After gentamicin injections, does physical therapy work?

It looks like your doc is using more of a low dose protocol with the gent. That is why he didn't take you all the way to total destruction. (evidenced by what you call short term dizziness which would indicate the vestibular function of that ear was killed off...temporary dizziness means the ear is dead and your brain is adjusting to the other ear only) Doing a low dose to dumb down the balance function then giving it a little while to see if you get relieve is a really good route. So kudos to your doc to not move too fast. The PT will only help retrain your brain to deal with lesser balance ...flying more with the engine on the other side. But if after some period of time....things remain classic MM....then you may have to ramp up the gent and go for the kill. If you remain in a state of intractable vertigo and no medical protocol is working even the gent....then of course you can kill it off for sure with a laby. You can only have a spin if you have vestibular misinformation to the brain. With a totally effective gent protocol or a laby ALL balance information ceases....so no spins. But it does take a little while for your brain to compensate and rely on the other ear. This article will help you a lot. http://www.dizziness-and-balance.com/disorders/menieres/menieres.html and http://www.dizziness-and-balance.com/treatment/ttg.html

 

oops typo....relief not relieve

probably a few more....sorry about that.

 

Thanks for the info, sjw. From the paper on the link it seems gent injections have low risk to hearing.

I hate to think that I've been living half a life over the past couple years because my ENT told me my hearing was not bad enough to risk gent injections. She is not qualified to give gent injections and I did just today make an appointment with an oto at Penn Hospital in Philadelphia but he cannot see me until 23 June.

Are labys risky to hearing?

T h banks.

 

A laby destroys all hearing on that side

 

Another surgery, vestibular nerve section (VNS), will preserve the hearing you have at the time of the surgery. It may, however, continue to deteriorate over time, as the VNS does not stop whatever causes the vertigo to happen. The vertigo attacks continue to happen, but you don't feel them because the nerve to the brain from the inner ear has been severed and the conflicting messages from the inner ear have no way to travel to the brain.

 

Thanks all for the info. I do intend to continue the JOH and anti-viral treatments as well as explore the upper cervical treatment.

The tinnitus and the fullness are tolerable. I'm just sick of playing the waiting game of not if but when the surrounding environment is going to become unstable. The changing of the rotational vertigo from horizontal to vertical in recent years (and sometimes to just haphazard) has me thinking that the disease has morphed into a different phase and I just can't play the loss of balance game any more.

The violent vertigo sucked but at least it was normally followed by a stretch of stability. This disequilibrium resulting in frequent nausea and brain fog is a constant companion and I have to get away from it.

Is it acceptable to demand the gent injections or VNS surgery? I know we're all responsible for our own recovery, but the medical community seems to have a pretty consistent protocol and the people I've been dealing with seem to be against the surgery if the hearing is relatively good.

Sorry if I hijacked this post, Pupper, but it seems like your original question was answered.

 

Teesdale....good questions. I do think we should all play a very active role in our med care. I am laby L side. Was finally at the end of my rope with intractable vertigo. My doc and I developed a good partnership. He asked...."are you ready to kill it?" I said yes. We went straight to admissions and scheduled an OR for the next day. But of course a lot of history and failed attempts before that occurred. So having a flow chart type plan of action...what happens if this does not work?...whats the next step....then the next is a nice thing to have with your doc. Ones like Hain (no surgical practice) does exactly what I am describing. Gives a trail period for each step. But those windows can be different for every person....their condition....their life demands.

My problem is I am now bilateral. Deaf in the R ear. So that makes me totally deaf. So a laby has its risks (going bilateral). VNS are indeed possible but many surgeons go for the laby since its easy and certain. Many docs take out the balance portion (semi circular canals) but leave the cochlear in place for a implant if ever needed. But scar tissue can be a problem. Depending on your other ear....and criteria for a CI....some do a combo laby and CI. But only if it meets insurance criteria etc. (depends on other ear) Emory in Atlanta does combos. If you are preserving hearing then high dose strep or gent is the treatment of choice.

So yeah....if you are ready to say kill off the vestibular function with gent its ok to suggest that and push in that direction. Same is true of any destructive procedure like a laby. But they will be slower to say ok on that. Just have to tell them you are ready to get this chapter behind you and move on. And that you understand the risk. But IMO don't rush it. Take it one step at a time and do the least invasive things possible first. But I know it does not take long of barfing your guts out to make a kill it off decision. Rotational vertigo is hell.

Hang tight. I think this thread is still in the ball park with Puppers intent since it is dealing with the same gent sort of issue. PT is just a brain retraining dimension of it all.

S

 

Sjw, thank you so much. I'm scheduled to get the Northstar brand of valacyclovir on 6 June so maybe I will give that a run before the destructive route. Northstar seemed to work for me in the past but the last three brands they sent me have been much less effective.

 

Absolutely. Good luck. Its also comforting to know...especially for those unilateral....that after some period of MM being active it often just gets better and thats it. So anything you try to buy some time before surgery or destruction of any type is often a good thing. While total natural "burn out" by clinical criteria is rare...mother nature does seem to give a helping hand with the vestibular function being diminished over time. Sort of a natural gent and the ear dumbs down on its own. So things like the Meniett Pump, vitamin regimens, and any other thing that mainstream medical care does not recognize can still get someone to remission just due to time. Your current treatment results in good benefit for many. Plus you can rest assured that you can take it offline if you ever need-want to. You the man. Take care.

 

Pupper, I find effectiveness in physical therapy. In particular, neck stretch exercise is effective regardless of gentamicin injections. While I don't support any destructive methods, neck exercises are much safer, non-intrusive options for most of us.

http://www.webmd.com/pain-management/managing-neck-pain-home#2
http://mypinchednerveinneck.com/pinched-nerve-neck/
https://drive.google.com/file/d/0B4smSaYBVJ9gaXN6aVJiRHRFUXM/view?usp=sharing

 

I have chronic neck pain that seems tied into my mm and MAV, and barometric changes.

I’ve got a good neck physio right now whose given me very specific exercises. Something called Somatics also helps loosen up my neck and back, but I have to be not too dysequilibriated to do them.