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HELPFUL INFORMATION ABOUT RINGING EARS

Articles About Tinnitus

By Dr. Mandi Solat, Au.D.

DOCTOR OF AUDIOLOGY
& OWNER AT AUDIOLOGY SERVICES & HEARING AID CENTER IN LAKEWOOD, CO

By Dr. Mandi Solat: A few months back I had a brief fever. It must have lasted about an hour and went away when I took Tylenol. At the time, I was just relieved that what I experienced wasn’t COVID-19. But the next day I woke up with slight hearing loss in my left ear and a continuous, high-pitched whine in both ears – with the tone being louder in one ear over the other. I was also a little dizzy. At first, I thought that maybe I’d had a virus, and these were just the temporary side effects. But while the dizziness subsided, the ringing was still there, and I thought the volume in my left ear might still be a little lower. So, I asked my friend, Dr. Mandi Solat whom I know from growing up in Parsippany, NJ, what she thought was going on. Every time I have a question about ears, I ask Mandi. “I think you’re finally feeling the effects of going to so many Springsteen concerts,” she said. It is true, I have been to many concerts by Bruce Springsteen and the E Street Band (43 or 47 times, I’m still trying to figure out the exact number). Additionally, I’ve seen many shows by many other bands, in stadiums, arenas, outdoor festivals, theaters, clubs, and bars. And never while wearing hearing protection. Not to mention that I’ve listened to music through headphones, probably at volumes I thought were harmless. What I seemed to be experiencing was the effects of Tinnitus. What is Tinnitus? Tinnitus is one of the most common health conditions in the U.S. The American Tinnitus Association says it “is the perception of sound when no actual external noise is present.” It’s often called “ringing in the ears.” Tinnitus can cause people to perceive that sound as buzzing, hissing, whistling, swooshing, and clicking. In rare cases, people may think they’re hearing music. The condition can be temporary or ongoing. An estimated 50 million+ Americans experience some form of tinnitus; about 20 million struggle with a chronic form, and 2 million have extreme and debilitating cases.  The two most common forms of tinnitus are called subjective and objective. The subjective form is responsible for 99 percent of cases and includes. noises that are perceivable only to the person hearing them. It is usually that to be the result of auditory and neurological reactions to hearing loss. But it can also be caused by other factors. The rarer objective form includes noises audible to patients and others. The circulatory and musculoskeletal systems usually produce the noises. What Causes Tinnitus? An exact cause for tinnitus is often never found, but many health conditions can cause it or worsen it. The Mayo Clinic says causes of tinnitus can include: Hearing loss Tiny, delicate hair cells in the inner ear (cochlea) move when the ear receives sound waves. Such movement triggers electrical signals along the nerve from the ear to the brain, and the brain interprets these signals as sound. But if those hair cells are bent or broken, which happens with age or with regular exposure to loud sounds, they can force random electrical impulses to the brain, resulting in tinnitus. Ear infection or ear canal blockage. Ear canals can get blocked with buildups of fluid from ear infections, wax, dirt or other material. A blockage can change ear pressure and cause problems. Head or neck injuries.  Medications.  Some drugs can cause or worsen tinnitus, especially at higher doses. Noise may disappear when stopping use of such meds as nonsteroidal anti-inflammatory drugs (NSAIDs), antibiotics, cancer meds, water pills (diuretics), antimalarials, and antidepressants. Less common causes can include: Meniere's disease Eustachian tube dysfunction Ear bone changes Muscle spasms in the inner ea. Temporomandibular joint (TMJ) disorders  Head and neck tumors Blood vessel disorder. Atherosclerosis (“hardening” of the arteries), high blood pressure, or kinked or malformed blood vessels, may cause blood to move through veins and arteries with more force, causing tinnitus or making it more noticeable. Chronic