Hearing Loss Help  

by Neil Bauman, Ph.D.

If all of a sudden you feel dizzy and your balance is off, has something just happened to the balance parts of your inner ears, or have you just had an ischemic stroke in your brain? Your doctor needs to determine what has happened right away.

Up to now, doctors typically ordered MRIs to look for a blood clot in your brain which would indicate a stroke. Unfortunately MRIs are both expensive and do not always find tiny blood clots, especially at the outset.

Now researchers at Johns Hopkins and the University of Illinois have discovered a fast, accurate, low-tech way to determine which is which. Your doctor can tell in under a minute whether you’ve just had a stroke or not. Here’s how he can do it.

Your doctor gives you a three-part eye test called H.I.N.T.S. (In case you’re interested, H. I. stands for “head impulse”, N.T. for “nystagmus test” and S. for “skew”.)

First, is the Head Impulse Test. Here your doctor rotates your head while you keep your eyes focused on his nose. If you have had a stroke you cannot do this. However, if you have an inner ear balance problem, you can keep focused on his nose.

Second, is the Nystagmus Test. You follow your doctor’s finger as he moves it. If you have a balance problem, your eyes will jerk in only one direction. However, if you have had a stroke, your eyes will most likely jerk in both directions.

Third, is the Skew Test. Here your doctor looks at your eyes to see if one eye appears higher than the other. If one eye is higher than the other, you have had a stroke. If they are the same level, then it could be inner ear balance problems.

According to David E. Newman-Toker, MD, PhD, assistant professor of neurology at Johns Hopkins University School of Medicine and coauthor of this study. “These three eye tests tell, with 96% certainty, whether or not the patient has had a stroke.”

According to Bottom Line’s Daily Health News, December 14, 2009, “Dr. Newman-Toker advises seeking attention for any dizziness that comes on unexpectedly and has no obvious explanation, particularly if it lasts more than a few seconds. In situations where you still feel dizzy when you arrive at the ER, request the eye tests, he says, but be aware that not every doctor has the training and experience to perform them.”

by Neil Bauman, Ph.D., with Tony

In 2005, Tony had surgery to remove a large (4.5 cm) acoustic neuroma (non-malignant tumor) growing on his left auditory nerve. In the course of removing the acoustic neuroma, the surgeon, not only had to cut the auditory nerve leaving him totally deaf in his left ear, but also sever the vestibular nerve, thus totally destroying the balance system on his left side. The result of this surgery left Tony wheelchair-bound. However, he didn’t stay there. With vestibular therapy and much hard work, Tony now can lug his golf bag around the course as he plays 36 holes of golf. Here is his story.

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Three years ago I lost a balance nerve to surgery and was left in a wheelchair. I could not walk unassisted, and had to relearn how to balance myself again. This was a long process. However, given the benefits and independence I now have, it certainly was worth it!

After the surgery, my first experience with poor balance occurred when I fell out of my hospital bed—face down onto the floor with some force. Ouch! You see, the surgery had cost me my left side balance, and I didn’t realize just how “shot” my balance system was.

As the days went by, I became increasingly aware that my lack of balance was affecting me in many other ways. For example, I fell numerous times. (In self-defense, I kept an eye out for somewhere soft to land if possible. I needed an area where a fall was not going to hurt me.) I collided with people and objects. I was clumsy. I often dropped things. I found it was a good idea to stay away from work on ladders!

Furthermore, I had trouble coordinating my left and right hands. This was brought home to me 8 weeks later when I was trimming the hedge and nearly lost a finger to the electric cutters!

Each day as the hours went by, I became more and more tired. The result was that my coordination became progressively worse to the point where I was not able to move around safely.

Consciously keeping my balance proved to be exhausting. I experienced profound fatigue when engaged in almost any task, whether physical or mental. My lack of balance affected my speech too. The wrong words came out, or I mispronounced words.

