When I’m questioned about why I’m retired already; or when someone airs doubts about my invisible disability, are you really disabled? the subject of Meniere’s disease is bound to surface. It is bound to surface because Meniere’s disease is the answer to both questions. If you just stumbled across this article on my blog and want to know, what is Meniere’s disease? I’ve never heard of it. I can understand that feeling. I’d never heard of it before its symptoms wrecked my life. Here’s the skinny on the subject of Meniere’s disease from my favorite resource.
Ménière’s disease (MD) is a disorder of the inner ear that is characterized by episodes of feeling like the world is spinning (vertigo), ringing in the ears (tinnitus), hearing loss, and a fullness in the ear. Typically only one ear is affected, at least initially; however, over time both ears may become involved. Episodes generally last from 20 minutes to a few hours. The time between episodes varies. Over time the hearing loss and ringing in the ears may become constant.
The cause of Ménière’s disease is unclear but likely involves both genetic and environmental factors. A number of theories exist for why it occurs including constrictions in blood vessels, viral infections, and autoimmune reactions. About 10% of cases run in families.Symptoms are believed to occur as the result of increased fluid build up in the labyrinth of the inner ear. Diagnosis is based on the symptoms and frequently a hearing test.Wikipedia, the free encyclopedia
That description matches up to my experiences quite nicely. I’ll take that as a working definition for the subject of Meniere’s disease. Feel free to read the rest of the referenced article if you need to know more. That handles the basic introductions, for anyone who might need basic introductions. If you are a fellow sufferer and I sent you here to read this, The rest of this post is for you. I want to answer your questions. That is why I wrote this post. That is why I maintain this post with my current experiences.
The questions about Meniere’s and my relationship with Meniere’s usually come in two forms. “What symptoms do you have?” is probably asked most frequently because not everyone diagnosed with Meniere’s has all the symptoms associated with the disease. Most doctors do not know what constitutes Meniere’s and many people could have an incorrect diagnosis from a well-meaning but poorly informed doctor.
The other question I get a lot is “what do you do to combat Menieres?” This question is usually asked because, rather than there being no information available on the subject of Meniere’s online, there is a lot of contradictory information about the subject from a myriad of sources; from both non-profit assistance groups and from for-profit websites peddling their own wares.
What I hope to achieve with this post is to cut through the noise of what everyone else is telling you about their opinions and their magic elixirs, and I’m just going tell you about the experience I have with Meniere’s and how I deal with treatment for myself. With any luck you’ll recognize symptoms and treatment options that appeal to you while reading this.
I haven’t done a thorough reporting of symptoms at any point during the life of this blog. I haven’t talked much about the disease at all since I first started writing a public diary back in 2005, and that first entry was a compilation of entries made on other forums over the course of several years. I avoid thinking about my disability, a feeling most sufferers probably share. It’s uncomfortable to acknowledge such a fundamental difference from everyone else.
I was a hardcore individualist for decades. I prided myself on knowing how to make things from scratch; knowing the ins and outs of the most rudimentary technologies an individual can master. I did this just in case I was ever alone and without the necessities we take for granted, especially today. I treasured this hard-won knowledge. It was my zombie plan before there was a thing called a zombie plan. I’d been collecting that information with just such an apocalyptic scenario in mind since the mid seventies. Between Soylent Green, Planet of the Apes and Logan’s Run, was there much hope left for the future? Even Star Trek predicted eugenics wars and near extinction in the time between the 1960’s and the future where we could cross interstellar space in the blink of an eye. The apocalypse everyone expected thankfully never came, but I did meet some interesting people in different survivalist circles as the years progressed from the 1970’s to the 1990’s.
Then came the Fall. Or was it a Spring? Seasonal allergy humor, never mind. Then came the vertigo. That’s what happened. Then came the vertigo, and everything changed.
Starting in the year 2002, I began to be subject to regular bouts of rotational vertigo that hit me without warning. These weren’t my first encounters with this particular symptom, but it was the first time that a discernable pattern emerged from the noise of my everyday life. My first vertigo attack occurred as a single incident many years earlier, probably sometime in 1984. In that instance I triggered the vertigo myself by accident while trying to clear the pressure in my left ear. I had just started noticing this discomfort, this feeling that my inner ear was swelling up, pressing against the skull from inside the skull, as far as I could tell. I was sitting the shower in an apartment that I shared with a fellow draftsman. Sitting with my painful ear directly under the hot stream of water in a desperate attempt to make what I thought was a blockage in the ear pass down through the eustachian tube. When the pressure finally eased in the ear, the blockage apparently cleared, I found that I was lying down in the shower and so dizzy that I couldn’t walk. I crawled to the bed and got in it, afraid that I might have done myself permanent damage. When I woke up the next day I felt tired but no worse for wear overall. Best of all the ear pressure seemed to be gone.
