My grandmother complained of 'giddiness.' She would lie down, apply compresses of good old-fashioned bayrum, and be good to go in a very short space of time. Since a doctor was never consulted for her giddiness/dizziness, it was labelled 'old age.' One thing of which I am now certain after having spoken to an Ear Nose and Throat Specialist and two women who suffer from the debilitating disease called 'Meniere's' for which the main symptom is dizziness, is that my grandmother's attacks were not Meniere's.
Eighty year old B started hearing some strange noises in her ear, and was referred to an Ear Nose and Throat specialist, where she discovered that so far they have not been able to find out what brings it on nor is there any cure for it. "In short one has to live with it so I keep away from loud noises, like the steelband; and because of an imbalance I make sure and put my hands to the wall when walking down stairs." At times B forgets she is suffering from Meniere's and wonders why she has awakened feeling nauseous.
The good part is that "it goes as it comes" says B. "There are times when there are terrific noises in my ear and I will forget and put my hand to keep out the noises, anyone sitting or standing next to me wouldn't know I am going through an episode. Sometimes it is like at the seaside- a calm sound, other times it could be terrific." When asked by a friend "does that thing still bother you" B replied "when I don't hear the noises, I miss them."
This sensible woman who has learned to keep away from noises, and uses ear muffs when travelling or at certain events, considers herself lucky as only twice since diagnosis five years ago has she experienced terrible dizziness "like if the whole house is falling in or you are on a roller-coaster." And while some patients get into bed, B keeps moving "I do what I have to do as if you really bother you would rather not go out."
The Ear Nose and Throat Specialist with whom I spoke confirms that there is no known cause for this debilitating disease described by a Frenchman, Prosper Meniere, in 1861 as paroxysmal episodes of vertigo associated with vomitting, fullness in the ear, changes of intensity and pitch of the noises in the ear and sometimes deafness.
"The problem" says my consultant "is with the Inner Ear (see diagram) which is encased in petrous bone (petrous means rock) which is the hardest bone in the body. The inner ear is like a tube within a tube, for example, like an inner tube in a tyre within an outer tube which is the tyre itself. In the inner tube, there is fluid which is continually produced and reabsorbed and this is called endolymph. Between the outer tube and the inner tube there is a different fluid called perilymph which is similarly produced."
"In Meniere's Disease, there is an increased amount of endolymph and so the pressure in that inner tube is increased. Why this occurs no one knows for sure but there are many different theories. Attacks of Menieres are thought by some to be caused when tiny areas of the membrane of the inner tube rupture. There are many different theories as to the cause of this problem."
There are no statistics for Trinidad and Tobago, but developed countries report just 15 new cases per 100,000 every year, with a prevalence of about 200 per 100,000. Also in10 to 20% of the patients there is a family history of this disease. Some people may get advanced symptoms. Treatment could be medical or surgical, however in 60 to 80% of the cases it may just go away.
Medical treatment includes medications, such as, antihistamines which help to alleviate the vertigo which may last from half an hour to twelve hours. Other treatment includes medications to increase the blood flow to the inner ear, and diuretics. Investigation of any obvious triggers, and lifestyle changes, such as, alleviation of stress and decreased salt intake, are also suggested. Surgical methods of treatment range from as simple as placing a tube in the ear drum to radical inner ear surgery.
Greta, the other Meniere's patient, has had surgery done in London. After experiencing the disease "for donkey's years. The room used to go around horizontally and then it started to go vertically" which says Greta "was worse as I would fall on things. Eventually I had an endolymphatic sac drainage operation, when they inserted a capillary drainage tube into the tip of the mastoid buried in a special kind of sponge, through cutting the back of my ear in the crease. And that is how I have gotten back my life with my tube and sponge in there since 1982." Where does the excess fluid go when the sponge is saturated? "It drains out into your body, my doctor said. But I could drive again.
For three years I couldn't drive with the vertical dizziness, even sitting in the car I would fall on them, I just couldn't be left on my own." The one thing that my Consultant/Specialist is very definite about is that "no treatment cures Meniere's but variable amounts of relief of symptoms may be gained. Also that there are many different causes of vertigo including other diseases of the outer, middle and inner ears, head and neck pathology, and anemia. These must be ruled out before a diagnosis of Meniere's is made."
"In summary, Meniere's is a disease of increased pressure in the inner ear, the cause of which is unknown. There is no cure but treatment is available for relief of symptoms. Research is ongoing in this area and eventually the cause and cure will be found."