I placed Counseling and Physical Therapy together because some of the best counsel I’ve received has come from doctors of Physical Therapy. Maybe it’s because Ménière's patients spend more time with physical therapists than they do with other types of doctors. Maybe it’s because physical therapists are more ‘hands on’ and spend more time with patients. Whatever the reason, I’ve personally benefitted from their counsel, and I’ve heard the same from other Ménière's sufferers.
Counseling
Counseling is simply the process of two people talking about something of interest to both of them. The American Counseling Association defines counseling as, “a collaborative effort between the counselor and client.” Your counselor may be a doctor, a professional counselor, a family member, a friend, or someone who is also suffering from Ménière's.
This disease affects the real essence of life and can be debilitating. Finding support within a community that suffers with similar symptoms can help you build effective coping strategies. This is particularly important for those recently diagnosed. Find a support group near you through the Vestibular Disorders Association. Connecting with a community is essential for any chronic illness but particularly for one that has symptoms as debilitating as this condition. One-on-one counseling can also help you learn to adjust to your new reality while also learning effective stress-busting techniques when tinnitus or vertigo symptoms flare. Natural Ways to Manage Meniere’s Disease Symptoms
This is a tough disease. I’ve heard some people say that Ménière's is the worst disease that doesn’t kill you. 2nd Chapter Productions is working on a documentary called “Unheard: The Ears of Meniere’s” that includes many personal testimonials about how difficult it is to live with Meniere’s. I recommend you watch the trailer and share it with people who don’t understand what this disease can do to people.
There are times when some sufferers wonder if they can go on another day. Ménière's Disease is a thief. It steals very precious things from lives including balance, hearing, a sense of personal control, relationships, and even careers. You often have to cancel appointments at the last minute, which may cost you financially. I’ve learned to tell people that I may have to cancel at the last minute if I have an attack. Some professionals will understand — some won’t. I have to find the ones who do. That’s just the reality of having this disease.
That kind of continual onslaught year after year takes a toll on a person. We need someone to talk to about how it’s affecting us, but who will listen? That’s where ‘counseling’ becomes an important part of the equation.
I’ve personally met more than two dozen doctors, nurses, clinicians, and therapists in the last decade. Most told me the same thing — my condition will get worse and there’s no cure. As a journalist, and a realist, I appreciate hearing the truth. I just wish the truth was different than what I heard. I watched my mother and other close relatives go through the same thing, so I know what may be coming. Though I wish no one the suffering and struggle of this disease, there is something about talking with someone who understands what you’re facing and how you feel about it.
People with Ménière's need understanding and a support system. That support can come from family, friends, co-workers, and other people with MD. Counseling may also help. You may want to meet with a professional counselor. If you can, find one who has some knowledge about Ménière's. If they don’t know about it, ask them if they’d be interested to learn about it to better help them help you. If they’re not interested to do some research, you may want to look for another counselor.
Ask your ENT, Neurologist, Audiologist, or Physical Therapist if they know someone they’d recommend as a counselor who understands Ménière's. You may find it helpful. If not, at least share your thoughts and feelings with someone you trust. Sometimes we just need someone to listen and care.
Ménière's Disease can be an isolating illness, especially as it progresses. People can misunderstand why they don’t see you out and about as often. Life moves on and you can feel as if you have nothing left to offer the people you love.
My greatest Counselor is God. Isaiah the prophet wrote that He was going to send His Son — “And His name will be called Wonderful, Counselor, Mighty God, Everlasting Father, Prince of Peace.” Jesus Christ promised His disciples “another Helper.” That other Helper is the Holy Spirit — “the Spirit of truth.” (John 14). The Apostle Peter told people about “casting all your care upon Him, for He cares for you.” (1 Peter 5)
God is my greatest Counselor. He cares about me and always hears me. When I’m too sick to get out of bed, He hears me and I hear Him as I repeat Bible verses memorized through the years. When all I can do is sit in a chair and hold my head in my hands until the spinning stops, God is there.
