MenieresInfo.com Blog

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Saturday, February 25, 2006, 5:13 pm

How Does One Perform One’s Job With Meniere’s Disease?

A reader asks:

My neurologist diagnosed me with “probable” Meniere’s Disease three years ago based upon a severe attack of ataxia that lasted for three weeks.  At that time, MRI scans were taken with and without contrast and no lesion was seen.  Recently, I have just fallen — twice — for no apparent reason.  I broke my ankle the second time.  My question is, how does one work with Meniere’s Disease?  I plan to go back to work soon.  I have not spoken with my neurologist about this.

Ataxia is defined as the inability to coordinate muscle movements.  Read about the diagnosis of Meniere’s Disease at the MenieresInfo.com Diagnosis Page.  As you can see there, a diagnosis of Meniere’s Disease involves a “differential diagnosis,” and diagnostic tests.  Most doctors use the AAO-HNS criteria to define Meniere’s Disease, and what you have described that happened three years ago and what you have described that happened recently do not fit that criteria.  Furthermore, we are puzzled as to what a diagnosis of “probable” Meniere’s Disease might mean.

It’s not clear to us that your recent falls are due to the same condition that brought on your ataxia three years ago.

Obviously (to us, at least), you need to get diagnosed by someone — either your neurologist or some other doctor.  We always recommend multiple medical opinions, both for diagnosis and for treatment options.

If you have Meniere’s Disease, the way that you work, in simple terms, is to (1) get treatment for the Meniere’s Disease and (2) if you become disabled, request reasonable accommodations for the disability.

See the MenieresInfo.com Treatment Page and the MenieresInfo.com Disability Page.

Friday, February 24, 2006, 3:03 pm

Can Aerobic Exercise Help With Meniere’s Disease?

A reader asks:

I was diagnosed with Meniere’s Disease 25 years ago.  I read in my vast research of the disease that exercise is good for Meniere’s Disease because it increases circulation. A year ago, I started doing fairly energetic aerobic exercises.  [The reader doesn’t state the results of thr exercised.]  Recently, the tinnitus has accelerated and the exercise seems to intensify the noise level.  Am I doing the wrong kind of exercise?

We know of no authoritative source for the proposition that aerobic exercise will or can either improve or intensify the symptoms of Meniere’s Disease.  We find nothing in PubMed that supports that proposition.  Click here.  Note that the term “exercise” in the results appears in the context of vestibular rehabilitation exercises rather than aerobic or cardiovascular exercises.  We recommend that you discuss this issue with your doctor.

For information on the treatment of Meniere’s Disease, visit the MenieresInfo.com Treatment Page.

Thursday, February 23, 2006, 6:15 pm

I Think My Doctor is Looking in the Wrong Place

A reader asks:

I have had severe dizzness for about six weeks and now I have fullness and tinnitus, too.  My doctor has prescribed antibiotics and tests for seizures and heart trouble.  I think she is looking in the wrong place.  Can you give me any help?

No.  We are not doctors.  You need to be diagnosed by a doctor.  You should share your belief that she is looking in the wrong place with your doctor, and discuss your concerns with her.  If you lack confidence in your doctor, then we recommend that you find a different doctor.  Of course, we always recommend multiple medical opinions, both for diagnosis and for treatment options.

Perhaps you think you have Meniere’s Disease.  That would probably be a misplaced thought, because the symptoms of Meniere’s Disease, including the symptoms of “dizziness,” fullness, and tinnitus, are the symptoms of many diseases.  Doctors have to perform a “differential diagnosis” to figure out which of the many possible disorders are causing any one patient’s symptoms.  “Dizziness” is a non-specific description of a symptom, and could mean a lot of things.  The dizziness that one experiences with Meniere’s Disease is a specific form of dizziness — rotational vertigo.  If one is dizzy, but one does not experience rotational vertigo, then doctors may well look in another direction.

There is more information on the diagnosis of Meniere’s Disease at the MenieresInfo.com Diagnosis Page.

Thursday, February 23, 2006, 6:04 pm

Could This Trigger Vertigo Attacks?

Many patients ask whether X or Y could trigger vertigo attacks, including drop attacks.

The answer is that virtually anything can be a trigger for any one individual patient.  If it’s a trigger for you, then it’s a trigger for you, no matter what “it” is.  There is a discussion of triggers, including common triggers, in the trigger section of the MenieresInfo.com Treatment Page.  But even the so-called common triggers are not triggers for everyone.  For example, consumption of sodium in the form of salt bothers many patients, but it also does not bother many patients.  Simarly, consumption of alcohol bothers many patients, but it also does not bother many patients.  The treatment objective is to identify the things that are triggers for you, regardless of whether they are triggers for anyone else, and to avoid them.

