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Wednesday, June 18, 2014

Meniere's Disease


Meniere's disease is a disorder of the labyrinth in the inner ear. The labyrinth is a system of cavities and canals in the inner ear that affects hearing, balance, and eye movement.
The Inner Ear
Nucleus factsheet image
Copyright © Nucleus Medical Media, Inc.


An increase in the volume or pressure of fluid in the labyrinth can result in Meniere's disease. The cause of these fluid changes is unknown. Possible causes may include:
  • Part of the labyrinth ruptures, allowing fluid in different compartments to mix
  • Scar tissue causes a blockage in the labyrinth
  • Inner ear injury due to:
    • Viral infection
    • Syphilis , a sexually-transmitted disease
    • Autoimmune disorders
    • Blood vessel problems
    • High cholesterol or other fats in the blood
    • Hormonal disorders
    • Medications, such as antibiotics and chemotherapy agents

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition. Risk factors for Meniere's disease include:
  • Age: 20 to 60
  • Race: Caucasian
  • Family history of Meniere's disease
  • Stress
  • Allergies
  • Excess salt in the diet
  • Excess noise


The intensity of symptoms can vary from one person to another. Symptoms usually come on suddenly. They typically involve only one ear, but may involve both.
Symptoms may include:
  • Episodes of vertigo (spinning sensation), often accompanied by:
    • Nausea or vomiting
    • Sweating
    • Paleness of the skin
    • Weakness or falling
    • In some cases, headache or diarrhea
  • Hearing loss may worsen during attacks of vertigo
  • Tinnitus (ringing in the ears)
  • Feeling of fullness or pressure in the ear
  • Poor sense of balance
  • A tendency for symptoms to worsen with movement


The doctor will ask about your symptoms and medical history, and perform a physical exam. This will include an examination of your ears and a neurologic exam to evaluate for possible nerve damage.
Tests may include:
  • Blood tests—to check for an underlying cause
  • Hearing test —this is also called an audiometry
  • Electronystagmogram—a type of eye movement test
  • Auditory brainstem response—measures electrical activity in the hearing nerve and brain stem
  • Electrocochleogram—measures electrical response of the inner ear to sound
  • MRI scan —a test that uses magnetic waves to make pictures of structures inside the ear


Treatment may include:

Dietary and Lifestyle Changes

These may help limit symptoms:
  • Bed-rest during acute attacks of vertigo
  • Avoid foods that are high in salt and high in sugar
  • Drink adequate fluids
  • Promptly begin replacing fluids lost to heat or exercise
  • Avoid caffeine, aspirin, and smoking
  • Minimize stress
  • Avoid medications that seem to bring on or worsen symptoms
  • Consider a hearing aid, if necessary
  • Consider masking devices (white noise) to limit the effects of tinnitus
  • Take safety measures to avoid falling
  • Restrict chocolate consumption
  • Reduce alcohol intake

Vestibular Exercises (Vestibular Rehabilitation)

Your doctor may suggest specific vestibular exercises. These exercises use a series of eye, head, and body movements to get the body used to moving without dizziness. You may work with a physical therapist to learn these.


Medications include:
  • Drugs to treat vertigo, such as meclizine or scopolamine
  • Antiemetics—medications to help control nausea
  • Other medications that may improve hearing, control inner ear swelling, or limit overall symptoms, including:
    • Antihistamines
    • Cortisone drugs for a short time
    • Antidepressants or anti-anxiety medications
    • Diuretics
  • Aminoglycoside therapy (such as streptomycin or gentamicin) to permanently destroy the part of the inner ear that deals with balance


Surgical procedures are not always helpful, and include:
  • Endolymphatic sac decompression—removal of a portion of inner ear bone and placing a tube in the inner ear to drain excess fluid
  • Labyrinthectomy—destruction or removal of the entire inner ear, which controls balance and hearing
  • Vestibular nerve section


There are no specific guidelines for preventing Meniere's disease. However, to help reduce your risk, avoid the following risk factors:
  • High-salt diet
  • High-sugar diet
  • Excess noise
  • Excess alcohol
  • Stress
  • Smoking
  • Use of drugs that can be toxic to the ear such aminoglycosides, aspirin, and quinine

Tuesday, June 17, 2014

Map Of The Gallbladder recently launched a free interactive "Human Body Maps" tool. I thought your readers would be interested in our body map of the Gallbladder:

The gallbladder is a pear-shaped, hollow structure located under the liver and on the right side of the abdomen. Its primary function is to store and concentrate bile, a yellow-brown digestive liquid produced by the liver. The gallbladder is part of the biliary tract. The gallbladder serves as a reservoir for bile that is not immediately used for digestion. The gallbladder's absorptive epithelial lining concentrates the stored bile. When food enters the small intestine, a hormone called cholecystokinin is released, signaling the gallbladder to contract and secrete bile into the small intestine through the common bile duct. The bile helps the digestive process by emulsifying fats and neutralizing acids in partially-digested food. An excess of cholesterol, bilirubin or bile salts can cause gallstones to form. Gallstones are small, hard deposits inside the gallbladder that are formed when the stored bile crystallizes. A person with gallstones will rarely feel any symptoms until the gallstones reach a certain size, or if the gallstone obstructs the bile ducts. Surgical removal of the gallbladder (cholecystectomy) is the most common way to treat gallstones.

Sunday, June 1, 2014

Caramel Pretzel Chocolate Chip Cookies

  • 1/2 cup Fat Free Vanilla Chobani Yogurt
  • 1/4 cup plus 2 Tbsp sugar
  • 1/4 cup plus 2 Tbsp brown sugar
  • 1/2 tsp vanilla
  • 1 egg
  • 1/2 tsp baking soda
  • 1 1/2 cups unbleached flour
  • 3/4 cup stick pretzels, broken into thirds
  • 1/2 cup caramel bits
  • 1/2 cup milk chocolate chips
  1. In a stand mixer, cream yogurt with sugars. Add vanilla & egg. Incorporate & scrape bowl.
  2. Combine baking soda, & flour. Gradually add to wet mixture. Mix until combined.
  3. Fold in broken pretzels, caramel bits, & chocolate chips with a spatula.
  4. Spoon onto a baking sheet with parchment paper.
  5. Bake at 350*F for 11-12 minutes.