Meniere’s Disease and Buhari’s Health

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As President Muhammadu Buhari, earlier in the week embarked on the treatment for Meniere’s disease in London, Martins Ifijeh got expert views on its causes, symptoms, complications and treatment

When President Muhammadu Buhari, cancelled his much publicised official visit to Lagos to commission a number of projects, many political analysts and observers assumed he shelved the plan because he had read the mood of most Lagosians who were not happy with the state of the nation, especially with the recent increase in pump price and the resultant inflation in the price of goods and services.

And then there was the cancellation of the Cross River trip where he was billed to commission the Monorail and Garment factory projects in Calabar. As usual, there was no concrete official reason for the cancellation, even though words were beginning to trickle in that the President might be going through some health challenges that had prevented him from going to the two official trips. But like an iced water in a covered glass bottle, the secret could no longer hold when the all important trip to Ogoni land was cancelled.

News however broke that he was suffering from an ear infection, otherwise known as Meniere’s disease, but like the usual denial syndrome by government officials, the President’s Special Adviser, Media, Femi Adesina, flatly denied the information, arguing that Mr. President was hail and hearty. Until Sunday when he swallowed the humble pie and finally opened up on the health of the President, who, since Monday has been receiving treatment for Meniere’s disease in the United Kingdom.

Expectedly, since the news broke that the President was being treated for ear infection, concerned Nigerians have been seeking informations on the nature of Meniere’s disease; whether it’s a chronic or acute disease, and whether it has an incapacitating feature on its victims. Point blank, they want to know if President Buhari would be cured from the disease and able to discharge the responsibility of the country’s Commander-in-Chief effectively.

This, therefore led THISDAY to inquire from medical experts, especially Ear, Nose and Throat (ENT) specialists, on the nature of the disease, its cause, symptoms, complications, treatment, management and prevention, as well as the resultant consequence of its complication for a public office holder.

According to the Medicare Online Portal, Meniere’s disease is a disorder of the inner ear that causes episodes in which one feels as if he or she is spinning (vertigo), fluctuating hearing loss with a progressive, ultimately permanent loss of hearing, ringing in the ear (tinnitus), and sometimes a feeling of fullness or pressure in the ear. In most cases, the disease affects only one ear, but could affect the two, causing more damaging effect to the victim.

Speaking with an Ear, Nose and Throat specialist, Dr. Rufus Ogbejiele, who is also the Medical Director, Graceville Medical Centre, Lagos, he explained that Meniere’s disease, which is an ear infection often affects one in every 1,000 persons, adding that it starts between the early 20s and 50s, but may start at a later age. He said that of President Buhari may have started long ago, but as the symptoms of the disease is known to occur it was probably not being managed effectively before now.

Ogbejiele explained that despite the condition of the disease varying from person to person, the level of impact on President Buhari may be that which could be treated without any serious hassle, therefore downplaying concerns of the citizens whether the disease could negatively affect his leadership role as the President of the country or not.

What are the causes and symptoms of Meniere’s disease?
According to him, there was no known cause of the disease, but that it was sometimes suspected that too much fluid in the inner ear may be a direct cause, adding that the leakage of fluid from the inner ear to the outer ear has often times been suspected to be the cause of the health issue. “This leakage may cause a chemical reaction that paralyses the balance system in the inner ear until the fluid balance becomes normal again.

“This is why people suffering from the scourge most times complain of inability to have a good balance, dizziness that comes in form of episodes, ringing in the ear, nausea, vomiting, hearing loss, headache, slow pulse development, pale colour, among others.

“A person with this condition usually has one or more attacks a year, which may come alone or in groups. The attacks last from approximately 20 minutes to 24 hours and go away gradually. The attacks may come more often, causing embarrassment for the victim, especially if he or she is a public figure who must be scrutinised by his people at every point in time.

“During a dizzy spell, the person feels like the world is whirling around them. They stagger from side to side and sometimes even fall down. These falling spells are called drop attacks or Tumarkin spells,” the ENT specialist explained.

He said a person with the condition can go for years without having an attack and sometimes may never experience another attack, but warned that sometimes, the hearing in the affected ear may decline gradually over time. “A major issue associated with the disease is that of unannounced dizziness, which causes experts to warn sufferers from driving, or operate machines.”

Of particular note, according to him was the sudden fall which happens as a result of imbalance and mechanical deformation of the otolith organs of the ear. “These falls are called ‘otolithic crisis of Tumarkin’. Patients suddenly feel that they are tilted or falling even though they may be at a balanced position. This is a very disabling symptom as it occurs without warning and can result in severe injury or great embarrassment for the person involved,” he said.

He explained that episodes of the disease may occur in clusters; that is, several attacks may occur within a short period of time. Adding however that years may pass between episodes, with such persons likely to be free of symptoms in between episodes.

Treatment and prevention of the disease
What is the best result that can come out of the treatment of Meniere’s disease? A medical expert, Dr. Olawale Olarenwaju provides a guide: “There is no cure for Meniere’s disease, but there exist various treatment plans, including surgeries targeted at relieving the symptoms associated with the health issue.

“Treatments include acupuncture, herbal remedies, and various medications. Diuretics, vasodilator medications, and a low-salt diet could help in relieving symptoms by taking fluidaway from the head and ear and maintaining the fluid balance in the body. As part of treatment plans, the patient will be advised to avoid alcohol, cigarette and caffeine use,” he explained.

According to him, one treatment plan involves the process of diuretics, such that the kidney is forced to pass more fluid, salt, and potassium than normal from the body, as this has been proven to reduce the frequency of attacks.

He explained that there exist other types of treatments aimed at tackling symptoms like nausea, vertigo, among others, adding that, listening to music can temporarily aid in reducing the noises felt in the ear due to the disease.

“Even with the various treatments, it may not be unlikely that further treatment plans, like surgery may be needed to tackle the health issue.” He however warned that surgeries may have its own down sides, which includes ear damage. “A type of surgery called labyrinthectomy usually relieves the dizziness but it results in total hearing and balance loss in the affected ear.

“Another surgical procedure involves cutting the nerve leading to the organ of balance in the middle ear. Like alabyrinthectomy, this procedure relieves the dizziness. However, unlike a labyrinthectomy, it often preserves the hearing in the ear that was operated on. It is a more complex operation and requires a longer hospital stay, and there is a risk of damage to other parts of the ear.

“Endolymphatic sac surgery is another type of surgery that is often used for people who have dizziness but good hearing, as it can relieve the dizziness and usually preserves hearing in the ear that is operated on,” adding, he also noted that in about four per cent of cases, hearing may get worse.

Also as part of treatment, he noted that certain chemicals may as well be used to destroy either all or part of the balancing functions of the ear, making the vertigo attacks less severe.
He wished President Buhari success as he embarked on treatment for the disease.