My short-term memory dropped dramatically. You see, the effort involved in consciously maintaining balance like I now had to do affected my short-term memory. As a result, in addition to my speech problems, I easily forgot simple things, and was forever losing things.

For several months after my surgery, I needed a midday nap. Unfortunately, napping messed up my night-time sleep patterns, and I would be awake in the early morning hours. The result was that I invariably awoke exhausted before the day had even started! All these balance-related problems reduced my self-confidence. I became both frustrated and depressed.

While I was still in the hospital rehabilitation unit, I was determined to get well. I requested assistance in using the gymnasium, but was told no one was available to help me. Next day, while still in my wheelchair, I broke into the gym and began using the equipment by myself. They were not too impressed with my actions (I was spotted on the security cameras), but I made my point. The following day suddenly staff were available to assist me. I made rapid progress. My stay was just 32 days, not the expected average of 82 days.

To get my balance back I needed to exercise. To some degree it almost doesn’t matter what the exercise will be. The real key is to do something that you really enjoy and be able to stick at over a long period of time. For me that was playing golf!

Hospital rehabilitation got me walking again, but my first golf experience showed me just how weak and frail I had become. For example, when playing my first golf game (four months post operation), I could only manage four holes before becoming completely exhausted.

Therefore, I set out on a course to rebuild both my balance and my stamina. Fortunately I was (and still am) a keen golfer, so I did not consider time devoted to playing golf as a big issue.

Golf involves a combination of balance, movement, and eye/hand coordination. In this respect, golfing was an ideal therapy for me. Throughout all the days, whether sunny or rainy, I don’t ever recall thinking “this is a chore”. Rather, my feelings were, “I am getting better” (both my balance and my golf game)!

Throughout all this rehabilitation I felt so tired—close to complete collapse was more like it. However, I discovered that if I simply stopped, sat down somewhere quiet, and shut my eyes for 10 or 15 minutes, something quite miraculous happened. These short breaks were equivalent to about four hours sleep in terms of my body’s recovery. They had the added advantage that they did not disrupt my night-time sleep patterns.

I really pushed myself. However, there is a fine line between pushing yourself and overdoing it. When I really did overdo things, my coordination became increasingly erratic. At this point, drills, power tools and hammers were simply too dangerous for me to use—best kept safe for another day.

Over time, my strength and stamina slowly returned. I was now able to take on increasingly longer and more demanding exercises. My average golf practice now consisted of 140-160 long-range shots, considerably more than in a full game of golf.

As my balance improved, I also noticed that my thinking and coordination improved as well. I could now get through a day without a nap.

Just how much I have improved really came home to me when I moved 300 sidewalk slabs (over three and a half tons) from the front of my house to the back garden. It took me four hours. Yes, I was smashed afterwards, and hurt just about everywhere, but I did it!

My balance will never be perfect. My new balance system requires a visual point of reference. In other words, if it is completely dark, even simple movements are difficult. Thus, in the dark I find it wise to carry a flashlight. At home, I use low-wattage nightlights in the hall. This makes a big difference when I am moving around in the early hours.

When walking up and down stairs I usually extend both elbows out as additional stabilizers. I’d rather have a bruised elbow than a bruised head! Uneven ground almost always presents a challenge for me. I’ve found it best not to try and carry stuff in such circumstances.

I am not anti-alcohol, but my new balance system does not cope as well with the effects of alcohol as my old one did. My tolerance to alcohol is now reduced. These days I only drink at home when there is no possibility of any further travel or driving that day.

Because my brain is more occupied with keeping me balanced than in remembering things, I’ve found that it is worthwhile for me to take notes during meetings and to create to-do lists rather than relying on my now faulty memory.

Without a doubt, regaining my independence definitely helped my feelings of self-esteem and self-confidence. I can now work a 12 hour day with a two-hour journey at each end. Equally, I now understand and value rest when I can take it. All of this was possible only because I took the rebuilding of my balance and my health to be a fundamental and key issue in my life. Now, I am no longer confined to a wheelchair, or to walking with a cane. Finally, and to the disgust of my golfing friends, I can now beat them at their own game! This I call “success!

