Living with Tinnitus

Will my tinnitus ever go away? This is a question I get asked frequently by people who learn that I have tinnitus. Having first experienced intermittent but gradually steady episodes of tinnitus since I was 15 years old, I can tell you that for me personally, it has not gone away and remains a permanent fixture in my life. Learning to cope and deal with tinnitus is another story better left for another day.

However, don’t let my sob story dismay you. In many cases, tinnitus has been known to go away. In some, it can go away in a matter of hours. In others it may take days, weeks, or months. The recovery period really depends on the amount of noise the ears were exposed to and for how long. Many children and teenagers are increasingly developing mild tinnitus in this day and age due to the use of earbuds with music cranked up from their iPods much too loudly. Repeated exposure to this loud music eventually weakens the hairs in the ears that pick up sound and cause tinnitus to become permanent.

If you’ve noticed a ringing in your ears, ask yourself about the abuse your ears have taken, both long and short term. Do you listen to music through headphones? Do you like to go to loud music venues? Do you like the club scene where the DJ blasts music just a few feet from the dance floor? Exposing your ears to these harsh audio environments can cause tinnitus. If you are a chronic abuser, then don’t expect the ringing to stop any time soon.

In many situations people are exposed to a loud noise like an explosion or gunshot. This usually causes temporary tinnitus when hearing seems muted and a high pitch frequency ringing develops. If it is an isolated incident like this one, then the tinnitus is temporary and may disappear after a few hours. Perhaps you’ve gone to a music concert where you listened to loud music for a few hours. In this case it may take a day or even more to fully recover. If you constantly go clubbing, expect longer and longer recovery periods.

Continual exposure to these loud noises will eventually cause permanent damage to your hearing and as a result, potentially permanent tinnitus that will not go away, ever. Since you are now onto the fact that a ringing in your ears has developed, simply take the appropriate measures to eliminate these exposures in order to save what’s left of your hearing.

Other causes of tinnitus include:

• Meniere’s disease
• Narutal hearing loss due to aging
• Earwax build up
• TMJ and nerve pressure
• Ear bone changes
• Certain types of medication

Depending on the cause of tinnitus (consult a doctor for tinnitus testing) and if the condition is curable or reversible, you also stand a chance of having your tinnitus magically go away. Obviously, age-related hearing loss is perfectly natural and unfortunately unavoidable. However, causes like TMJ can be corrected and may cause any ringing to go away. When taking certain medications, tinnitus may appear while using them, but go away after medication stops.

Want to know what it’s like with tinnitus? Imagine fearing the sound of an ambulance speeding by. Loud noises like this, taken for granted by people who don’t have tinnitus, can trigger severe episodes of high frequency torture. Trust me on this, you do not want this happening to you. It can even affect your personality or destroy your life.

So to answer the question, will tinnitus go away? The answer is yes, it is possible, but it depends on your history.

The benefits of support groups have been well documented and include providing information, reducing the feeling of isolation, giving the opportunity to share experiences and coping skills, as well as gaining inspiration from others.

I took on the task of setting up a local tinnitus support group because of interest expressed by patients in our tinnitus clinics. Many wanted information and additional support during the early stages of their treatment. While the tinnitus clinic can offer individual assessment, investigation and management there was a feeling that meeting others, especially those that had developed good strategies to reduce the affects of the tinnitus, would be invaluable.

The meetings are attended by between 30-50 people, many bring their significant others. There is usually a formal presentation followed by a cup of tea and group discussion. An audiologist is on hand to answer any questions. At each meeting we stress the need to respect confidentiality and any shared experiences. The fact that the support group is not a substitute for individual assessment in clinic is stressed.

The views of the group have been formally audited twice and more than 90% stated that the support group had made a positive difference and that they had learned new skills to manage their tinnitus. There is certainly enough enthusiasm to keep the group going into the future. There are many positive ways to help manage tinnitus well and getting this message across is one of the main aims of the group.

May 15-21, 2011 is the American Tinnitus Association’s “Tinnitus Awareness Week”. Tinnitus Awareness Week is part of a larger awareness campaign in May.

Established in 1927, May has since been known as “Better Hearing and Speech Month” – a time to raise national public awareness, knowledge and understanding of speech, language and hearing disorders. To complement ATA’s year-round advocacy efforts, each year we set aside a week in May to focus specifically on increasing public awareness about tinnitus and most importantly the need for increased funding for tinnitus research. And this year, as we celebrate ATA’s 40th anniversary – we want to bring even more attention to this great opportunity to raise tinnitus awareness. Let’s continue to “Restore Silence: One Decade at a Time” together.

