Have an Appointment with an ENT Specialized in Tinnitus and Hyperacusis

I am trying someone new. They specialize in T and H. The office says I have to get another hearing test. I really don't want to because I don't want to sit in that chamber to focus on my noises.

But will a new hearing test do anything anyway? I mean even if I have hearing loss (which I didn't in my first test 6 months ago) will that do anything about the T and or H?

 

Why do you keep going to doctors? Haven't realized yet they can't do anything? Please don't be clueless

 

Actually they have helped me. With H they have told me that anxiety has a direct link to it and every single time I have had a flair up of H it is when I get anxious and every single time when I followed their advice it went away. I would also like to know if there is anything I am doing to make the T worse.

 

And to be honest that is terrible advice. There are many on here who have said they have had doctors that helped them. Maybe a doctor hasn't helped you but that doesn't mean they haven't been able to help many. Go take a look at many of the success stories. It is when people think doctors can't help at all that T becomes much worse of a problem for many.

 

Call them up and ask how high the hearing test goes to. Tell them you want it to go past 8khz. Also, if you have anxiety issues, you may want to look into Passion Flower and maybe Valerian Root. My friend says they shouldn't be taken everyday though. Probably best though to ask a doctor about the supplements. Anyways, check this thread out to see what I mean about the audiogram:

https://www.tinnitustalk.com/thread...want-to-consider-an-extended-audiogram.17466/

 

@Marie79 I agree with: gotyoubynuts You haven't had tinnitus long and you have already been seen at ENT and had a hearing test. I am assuming that you've also had an MRI scan? If all tests have come back okay, then you don't need another hearing test of MRI scan. If there is no underlining medical problem causing your tinnitus and you have straight-forward tinnitus, then you should be referred to a Hearing Therapist in my opinion. If you are sure that your tinnitus was caused by an ear infection, then it's likely the tinnitus will go in time.

I advise that you don't listen to any type of audio through headphones, headsets etc even at low volume. There is more information about this in my post below. It is long, but was written for newbies like yourself that might find it helpful. Stick with one clinic, talk with your Doctor about being referred to a Hearing Therapist. Best of luck. Michael

An Introduction To Tinnitus

For most people the onset of tinnitus can be very traumatic. It was no different for me having lived with this condition for twenty years now. Thankfully, there is light at the end of the tunnel with help from various tinnitus organisations, books and online forums that can help a person through the difficult times so they don’t feel so alone.

The ear is a very sophisticated and delicate organ. I think I’d be right in saying that many people don’t give this much thought or know the complex things that it does to enable us to hear and to keep our sense of balance. That is, until something goes wrong with it. The ear consists of three main parts:

The Outer ear. This is the part that we see attached to the side of our skull and is called the Pinna. Its job is to collect sounds from the outside world and funnel them down the narrow passageway inside our head called the ear canal. It is approximately 26mm long and connects the outer ear to the inner ear. The ear canal is lined with wax, the medical term: cerumen. It protects the skin of the canal and helps prevent bacteria, dirt and other foreign substances from entering.

The Middle ear. This comprises of the eardrum and the three smallest bones in the human body that are connected to it, called: the hammer (malleus) The anvil (incus) and the stirrup (stapes) The sound waves in the ear canal are directed onto the eardrum also known as the Tympanic membrane. It is a thin piece of tissue that is stretched between the outer and middle ear and vibrates when sound waves hits it. As the eardrum moves the malleus, incus and stapes, which are joined together also move and transfer the sound to the cochlea, which is in the inner ear.

The Inner ear. The cochlea is the hearing part of the inner ear and is pushed by the stapes. It is a spiral tube that is filled with fluid. Its coiled structure looks similar in appearance to a snail. The vibrations that are delivered to it are turned into electrical signals by thousands of tiny nerve cells that are attached to it. These nerve cells are also known as ear hairs. As the nerves begin to vibrate to sound, the electrical signal travels directly to the brain via the vestibulocochlear (auditory nerve) known as the eighth cranial nerve. The brain interprets these signals into sound.

The vestibulocochlear nerve transmits sound and balance information and is split into two: The cochlear nerve and vestibular nerve. Whilst sound travels along the cochlear nerve to the brain, the vestibular nerve is connected to the Semicircular canal.

There are three semicircular canals or ducts in each ear. These small tubes are interconnected and filled with a fluid called endolymph, which contains motion sensors. The canals are at right angles to each other. When the head moves the fluid in the canals detect it and sends this information to the brain, so it knows how to keep the body in balance.

It may surprise some of you to know that tinnitus is quite common. Mention to a friend or family member that you’re experiencing ringing in your ears and it’s causing you no end of distress and you’ll probably be told: “I get that but just ignore it”. “Mine only bothers me at night when it’s quiet but once asleep I’m fine. Another might say: “It plays a tune, at first it was strange but I’m used to it now”. And so the story goes on.

This casual approach to tinnitus doesn’t stop there for even some healthcare professionals have a cavalier attitude to it as if it’s no problem at all. I have read on Internet forums and been told by people after seeing their GP that the sage advice given was “learn to live with it as there’s no cure.” Telling someone this when they are in distress and seeking help with their T is the last thing they want to hear, as it can often leave one at a crossroads and not knowing which way to turn.

All things considered, it must be said this relaxed attitude towards tinnitus is changing amongst some healthcare professionals and the way they treat their patients. More understanding is being given as it’s realised when tinnitus is intrusive it can seriously affect a person’s quality of life and their emotions. This hasn’t come too soon and such people whom we reach out to for help are to be commended.

We are all different for no two people experience tinnitus quite the same. Similarly, the condition comes in many forms: Mild, moderate and severe. It can either be constant or intermittent. It can manifest itself in one or both ears. When in both ears it is known as bilateral tinnitus and with this one can sometimes experience a sensation of the noise coming from withing the centre of the head. As if that isn’t enough, tinnitus can fluctuate in intensity daily, which can complicate matters and make habituation more difficult but still possible.

