A number of questions concerned activities in which the atmospheric pressure surrounding the body was likely to change. Although I originally also included questions about activities such as scuba diving, I should have known that very few individuals with Meniere's were likely to enjoy such a pastime. Since I got so few responses to that part of the questionaire, I have not included them here.
Of our respondents, by far the most problems are apparently created by pressure changes associated with weather patterns which affected over 70% of respondents. Driving up hills and mountains affected 56%. Although flying in commercial airliners affected fewer people, the larger "don't know" response, from individuals who do not normally fly distorts this response. When "don't know" responses are excluded, the percentage of patients who are affected by driving (62%) is almost identical to the number who are affected by flying (63%) suggesting that both these activities may be equivalent. The number of individuals affected by using elevators was a little lower, at 44%.
In this plot, it is apparent that the characteristics of symptom changes with driving up hills and mountains are somewhat similar to those associated with flying. Fullness is more commonly reported as a problem, with hearing and tinnitus being indicated less often though to a similar degree, and vertigo being less frequently reported as a problem. It should be noted that for non-Meniere subjects, we would expect fullness to rank as the most noticeable characteristic of the pressure changes associated with altitude changes. It is difficult to assess how much the perception experienced by Meniere's patients is over-and-above that normally experienced. It is likely that starting with a degree of fullness would contribute to an exacerbation of the problem.
One area in which I now realize the survey was deficient, is the fact that this question asked "Which of the following affect your Meniere's symptoms?" which did not differentiate whether symptoms were made worse or better by the activity. While it is clear that the vast majority of respondents regard these activities as "problems" i.e. their symptoms are worsened, some individuals have commented that their symptoms were improved by flying or driving where altitude changes were involved.
Symptoms experienced during the use of elevators show considerably different characteristics. The largest problem reported in this case is vertigo, with tinnitus, hearing and fullness all at lower levels than with the above travel-related activities. In my view, the influence of elevator travel is more likely to be linked with motion occurring without a visual reference (i.e. contradictory information from the vestibular and visual systems) rather than due to the the atmospheric pressure changes from moving up or down. This is supported by the fact that 83% of respondents indicated that elevator movements of less than 10 floors would give rise to symptom changes.
Weather changes seem to influence symptoms differently from the three forms of travel, with tinnitus and fullness representing the major problems and hearing changes being far less of a problem.
For all the above activities, the majority of respondents indicated that symptomatic changes occurred rapidly.