A life thrown out of balance

At first I dismissed the slight dizziness, nausea and a stuffy feeling in my right ear as an oncoming cold. But walking to my car later that afternoon, the world looked off-kilter: People sped past in a blur, and the sidewalk surprised me by how quickly it rose to meet my feet. I stumbled and hugged a nearby traffic signal pole, intent on finding my bearings. Driving home, the horizon wobbled and everything began to spin.

"You look fine to me," my internist said that evening, as he stared into my ear canal. "Must be an inner ear infection. Take an antihistamine."

But the antihistamine didn't help, and two days later an ear-nose-and-throat specialist ordered some lab tests. A hearing test confirmed what I had already begun to notice -- a slight hearing loss in my right ear. An MRI ruled out the scariest diagnoses, such as a brain tumor and multiple sclerosis.

Finished with the diagnostic rigmarole, I sat waiting for the doctor to explain why exactly his face was swaying back-and-forth and making me feel seasick. When I'm ill, I yearn for a precise scientific explanation for what ails me. What I got instead was an answer steeped in ambiguity: I had Meniere's disease, my doctor said, a relatively rare inner ear disorder whose diagnosis can be confirmed only by an autopsy.

Meniere's, estimated to affect fewer than eight people per 1,000, is not life-threatening -- although incessant vertigo and nausea can make you wish for that autopsy. To anybody unfamiliar with vertigo: Hold a heavy book in outstretched arms, spin quickly for a few minutes, and stop suddenly. Now imagine that sensation coming on without warning and lasting indefinitely.

I prodded the doctor for medical certainties."So I have Meniere's?"

"I can't be sure you have Meniere's."

"Why do you think I have Meniere's?"

"Your symptoms match, and we've ruled out some other diagnoses."

"But you said earlier that Meniere's patients have ringing in their ears. I don't have that."

"Some have tinnitus, some don't."

Most doctors believe that Meniere's disease is closely related to a condition known as hydrops, an excessive buildup of fluid in the inner ear that causes the membranes to inflate like a balloon and damages delicate hearing and balance systems. It is not known what causes hydrops, but hypotheses include allergies, genetic flaws and autoimmune disease.