Tinnitus

Tinnitus.

Tinnitus is a condition that comes in many different forms and intensities. Most people habituate and are able to carry on with their life doing everything that they want to without too much difficulty. It usually becomes a problem when it is loud and intrusive and begins to interfere with a person’s quality of life and their mental well-being.

Since exposure to loud noise is the most common cause of tinnitus, it has been suggested to me on more than one occasion, it is a modern day condition that has come about by the increasingly noisy world in which we live, or to be more precise, the high sound levels that some people expose themselves to while blissfully unaware of the potential risks that are involved.

There maybe some truth in this, when one considers the amount of people that go about wearing ear buds, that are attached to their mobile phone or an mp3 player and listen to music that is often at high volume levels and do this for long durations. I feel these devices have contributed to it becoming more prevalent in today’s society especially amongst the young. In addition to this, those that regularly attend nightclubs, concerts and multiplex cinemas could also be at risk.

There are those that believe the louder the sound at these venues the better the audio experience and will scoff at the mere mention of using noise-reducing earplugs. One should be able to go out and have a good time if they want to, but also be aware of high sound levels their auditory system might be subjected to at these places of entertainment. Therefore, it would be prudent to carry adequate hearing protection should the need arise to use them.

Someone once told me when their ears are ringing after leaving a club it’s a sign that they’ve had a good night. That’s fine I said until the day the ringing doesn’t stop. This can happen when the ears are repeatedly exposed to high sound levels. What might start out as a pleasant experience can quickly change into something quite distressing if tinnitus becomes loud and permanent. Many other things including an underlying medical condition, not necessarily associated with the ear, can be responsible for it too.

In fact tinnitus isn’t a modern day condition at all and has been around for many centuries and goes way back to the Egyptians, when the first written account and medical treatment for it was recorded. There weren’t any treatments like the ones in use today. How did people cope and what form of treatment was available then, and right up until now? The Egyptians used a concoction of remedies to treat the “bewitched ear or “the humming ear” as it was called. Infused oil, frankincense, tree sap, herbs and even soil would be administered into the external part of the affected ear using a reed stalk. By today’s standards such treatments might seem bizarre. Nevertheless, it’s what the doctors at that time believed in and therefore, who are we to say such methods didn’t bring some relief to the affected person?

The Mesopotamians, a collection of cultures and considered to be the cradle of civilization, used to chant to get rid of the whispering or singing in their ears. “Whoever thou may be, may Enki restrain me.” This was just one in a list of mantras used, to perhaps condition the mind and probably helped to push the noise further into the background making it less noticeable. An early form of sound enrichment?

I believe a real breakthrough in coping with tinnitus came with the use of sound as a form of masking. Two famous Greeks first introduced it: Aristotle and Hippocrates. One a philosopher and scientist the other a distinguished physician, who is often referred to as the “Father of modern medicine. Perhaps this is the reason all newly qualified physicians take the Hippocratic Oath. Both were fond of saying: “Why is that buzzing in the ear ceases if one makes a sound. Is it because a greater sound drives out the less?”

A very helpful device that has brought relief to many people with tinnitus is the wearable white noise generator, formally known as a masker. I like to think fate had a part to play in the inception of this little miracle and it didn’t happen just by chance. Although at first glance this does seem to be the case.

In 1973, Jack Vernon PhD led a research group in the studying of tinnitus. He was traveling with a friend Dr. Charles Unice who had severe tinnitus. As they were walking passed an outdoor fountain, Dr Unice stopped abruptly and was reluctant to continue. Listening to the soothing sounds of the fountain, he told Dr. Vernon. “Standing right here I cannot hear my tinnitus. It’s the first time I’ve been unable to hear that unconscionably wretched sound since it began over two years ago. This is wonderful!” This intrigued Dr. Vernon and led him to research the matter further, until coming up with the idea of a wearable masking device, as a way of providing relief for tinnitus.

