How to Manage Meniere’s Disease

By Brian Robinson.

Vertigo is not a condition in itself: it is the reaction to a condition in our inner ear.

Rather than ask is it possible to manage Meniere’s Disease, it is probably better to ask is it possible to mismanage the condition. I believe the answer is yes.

Mistake number one, would be to stop taking your medication, perhaps because you think it’s not working. Betahistine is the recognised treatment for vertigo and has been for many years. According to a top UK consultant, medication can be used to control vertigo in about eighty percent of patients. Dosage is usually 8mg or 16 mg three times a day. However, this can be increased significantly if the lower dose proves ineffective. Betahistine can also be used alongside a diuretic. The aim of the diuretic would be to reduce water retention and so decrease the pressure in the inner ear.

Sufferers are often prescribed a medication to help with nausea but I didn’t find this helpful, and besides, unlike Betahistine, it is not a medication that can be taken for more than a couple of weeks. Peppermint worked far better in easing the nausea and in my case it shortened the vomiting on more than one occasion. Buccastem M tablets are sometimes prescribed to help with vomiting. These are inserted behind the upper lip on the gum and dissolve slowly and so cannot be vomited up. I have never used these myself but have been told by a top consultant that they can be effective.

It should be said though, that all medications have side effects and this should be a consideration especially when thinking about increasing dosage. For example, Betahistine can cause gastritis and increasing the dose may cause problems in the stomach. Equally, a diuretic can reduce sodium levels so this should be monitored carefully. As an older person, both increasing the dose of the Betahistine and the use of a diuretic were ruled out.

Mistake number two, would be not getting to bed soon enough when experiencing an attack of vertigo. In my case, vertigo could involve a bowel-emptying reflex as well as a vomit reflex. This often led to a natural reluctance to leave the bathroom. However, once you feel you have more or less emptied out from both ends, it is best to get back to bed even though you may find this difficult. Vertigo only subsides when you are laying down in a quiet place with your head held perfectly still. That’s what your brain wants you to do and that’s the central idea behind vertigo.

Mistake number three, would be not to control your salt intake. It is a well known fact that too much salt in your diet exacerbates Meniere’s Disease. Reducing salt intake to around one and a half grams per day seems to be the ideal suggested by the medics. I found myself comfort eating salted peanuts and crisps and paid a heavy price for doing so.

Mistake number four, would be not to control your intake of refined sugars. Again, it is widely accepted that eating too much refined sugars is bad for our health and I found that this definitely made matters worse.

Mistake number five, would be not trying to control any allergies you may have. There is a strong theory that Meniere’s Disease is actually caused by allergies, although the wider view is that the cause is unknown. However, it is know that allergic reactions commonly occur in the nose and throat and it may well be that these reactions bring about adverse conditions in the inner ear. After all, ear, nose and throat are all connected.

Mistake number six, would be not to control your intake of caffeine. This is present not only in tea and coffee, but also in fizzy drinks and chocolate. Caffeine is a stimulant and will amplify the symptoms of Meniere’s.

Mistake number seven, would be not to control your intake of alcohol. The brain becomes confused enough as it is by messages sent from the inner ear without confusing it more with alcohol. Too much alcohol can make you feel dizzy and sick so it makes perfect sense to avoid it.

Mistake number eight, would be to ignore your vertigo triggers especially when in a state of relapse. Triggers vary from person-to-person but there are a few standard ones. The TV was a big one for me. Camera techniques that misrepresent how things work in the real world have become more and more a feature of our viewing. With Meniere’s, our brain is trying to switch to using visual data to work out where we are in the world, rather than using the confusing data sent from our damaged ear. It is no wonder then that our brain freaks-out when watching TV. Too much head movement was another major trigger for me. And besides that, my brain didn’t feel comfortable in the dark, especially when the darkness came unexpectedly, like when you turn off a light for example.

Mistake number nine, would be not managing stress. Stress is a known trigger for vertigo. There is a stress management guide on the internet called the ‘Four As’. This contains some good advice on how to become more relaxed and avoid stress. However, avoiding stress can be tricky because the vertigo itself can cause us to become stressed. The best way to become more relaxed about vertigo is to have a management or treatment plan which holds out hope for the future. The other positive, is that the last stage of Meniere’s Disease tends to involve less vertigo. And remember, it is a known fact that Meniere’s Disease does eventually burn out. We can be sure about that.

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