{"id":3819,"date":"2021-01-06T16:30:20","date_gmt":"2021-01-07T00:30:20","guid":{"rendered":"https:\/\/keck.usc.edu\/news\/beating-back-menieres-disease\/"},"modified":"2025-10-23T13:32:32","modified_gmt":"2025-10-23T20:32:32","slug":"beating-back-menieres-disease","status":"publish","type":"post","link":"https:\/\/keck.usc.edu\/news\/beating-back-menieres-disease\/","title":{"rendered":"Beating back M\u00e9ni\u00e8re\u2019s Disease"},"content":{"rendered":"\n \n \n\n\n\n\n\n\n\n
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\n\n \n Press Release<\/span>\n\n\n\n<\/div>\n \n \n
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Beating back M\u00e9ni\u00e8re\u2019s Disease<\/h1>\n\n\n<\/div>\n \n \n
\n Diane Krieger<\/span>\n \n January 06, 2021<\/span>\n <\/div>\n \n \n
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Photo: John Snider<\/figcaption>\n <\/figure>\n \n \n \n\n<\/div>\n \n\n <\/div><\/div>\n\r\n\r\n\n\n \n \n\n\n\n\n\n\n\n
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When Courtney Voelker, MD, PhD, first saw John Snider in 2017, he was \u201creally, really sick. He felt completely dizzy or lightheaded nearly every day.\u201d<\/p>\n

Though Snider had lived with M\u00e9ni\u00e8re\u2019s disease since 2009, the mysterious chronic illness of the inner ear was under control for much of that time. With drug therapy and a low-salt, no-caffeine, no-alcohol diet, Snider had been vertigo-free for five years.<\/p>\n

Then out of the blue, his world started reeling again. He experienced 23 attacks in 45 days \u2014 each throwing him into vestibular chaos, collapse and a desperate crawl toward his bed. The violent spinning sensation would last for hours and leave him feeling physically battered. \u00a0\u00a0\u00a0<\/p>\n

The ear doctor he had been seeing was pushing for surgery or chemical ablation \u2014 despite the very real chance it could permanently upend Snider\u2019s everyday equilibrium and destroy what hearing remained in his already-impaired left ear.<\/p>\n

Snider came to the USC Caruso Department of Otolaryngology\u2013Head & Neck Surgery at Keck Medicine of USC, seeking alternatives.<\/p>\n

When he left that initial consultation with Voelker<\/a>, there was a spring in his stride.<\/p>\n

\u201cWe connected from the very start,\u201d Snider says, of his meeting with the board-certified neurotologist. \u201cShe showed me great care, and she did not talk surgery!\u201d<\/p>\n

Instead, Voelker put him back on sublingual drops of betahistine, the anti-vertigo medication that had kept Snider\u2019s attacks at bay for years. The vertigo had returned with a vengeance after he switched to an oral formulation of the same drug.<\/p>\n

He thought there was no choice. When Snider complained that his pharmacy no longer dispensed the sublingual drops, his previous doctor had shrugged.<\/p>\n

Voelker knew better. She special-ordered the drops from a compound pharmacy that same day. She also greenlighted Snider\u2019s request to try acupuncture and massage therapy \u2014 treatments his previous doctor had rejected as useless.<\/p>\n

Within days, Snider was a new man. \u00a0<\/p>\n

\u201cMy situation greatly improved with no surgery,\u201d he says, triumphantly.<\/p>\n

In M\u00e9ni\u00e8re\u2019s disease, surgery is a treatment of last resort.<\/p>\n

\u201cWe reserve it for people with the most intractable cases. And I say that as a surgeon,\u201d says Voelker, who is chief of the division of otology, neurotology and skull base surgery and director of the USC Pediatric Cochlear Implant Program. \u201cI love doing surgery, but until all other possibilities are exhausted, I won\u2019t jump into it with a patient with M\u00e9ni\u00e8re\u2019s. John is an example of a patient we were able to turn around from being really, really sick to medically managing his chronic illness.\u201d<\/p>\n

Snider appreciates her incremental approach, having butted heads with his previous doctor, who made him feel \u201clike a commodity \u2014 just part of the assembly line.\u201d<\/p>\n

His experience with Voelker has been refreshingly personal.<\/p>\n

\u201cI love her bedside manner,\u201d he says. \u201cShe listens. I never feel like I\u2019m being rushed. She takes a long time with me whenever I see her\u2014which is every three or four months. I know she cares very deeply.\u201d<\/p>\n

A multidisciplinary team, including physician\u2019s assistant Erica Quenville, supports the care Snider receives from the USC Caruso Department of Otolaryngology \u2013 Head & Neck Surgery.<\/p>\n

\u201cErica is the point-person on all of my prescriptions,\u201d he says. \u201cShe\u2019s very knowledgeable, almost like a partner.\u201d<\/p>\n

Personal attention is especially important for patients with M\u00e9ni\u00e8re\u2019s, as no two cases are alike.<\/p>\n

\u201cThe one predictable thing about this disease is its unpredictably,\u201d Voelker notes. \u201cAs a doctor, you have to look at each patient individually and just walk the path with them.\u201d<\/p>\n