When I first started having the subsequent and almost regular vertigo spells, they seemed to be related to my seasonal allergies and those times of the year (spring and fall) when my allergies had always bugged me. And when I say always, I mean always. As far back as I can remember, I have had allergies. I was treated with allergy shots back in the early seventies, administered by my mom but prescribed by a doctor. I had recurring sinus and ear infections because of these allergies when I was a child. Allergies that I started associating with the annoying pressure in the ear. Distortion of the hearing in the ear that made enjoying any kind of music nearly impossible for weeks and then months at a time. All of these symptoms progressed slowly from year to year. Each Spring longer spans without music, each Fall more trips to the doctor demanding some kind of treatment for the discomfort. And then, as I said, came the regular bouts of vertigo in 20002.
As time progressed the vertigo spells became more generalized and could be brought on by high pressure weather, or just by turning my head the wrong way. These bouts of vertigo seemed to last anywhere from 6 hours to a full day, and frequently caused me to miss two days of work. Towards the end of my work life I was getting vertigo about once a week, making my average work week 3 days long. This kind of attendance pattern does not produce enough work for most employers. I was definitely not working enough to satisfy the architect I was working for then. Consequently I was fired from my last job for being sick too much, even though I accepted the job with the stipulation that I was frequently ill and had only been on the job for eight months.
It was at that low point, unemployed, cash strapped and suffering near-constant vertigo that I sought and was granted disability. Now that I am on disability and free to manage stress for myself, I count myself lucky if I can go a month or two without vertigo. Some years are better than that, some years are worse. You play the hand you are dealt, a mantra I’ve relied on all my life. This is what I have to work with, I will make the best of it that I can.
However, the vertigo is just the most visible symptom of the disease. There are many others, as the definition I cited above states. I have all of the usual symptoms. Almost as debilitating as the vertigo is the constant tinnitus, a ringing/whining/whistling in the ears which comes close to drowning out normal conversation and makes concentration very difficult. The tinnitus never stops. Sometimes it is loud, sometimes it is soft, and sometimes it causes the affected ear to amplify what little sound it hears, a condition known as hyperacusis, making even the smallest of sounds painful and sending me into a room by myself so that I can keep things as quiet as possible.
Then there is the pressure in the ear that I mentioned previously. Like the tinnitus this varies in discomfort, sometimes a nagging ache, other times a stabbing pain as if some fluid containing vessel in the ear is about to burst. The pressure in the ear is often a precursor to vertigo. If I get a metallic taste in the mouth with a sudden surge of pressure, I hit the medication immediately. Paying attention to how I’m feeling on any given day is how I’ve managed to keep the vertigo to a minimum through the years of disability.
I have slight dizziness and disorientation almost constantly. Disorientation brings on the brain fog on bad days, more pronounced after vertigo attacks. There are good days and bad days, but turning corners always carries the risk of colliding with objects I know are there and thought I would miss. The last symptom that I can tie to Meniere’s is a seriously vicious migraine headache. In 2014 I was getting them about every 4 days, but a trip to the GP where I finally admitted the headaches were that frequent got me a daily script that has reduced the migraines to something I only enjoy during allergy seasons.
On February 9th of 2018 at 6:30 in the morning I went bilateral with Meniere’s. Bilateral Meniere’s means I have identifiable hearing loss in both ears. Meniere’s disease produces hearing loss in predictable ranges that doctors can see and diagnose. I know the exact time that I went bilateral because that was the moment when my mother was dying in my arms. Trauma? Stress? Yeah, there was a bit of that. Two of my biggest triggers for bringing on the symptoms of Meniere’s. When I went to see the ENT later that week, she wanted to make sure that what was occurring was not something they could treat, so I went to visit a rheumatologist to insure that what I was suffering from was not autoimmune inner ear disease. A few blood tests later and that was ruled out. Sadly, I still have Meniere’s. Damn.