Tuesday, February 21, 2006, 4:32 pm

Do All Patients Get Warning Symptoms Before Vertigo Attacks?

Originally posted January 31, 2006.
Comment added February 21, 2006.

A reader asks:

About 15 minutes before an attack of vertigo or dizziness, I get a sudden increase in the volume level of my tinnitis. When this happens, I drop everything and either go home if I am close or else have someone come and take me home — usually before an attack occurs in public. Do all Meniere’s Disease patients get such warning symptoms before an attack?

We didn’t find any studies at PubMed that establish a basis for warning symptoms preceding an attack of vertigo. (We reviewed the abstracts; it is possible that there may be more relevant information in the full texts.) However, we have seen many anecdotal reports of some patients who do get such warning symptoms every time, some patients who get such warning symptoms some of the time, and some patients who never get warning symptoms. In addition to increased tinnitus, patients report that increased fullness and sudden hearing drops can be warning symptoms of an impending attack of vertigo. Once again, we find that Meniere’s Disease affects each of us somewhat differently.

Added February 21, 2006.

A reader comments:

I have found that when the ringing in my ear becomes louder and more persistant along with an increase in the “fullness factor” and loss of hearing, I’m in for a spin.  I was in an extremely bad state before I had intratympanic gentamicin treatments two years ago.  It took almost a year before I actually saw a reduction in the number and severity of vertigo episodes.  Then I was essentially vertigo free for a year, although I occasionally had that “bouncy” feeling.  The vertigo has recently returned (always accompanied by the loud ringing), but not as severe as before.

This patient gets a “warning” before vertigo attacks, as do some other patients — but some patients get no warning at all.  On the gentamicin treatments — we are not doctors, but we don’t see any connection between gentamicin treatments at Point A and improved symptoms at Point B one year later.  We’d say that it is more likely that the gentamicin treatments failed to produce improvement and then the patient experienced a fluctuation or typical temporary remission a year later, followed by another fluctuation or typical relapse a year after that.

Tuesday, February 21, 2006, 3:31 pm

Can Hearing Aids Trigger Vertigo Attacks?

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.”

Saturday, February 18, 2006, 4:17 pm

Is There Current Research Into Genetic Connections to Meniere’s Disease?

A reader asks:

I am researching my family’s medical history, and I have found that there is an extremely heavy incidence of Meniere’s Disease, or at least symptoms of Meniere’s Disease, in the Scot line of my paternal grandmother.  It looks like nearly 50% of her descendents had it, but the incidence does not run in a direct line.  I believe my father had it, although it was not diagnosed.  My brother did not have it, but two of his three children do.  Is there a research group that is researching genetic connections pertaining to Meniere’s Disease?

The research to date shows that Meniere’s Disease is not hereditary, but that the incidence is higher in some families, for reasons not understood.  Thus, Meniere’s Disease is said to be “familial.”

We don’t know one way or the other whether there is any current research into possible genetic connections to Meniere’s Disease.  As far as we know, there is no repository of current research (other than clinical trials — click here and here).  The world’s largest repository of medical research, PubMed, is pretty much limited to completed studies that have been published.

Click here to search PubMed for articles on the hereditary or familial aspects of Meniere’s Disease.

Perhaps an astute reader can enlighten us further.

Tuesday, February 14, 2006, 5:51 pm

I am a Graduate Student Plagued by Fatigue and I Don’t Know What to Do

A reader asks:

I am a graduate student with Meniere’s Disease. My problem is that I can’t work as hard as I need to, because I get really tired. The department that I major in at school has been really kind to me, but I still can’t handle my studies well. I just don’t know what to do. I don’t even have confidence that I will ever catch up to my fellow graduate students.  I don’t think I can ask for more accommodations for my Meniere’s Disease from the dean.  What can I do?

About school.  You can ask for the same accommodations as any other severely ill student, such as students with multiple sclerosis (MS), attention deficit hyperactive disorder (ADHD), leukemia, ovarian cancer, and any other serious illness.  However, we know the feeling.  When people are not openly accusing us of shirking, they are wondering whether we are shirking, and one never knows when they will turn on us.  See the MenieresInfo.com Start Page and Disability Page.

No doubt some of what you are feeling is anxiety that the stress and fatigue will bring on an attack of vertigo.  Anxiety is not a symptom of Meniere’s Disease but, for many patients, it is a consequence of the symptoms of Meniere’s Disease.  If the fear of vertigo is greater than the likelihood of vertigo, there are anti-anxiety drugs to consider, although they are not without side effects that must be weighed.  Talk to your doctor.  Of course, if you fear vertigo, your fear may be well-grounded because of frequent vertigo attacks, and that is a different situation.