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To learn more about your balance system, how all the various parts work together and what happens when it gets damaged, read “Protect Your Balance System—or Else“. If your balance system has been damaged, take courage and follow Tony’s example. Never give up. Rebuild your balance system as much as is humanly possible. When you do that, you too will find your level of success!

by Neil Bauman, Ph.D.

A woman explained:

I read one of your articles on the Internet about SSHL (Sudden Sensorineural Hearing Loss), which I had when I was 11 years old. I had 80% loss in my left ear, which has been permanent. I am now 54 years old. The diagnosis of the cause of the hearing loss was an unknown virus. At the time of the hearing loss I did experience vertigo.

My question is, over the years I have experienced periods of vertigo. Usually one episode every 2 – 3 years. In the past 5 years I have had 4 or 5 episodes. I do not experience hearing loss or tinnitus. The vertigo becomes severe, and I usually have to lie down with my eyes closed for 24 hours on average. Plus in the last few episodes I have had extreme nausea (vomiting every few hours for 24 hours). I have been through extensive tests with an ENT doctor, also had an MRI, and his only opinion is that the vertigo is related to some extra sensitivity related to my nerve deafness. My question is, do people with SSHL often experience vertigo later and throughout their lives as I have described?

I’m not surprised you had some vestibular (balance) problems in addition to your sudden hearing loss. The virus that gets into your cochlea and causes hearing loss, often at the same time, gets into the vestibular system and causes balance problems such as your vertigo. However, that happened many years ago now. I wouldn’t have expected vertigo from back then to still occur. Perhaps these episodes of vertigo are not directly related to the original viral attack.

One possibility is that you may have a form of Meniere’s disease that only affects the vestibular system and not the whole inner ear. It may be called endolymphatic hydrops, but more commonly it is known as vestibular hydrops. This could account for your periodic attacks of vertigo without the accompanying tinnitus and hearing loss. Have your doctors considered this?

Do you have any allergies at all? If so, do the episodes of vertigo correlate to the allergy outbreaks? Often allergies are the underlying cause of Meniere’s disease.

by Neil Bauman, Ph.D.

A veteran wrote:

My hearing loss and tinnitus is service-connected. I was exposed to constant cannon fire while in the Marine corp. No hearing protection. Marines were expected to tough it out. Now I’m paying for that silly theory with my hearing problems.

I am trying to explain to the VA doctors and audiologists about my severe sensitivity to sound. Some loud sounds hurt my ears really bad. This is causing me to have anxiety and panic attacks secondary to the loud sounds.

The VA has said that my problems are psychological so I’m now seeing a psychologist. I am very depressed because of my inability to hear well, and my tinnitus is extremely loud. I sometimes think that there are mice in my ears scratching to get out. The tinnitus and combined hearing loss is very depressing, but so also is the sensitivity to loud sounds.

Loud sounds cause me to become disoriented and dizzy and I lose my balance. Several times, upon hearing loud sounds, I have fallen. I realize that this is caused by my anxiety reactions and panic reactions to the pain of the loud sounds. My problem is that I can’t seem to make the VA medical people understand.

They just think I have to get over the depression. They think the depression is causing the problem and that when the depression goes away so will the tinnitus and sensitivity to sound. I also hear phantom sounds, which I know are a part of my hearing loss and tinnitus. But again the VA is saying no. They want to blame it on psychosis? The bottom line is that the depression, anxiety and panic disorder are secondary to my hearing problems.

Fear of sounds is called phonophobia. In your case you perceive the sounds as so loud they hurt. No one wants to be hurt—whether it is loud sounds or anything else.

