Esther's Story
Esther Emmerman had never experienced anything like what started happening to her in 1996—dizzy spells, vomiting, and loss of balance. It seemed to strike out of nowhere, and the episodes left her exhausted and weak. Confused and frightened, Esther visited a neurologist who diagnosed her with Benign Paroxysmal Positional Vertigo (BPPV)—a dizziness disorder believed to be caused by debris in the inner ear.
Esther was treated for BPPV, and underwent some occupational therapy that included special eye movements and balancing exercises. She also practiced the Epley maneuver—a series of coordinated movements that help reposition debris in the inner ear so that it doesn’t interfere with proper balance. The exercises and therapy seemed to work until 2002 when Esther was struck with one of the most severe dizzy attacks she’d ever had.
The attack came on in the middle of the night. With all the vomiting and nausea, she thought she had stomach flu. She waited it out, and the attack passed, but she kept experiencing dizzy spells on and off after that. As a speech and language pathologist, her work was demanding. Esther tried to cope as best she could, but on some days, she could barely make it into the office.
Beginning in 2003, the attacks became extremely severe. “Thankfully I have a very patient husband who literally carried me around when the attacks were especially bad,” Esther says. Normally a highly active woman, Esther, then 65, was unable to go out on her own, couldn’t drive, and lived in fear of another attack. She was frustrated with her current treatment, which included a reduced salt diet, and high doses of Valium to control the nausea associated with her vertigo.
That year, Esther and her husband moved from the suburbs to Chicago, where she began seeing Dr. Timothy Hain, M.D., and Alan G. Micco, M.D., at Northwestern Memorial Hospital.
Drs. Hain and Micco diagnosed Esther with Meniere’s disease, a balance disorder related to the inner ear that causes vertigo, or dizziness. They suggested gentamicin shots delivered to the inner ear to help lessen the vertigo. Gentamicin is an antibiotic, which ironically, is ototoxic, meaning it can cause hearing loss. However, when given in the proper dosage, gentamicin is very effective at reducing the symptoms associated with Meniere’s disease and has been used with great success.
“My life was so severely impaired by my disease that when I heard about the shot, and how it has helped other people, I decided right away to go for it,” Esther said, even though there was a risk associated with it.
Before giving Esther the gentamicin shot, her physicians needed to determine which ear her Meniere’s disease originated from. It was especially important in Esther’s case, as she was deaf in her left ear due to childhood mumps. They wanted to make sure the Meniere’s was associated with her deaf ear so that there would be no risk of causing additional deafness by giving her the shot. Esther wanted to preserve hearing in her right ear in case she wanted to get a cochlear implant later on in life.
After careful testing, it was determined that the Meniere’s was associated with her left ear—the deaf ear. Esther decided to get the gentamicin shot, which was administered at Northwestern Memorial Hospital by Dr. Micco in September 2005.
Dr. Micco explained that she would likely experience an attack of vertigo within three days, but that after that, she would hopefully be fine for a long time if the shot worked as expected. Esther waited seven days before the attack hit her. “And it was a big one,” Esther says. It was another 10 days before she started feeling the vertigo lessen. “But it was still worth it because I’ve been practically attack-free since then.”
Esther says that although she hasn’t had any dizzy attacks since her shot, she occasionally bumps into walls and experiences feelings of a “heavy head.” While she is not “cured,” she says she is grateful to have her life back. She can go out on her own, can drive again, and plays 18 holes of golf. Many patients who get gentamicin therapy occasionally need “booster shots” every few months, or even years, depending on their symptoms. If she started to experience attacks again, “I’d get another shot in a heartbeat,” she says.