Depression is a common consequence of the symptoms of Meniere’s Disease.  Depression can manifest as fatigue.  This is something else to discuss with your doctor.

Talk to your doctor and get multiple medical opinions about diagnosis and treatment options.  We are fans of multiple medical opinions.  No doubt there are possible treatments that you have yet to explore.  Any one treatment may or may not help you in particular, but it’s worth exploring them to see which treatment works best for you.

The truth of the matter is that Meniere’s Disease can be so severe for some patients in your circumstance that a short term or long term withdrawal from school might become necessary.  However, we hope that for you that does not become necessary.

Monday, February 13, 2006, 3:01 pm

Does A Change in Tinnitus for the Worse Indicate a Worsening of Meniere’s Disease?

A reader asks: 

I was diagnosed with Meniere’s Disease several years ago, but I seem to be symptomless most of the time except for the ringing in the ears.  Recently, I have been hearing a “clattering” sound.  This sound is much more disturbing to me than the ringing.  Does this indicate a worsening of Meniere’s Disease?

We presume that you mean, “does this indicate that my other symptoms, especially vertigo (dizziness), are about to get worse”?  The honest answer is that we don’t know.  We know of no authoritative references one way or the other.

We assume you already know that Meniere’s Disease is progressive, but that the rate of progression varies among patients, some progressing rapidly and others progressing quite slowly, with lots of variations within those groups.  (Progression followed by short or long remissions, etc.)  See the MenieresInfo.com Prognosis Page.

Thursday, February 9, 2006, 4:49 pm

VA Medical Journal Publishes Special Issue on Hearing and Hearing Loss

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 Diseaseclick 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.
Thursday, February 9, 2006, 3:48 pm

What Can You Say About My Tinnitus?

A reader asks:

I have had tinnitus for 2 weeks. My hearing is very good in my right ear but the problem remains in my left. I have a low frequency roar/hum and therefore cannot hear lower frequencies well with my left ear. What lower frequencies I do manage to hear sound a pitch lower than in my right ear. I have not suffered any vertigo or unbalance yet. Also, when tilting my head side to side, the noise disappears for a brief moment.  Do you have any comments or suggestions?

What you are really asking is for us to guess at what is causing your tinnitus.  This we cannot do, for we are not doctors.  Our suggestion is *always* to seek a diagnosis from a licensed medical professional.

If you want to learn more about tinnitus, we suggest that you visit the following websites:

Wednesday, February 8, 2006, 3:17 pm

Dog Awarded for Giving “Life After Deafness” to Meniere’s Disease Patient

A mixed Cocker Spaniel-Havanese dog was given an award for giving “life after deafness” to a patient who suddenly lost her hearing due to Meniere’s Disease.  “Tess” was awarded Hearing Dog of the Month for February 2006 by the U.K. charity Hearing Dogs for Deaf People, which provided the dog to its owner, Meniere’s Disease patient Sheila Walker.

See the February 6, 2006, Community Newswire article here.

See the Hearing Dogs for Deaf People article here.  In this article, Walker describes how Tess senses a coming vertigo attack before Walker does, and how Tess signals Walker to sit down before the attack commences.

Wednesday, February 8, 2006, 12:57 pm

Discrimination at Work — How Does One Deal With This?

Originally posted February 4, 2006.
Slightly revised February 5, 2006.
A reader’s comment added February 8, 2006.

A reader asks:

The people in my job are really mean towards me and this makes me get sicker. They have some type of vendetta towards me that I do not understand. The harrassment is so massive it’s unbelievable. I work in a government office that, believe it or not, is supposed to guard against discrimination (in housing). How do I deal with this work situation?

This is a disability question, and there is a good deal of disability information at the Disabililty Page at MenieresInfo.com. Employment-related disability questions are essentially legal questions, and there is information at that page on disability lawyers. Initial consulations with lawyers are often available at low-cost or no-cost (ask the fee when you call for an appointment). If there is a fee for the initial consultation, it will no doubt be well worth it. (Note on that page that fees for legal representation before the Social Security Administration (SSA) are a separate issue and are regulated by SSA.)

There are few things worse in life than a job that one hates to go to every day and that one dreads all weekend going to on Monday. This has a downer effect on everything else in one’s life.

