Meneires Disease

[timonase]

Hello All,

I most likely suffer from meniers disease. The vertigo and hearing loss starts to come more freuently now. Unfortunately I have been to quite some doctors in Bangkok and none seemed to be very knowledgable about this syndrom.

Is there any body out there who has a recommendation for a doctor in Bangkok......I urgently need a specialist.

Thanks for the help

Timo

[lopburi3]

Have no personal experience but do have experience with ENT at below hospital for treatment of a retired nurse from Lopturi who had impacted wax and infection which Lopburi Hospital doctor told her to stop using cotton buds and nothing wrong (she never had used) - doctor here cleaned and treated with anti biotic and three days later she was able return upcountry without infection or hearing problems or pain.

At any rate below it first hit on Google search and is the hospital I use and that was used above.

http://www.ear-nose-throat-treatment.com/Meniere_Disease.php

[timonase]

Thanks lopburi,

at least they have the disease on there webpage. Still looking for more peronal recmmoandation, as i play the game of finding the right one for a while. My disease is progressing and i am desperate to find a knowledgable doctor.

regards

Timo

[Dakhar]

PM me. I am an American trained audiologist in Thailand (Doctorate level)

I can think of 3 doctors that may be of some help.

Treatment for the disease is very hit and miss, and sometimes surgeries can be done. I would rec. you do some serious google work so when you go in to the doctor visits informed of your options.

If you want to visit with me, that is fine, but I can not treat your issues, I can really only inform you of the options out there.... google can do the same.

[timonase]

Hello Dakhar,

thabks for your input, i wll PM you in a minute. I have googled, read and informd myself to the max. Cant say i know everything, but alot, also about the possible treatment ans surgery options. What i need is a doctor who knows as much as i do possibly more)( have not found that in BKK yet) and is willing to listen and then try to find the right solution for me.

regards

Timo

P.S If anybody else still has suggestions for doctors....always welcome

[timonase]

dakhar, i have just sent you a PM, hope it went through ok,

regards

Timo

[RubbaJohnny]

You have my sympathy I have this problem too although in remission at present

I saw a v good local Dr and read up everytning I coud find online

Unless very severe surgery is alst resort

Diet may be a factor

Please pm if you wish and you can call for achat sat pm if it will help

Are you sure it is Menieres?

[timonase]

Thanks for all the input so far.....

any specific doctors names, any one???

regards

Timo

[Old Man River]

Thanks for all the input so far.....

any specific doctors names, any one???

regards

Timo

I thought I had meniers and was referred to Dr. Saowaros at Bamrungrad, but as it turned out I didn't (she correctly diagnosed the problem). I would talk to her. Note, she doesn't take appointments because she takes a long time when she first sees a patient (which is what you want). Hence, it is on a first come first serve basis. People actually sign up for an afternoon appointment at 9AM in the morning (I think they send their drivers to sign up for them). She is busy. If she can't help you (for any reason), she will know who can.

Name: Dr. Saowaros Asawavichianginda

Specialty: Otolaryngology (Ear, Nose:Throat)

Language: Spoken: English,Thai

Qualifications: Medical School:

- M.D., Faculty of Medicine, Siriraj Hospital, Mahidol University, Thailand, 1985

Board Certifications:

- Diploma of The Thai Board of Otolaryngology, 1991

Associated Professor, Chulalongkorn University, Department of Otolaryngology, Thailand

Fellowships:

- Neuro-otology, University of Toronto, Canada, 1994-5

Special Clinical Trainings:

- Vertigo & Balance Disorder, Hearing Disorder and Ear Surgery

Special Clinical Interests:

- Vertigo, Physical and Surgical Therapy for Vertigo, Early Hearing Detection Program and Tinnitus

[timonase]

thank you,

someone else has recommended her before, but unfortunately she is on research and will not come back to work until march 2010

thanks anyways.

regards

Timo

[aree2]

Timo, I greatly sympathise.

