Sunday, 19 January 2014

For whom the bell tolls - Tinnitus


If you know anyone with tinnitus, or ringing in the ears, you might know that it can be a real problem. Some people don't notice the pinging, ticking, buzzing or bells. Others are devastated by it.  And you almost certainly do know someone with tinnitus since it affects 1 in 5 people (Mayo). Thing is, people with tinnitus usually don't like to talk about it. Let's learn why.


Tinnitus is a noise or ringing in the ears. It can affect both ears or just one. The noise can be subtle or screamingly overt. The sound can be a gentle hissing (like a tap running in another room), a ticking or clicking (like a watch held to the ear), or a loud buzzing, ringing, or high pitched whine (like an air raid siren from London 1944).

Tinnitus can start right out of the blue and quite often scares the heck out of people. It can be temporary. It often isn't. But the brain adapts so it appears to recede or go away. I will explain that in greater detail in a minute.

Tinnitus is a symptom that has a number of different potential causes. The absolute most common cause of tinnitus is hearing loss. Hearing loss can come with ageing (known as presbycusis), or from exposure to loud noise (heavy equipment, loud music, firearms), or from a structural problem with sound conduction (ear wax or ear bone changes like otosclerosis).

Other causes of tinnitus are not as common but your NP or Physician will want to exclude these conditions. Meniere's disease, TMJ disorders, head injuries, metabolic disorders (diabetes, thyroid disease), atherosclerosis (clogging of the arteries) or vascular/capillary abnormalities, high blood pressure, and head and neck tumours can all cause ringing in the ears. Acoustic neuromas (tumours on the cranial nerve responsible for hearing) will do it but only in one ear.

Some specialists will want to rule out neurological conditions like multiple sclerosis and infections like syphilis. Medications can cause or worsen tinnitus usually when they are given at higher doses. These include some antibiotics, cancer medications, quinine, aspirin, diuretics and some psychiatric drugs like antidepressants.

The process of eliminating all of these horrible conditions can be quite terrifying. Some things are simple to rule out with a carotid artery ultrasound or simple physical exam. Other conditions require an MRI scan of your noggin which for some people is about as much fun as doing your taxes. At minimum if you experience tinnitus you should be having a hearing test, blood pressure readings, basic blood tests, and a physical examination by your health care provider.

In truth for all the years that I have been providing primary health care almost all of the patients with tinnitus have it from hearing loss. I have patients who are in their late 30's with tinnitus and others who don't notice it until they are in their 80's.

Regardless of the cause constant ringing in the ears can cause a multitude of problems. It's true that many of my patients really don't notice it much. Others are considerably more distressed, particularly when it first starts, and they may experience insomnia, fatigue, severe stress, memory and concentration problems, anxiety and depression. Often people with tinnitus have difficulty hearing quiet or high pitched sounds. Some people become isolated when they avoid social situations because they are distressed or cannot hear. Many people don't like to talk about tinnitus because it makes them focus on the ringing which is then perceived to be louder. Tinnitus is often compared with chronic pain in that it is constant, subjective, and can be traumatizing if we feel that we have no control over it (Canadian Academy of Audiology).

So when does this story get better? Well in fact it does. Because  we can gain control over tinnitus with a number of different strategies and tools. Sometimes patients are told by their health care provider that "tinnitus can't be cured". Or to "go home and get used to it". This is NOT helpful and really isn't accurate. It's true that we don't "cure" tinnitus. But we can decrease our sensation of it - just like we do with pain.

The brain is a truly amazing thing and what happens is that it adapts to the tinnitus and ultimately blocks it out. In most cases of tinnitus we stop hearing part of the hearing range. The brain "fills in" that part of the range. But it isn't able to make it sound exactly like the ambient noise around us which is always changing. So what we hear is a ringing or whining sound. But over time our brain then adapts to the new sound and starts to block it out.  When the ringing first starts it can be perceived as extremely loud - almost like a buzzer. But over time this recedes into the background until you go days and days without noticing it.

