Low frequency hearing loss - need advice

Hi vaita,

I hope that you find some relief with the antivirals. I did see improvement with that dosage, but it didn't last. If you do see some improvement in your hearing, book an audiology appointment right away so that you have some evidence of a change.
Dr. Gasek's regimen for Valcyclovir is much stronger / longer -

3000mg / day for 21 days. If you see improvement, taper down to
2000mg/ day for 21 days. If you see improvement, taper down to
1000mg/ day ongoing

(if you don't see improvement, he will keep you at the higher dosage for up to 6 months)

 

Hi,
Is there any statistics available that show what percentage of people see improvement with this type of antiviral therapy for this physician's patients ?

Randy

 

In Dr Gacek's clinical practice I think he has a 90% success rate using AV's. Take a look at his paper I linked you to on your thread.

 

this is from page 104 of the pdf file link I sent you:
The antiviral treatment protocol for patients with recurrent vertigo is as indicated below.
Discontinue all previous medical treatments; ensure that patients are cleared for normal
renal and liver function; use acyclovir tabs 800 mg t.i.d. for 3 weeks and reexamine. If there
is significant relief of vertigo, decrease to 800 mg b.i.d. for 3 weeks, then to 800 mg daily as a
maintenance dose. If valacyclovir is selected (in those who fail to respond to acyclovir), use
1 g t.i.d. for 3 weeks with taper to b.i.d. for a further 3 weeks and then 1 g daily as a maintenance
dose. The starting dose of acyclovir was given for a longer period (3 weeks) than that
used for zoster because it was felt necessary to cross the blood-brain barrier to reach ganglion
and satellite cells with virus. Most patients experienced relief from vertigo in the first 2 weeks
but some required a longer period. The gradual lowering dose was then used to find the
lowest level maintenance dose for a given patient. Most were controlled on a single dose daily
but occasionally a patient required an adjustment to 1,200 mg of acyclovir or 1,500 mg of
valacyclovir.
These dosages may require adjustment in patients with impaired kidney or liver function.
The follow-up period was as short as 3 years in the most recent patients and 8 years in the
earliest patients in the series. Of 106 patients with VN (the earliest patients evaluated up to
8 years), 93 (88%) had complete relief of symptoms with oral acyclovir, 54 of 60 patients
(90%) with MD were relieved of vertigo, and 27 of 45 patients (60%) with posterior canal
BPPV were relieved of symptoms. Between the use of antivirals and repositioning maneuvers
(physical therapy), the number of chronically disabled patients who were candidates for
ablation of posterior semicircular canal function (canal occlusion or singular neurectomy)
was reduced significantly.

 

my error I posted it in response to someone else's post here is the link
http://www.mm3admin.co.za/documents/docmanager/6e64f7e1-715e-4fd6-8315-424683839664/00056616.pdf

 

ahh I didn't realize he published a more recent paper, very cool.

 

the dose in that abstract you linked for valcyclovir is the same dose as on the paper I sent, but yes it focuses more on vertigo control

 

Not speaking to dosages, but antivirals have a very good record of hearing recovery. I am a case in point.

 

I first tried anti-virals on my own from a limited supply that I had in an old bottle at home. I was taking 1000mg / day. (2 x 500mg). After the third day my hearing returned to the point that I couldn't distinguish the difference in my ears. No tinnitus, no distortion and I heard the wind in my ear - which I hadn't heard in 3 months at that point.
My symptoms returned after a brief period even on the 1000mg / day dose. I ran out of valcyclovir and that was when I booked an appointment to see Dr. Gasek. He put me on the proper dosage - this time it took 9 days for my symptoms to clear up, but when they did they stayed clear. My audiology report shortly after that showed that I have normal range hearing in both ears.

 

It was a very hard adjustment for me for 9 months. I finally saw a very good yoga teacher. I took private lessons geared to my age and fitness level and developed a daily practice. Thi calmed me down a lot. But it was hard. The antivirals and allergy treatment are what got my hearing back, but the yoga helped get me to a point where I could find the right treatment and communicate with doctors well enough to get that treatment. Hearing impairment and particularly distortion is very very hard on the nerves.

 

My hearing loss was in the 250-500 range and at 8000. The typpical Menieres curve. Losses fluctuated up to 50 dcb at the worst. I had had very bad distortion for 9 months. When I first took acyclovir, I got the first glimmer of hope on days 4 and 5 when the distortion began to cut in and out. At the end of a month, I judged subjectively that the distortion type symptoms including hypercusis etc were 65% improved. At that time I had a 5 dcb improvement in hearing. It was the most significant quality of life improvement I had had in almost a year.

I continued to take acyclovir but had a set back in allergy season. At that time I went to Dr Derebery at House Ear in LA because my family dr was kind of winging it, this not being in her area of expertise. I then took famvir for 3 months and by the end of that time, the distortion including tinnitus was pretty much gone. I tiik allergy shots which seemed to be key to hearing improvment and some other symptoms. That imrpvement was very gradual over several years. I still take allergy shots.

 

After 2-3 years my hearing was in a normal range except at 8000 where i have a permanent loss of 40 dcb. The higher freq losses do not recover very often, I am told.

 

vaita 5 days isn't enough time. Try and be patient and see how you are by the end of the 3 weeks on the highest dose. Some have gotten improvements in a few and others in a few weeks. Some need to stay on the highest dose longer than the 3 weeks. Fingers crossed for you!