There is no hard and fast rule for the way tinnitus will affect a person nor is there any definitive treatment that will work to make them cope better. However, it is my intention to try and convey to you that I understand how distressing tinnitus can be when it’s severe and the way it can make a person feel having lived with it for many years. At times it hasn’t been easy but like others that have learned to habituate to their T, I hope to make your path to it a little easier and less stressful.

I want to dispel the doubts and fears that are often associated with tinnitus when it’s loud and intrusive. Remove that wall of negativity that some people find difficult to overcome which can hinder or stop the habituation process. Replace it with positive thinking and in doing so you’ll be able to move forward and realize there is light at the end of the tunnel. Just because you have tinnitus doesn’t mean your future is mapped out to be one of doom and gloom. With positive thinking a lot can be achieved and I will discuss this later. For now I’ll say this: Once you learn how to harness positivity and incorporate it into your daily living, gradual changes will start to take place both in your mind and thought process about this condition as life will become easier and less problematic.

As I’ve previously mentioned tinnitus is a common condition. When it is mild or moderate many people are able to live quite comfortably without it impacting too much on their daily life. For these kinds of people habituation to their T happens quite quickly and therefore, the need to visit their GP or to be referred to a tinnitus clinic doesn’t usually occur.

The causes of tinnitus

For the less fortunate amongst us that have intrusive tinnitus it can become a problem that usually requires a referral to a hospital ENT department, where further investigation needs to be carried out to try and find the cause of this anomaly.
Some of you may have already been seen at ENT, but for those that haven’t, I will give a account of what you’re likely to expect on the day you arrive for your appointment. I won’t be able to cover everything but hopefully I’ll include the most relevant.

Your consultant or ENT specialist will ask a series of questions that will probably begin with, how long have you been experiencing tinnitus and when did it start. Is it in one ear or both and whether it’s constant or intermittent? You will be asked to explain in detail what the tinnitus sounds like and does it change. Tinnitus varies considerably between people from buzzing, whistling and sometimes musical tones are heard.

One of the most common is a hissing sound, which resembles white noise. You’ll be asked when does it bother you the most and how does it affect your daily living. A common question is do you have any idea what might have caused the tinnitus, as there are many factors

Whilst this is going on your doctor will be listening and observing your body language as this can give an indication of how the tinnitus is affecting you physically and emotionally. The questions are necessary for it is you that is experiencing the tinnitus, as no one else can know what you’re going through so try to remain calm as possible.

Notes will be taken about your medical history and whether you’re taking any medication. Your occupation could also give clues as to the cause of your tinnitus especially if you work in a noisy environment or operate machinery where noise levels are high. You may be off work sick due to your tinnitus, which is not uncommon. An important piece of information is what do you like to do socially. Do you attend nightclubs or visit places where music is played loud regularly? Over time subjecting one’s hearing to high sound levels can cause tinnitus.

We live in a world where most people have a mobile phone on their person the majority of the time. These devices have much wider uses these days than mere telephony. They can browse the Internet when we’re out and about take photos, communicate on social media websites and do many other things. They are often used to listen to music via headphones. Walk along any high street or travel on public transport and you’ll see people listening to their music through headphones or attached to an MP3 player. They are often totally immersed into what they’re listening to and sometimes oblivious to those around them who can clearly hear their music, which is an indication that it’s too loud. Prolonged headphone use and listening to music through them at high volume levels can cause tinnitus.

One of the main causes of tinnitus is exposure to loud noise, although stress, hearing loss and some medications, and including an ear infection are also known to cause it. With noise induced tinnitus a person can also experience hyperacusis, this is having a sensitivity to sound. I will be covering this in more detail later on as it deserves to be explained at length and how best to treat it since it’s closely linked with tinnitus. You will probably be asked if you are sensitive to sounds.

Usually the doctor will look into your ears using an Auriscope to inspect the ear canal, eardrum and to see if there is any wax build up. If everything is fine this part of the consultation will be drawing to a close. The next step you’ll probably be having a hearing test which will be carried out by an Audiologist, afterwards you’ll see the ENT specialist again for the results and further consultation will take place.

A routine procedure for someone that has had tinnitus for some time and referred to hospital for treatment is to have an MRI scan: Magnetic resonance imaging. It will enable the ENT specialist to closely examine the inside of your ear and brain to see if there is an acoustic neuroma present. An acoustic neuroma is a benign slow growing tumour attached to the eighth cranial nerve, also known as the vestibulocochlear nerve. It connects the inner ear to the brain. It can cause problems such as hearing loss, dizziness and tinnitus.
If your hearing test and MRI scan show no abnormalities, then it’s likely your doctor will discuss with you the different treatments that are available to help you manage and cope with your tinnitus better. Most people will be referred to a Hearing Therapist and you’ll probably be advised to wait for an appointment letter.

Tinnitus can play havoc with one’s emotions especially in first few months of having the condition. Some people can find it overwhelming and feel stressed out. This is quite understandable so mention this to your doctor as an antidepressant might be prescribed if you haven’t already been given them by your GP. Antidepressants can help prevent a person becoming too down due to their tinnitus. Tinnitus has a direct affect on a person’s moods. The more stressed one becomes the louder and more intrusive it will appear to be which can result in a person’s feeling more depressed. Tinnitus feeds stress and stress feeds tinnitus.