Adaptation takes weeks to months so it is important that patients remember two things - one is that it will fade into the background - the other is that there are a lot of strategies and management techniques that can be employed in the meantime. Often the person with the tinnitus will not think of these things so we need to help them out.  I cannot stress enough how important it is that if someone in your life has tinnitus please make sure they are getting all the help and support that they need. 

First of all there are a number of distracters/masking devices/noise machines. What these do is provide an external noise for your brain to focus on so that it doesn't hear the tinnitus. These can be immensely helpful for getting to sleep but some people like to have them on in the background during the day. You can buy a number of devices on-line and now there are a selection of mobile phone applications that you can download (most are free). There are some things you may already have in your house that are often effective - a fan, a bubbling fish tank, air humidifiers, air filters, and decorative water features.

Medications should definitely be reviewed. Any medication that is a known cause of tinnitus (e.g. aspirin) should be reduced. And there are medications you might start that can have a very positive impact on life quality - such as anti-depressants and sleeping tablets. You may not need these medications forever but until your brain adapts and you start to block out the ringing it can be very important to take these medications in consultation with your provider.

If tinnitus is caused by hearing loss it can be extremely helpful to see a hearing specialist and try hearing aids. Some people will get tinnitus before hearing loss registers on their test - the canary in the coal mine so to speak. Other people will show advanced hearing loss. Either way hearing aids can be very effective.

Counselling and cognitive behavioural therapy is also helpful to a lot of people. Most social workers can provide this type of care. There are also specialized centres that focus on tinnitus management and retraining therapy. Some of these centres provide care at their centres as well as counselling and management programs on-line.

Anyone who has potentially acquired tinnitus from noise damage and hearing loss at work should consider a WSIB claim. In any place where there is identified hearing loss risk (factory workers, mine workers, working with heavy equipment, military personnel)  financial support for hearing aids and management aids and programs are often provided.

Best of all is to reduce the risk of tinnitus in the first place. If you are told to wear hearing protection at work - use it! And make sure that it is working properly and doing the job. Pay attention to your general and cardiovascular health - don't smoke, exercise often, eat a healthy whole foods diet, and keep your screening tests current (if you know the words here - sing along).

And most importantly - reduce your noise exposure. I first developed tinnitus when I was 41 years old. It came on during a pertussis infection (and antibiotics) that I contracted at work. I will never know if it was caused by the infection, the drugs, or the eventual hearing loss picked up on my hearing tests. But if I could, I think I would take back the miles and miles of marathon and triathlon training with the music at full blast on my earphones. Or standing by the larger-than-life speakers at the many concerts - Midnight Oil, Violent Femmes, The Clash, The Stones, Sting, Bowie, Genesis, Peter Gabriel, Blue Rodeo, Indigo Girls, Sarah McLaughlin, Bob Seger, Joe Jackson, Dave Brubeck, Elton John, Eurythmics, Blur, The Hip, Spirit of the West, Jan Arden, The Waltons, Great Big Sea, and so many more.  I might even have missed all of the Bruce Springsteen concerts if it meant I could have skipped that MRI scan.


Thanks for reading Getting Healthy with NP Sam. Comments welcome - please click the pencil icon below. 



Resources:
Basics of Tinnitus (Mayo Clinic)
Tinnitus (Canadian Academy of Audiology)
Tinnitus Retraining Therapy (Canadian Tinnitus & Hyperacusis Centre)
Tips for Managing Tinnitus (Canadian Tinnitus Foundation)
Deborah Lain, BA, MSc Psychology Services for people with Tinnitus
Tinnitus Management Modules (Deborah Lain - Hope for Tinnitus)
Sound Devices for Tinnitus (Sound Oasis)

16 comments:

Anonymous said...