Going bilateral has meant that I have more frequent bouts of vertigo again just as I did when I was first diagnosed back in 2003. The years of experience with this disease have made the trials of bilateral Meniere’s easier to deal with, but the symptoms take their toll no matter how well you can cope with them.
The Ear, Nose and Throat doctor (ENT) informed me in 2015 that the hearing in my first affected ear (left ear) is about half of what it should be and is still getting worse. That is apparently the point that most sufferers opt to have procedures done in order to alleviate symptoms. There are a couple of interventions available to me, but neither of them offer better than 60% chance of long-term relief, so I’m not jumping up and down to have any of them done. Gentamicin injection into the cochlea is the procedure he wanted me to do. I will not be doing this procedure unless the vertigo gets worse; as in, as bad as it was when I was a working stiff. There is also a surgical procedure or two that will interrupt the signals from the affected ear. Those procedures will make you completely deaf in one ear, and the Gentamicin can also make you deaf if not done properly. This is too much risk for too little reward based on the situation I am currently in. My going bilateral rules out doing any of these procedures now unless medically necessary. The chance of going completely deaf is a risk that you want to avoid if at all possible.
I’ve only had two surgeries in my life. When I was a child I had my tonsils removed. It was a common practice back then (1973) for children having extreme allergic reactions and associated throat swelling to have their tonsils taken out. I wasn’t even the only one in my class in the small town I grew up in to have had this procedure performed on them. Most recently (2003) I had a procedure done that corrected a deviated septum and reduced the turbinates in the sinuses. Since allergies were so bad for me as a child, and allergies seemed to be a big trigger early on in the progression of my Meniere’s, it seemed like a logical step to see if fixing the breathing problems might not alleviate the Meniere’s symptoms. Sadly this has not turned out to be the case, but has apparently reduced my allergies and the number of sinus infections I have to suffer through. I will never forget the first time I went swimming after the surgery and got water in my sinuses. Before the surgery it was a major struggle to get the sinuses to clear. After the surgery I just tipped my head forward and the water ran out. “so that’s what working sinuses are like!” I exclaimed to the amusement of all present.
There are many behavioral approaches to treating Meniere’s. This is especially true since there are no cures and no known causes for the disease. This means that most sufferers cobble together a mish-mash of dieting and homemade concoctions that they swear by. If it eases their symptoms, then it really doesn’t matter to me if their relief is scientifically verifiable or not. For me personally, I like the agnostic approach of a proper scientist.
I have tried most of the alternative medical treatments that I didn’t deem outright dangerous to try. Essential oils. Myriads of supplements. I tried far too many different things to name here, even if I could remember them all, and I’m pretty sure I can’t. Mom was into alternative medicine and she would show up every few months with some new thing or other for me to try. I dutifully tried them all, to no real effect. It was at about this time that I started to question why I took things like daily vitamins. One by one I discontinued the various supplements I was taking until I had discarded them all as producing no noticeable effect. I even stopped taking vitamins for about two years until I started developing unusual skin problems. I don’t know which vitamin I’m low on, but chewing a daily gummy does seem to keep the skin working like it is supposed to, so I keep taking them. One of these days I’ll remember to ask the dermatologist which vitamin I might be needing, then the vitamins will be one more prescription, just like everything else I take.
I avoid stress and allergens as often as I can. That means getting enough sleep first and foremost, since stress is directly related to the amount of sleep that you get versus how much you need. This is one of the hardest things to do in this culture, the US culture, justify getting a full night’s sleep. I can and do sleep for longer than 12 hours on occasion, especially when I’ve had a particularly severe vertigo attack. I have found that 8 hours is more than enough sleep if I can get those hours from 10pm to 6am, but the problem is getting to bed before midnight (as I’m sure most people will agree) and staying asleep for the full 8 hours. I was diagnosed with sleep apnea and I started using a CPAP machine in 2016. That has shortened my sleep cycles to a more predictable eight to ten hours and I wake up feeling like I’ve slept well for the first time since I can’t say when.
