Sunday, June 17, 2012

Exercise, tinnitus and Meniere’s disease


I have been sick the past week with bronchitis, which is something I really dread because of the coughing, wheezing and the lack of sleep that comes with it. Although it hasn’t brought on a Meniere’s disease attack (keeping my fingers crossed!) I have definitely been lightheaded enough to be concerned. One thing that I have noticed in the past week is bout of tinnitus.  In the spring when I was sick I heard the same kind of soft pounding noise.  But it seems that tinnitus comes in different sound on different occasions.

This past week I got an email from Richard of Miami about his experience with tinnitus and exercising. Here is part of the letter…

I notice that every time I go to the gym and have what for me is a good workout, by the time I drive home, I have a rather loud humming on the right side of my head coming mainly from inside my right ear. I think the doctor once told me that was just another form of tinnitus, the most common form being that high-pitched never-ending tone, which I have in my left ear. Do you think there's a connection between exercise and this humming form of tinnitus, and if so, can anything be done about it? Have you yourself ever experienced this phenomenon?

I wonder if the movement of exercising somehow causes the inner ear mechanisms to cause this type of tinnitus, I’m not really sure.

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Thanks

22 comments:

  1. Hi all,
    I've noticed at times when I'm taking my walks that when I am really pushing it and going up some of the hills near my home, that not only does my tinnitus increase in volume, but I sometimes tend to get dizzy. I check my BP when I get home and it is absolutely normal, which for me these days is around 116/72 give or take a few either way. My tinnitus has been very loud, mostly in my right ear, but I notice it in both at times, but always louder in the right.

    I love this sight and all the comments, mostly for the fact that I find I'm not the only one experiencing a lot of what I do. Hope you're feeling better David, and to everyone, keep plugging along..

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  2. I myself go to the gym 3 days a week. And most of the time when I get back I have this "pounding" or I'm not sure how to describe it, kind of tinnitus. It's somewhat different than the constant tinnitus I always have. I've never really had it checked out or asked about it since it mostly goes away a while after my visit to the gym.

    So I suppose it has something to do with your blood flow. Which would probably go up when you are exercising.

    So yes, I've experienced this too, many times, although I have no clue if it's normal or what to do about it.

    Kind regards.

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  3. hello
    this is one of the saddest parts of my life prior to menieres i was so sporty, had a great body and felt amazing. know i am chubby and have high cholestral. lol, you have to laugh sometimes at this illness.
    people say you have to be active but for me if i push it too much my menieres kicks off big time.
    i just had a sac decompression, i told my surgeon give me 6 months to feel the effects, and see if i can start being active again, when i go back in 6 moths i will either do a sac decompression on my other ear or somthing else, lets see what will be in store.
    ali

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  4. Ali,
    Do you have any hearing loss after the surgery? What is the overall feeling after the surgery? Is it working?

    Alex

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  5. Also, the reason why I've never stopped going to the gym is because, yeah, I've been going for ages, my workouts are always "hard", I'm not just going for cardiovascular health, but also to build muscle. And the reason why I haven't stopped going is because I've had MONTHS where I've had no signs of vertigo whatsoever, only mild tinnitus etc..So I never really thought about working out having an influence on Menière's.

    Although since my ear got worse, I've dropped a few very strenuous exercises from my program. Because I've read that in some cases (or most cases?) fysical stress is also a trigger for Menière's. So yeah, I'm kind of not sure if I should slow it down or not, also can't find alot of information about it..

    Kind regards

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  6. hello alex
    my hearing in the operated ear is much worse at the moment, i am having good days and bad days. i have heard you must wait a good 3 months before you can really see if it better or not. i will give a full analysis of the op in time.
    as now it is far to early to tell if its worked or not.
    ali

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  7. I haven't noticed tinnitus on its own increasing due to exercise, but I pretty much can't do anything that involves a bouncing-type motion or rotational motion of my head (jumping, running, sit-ups, etc.) without getting the spins. I'm still not sure if it's the head motion or the vision that causes the vertigo. Sometimes the spinning is short-lived and isn't accompanied by the tinnitus, but sometimes it goes into a full-blown attack.