When you meet with your Hearing Therapist for the first time you’ll probably have a lengthy conversation, where you’ll be able to relay how you’ve been feeling since the onset of your tinnitus. Remember, the person you’ll be seeing knows lot about this condition and the way it can affect a person emotionally and physically. Some of the comments that you may have been told by people that play down tinnitus as a mere minor irritant because there’s isn’t intrusive won’t be mentioned. Throughout the consultation you’ll be listened to and advised how to look at your situation a little differently which comes with time and adopting a more positive approach to life. Hearing Therapists help their patients by showing them a way forward and demystifying a lot of the negativity that surrounds tinnitus. Not surprisingly, this level of understanding and empathy doesn’t always come from training and working in an ENT department alone, for some of these people also have tinnitus. Over the years I’ve met quite a few Hearing Therapists and Audiologists at tinnitus forums helping people who said they have tinnitus.

Coping strategies
Coping strategies that people have found helpful will be explained, as well as giving you advice on the type of equipment and treatments available to you at the clinic. Some are listed below.

TRT (Tinnitus Retraining Therapy)
Sound machine. Sound enrichment
CBT (Cognitive Behavoural Therapy)
Relaxation exercises
Natural environmental sounds
CDs and MP3 downloads

Tinnitus Retraining Therapy
Tinnitus retraining therapy or (TRT) has been around for a while and is one of the most effective treatments for tinnitus. Many patients achieve good results with it but like anything, the benefits will be variable from person to person.It involves using sound enrichment and counselling. Sound enrichment is achieved by wearing white noise generators (wngs). The device closely resembles a hearing aid and fits around the back of the ear, from which a small tube is attached that rests in the entrance to the ear canal. The white noise is adjusted via a small rocker switch on the wngs.

There is another type of white noise generator that serves the same purpose but is smaller and more discreet which some people might prefer. The device is inserted into the ear canal and has a small volume control to adjust the white noise. The second part of the treatment is involves counselling. It is necessary for the patient to have regular outpatients appointments, with their Hearing Therapist who is trained in the field of tinnitus and the perception of it. Some patients are also affected with Hyperacusis (sensitivity to sound). If it is present at the same time as having tinnitus then the white noise generators will also treat it.

TRT was founded by Professor Pawel Jasterboff and follows a strict protocol, which should be adhered to for the patient to receive maximum benefit. It must be said, the treatment can be expensive. Some clinics that practice it choose to modify the treatment to their requirements but good results are still possible.
Tinnitus retraining therapy is not a quick treatment and therefore must not be rushed. It requires the patient to wear two white noise generators for up to ten hours a day. They are first put on in the morning and the white noise set to just below the tinnitus, and then left alone. It can be tempting to turn up the volume when out on the street as traffic noise can make it difficult to hear them. Please don’t do this.

Constantly adjusting wngs volume will delay the habituation process. Over time the brain habituates to the white noise generator and pushes the tinnitus further into the background where it becomes less noticeable. This cannot be successfully achieved if the wngs is repeatedly adjusted throughout the day. Tinnitus counselling is a vital part of TRT. Tinnitus can become a problem when the patient starts to believe nothing can be done about the condition. If one isn’t careful anxiety and depression can start to take hold. Through regular counselling sessions with a Hearing Therapist trained in TRT, the patient learns not to look at their tinnitus as life threatening nor to be constantly afraid of it and to be monitoring every little change in its perception. The Hearing Therapist does this in a controlled and precise manner so that the patient feels relaxed and not pressured. Over time the negative thinking that is often associated with tinnitus and hyperacusis gradually dispelled and demystified. Therefore, it must be stressed and understood, this treatment takes time.

To complete a course of TRT takes approximately twelve to twenty four months and in some cases longer. The duration of each counselling session is left to the discretion of the Hearing Therapist. Typically, these can last up to one hour or more. The amount of appointments required will be different for each patient, but it is quality rather than the quantity of the counselling that really matters. There are a few misconceptions about TRT and the way it is administered that some people misunderstand which I want to address. If a patient is given one white noise generator to wear this is not TRT. When two wngs are issued and no tinnitus counselling is offered on a regular basis, it is not TRT. I am not saying that a patient will not gain any benefit from the above treatments; I only want to state they do not follow the proper Tinnitus retraining therapy protocol.

White noise generators should not be used when going to sleep at night. When retiring for the night, one should use a sound machine by the bedside and adjusted to a level just below the tinnitus. The sound machine should be set to play throughout the night until morning.

The Sound machine

When the brain hears tinnitus for the first time it can feel threatened, as it has never heard this strange new noise before and because of this, it latches onto the sound and doesn’t want to let it go. It is similar to someone moving home and relocating to a new area where trains or motorcars might frequently be passing near their home. The brain is not used to hearing this amount background activity and starts to focus on the sounds and in do so they are given importance and thus become louder. However, the brain is capable of doing and adapting to many things. As time goes by, it no longer interprets these sounds as threatening and slowly pushes them into the background of the mind where they are now seen as unimportant.

Tinnitus and the way the brain reacts to are a little similar. As previously mentioned, most people with mild or moderate tinnitus adjust to it quite quickly. Although, we are all different, it’s natural to expect some people will take longer than others, so there is no definite time frame. However, the outcome will usually be the same for people in this group. After while the brain will perceive the tinnitus as unimportant and gradually push it into the background where it becomes less noticeable and this is called habituation.

The same does not always apply to anyone with loud intrusive tinnitus. People affected in this way should try to avoid quiet rooms and surroundings during the day and especially at night, as it’s quieter, and the T will appear to be louder and more intrusive. It is a good idea to buy a sound machine that plays nature sounds. They are often recommended to people with tinnitus who find difficulty getting off to sleep. In m opinion anyone new to this condition should buy one.

The sound machine can be placed by the bedside and also used during the day. For night use some people prefer to connect it to a pillow speaker particularly, if they have a partner that might be disturbed by it; although most people find they can drift off to sleep easily when listening to the soothing sounds of nature.
If you decide to use a pillow speaker, make sure the sound machine that you buy has a 3.5 audio output socket fitted that will enable the pillow speaker’s cable to connect to it. The volume of the sound machine should be set just below your tinnitus and not at a level that will completely mask it. The same also applies when a pillow speaker is being used.