conditions like: Diabetes Thyroid problems Migraines Anemia Autoimmune disorders. ‍ ‍So, How Did I Really Get Tinnitus? So many thoughts raced through my head as to why I might have tinnitus. Could all those concerts come back to haunt me all at once? Am I taking too much aspirin? Is one of the drugs I take causing tinnitus and if I stop taking it, will it go away? Did that fever trigger something? The best way to find what is now causing that high-pitched whine, Dr. Mandi advised me, was to see an ear nose and throat specialist (ENT) and get a hearing test by an Audiologist. Hearing tests are fairly easy to take, and you don’t have to study for them. Mine consisted of going to an audiologist, going into a sound booth, putting on headphones, and listening to a series of tones at different volumes. When my results came back, my understanding became a little clearer. The ENT said I there was nothing in my symptoms or from his view inside my ears to suggest there was anything structurally wrong or that a virus damaged my ears. But the test did show that I have slightly lower levels of hearing at higher frequencies. Lower levels of high-frequency hearing are common for people as they age. However, what I’m hearing may have something to do with how my brain works. “There is some preliminary research that indicates your brain is looking to interpret those high frequencies,” says Dr. Mandi. “And since they’re just not there, it may fill in the missing sound with its own sound. That may be why you’re hearing a constant, high-pitched whine.” Ways to Deal with Tinnitus I feel very lucky that I don’t have a severe case of tinnitus. Severe cases can be debilitating, cause people to lose sleep, and experience depression. In fact, I may have gotten used to that high-pitched ringing already. I don’t always notice it, but when I do, it is usually in quiet periods, when I’m writing and there is no music on. And going forward, I will be wearing protective earplugs at any concerts.  There are ways to combat the effects of tinnitus, though, and possibly help prevent it from progressing further. Audiology Services and Hearing Center of Lakewood, CO has gathered many applications that help people retrain their brains to avoid noticing tinnitus-influenced noise on a website called TinnitusApps.com. The site lists free apps and ones that require payment. Some are meant to be streamed through hearing aids, others can be listened to on a phone or computer, and a brief review accompanies each product listed.  Other coping methods with tinnitus are also available, such as meditation or cognitive behavioral therapy. White noise machines can produce sounds similar to static or environmental sounds like rain or ocean waves that help mask tinnitus sounds. Fans, humidifiers, dehumidifiers, and air conditioners that produce white noise may help make tinnitus less noticeable at night. There are in-ear devices that produce white noise. And for people with tinnitus who wear hearing aids, masking sounds can be directed through the aids, usually via Bluetooth connections. Tinnitus can be frustrating. If you think you have it, you may want to take Audiology Services and Hearing Aid Center’s online test. Click here. And if you’re experiencing tinnitus, consider setting up an appointment to have your hearing tested through an audiologist or ENT. If you are in the Lakewood area, conducting hearing tests and treating tinnitus are just two of the services available at Audiology Services by Dr. Mandi and her husband, Larry Solat. Sources:‍ Understanding The Facts. American Tinnitus Association Tinnitus. Mayo Clinic.  Tinnitus causes: Could my antidepressant be the culprit? Mayo Clinic ​ Howard R. Seidman is a writer and web content professional who has written extensively on consumer health care, aging adults, education, and various topics. He began his career in newspaper and radio before becoming a communications, marketing, public relations, and writing staff member at hospitals, pharmaceutical companies, universities, and insurance companies. He currently consults with clients and organizations on developing written website content, building and redesigning websites, and social networking. Contact: Howard.Seidman@gmail.com.