Some people endure symptoms their whole lives. Others go through waves. With younger patients, the frequency and severity of attacks can decrease as the body chemistry changes. With older patients, as hearing fades, sometimes the vertigo retreats.<\/p>\n

\u201cFor some folks, it\u2019s really bad no matter what we do. They have constant episodic vertigo \u2014 two to three bad attacks a week, sometimes one every day,\u201d Voelker says.<\/p>\n

Snider counts his blessings. He\u2019s one of the lucky ones. \u201cWhen I\u2019m not having an episode \u2014 which is 99.5 percent of the time\u2014I\u2019m completely normal. I have no lightheadedness,\u201d he says.<\/p>\n

In September, he celebrated a year without an attack. He\u2019s had three mild to moderate episodes since then, but he remains optimistic.<\/p>\n

At 65, he leads an active life. Most days begin with a miles-long walk in the foothills around his home in Arcadia, California. Since retiring from a high-stress career, Snider has taken his wife Mary on European river cruises and crisscrossed North America indulging a passion for Major League Baseball stadiums: only three remain on their touring bucket list.<\/p>\n

A USC graduate (MBA \u201984), Snider stepped back from his job as a senior portfolio manager with a Los Angeles-based asset management group in 2018, though he continues to serve on corporate and philanthropic boards. A self-described \u201cnumbers guy\u201d who crunches baseball stats for pleasure, he now consults for clients in the world of professional baseball and uses his data analytics chops to boost his performance in a competitive fantasy baseball league.<\/p>\n

\u201cBottom line: I feel great,\u201d Snider says. \u201cI went out for a five-mile walk today. I know people with M\u00e9ni\u00e8re\u2019s disease who couldn’t walk to the end of the block without getting dizzy.\u201d<\/p>\n

There are no guarantees for the future, but he takes comfort knowing that \u201cat Keck Medicine of USC, they treat me like an individual.\u201d<\/p>\n

First Attack<\/strong><\/p>\n

\u201cI went to work on Wednesday, December 9, 2009, and everything was normal. I was a healthy 54-year-old-man. I came home, got in a workout, had dinner and I was sitting on the couch watching TV when the world just started to spin. I\u2019ve never been dizzy in my life. I thought I was having a stroke. My wife helped me to bed. Trying to fall asleep with the world spinning \u2014 it\u2019s just horrible. When I woke up around 1 a.m., I felt completely normal.<\/em><\/p>\n

\u201cA month or two later it happened again. The terrible thing about M\u00e9ni\u00e8re\u2019s<\/em> disease is you don’t know when the next attack is going to come. You worry about driving, traveling, sports. Sometimes you have a drop attack, where you can be standing up and you’ll suddenly be on the floor. For me the only way to feel better is to physically go to bed. Whether it’s 8 a.m. or 1 p.m., I\u2019ve got to sleep for three, four, five, six hours. And when I wake up, it feels like I was hit by a truck.\u201d<\/em><\/p>\n

About Meniere\u2019s Disease<\/strong><\/p>\n

According to the American Hearing Research Foundation, M\u00e9ni\u00e8re\u2019s affects about 615,000<\/a> people in the United States. Onset can happen at any age, but most patients are 40 or older. Although the disease\u2019s underlying cause is unknown, its mechanics are well understood: a fluid, called endolymph, normally circulates within the membranous labyrinth of the inner ear. With M\u00e9ni\u00e8re\u2019s this fluid begins to build up, causing swelling and disrupting the normal balance signals sent to the brain. Maddeningly unpredictable in its fluctuations, the disease is characterized by sudden, extreme bouts of vertigo, muffled hearing, tinnitus, blurred vision and hearing loss.<\/p>\n

\u201cM\u00e9ni\u00e8re\u2019s disease is a big black box in our field,\u201d Voelker says. \u201cIt’s a difficult disorder to study because it fluctuates. When you give an intervention, you don\u2019t know if it\u2019s the natural course of the disease\u2019s fluctuations or the intervention you gave that made the patient feel better.\u201d<\/p>\n

While there\u2019s no cure, M\u00e9ni\u00e8re\u2019s can be treated with diuretics, steroids and antihistamines, along with dietary changes and supplements. In extreme cases, neurotologists can provide surgical relief to patients who experience continuous vertigo. The range of possible procedures includes decompressing the endolymphatic sac, severing the vestibular nerve or injecting an ototoxic drug through the eardrum into the inner ear.<\/p>\n\n\n\n<\/div>\n <\/div>\n\n\n <\/div><\/div>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":87,"featured_media":3821,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"advgb_blocks_editor_width":"","advgb_blocks_columns_visual_guide":"","footnotes":"","_links_to":"","_links_to_target":""},"categories":[6],"tags":[628],"class_list":["post-3819","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-press-release","tag-usc-caruso-department-of-otolaryngology-head-and-neck-surgery"],"acf":[],"yoast_head":"\nBeating back M\u00e9ni\u00e8re\u2019s Disease<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, 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