When we sleep the auditory pathways and brain are still active. If the brain hears silence it has the ability to increase the level of the tinnitus making it louder and more intrusive during waking hours. The sound machine with its low level non intrusive sounds, will gently deliver sound enrichment to the brain while we’re asleep which will, over time help it to push the tinnitus further into the background of the mind making it less noticeable during the day and helps the habituation process. Anything new that we bring into our lives takes time to get used to. Most people are used to sleeping in their bedroom at night in complete silence. Therefore, please remember the sound machine takes a while to get used to but the benefits are realised you won’t want to be without it.

Cognitive Behavioural Therapy for Tinnitus.

Cognitive behavioural therapy (CBT) maybe offered as a treatment for tinnitus. It can teach coping techniques to help a person deal with the negative thinking and thoughts that often accompany the condition when it’s intrusive and for those that are new to it. This treatment can be practiced through a Hearing Therapist or clinical psychologist. Patients are asked to keep a diary of the times they find their tinnitus to be most annoying and distressing. Detailing the nature of the distress and what might have caused it. All this information helps the therapist to make suggestions on how to think and do things differently, which the patient might find helpful. By changing the way one looks at their tinnitus the distress is reduced and the noise becomes less noticeable.

Relaxation exercises

Relaxation exercises can be beneficial and a good way to channel stress. It can take a while to learn the technique. If you are offered the opportunity to attend a relaxation class and have the time, then it’s something to consider trying.

Natural environmental sounds

Some people find natural environmental sounds to be very therapeutic for their tinnitus. The opening of a window or the sound of traffic and even the rustling of trees has been mentioned. It’s as if all one has to do is turn to mother nature to find all the answers. A personal favourite is to be by the sea and listening to it lapping against the shoreline for it creates the perfect ambiance for relaxation.


CDs and MP3 downloads
Not only is tinnitus experienced differently by each person, the type of treatment that one uses to get relief from the condition and make life a little easier can be different too. Some people find listening to relaxation CDs through a portable cd/radio player beneficial or downloading MP3 tracks from the Internet and listening via their mobile phone or MP3 Player. Listening to music through a mobile phone or MP3 player is fine in my opinion, as long as they are connected to a docking station that has speakers attached.

The sound therapies mentioned above come under the heading of sound enrichment for tinnitus. My advice is to experiment and see what works best for you, including household items such as a fan or ticking clock. Most people with intrusive tinnitus prefer non-intrusive sounds such as white noise, sound machine and environmental sounds. Music on the other hand tends to draw attention to itself and evokes emotions, which probably isn’t the best source to use for sound enrichment.

This brings me to issue a word of caution. I advise anyone whose tinnnitus was caused by exposure to loud noise not to listen to music through headphones even at low volume. Even if their tinnitus wasn’t caused by exposure to loud noise my advice is not to use headphones. There are mixed feelings over headphone use and tinnitus but many people that have had this condition long term share my view.

Headphones and Tinnitus.

The views on whether a person with tinnitus should listen to music through headphones are controversial. Some people show no adverse affects while others do even when the volume level is kept low. As I have already mentioned we are all different so the only way a one can know is to experiment for themselves if they want to. In my opinion, when the tinnitus was caused by exposure to loud noise/music and it has become intrusive - by this I mean a person having to seek help at ENT, then they shouldn’t listen to music through headphones no matter how low the volume is set.

Most music has syncopation throughout its frequency range, so it’s constantly changing in pitch, rhythm and timbre. The beat of the music and volume can also change while listening. This evokes pleasure and can stir our emotions. This happens whether we listen to music loud or soft, although certain types of music does sound better played at a higher volume than others, and vice versa. Once the Cochlear in the inner ear becomes damaged by noise exposure, it is much more sensitive to sound. This is one of the reasons hyperacusis (sensitivity to sound) is often experienced with noise-induced tinnitus. The wearing of WNGs (white noise generators) as part of TRT treatment can often cure the condition. I will be covering Hyperacusis and Habituation in more detail later on.

The organ of the Corti, which is attached to the Cochlear, has approximately 20,000 hair cells. These hair cells move to the vibration of sound and are just one of the components in the auditory system that enable us to hear. Someone that already has a sensitive auditory system due to noise-induced tinnitus and listens to music through headphones at a low volume, risks irritating the Cochlear further; this can make the tinnitus louder and more intrusive. In my opinion, it can be misleading when some health professionals tell tinnitus patients, listening to music through headphones is fine as long as long as the volume is kept low. These health professionals mean well and know a lot about the anatomy of the ear and therefore, it is not my intention to try and undermine their abilities or expertise. However, It must be said, that many of them have never experienced intrusive tinnitus. This leads me to say, one of my ENT consultant’s who is an Audiovestubular consultant, and someone that I have a lot of respect for, once told me that I know more about tinnitus than she/he. This person explained, for the simple reason they had never experienced it.


I have spoken to people and corresponded with them by email and at Internet forums, complaining their tinnitus has become worse because after listening to music through headphones even though the volume was kept low. My advice to anyone that has tinnitus that was caused by exposure to loud noise is not to listen to music through headphones, as the auditory system is more sensitive.

White noise generators.
Some may question the use white noise generators since they emit white noise directly into the ear. White noise generators don’t usually irritate the auditory system due to the volume being kept low and its frequency range remains constant so there is no syncopation within it unlike music. Although white noise generators can be bought privately to treat tinnitus I don’t advise anyone to do so, unless a Hearing Therapist/Audiologist has first tested their auditory system for suitability. A person must also be shown how to use these devices correctly, as improper use can make the tinnitus worse. Furthermore, they are normally used in conjunction with Tinnitus Retraining Therapy to get maximum benefit.

