Dr. Charlie — ENT Specialist With Tinnitus

@Karen
Are you familiar with Superior Canal Dehiscence?

http://www.dizziness-and-balance.com/disorders/unilat/scd.htm

Also check:

http://www.dizziness-and-balance.com/disorders/hearing/tinnitus/pulsatile.html

 

Hi Dr. Charlie.

Thanks for your helpful advice. Sadly there are many ENT specialists around who are the complete opposite, unhelpful and dismissive. I wish i had an ENT in my locale who was willing to administer their knowledge half as much as you are.

I am booked in for an MRI scan tomorrow to hopefully rule out any tumors, in my first step towards a diagnosis to what is the cause of my roaring tinnitus and debilitating vertigo.

 

Thank you for the advise Doctor. I have to take warfarin and beta blockers for my AF, would this interfere with my blood readings enough to cause EH?

I also have hearing loss.

 

Thanks Dr Charlie,
I have spoken with many coeliacs who also have meniere's who sadly say that going totally gluten free did not affect their menieres
I follow a very steady diet, we have a rotating 4 week meal plan in our house as I need to be organised to make sure we are all fed. Unfortunately flare ups seem to have a life of their own with no relationship to food whatsoever.
Many ppl with meniere's also seem to have other autoimmune conditions. I've been tempted to try Terry Wahls paleo autoimmune diet, but it is very expensive.
For me hearing loss is by far the most difficult thing I am dealing with. Hearing my daughter who is 16 months old and my husband sound distorted and weird, its like living in a nightmare. Its like being in an underground bunker with broken appliances whirring at 90dB. Its hideous. I wish deafness just meant quietness.
Sorry this is a negative post. I'm so upset at losing my only hearing ear, I feel so helpless.

 

Dr Charlie I'm so glad you've joined TT. Just reading the post and your replying to each of us who have asked questions ,been a God send .Today I'm wheat ,lentil,free ,and keeping a diary ,going to be rigid in this .
I drink 4/5 x 50 mls water every day since virus ,but will take on 1 more 50 mls,see how things go ,from here .
I'm in agreement with Matt,glad to have someone from ENT who can explain,the problems that come up with T .
Our health providers do need people with T ,working in ENT more ,not many on TT wouldn't disagree with me I'm sure .weve all at some time have said or thought this .

 

Welcome here. I want to ask a quastion. How is it possible that when i walk i hear the sound (like a woosh woohs sound) going on the rhythm of my walk? And how is it possible that when i replace my jaw the sounds is almost gone?

I did have 3 hearingtest and the one at the ent he saw i slight hearingloss of 20db at 4khz. But 2 week after at some other place my hearing whas fine. Can it still be a damage of is it stress related? Because when i am having stress the sound goes up like a spike.

 

Welcome to the forum! It's moving to see our board's member's supporting another, and I definitely think Markku is right in the milestone of you joining, having an ENT proactively take this amount of interest and time to support is what everybody with t/h needs
Seeing as you aren't a sufferer anymore of t, might you add your t-success story to the success section? Many would appreciated it a Lot.
cheers and welcome once again

 

Bless each of you for your kind words. Allow me to address your questions:

First, I no longer suffer from tinnitus because I removed the fear and anxiety associated with it. Once I accomplished this, my brain automatically considers the noise unimportant (non-threatening) and I simply do not hear it. When I choose to focus on it (such as right now,) the noise is there. The volume gradually diminished once I removed the fear response from the noise, but it is always present if I check.

I do not believe blood thinners would affect EH. I've never seen an association.

Eliminating wheat, such as with a gluten-free diet, may solve the problem of EH for some, but not all. Other substance sensitivities must be explored when this is the case. In particular, soy products, corn, milk products (typically cow-dairy products,) nuts, seeds, or other grains. I have never known rice or potatoes to be a problem, so they are good carbohydrate substitutes. Most people already know to limit salt intake and avoid caffeine, chocolate, alcohol, and tobacco products. Again, keeping a very inclusive food and drink diary may assist your investigation. Be sure to include vitamins, toothpaste, chewing gum, mints, gargles, nose spray or drops, etc - anything taken into your system.

Re the woosh woosh sound when walking and related to jaw position, this might represent a patent Eustachian tube issue. Does your own voice sound hollow, like an internal echo when in this situation?

 

Welcome Dr Charlie!

Absolutely glad to have an ENT here at TT. I think you're helping out a lot of people who are in discomfort and I think that it is a very commendable thing. I'm sure we will all benefit tremendously from your knowledge and expertise.

