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2008-07-28 12:02 PM
in reply to: #1245178

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Subject: RE: Vestibulitis/Mastoiditis/Veritgo

Damn, I can't believe you're still having to deal with this.

I had a massive episode of vertigo on the swim at IMAZ and had to be pulled from the water a mile in puking my guts out.  MRI, neuro, all the workup, no real cause although the neuro thinks (in my layman's terms) it was an imbalance in the inner ear system between two membranes, one mostly sodium and one mostly potassium, and I had been taking salt tabs before the race to deal with heat - stupid move - thought was it increased my sodium levels and threw the system out of whack, then add some cool-ish water and the swimming motion.  blammo

took abut 6 weeks to fully resolve.

I hope you find your answers.



2008-07-28 1:50 PM
in reply to: #1563064

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Master
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Subject: RE: Vestibulitis/Mastoiditis/Veritgo
exnavydoc - 2008-07-27 8:07 PM

Sounds like Menieres disease to me. Sorry.


Nope, not for me at least. I wish it was, I could deal with that, as that is fairly easy to treat.
2008-07-28 3:09 PM
in reply to: #1564047

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Champion
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Subject: RE: Vestibulitis/Mastoiditis/Veritgo
exnavydoc - 2008-07-28 11:13 AM

Sorry about the diagnosis. A quick mind dump on Menieres:
Presumed etiology is faulty sodium metabolism in the inner ear system. Water follows sodium in the body. So if sodium levels build up in the endolymph (innermost) ear fluid component, water follows. The compartment swells (pain, fullness in the ear, increased ringing), eventually rupturing the membrane between the inner and outer (perilymph) fluid compartments. These two fluids are toxic to each other and mixing results in the symptoms (acute hearing loss, vertigo). As the membranes are repaired, the vertigo settles and hearing may improve although not back to the initial state. Steroids may help reduce the inflammation of the acute episode and mitigate the symptoms. I tell my patients Menieres is a disease of "70s" and "50s".
70s means the 70percent of people get spontaneous remission at any stage of the treatment algorithm. Treatment starts with the acute phase as you describe, the for long term treatment 70% respond to menieres diet (no added salt). Of the failures, 70% respond to Dyazide or aldactone (jump start body sodium metabolism). Of the failures 70% respond to ablative procedures late in the disease course. Treatment is of course aimed at minimizing disability due to disequilibrium.
50s means the end game is a 50 dB hearing loss, and a 50% loss of word understanding when the disease reaches "burn out". Also, 50% of the time it will affect the second ear.
So you can see, fluid and electrolyte management is all about exacerbations of menieres. Unfortunately I'm not an exercise phys guy so I can't help you with your own optimization.
BTW, your ENT should have told you all the above, or at least directed to web based resources. If my doctor didn't talk much to me, I would be looking for another doctor. Just my opinion.

Hope that helps.


Thanks for the write up; it does help. I have s#it to pick from for local docs. I might take the drive to Lebanon and see your guy at Dartmouth. At least I'll look a bit and get some other advice. I hate the "here's your pills, now go away treatment". I'm a pharmaceutical scientist by trade and want a good understanding of the biology of what's going on. Some docs love this (cool to have an educated patient), some hate it (This guy's a wize-a$$).

You're scaring me a bit w/ the hearing prognosis. I was upset when I failed some of the word recognition in my left ear; I knew she had said something, but it could have been any word. The right was perfect. She said I missed one, but knew I passed on at least 4 words. My upper frequency range has fallen off by 15% since 2002 and 30% total since 1995. My bass response was poor as well, bnut she said that's likely due to this current episode raging right now and it'll be OK once I feel better.

I have the worst luck w/ docs lately. The only time I get decent treatment, it's from Yale-New Haven. Going to look there now...
2008-08-02 3:20 PM
in reply to: #1245178

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Subject: RE: Vestibulitis/Mastoiditis/Veritgo
Well, I'm back! After 9 days of diuretc, I finally feel OK again. "A" race season is next week and the layoff either killed me or refreshed me (Unfortunately, I think it didn't help at all). The OLY on Sunday 8/10 is going to be a laugher; Oh well. I'm able to swim and run w/o any issues. Haven't been on the bike, but I bet no issues.

The vertigo has subsided and the inner ear pressure is at least manageable. I'm minding the hydration, reducing the sodium and upping the potassium. Hopefully I can keep it at bay.
2009-02-15 2:29 AM
in reply to: #1578074

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Master
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Subject: RE: Vestibulitis/Mastoiditis/Veritgo
To all who are reading this, yes, I'm back this year. My worked with my neurologist to get a referral to the Cleveland Clinic. Great Doctors, Great Facility, Great People there, I have nothing bad to say about my experiences, and the cool part, they paid for it under a "scolarship" from the Cleveland Clinic Foundation. The doctor somewhat has released me to do what I feel I can tolerate, and I joined LA Fitness during the winter - spin Nazis, nice treadmills and weights, and close to my home and close to where I was working. It's not too hard to ride the 25 odd miles to the local LA Fitness and shower before work, and head the last 2 miles to work all nice and not stinky. I still have lots of recovery still to do. I can not ride a 2 wheel bike yet, or balance enough to do some of the yoga I used to do. I have plans for Steelhead. That's the goal. I'm working through physical therapy, using a Wii Fit (believe it or not, this is an incredible training and balance tool), balance boards and balance balls.

Prognosis for everything: Shingles on my brain damaged nerves 7 & 8 on right side. I have about 20% hearing on the right, so nobody yell "On your right", or I may just crash into them.

Additionally, from my cervical fusion the year before, my occipital nerve has lots of scar tissue and stuff causing issues. The muscles in my neck & head were having seizures, and strangling the nerves. Depcote & large dose of magnesium had made things more tolerable, enough for me to go back to work for 4 weeks before they decided to terminate my employment for absenses due to my scheduled depcote infusion treatments that my employers were aware of. I'm legally disabled now, and am in a protected class. Can we say EOCC ADA Title I. Anyone have experience with this?

So for now, I'm out of a job - Anyone know of a IT job in the Indianapolis area? I can do just about anything, and have been in IT since 1991. I just need to have 3 days per month to travel to the Cleveland Clinic for my treatments.
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