The brain cannot habituate to a sound that it cannot hear.
Some people believe totally masking or covering up their tinnitus with another sound so it can’t be heard means they have habituated. This belief is incorrect. The brain cannot habituate to a sound that it cannot hear. As soon as the source masking the tinnitus is removed, the brain will immediately focus on it and in some cases the tinnitus can become louder and more intrusive. The correct way to use white noise generators, sound machine, or any other source for sound enrichment, is set their level just below your tinnitus. In other words, make sure the tinnitus can be heard above the sound source.



Answers to Hyperacusis and Habituation

Hyperacusis.

Two questions often asked about tinnitus are: How long does it take to habituate? How do I know if I have hyperacusis?

One of the main causes of tinnitus is exposure to loud noise. Quite often though hyperacusis, (sensitivity to sounds) accompanies the condition. This is because the nerves in the auditory pathway have been subjected to noise trauma and thus become highly sensitised. Hyperacusis can be extremely painful. It can cause tinnitus to spike sometimes making it last for days until it settles down again. Within this time the person affected can be in a lot of discomfort. Music that was once pleasurable to listen to through a home music system or radio is now an ordeal so one prefers not to listen to it. The closing of doors, washing up of kitchen plates and cutlery is enough to send a person running for cover, as it can feel like a pneumatic drill is piercing through your ears and head. It can become such a problem a person is afraid to venture outside their home in fear of road traffic noise sparking an increase in their tinnitus due to their sensitivity to sound.

One of the best ways to treat hyperacusis is by using “sound enrichment”. This can be achieved in many ways but I one of the best to wear white noise generators. Two should be worn to keep your auditory system in balance. The sound level of these devices must be adjusted correctly so as not to cause further irritation to a person’s auditory system, which can make the hyperacusis and tinnitus worse. It is best to always make sure their sound levels are set just below the tinnitus. Wngs are usually worn for up to ten hours a day. Two things are achieved over time. The hearing system is constantly subjected to low-level non-intrusive white noise, which will help to desensitise it. Secondly, they help the brain to focus less on the tinnitus and push it further into the background making it less noticeable. This form of treatment is also known as TRT.

An alternative to wngs is to use a tabletop sound machine that plays nature sounds. This can be used for sound enrichment to help the healing process of hyperacusis. Again it is best to set the sound level just below the tinnitus. As previously explained sound machines can be very useful at night by the bedside and in the day used to fill in the background ambiance in room.

Treating hyperacusis takes time as there is no quick fix and everyone will respond to treatment differently.
Please bare in mind that a person with tinnitus and hyperacuisis, if the hyperacusis is left untreated sensitivity to sound will always remain a problem. In some cases hyperacusis can get better naturally without using sound enrichment but there is no guarantee. A word of caution. Some people use earplugs to help suppress external sounds because of their sensitivity to sound. Earplugs are available but should only be used when in noisy surroundings and not to suppress normal every day sounds, as doing so can prevent the healing process of hyperacusis.


Habituating to Tinnitus.
Habituating to tinnitus often seems shrouded in mystery for the more seriously affected people that are in distress and have had to seek help at ENT. It can be particularly difficult for people that are new to tinnitus to comprehend. How does one know when they have habituated to their T and more importantly what does this actually mean? The following doesn’t apply in every case of tinnitus for there are some people that have large fluctuations in their T and every day can be a different experience. This is one of the most severe forms of tinnitus and medications may be required to help cope with the condition. Habituating to this type of tinnitus is still possible to an extent but does present additional problems.

To others I will say this: You’ll know when you have habituated to your T regardless of whatever treatment you are using via ENT etc as your brain will over time push it further into the background so it becomes less significant, in a similar way to the people that have mild tinnitus. Although your T may be present and on occasions it will spike, over time it will cease to be so much of a problem unless you deliberately focus on it and bring it to the forefront of your mind.

Computers and tinnitus
This topic has caused much discussion on tinnitus forums whenever it is mentioned. Some people refuse to believe that using a computer can make tinnitus worse, while others are more open minded about the issue. Then there are those that agree with me that using a computer can make tinnitus worse for some people, due to the EMF (electro magnetic field) that all computers emit.

I believe it would help if I explain the way near field computer use affects me, and the steps I’ve taken to reduce my exposure to computer EMF. IF anyone decides to try my suggestions their life might become a little easier. In 2008 my tinnitus became increasingly worse for reasons I’m not quite sure, as I’m usually careful about being around loud sounds. One evening I was listening to a favourite symphony on my HI-FI and enjoying quite a lot turned the volume up but didn’t notice any adverse effects. It wasn’t until the next day that I noticed my tinnitus begin to increase. This continued over the next two weeks and times it was excruciating. I needed help, as there were no signs of it reducing to its previous levels.

After various tests at ENT I was referred to a Hearing Therapist and began TRT for the second time in eleven years. I didn’t know at the time that my tinnitus would change so dramatically and affect my life for nearly five years. For two years I was unable to read a book and using a computer was a definite no. Every time I tried within a few minutes my tinnitus increased to unbearable levels that would last for days.
At the time I knew nothing about the effects of EMF from computers but was convinced it was causing my tinnitus to increase every time I used it. I spoke with two electronic engineers that also have tinnitus and told them about my problem. They mentioned some people with tinnitus are sensitive to EMF that a computer emits. I was advised to move my PC into another room and use a: wireless keyboard, mouse and external monitor. I was prepared to try anything so bought the relevant cables, wireless keyboard and used a TV as a monitor.

The advice that I’d been given worked for I was able to use my computer without my tinnitus becoming louder. Six years on, the computer base unit is still in another room and I use a wireless keyboard, mouse and external monitor. I also have a laptop. On many occasions, I have tried using it in the conventional way to make sure my symptoms were not psychosomatic. Each time my tinnitus becomes worse within an hour or two. I have persisted and the tinnitus reaches such unbearably levels I have to switch it off. I have passed on my experience to others that were having difficulty with their tinnitus and also use a computer. Some people have noticed an improvement after trying my suggestion, or reducing the time they’re at the computer.

