Possible menieres disease

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Mikegxgt2000

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Mikegxgt2000
Last April during bday weekend i went out drinking. Following day i felt fine went to the zoo and on my way back i got an extreme case of motion sickness. I could barely drive a few blocks until i got the urge to throw up. I didnt have vertigo and I can control the car I just got a really bad motion sickness. I was like that for around 3 days then I was slowly able to drive and fly again but had some nausea. After a month it completely cleared and out of no where the same thing happened while I was flying on aug 17. Yet again I know I didnt have vertigo because I was able to land just fine. 3 days later I went to urgent care and they said they found fluid with bubbles in my left ear. Lately I've been having pain in my left ear, feeling like its stuffed and tinitus. I'm still having issues with driving and motion sickness and it's been two months now. I went to 3 ents. Two thinks it might be menieres and one thinks it was eustachian tube disfunction. I start with skywest next month so I really want to get over this before my class starts. When it happened in april I was still flying and driving I just took pepto bismol for the nausea and mucinex because I thought my ears were full. I have a allegory test and balance test next week. Anybody have any idea what this might be. I really dont want to miss this class or loss my opportunity to be a airline pilot.
 
I think the ENT doctors you saw are your best advice and you should follow up with them. The details of the exam and history will matter in terms of figuring this out. Anything people here can tell you will be considerably less accurate.

Best wishes for a speedy recovery.
 
Some Googling found these items:

https://www.aopa.org/go-fly/medical...-nose-throat-and-equilibrium/menieres-disease

Federal Air Surgeon's Medical Bulletin (Page 6)

Guide for Aviation Medical Examiners, Vertigo or Disequilibrium

from the AOPA article:

The FAA will consider medical certification for pilots who have had symptoms or who have been diagnosed with Meniere's. However, thorough documentation of diagnostic testing and treatment is required for review, usually by an FAA otolaryngology consultant. And, even more importantly, there will need to be a substantial period of time since the last symptoms occurred before favorable consideration can be given for any class of medical certificate. Although the period of uneventful recovery is on a case-by-case basis, it's not unreasonable to expect to wait 12 months or more after the last event before the FAA will favorably consider a diagnosed case of Ménière's disease.
​
From these documents, my read is that you cannot just "let this go" and ignore it. The sooner you nail down the diagnosis, the sooner you will know what's needed to treat it and apply the HEALTH FIRST, FLY LATER mantra. As Peter indicated, the vast majority of us here ARE NOT doctors and therefore cannot properly comment on what you are experiencing.

Forget the flying for now and get diagnosed and treated before anything you are experiencing causes irreversible damage.

And once you know for sure what's going on, then you can consult with the right Senior AME on what's needed to build the proper submission file to retain your medical.

Regarding Skywest and your class, this is something you need to discuss with your assigned pilot mentor.

Finally, please remember that §61.53 likely applies to you while you're dealing with this.
 
FWIW, I had an equilibrium issue a few years back. I did a full spectrum of tests with an ENT that specialized in dizziness. He went as far as to pierce my eardrums and inject steroids to see if it would help. It didn't. Ultimately the issue turned out to be something else but before I knew that I had a 3rd class medical renewed. I reported what was done. I got lots of flack about a small dose of thyroid but nothing was ever said about the dizziness or treatment. Crazy but true.
 
I am not a doctor, but I do have a little insight into this.

Meniere's was one of the many things that my first ENT didn't quite rule out, but never diagnosed either, when I had hearing loss in my right ear some years back, along with severe tinnitus. Over the years, other ENTs have reached the same absence of a conclusion. Apparently otorhinolaryngology isn't an exact science.

The fact that I didn't have vertigo, which is the hallmark symptom of Meniere's, further complicated the matter. And believe me, ENT docs have tried their best to induce it in me, to no avail. If I had Meniere's, they could have treated it. But without the balance symptoms, they couldn't.

I've also had more CT scans and MRI's than anyone should have to endure. You know what sucks worst about MRI's? The smell. All MRI machines seem to smell like vomit. I don't care if they just came out of the box. They all smell like puke.

Some of the things that were ruled out included syphilis, MS, aneurysms, acoustic neuroma, rabies, lupus, and many other diseases. But nothing was ever definitely diagnosed. The VA thinks it was a result of a live-fire drill in GTMO that caught everyone on deck by surprise, so we didn't have hearing protection on. The last civilian doctor I saw about it said it was "idiopathic," which is doctor talk for "I dunno." He suspected, but didn't actually diagnose, Eustachian tube dysfunction.

In the end, a Chinese pharmacist who had been a doctor in China told me to restrict sodium and prescribed herbs. I've experimented over the years and found that the two that seem to work best are vinpocetine and lemon (not "citrus") bioflavanoids. Others that he prescribed included licorice root and ginger, which I have learned are more for the nausea, which I wasn't experiencing anyway.