To address your specific query: a Thai acquaintance of mine suffers badly from Meniere's: I'm attempting to contact her to find out if she can recommend a good specialist in BKK, and will post a note here if/when I get any info from her

To relate my own experience: I have had some form of Meniere's / intermittent labyrinthitis since 2003. I was first treated & examined in the ENT Dept at the BNH; I was told I probably had to face increasing deafness & more frequent vertigo attacks etc - but that hasn't happened since I saw a UK specialist also in 2003 and started taking SERC (beta-histine hydochloride) 16mg 2-3 times daily whenever I get the feeling of pressure building up in my left inner ear & notice an increase in my background tinnitus. However I'm not sure if SERC is available in Thailand. In BKK I was simply advised to take dramamine 50mg or Stugeron 15-25mg tabs (easily available) to ward off any incipient vertigo. I keep 3-4 dramamine pills with me in my wallet just in case, since the vertigo can come on very suddenly (altho' I now go for months at a time without an attack).

As you obviously know, Meniere's Disease seems to be extremely variable in its onset, reliability of diagnosis, and clinical course etc. Despite researching my own condition (which started in 2003) I still don't know if I have Meniere's or simply recurrent labyrinthitis, and neither did a UK specialist. On the bright side, you may well go into remission or partial remission if you can find the right combination of medicine(s) and possibly diet. You might even have a treatable ear infection, or a virus infection which will pass. That's where a specialist ought to be helpful. But don't rush to have surgery unless and until you've exhausted all other options.

[IMBabaBobo]

Hi Tim,

I've had Meniers for 25 years and been through every imaginable test and treatment, but the only thing that worked for me--which I haven't seen mentioned anywhere--is a 500mg dose of lemon lipoflavinoid (NOT orange). It was prescribed by my doctor at the time, a specialist in Meniers in the US. It's a vitamin, so no side effects. It's not available in Thailand as far as I can tell. It is very inexpensive and can be shipped here. You will have to experiment with the dosage. I started with one tablet in the morning, another in evening, then after some weeks, only had to take one a day. Unlike drugs, you don't take more to get the effect, but less. It doesn't cure the problem, but does cut back the intensity of ringing and all of the vertigo. If this doesn't work for you after a month, then you've only lost a few dollars.

Also, very important, no caffeine of any kind, or aspirin, as they thin the blood and will make your situation worse. Remember, decaf coffee is NOT caffeine free. So no Cokes, tea, or M150.

Good luck.

[timonase]

Hello all.

thanks for your replies. I am on Serc( betahistine) at the moment, but some doctors say one can see the onset of effect only after a month or so( if there are any effects). Please try to get in contact with your thai friend, to find a specialist in bangkok.

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I will try to look into the vitamin you recommended!! Thank you!!

I had a whole lot of test done already, to rule out infections as well as MRI and CT to rule out tumors. Still there are more things that can be tested, to be nore certain that it is indeed meniere( i know there will be no 100% diagnosis), but i have yet not been able to locate a specialist to do the remaining tests.

thanks for all your sympathies

Timo

[timonase]

Hello again,

i might add, that i have somewhat of a strange onset with the disease. For me it starts with the fullness of the ear and slight tinitus, then hearing loss. All of these symptoms increase over a period of sometimes 2 days. Then the vertigo sets in and the hearing gets better again....when the vertigo is gone the hearing is back to normal.I have read similiar onset are reffered to the Lermoyez-Syndrom, which is a different form of meniere.

regards

Timo

[Robroy]

I had the beginnings of Meniere's Disease (inherited from mother).

It disappeared around 15 years ago, when I changed my diet - less grains, beer, etc. (Paleolithic diet.) Never came back.

Most of my other ailments disappeared round this time too.

I doubt there is anything medical that can be done.

[aree2]

Hello again,

i might add, that i have somewhat of a strange onset with the disease. For me it starts with the fullness of the ear and slight tinitus, then hearing loss. All of these symptoms increase over a period of sometimes 2 days. Then the vertigo sets in and the hearing gets better again....when the vertigo is gone the hearing is back to normal.I have read similiar onset are reffered to the Lermoyez-Syndrom, which is a different form of meniere.

regards

Timo

Timo

no news yet from my Thai acquaintance, to whom I've now been able to send an email. She travels widely, and I've no idea where she is now.

Your symptoms sound exactly like mine.

My advice is, don't panic - stress makes my condition worse. I've taught myself to control the symptoms by taking an anti-vertigo medicine like dramamine or Stugeron (cinnarizine) when the sensations warn me of impending vertigo. The disease comes and goes in waves. Taking Stugeron before I go to sleep also helps me when things are bad. But if you don't have increasing permanent deafness my guess is that you'll learn to live with the condition, as I have.