Great article. I have a family member who's suffers tinnitus and they went through a very difficult time, especially through all the medical tests early on. Not that the tests were difficult per say, but in the sense that it took a few months to have all the tests completed and during that time they were obviously experiencing tinnitus with zero relief and undergoing massive stress with not knowing why they had developed tinnitus and how to treat or at least manage it. So for what it's worth, anyone going through the early stages of Tinnitus and the medical tests should immediately purchase a white noise machine such as Sleep Mate. They can be purchased online and if purchased through a store such as Amazon the shipping is free. I believe they go for about $65. Money well spent to help a Tinnitus sufferer get much needed sleep while they wait for a management plan from their health care provider and while their brain adapts to Tinnitus. Also, in my experience, family and friend support is huge....this is extremely stressful in the early days for the patient. Also, don't bring up the subject of Tinnitus to the patient....this will make them re-focus on the tinnitus and make it worse temporarily. Let them bring it up if they want to speak about, otherwise just be there and do your best to take their mind off of it!

By the way, my family member with Tinnitus, still has it, but has learned how to manage it and is doing light years better. So to anyone who is suffering from this....it will get better....just listen to the advice in this article and follow it! The advice is bang on.

Jessical Alba said...

ALL THANKS TO DR WILLIAMS FOR THE GREAT DEED HE HAVE DON FOR MY DAUGHTER?
My daughter suffered from a terrible tinnitus for more than 23 years which started after she turned 5 we all thought it will end but got even worse as days went by. We tried all several treatments and therapy prescribed by various doctors we met but to no avail, she lost total concentration and screamed most times. She usually tells me she hears hissing and ringing noises. This were steady noise that disrupted her entire life, even at night she screams even more because the sounds become louder because everywhere is quiet and she slept less because of this.It was during a casual conversation with a friend that i learned about dr Williams herbal medicine I was able to contact him on his email address. and give him all the necessary information that he needed,few day later he sent me the herbal portion and his medicine was able to restore her back to normal and she is very okay now without any side effects whatsoever. If you have Tinnitus, do not hesitate to contact him on drwilliams098675@gmail.com for advice and for his product. I hope this also helps someone out there

SOPHIE LEWIS said...

I am sophie from Canada, I once suffered from a terrible and Chronic tinnitus ,in 2016, the doctor told me it has no permanent cure i was given medications to slow down its progress, i constantly felt my health was deteriorating as i constantly go out of breath,and this noise was really terrible especially when am sleeping, i have this constant ringing in my ears for about 8 months, this was really a terrible noise ,on thin one day that i was going through the internet,and i came across a post of Mrs Kate on how she was been cured from tinnitus through dr Williams herbal product, I contacted this herbal doctor via his email and explain everything to him and make purchase of his product,few days later he sent me the herbal medicine through courier service, when i received the herbal medicine i used it for 3 weeks as prescribed and i was totally cured of tinnitus within those week of usage,on thin now i have not hear anything ringing in my ears.if you need his help you can Contact this herbal doctor via his email drwilliams098675@gmail.com for help

karen dish said...

ALL THANKS TO DR WILLIAMS WITH HIS HERBAL PORTION I WAS COMPLETELY CURED FROM A TERRIBLE TINNITUS.
How can I ever stop thanking Dr William for the great deed he have done for me, i got an accident when I was 27 years old, from that day on i started experience ringing ear (tinnitus) i have taken all the western drugs prescribe by various doctor but to no avail . my tinnitus was very loud in the afternoon and I sleep less at night because of this problem i stop my work, few days later i was going through the Internet and I saw a post of so many people testifying about Dr William herbal remedies on how they was being cure for over many years suffering from tinnitus the story Really motivated me that I have to speak with my husband about it, and he said i should give him a try, i contacted Dr William and explain all i have be facing in my life. He assured me that everything is going to be fine if only I can get his herbal portion, i said yes and I requested for it, few days later the herb was sent to me in Kuwait,i started using it as instructed by Dr William for me to take it for 21 Days which I did, can you imagine after talking Dr William herbal medicine for just two weeks i started experience results, it was like a miracle,and now i am permanently cure from this terrible tinnitus, i promise that am going to publish his herb on thing my last breath for the great deed he have done for me. For those with similar ear problem should please contact him on his email address drwilliams098675@gmail his a good man and am proud of him.

