MenieresInfo.com Blog

A reader asks:

I bought hearing aids six weeks ago and have since had three severe attacks of vertigo. I have never had attacks that strong in my 22 years of dealing with Meniere’s Disease. Can hearing aids trigger vertigo attacks and make them stronger than they were before the hearing aids?

You are really asking whether others have found that hearing aids trigger vertigo attacks, but we don’t think that matters.  It’s the nature of Meniere’s Disease and triggers that virtually anything will affect some patients and yet not affect others.  If something is a trigger for you, it’s a trigger for you, whether it’s a trigger for a million others or no one else.  We take it that you have eliminated, at least in your own mind, the slim yet real possibility that you are experiencing a progression that coincidentally occurred at the time that you obtained your hearing aids.

We recommend that you see your doctor and/or your credentialed audiologist (usually having a master’s degree) about this.  If your medical professional believes that the aids are the trigger, the professional may suggest adjustments that might be tried.  With digital hearing aids, adjustments may need to be programmed for you.  It might be that it is certain frequencies at certain volume levels that are triggering your attacks. Like most other trigger-related issues, one must engage in trial-and-error to figure out the trigger and then to narrow the circumstances under which one will experience the trigger effect.

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January 30, 2007 — A reader sends this information:  

“I am responding to the question regarding whether hearing aids can trigger vertigo attacks. I say YES! I have had profound hearing loss for 34 years, and then Meniere’s Disease for 7 years. My Meniere’s symptoms are relatively mild most of the time — moderate tinnitus and mild vertigo. However, I have learned that when I am in a noisy environment such as a sporting event, party, church with loud singing and music, etc. my dizziness and tinnitus get worse. If I turn my hearing aid off and shut off the sound, the dizziness immediately goes away, and the tinnitus takes a little longer to abate. So with me there is a huge correlation between loud noises and vertigo. I feel fortunate I can just ‘turn off’ the dizziness just by turning off the sound.”

The Journal of Rehabilitation Research and Development (JRRD), a publication of the U.S. Department of Veterans Affairs (VA), has published a special issue on hearing and hearing loss:  Volume 42, Number 4, Supplement 2, July/August 2005.  This issue is the “current issue” and was apparently published this week, despite the July/August 2005 date.

The issue contains a number of articles that will be of interest to Meniere’s Disease patients.  A press release authored by Judith LaVoie of the VA nicely describes the contents of the special issue and the significance of each article.  LaVoie has somewhat recharacterized the titles of some of the articles for the benefit of us lay folks, so use the page numbers rather than the titles to go from the press release to the actual journal article.

Here are a few articles that caught our particular interest:

• An article involving the diagnosis of noise-induced hearing loss, idiopathic sudden sensorineural (nerve-based) hearing loss, otosclerosis, and Meniere’s Disease — click here.
• An article involving hair cell regeneration, and whether restoration of hearing and balance might be possible — click here.
• An article reviewing the treatment of tinnitus — click here.

A reader asks:

I have severe hearing loss in one ear due to Meniere’s Disease. I was told I was ineligible for any kind of hearing aid due to the fact that my “speech discrimination” is so poor. What does that mean?

The principal reason that most hearing-impaired folks seek hearing aids is to help to understand what people are saying. The ability to hear a spoken word and to understand what it said is called “speech discrimination.” This is measured by word recognition scores — the percentage of words understood.

See Dr. Timothy Hain’s page on hearing testing — see the section on “speech audiometry.”

During word recognition testing, the spoken word is amplified to see whether hearing aids would be helpful.

Perhaps you are being told that your word recognition score is so poor that hearing aids would not help you to understand people’s speech any better. But you should ask your hearing professionals exactly what they mean.

Whether hearing aids are indicated is to some degree a value judgment. It seems to us that the patient should be provided with the information necessary to make the decision, but that the decision should be left up to the patient, especially when (as in most cases), the patient will do the paying.

Some patients would be delighted with a 5% improvement in word recognition. Others would say that it wouldn’t be worth the cost. Some patients have more money than others.

But even when word recognition isn’t improved, there can be benefits to hearing aids. Say that you live in a place where automobile drivers sit on the left side of the car, as in the U.S. and Canada. And say that you are very deaf in the right ear. Even if you couldn’t hear words any better, you might be able to hear the noise of traffic approaching on your right with a hearing aid. Or you might be better able to hear your baby crying in another room. Or you might benefit from a “crossover” hearing aid, where there would be a microphone placed over your right ear, and the sound piped into a hearing aid in your “normal” left ear. You could then understand speech on your right side, although the direction of that speech would be unclear to you.

Of course, we always recommend multiple opinions — including opinions as to whether a hearing aid would be helpful to you. In many areas, the law provides for a refund if during a trial period it doesn’t work out. Be sure that you have the details of any trial period in writing. If your hearing aid isn’t working out, don’t agree to keep the aid beyond the trial period unless the trial period is extended IN WRITING. See this article in The Washington Post: Listen Closely When Buying Hearing Aids: Pitfalls Abound.