    I also had the endolymphatic sac decompression + shunt surgery a month ago. I felt reasonably well for the first week or so, and the temporary tinnitus and hearing issues from the surgery were getting significantly better. Sadly, 9 days after surgery, I had a severe Meniere's attack that lasted 24 hours and left me immobilized on the couch. It ended up destroying a significant part of my sick ear's balance and hearing function. (That's the specialist's assessment of what happened.) I have tinnitus 24/7 now, a high pitched ringing all the time that fluctuates a little bit in pitch and volume, and then a low frequency thumping (bass-line) that comes and goes and seems independent of my heartrate. I'm still off work and can't drive because my brain is going through the compensation process to relearn to balance. A slow, wobbly walk around the block (1/3 of a mile) is about all I can manage as far as activity. Some days are worse than others, so I'm not sure if I'm having other Meniere's episodes on top of the baseline level of crappiness or what. I'm starting vestibular rehab next Monday to help the retraining process, but apparently it can take a few months to settle into a new normal. They also don't know yet how much, if any, of the hearing lost during the attack will come back. I'm pretty bummed since I had very minimal hearing loss before the surgery that was only in the lowest frequencies; now I've got moderate loss in all of the low frequencies and severe loss in all of the high frequencies.

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  8. hello drea
    keep strong its a heavy opertaion, takes time to fully heal/recover.
    hoperfully overtime you will get the benefits, i think the severe hearing loss is probably all the bruising and the bashing the ear took from th operation. as most people after this op have better hearing after a while.
    hence why i stressed in my post that i will only really give a full analysis after 3 or 4 months.
    regards
    ali

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  9. Drea, keep up the good work! I hear that exercise helps you adapt and adjust more quickly to the new realities of Meniere's-deprived balance. And I am pretty sure I feel a bit more "centered" since I started using the elliptical trainer and doing yoga.

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  10. Ali,
    I understand most people will go thru severe hearing loss after the surgery, it's a result of the trauma the ear goes thru. Did you doctor say that eventually hearing will recover though?

    And so far have you had any vertigo attacks?


    And @Drea, did your doctor tell you why you still had the vertigo attack after the sac decompression?

    Thanks,
    Alex

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  11. hello alex
    currently i am having hearing loss, but as you stated its the trauma. only 2% of people that have this surgery get worse hearing.
    i have not had a major attack, but i do feel quite dizzy somedays, hence i take my buccastem
    in 2 months i will give you a proper low down as at this stage its far to early to say if its a good op or not.
    overall i am quite confident.
    regards
    ali

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  12. @Peggy, thanks for the encouragement! In the course of looking for snowboards on craigslist a couple days ago, I found a product called an Indo Board that helps balance training and snowboard training in the off season. While the actual Indo Board was really expensive, I made my own pretty cheaply yesterday. I'm pretty terrible on it right now, but I hope it helps both skills. :)

    @Ali, it will be interesting to compare notes over the next few months about the recovery process. My doc said that some of the hearing may come back over the next month or two as my ear continues to heal from the surgery and rebound from the attack, but he was straight forward with me that it may be permanent due to the severe attack. They put a massive dose of steroids in my inner ear during surgery and I took another lengthy round of oral Prednisone immediately after the attack to reduce the permanent hearing damage. While I don't like the side effects of steroids - insomnia, crazy appetite swings, and agitation - they really helped me feel alright during the first week after surgery.

    @Alex, my doc thinks the timing of the attack coincided with the wearing off of the steroids they put in the inner ear during surgery. I tend to agree since the night before the major attack was the first night I actually slept well. He also wasn't surprised that I'm still having attacks since the surgery only has a 60% success rate, and 10-20% of patients' MD gets worse after surgery than it was before. He made sure I was aware of that before I made the decision to have the surgery.

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  13. hello drea
    would be good to keep notes, one thing i notice though is that when i wake up my hearing is terrible on the operated ear, but by the time its bed time some hearing has come back.
    regards
    ali

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  14. Drea,
    I hope you are getting better everyday.
    Has your doctor told you the next steps if the sac decompression didn't work?
    Stay strong!