However, I think that rather than having phonophobia, you have hyperacusis—where you perceive normal sounds as too loud. Hyperacusis is often the result of having your ears damaged by loud noise such as you were exposed to in the Marines.

Living with loud tinnitus day in and day out can lead to depression. Actually, this is sort of a Catch 22 situation. Depression often leads to louder tinnitus—so you want to get your depression under control in order to help control your tinnitus, but on the other hand, loud tinnitus leads to depression, so you want to get your tinnitus under control if at all possible.

You can learn to live and enjoy life even though you have tinnitus and can’t hear much. I don’t hear much at all now, and I’ve had tinnitus day and night for 35 or more years—but I don’t let it affect my happiness. My book, “When Your Ears Ring—Cope With Your Tinnitus—Here’s How” has helped many.

It’s interesting (not nice, but interesting) to note that loud sounds also cause you to lose your balance. I don’t see how it relates to anxiety reactions like your doctors think it does. To me, it seems you have a condition called Tullio’s Phenomenon in which people lose their balance from loud sounds—not from anxiety or panic.

Another name for it is Superior Canal Dehiscence Syndrome. Basically what happens is that you have a hole or thin spot in the bone separating the balance system from the hearing system. Thus when you hear a loud sound, the sound wave travels via the hole to act on the balance system. Since it is a sound signal and not a balance signal it sends false balance information to your brain. This totally confuses your brain and the result is loss of balance. Some people drop to the floor like they were knocked out. Others have vertigo and some dizziness and imbalance. Sometimes doctors can patch the hole and cure this, but other times not.

If this is what you have, then the psychologist is wrong in trying to treat you for anxiety and panic. Yes, you need to get those under control too, but you also need to have an otologist check you out for things that cause Tullio’s Phenomenon such as Superior Canal Dehiscence Syndrome.

You have several ear related problems and each one needs the proper treatment by the appropriate professional. Blaming it all on you just isn’t going to help!

by Neil Bauman, Ph.D.

A man wrote:

I hope you can help me It all started on March 11. I got to work and started walking to the job and got dizzy and light headed. During the next 3 hours, I felt worse and worse. I got sick to my stomach. I called my wife to come and take me to the hospital. As we were going to hospital my chest, hands and feet felt numb. At the hospital I told them my chest hurts, my hands and feet feel numb, and I’m spinning. I was in the hospital 10 days.

After I got out, they sent me to an ENT doctor because I had lost the hearing in one ear. He put me on Prednisone and some other drugs. My hearing came back quite fast. However, since this happened, I need to use a walker because I am dizzy. My wife drives me around, and just the motion of the car, and seeing cars whiz by makes me dizzy.

I am just 54. They have done an MRI and found nothing. They say only my left ear was involved. The neurologist said today that a small blood vessel going to my ear could have caused a small stroke. Of all of the stories that I’ve read on the Internet, no one talks about numbness. Furthermore, I can’t believe that hearing plays that much of a role in having to use a walker.

That’s quite an experience you have gone through. I agree with you that numbness is not a part of “ear problems.” Typically, numbness is the result of a lack of blood flow to the affected parts of your body. Hence the sensor nerves there (pain, heat/cold, pressure, etc) temporarily cannot send their messages to your brain. Thus you have the numb feeling (or rather lack of feeling).

Whatever you had obviously affected your whole body, including one of your ears. When the blood flow was cut off to this ear, it immediately affected the two things your ears give you—your hearing and your balance.

Since the vestibular parts of your inner ears are the main balance organs in your body, when one or both of them are damaged, you typically get violently sick and the room spins— just as you experienced.

Thankfully, your hearing came back, but you are now left with what appears to be some permanent balance problems. Let me explain what happens in your ears that causes you to have these balance problems.

Your inner ears consist of two parts, the cochlea and the vestibular system. When something damages the cochlea, you lose hearing. Apparently the same thing that affected your cochlea also affected your vestibular system causing your dizziness and vertigo. Often both are damaged together since both structures lie side by side and share the same fluids.