Probably the single most beneficial behavioral thing I’ve done aside from sleeping more and getting the CPAP is I stopped sleeping on a flat surface. I always try to sleep with my head elevated. A touring musician who is a fellow sufferer (I wish I could remember her name) suggested sleeping with the head elevated because fluids tend to pool in low areas of the body. I don’t know how true that is, but it does seem to help. I tried wedging the head of the bed up, and that seemed to produce even better results than just stacking up pillows. Unfortunately the wife hates the heads-up sleep position, so I begged an adjustable bed from a friend who had one in storage. I’ve been sleeping on that bed ever since, and I credit it with reducing most of the inner-ear pressure that I used to experience while trying to sleep. If you don’t believe me, try it. It really can help.
I walk everyday, or as close to everyday as I can manage, regular exercise (sadly) being another facet of stress reduction. Walking puts me afoul of my allergies for almost anything that grows, so I have to do some of it indoors on a treadmill. I prefer to be outside whenever I can manage it, so allergy medications are something I tend to take frequently.
There doesn’t appear to be any real treatments for the tinnitus. Mostly it is a matter of enduring the constant sound which does contribute to the brain fog, or masking the sound with other sounds. I find Rainymood, suggested by a redditer, works best for days when the tinnitus is incredibly annoying. Most other days I just endure the constant barrage. You can train yourself to ignore the sounds using various methods that you may or may not find useful. I’ve never stumbled across anything that worked for me, and there have been many promises made over the years to reduce your tinnitus! promises that remain unfulfilled.
I have the least to say about tinnitus, I think, because hearing loss and the accompanying tinnitus stole my enjoyment of music from me. When the songs stopped sounding good in my ears, I simply stopped listening to them. I think that has been one of the hardest things to cope with, almost as hard as not being able to work. Music defined my life, as it seems to do for most people. My music appreciation stopped in 1999. I can’t recall a single new artist that I have followed since Prince. That, in music years, is several lifetimes.
I was already avoiding salt because of a hypertension diagnosis, and my hypertension medication contains a diuretic which was the first medication suggested by my ENT. Salt can increase blood pressure which increases stress. Stress is a major trigger. Caffeine is something I try to avoid because it disturbs my sleep, not just because it makes me dizzy. Caffeine can also increase stress. Anything dietary that causes stress can cause Meniere’s symptoms, so just avoiding things you think cause you stress can make your symptoms seem less noticeable. Don’t rock the boat and it won’t capsize. this, as usual, is easier said than done.
Other than avoiding salt and caffeine as much as possible, I don’t really follow any other dietary restrictions or fads. I live in the South so everything comes fried, which I’m then compelled to avoid because of cholesterol concerns (hypertension) the resultant impact of culture and health problems produces a tofu eater in the land of chicken fried steak, but then all of Austin is a little bit weird like that.
On top of the diuretic/hypertension medication mentioned previously, I take a variety of additional drugs both prescription and over the counter. If the affected ear is bothering me and I don’t have vertigo yet, I take Pseudoephedrine/Guaifenesin, this combination is usually effective at reducing ear pressure. If my allergies are acting up, I add Fexofenadine or Loratadine. As of 2018 I have a prescription for Azelastine that I find works wonders for the allergies. Using Azelastine daily has caused me to almost stop taking Pseudoephedrine/Guaifenesin, something the cardiologist has been trying to get me off of for years. If the migraine is kicking in, I take prescription doses of Ibuprofen and Acetaminophen together. A daily prescription for Amitriptyline has removed my need of other painkillers almost completely. I only take my megadoses of painkillers/allergy medication now on the really bad days, days when I’ve done something stupid like carry 40 lbs. of dog food or gone for a walk on a high allergy day.
Vertigo, the most debilitating symptom, deserves it’s own heading. This is a key point in understanding Meniere’s and its treatment; nearly all the procedures recommended by doctors are designed to stop the vertigo. The vertigo is thought to originate within the labyrinth of the inner ear, so most treatments are centered around that part of the body. From the most drastic to the least invasive, nearly all of the surgical treatments silence the affected ear, permanently. Some of the less invasive will leave you with some hearing in the ear, but their efficacy is highly questionable.
Vertigo treatment for me started with Meclizine (Dramamine) This is what I took in 2003 when I was first diagnosed. I still take it on occasion when I feel dizzy, but not spinny. There is a difference as any Meniere’s sufferer can tell you. If I’m having an active vertigo attack and it has already made me nauseous, I take Promethazine. If the vertigo doesn’t respond to the Meclizine (Which happens. Frequently) then I take Valium to let me sleep or Xanax to relieve the anxiety of the attack (do not take Valium and Xanax together. The combination is deadly) All three of those drugs require prescriptions in the US and are controlled substances which makes them much harder to get.
