Photo: Aloha Big Mike
A few years ago, I was working for a company that specialized in giving educational tours of Israel. We had just finished updating our brochure outlining the educational program and I was in a hurry to get it to the printer. Not having a car at the time, I ran down street about four hundred yards to catch the oncoming bus. On the bus, I started to sweat profusely and felt really bad — I have always been a fairly decent athlete. I thought, I’ll just take deep breaths to slow my pulse and I’ll be fine.
By the time I got off the bus, a 10-minute ride, I was drenched in sweat and had severe abdominal cramps. Everything around me started to spin. I thought that I might be having a heart attack, but my immediate concern was finding a restroom. I looked around and saw a McDonalds at the entrance to a nearby mall. I made my way to the location and, luckily for me, I ran into my sister-in-law as I entered the restaurant. I told her what was going on and asked her to wait. I made it to the bathroom; by then, the spinning and stomach cramps were out of control. After an unpleasant few minutes in the restroom, my sister-in-law drove me to the emergency room. We had to stop on the way for me to throw up. I spent a few hours in the emergency room getting an EKG and a couple infusions to keep me hydrated. Eventually, the diagnosis was in. The doctors ruled out a heart attack — apparently, I had suffered from a Meniere’s attack.
At the time, I had no idea what Meniere’s was, but apparently the disease can really wreak havoc on one’s life. The disease is related to inner ear health and affects a person’s ability to balance naturally as the internal gyroscope of the inner ear ceases to function. Immediately after my first attack, I lost about 40% of hearing in my left ear. The more stressful and anxiety-inducing development for me was the onset of chronic tinnitus (constant background noise) and vertigo. Over the course of a year I became woozy at times, had several repeat attacks and was learning to cope with the constant screaming or wale of a siren in my left year. But my main concerns were one-track minded. How am I going to surf with this problem? My balance is off and what do I do if I have an attack out in the water?
Without (L) and with (R) Meniere’s disease. Photo: Northwestern University
Fortunately for me, my attacks have become less frequent over the course of time. My surfing has been mostly unaffected, though I did struggle a little with balance issues for awhile at the beginning. The brain and our minds are amazing things and sometimes they are able to help us compensate. I’ve managed to regain my balance and use visual references like the horizon to help maintain balance when the internal system isn’t 100%. I have also worked on keeping my pulse rate down as well as keeping a healthy blood pressure level in an effort to reduce my chances of repeat attacks. And I have learned how to cope with the tinnitus: if I don’t think about the noise, it doesn’t bother me — I’ve altered my diet and tend to avoid loud noises like drilling, a trigger for one of my previous attacks. In the water, I use earplugs and try to protect my ears.
Avoiding unnecessary damage to our ears is very important. Most surfers, at some point, suffer from a perforated ear drum. We expose ourselves to loud music at concerts and parties or by blasting our headphones all the time. It may be difficult to prove direct correlation to Meniere’s, but why increase your chances? Take care of your ears. Consider using a good pair of ear plugs when surfing to decrease your chances of injury. I know, I hate ear plugs too. But I hate sitting on the beach and missing a good swell a whole lot more.
I recently caught with ENT Dr. Leslie Berghash for an explanation of what exactly Meniere’s Disease is.
Jay Kohn: What is Meniere’s disease?
Dr. Leslie Berghash: Meniere’s Disease is an inner ear disorder that affects both the hearing and balance portions. It is caused by a build up of pressure of the inner ear fluids due to reasons not known. When the pressure reaches a critical level there is a release of the pressure which causes the symptoms of severe vertigo, tinnitus and hearing loss. The episodes last usually 24 hours with extreme dizziness, nausea and vomiting. After the episode you may feel fine or a bit woozy. These episodes are very unpredictable. They may come again in days, weeks, months, years, or not at all. Those unfortunate enough to have recurring episodes will, over time, lose their hearing. At times, this may require a hearing aid. Meniere’s Disease typically affects only one ear.
Can it be treated? If so, what are the treatments?
It is treated typically symptomatically with anti-dizzy medication, usually Valium, IF you can feel an episode coming on then a patient takes the Valium to lessen the symptoms. Anti nausea medication may also be Rxed. Some patients are placed on a diuretic (Dyazide) in an attempt to keep the inner ear pressure low on a constant basis.
Is there anything that can be done to prevent or lessen the chances a Meniere’s attack?
Prevention can be with a low salt diet and medications like Dyazide.
What are the dangers in entering the water?
Only danger in entering water is if you get an attack while you are in the water. I do not know specifically that the act of surfing would bring on an attack.
What can you do when you feel an attack coming on?
If an attack comes on, take Valium (Rxed). Obviously if you’re in the water you want to make your way to shore.
Do you have any safety recommendations or for surfers or swimmers?
Safety recommendations: I am not aware of any study that says getting water in your ears would trigger a Meniere’s attack. Other than that, Stay out of the water when sharks are around. LOL.
Dr. Leslie Berghash is certified by the American Board of Otolaryngology and is a Fellow of the American College of Surgeons. He also serves as a Clinical Assistant Professor for Florida State University College of Medicine.