I know that this life is temporary. Ménière's is not a permanent disease. I will be cured when, as the Apostle Paul wrote, “this corruptible must put on incorruption, and this mortal must put on immortality” (1 Corinthians 15). In light of that, we continue to do God’s will to the best of our abilities knowing that our labor is not in vain.
Physical Therapy
I’ve had several different physical therapists in the last several years. I found that some move to other locations as they gain more certifications. I’m glad for them, even though it’s hard to see them go. Most of the physical therapists I’ve seen had some knowledge about Ménière's Disease, but there are some who specialize in what’s known as ‘vestibular rehabilitation therapy.’ They’ve been especially helpful to me personally because I’ve also been diagnosed with Cervicogenic Vertigo (CV).
The reason I mentioned that is because several therapists told me that there is little they can do for someone with Ménière's Disease — especially in the early and middle stages when vertigo attacks are still a challenge for the patient. Research about Vestibular Rehabilitation Therapy (VRT) supports those comments —
Patients whose symptoms occur only in spontaneous episodes, such as seen with Ménière's disease, are unlikely to benefit from VRT. VRT is unsuccessful in patients with only spontaneously occurring events of disequilibrium, especially if the spontaneous vertigo or disequilibrium develops more than once per month. The primary objective in such patients is to prepare them for anticipated dizziness rather than to make any permanent change in their vestibular condition. Patients suspected of perilymphatic fistula whose condition deteriorates during exercise therapy are more likely to benefit from other treatments such as surgery. Vestibular Rehabilitation Therapy: Review of Indications, Mechanisms, and Key Exercises, National Library of Medicine
Due to the fluctuating nature of the disorder, vestibular physical therapy has had a limited role in the treatment of Meniere's disease. In general, rehabilitation has been used only as a postoperative treatment for the acute vertigo seen after vestibular neurectomy or labyrinthectomy. This is the first report advocating the role of vestibular physical therapy in a group of patients receiving medical therapy of intraear medicines (other than gentamicin). The role of vestibular rehabilitation in the treatment of Meniere's disease, Sage Journals - Otolaryngology–Head and Neck Surgery
Interestingly, the Academy of Neurologic Physical Therapy listed Ménière's as an ‘exclusion’ to the ‘effectiveness’ of vestibular rehabilitation —
Exclusions: Compensated vestibular loss; cognitive or mobility deficit that impedes effective application; or active Meniere’s disease
Exclusions: Cognitive or mobility deficit than impedes effective application or active Meniere’s disease
I did find some hopeful information about VRT being somewhat helpful to Ménière's patients who are in the late stage of the disease or have had certain types of surgeries that ended their vertigo attacks —
Once the episodic spells of vertigo associated with Meniere’s disease have abated, vestibular rehabilitation exercises play an important role in promoting adaptation to the decreased vestibular input. Outlines of different treatment approaches for three types of patients with Meniere’s disease are presented. The exercise approaches advocated here consist of exercises to foster adaptation of the vestibular system in cases of unilateral loss or hypofunction and exercises to promote the substitution of alternative strategies and to enhance remaining function in cases of bilateral vestibular hypofunction. The selection of the appropriate exercises is based on the nature of the vestibular loss, the patient’s symptoms, and the functional capabilities of the patient. Based on an understanding of the vestibular system, the balance system, and normal functional capabilities, appropriate rehabilitative exercises can be designed for this group of patients. Vestibular Rehabilitation Strategies In Meniere’s Disease, Otolaryngologic Clinics of North America
I would be interested in hearing your experiences with Counseling and Physical Therapy. Please leave your thoughts in the Comment section below. Knowing which stage of Ménière's you are in will also be helpful to the readers.
Resources You May Find Helpful
Vestibular Rehabilitation — Ménière's Society
For patients who have been referred for vestibular therapy — Dizziness-and-Balance
We’ll look at Alternative and Complementary Therapies in the next Managing Ménière's Disease newsletter.
“… rejoicing in hope, patient in tribulation, continuing steadfastly in prayer.” Romans 12:12
Here’s to hope!
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