People with disabilities in general are often seen as slackers who use their disability as an excuse to shirk work. Sometimes the reality is that these same disabled people carry the load of others in addition to their own work and get no credit for it. Everything they cannot do seems magnified out of proportion. Everything good that they do seems to go unnoticed.

This is ten times worse with “invisible disabilities” — when the disability is not obvious to the naked eye. A coworker in a wheel chair is seen as more sympathetic than a coworker who “looks normal” but isn’t. Examples include disabled employees with ADHD (attention deficit hyperactivity disorder), CFS (cronic fatigue syndrome), and, of course, Meniere’s Disease. When we are sick, we are accused of “faking it.” The fluctuating nature of the condition doesn’t help the visual perception — sometimes we are OK; sometimes we are not. People will say “every time thus-and-such some up, so-and-so (us) gets sick; how convenient.” They see connections where there are no connections. We can end up being outcasts, somewhat like in high school only much worse.

Of coure, there are laws against discrimination in the U.S. workplace, notably (but not exclusively) the ADA (Americans With Disabilities Act). See the Disability Page at MenieresInfo.com. Unfortunately, laws don’t actually stop discrimination, and people break these laws every day.

It seems to us (and we claim NO expertise) that there are three possibilities: (1) pursue remedies for discrimination, (2) get another job in the same agency, or (3) find a job in another agency.

In an enlightened and competent bureaucracy, once you file a complaint of discrimination, you may be fortunate and get all the relief to which you are entitled. A complaint properly acted upon might even get you reassigned to another work unit with a different supervisor, and with different duties, and with accommodations for your disability. Unfortunately, in an unenlightened or incompetent bureaucracy, you may be become even more ostracized than before, and your performance evaluations may suddenly take a nose-dive in retaliation. Retaliation is illegal but still possible, perhaps even likely. It’s a crap shoot.

The simpler solution is to find another job or at least another supervisor on your own. Even “normies” have to duck and dodge sometimes to get out from under the thumb of a supervisor or coworkers who have ostracized or oppressed them. For a variety of reasons, that may not be possible. In a government job, one is typically so committed to the pension and other benefits, and one’s job expertise is typically so narrow, that one’s reassignment opportunities are limited. Worse, one receives an unfairly poor evaluation due to the unfair perceptions attached to one’s Meniere’s Disease that makes it difficult to compete successfully for another job. Nonetheless, that is the simpler, more practical, solution. It pains us to say so, because you shouldn’t have to be discriminated against in the first place and, when you are, you should be able to get the discrimination stopped. The right thing should prevail. Sadly, it oftentimes does not.

Oddly, those of us who are blessed with wonderful supervisors and wonderful coworkers and supportive home situations won’t understand this at all. Sad but true, sometimes you just gotta be there.

After all of this blather, you by now have deduced that we just don’t know what in blazes to tell you — but we sure do understand the situation. It’s tough.

We’d be delighted to receive well thought-out comments from readers to add to this issue.

Added February 8, 2006

A reader provides comment:

Since this person is a government worker, chances are the worker belongs to a union.  Harassment, as well as worker disability, are union issues and this person should contact a union representative for assistance and representation in this matter.

This astute reader adds the issue of workplace harassment contrary to a union contract to the issue of employment discrimination based upon actual or perceived disability, and notes the possible, perhaps probable, availability of union representation in either case.  We are grateful for the comment.

Many U.S. government employees are in a “collective bargaining unit” which is usually represented by a union.  The ability of the union to deal with any issue depends on the wording of the “collective bargaining agreement” (the “union contract”) and the resources of the local chapter of the union that represents the bargaining unit.  The alternative as to the discrimination issue might be a counselor in the agency’s equal employment opportunity (EEO) office (the Equal Employment Opportunity Commission may not have initial jurisdiction in a U.S. agency matter, but it’s worth looking into).  While the agency EEO office is supposedly independent, in fact it is usually part of the same management that is at fault either directly or by failing to take positive corrective action.  As to the discrimination issue, the employee may be faced with a choice in the very beginning of going “the union route” or ”the EEO route.”  If so, the union representative (usually a “steward”) can provide counsel on making the choice.  Whether a claim of harassment could be represented by the union in addition to a separate claim of discrimination brought before the agency EEO office is something to consider.

Despite the existence of anti-discrimination laws (and, possibly, anti-discrimination provisions in union contracts), workplace discrimination remains a disturbingly frequent occurrence in the workplace.  The remedy should be easy, and sometimes it is, but too often the employee faces an uphill battle.

Tuesday, February 7, 2006, 4:28 pm

How Can I Find an Attorney Who Will Help Me?

