how i lost my hearing

for the short version, scroll to the very bottom of post.

long version:

the point of this entry is not to seem bold, or to render sympathy, or anything like that. rather, a lot of people have wondered what happened to me lately, so this writing aims to:

(a) tell the whole story so i don't have to repeat myself tons of times

(b) educate people with random tidbits about inner ear problems

(c) bring attention to how amazing the human body is

(a) how it went down

thursday (june 3), i worked out at the gym after work, like always. it was triceps/biceps/shoulders day, and i pushed hard on the clean & presses and shoulder presses, setting new personal records. at the end of my workout, my ears felt very stopped up and weird. no pain, just weirdness. i drove home. arrived by 8pm. by 11pm, my ears started to ring. they both just felt weird. no pain. i went to bed at midnight.

friday morning (june 4), 5 a.m., i woke up for no reason and the room was spinning uncontrollably. you've felt dizziness before. imagine what dizziness feels like. the room spins a little, and it's kind of silly. well, this was 10x more than that. i was half asleep, and out of nowhere it appeared that the room was moving upwards and over very fast. it was as if i were going to fall out bed, even though i was lying down. this is "extreme vertigo."

luckily, sheley was staying over -- sleeping in the living room -- because she originally had a flight at 8am and i was going to drive her to the airport. i woke her up, saying "sheley. something's not right!" i felt very nauseous and couldn't even stand up on my own, much less walk to the bathroom. with sheley's help, i made it. i vomited many times.

harvard's hospital, ranked top 5 in the nation, is literally 1 street away from my apartment. yet, i couldn't even make it there on my own. sheley to the rescue! she drove me. i was admitted to the ER and vomited many times over the next few hours. having received little sleep, i wanted to sleep. however, closing my eyes or reclining back even a few inches made me really nauseous.

friday 3pm: i was moved from the ER to an observation room. they continued to pump fluids into me through an IV. i was told that i vomited many more times between 3pm and 11pm. i have no memory during this 8 hour span, and i was asleep during most of it.

saturday (june 5) 4pm: i was released from the observation room. i was a little dizzy but stable. still no hearing in left ear. sheley was a complete lifesaver. if it weren't for her, things would have been very ugly. just for me, she even cancelled her flight home to see a wedding of an immediate family member. now that's love! she's so great.

sunday (june 6) - today (june 12): i still feel the same. i can walk on my own pretty well, but any quick head movements or turning takes a second or two for things to register. i have zero hearing in my left hear, and it's been ringing for 1 week straight.

what's it like to only hear out of 1 ear?

imagine wearing noise-cancellation headphones only on 1 ear. plus, the headphones constantly emit a high-pitched ringing. imagine wearing these headphones for over 1 week straight. that's the best i can describe it.

loud places with many people (i.e., subway and cafeterias) seem to really do a number on me. imagine: people to your left, who are out of sight, make noises. the noises bounce of walls to your right and enter your right ear. so, you hear the noises coming from your right, but clearly nobody over there is making the noises. plus, you are unfamiliar w/ their voice, so your vision and all gets even more confused. now imagine this happening all around you, with dozens or hundreds of people all talking at once. lol, it's really pretty trippy. it drowns out and overwhelms my right ear so much that everything gets muddled and it's really draining. pretty wild stuff!

i've realized how much of our vestibular/vision/hearing systems that we really take for granted. it's amazing how much is being processed by our bodies all the time.

(b) researching the cause, thanks to doctors and the internet

i initially experienced "extreme vertigo" -- the intense feeling of everything spinning. but, the vertigo itself was not the problem; it was merely the result of the underlying issue. many (17-42%) of people who report vertigo, have it due to something called benign paroxysmal positional vertigo (BPPV) [1][2].

BPPV:

basically, everyone's inner ear has a collection of calcium crystals that hang out within the 'utricle' (see above pic). but, it's possible for these crystals to randomly migrate to the semi-circular canals (the big looping things in above pic). when this happens, crap goes wrong (aka, you get sessions of vertigo).

but wait, what would cause this to happen? BPPV is considered idiopathic, meaning there is often not a clear cause; it just happens. it usually happens in older people, usually in women. it usually lasts for short periods, but can persists over years. oh crap. but there are solutions to it.

the canonical method to diagnose BPPV is to use a voodoo-looking technique called 'dix-hallpike.' basically, the patient tilts the head in certain ways, lies back, rotates head, sits up, and does silly things like this. there are many variations of this. it makes the patient dizzy, but one can look at the patient's eyes to conclude if it's BPPV or not. very interesting: it the patient's eyes spin downwards, it may often suggest that a brain lesion exists, rather than BPPV!

epley manuever, another silly method similar to dix-hallpike, is often used to treat it. how crazy is that? merely turning the head in certain directions can re-adjust the crystals in your inner ear and fix your balance and everything.

the doctors found a liquid buildup/pressure behind my left inner ear. BPPV doesn't necessarily include this. also, my prolonged hearing loss is not too characteristic of BPPV.

let's rule out BPPV.

so, what's causing my inner ear problem? there are a few typical causes:

• brain lesion(s)
• meniere's disease
• labyrinthitis

brain lesions: i didn't have any head injury, but having 8th cranial nerve damage would yield the same exact symptoms as i'm exhibiting (i.e., no hearing in 1 ear, vestibular system messed up). i got an MRI and no tumors were found:

whew! yet, it doesn't mean that nerve damage couldn't exist. we don't know. so, the doctor prescribed a small dosage of prednisone for anti-inflammatory reasons, just in case.

meniere's disease: i might have this. it includes everything i have, including the fluid build-up. it's also idiopathic -- no clear cause -- but the only thing that suggests that it might not be this is that i haven't had migraines, as they often occur within those with meniere's.

labyrinthitis: the doctors listed this as the probable cause. seems about right, and i really hope this is what it is. often, labyrinthitis is cause by a virus in the inner ear -- as opposed to a bacteria -- and goes away within 2-6 weeks, but can take months or years. hearing is gone until it goes away. rarely, permanent hearing damage occurs. [3]. viral labyrinthitis may re-occur anytime, maybe several years later, but if it does, it's likely actually just meniere's disease. they are very similar.

so, what can/should i do in the meantime?

• don't drive
• don't do anything that requires balance beyond walking
• take over-the-counter medicine to help de-congest me.
• take over-the-country motion sickness medicine
• take prescribed predisone for 10 days to help w/ possible inflammation
• avoid loud, crowded places

oh, i forgot to mention that the MRI results show that my sinuses had thick lining, which further suggests that it's either labyrinthitis or meniere's, as opposed to my straining too hard in the gym and causing a hole in a membrane. whew, i hope that's true.

(c) the human body:

how crazy is it that such a very tiny area within the inner ear can completely wipe someone out and make them unable to stand up? sure, parts within the brain are even more sensitive with respect to vitality per volume. it's interesting how vital every part of the body is, and that luckily, most of our body is very resilient and good at automatically rebuilding itself. think about how insane that is.

short version:

over a week ago, i woke up to the world violently spinning. vomited tons, and i haven't had hearing in left ear since. it's hopefully labyrnthitis, a virus in the inner ear, and will go away in a few weeks and maybe never come back again?

[1] Bhattacharyya N, Baugh RF, Orvidas L et al. (2008). "Clinical practice guideline: benign paroxysmal positional vertigo"

[2] http://en.wikipedia.org/wiki/Benign_paroxysmal_positional_vertigo

[3] http://www.dizziness-and-balance.com/disorders/unilat/vneurit.html