You can take steps to prevent your sense of hearing from excessive noise:

1. One common problem in our society is listening to music that is too loud through headphones. A good general rule for listening to music on headphones is: if someone sitting next to you can hear your music, the volume is too loud.
2. It is a good idea to wear ear plugs during loud concerts and during activities that produce a high level of noise, such as mowing the lawn.
3. Loud power tools and machinery can also produce sounds that are loud enough to cause hearing damage, so if you are working with these tools on the job, wear hearing protection.
4. Ambulance and fire sirens make extremely loud sounds that can damage your hearing if you are regularly exposed. You can cover your ears when a vehicle with a siren goes by to protect your ears.

Tinnitus can also be caused by ear problems, such as a blockage of ear wax, damage to the hair cells of the inner ear, Meniere’s Disease, or a middle ear infection. Certain medications, such as some antibiotics, malaria medications, anti-cancer drugs, diuretics, and extremely high doses of aspirin are also known to cause tinnitus or make an existing case worse. High blood pressure, arteriovenous malformation, and atherosclerosis are cardiovascular problems that can result in tinnitus. Very rarely, a benign tumor growing on the cranial nerve responsible for hearing can cause tinnitus in one ear. Other possible causes of tinnitus include problems with the temporomandibular joint (TMJ), head injuries, and neck problems. These conditions can cause other problems, including pain. Tinnitus is also correlated with, and worsened by, high levels of stress and depression. See your doctor for diagnosis and treatment of these conditions.

Over time, I compiled a list of “Tinnitus Spouse Survival Tips” that are based on my not-so scientific research with a patient population of one. They are, however, the result of my objective observations and my subjective experience as a wife. I hope that the reader might find value in them as well.

• Learn as much about tinnitus as possible.
• Take notes and ask questions. Become your spouse’s medical liaison and advocate.
• Don’t underestimate the value of good psychiatric or psychological intervention for your spouse and for you.
• Challenge distorted thoughts. Accentuate what is positive, and acknowledge but redirect negative thinking.
• Get your spouse moving. Exercise, outings, and chores will build a résumé of success that you can use to fight feelings of worthlessness.
• Decrease as much extraneous stress in your lives as possible. (This may not be the year to make quilts for everyone on your Christmas list.)
• Be compassionate and commiserate on occasion, but be tough when there is too much whining.
• Be patient. Successful treatment is probable but this is not strep throat! No 10-day course of Amoxil here.
• Maintain your social contacts and outside interests. Without any personal outlet you will become less effective in your supportive role.
• Keep yourself physically and emotionally fit. Your spouse and your family need you and you deserve it!

Other things to try: think positive thoughts, understand someone else’s viewpoints, or join a tinnitus support group.

Since Tinnitus Awareness Week just wrapped up a month ago in the UK and is set for May in the US, I felt that I would give a little reflection on a question I was asked the other day.

I feel very strongly about this and want to state, publicly, that I am 100 percent against sound limits. I am against prohibition in general. What I am for is knowledge and education. I just want people to make an informed decision, something I never had when I was growing up. I thought the ringing in my ears was part and parcel of the ‘going out to gigs’ experience. Nobody told me I could permanently damage my brain.

See – that sounds bad doesn’t it? ‘Damage my ears’ doesn’t sound so bad, certainly not bad enough for the government to do anything about it. If the civil servants making these decisions were informed of the facts, that it’s brain damage we’re talking about, then perhaps we’d see less apathy and more action.

Would it not be more intelligent, more caring and responsible to use some of the money allocated to these sorts of public information campaigns for educating people with the truth about tinnitus? That they can permanently damage their brain just by walking into a pub, or a club, or a gig. Surely there must be a plaque, a sign, on display, next to the one that says ‘licensed to sell alcohol’ which reads ‘You can permanently damage your hearing if you do not protect yourself in this venue’. Is that really too much to ask? Wouldn’t a law that makes it the venue’s responsibility to supply earplugs for sale behind the bar make social and economic sense?

Just saying…

What are your thoughts on this?

It feels great to have influential and famous people like Mr. William Shatner help raise awareness about this affliction. Thank you Mr. Shatner!

More Resources:
http://www.ata.org/taw-press-release
http://www.ata.org/about-ata/news-pubs/media
Tinnitus Awareness Week

If you don’t know how to identify the right tinnitus symptoms, chances are you might not even be able to identify the tinnitus experience at all. And unfortunately, this is the case for most people who already have had several instances of tinnitus. They often times dismiss it is a menial occurrence that will eventually stop bothering them, but many of them don’t realize that these symptoms of tinnitus hearken to an underlying medical condition that may probably need some form of treatment or medication. And so the bottom line is, the problem isn’t necessarily tinnitus, it’s the condition that it belies.