SERC reduces my background tinnitus etc when I've been taking it for a few days, and seems to prevent attacks of the feeling of fullness in the ear, + deafness + vertigo if I remember to keep taking it. But if I've forgotten to take it, it won't stop an attack of the kind you describe. Its benefits seem to need several days to kick in.

The dietary suggestions made by others seem sensible, especially low cost things like the fruit extract. I thought for a while that taking folic acid helped my condition but my last bad patch of vertigo in January this year came after a period of remission of 18 months during which time I'd been taking folic acid every day. So who knows what one should take?

[timonase]

Hello Aree2,

are you in thailand at the moment?

regards

Timo

[aree2]

Hello Aree2,

are you in thailand at the moment?

regards

Timo

Timo

just heard back from my Thai acquaintance; sorry to say she's only ever seen a doctor in London

my best wishes for your speedy return to better health - I don't think I can add anything more to what I've written already

[timonase]

Hello All,

thank you very much for all the answers and help regarding my condition. I have gotten many nice replies and recommendations, also for specialists in bangkok. I have an appointment with a specialist in Bangkok on Saturday. I hope this will at least rule out all other diseases and i can focus on living with meniere the best way i can.

thanks again

Timo

[Old Man River]

Hello All,

thank you very much for all the answers and help regarding my condition. I have gotten many nice replies and recommendations, also for specialists in bangkok. I have an appointment with a specialist in Bangkok on Saturday. I hope this will at least rule out all other diseases and i can focus on living with meniere the best way i can.

thanks again

Timo

Please let us know how this turns out. I think many of us are getting to the age (not old -yet) where we are getting more concerned with our health than we used to.

Edited November 11, 2009 by Old Man River

[aree2]

Hello All,

thank you very much for all the answers and help regarding my condition. I have gotten many nice replies and recommendations, also for specialists in bangkok. I have an appointment with a specialist in Bangkok on Saturday. I hope this will at least rule out all other diseases and i can focus on living with meniere the best way i can.

thanks again

Timo

Please let us know how this turns out. I think many of us are getting to the age (not old -yet) where we are getting more concerned with our health than we used to.

Timo,

Glad to read that you've found someone to see.

As Old Man River suggests - please do pass on any useful advice to us - one can never be entirely up-to-date on this front, and the condition is so unpleasant that I for one would always be glad to hear if there's something else I ought to be doing to remain mostly in remission - the more so in this case since your symptoms and mine sound identical, as I said before

[timonase]

Hello All,

i will let you all know how it went on saturday and will post the name of the doctor if he is indeed what i hope he will be.

thanks again and i will keep you guys informed.

regards

Timo

P.S. I had another attack last night, but luckily not too severe

[newtronbom]

Hello again,

i might add, that i have somewhat of a strange onset with the disease. For me it starts with the fullness of the ear and slight tinitus, then hearing loss. All of these symptoms increase over a period of sometimes 2 days. Then the vertigo sets in and the hearing gets better again....when the vertigo is gone the hearing is back to normal.I have read similiar onset are reffered to the Lermoyez-Syndrom, which is a different form of meniere.

regards

Timo

Hi there. Doctor Naruemon Jintapatthanakit at Chaophraya Hospital Pinklao, is very experienced in neurological problems. She regularly attends conferences internationally and speaks very good English. Downside - fees are a bit high, as is private hospital, but staff and doctors speak good English and the service is excellent. There are may forms of meniere. I thought I may suffer from it, but to my relief I do not, and have been successfully treated at this hospital and "highly recommend" it. There equipment is state of the art as well! See this link for self awareness

http://en.wikipedia.org/wiki/M%C3%A9ni%C3%A8re%27s_disease

Edited November 13, 2009 by newtronbom

[timonase]

Hello,

thanks for your input. I will wait and see what my appointment tomorrow will bring, but keep your recommandation in mind.

thanks

Timo

[timonase]

Hello All,

as promised i report back after my appointement with a doctor recommended to me by a fellow thaivisa user. I have to say, he was by far the most knowlegable doctor i have encountered about the meniere disease i have met so far in Thailand. In addition to that, he took his time, which is almost as valuable in my opinion. He did not rush, eventhough there were other patients waiting.