Perhaps you don’t know this, but you actually have 3 separate balance systems in your body. First, and the most important, is the vestibular system in your ears. Second is your eyes. Trailing a distant third is your proprioceptive system (pressure sensors in your legs and feet).

Since there are two of each of these subsystems, you really have 6 separate parts of your balance system—all sending balance information to your brain. If all 6 send the same consistent information, you have normal balance.

However, if one (or more) of these parts is damaged and begins to send different (false) balance information, then instantly your brain is confused. The result is the dizziness and vertigo (spinning) you experienced.

Fortunately, over time, your brain generally learns how to ignore the bad signals. When this happens, the vertigo and much of the dizziness goes away. It can take a few months or more for your brain to adjust.

One thing that helps is to do balance exercises that teach your brain to ignore the bad balance signals, and only use the good ones.

One more point. You mention, “My wife drives me around, and just the motion of the car, and seeing cars whiz by makes me dizzy.” This is often the result of damage to your vestibulo-ocular reflex. This is just a fancy way of saying that the vestibular system in your inner ears and your eyes are tied together in intricate and wonderful ways so that when you are moving around your eyes have a stable horizon or reference point.

When this vestibulo-ocular reflex is damaged or broken, then your eyes move independently, rather than being coordinated by your brain to move in unison with your body movements. One of the results is the dizziness you feel when you, or something around you, is moving.

When you wrote, “I can’t believe that hearing plays that much of a role in having to use a walker,” you were only thinking of your ears as hearing organs. By now you realize they are so much more—they are critical to proper balance. When you don’t have good balance as you have unfortunately discovered, you cannot always function independently.

by Neil Bauman, Ph.D.

A concerned mother explained:

Our daughter is 8, and has a bilateral vestibular disorder. She has trouble reading and if she reads too much she will get horrible vertigo spells. Even her gait is affected. When she comes home from school on Friday, her stance is wider than normal and she tends to plop her feet down. This abnormal gait disappears by Saturday.

Other than balance and hearing difficulties that come and go, she appears fairly normal. I liken my daughter’s brain to ‘RAM’ on a computer. It seems her brain does not have enough ‘RAM’ to hold several ‘programs’ open at once, unlike a computer (and most people’s brains) which can hold open, and use, several ‘programs’ at a time.

For example, if she’s using her vision program, her hearing and motor programs may shut down. If she’s using her hearing, her vision and motor programs may shut down. If both her vision and hearing programs are taxed beyond their limits, her vestibular program can’t operate either.

If she’s in a busy place such as a grocery store, or even at school, her vision goes first, then her hearing, then her muscle control and finally her balance. She literally slithers out of her chair to lie prone on the floor for which she gets into great trouble at school for ‘refusing to listen’ and get back up in her chair, going to her room to get some quiet, etc.

Her inability to keep more than one program open at a time also leads to very high distractibility. For example, if she’s looking, she can’t hear. If she’s listening, she’s not looking. If she’s walking and hears a noise, she drops whatever is in her hand.

Do you know of anyone that has a child who even remotely behaves like this?

Your daughter’s behavior seems so strange so as to be almost unbelievable–but similar things happen to other people too.

Although your daughter has several health problems, if she had just lost her balance system, she could have similar experiences.

You see, normally our balance (vestibular) systems work automatically and subconsciously behind the scenes. However, is something destroys our vestibular system, then the conscious parts of our brain have to take over for the subconscious parts (in this case, the vestibular parts) and try to keep us upright. This requires a lot of RAM (to use your analogy) and when too much is used for balance, then the other systems suffer (and may fail). Symptoms of a  damaged/destroyed vestibular system may include memory loss, fatigue, nausea, blurred vision and other visual problems, and in extreme cases, sensory shut-down.