However, if by this time you still have no idea what tinnitus is, then here is a brief primer on the medical condition and how you can best identify it.

Ever experienced that strange sensation of ringing in your ears without any identifiable external cause? Then you are most likely experiencing tinnitus. Characterized by a ‘ringing’ in one’s ear, tinnitus is not in itself a medical disease or condition in its strictest sense, but is often a symptom that points to an underlying medical condition that may or may not need immediate medical treatment.

However, symptoms of tinnitus may vary from person to person. While the general experience is characterized by the ringing inside one’s ear, there are other people who experience more extreme tinnitus symptoms, such as high pitched whining, buzzing and even screaming—and these can all the more be bothersome for the person experiencing it.

In a lot of ways, the tinnitus symptoms one feels are natural medical alert systems that tell you and your body that there is an underlying problem that is causing the tinnitus. And tinnitus is normally an indication of a belying ear or nose-related medical condition, such as wax build-up, ear infections, nose allergies, and sometimes, psychological conditions such as stress. Therefore, it is important to regard tinnitus as your body’s way of telling you to pay a visit to your doctor to figure out what is wrong and what you can do about it.

Get more information here:
http://www.floridahealthfinder.gov/healthencyclopedia/health%20illustrated%20encyclopedia/1/003043.aspx
http://www.eugene-or.gov/healthierathome/p93-94%20Tinnitus.htm
http://www.acousticneuroma.neurosurgery.pitt.edu/tinnitus.html
http://www.urmc.rochester.edu/childrens-hospital/audiology/tinnitus.cfm#symptoms

I’ve compiled a few tips that have helped me cope with the ringing in my ears when it gets unbearable. Some of these tips are long term and others are short term solutions. At any rate, these tips should help as they certainly did for me.

1. Stop the noise. As anyone who has ever attended a loud rock concert knows, the noise lingers on long after the melody ceases. But you may be raising your risk for tinnitus every day if you blast the volume of your iPod, Walkman, or other portable music device and find that your ears still ring long after you have removed the headphones. Worse, you could end up with temporary or even permanent hearing loss. Every additional exposure to loud noise damages the tiny hair cells in the inner ear even more, reducing the chance that damaged cells might heal or that the central nervous system might develop a tolerance level to block the noise out over time.
2. Keep in mind that you don’t have to be a fan of loud music to endanger your hearing. Many people, such as factory and construction workers, are exposed to the harmful effects of loud noise on the job. Some hobbies, such as hunting or target shooting, may damage hair cells, too. So turn down the volume of your music, and if your job or hobby exposes you to loud noise, wear adequate hearing protection.
3. Check your blood pressure. Ringing sounds in the ears can often be traced to high blood pressure. If that’s the case, think of the ringing as a warning bell to get a complete physical checkup, since blood pressure that is high enough to produce tinnitus may well be wreaking havoc elsewhere in the body. High blood pressure is a primary risk factor for heart disease that, unlike the ringing in your ears, you should never try to ignore.
4. Lick the salt habit. Sodium is not always problematic for tinnitus sufferers. If you have an inner-ear disorder such as Meniere’s disease or have high blood pressure, however, you should cut out sodium as much as possible. And don’t simply put away the saltshaker. Become a careful label reader and look for stealth sources of sodium in your diet, such as snacks, deli meats, frozen foods, and canned soups. Search out foods labeled “sodium free,” which means that the item has less than five milligrams of sodium per serving.
5. Limit aspirin. Aspirin in high doses often causes reversible tinnitus for a day after it is taken. And if aspirin is taken on a regular basis — say, for arthritis or chronic pain — there’s a risk of damage to the hair cells in the ear, although it may still depend to some extent on how much is taken on a regular basis (damage is less likely in those who take a baby aspirin each day for their heart, for example). Try to limit your intake of aspirin to see if your tinnitus improves (if the aspirin has been prescribed by a doctor, however, check with the doctor first). Be sure to check labels on any other over the-counter medications you take, too, since many of them contain aspirin. If you take aspirin for a chronic conditions, talk to your doctor about alternate medications.

For more tips on dealing with tinnitus when the ringing becomes unbearable, visit http://health.howstuffworks.com/wellness/natural-medicine/home-remedies/home-remedies-for-ringing-in-the-ears.htm.

Question: I’ve begun hearing an annoying buzzing or ringing sound in my ears. What’s going on?

Answer: The fancy name for the sounds you are hearing is tinnitus. Some people pronounce it “TIN-ih-tus” and others “tih-NYE-tus.” Either way is correct. Both are in the dictionary.