When I saw my hearing therapist in clinic, I told her what I’d done with my PC, and explained the effects of computers and EMF. That it can make tinnitus worse for some people. I was informed no other patients had mentioned it. I didn’t pursue the matter any further and let it rest. Around four weeks later I returned to clinic as part of my TRT treatment. It was then explained to me that a few of her patients had talked about noticing an increase in their tinnitus whenever using the computer.
This topic has raised many questions whenever it is talked about. There will always be people for and against something. The sceptics want scientific proof that near field computer use can make tinnitus worse for some people. My answer to this is: I have none but there is information on the Internet about EMF from computers making tinnitus worse for some people that are hypersensitive to it.

Positivity and tinnitus

For some people prolonged intrusive tinnitus can be very stressful and at times debilitating. This can sometimes lead to depression and a person may need to go on a course of antidepressants. I have often been asked in tinnitus forums and via email “It is great if you’re able to be positive, but simply telling someone to be more positive about tinnitus isn’t going to change anything”. I want to clarify here and now, that isn’t what I mean. Thinking more positive about tinnitus and bringing positivity into your life takes time it isn’t achieved overnight or by simply thinking to yourself “I must be positive about my life”.

If a person wants to improve the quality of their life they have to be prepared to try and help themselves, because there is no wonder drug or operation that can cure tinnitus at this time. Unless a person faces these facts they will forever be trawling the Internet going from forum to forum complaining why there is no treatment for tinnitus when actually many of these people want a complete cure.
I once read a newspaper article that mentioned: nineteen out of twenty medical conditions cannot be cured. Someone once told me “I don’t want to be positive about tinnitus, I hate it. Being positive wont make it go away. This is true, however, thinking more positive and bringing positivity into your life will reduce the perception on how you relate to tinnitus. CBT and TRT are based on having a positive attitude, without that these treatments aren’t effective.

Long before CBT, TRT and the Internet came on the scene Doctors have been telling tinnitus patients, there’s no cure you’ll have to learn to live with it. Most of us know this is easier said than done. So how does one start to think more positive about their tinnitus and to bring positivity into their life?
The fact that someone with tinnitus is reading this page suggests to me their tinnitus for today at least isn’t so intrusive that they are unable to function, for that I’m pleased because this is something positive, instead of lying in bed on medication doing nothing. If you are able to work that’s even better as your tinnitus isn’t so severe you’re incapacitated. I see this as something positive in a person’s life. Being able to earn a living and support yourself. Therefore, you’re able to do all the daily tasks one needs to survive in this world. You may have some difficulty granted, but you’re still achieving and that's progress.


It is still better than someone that is visually impaired or severely disabled and unable to earn a living. Or, people with severe tinnitus that are depressed and on medication and unable to work. So by looking at our own circumstances and seeing what we’re able to do and achieve we can think more positively about ourselves. There is nothing more satisfying than being independent and I suggest you hold onto those thoughts. If you live by yourself consider getting a cat or a dog so your home environment won’t feel so lonely. If you have a partner and family think about spending some quality time with them, as this can help reinforce your sense of belonging, and the love that binds you together, then your T won’t make you feel so isolated. Sometimes opening up sharing your thoughts and how you feel can help immensely and keep negativity at bay.

I have just given a synopsis of what I believe can help a person’s quality of life improve with positive thinking. It doesn’t happen overnight but a lot can be achieved when one is prepared to try. By moving forwards and taking one day at a time you can occasionally look back and see how far you have come.

Michael

 

7 months? I hope so but I don't think so. I have ringing in my other ear now and now a low one in that same ear. I don't know if I had all of this before and never noticed or if there is something I am doing to make it worse.

Also you don't think the soft headphones are on? Like the wrap around headband ones? I've been using that

 

HI Marie. Give it time. Please read my post. I have had tinnitus for many years and know quite a bit about it just like others in this forum. You haven't had tinnitus long. Please do not use any type of headphone to listen to audio/music including the wrap around headband you are using as in my opinon, you'll make your tinnitus worse!. At night, I suggest using a sound machine by your bedside. Avoiding quiet rooms especially at night will help the habituation process. As I said, please read the post and for more information click on my profile as there's more articles there which you might find helpful. Discuss with your Doctor about being referred to a Hearing Therapist. That is the way to get yourself bettter and in time you will, believe me. Best of luck. If you need any more help ask.
All the best
Michael

 

@Michael Leigh, Have you personally tried TRT? If so, would you recommend it? One ENT I've recently seen said there was a high dropout rate for TRT. It would be nice to get away from drugs such as Gabapentin and Clonazepam. I do use them for some spinal/pain issues so may get a dual benefit from them however. I was considering TRT, but was a bit leary about sound therapy. SoundCure seemed to make my tinnitus worse. Thanks for any reply.

I found a old post of mine listing TRT practitioners in the U.S. and other countries.
https://www.tinnitustalk.com/threads/tinnitus-retraining-therapy.43/page-8#post-109816

 

To answer your original question, most specialists want their own test results.

 

Being here on the forum would be against their expert opinion no?

 

@Telis and @valeri you just need to stop being anxious!

 

You can't say that, this ENT "specialises" in T and H so "sure" they can help!
Once you're cured @Marie79 please share the name of this dr you're seeing.

 

@just1morething . Hi. I have had two courses of tinnitus in the 20 years that I've had the condition and both times they lasted just over 2 years. I wore 2 white noise generators and also had counselling with a hearing therapist. TRT is one of the best treatments for tinnitus but it must be administered correctly so the patient gets maximum benefit. This means, wearing two white noise generators for approximately 8 to 12 hours a day and also having tinnitus counselling with a hearing therapist. The counselling is very importatant, because without it the patient will to get the best results from TRT.