A lady recently told me about her sister, an RN, who had something similar happen to her. This sister had taken Gentamicin drops in her ear on her doctor’s orders–but she had a hole in her eardrum and the Gentamicin got into her middle ear, and from there totally destroyed the balance in her inner ears.

She wrote:

My sister has been diagnosed with vestibular damage [balance problems], nystagmus [eyes jerking horizontally], and oscillopsia [bouncing vision]; she experiences all the gamut of symptoms you mention–the vertigo, dizziness, nausea, vomiting, and ataxia [staggering gait]. She even experiences motor function shut-down, and a loss of consciousness when in an environment that becomes too challenging for her brain–too much visual stimuli.

Particularly notice that last sentence. This is somewhat similar to what your daughter is going through. Notice that this nurse experiences too much sensory overload, she too, “slithers to the floor” so to speak–totally out of it.

Thus, if a person has vestibular system problems such as both your daughter and this lady have, the answer is twofold. First, try to cut down on the amount of sensory stimulation that you receive at any given time. This may mean simplifying your environment so as not to overload your brain and cause it to shut some systems down in order to cope. Second, schedule a number of “quiet time” breaks in a less challenging atmosphere throughout the day in order to give your brain time to recover before it shuts some things down.

by Neil Bauman, Ph.D.

On June 4, 2006, the New York Times ran an article entitled: “Inner Ear May Take Beating From High-Impact Aerobics” It pointed out that the last thing on the minds of people jumping and bouncing to music is that they could be damaging their inner ears. Let me explain what can happen.

There are two separate causes of inner-ear damage. The first is that generally music is played at ear-damaging levels. Often the first symptom to appear is tinnitus or ringing in your ears. If you do not heed this warning, later you may notice that your ears begin to feel plugged or blocked, and if you get your hearing tested, you’ll discover to your shock and dismay, you now have a significant hearing loss. This may not happen all at once, but the longer you expose your ears to loud sounds, the quicker it will happen.

The obvious solution to prevent damage to the hearing part of your inner ears is to turn the music down to a level of 80 decibels or less. Failing this, wear ear plugs with a rating of 20 dB or more when you do your aerobics.

The second cause of inner ear damage is in the vestibular or balance part of your inner ears. Damage here can result in dizziness, vertigo, feelings of imbalance and motion sickness.

What happens is that with all the high-impact aerobics, the jarring of your head causes the “rocks in your head” (technically known as otoconia) to be jarred out of their normal place (the utricle in your inner ears) and bounce around in your semi-circular canals. Whenever one of these “rocks” touches the tiny hairs (cilia) there, it causes the cilia to generate a spurious balance signal that is sent to your brain. When you brain receives both good and bad balance signals it gets confused. That confusion results in the vertigo and other imbalance problems.

Activities that can cause such imbalance problems include high-impact aerobics that involve a lot of bouncing up and down with both feet off the ground at the same time, high-mileage running or when playing sports where a lot of jumping in involved such as in volleyball.

To minimize the chances of your developing balance problems, you can do three things. First, limit the time you spend on high-impact aerobics. You don’t have to stop these activities completely. Moderation is the key here.

Second, consider switching from high-impact aerobics to less jarring activities such as step exercises or low-impact aerobics where one foot is always on the ground.

Third, wear good shoes that are specially designed to absorb much of the shock of the above activities.

by Neil Bauman, Ph.D.

An 80-year-old man wrote:

During the night if I have to walk in semi-darkness or on badly lit pavement, and especially if I have to look up and down (to avoid potholes in the street pavement), I develop imbalance and a staggering gait, which embarrasses me a lot. My ENT consultant told me I had age-related Vertigo, and prescribed a short medicinal course which has not really helped.

I can understand your embarrassment. You appear drunk, but you’re not. What has happened is that the balance system in your inner ears is damaged–but people looking at you don’t know that.

Furthermore, I disagree with the diagnosis your ENT made because you are not experiencing vertigo from your description of your problem. Basically, you don’t have problems in good light–just when the light is poor. This is not the way vertigo works. Thus I am not surprised that the medications he prescribed didn’t work.