I had a question which pertains to my own tinnitus issues which started about 5 months back now. I have unilateral tinnitus in my left ear. I got an MRI done and all was fine, normal hearing in the audiogram. I have some sinus issues. Specifically (which were highlighted in my MRI):

"Deviation of nasal septum to the right. Mild mucosal thickening over left inferior turbinate. Concha bullosa is seen on the right side. Complete opacification of both frontal sinuses and ethmoidal air cells. Mild peripheral mucosal thicking in sphenoid sinus."

I was told that these might be the cause for my T by my doctor. But, when I talked to some other medical practitioners they said its highly unlikely. I was just wondering if I could ask your opinion on this?

 

Unlikely, but possible if there is an associated ET malfunction. Which sphenoid sinus shows mucosal thickening? Also, left or right ethmoid sinuses?

 

In eliminating things that may activate tinnitus or ear fullness from EH, the absolute worst are MSG (monosodium glutamate) and Aspartame. Nearly all packaged foods contain MSG. Since a certain minimum level in required (in the U.S.) before MSG must be listed on package labels, it is often disguised. The FDA considers it misleading to put a “No MSG” label on foods containing glutamic acid, but the substance appears without calling attention to itself in food additives such as hydrolyzed vegetable protein (HVP,) sodium caseinate, calcium caseinate, yeast extract, textured protein, autolyzed yeast and hydrolyzed oat flour.

The amino acid in HVP that is responsible for “enhancing” the taste of foods is glutamic acid. In its crystalline form, glutamic acid is more commonly known as monosodium glutamate, or MSG.

Aspartame is approved as an artificial sweetener in many diet sodas, toothpastes, breath mints, and other ingestables. I believe it is one of the worst substances ever approved for human consumption, along with genetically modified soy products.

Nearly all fast food vendors add MSG or HVP to their products.

Read labels!!

 

@Dr. Charlie
Here's something I have been wondering about.
When I walk or rather jog ..I can hear a clicking sound in my jaw on the left side , my left ear is also more affected by T . Does this mean anything ? Did not notice this ever before T .
Thanks for you help

 

Thank you for your response. I was specifically referring to this section https://www.tinnitustalk.com/forums/success-stories.47/
It would be fantastic if you would post your story of habituation in that specific section as well. It's a section on success stories Only, where new and old members share their story of habituation, a focused positive space collected for all to read

 

@RaZaH,

Probably unrelated. Is the clicking sound in your jaw joint? Do you still hear the clicking sound when you open your mouth widely? Does your tinnitus change (not the clicking, but the sound of tinnitus) if you open your mouth and press hard against your chin with one hand?

 

@Dr. Charlie

I just read the "open your mouth and press hard against your chin" part in your recent post to @RaZaH .

Ive been trying to release some of the tension in my jaw muscles as of lately, but when I open my mouth and add some pressure just in front of my ear lobe, Id say the little window between the zygomatic process and the mandibular notch, the pain becomes so severe that I almost faint (which is why I have a hard time releasing tension in this area).. The pain radiates around my entire head and I end up dizzy and nauseated. If I keep pressing my finger around in this area, it does feel like some of the tension releases.. Also, soon after I usually end up with a sensation of a sudden pressure change in my ear (not sure if its related to the eardrum or what), and the tinnitus either just disappears for a few seconds or it changes dramatically in frequency.. And it all happens at the exact same moment I have this sensation of pressure change in my ear.. I also have a constant weird feeling in my ears which is super annoying..

Do you have any idea what exactly this sensation of pressure change might be and the mechanics behind it? And why it seems to happen when working with my jaw and sometimes neck muscles? I just cant wrap my head around it..

My ET seems to work fine, and it doesnt seem to be any odd under/over pressure in my middle ear.. Its just a sensation..

Thank you so much for joining this forum and offer your support!

 

Dr Charlie, would it be possible to speed up the habituation process of tinnitus by consciously focusing upon it during periods of extreme relaxation? I'm wondering if the neural association of T with periods of very low limbic arousal, might in theory place it in the mental box of "safe to ignore" and mediate it's communication to the conscious mind as a threat to be aware of.

The reason I'm thinking of this, is my T has been reasonably ok for about a year but about a month ago I had a health scare (testicular lump) which sent my T through the roof. As it turned out it was nothing (an epididimil cyst) but upon the diagnosis (I'm actually feeling the relief again just typing this) I actually forgot I had T for a week.

My conjecture is. Tinnitus only exists if you're aware of it at an unconscious level and until the limbic brain decides it's a threat and only then does it bother you.

I lived by the sea for 20 years and for all that time the sound of the waves on the shingle never bothered me even though it was always there. It was just background noise; nothing to concern yourself about.

That's what I'm aiming for.

