DEAR DR. ROACH: My wife is suffering from Meniere's disease, a condition that causes, at times, severe vertigo and disorientation. Although she's never actually been diagnosed with the condition, after several months of numerous tests on her heart, brain, ears, eyes and balance, the doctors "think" it's Meniere's disease. It came upon her rather suddenly, which is another puzzling aspect of her condition.
Most times, she can control it by sitting still or with focus techniques or motion-sickness drugs. She is able to drive, but other activities cause her distress. She is seeing a physical therapist and using relaxation techniques suggested by the therapist to help relieve tension in her shoulders, neck and head. Sometimes she wakes from sleep and will have to walk around the room to "collect" herself from spinning in bed during sleep.
This condition is affecting many aspects of her and my life, including diet, ability to eat, movement and intimacy. Is there anything other than what she is currently doing that will help her find a more normal daily life? Most of what we've read online suggests there's no cure for Meniere's disease but that it can be controlled. As of this writing, none of the "controls" have been effective. Thank you. — G.S.
ANSWER: Meniere's disease is a cause of recurrent vertigo, the sensation of dizziness, often with a feeling that the room is spinning or that the person is spinning. Meniere's disease also may include tinnitus, a ringing in the ears, and hearing loss, although not all cases feature these symptoms.
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There are some things I would recommend immediately for your wife. The first is to stop taking all motion-sickness drugs, since long-term use of these tend to prevent the body from ever getting completely better. Secondly, she should find a physical or occupational therapist who's familiar with vestibular rehabilitation, a type of therapy intended to use the body's own systems to retrain the affected organ of balance. Finally, she needs a doctor experienced enough in Meniere's disease to determine whether she would benefit from sodium restriction or a diuretic. By finding and avoiding triggers for symptoms, in addition to stopping any problem medicines and getting vestibular rehab if needed, 90 percent of Meniere's disease sufferers can maintain normal activities.
DEAR DR. ROACH: I have severe halitosis. I have had my sinuses, teeth and gums checked to see if they are the cause of the odor, but the dentist and ENT found nothing. I was referred by my primary doctor to a G.I. specialist, who found I had a sliding hiatal hernia, which was causing acid reflux. He recommended surgery to push the stomach back into its normal position below the diaphragm. I decided to pass on the surgery. He recommended taking over-the-counter medications such as Nexium, but after several days my lower back started to hurt, so I stopped taking them. I am reconsidering the surgery and was wondering if this is a good idea. Is it possible that the hernia has nothing to do with the halitosis? — E.H.
ANSWER: Experts believe that 90 percent of the time, halitosis comes from the mouth. What your gastroenterologist is suggesting as the cause of the halitosis is plausible. I found several anecdotal cases where surgery cured the halitosis. However, it's not only possible that the hiatal hernia has nothing to do with the halitosis, I think it is unlikely that it does. Since surgery would not otherwise be recommended for a sliding hiatal hernia, I can't recommend surgery.