What has happened is that your vestibular system (balance system in your inner ears) has been damaged. When the light is good, your eyes compensate for your poor vestibular function. However, when there is no light, or poor light, then your eyes aren’t of much use, and you have the balance problems, staggering gait, and the lack of a steady horizon (indicated by your problems when looking up and down–technically known as oscillopsia).

Let me explain how this all works. Your body has three separate balance systems, your ears, your eyes and your proprioceptive system (basically pressure sensors in your legs and feet that tell you when you are upright). Your ears are the most sensitive of these three systems, your eyes are next and your proprioceptive system trails a distant third.

You can function reasonably well with any two of these three systems working. That is why under good light you have reasonable balance–your eyes and proprioceptive systems are doing their jobs. However, when you lose the light, your eyes no longer help you much. Thus only your proprioceptive system is working properly and consequently you have balance problems.

If this vestibular damage is permanent (and it may be), you have to learn how to live with it. As you can see, one of the secrets is to do your moving around during the day and limit where you go at night. Under poor light conditions, you would do well to have a companion to lean on and steady you. In the house, use night lights in the hallways so you can see well enough to go to the bathroom at night. Also, holding on to the walls helps.

Something obviously damaged your vestibular system. Perhaps it was from taking one or more of the many drugs that can damage your ears (ototoxic drugs). One strong indication of this would be any medication you started taking in the days or weeks before you bagan to notice your balance problems.

To learn more about this, read Part I of my article on Ototoxic Drugs at http://www.hearinglosshelp.com/ototoxicupheaval.htm. “Ototoxic Drugs Exposed” reveals most of the drugs that can damage your vestibular system. You can get a copy at http://www.hearinglosshelp.com/products/ototoxicdrugbook.htm.

by Neil Bauman, Ph.D.

A lady wrote:

I’ve been reading your books with interest and read that eventually the balance system is irreversibly damaged in most people with Meniere’s disease. I was wondering how people cope with mobility at this point. Is a cane or walker still helpful or does it mean a wheelchair? What do most people do?

Meniere’s disease can indeed damage the balance system in your ears. However, even totally destroying this balance system (called the vestibular system) doesn’t leave you flopping around on the floor like a jellyfish. This is because we have, not one, but three separate balance systems. Thus when one quits working properly, our brains rely more on the other two to help keep us balanced.

You can read about our three balance systems (vestibular system, visual system and proprioceptive system) and how they all work together to keep us upright in my article at http://www.hearinglosshelp.com/articles/balancesystem.htm.

Furthermore, each of these balance systems consist of two (redundant) subsystems. For example, there is a separate vestibular (balance) system in each of our inner ears. Thus, if one side is damaged or destroyed, the other side takes over and allows us to keep our balance.

In fact, this is exactly what happens in the vast majority of people with Meniere’s disease. Meniere’s disease typically only attacks one ear. Thus, most people with Meniere’s, unless they are having a severe vertigo attack where they can’t even sit up, use whatever balance systems are still working and manage to get around reasonably well. Their brains learn to adapt and pay more attention to any balance system information that is still reliable.

However, people with damaged vestibular systems are not as steady on their feet as they once were. In fact, if the damage is severe in both ears, they may lurch and stagger–much like the proverbial “drunken sailor.” Such people often use canes or walking sticks to help steady themselves. Even so, I don’t know of any that are confined to wheelchairs solely because of their Meniere’s.

If you have damaged both vestibular systems, you will have a much more difficult time when it is dark (when you can’t use your eyes effectively) or when walking on uneven or soft ground (which messes up your proprioceptive system). Under such conditions you may have to “hang on” to a wall or another person.

To learn more about Meniere’s disease and what you can do about it, point your browser to http://www.hearinglosshelp.com/products/books.htm#menieres_disease.