Flying is the fun part. I have to be medicated to fly. I used to take Promethazine and Valium, but Xanax alone is sometimes enough of a treatment to keep the vertigo at bay. I much prefer the Xanax because I don’t always go to sleep when I take it, but I have to have supervision because Xanax makes me a bit fearless (anxiety reducer) while not actually giving me any better balance. I’m just an accident waiting to happen then, but at least I can sit through a flight without freaking out at every movement, getting queasy and vertiginous.
I have another secret weapon for managing flying. Cinnamon chewing gum. I always travel with a pack of gum. I have always chewed gum while flying since I first went up in a Cessna with my dad as a child. If your ears bother you because of pressure, chew gum. Far more useful than earplugs.
I heard about Serc or Betahistine from Menierians in online forums years ago. This is a drug commonly prescribed for dizziness and specifically prescribed for Meniere’s disease in the UK and a good portion of Europe. I was initially dubious that the drug would have any effect since it had been trialed in the US previously and found to be no better than placebo at preventing Meniere’s symptoms.
In the summer of 2017 my ENT’s office took on a new doctor and I was referred to her for my annual Meniere’s symptom review and prescription renewal. She suggested a trial of Betahistine during my first consultation with her. As I established earlier in the text, I don’t reject any suggested treatment out of hand (any treatment that isn’t damaging or potentially life threatening. I could tell you stories, but I won’t) I decided to give Betahistine a try. The drug is not available in the US under its European brand name, Serc. It has to be compounded, and as a consequence of this it isn’t on the average health insurance formulary. This makes Betahistine more expensive to take and harder to get, but at least it was legal for me to try it.
As of this writing (January 2019) I have been taking 16 mg of Betahistine three times a day for over a year. While I can’t say it is doing everything I had hoped for, it is doing something. My head seems clearer, my concentration sharper. The tinnitus continues unabated but the ear pressure is less noticeable. I still get occasional bouts of vertigo but they seem to last for shorter durations.
Intratympanic Steroid Injection
In the Spring of 2018 I started getting steroid injections in my ears. Most frequently this has been the left ear, although I have had injections in both of them over the past nine months. Intratympanic injections were originally suggested as a possible remedy to the hearing loss in the right ear immediately following the diagnosis of bilateral Meniere’s earlier that Winter. The hearing test following the right ear injection didn’t show any major improvement, but I was impressed with the pressure relief that I got from the injection in the right ear. I was so impressed that I insisted the doctor inject the left ear just to see if it produced any noticeable effect there. It did, and I have had her inject the ear a few more times since then due to repeated battles with vertigo and/or pressure in the ear.
My last injection (December 28th, 2018) illustrated the downside of this treatment for me in pretty stark terms. You are not supposed to swallow if you can help it for the first few hours after getting an injection. You shouldn’t attempt to pop your ears or force air into your eustachian tubes (this is a frequent habit with Menierians when they are trying to get the pressure off of an affected ear) for several days, and really shouldn’t even use straws or swallow hard for that period of time.
Well, I screwed that up about ten hours after the injection and somehow got air up in the ear that caused the ear to pop. What followed was about three days of bedridden vertigo and constant medication. It’s been almost a week now and I’m finally feeling more like what passes for normal these days. The pressure is still off the ear and the world doesn’t turn inside out when I put pressure on the eardrum from outside. So the injection did what I wanted it to do, even though I screwed up the post-treatment regimen.
I had the ENT puzzled with that symptom, something I’d never noticed before myself. When the left ear is acting up, I can stick my finger in the ear and wiggle it, and my body feels like it changes shape. It feels like my right shoulder is getting longer and my right leg/hip is moving. It’s the weirdest damned thing I’ve ever felt, and I’ve only started noticing it since altering my allergy regimen. I may have to re-introduce some Guaifenesin into my regular treatment in order to keep the inner ear fluid pressure down. I’ll try testing that the next time I notice the weirdness in the ear. The ENT was suggesting putting a tube in the eardrum to see if that took the pressure off the eardrum, even though the eardrum does not appear to be under pressure. I may try that treatment at some point in the future. It is reversible, so isn’t something I will have to live with forever once done. Test and retest. Check and verify. It gets tedious, but it’s the only way to know for certain what works and what doesn’t.