By Dr. Mandi Solat: Who can pronounce tinnitus correctly? There are two different pronunciations. Both are correct. ti-NIGHT-us : typically used by the population. We hear this pronunciation the most in Colorado. TINN-a-tus : typically used by clinicians and researchers‍ ‍ At least 50 million American’s experience tinnitus, and over 390 million worldwide Tinnitus can be defined as hearing sound in the ears or head when there is no external sound. The sound is frequently described as ringing, buzzing, hissing, whistling, humming, roaring, screeching, thumping, ticking, clicking, and even the sound of an old typewriter. With all the information that is out there about tinnitus, there is still so little that we know about it. Unfortunately, there is no cure. The treatment available is very subjective, limited in its scope, and can be expensive. Because there is no known cause or cure, the attitude towards tinnitus is usually very negative and the effect it has on the quality of life for many people can be ravaging. There are treatments that work and give relief to those who have tinnitus. There is a Facebook group called “Tinnitus Sufferers”. They support each other, vent, complain, cheer, and strive to find a way to cope with their maddening tinnitus. I posted the following questions on their site: What do you think caused the onset of your tinnitus? What treatment has worked or partially worked to lower the tone, and cope with the tinnitus? Their responses are below and make for a great discussion. There were many variations of all the answers. I did not come across anyone who responded positive towards any widely advertised supplements. Most indicated a waste of money purchasing a special formula, herbal concoction, pills, drugs that pop-up on our social media pages, or in our email boxes. If it is too good to be true it probably is. If a cure or miracle treatment are found it will be international news. Tinnitus affects millions of people worldwide. You can read about hearing loss and tinnitus statistics Hearing Health Foundation by clicking here.‍ Read on for the Tinnitus Sufferers groups answers to the questions. ‍ What do you think caused the onset of your tinnitus? Top answers: Noise induced. Hearing Loss Ear infection Stress related Drugs/medication Accident/Fall/Abuse TMJ Sinus Infection /Flu Honorable Mentions: Pressure Change in ear Covid19/Vaccination Chemo Meniere’s Disease Diabetes EarWax Dental work Abuse (as a child) Depression Aspirin What treatment has worked or partially worked to lower the tone, and cope with the tinnitus. Top answers: Hearing aids with or without maskers Nothing works Diet/Exercise Sound Therapy (TV, Music, White Noise, Fan Noise, Noise Machines, Nature) Better Sleep Stress management/Changing state of mind Noise Prevention/Hearing Protection Honorable Mentions: Vitamins/Drugs Acupuncture Lower Carbs Meditation Listening to podcasts Quit smoking Psychologist/Audiologist CBD Keeping busy ‍ ‍ Why finding a cure is difficult: We have more questions than answers! Why do some people develop tinnitus and others do not? Why doesn’t everyone develop tinnitus from noise, or drugs? These are high risk factors leading to the onset of tinnitus, but not everyone develops ringing from noise exposure or drugs. Why doesn’t everyone who has hearing loss have tinnitus? Why do people with normal hearing have tinnitus? The highest risk factors listed for the onset of tinnitus does not occur in everyone. We see people every day in our clinic for hearing loss. Conductive losses, and sensorineural losses. Not everyone has tinnitus. My mother and I have the same genetic loss. She does not have ringing, but I do. I went to a lot of concerts growing up and subjected myself to a lot more noise than she ever experienced. I also had intermittent ringing that would come and go before I went to my first concert. The concerts most likely are the trigger that aggravated my tinnitus to the high level, and constant ringing I currently hear today. What might tinnitus sound like? Click here to listen to the sounds of tinnitus! There are many different theories as why tinnitus exists. One popular theory proposes “the brain is filling in sound where it is missing sound”, but how to account for those who have tinnitus and normal hearing. It is highly suspected that there are other areas along our auditory pathway that might be responsible for tinnitus. We currently cannot measure this objectively. It is all based on subjective and descriptive views of people who experience tinnitus. We cannot objectively detect, hear or measure subjective tinnitus with any equipment currently available. How can we provide treatment for something if we do not know where or what to treat? What part of the ear or auditory pathway do we treat? Is this internal noise in the ears, or in our head? We cannot see it on the MRI, and we heavily rely on the patient’s perception. With all that said above, there are treatments that work better than others. Hearing aids are the number one treatment that works best with a high percentage of people receiving full, or partial relief from their tinnitus when their hearing aids are in their ears. Sound machines, white noise, music, and television provide excellent relief of the daily ringing in our ears or head. The treatments above clue us in to let us know that bringing in sound works to decrease the sound in our ears or head. The treatments above work for many people. We must be persistent and try different things. Some things will not work for every lifestyle, or person. As the saying goes ‘different strokes for different folks.’ The most important area holding back tinnitus research is funding. There is not enough funding to find a cure for tinnitus. Let’s assume that the pandemic put tinnitus research on hold for the year, but hopefully will resume. Frontiers in Neuroscience posted an excellent article before the pandemic titled “Why is There No Cure for Tinnitus” It is exceptionally long, but excellent article on information pertaining to this very reason. You can read that here. Lastly, tinnitus onset and successful treatments varies in many ways. I did not include every tinnitus onset that was mentioned, or every treatment. There were so many mentioned. The only conclusive agreement I did get is that we long for a cure, and it is frustrating to those that have it. For tinnitus relief ‍Try the above-mentioned tinnitus treatments that worked for many people. Be consistent and persistent! There are lots of different mindfulness programs on the Tinnitus Apps Resources Page that might be helpful, and many are free!