Through exclusion of most likely everything else i could have in the ear or brain, he came to the conclusion that i indeed have menieres disease. PM me if you would like more details on tests done etc.

The next step was for me to find out, weather he is up to date to the many different treatment methods on meniere. And again, i have to say....he is. He knows or has read of every even the newest approaches. Some he believes in some he does not.

Of course, inreversible surgical methods are for him also a matter of last resort, but even on this matter he is up to date on many different ways.

He is a follower/believer, as in the same opinion, as a German professor, That betahisine( Serc) should be given. BUT in very high doses. ( 48 mg 3 time a day), so thats what he prescribed me. In addition, due to the high frequency of my attackes i was given a duretic, to control my natrium( salt) level in my blood, after making, sure by looking through my recent blood tests that my kidney functions were ok.

Of course he gave all dietry advices, already discussed in tis threat. Low Salt, low caffein, low alcohol. low nicotine etc.

Overall a very pleasent doctor and very sympathetic to meniere sufferes.

We willl now see, whether the medication does help and even if not...i had the feeling, he would have one more trick up his sleeve if this method of treatment does not show positiv effects.

Thank you all for the input and of course i am more than willlin to answer any questions you might have.

regards

Timo

[Sheryl]

Thanks for the uopdate, Timonase, and glad to hear that you are in good hands.

for the benefit of other members, may I ask the doctor's name and location (hospital)? Thanks!

[timonase]

Hello Sheryl,

the doctors name is: Dr. Permsarp Isipradit and he works at Bumrungrad and Chula Hospital.

regards

Timo

Edited November 16, 2009 by timonase

[aree2]

Hello Sheryl,

the doctors name is: Dr. Permsarp Isipradit and he works at Bumrungrad and Chula Hospital.

regards

Timo

Timo, noted, thank you.

Did he give you specific advice about how to prevent an attack coming on, when you feel the 'fullness' etc in your ear?

That's when I take Stugeron or dramamine

I'd be interested to know if he recommended medicines other than SERC to cope with the acute onset phase of the condition

[timonase]

Hello Aree2,

sorry for delay in replying. I was out of the country. Well, drammamine is sufficent when having an attack unless you have problems with vomitting during the attacks. This doctors focus was clearly on preventing the attacks and the lowering the number of attacks. Thats where the SERC comes into play( preventive) and the Moduretic ( preventive and trying to dont have the attacks too often. As you probably know, there are no long time studies on SERC and some believe in in some not. Same goes for the duiretic drugs.

So far i have been attack free, which is the longest in 4 month....placebo affect or drug...i dont care!!!

As per my previous post, i believe this doctor has some other things to try, if after a while we come to the conclusion that the current medication does not help.

if you have any other questions, please feel free to contact me again.

regards

Timo

[aree2]

Hello Aree2,

sorry for delay in replying. I was out of the country. Well, drammamine is sufficent when having an attack unless you have problems with vomitting during the attacks. This doctors focus was clearly on preventing the attacks and the lowering the number of attacks. Thats where the SERC comes into play( preventive) and the Moduretic ( preventive and trying to dont have the attacks too often. As you probably know, there are no long time studies on SERC and some believe in in some not. Same goes for the duiretic drugs.

So far i have been attack free, which is the longest in 4 month....placebo affect or drug...i dont care!!!

As per my previous post, i believe this doctor has some other things to try, if after a while we come to the conclusion that the current medication does not help.

if you have any other questions, please feel free to contact me again.

regards

Timo

hello Timo

no problem about the delay

what you say is re-assuring - thank you. My attacks are now much less frequent (and less severe when they occur) than they were when they first started - when they were so bad I'd hesitate to write down all the symptoms! - and I hope that will be your experience too. It sounds as if you're on the right track now.

My feeling is that SERC has helped me to manage the 'disease' - I only take it intermittently - if I get any hint of increased tinnitus or an onset of deafness. I've never taken a diuretic, so that speaks in favour of the SERC having some effect.

The devil of it is that I can go for ages without symptoms, think that I'm quite OK, and then have a recurrence - but never as bad now as in 2003 - presumably because I know how to moderate the symptoms by taking dramamine during the day, and sometimes stugeron before I go to sleep, and going back onto the SERC for a few days.

anyway, good luck!