A Word of Caution. A Word of Hope.
I make a lot of drug recommendations in this blog entry. Having suggested drugs for various treatments, I really should also offer the following caution; these drugs all have different effects for different people, and this fact can not be overstressed. These medicines work for me and I’m thankful that they do. Treating Meniere’s means finding your triggers and then doing your best to avoid them. My triggers seem to be stress or allergy related. It will be a trial and error process finding what will work for you. Here’s hoping it takes less than a decade for you to find your feet again. It will happen, it just takes time. If you find that a drug I suggest doesn’t work for you, try a different one. Keep working at it till you find a solution that works for you and then stick to it. The important part is to not give up.
When you start reading through the treatment page on the Meniere’s Disease Information Center website (a resource that is now defunct except as an archive) it becomes very clear that most sufferers will try anything to stop the vertigo. If you’ve ever been afflicted with a Drop Attack from rotational vertigo, and can imagine that sensation continuing for hours and days at a time, you would understand why sufferers are willing to try anything to make it stop, even drugging themselves (myself) to unconsciousness for days at a time to avoid the symptom. Unconsciousness is a mercy when consciousness is a never-ending torment of spinning. Spinning without end. Don’t let this disease kill you. Don’t let it win. Don’t hide from life for fear of that next attack.
If you are reading this because you to have Meniere’s, then I am truly sorry. I have often said that I wouldn’t wish this disease on my worst enemy. Being disabled has made me question many of the beliefs that got me through life before I was struck down by Meniere’s. Most of the things that I thought were real as a healthy person turned out to be delusion once I became chronically ill. Problems that I thought were paramount when I was healthy now seem trivial. Services that I complained about paying for are now essential to me and my family’s survival. Seeing life from this viewpoint has made me a better person, but there has to be easier ways of getting access to this kind of insight. Ways that don’t rob you of hope, of purpose. What can feel like forever, from the inside.
I miss architecture and drafting nearly every day. Those were my purposes in life prior to this debilitating disease. More than a decade later, I still have dreams involving architecture. Admittedly, the last dream involved all my drafting tools being ruined because they had been piled in a trailer for ten years, but still the dreams persist. I have them almost nightly, reliving events from my productive past only to wake up to the reality I face now.
So if you are a fellow sufferer, please know you have my utmost support. We all need people we can rely on now, because there are times when we really are helpless and won’t survive without them. While that has always been true of everybody, most people go through their lives never admitting this fact. Cherish those around you who are there when you need them. That is what it truly means to be human.
This is a periodically updated post, completely different from most of the other posts on this blog. The content of this post will and has changed as my experiences and treatment have changed. As of the addition of the edit history, I had made several periodic updates. Most of those updates were minimal tweaks due to my personal dissatisfaction with cludgy wording, or meanings that I don’t think I made clear in my first attempt at documenting symptoms and treatment. I added the section about chewing gum. I added the section noting there were no known effective treatments for tinnitus. I think those were the most intensive change prior to this edit. However, this edit will alter several points of the post so I deemed it prudent to document what I’m about to change.
August 6th, 2017. I am doing my first major alteration of the content and intent of this post. I’m adding headers to separate information. I added the recollection of my first vertigo spell, having dredged that memory up from somewhere. I can still vividly picture the inside of that Abilene apartment, almost like a nightmare. Tinnitus stole my music was added. I have revised the section on dietary habits radically. I discounted what I considered to be an obsession that most Menierians have about watching their diets in the original version. There are scientifically valid reasons to restrict your diet, and I was wrong to discount this fact (apologies offered where needed) so I altered the text to fit my current understanding. I am adding some verbiage about Betahistine (Serc) since I am now taking that drug and finding it effective. I changed Phenergan to Promethazine because that is the name the reference site uses. A general reorganization of information into coherent sections was a part of this edit as well as the specific changes mentioned. I hope the content is easier to absorb than it was before.
July 30th, 2018. I added the paragraph describing how I went bilateral.
December 29th, 2018. Migration to WordPress. General format changes. Additional history added concerning allergies and their linkage to Meniere’s symptoms and a reworking of the entire introductory section including the addition of an intro for non-sufferers. Edited in the switch to Loratadine and Azelastine for allergies. Added a section for the steroid injections started this year.
January 14th, 2019. Replaced the anonymous Minion meme with medcomic.com’s Meniere’s illustration. Used with permission.