Meniere's Disease Survey

At what age were you diagnosed with Meniere's? ---- 0-10 11-20 21-30 31-40 41-50 51-60 61-70 71+

How many doctors have you seen regarding your Meniere's? ---- 1 2 3 4 5 6 7 8 9 10 10+

Were you ever misdiagnosed with something other than Meniere's? Yes No

Do you have bilateral Meniere's? Yes No

Do any members of your family have Meniere's? Yes No

Do you suffer from dizziness? Yes I used to No

Do you suffer from vertigo? Yes I used to No

Do you suffer from tinnitus? Yes I used to No

Do you suffer from hearing loss? No Yes - mild Yes - moderate Yes - severe Yes - profound

Do you suffer from aural fullness in your ear(s)? Yes I used to No

Do you suffer from nausea? Yes I used to No

Do you suffer from vomiting? Yes I used to No

Do you suffer from drop attacks? Yes I used to No

Generally, how severe is your dizziness/vertigo? ---- Non-Existent Annoying Disrupts daily activities Disabling - unable to walk Disabling - unable to sit up Incapacitating - unable to move

How often do you suffer from nausea/vomiting? ---- Never Sometimes Most of the time All the time

Generally, how severe is your tinnitus? ---- No tinnitus Soft Loud Very Loud

Do you suffer from brain fog? Yes I used to No

Do you suffer from anxiety? Yes I used to No

Do you suffer from depression? Yes I used to No

Does salt aggravate your symptoms? Yes No

Does caffeine aggravate your symptoms? Yes No

Does alcohol aggravate your symptoms? Yes No

Does stress aggravate your symptoms? Yes No

Does visual stimuli aggravate your symptoms? Yes No

Do changes in the barometric pressure aggravate your symptoms? Yes No

Was the reduction of salt intake helpful? Yes No Have not tried

Was the reduction of caffeine intake helpful? Yes No Have not tried

Was the reduction of alcohol intake helpful? Yes No Have not tried

Was acupunture helpful? Yes No Have not tried

Were chiropractic manipulations helpful? Yes No Have not tried

Was vestibular rehabilitation helpful? Yes No Have not tried

Was Maxide helpful? Yes No Have not tried

Was Lasix helpful? Yes Worked for a short period of time No Have not tried

Was Diamox helpful? Yes Worked for a short time No Have not tried

Were any other diuretics helpful? Yes Worked for a short time No Have not tried

Was Meclizine helpful? Yes Worked for a short time No Have not tried

Was Serc helpful? Yes Worked for a short time No Have not tried

Was Phenergan helpful? Yes Worked for a short time No Have not tried

Was Dramamine helpful? Yes Worked for a short time No Have not tried

Was Compazine helpful? Yes Worked for a short time No Have not tried

Was Scopolamine helpful? Yes Worked for a short time No Have not tried

Was Vistaril helpful? Yes Worked for a short time No Have not tried

Were any other anti-nausea medications helpful? Yes Worked for a short time No Have not tried

Was Valium (diazepam) helpful? Yes - for dizziness/vertigo Yes - for anxiety only Worked for a short time No Have not tried

Was Ativan (lorazepam) helpful? Yes - for dizziness/vertigo Yes - for anxiety only Worked for a short time No Have not tried

Was Xanax (aplrazolam) helpful? Yes - for dizziness/vertigo Yes - for anxiety only Worked for a short time No Have not tried

Were any other anti-anxiety medications helpful? Yes - for dizziness/vertigo Yes - for anxiety only Worked for a short time No Have not tried

Was Prednisone helpful? Yes Worked for a short time No Have not tried

Was Cortisone helpful? Yes Worked for a short time No Have not tried

Were any other steroids helpful? Yes Worked for a short time No Have not tried

Have any natural supplements been helpful? Yes Worked for a short time No Have not tried

Have any natural supplements been successful? Yes Worked for a short time No Have not tried

Transtympanic Injections Successful Worked for a short time Unsuccessful Have not tried

Endolymphatic Sac Decompression Successful Worked for a short time Unsuccessful Have not tried

Endolymphatic Sac Decompression with Shunt Successful Worked for a short time Unsuccessful Have not tried

Vestibular Nerve Section (VNS) Successful Worked for a short time Unsuccessful Have not tried

Labyrinthectomy Successful Worked for a short time Unsuccessful Have not tried

Meniette Box Successful Worked for a short time Unsuccessful Have not tried

Have you found a way for keeping symptoms to where it doesn't affect you lifestyle as much? Yes No

Did your symptoms appear within a year after having major dental work done? Yes No

Did you have any health or stress issues just prior to your getting Meniere's symptoms? Yes No

Are you unable to work because of the severity of your symptoms? Yes No

If your Meniere's is in "remission," how long has it been? Not in remission Less than 1 year 1 year 2 years 3 years 4 years 5 years 6 years 6+ years

Are your symptoms aggravated by any of the following methods of transportation? Car Train Plane Boat Other None

Have you tried Vertigoheel (Cocculus compositum)? Yes, and it worked Yes, and it didn't work Yes, but it only worked for a short time No