JOHNSON KATE said...

ALL THANKS TO DR WILLIAMS WITH HIS HERB I WAS CURED FROM A TERRIBLE TINNITUS.
. Is my pleasure to comment on this site and i thank the admin of this site for his/her great work so far. I really don’t know how to thank DR WILLIAMS for helping me get cured for over 20 year of suffering from a terrible tinnitus, my tinnitus started when i was 28 year i thought is going to end one day but even get worse as days went by,i have tried all western drugs prescribed by doctors but to no avail i lost total concentration, even at night i screams even more because the sounds become louder because everywhere is quiet. i came across DR WILLIAMS contact through a headline news on internet about how DR WILLIAMS have help so many people to get cured of tinnitus and so many other with similar body problem ,i contacted him and he told me how to get his herb,few day later he sent me the herbal portion which i take every morning for 21 days, and his medicine was able to restore me back to normal and now am very okay without any side effects whatsoever If you have Tinnitus, you can contact him on his email address drwilliams098675@gmail.com for help

Jessical Alba said...

ALL THANKS TO DR WILLIAMS FOR THE GREAT DEED HE HAVE DON FOR MY DAUGHTER?
My daughter suffered from a terrible tinnitus for more than 23 years which started after she turned 5 we all thought it will end but got even worse as days went by. We tried all several treatments and therapy prescribed by various doctors we met but to no avail, she lost total concentration and screamed most times. She usually tells me she hears hissing and ringing noises. This were steady noise that disrupted her entire life, even at night she screams even more because the sounds become louder because everywhere is quiet and she slept less because of this.It was during a casual conversation with a friend that i learned about dr Williams herbal medicine I was able to contact him on his email address. and give him all the necessary information that he needed,few day later he sent me the herbal portion and his medicine was able to restore her back to normal and she is very okay now without any side effects whatsoever. If you have Tinnitus, do not hesitate to contact him on drwilliams098675@gmail.com for advice and for his product. I hope this also helps someone out there

LEONERDO DICAPRIO said...

I have been in the tinnitus community for a while now and I have experience what you are going though with tinnitus , I do know people that have got
tinnitus from having their implants done. Ringing in the ear after an implant can go away on its own, but that is BS of what the mouth and jaw specialist said. I have definitely seen and heard of a connection between tinnitus and teeth and mouth. There is a treatment for ringing ears and if you are
interested you can contact Dr William herbal remedies that what I take that stop the ringing in my ear that was really driving me crazy, don't Lose hope .,I have found a solution for my fellow citizens . If you haven't I would suggest trying Dr William herbal supplement. Again, this is a thing that takes time and usually requires time and patience for it to work WITH no side effects. But I'm not hear to sell you the product, I'm only hear to tell you that it works, but it is a journey and can be difficult. I hope at this point in want away on it own. Good luck . his email address drwilliams098675@gmail.com for advice and for his product

SOPHIE LEWIS said...

I am sophie from Canada, I once suffered from a terrible and Chronic tinnitus ,in 2016, the doctor told me it has no permanent cure i was given medications to slow down its progress, i constantly felt my health was deteriorating as i constantly go out of breath,and this noise was really terrible especially when am sleeping, i have this constant ringing in my ears for about 8 months, this was really a terrible noise ,on thin one day that i was going through the internet,and i came across a post of Mrs Kate on how she was been cured from tinnitus through dr Williams herbal product, I contacted this herbal doctor via his email and explain everything to him and make purchase of his product,few days later he sent me the herbal medicine through courier service, when i received the herbal medicine i used it for 3 weeks as prescribed and i was totally cured of tinnitus within those week of usage,on thin now i have not hear anything ringing in my ears.if you need his help you can Contact this herbal doctor via his email drwilliams098675@gmail.com for help

Anonymous said...