A reader asks:

Is there a list of attorneys who will take on the job for a Meniere’s Disease patient?  My attorney hasn’t called me in over six months and I need to get an attorney who will actually try to help me.  I was diagnosed in 2003 and I have been turned down three times.

Unfortunately, there are attorneys who are relatively uncommunicative with their clients, especially when they are not able to bill clients for telephone calls.

We take it that this reader is talking about a claim for Social Security Disability benefits.  (Reader:  If not, write to us again.)

Fees for practice before the Social Security Administration are regulated by SSA.  See the Menieresinfo.com Disability Page.  The fees come out of back benefits, and there is a maximum.  While there is room for profit for an attorney to handle these claims, there is not a lot of profit involved.  Dealing with SSA, even with an attorney, can be a long, dragged-out process.  Often nothing happens for a while.  Meanwhile, the claimant is begging for food.

We suggest that you call the attorney and ask for the status of what at this point is almost certainly your appeal.  A secretary or a paralegal might give you that information.  If someone gives you an answer, then you need to decide whether to stick with that attorney.  If you can’t get an answer, our suggestion is that you write a letter to the attorney that says so and asks for the status.  You are probably better off sticking with the original attorney for a number of reasons, not the least of which is the issue of fees.  If the attorney puts in an effort on your appeal, and you switch attorneys midstream, then you will owe that attorney a fee for the work performed, and it’s unclear to us how the fee obtained by your “new” attorney out of back benefits could be used to pay the “old” attorney for the work done before the “new” attorney was hired.

Of course, there are occasions when your best bet is to find a new attorney.  Finding an attorney isn’t easy.  We know of no directory of disability attorneys who have experience with representing clients with Meniere’s Disease.  But see the MenieresInfo.com Diagnosis Page for ideas.  Your state and local bar associations will be able to refer you to someone.  You could look up “disability attorney” in the telephone book.  Most attorneys will offer an initial consultation at low-cost or no-cost.  This will give you an opportunity to “interview” several attorneys.

We do appreciate your frustration, and we wish we had a better answer.  Readers are invited to send us their well thought-out comments on this issue.

Tuesday, February 7, 2006, 4:03 pm

Would an LCD Monitor Reduce the Frequency of My Attacks?

Originally posted February 7, 2006.
Comment added February 16, 2006. 

A reader asks:

When working for long periods on computers, I get more frequent attacks than I do otherwise.  I am using a CRT monitor.  Do you think it would be better for me to use an LCD monitor?  Do you have any evidence that the old CRT monitors can bring on attacks?

 A “CRT” monitor is a cathode ray tube monitor — in effect, a television set.  (Perhaps today we should say “an old style television set.”)  An “LCD” monitor displays using “liquid crystal diodes.”  Click here for an explanation of the differences.

Like all things Meniere’s, some of us are bothered by CRT monitors and some of us aren’t.  We don’t have an authoritative source one way or the other — but would it make a difference?  Forgive us for stating the obvious, but if a CRT monitor bothers you, it makes sense to try using an LCD monitor, and the results for you are the results for you, no matter what any study might show for anyone else.

Comment added February 16, 2006.

A reader comments:

This is a comment to the reader about CRT versus LCD monitors.I know that i had one of my WORST attacks ever after using CRT monitor for less than 5 minutes. Ever since then I will not even look at one. It was my son’s computer and i needed to access it since mine was down. My monitor by the way is a LCD — the flat screen kind. So, yes, like was said, do whatever works for you. I also know that i can only watch TV for very short lengths of time for this very same reason. Like so much about this disease, it is a process of elimination, trial and error, etc.

Friday, February 3, 2006, 2:44 pm

Could a Mastoidectomy Make One More Vulnerable to Meniere’s Disease?

A reader asks:

As a young child, I had a mastoid in one ear. Thirty years later, I was diagnosed with Meniere’s Disease. Could the mastoid have weakened that ear and made it more vulnerable to eventual Menieres?

The mastoid is a bone behind the ear that is full of air cells, usually spoken of as “the mastoid bone.” Click here for images. Perhaps you mean to say that you had a mastoidectomy — the removal of a mastoid bone.

Meniere’s Disease is “idiopathic” — meaning that the cause is unknown. We haven’t seen anything in the literature that suggests that the mastoid bone — or lack of a mastoid bone — is implicated in the etiology (cause) of Meniere’s Disease, but, as we always say, we haven’t seen everything. Certainly the vast, vast majority of Meniere’s Disease patients have not had a mastoidectomy prior to developing Meniere’s Disease.

Thursday, February 2, 2006, 3:50 pm

Why Am I Not Eligible for a Hearing Aid?

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.

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