It is important at night that the patient uses a sound mahine by the bedside as white noise generators shouldn't be worn in bed at night.
If you click on my profile there are many articles that I have written about tinnitus that you may find helpful.
All the best and wish you the best of luck
Michael

 

Never said or thought they could cure me. I want to ask some questions. It won't cost me a dime since I've met my out of pocket maximum. This also explains why I am seeing so many doctors because right now it doesn't cost anything. It will again in January.

I am seeing this doctor.. Dr Lin.. What difference does it make? It doesn't cost me a dime

http://www.cbsnews.com/news/ringing-in-your-ears-tinnitus-common-medical-condition/

 

I just want to know if I really have to do another hearing test. Does it make any difference to the T or H treatment other than giving hearing aides which I already have?

 

It is true that a lot of practitioners want their own fresh results from the people they trust. I did a silly number of hearing tests in the first six months, all of which came out the same, but they all wanted them.

Michael, the first ENT I saw did none of what you said they would (should) do. Basically: no history, no questions, no examination, just read the referral and said "oh there's no treatment for that" and suggested to me as I left that I may have had a stroke, but had nothing to say on why he said that or what I needed to do with such information. Just told me to see the girls at the desk (for his bill). I don't blame Marie for shopping around really, if what I received was any indication of how more of them are. Maybe I was just very unlucky with my (limited up here) choice. You gotta have an end point though don't you, where realize that all you are doing is making Doctors wealthier for no result.

 

Very true.

 

I don't blame Marie for wanting to see specialists. I certainly wanted to see them early on and did.

 

@PaulBe
Hi PaulBe,
My experience with tinnitus is based on the 20 years that I’ve had it and the treatment that I’ve received under the NHS, my post is a reflection on that. I know from corresponding with people that not everyone with tinnitus in the UK will get the same level of treatment that I’ve had over the years which has been very good.

It saddens me to know, not everyone gets this same level of treatment and help with their tinnitus in the UK and further a field. However, when a person is referred to ENT by their GP in the UK, their consultation and initial tests will be similar to what I’ve described in my post.

I believe, anyone that doesn’t get the quality of consultation that I’ve described in my post no matter where they live then should seek help elsewhere as they are not getting good quality service.

As I have previously mentioned: the relaxed cavalier approach that some Doctors and healthcare workers have towards tinnitus is changing and this is a good thing. After all tests are carried out on one’s auditory system and a person is diagnosed with “straight forward” tinnitus, by this I mean no underlining medical conditions causing it, then the next step is to be referred to a Hearing Therapist or Audiologist for tinnitus management which I’ve described.

Until there is a cure for tinnitus, the best people can hope for is learning to habituated to it and the majority of people achieve this with time. Even though I was medically retired from my job with tinnitus and it is severe at times, I have still managed to habituate to it at a certain level.

I wear white noise generators occasionally and use sound therapy (sound machine) at night and take clonazapam when my tinnitus is severe. These things help me to manage my condition and people must seek their own way of doing so. Restricting oneself to accepting nothing less than a complete cure from tinnitus can make a person have a negative outlook on life and will make themselves miserable and those around them. I appreciate the early onset of tinnitus is can be traumatic for some people but the majority do improve with time and help.

Michael

PS:
Based on my years of experience with tinnitus and counselling people with it, I believe the wrong approach especially within the first 6 to 12 months of having the condition, is getting into a panic. Attempting to try every wonder drug and alternative medicine out there in a hope to cure it. Often this wastes a lot of time and energy and can be financially expensive if one isn't careful, as there are a lot of charlatans and con artists ready to relieve someone of their money.

 

You know, If I'd gotten to competent holistic management in the first year, I think my situation would have been so much easier to deal with, and I realize now that in that time I became a very real suicide risk, given the way my thought processes moved un-directed and un-moderated. There's no doubt in my mind that that first ENT visit was very important in setting the tone for my recovery, and it was a disaster that left me mistrustful of professionals generally and lost for direction. Avoiding or mitigating that panic is something medicine could do, but does not do at all well, and unless you can get to a real Audiologist (not a Neuromonics salesperson) then there are few places to go for some of us. I did get to Melbourne and had a long consultation with Myriam Westcott, which was quite something because every Audiologist I've seen since is a glorified hearing-aid salesperson compared to her (only a few, I don't seek out help these days). What you outline above is pretty close to the model of treatment she advocates, and at this point in time seems to be best practice.

One advantage you have in the UK is proximity to most services as distances are not large when compared to us, and despite the best efforts to wreck it, you still have a fundamentally good public health system. We have a good system too in Australia (so far) for most things, but tinnitus/hyperacusis isn't one of those things, and being in a rural centre as I am, its worse. I do think a presentation of intrusive tinnitus requires a team-management approach which public systems like ours are best equipped to do. It seems like yours does it fairly well at times, and ours just doesn't. The annoying thing is, ultimately I have finally achieved a level of habituation in that I am working again and for the most part living much better, but looking back, were I able to access credible help sooner I could have certainly reached an accommodation with this also sooner. I have worked in the Hospital system many years as a highly trained ICU/Emergency Nurse, and over the past few years my trust in medicine as a discipline has been somewhat shattered. I know Myriam has made it a bit of a passion to educate medical professionals but I don't know how much headway she is making. One person can only do so much in a big country, but she wears big shoes.

Marie, read Michael's post. At this point in the evolution of T & H management, what he outlines (hardly an outline, I know) is as good as it gets for us. Michael, nice to see you back here. I haven't seen much from you for a while.

 

How did you manage to get medically retired from tinnitus? That would never happen in the US.

 

Hi Paul,
Thank you for your kind words.

It is true that I haven’t been posting here for quite a while but still visit and peruse the forums just to keep my hand in. My good friend Glynis, does a splendid job here and also people like you. The list of helpful contributors is far too many to mention but you all know who you are and do a great job. If Tinnitustalk were no longer here, I’m sure many people that turn to it for sage advice would miss it terribly.

