Actress Kristin Chenoweth Suffers from Meniere's Disease

Kristin Chenoweth is an accomplished actress both on TV and live on Broadway having performed in Wicked as Glinda as well as appearances in TV shows Glee and Pushing Daisies.

She also suffers from Meniere's Disease which was diagnosed in 2007.

As such, she is prone to dizzy attacks which may have contributed to well-known falls during performances over the years.

• 2003: Fell off the stage during rehearsals for Wicked
• 2006: Fell off the stage during Broadway revival of The Apple Tree
• 2011: Fell down the stairs during injuring her back on the set of Glee.

And those are just the falls we know about.

Meniere's disease is a disorder of the inner ear which leads to spinning dizzy attacks without any specific trigger. The dizzy spinning typically lasts several hours and is often preceded by tinnitus, aural pressure, and a hearing decrease on just the affected ear.

Fluctuating hearing loss is not uncommon as well.

Diagnosis is not straightforward and is usually obtained by history alone, but supporting tests include ENG (electronystagmography), VEMP (vestibular evoked myogenic potentials), ECoG (electrocochleography), ABR (auditory brainstem response), MRI scan, etc.

Once diagnosis of Meniere's disease is made, treatment occurs in stages:

Stage 1: Eliminate all salt (less than 1000mg of sodium per day), caffeine (no coffee, tea, decaffeinated, sodas, chocolate, etc), and alcohol from the diet.

Stage 2: If stage 1 does not help, addition of a diuretic pill like maxzide.

Stage 3: Invasive procedures which include endolymphatic shunt operation or vestibulectomy using intratympanic gentamyin injection into the ear or surgical lysis.

Flare-ups are treated symptomatically with phenergan and if needed, steroids whether oral or injection into the ear.

The Illusion of Healthcare Progress

Wellcome Film based in London has transferred numerous films dating from the early 20th century related to healthcare and medicine that anybody can view for free. Aside from the historical value, it is amazing that much of what we know and do now is not all that different than what was done in the 1920s. It makes me wonder sometimes what "progress" in healthcare actually has happened over the past century. In some things, tremendous change has occurred whereas in other areas of medicine, time might as well have stood still.

It also perhaps explains why in spite of all our "high-tech" medical equipment and sophisticated tests available in the United States that our health as a nation is still not as good as other nations without these benefits.

Take for example dizziness evaluation and understanding. Here are 3 films from 1925 that goes over dizziness evaluation and physiologic basis for it.

At its essence, nothing has really changed between 1925 and 2011. Sad really... Given this lack of progress, I would so far as to venture (with a straight face and all kidding aside) to say that American rates of dizziness is comparable to ANY other nation in the world with treatment protocols no better or worse too.

Not All Spinning Motions Cause Dizziness

In one of the stranger research projects I've encountered in awhile, French scientists reported on why in the sport of discus throwing, athletes tend to feel more dizzy than those who hammer throw.

Whether discus or hammer throwing, both require spinning on part of the athlete before letting the discus/hammer go for long distances.

59% report dizziness with discus throwing, but none with hammer throwing. Why?

This occurred even among athletes who did both sports eliminating individual susceptibilities to dizziness.

Based on slow-motion video analysis, it was conjectured that visual bearings can be used more easily with hammer throwing than during discus throwing. Moreover, less foot contact with the ground for ground-body tactile feedback and generation of head movements liable to induce motion sickness from acceleration were felt to be contributing factors.

How do these findings translate to patients who are dizzy?

1) Visual bearings - Fixate on objects that you know to be still
2) Increase body-ground contact - Wear flat shoes instead of stiletto heels as well as cane/walker use
3) Minimize sudden turning head motions - Turn with the body rather than the head, or turn the head slowly

Of note, this research project won the 2011 Ig Nobel Prize for Physics.

Reference:
Dizziness in discus throwers is related to motion sickness generated while spinning. Acta Otolaryngol. 120 (3), 390-5.