Your Consideration Please...

I'm not grumpy. I'm not irritated.

Well, okay, clearly I am, but it's NOT because of you.

Well, okay, it is because of you, but I know you're not trying to irritate me.

I've got a little sumpin-sumpin called Ménière's Disease compounded with hyperacusis.

***go to new discoveries / experiences***

Ménière's Disease is a problem of the inner ear. In short, the fluid sacks that "catch" sound stay filled with excess fluid. The primary consequences of the disease is life sounds weird. Much of the time, life sounds painful. Perhaps the worst part of Ménière's is trying to explain to people how the things they do cause you pain or gross discomfort. My complaints always sounds so self-centered. I really am sorry about that, but I don't know what else to do.

The hyperacusis condition is perhaps the worst of side of the diagnosis.  This condition comes from hearing loss.  Imagine five levels of sound labeled A thru E - A is the bottom low and / or quiet sounds.  E is the at top - high frequency and / or loud sounds.  A normal person can tolerate A thru D quite easily, E is painful, but you rarely experience noise at that level.  Hyperacusis happens when you yank out D.  E collapses down on top of C.  Most people can tolerate D with no problem, but because the way the ear works, your D sounds are now my E sounds.  This is called "tolerance collapse".  Virtually all sound is irritating.  Doing the dishes, for example, is excruciating.  (see right column).

I also suffer from nasty bouts of vertigo as well as constant ringing / buzzing in my ear (tinnitus). I also have hearing loss, especially in conditions with low, masking noise. For example, I love watching football on television. If the producers turn the crowd noise up too high, I can't hear much of what the announcers are saying. I can still see the cheerleaders so the game is not a total loss.

By contrast, I've got two bum knees. The right one was replaced when I was 49. At least with knee pain, I could do things to relieve it or get away from it. Ménière's / hyperacusis stays with me constantly. If I can manage symptoms and get away from the pain of percussive sounds, I still have the shrill screaming in my head and it's not my wife.

Percussive sounds are the worst. If you look at these images, you can begin to understand why. The stirrup is transmitting sounds from the ear drum to the membranous labyrinth which (for Ménière's suffers) is engorged with fluid. Imagine being underwater. Sounds rumble and persist. That's what Ménière's is like. Percussive sounds are the worst. They are painful and disorienting. They don't always have to be loud sounds. When my son taps the select button on his lap top it feels like someone is thumping directly on my ear. The sound of people walking on hardwood or tile floors is like getting slapped in the head with a pool noodle.

My doctor is generally very reluctant to diagnose Ménière's, but he made an exception in my case. When I described my symptoms and mentioned that my dad also had it (we think), he diagnosed it on my first visit - something he said he never does. I have the full gamut of symptoms.

Treatment. So far, the goal is to attack the fluid retention in the membranous labyrinth. The approach is two-fold: limit salt intake and enjoy a daily diuretic pill. The pill is easy. Take it. Limiting salt intake is more difficult. Doc suggests I eat less than 1500mg of salt daily. Check your Morton salt canister. Just one quarter teaspoon equals 590mg of salt! My entire daily intake of salt should be held to slightly more than a half teaspoon of salt. Think about that. One particular brand of flour tortilla has 900mg in one tortilla! Almost all soups are in the 1000mg range. Any time I eat out I am playing with dynamite. I enjoy cooking at home, but even that has been an adventure. Like Lemon Pepper spice on your grilled chicken? Careful, check your shaker. Most "lemon pepper" concoctions are mostly salt. And so it goes. Staying away from salt is a very challenging objective.

There are more aggressive treatments, but results are mixed and most of them result in some significant degree of hearing loss - like when they remove the inner ear. Yeah, that's aggressive.



My New Discoveries / Experiences

I'm looking forward to my next doctor's visit to discuss some new experiences I've been discovering.  (Before I go into detail about them, let me say I NOT a hypochondriac although Meniere's has driven me to the edge of wondering if everything is wrong with me.  I've had eight knee surgeries, a severely separated shoulder, a hernia, etc and not even my total knee replacement has affected me the way Meniere's does.)

Lately, I've been curious about Meniere's effect on my vision.  Meniere's affects a person's vestibular system / balance.  I've been aware for some time that Meniere's sufferers could not pass the physical portion of a law enforcement Field Sobriety Test even if I was stone cold sober.  The reason is simple - the body movement portions of the FST all assess a person's balance.  Since Meniere's directly attacks the vestibular system, tests of balance will all be failed forthwith.

One of the key FST components is the horizontal gaze nystagmus test.  That's where the cop tells the suspect to follow the pen with eyes only, not moving the head.  Nystagmus is the INVOLUNTARY jerking of the eyes (inability to smoothly follow Smokey's stupid pen).  (If you are some kind of freak and want a whole lot more detail on this, go to wiki1 and wiki2.  It's actually pretty interesting.) Basically, nystagmus is your eye's/brain's effort to stay balanced by freeze-framing on objects as your body moves - especially spins.  The problem is, if you are not moving, your eye should not jerk (nystagmus).  That's how Smokey knows you're drunk... unless you have Meniere's.  Then your eyes jerk a lot of the time for free, no beer required.  With Meniere's, your body thinks it's off-balance (spinning) a lot of the time anyway - that's why many of us have nystagmus.

Now, here's what I have noticed recently.  Not long ago, my gorgeous bride and I were eating dinner.  She was cool and relaxed and for some reason she was casually swinging her fork over her plate sort of like it was a clock pendulum.  I had to ask her to stop.  I wasn't sure why, but it was bugging the heck out of me.  Then I started noticing other vision events that I categorize as "picket-fencing" - any sort of repetitive visual stimuli - like a bright light behind a picket fence as you drive or walk past.  With my Meniere's-induced nystagmus, picket-fence stimuli (PFS) are quite unnerving.  Basically, PFS have a similar effect as tapping - it sets off my freak-out meter.

Anybody out there have similar experiences?  Send me a note.