Tinnitus is relatively common. At least 17 out of every 100 people around the world have some degree of tinnitus. Here in the United States, the American Tinnitus Association estimates that about 50 million Americans have tinnitus to some degree while about 12 million have tinnitus severely enough that they seek medical advice. About 2 million of these have tinnitus so bad that they cannot function normally.

Your doctor will examine your ears, head and neck to look for possible causes of tinnitus. Tests include:

• Hearing (audiological) exam. As part of the test, you’ll sit in a soundproof room wearing earphones through which will be played specific sounds into one ear at a time. You’ll indicate when you can hear the sound, and your results are compared with results considered normal for your age. This can help rule out or identify possible causes of tinnitus.
• Movement. Your doctor may ask you to move your eyes, clench your jaw or move your neck, arms and legs. If your tinnitus changes or worsens, it may help identify an underlying disorder that needs treatment.
• Imaging tests. Depending on the suspected cause of your tinnitus, you may need imaging tests such as CT or MRI scans.

The sounds you hear can help your doctor identify a possible underlying cause.

• Clicking. Muscle contractions around your ear can cause sharp clicking sounds you hear in bursts. They may last from several seconds to a few minutes.
• Heartbeat. Blood vessel problems, such as high blood pressure, an aneurysm or a tumor can amplify the sound of your heartbeat in your ears (pulsatile tinnitus).
• Low-pitched ringing. Conditions that can cause low-pitched ringing in one ear include Meniere’s disease. Tinnitus may become very loud before a vertigo attack — a sense that you or your surroundings are spinning or moving.
• High-pitched ringing. Exposure to a very loud noise or a blow to the ear can cause a high-pitched ringing or buzzing that usually goes away after a few hours. However, if there’s hearing loss as well, tinnitus may be permanent. Long-term noise exposure, age-related hearing loss or medications can cause a continuous, high-pitched ringing in both ears. Acoustic neuroma can cause continuous, high-pitched ringing in one ear.
• Other sounds. Stiff inner ear bones (otosclerosis) can cause low-pitched tinnitus that may be continuous, or may come and go. Earwax, foreign bodies or hairs in the ear canal can rub against the eardrum, causing a variety of sounds.

In many cases, the cause of tinnitus is never found. Your doctor can discuss with you steps you can take to reduce the severity of your tinnitus or to help you cope better with the noise.

The impact tinnitus has on a person’s life can vary enormously. Obviously there is a major difference between mild or short lasting tinnitus and loud, severe, constant tinnitus day in and day out. Some people learn to completely ignore their tinnitus. The fancy term for this is “habituation.” For many others, tinnitus is only a mild irritation. However, for some, tinnitus is totally debilitating and disrupts their entire life. People with severe tinnitus often have problems sleeping. They may be irritable and cannot concentrate on anything other than their tinnitus. As a result, they are constantly under stress, perform poorly, and lose their joy of living. The great musician, Beethoven, once lamented, “My ears whistle and buzz continually day and night. I can say I am living a wretched life.

It might be tough to accept, but research shows that people with tinnitus exhibit similar behavioral characteristics. A logical thing to ask then, is whether the characteristics actually cause the tinnitus, instead of the trigger or event that tinnitus patients often associate with tinnitus (the concert, the loud noise, the stress, etc.).

The following translation is not available anywhere else in the world. I personally translated the German text of the scientific study for you.

Here is my translation of Dr. Greuel’s “Die Biomentale Therapie.” (p. 39)

“…
Tinnitus Patient Personality Characteristics

In the course of treating several thousand patients, including the group for this study, a fairly uniform personality of tinnitus patients became apparent.

• Conscientious, duteous, strong sense of duty
• High-effort and diligence
• High demands of self
• High ambition
• Perfectionism to the point of being pedantic
• Compuslive and depressive
• Tendency to overextend, overwork, overburden, and exhaust oneself
• Lack of ability to relax, reduce the load of burdens, and regenerate

Most patients say that they can’t “turn off,” that they think constantly, they complain, and are mentally very active. (Note, the German “geistig ständig aktiv” also implies high emotional and spiritual activity along with mental activity).

Rest, relaxation, recuperation, vacations, being lazy, etc. are completely foreign to most tinnitus patients.
Also, the boundaries of one’s own capacity to cope with pressure tend to be either ignored or not honored. As such, the symptoms of tiredness and exhaustion that register themselves to our bodies in the form of temporary tinnitus, dizziness, pressure in the ears, headaches and migraines get ignored. The symptoms are not understood as warning signals anymore, they are dismissed or suppressed with medications.
…”