The word masking is not commonly used today in books when describing sound therapy although it is still used a lot in tinnitus forums. I think its use is outdated and for some time has been replaced with the term “sound enrichment” by health professionals. Hearing Therapists and Audiologists now advise patients, the preferred method is to set the volume level of the sound of choice, slightly below the tinnitus. By doing this, the brain is able to hear it and thus making the habituation process easier. Unless the brain can hear the tinnitus slightly above the sound enrichment the habituation process is usually more difficult. If one completely masks, as soon as the sound is stopped or temporarily removed, the brain will immediately focus back on the tinnitus and often, it will appear to be louder and more intrusive.

The wearable white noise generator has advanced considerably and is now available in various forms. The digital types require setting up on computer by an Audiologist and can be tailored to a patient’s specific needs. For example the user can select different sounds when required. Some are blue toothed enabling the streaming of audio. Hearing loss often accompanies tinnitus and therefore, dual-purpose devices are available that come fitted with a hearing aid.

Sound therapy using white noise generators, tabletop sound machine etc. Counseling and prescription drugs are available today and are able to play a significant role in helping to relieve not only the sound of the tinnitus but the stress and anxiety that often accompanies it. This has to be a good thing, despite some of the concerns some medications attract because they might exacerbate the condition or cause dependency. Not everyone is the same. What might affect one person might not in another. I believe, once a person is properly managed by their doctor, any problems that might arise due to medication, can quickly be resolved and a change of prescription is likely to bring the desired affect.

Although there is no cure for tinnitus at present. With the help of modern medicine, treatment therapies and having a positive attitude, people are often able to have a good quality of life. Depending on how intrusive the condition is, this might take a little longer for some but don't let that stop you believing.

Michael

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  • This is a great article , wish NHS would read it and provide the support we need !

  • Thank you for your kind comments Lindsay. I agree with you that the NHS could do more to help people with tinnitus, especially in certain parts of the country, where the care is not so good as in other parts. My personal experience with the NHS over the 21 years that I've had tinnitus, has been very good. I am still an out-patient and not long ago fitted with two new digital white noise generators.

    However, I know my experience will not be the same for everyone else. I also visit other tinnitus forums where the members come from all over the world. Some of the stories that I read makes me thankful I'm living in the Uk. Some of the basic care and treatment for tinnitus is not even available. There are others that can get tests and treatment but the cost is quite expensive due to it being private.

    Some countries where people pay for private healthcare they will get a hearing test and MRI scan and that's it. A referral to Hearing Therapist for example has to be paid for out of their own pocket as it's not covered by health insurance. The white noise generators I was recently fitted with cost around £2k and were free. In many other countries hearing aids, white noise generators have to be paid for by the patient.

    All the best

    Michael

  • It is interesting that having spent all my working life supporting individuals and and empowering communities to get the services and living environments that they deserve , I have not got the same confidence and courage to ' fight ' for myself ( the irony is most obvious when I go to my GP practice with whom I used to work assisting people with a range of health conditions ). I am in a double bind - I have always ' carried on ' as they tell me each time I say I am worried and struggling along with the cost element ( I plucked up courage to ask for MRI - no coz I had one 4 years ago and asked for nortripalyne, no coz pharmacists want to use amitriptaline. I tried it again despite not getting on with it last time - same bad t affects. I also think because i have only shed a few tears they dont get the paon. I feel there is a campaigning role for the BTA, even an advocacy one but I guess it's not for me to say ( but as a member I could share my thoughts ). I feel pathetic and weak , and this I am sure can't help my tinnitus. I am now struggling to work , my last refuge and fear I will start to self isolate because of the pain, and frustration. Thanks for letting me write ☺

  • Hi Lindsay, I do think you have to be assertive to get the treatment and help that tinnitus sufferers deserve. My GP and the privately-paid for ENT consultant were unsympathetic and useless. But I was referred to the local NHS audiologist who was understanding and provided practical help and suggestions. I was given a hearing aid and a masker which are what I believe quieten my tinnitus. But, a friend of my sister who got T 12 months after me (from taking certain meds for fibromyalgia) has had little or no help. And we use the same NHS hospital! She needs to make demands too!

    In fact, I am now into my second pair of NHS hearing aids and have had CBT sessions free of charge.

    I do hope you find what works for you. Love from Angela xx

  • Hi Michael, an interesting and informative post as usual. Thank you, Angela xx

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