What the vinpocetine and and lemon (not "citrus") bioflavanoids did do was restore most of my hearing, and on most days, eliminate the tinnitus. If I eat a salty meal at night, I'll probably wake up with some tinnitus. Other than that, it's a non-issue.

So what can I say? You have symptoms that are notoriously hard to diagnose. It's also possible that you do have Meniere's, in which case an attack at altitude most likely will kill you and your pax. So do everything you can to find the cause and treat it. Consider a doctor who specializes in balance issues. And in the end, if you don't get satisfaction, talk to your doctor about non-traditional treatments.

If nothing else, you may want to talk to your doctor about sodium. I have learned from ENT's and personal experience that sodium aggravates all kinds of inner-ear issues. The most succinct advice about sodium I ever got was to try to avoid it completely because in America, there's no way to do that, anyway; so by trying to avoid it completely, you may just limit it to a healthy level.

As for your medical, all I'll say is that this whole experience was one of the reasons I decided to go SP (and more recently, 103). Apparently the FAA frowns on symptoms without explanations. An AME in Queens told me that until I got a diagnosis from an ENT one way or the other, getting a medical would be a challenge. "Idiopathic unilateral hearing loss" and "possible Eustachian tube dysfunction" are suggestive of too many possible maladies, and ruling them all out would have cost a fortune.

Rich
 
As for sodium I think that what caused it. I was doing aerial survey work living in hotels all over the country. I never usually eat frozen meals but I was having alot of that and the hotel food they give at the hotels. My last bought I had congestion on my left ear for 3 days then it happened.
 
There are lots of medical conditions that can cause disequilibrium, many of them benign and temporary, if annoying. Viral infections (vestibulitis), misplaced otoconia, barotrauma, allergies, or ordinary otitis. Certain meds can also cause inner ear issues for some individuals, as well a blood pressure issues. A good ENT can help you sort these out. Meniere's disease is fairly rare in individuals under 40.

Viral vestibulitis is a fun ride, with fairly sudden onset and resolution taking weeks to months. BTDT, and it's definitely self-grounding. But it does eventually resolve. Good luck with diagnosis...hopefully it is something harmless and self-limiting.
 
Mikegxgt2000 said:
As for sodium I think that what caused it. I was doing aerial survey work living in hotels all over the country. I never usually eat frozen meals but I was having alot of that and the hotel food they give at the hotels. My last bought I had congestion on my left ear for 3 days then it happened.
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Again, I'm not a doctor. I'm not even especially smart. But I wouldn't be surprised if salt were a big part of it. If things get too quiet around here and I want a cacophony in my head, all I have to do is run out to the nearest Chinese restaurant and order anything on the menu. I'll be half-deaf with banshees in my skull keening for the dead within an hour.

Rich
 
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Mikegxgt2000 said:
As for sodium I think that what caused it. I was doing aerial survey work living in hotels all over the country. I never usually eat frozen meals but I was having alot of that and the hotel food they give at the hotels. My last bought I had congestion on my left ear for 3 days then it happened.
Click to expand...

Evidently a lot of people report Meniere’s disease being partly responsive to sodium in the diet, however, the evidence for the benefit of sodium restriction is apparently weak.
 
Mikegxgt2000 said:
I'm 32
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Meniere’s quite unlikely in a 32 yo. Not impossible. But it’s a dx is exclusion. Eustachian tube dysfunction sits higher on the list. Possible round or oval window damage but would require some type of valsalva or baro injury -not part of your story.
No ringing right??
Eustachian tube issue not hard to dx with a reasonable ENT and not hard to treat best case-nasal spray. Worst case myringotomy tube.
 
90 days after August 17 get an audiogram and a VNG at the ENT's office. If you don't have hearing loss, it's likely not menieres- but the agency requires 90 days down and no recurrences since last episode of vertigo, to "return to service".

If by Nov 17 you haven't had another spell, you should be re-issuable. Note; for fist class this requires all the records to OKC and the AME to call and ring the "revenue Aviator" bell.

If it's Meniere's, it's a year down.....

Bruce
 
bbchien said:
90 days after August 17 get an audiogram and a VNG at the ENT's office. If you don't have hearing loss, it's likely not menieres- but the agency requires 90 days down and no recurrences since last episode of vertigo, to "return to service".

If by Nov 17 you haven't had another spell, you should be re-issuable. Note; for fist class this requires all the records to OKC and the AME to call and ring the "revenue Aviator" bell.

If it's Meniere's, it's a year down.....

Bruce
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@Mikegxgt2000 .... here is some good guidance from Dr. Bruce Chien, a top flight Senior AME who has the complete collection of BTDT aeromedical shirts and coffee mugs.
 