I mustn’t forget the people behind the scenes that make all this possible. The Tinnitustalk managers and administration staff whom I salute. Please keep up the splendid work.
In truth, I don’t think I can add any more to the overwhelming helpful advice given here without constantly repeating myself, but I still like to occasionally post.

It was suggested to me a while back by people on another tinnitus forum to write a book on tinnitus. I have never written a book but hope to one day bring this to fruition, for I feel passionate about tinnitus and helping people that have it. I started to write and believed I was making good progress, but hit a stumbling block and went through a difficult time with my tinnitus so had to leave the writing alone. I want to continue, as I don’t like to start something and not finish it and hope this will be possible.

Turning to your comments about the UK and our NHS. I believe it’s still a very good health system and I’ve had good if not excellent help from it over the years. I was recently fitted with two new digital white noise generators that have two different tones that I can select. They were given free and cost around £2000 so I have no complaints. However, you are right, there has been some “best efforts to wreck it” and I hope it never comes to that.

My first tinnitus consultation 20 years ago was similar to yours. At the time I felt I wasn’t understood or given the time and patience I felt should have been afforded to me. However, things improved considerably after I had a word with my GP on the way I was treated.

You are correct that it’s vitally important in the early days for someone with tinnitus, to get the best help possible, because this can affect their whole out look on the future. This help might not always be available. Thankfully, there are people at Tinnitustalk who are experienced with tinnitus and can help those new to the condition through a difficult time, and make them see there is light at the end of the tunnel, as most people do eventually habituate.

Michael

 

@Marie79

The reason they prefer to do a hearing test on you even tho you have had one, two or even a hundred in the past, is they may be using a different software that might just be more tuned into what they are trying to find out about your hearing. Also, they get paid to do it so it becomes the norm when seeing new ENT's and Audiologists. Besides, hearing can be finicky and your levels can change overnight. A certain tone you could hear last week might not be detected now? I know my hearing changed from one test to the other. They need to know how it is today, and not how it was yesterday.

Keep going to your doctors and specialists. Search for what ever might help you adjust and cope with this. Eventually you will find a way to cope or even help with your situation. Don't give up looking until you feel you have gone as far as possible with doctors etc. In my case, nothing really helped but that is not always the case. I simply got to the point that I am now married to this and it can be a bad marriage or one I can deal with........ but it's up to me on how the relationship goes.

Best of luck and trust me, you will eventually get to a point that it's just your new life.

 

Hi Aulue,
Tinnitus comes in many forms and intensities no two people experience it the same. When tinnitus is severe and intrusive, it can be very debilitating and can affect a person’s quality of life considerably and their ability to work. I had an understanding employer.

I went off sick from work due to my tinnitus and was seen by more than one of their occupational Doctors over a period of time. They eventually recommended that I be medically retired. Medical reports wore also submitted by my ENT consultant and GP about my condition.

Some people think that employers or government health organisations don’t take tinnitus seriously, but I don’t believe this is always the case. I have corresponded with people that go off sick from work with tinnitus and say their employers are not sympathetic and show no understanding. When I ask them if they are having treatment at ENT I’m often told: they’ve only been seen a couple of times. A hearing test MRI etc.

A person must persist and try to get treatment for their tinnitus. This comes in the forms: TRT (tinnitus retraining therapy) CBT (cognitive behavioural therapy) counselling. The wearing of white noise generators or, taking anti-depressants etc.

Unless a person is receiving ongoing treatment for their tinnitus at a clinic or hospital, it’s unlikely their employer etc will take their condition seriously. If this were not so, anyone could say: “I have tinnitus and can’t work”. You need to be having treatment.
Michael

 

@Michael Leigh Michael Just want to say thank you for taking the time to put your thoughts and opinions in this thread. Having T for 3 years I look back at my experience and much of what you mention is exactly correct. I wish I had this post back then it would of saved me allot of money and who knows I might of been better off then I am now.
Thanks again

 

@Carlos1
Thank you for your kind words Carlos. It is stories like yours that keeps spurring me on to help people with tinnitus. Where it will lead I have no idea but thank you once again.
Michael

 

@Michael Leigh my office is quiet so i listen to my t all day but it doesn't stop me working. One of your comments where you said its so loud it made you have to go to bed is scary!! What were you working as by the way?

 

You should have the test just so you have a record of how your hearing has progressed. If you have found a doctor who is interested in listening to you and helping you, then go for it. I would guess that they would be able to help you in some way if they are trying. I don't understand the negativity here. No one here has any idea if this doctor can help you or not. Tinnitus does actually go away for some people and even if it doesn't it gets a lot better for many, especially if you do not have a confounding health problems. Good luck and let us know what you learn.

 

Hi Sam. Tinnitus comes in many forms and intensities and no two people experience it the same. When tinnitus is mild or moderate some people can easily learn to live with it and it's rarely a problem. However, when it is loud and intrusive this is an entirely different animal, believe me. My tinnitus ranges from: silent, mild, moderate, severe, and very severe. In my opinion, I don't believe it is a good idea for you to sit in a quiet office doing your work and listening to your tinnitus even though it's mild. You would do better buying yourself a portable sound machine and there are many available and have that on your desk while you work - If I were you I would also use a sound machine at night by my bedside and not sleep in a quiet room! Just a suggestion.

Even though your tinnitus is mild, your brain can focus on the tinnitus as you are doing and it has the ability to make the tinnitus louder over time.

I trained as a carpenter and joiner. It was after years doing my work that I then started having tinnitus. My doctors believe it was working with power tools etc and in a noisy environment that caused my tinnitus and not always using ear protection which I no better now. Whenever I'm mowing my lawn with my petrol mower or using the petrol weed wacker/strimmer etc I always use my ear-defenders.
Michael