CURE TO TINNITUS,. One night in October last two year, when I lay down to sleep, I heard this high pitched noise coming from my left ear.I did not pay that much attention and went to sleep. The following morning, it was gone. Then again, after one month since the first experience it came back, and this time it came to stay. It was a pretty high pitched noise, and only in my left ear. After 2 days, I went to see an ENT. He said that my left ear was full of wax and need to be cleaned. Actually he did a good job by cleaning both my ears but some hardly stuck wax was still in my left ear. He gave me ear drops. I went home and used ear drops as per his instructions. After two weeks, I revisited him again. He told me that my ears were clean and not to worry about Tinnitus, and reassured to me that it would go away after 2~ 3 week time. The Tinnitus was always there 24/7. In the 4th week I started to panic and then anxiety, depression and fear kicked in and started to have sleepless nights. I was sleepless for 3 straight nights. My wife was also started to worry about me but there was nothing she could do to help me.Then, I started to google about Tinnitus. I read about how Dr john product cure a woman who had tinnitus.i email dr john and i get the product which i use my tinnitus was cure. THANKS TO DR JOHN his herbal remedy is the only permanent solution to tinnitus for more information email him on johnewoig18@gmail.com

Ana melissa said...

"DR WILLIAMS, I wish to praise you for sharing such a simple but comprehensive herbal medication to tackle this disease from the root. This is truly a valuable resource for all men and woman suffering from tinnitus. It's been almost 10 months since my doctor first diagnosed me with tinnitus. My doctor suggested that I will try watchful waiting but as the months went nothing has changed.

As soon as I decided I'm going all the way and treat my tinnitus, I ordered Dr Williams and the results as you already know were shocking to say the least. The result I took clearly showed my tinnitus had completely vanished.

I have even encouraged my "Doubting Thomas" friend to order it and read it too. To have so much good information in one tight package is an unbelievable value. I would encourage anyone who suffers from tinnitus and/or any ears infection issue to take advantage of Dr Williams herbal medicine! you can contact him through his email on drwilliams098675@gmail.com for more information

Sincerely...

Arnold Pierre said...

Dr Williams,his medicine was extremely helpful to me. I have had tinnitus for 7 years now , and my doctor told me to have a tinnitus sugary . I am so glad I have found Dr Williams medicine (as I was surfing the net for a solution and saw a recommendation for it on a women's health forum early this year). I have felt so empowered by the knowledge you have given me and I quickly self diagnosed the individual cause of my tinnitus and armed with your clear instructions, I was finally able to beat this monster, in less than 4 weeks of using dr Williams medication. 9 weeks before the tinnitus surgery was due, I asked for a scan and it was clear that my tinnitus were gone,you can also email him on drwilliams098675@gmail.com for help.

Thank you, thank you , thank you. dr williams "

LEONERDO DICAPRIO said...

I have been in the tinnitus community for a while now and I have experience what you are going though with tinnitus , I do know people that have got
tinnitus from having their implants done. Ringing in the ear after an implant can go away on its own, but that is BS of what the mouth and jaw specialist said. I have definitely seen and heard of a connection between tinnitus and teeth and mouth. There is a treatment for ringing ears and if you are
interested you can contact Dr William herbal remedies that what I take that stop the ringing in my ear that was really driving me crazy, don't Lose hope .,I have found a solution for my fellow citizens . If you haven't I would suggest trying Dr William herbal supplement. Again, this is a thing that takes time and usually requires time and patience for it to work WITH no side effects. But I'm not hear to sell you the product, I'm only hear to tell you that it works, but it is a journey and can be difficult. I hope at this point it want away on it own. Good luck . his email address drwilliams098675@gmail.com for advice and for his product

karen dish said...

