have sensitivities to foods. I wish there was a way to figure this out and I wish I had the money to do what might help with air cleaners, duct cleaning, etc. I am supposed to go over to Cleveland Clinic to see several specialists as this all developed to this severity after a reactivation of Epstein Barr last year and then a severe reaction to vaccinations, both Prevnar13 and Flu vaccine. I have been in and out of the hospital 4 times and my doctors here are still not coming up with anything other than having some inner ear issues and slightly positive tilt table and maybe dysautonomia. I feel something is driving all this and like the posters above, I feel like a lot of mine started with the EBV and vaccines, but also that or something has totally set off my allergic reaction to something and I feel like I may be reacting to something rather severely. Unfortunately when I was in the hospital it didn't fix anything because I had the infection in my ear going on and I was eating foods that I am sensitive too. This has been a nightmare with sore throats, itching down in the throat and ear, plugging, vertigo, dysequilibrium, sinus pressure, diarrhea, palpitations,etc. I honestly don't know what to do anymore. I also have lost about 25 pounds and my TSH is low. I'm totally overwhelmed by the whole situation and sick of being like this. Any ideas would be appreciated, but I'm just not having any success in fixing this. I have had times throughout the day or days here and there where I have felt a little better and my equilibrium has been better. I am about to lose my marbles over this whole thing and just want it to go away. I have numerous things going on unfortunately.
 
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Rod Moser, PA, PhD replied to GBonnough50's response:
Yes, you do have numerous health issues. All this does is make your case more complicated for your medical providers. It can be extrememly diffucult to pinpoint the one (or more) causes for something a non-specific as vertigo. It can originate in the inner ear, but it can be centered in the brain as well. Imaging studies do well in telling your provider what you DON'T have (tumors and such), but it is uncommon for the studies to actually find a cause (or causes).

These things are very frustrating to the patient (you) but also frustrating to your medical providers who would really like to "cure" you. Many will just throw in the towel or refer you to someone else because they can't help. My only suggestion for you is to not give up. Find an medical provider who is willing to "go the distance" with you until this issue has been thoroughly evaluated, and to try varioius treatment modalities to see what may work for you. Every person is so different, it would be difficult to make any comparsions with others who have the same symptoms.


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