Dr. Balentine received his undergraduate degree from McDaniel College in Westminster, Maryland. He attended medical school at the Philadelphia College of Osteopathic Medicine graduating in1983. He completed his internship at St. Joseph's Hospital in Philadelphia and his Emergency Medicine residency at Lincoln Medical and Mental Health Center in the Bronx, where he served as chief resident.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
What Are Some of the Treatment Options for Meniere's Disease?
Meniere's disease does not have a cure yet, but your doctor might recommend
some of the treatments below to help you cope with the condition.
Medications. The most disabling symptom of an attack of Meniere's disease
is dizziness. Prescription drugs such as meclizine, diazepam, glycopyrrolate,
and lorazepam can help relieve dizziness and shorten the attack.
Salt restriction and diuretics. Limiting dietary salt and taking diuretics
(water pills) help some people control dizziness by reducing the amount of fluid
the body retains, which may help lower fluid volume and pressure in the inner
ear.
Other dietary and behavioral changes. Some people claim that caffeine,
chocolate, and alcohol make their symptoms worse and either avoid or limit them
in their diet. Not smoking also may help lessen the symptoms.
Cognitive therapy. Cognitive therapy is a type of talk therapy that helps
people focus on how they interpret and react to life experiences. Some people
find that cognitive therapy helps them cope better with the unexpected nature of
attacks and reduces their anxiety about future attacks.
Injections. Injecting the antibiotic gentamicin into the middle ear helps
control vertigo but significantly raises the risk of hearing loss because
gentamicin can damage the microscopic hair cells in the inner ear that help us
hear. Some doctors inject a corticosteroid instead, which often helps reduce
dizziness and has no risk of hearing loss.
SOURCE: National Institute on Deafness and Other Communication Disorders,
National Institutes of Health. Meniere's Disease.
What is Meniere's disease?
Meniere's disease is a disorder of the flow of fluids of the inner ear.
What causes Meniere's disease?
Although the cause of Meniere's disease is unknown, it probably results from an abnormality in the way fluid of the inner ear is regulated. In most cases only one ear is involved, but both ears may be affected in about 10% to 20% of patients. Meniere's disease typically starts between the ages of 20 and 50 years of age (although it has been reported in nearly all age groups). Men and women are equally affected. The symptoms may be only a minor nuisance, or can become disabling, especially if the attacks of vertigo are severe, frequent, and occur without warning. Meniere's disease is also called idiopathic endolymphatic hydrops.
What are the symptoms of Meniere's disease?
The symptoms of Meniere's disease typically include at least several of the following:
Episodic rotational vertigo: Attacks of a spinning sensation accompanied by disequilibrium (an off-balanced sensation),
nausea, and sometimes
vomiting. This is usually the most troublesome symptom. The vertigo usually last 20 minutes to two hours or even longer. During attacks, patients are very disabled, and sleepiness may follow. An off-balanced sensation may last for several days.
Tinnitus: A roaring, buzzing, machine-like, or ringing sound in the ear. It may be episodic with an attack of vertigo or it may be constant. Usually the tinnitus gets worse or will appear just before the onset of the vertigo.
Hearing loss: It may be intermittent early in the onset of the disease, but overtime it may become a fixed hearing loss. It may involve all frequencies, but most commonly occurs in the lower frequencies. Loud sounds may be uncomfortable and appear distorted in the affected ear.
Ear fullness: Usually this full feeling occurs just before the onset of an attack of vertigo.
Tinnitus is a ringing or swishing that seems to originate in the ear or head. Most of the time it is not a serious problem (it is however, a nuisance to those that suffer from the condition). Causes of tinnitus include loud noise exposure (firearms, loud music), medications, and other diseases (Meniere's disease). Treatment options are limited for tinnitus. Tinnitus can be prevented by wearing hearing protection when exposed to loud noises.
Nausea is an uneasiness of the stomach that often precedes vomiting. Nausea and vomiting are not diseases, but they are symptoms of many conditions. The causes of vomiting differ according to age, and treatment depends upon the cause of nausea and vomiting.
Vertigo is a feeling of spinning movement, and at times accompanied by nausea and vomiting occur. Vertigo is most often associated with an inner ear problem. The treatment for vertigo can be lifestyle changes and medication if necessary.
Balance is a state of body equilibrium or stability. We often take for granted how dependent we are on a healthy balance system. When the system breaks down, however, patients will describe symptoms such as dizziness, vertigo, lightheadedness, or motion sickness.
Noise-induced hearing loss may be an acoustic trauma (temporary hearing loss), or permanent due to an acute acoustic trauma. Experts agree that continual exposure to more then 85 dBs (decibels) is dangerous to the ears. Ear plugs and ear muffs can help prevent noise-induced hearing loss as well as decreasing exposure to loud noises.
Hearing loss (deafness) may be present at birth or it may manifest later in life. Deafness may be genetic or due to damage from noise. Treatment of deafness depends upon its cause.
A computerized axial tomography scan is an x-ray procedure that combines many x-ray images with the aid of a computer to generate cross-sectional views and, if needed, three-dimensional images of the internal organs and structures of the body. Computerized axial tomography is more commonly known by its abbreviated names, CT scan or CAT scan. A CT scan is used to define normal and abnormal structures in the body and/or assist in procedures by helping to accurately guide the placement of instruments or treatments.
A large donut-shaped x-ray machine takes x-ray images at many different angles around the body. These images are processed by a computer to produce cross-sectional pictures of the body. In each of these pictures the body is seen as an x-ray "slice" of the body, which is recorded on a film. This recorded image is called a tomogram. "Computerized Axial Tomography" refers to the recorded tomogram "sections" at different levels of the bod...
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