ALL THANKS TO DR WILLIAMS WITH HIS HERBAL PORTION I WAS COMPLETELY CURED FROM A TERRIBLE TINNITUS.
How can I ever stop thanking Dr William for the great deed he have done for me, i got an accident when I was 27 years old, from that day on i started experience ringing ear (tinnitus) i have taken all the western drugs prescribe by various doctor but to no avail . my tinnitus was very loud in the afternoon and I sleep less at night because of this problem i stop my work, few days later i was going through the Internet and I saw a post of so many people testifying about Dr William herbal remedies on how they was being cure for over many years suffering from tinnitus the story Really motivated me that I have to speak with my husband about it, and he said i should give him a try, i contacted Dr William and explain all i have be facing in my life. He assured me that everything is going to be fine if only I can get his herbal portion, i said yes and I requested for it, few days later the herb was sent to me in Kuwait,i started using it as instructed by Dr William for me to take it for 21 Days which I did, can you imagine after talking Dr William herbal medicine for just two weeks i started experience results, it was like a miracle,and now i am permanently cure from this terrible tinnitus, i promise that am going to publish his herb on thing my last breath for the great deed he have done for me. For those with similar ear problem should please contact him on his email address drwilliams098675@gmail.com his a good man and am proud of him.

Dawson Ella said...

Just wanted to say a huge thank you to Dr Williams for everything he have done in my life. I have been in tears for so many years now, having found that am having tinnitus, lesion after some years of being under extreme stress., . I spent 24 hours freaking out and finally calmed down after reading some testimony on here about Dr Williams herbal medicine to tinnitus. The moment came and I mumbled out to my husband about Dr Williams product (with a few tears) and he was AMAZING – . He was just worried about me been free from the ringing in my ears , after taking Dr Williams medicine for just within a period of one month. We went to the doc together who confirmed that i was tinnitus free.
Thank you again for being upfront, truthful and taking this pain away from me for more information about his product you can email him on drwilliams098675@gmail.com i hope you can also help other terrified people in a similar situation.

LEONERDO DICAPRIO said...

I have been in the tinnitus community for a while now and I have experience what you are going though with tinnitus , I do know people that have got
tinnitus from having their implants done. Ringing in the ear after an implant can go away on its own, but that is BS of what the mouth and jaw specialist said. I have definitely seen and heard of a connection between tinnitus and teeth and mouth. There is a treatment for ringing ears and if you are
interested you can contact Dr William herbal remedies that what I take that stop the ringing in my ear that was really driving me crazy, don't Lose hope .,I have found a solution for my fellow citizens . If you haven't I would suggest trying Dr William herbal supplement. Again, this is a thing that takes time and usually requires time and patience for it to work WITH no side effects. But I'm not hear to sell you the product, I'm only hear to tell you that it works, but it is a journey and can be difficult. I hope at this point it want away on it own. Good luck . his email address drwilliams098675@gmail.com for advice and for his product

BILLIE LORA said...

With Dr Williams herb i was completely free from tinnitus.You are an amazing doctor.Matching diagnosises aside, I just want to be your friend. Lol You inspire me on a feminist level. On an intelligence level. you are a good man doing so much for mankind, level.Thank you for being you.For keeping a lot of us . For reminding us that we aren’t a fucking statistic or a status, we are still PEOPLE. With brains and personalities and jobs and lives.I’ve only been diagnosed for so many years now with tinnitus, and the roller coaster of emotions is all too real.I’m sure I speak for everyone here when I say thank you. From the deepest part of my soul. THANK YOU.You give us all an indescribable level of comfort and absurdness in sharing our diagnoses and, almost a green light to continue to celebrate our lives,for you always been there.For every jerk who throws you hate, there are hundreds of us thanking the universe for you.for more information about Dr Williams product you can email him on drwillliams098675@gmail.com