    Alex

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  15. Alex,
    I can still try the Meniett Device, which I understand also has a 50-60% success rate. My insurance (military) has already declined paying for the device, so I can either wait until they medically separate/retire me (probably 9 months or so) and see if the VA will cover it, or I can pay for it out of pocket and pray that it works. The VA can't tell me straight out whether they would cover it or not, but they are better about paying for durable medical equipment, so maybe.

    If the Meniett doesn't work, I'm somewhat out of options for a few years. My ENT doesn't have a high opinion of steroid injections, especially in my case. I've only had the disease for 10 months, and my doc prefers to wait a few years after initial onset to see if it is likely to go bilateral and for my hearing loss to increase before they do anything permanently destructive. I'm not sure if/how the new development with losing so much hearing and balance function at once will impact that timeline.

    As far as meds and lifestyle changes, the low sodium diet only helps a little, I couldn't tolerate the diuretic since my blood pressure is already at the low end of normal, and of all the anti-vertigo meds, scopolamine is the only thing I can take if I want to stay conscious. The scop helps some, but only as a preventative, and the side effects (dilated eyes, blurry vision, dry mouth) aren't that great to live with 24/7. That's what led us to the decompression surgery in the first place.

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  16. Drea, I'm not sure what the objection to steroids would be... they don't do any damage to the hearing or the structure of the ear. They basically act as an anti-inflammatory. Steroids are pretty much the last thing a doctor can do *before* they have to turn to destructive remedies.

    It's good that your doctor doesn't want to immediately jump to destructive treatments, though. Those should be held in reserve until you see where the Meniere's is going.

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  17. Drea,
    In theory, the Meniett device decompresses the sac with the pressure it releases into the inner ear. However since you've already had your sac decompressed, I don't see how this is an option.
    And I think steroids should be a better option since it reduces the swelling somewhat.
    I also find that low salt diet doesn't help that much, and the same thing with diuretics.
    Alex

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  18. hello alex
    i would disagree with you in reference to a low salt diet not being helpful.
    menieres is a multi layered ilness, it is very much a process of elimination in reference to finding oneself symptom free, i can assure you that most of us if we went crazy on salt are attacks would come thick and fast.
    also with diuretics, its a balance game as to how much you can take before it become counter productive.
    @ drea, you need to relax and take it easy for 6 months after your sac decompression, and then re-analyse where your at. thats the general rule with menieres you have to give things time and see how things are.
    regards
    ali

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  19. hello
    theres a feeling i want to describe, that happens. its odd to explain, you will probably only understand if you have the same feeling. basically its like there is electricity in your head. does anyone know what i mean? this feeling for me is one of the sensations that signals there could be an attack round the corner.
    regards
    ali

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    Replies
    1. Hello Ali,
      Yes, absolutely. Ask your ENT about vestibular migraine as I've also had this unusual symptom.

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    2. Hello Gayle
      I was also a very sporty person, so depressing not being able too push one self let alone do anything remotely active, I can get away with light cycling and a bit of swimming. Years ago I went to a neurologist, I was given propanlol for migraines.
      Recently I asked my GP for a referral to a migraine specialist, the guy had an 18 month waiting list, I have another 6 moths wait for him, will see what happens. As you were sporty how is your neck, do you advise any messages that are good for menieres/migraine? Its ironic that you also have the electric feeling I mentioned. This could well be body/neck misalignment from the sport. What’s your views?
      Regards
      ali

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  20. Hello David

    From my experience, exercise does indeed worsen tinnitus. I am a cyclist, long ago a racer, but every time I try to train "normally", the tinnitus flares up. This happens only if I am training in the higher heart rate zones. An easy spin doesn't trigger it.
    My experience is symptoms of Meniere's & vestibular migraine worsen when the body is put under prolonged physical stress. (My MD is not classic, and the ENTs suspect vestibular migraine along with atypical MD) Flare ups of symptoms due to stress on the body are consistent with my experience of vestibular disorders for the past ten years. What really works for me is eating well i.e. organic/natural, avoiding trigger foods, low stress, routine, mild exercise...
    But, I struggle as I love to ride, and ride hard. I wish I had a solution for you but I too am searching for the answer. My best guess is the increased inflammation in the body due to the intense activity may worsen inflammation in the inner ear/vestibular system and increase symptoms.
    Good luck,

    Gayle

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