A reader comments:

I am embarrassed and feel older psychologically because I don’t want to ask people to repeat everything they say. But it’s getting more and more difficult by the day. I have two dogs, so they hear things that I can’t hear anymore. At any rate, this is not something I had planned on in my life, and I find it very frustrating.

Meniere’s Disease patient David Copithorne has written a lot about his hearing loss, the way that hearing loss changed his life, and how hearing aids have helped him. He also writes about the latest developments in hearing technology. We suggest that you start reading his posts here, and continue here (read from bottom to top). Then go on to the rest of his blogsite, www.hearingmojo.com.

A reader asks:

I had unilateral Meniere’s Disease for five years, and have recently become bilateral. I have learned to manage the vertigo over time. My primary concern now is the preservation of my hearing. A recent loss of hearing in my previously uninvolved ear has forced me to get a hearing aid for the first time. What can be done to specifically preserve hearing, apart from the usual treatments for vertigo?

There are many possible treatments for Meniere’s Disease. See the MenieresInfo.com Treatment Page. As this reader implies, treatments for Meniere’s Disease are usually aimed at relieving vertigo. The vast majority of patients find that vertigo is their most severe problem, but some, like this reader, have vertigo under control and for them their greater concern is preserving hearing. Of course, none of the symptoms of Meniere’s Disease (fluctuating rotational vertigo, hearing loss, aural fullness, and tinnitus) is pleasant. We would all like to be able to reduce all of the symptoms. That said, we all tend to prioritize our symptoms and identify the worst of them at any particular point in time.

However, many treatments, if successful, may (or may not) relieve other or even all other symptoms in addition to vertigo.

Lifestyle treatments, such as stress reduction, low-salt diets, elimination of potential triggers such as tobacco, caffeine, and alcohol, can have an effect on Meniere’s Disease overall, including all symptoms.

Diuretic drugs, such as Maxide, Diazide, and Diamox may improve Meniere’s Disease symptoms overall.

For patients whose Meniere’s Disease is responsivle to immuno-suppressant drug therapy, all symptoms may be improved.

Surgical implantation of pressure equalization tubes (PE tubes, or “grommets”) may or may not have an effect on all symptoms.

Intratympanic (transtympanic) instillation and perfusion of gentamicin, or gentamicin delivered by the Silverstein microwick or the Arenberg round window micro catheter, when specifically intended to ablate (destroy) the so-called “dark cells” that produce endolymph, if successful, might affect all symptoms. However, hearing loss is a risk of this treatment.

Endolymphatic sac surgery to reduce the volume of endolymphatic fluid, if successful, might or might not affect all symptoms. Hearing loss is a risk of this treatment.

Chemical and surgical labyrithectomy, of course, destroy hearing.

Vestibular nerve section (vestibular neurectomy) is intended to eliminate vertigo attacks, without damaging remaining hearing, but hearing loss is a possible consequence of the surgery.

To evaluate the impact of any particular treatment on symptoms, vertigo or otherwise, one should read the published studies. There are links to PubMed research on the MenieresInfo.com Treatment Page and Research Page.

The key to any treatment is to research the possibilities and discuss one’s concerns and questions with one’s doctor. We always recommend multiple medical opinions, both for diagnosis and for treatment options.

A reader asks:

I’ve had Meniere’s for four years. Lately I haven’t lost any more hearing, but I’ve lost more speech discrimination. Is decreasing speech discrimination without additional hearing loss common with Meniere’s Disease?

We don’t know. But it seems that there is little that is “normal” or “common” in dealing with Meniere’s Disease. We haven’t seen any study that answers the question.

Click here to search Google.

Click here to search PubMed.

There’s just no lesser way to say this without being inaccurate: HearingMojo.com is a great website. If you’re hearing impaired, as most (but not all) of us Menierians (Meniere’s Disease patients) are, a regular visit to that website is a must-do on your to-do list.

For the latest news about hearing aids, check out these posts about recent developments with the following brands:

Phonak, November 15, 2005.
Siemens, November 14, 2005.
Sonic, November 10, 2005.
Oticon, October 22, 2005.

Perhaps you are looking into cochlear implants. Do you know that consolidation leaves just three global manufacturers of cochlear implants? You would if you read this article, published on September 22, 2005.

Do you know about CapTel telephone captioning? Do you know what it is? Do you know that it was available in 32 states? We didn’t, until we read this article from September 19, 2005. Do you know that it is now available in 35 states? Not us, either, until we read this article from November 15, 2005.

Do you know that there are gizmos available to keep you from losing your valuable hearing aids during activities? You would if you read this article from October 26, 2005. Maybe you think that you don’t have a use for them. You’ll change your mind when you read this article from November, 14, 2005, updated here on November 16, 2005.

These are just a few recent highlights from HearingMojo.com. You’ll want to become a regular visitor. The life you improve may be your own.

Closed captioning on television is at once a godsend and a bedevilment. David Copithorne explores the struggle to improve the quality of closed captioning by a January 1, 2006, deadline over at HearingMojo.com.