I had ringing, ear fullness, ear pain and sometimes my left side if the neck was stiff. I'm still getting motion sickness but not as bad as before. I realized something strange when I'm driving I can have either pain when I accelerate or I hear a pop. After the pop I get alot of mucus that comes out post nasal and the nausea goes completely away. Sometimes when I pop my ears it goes away too. Some days is worse than others. There's no consistency to it. I did a hearing test and it came back normal and showed no fluid in my ears. One of the ents I went to made me step 50 times with my eyes closed and I moved alil to the left. All other test with my eyes close were fine. I'm currently taking a diuretic and pressure and pain in my left ear is gone. I get some tinnitus sometimes.
 
Mikegxgt2000 said:
I had ringing, ear fullness, ear pain and sometimes my left side if the neck was stiff. I'm still getting motion sickness but not as bad as before. I realized something strange when I'm driving I can have either pain when I accelerate or I hear a pop. After the pop I get alot of mucus that comes out post nasal and the nausea goes completely away. Sometimes when I pop my ears it goes away too. Some days is worse than others. There's no consistency to it. I did a hearing test and it came back normal and showed no fluid in my ears. One of the ents I went to made me step 50 times with my eyes closed and I moved alil to the left. All other test with my eyes close were fine. I'm currently taking a diuretic and pressure and pain in my left ear is gone. I get some tinnitus sometimes.
Click to expand...
The sooner you nail down the diagnosis, the sooner you will know what's needed to treat it and apply the HEALTH FIRST, FLY LATER mantra. As Peter indicated, the vast majority of us here ARE NOT doctors and therefore cannot properly comment on what you are experiencing.

Forget the flying for now and get diagnosed and treated before anything you are experiencing causes irreversible damage.

And once you know for sure what's going on, then you can consult with the right Senior AME on what's needed to build the proper submission file to retain your medical.

Regarding Skywest and your class, this is something you need to discuss with your assigned pilot mentor.

Finally, please remember that §61.53 likely applies to you while you're dealing with this.
 
When it happened in aug I def know I had fluid in my ear because when I popped them I can hear multiple pops especially when going up in altitude. And according to urgent care they saw fluid with bubbles in my ear. Alil over a month later after taking mucinex for a few days I woke up in the middle of the night with with alot of fluid going post nasal so I'm assuming my eustachian tube finally opened up. I was also having mucus build up in my ears. I would take all day to clear them out by using steam and messaging my eustachian tubes just for them to fill up again over night when I slept. I also had to move my jaw forward with my two hands to open up my tubes and I had thick mucus coming down. Sometimes I would have to put my head upside down in order to pop my ears because I had so much mucus pushing down on my eustachian tubes. I think I might of had sinititus as well because my left cheek and forehead was hurting. When I pushed down my cheeks and close to my nose I can taste mucus in my mouth. I also had pain in back and lower jaw and felt in on my teeth on the left side.
 
I could give you my life experience advice, which started alarmingly similarly to your story.... go see a cardiologist. But that's just a pirep.
 
I'll look into that but my blood pressure is 117/ 75 last time I got it done. I'm 158lbs and 5ft 7 and normally go to gym 3 or 4 days a week so I try to take care of myself
 
This sounds more and more like an odd case. I suggest following up with a good otolaryngologist.
 
Yea that's why I doubt its menieres especially since I dont have vertigo and the whole popping ear hurting when I accelerate thing
 
Rather than take the guidance provided to keep your medical and your future flying career, it sounds more like you want a pat on the head confirmation to do it your own way. That attitude is gonna serve you well as a pro pilot. :frown2::frown2:

To quote Mark Cuban, "I'm out."
 
My wife was diagnosed with Menieres a year ago. She loves to fly but gets motion sickness & vertigo. Just like you described. She went to an ENT & he told her to do two things; cut out the sodium & CAFFEINE. Now, this is a woman that love chocolate & tea.

The bottom line is; since she quit caffeine & sodium her symptoms are almost gone.

I just thought I'd mention this since caffeine has not been mentioned.

Good luck with your airline endeavors.
 
No I'm going to follow your advice and go through the proper channels. Just blows I'm been working towards this for 5 years and super broke and then this pops up just as I'm finally going to start my career and pay off the 150k in debt I'm in. Obviously if I dont fix this I won't be able to function.
 
I'm 60. I've had vertigo a couple of times. But, its been about 3 years since I've had it. That was chalked up to BPV by a specialist I went to see back then. I have the other symptoms: fullness in the ears (like having swimmer's ear), tinnitus, and constant post-nasal drip. The ENT says I have allergies and high-frequency hearing loss. He says the hearing loss is probably normal age related hearing loss for someone who's worked around aircraft a long time. And, the tinnitus is a normal symptom of that. He also says my ears are clear, no fluid build up. But, that it could have something to do with my "environmental" allergies.

He's prescribed over-the-counter Claritin, and a prescription Fluticasone nasal spray. They don't really seem to help. I've decided to change my diet and eat less processed foods.

It'll be interesting to hear how your case goes. Let us know.
 
Will do. Since being on the diuretic for a few days my ear cleared up. Alil nausea when driving but way less than how it's been and I still get some to tinitus.
 
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