 

Mr. C: Sounds as though you have TMD (temporomandibular joint disorder, formerly TM Joint Syndrome.) Have you consulted a knowledgeable dentist or orthodontist to balance your bite? Check out this link for information:
http://www.tinnitusformula.com/library/tinnitus-and-tmj-dysfunction/#.VHPaiNLF-Ag

S: Try your method and see how it works. I'm not a fan of consciously focusing on the noise for any reason; however, I'm also not aware of anyone who has done this specific exercise. Habituation of the noise of tinnitus becomes possible only when the limbic brain considers the noise non-threatening.

Keep us posted re how it works for you.

Dr C

 

It's a great idea Silvine!
I am trying it at the moment using meditation.

 

Hi Charlie!

Thank you so much for your response! I have suspected that TMD is a major contributor to my tinnitus, pain etc. for quite some time indeed. I have seen two dentists, but they didnt seem very knowledgeable regarding TMD. Ill probably see if I can find someone else that are more into this stuff. Also, thanks for the informative link you provided

I find it touching to read how you respond to people and the way you are giving away your own time and knowledge in order to help other people that are suffering. So many years of experience and practice, yet so humble and down to earth. I think that a few people in this world have been blessed with a halo, and you are certainly one of them

Im so thankful that you joined this forum to offer your support, it really means a lot

God bless

 

I appreciate your interesting postings, Dr. Smithdeal. It is great to have the input of a Board Certified ENT.

I have a question about the passage I just quoted above. Since tinnitus is a subjective entity, the only volume that really matters is the loudness as you hear it, your tinnitus loudness rating (i.e., your judgement on a 1 to 10 scale). There is no way of knowing this, of course, but in your opinion had you undergone a tinnitus loudness match back when you were truly suffering (i.e., in dB SL and measured by an audiologist under controlled conditions in an audiology booth) and were you to undergo it again today, do you believe that you loudness match would be lower as well - or only your loudness rating.

Thank you -

stephen nagler

 

A very interesting question, Dr Nagler. I don't like to speculate, but it's the only way I know to answer your question. Certainly the loudness rating is significantly lower. I suspect the loudness match might be slightly lower as well. Because of - as you point out - the totally subjective nature of this malady, my opinion may be incorrect. Yet another beauty of the human body is that the relief attained through habituation is the same to me, regardless.

 

Thank you, Mr. C. My wife would likely have a good laugh at the halo suggestion, but I appreciate your kind words. I feel honored to share some of the information and experiences I have acquired over these many years. May God continue to bless each of us.

 

We are overjoyed to have you Dr. Charlie. Thank you for kind, patient and diplomatic responses.

It's clear you have a big heart and a kind spirit. I think that will only lead others on the forum to spread that goodwill. Thank you for your time and for bringing such a light-hearted and giving disposition

 

AW: Thank you. I hope others will pay forward whatever I am able to share.

\0/

 

That's the point I was hoping you'd make.

It seems to me that - in general - tinnitus sufferers would be far better off focusing on the achievement of meaningful lasting through habituation relief rather than purely on the mitigation of their tinnitus.

stephen nagler

 

Hello, @Dr. Charlie, I just wanted to add my welcome to the many others here. It is especially valuable to have the input of someone who is both an ENT and a person with tinnitus. Perhaps you might consider joining Doctor's Corner? It's a good way for us to ask questions specific to our own conditions. @Dr. Nagler is kind enough to field many of them.

 

@Dr Nagler,

Thank you. To me, it's sort of a tree in the forest analogy regarding my tinnitus noise. As long as I don't hear it, I really don't care if it's there or not.

Reminds me of the following:

One evening an old Cherokee told his grandson about a battle that goes on inside people. He said, "My son, the battle is between 2 "wolves" inside us all.

One is Evil. It is anger, envy, jealousy, sorrow, regret, greed, arrogance, self-pity, guilt, resentment, inferiority, lies, false pride, superiority, and ego.

The other is Good. It is joy, peace, love, hope, serenity, humility, kindness, benevolence, empathy, generosity, truth, compassion, and faith."

The grandson thought about it for a minute and then asked his grandfather: "Which wolf wins?"

The old Cherokee simply replied, "The one you feed."

 

@Dr. Charlie, that is one of my absolutely favorite legends/sayings/fables. Someone very dear to me who has suffered/still suffers from a great deal of pain among other deeply troubling symptoms (tinnitus included), told me that story. He deals with more than I can imagine, but is one of the most peaceful people I know and full of gratitude.

That tale goes for tinnitus and all other woes in life, thanks for bringing it to the front of my mind again, a wonderful share!

 

Thank you, awbw.

Dr Nagler, allow me to add that - having had a thorough evaluation by an ENT specialist and learning that I have nothing to fear as regards my tinnitus -

- I have the luxury of not caring if it's there or not.