I've had tinnitus for a long time. When I was in middle school, I used to think sirens were shrieking all night long. Then, in high school, I realized it was my head or ears creating these weird high pitch sounds. It wasn't constant, and I noticed it only at nighttime. I didn't tell anyone—I didn't realize it wasn't normal. Over the years, I've had plenty of time to think about tinnitus. It wasn't mentioned much in my bachelor's or master's programs (over twenty-five years ago). I studied it during my doctorate program, but that didn’t feel like enough. There is still much unknown about tinnitus, but a few things have come to light over the past few years. The answers I was seeking came from a change in my attitude and thoughts towards tinnitus. It didn't come from an article, a webinar, or a book. I received the Certificate Holder in Tinnitus Management from the American Academy of Audiology in 2020 (CH-TM). I learned helpful information studying for the certificate, but I still felt unsatisfied. I still had no answers about a cure for tinnitus, but there were many ways to habituate. Therefore, I decided to share a few questions I asked myself and some answers that satisfied me. I found closure with the answers to these questions, and maybe you will too. Why do people have so many different reactions to tinnitus? There are hundreds of reasons for the onset of tinnitus, but why are there so many different reactions? One person can ignore it, and another is seeking medication or counseling. This question has more than one answer. Is it when the tinnitus presented itself that possibly indicates a person's long-term reaction to it? Suppose the onset of tinnitus is during an overwhelmingly stressful time in a person's life. Is the reaction more severe if it presents during a less stressful time? When tinnitus is present, our limbic system creates a terrible adverse response and overreacts. Our limbic system is the part of the brain that controls our emotions. This may mean how we respond to our tinnitus is completely reliant on how our brain handles emotion and may directly correlate to when, how, and why the tinnitus started. I understand how some have entirely negative feelings towards tinnitus no matter when it starts, but are these feelings stronger when associated with a horrible time in our lives? Are we reminded of this horrific time whenever tinnitus is present? In the tinnitus sufferers' article, I wrote in May 2021, the sufferer’s response to stress was one of the top indicators of the onset of their tinnitus. If tinnitus is constantly associated with a negative memory, that could indicate the many different reactions. Tinnitus Sufferers Article I'm very fond of therapies and believe that they work. So, I asked myself what other diseases or conditions are out there that are manageable, but there is no cure? For example, there is no cure for diabetes or multiple sclerosis, but they are manageable. Different people will react differently to these conditions, and tinnitus is no different. Changing the way we all look at tinnitus could be the key to living with it. In addition, there are many things we can do to manage our tinnitus. Hearing aids, sound generators, and taking care of our health seem to be the number one solution to living well with tinnitus. So, I've changed my attitude towards treatment. If I can help 80% of the people manage their tinnitus, the quality of their lives might be better. That's worth the shot. There will be another 10% who experience partial relief. Another 5% will refer for behavior therapy that is beyond my field. I will stay within my scope of practice. It's all attitude! There are online managing programs with excellent instructors who work exclusively with tinnitus patients. You can find them on our tinnitus website here. The Tinnitus Sufferers article referenced above. ‍

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