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A Grain of Salt | By Dr. Lenny Salzberg


It’s in nearly everything we cook and eat, but Cece Adams has found that avoiding salt has been the answer to coping with a condition called Meniere’s disease. She is even working on a book to help others battle the disease. Four years ago, while working in her hair salon, Cece Adams felt a sudden and severe wave of vertigo that left her unable to move any part of her body, everything but her eyes, which violently jerked back and forth. She cancelled her appointments for the rest of day, then the week. Over the next several weeks, her daughter had to help her to the bathroom and bathe her. She was bedridden for months. Adams has since been unable to reopen her popular salon. “It’s like I had a life before that day and a life after that day,” she says. Adams has Meniere’s disease. It causes the spontaneous episodes of vertigo but often comes with more lingering symptoms as well: balance problems that persist for days, the eye jerking known as horizontal nystagmus, hearing loss, ear pressure and perhaps the most maddening symptom of all, persistent ear ringing known as tinnitus. It is estimated that anywhere from 15 to 157 people per 100,000 suffer from Meniere’s with most receiving a diagnosis in their 40s or 50s. More cases occur in women than in men, and researchers still do not know the cause. Adams has an anatomic defect that has led to recurrent ear infections throughout her life, and it’s possible this defect may have predisposed her to the condition. She is also of Irish and English descent; the disease is more common in people of northern European descent. She is the first in her family to suffer through this. For Adams, Meniere’s has been both chronic and disruptive. She had to close her business after a 30-year career. The vertigo comes without warning, the feeling of riding a roller coaster after a few drinks too many, and a bout will leave Adams in bed for days. The ear ringing only stops for about two or three hours a week, giving her a brief and frustrating reminder of what normal life feels like. “It’s so absolute,” she says about the disease. “The totality is so encompassing.” For many people, life with Meniere’s disease often leads to depression and anxiety. But Adams has been able to gain some control thanks to medications and a diet extremely low in salt, so extreme Adams limits her daily sodium intake to 100 milligrams a day. Compare that to the 1,500 to 2,400 milligrams recommended by various health organizations, including the National Academy of Sciences’ Institute of Medicine, though the average adult consumes much more, about 3,400 milligrams every day. Sodium counts add up quickly – a can of Campbell’s classic condensed tomato soup, for example, has 1,200 milligrams of sodium. Adams has been forced to get creative when cooking – she even uses color-coded spoons so as not to mix her food with the meals she prepares for her husband – and eating out requires advanced planning and special requirements. She found help through several books: “Medifocus Guidebook: Meniere’s Disease,” “The Everything Low Salt Cook Book” by Pamela Rice Hahn, “Cooking Without a Grain of Salt” by Elma W. Bagg, Susan Bagg Todd, and Robert Ely Bagg and Web sites such as: healthymarket.com and saltwatcher.com. But Adams is also working on a book of her own. She is writing about her experiences with Meniere’s, sprinkling in recipes that she has either modified or created. The book is an extension of the help she has been giving to fellow patients on the phone and online. If there’s something she can do to help other people avoid the suffering and frustration she has experienced, she says, it’s worth the work. Some days, she says, “I feel like a pioneer.” Dr. Salzberg sees patients and teaches at the Southern Regional Area Health Education Center.