My ENT Visit. Time to Vent.

To say, after four months of waiting, that my ENT visit was profoundly disappointing would be an understatement.

Every stereotype I heard related to ENTs and tinnitus came true. First, he looked very unconcerned and mildly annoyed. He does a hearing test. Checks inside my ears. Makes me do facial exercises. A total of 7 minutes.

"Well you look perfectly healthy. Ears look fine. Aced your hearing test. I'm gonna take a hunch here and say your ringing will fade. If you have hearing loss, it would be permanent, and you don't. Whether that takes a few weeks, months, or years remains to be seen. No need for an MRI."

And that was it. Sent me on my way. I ask about "hidden hearing loss" which I read on this forum but he looked at me like I was an idiot (he raised an eyebrow!) and dismissed such an idea.

I wasn't expecting much from my visit but at least some answers. I almost feel like he told me the tinnitus would fade just to placate me. I couldn't believe how fast I was in and out of there. Seriously, 7 to 8 minutes tops to be told "you're fine. See ya'!".

Ugh. Just had to vent.

 

What is your T like?
Did he check your hearing in the higher frequencies? i.e. 8-16kHz?

 

@RonnieCarzatto ,
ENT are great at checking ears and doing operations and hearing tests but it's audiology whom help tinnitus sufferer and more understanding to your needs.
Love glynis

 

@RonnieCarzatto
The consultation you have had with your ENT wasn't a proper consultation or examination of your auditory system. Most ENT doctors prefer to see a tinnitus patient after they've had the condition for around 6 months and there is good reason for this. However, if a person also has: Pain in the ears, problems with balance, dizziness felt or deafness, then there is cause for concern and a patient is usually seen more quickly.

ENT doctors are not tinnitus specialists, they are physicians. They know all about the anatomy of the ear and are able to treat it medically or surgically. If there is no underlying medical condition causing the tinnitus, a patient is often referred to a Hearing Therapist or Audiologist for tinnitus management. This can involve: The wearing of hearing aids. Treatments such as TRT, CBT and tinnitus counselling. These health professionals are the tinnitus experts, they specialise in treating tinnitus patients which calls for a set of skills that most ENT doctors do not have. It is not unusual to find a lot of Hearing Therapist/Audiologists that work with tinnitus patients also have tinnitus.

Please click on the link below and read my article: Tinnitus, A Personal View. This will give you more insight into what should happen at an ENT consultation, tests carried out. Treatment and coping methods.

https://www.tinnitustalk.com/threads/tinnitus-a-personal-view.18668/

Michael

 

When my T first started with ear pain and dizziness back in 2010 I couldn't even get past the "gatekeeper" (reg doc). So I know what its like to get disregarded.

After an increase in the T I've finally been seeing an ENT. So far he has been helpful but he has a physical issue to focus on. He's somewhat younger though so maybe he hasn't become jaded yet.

At least your tests turned out OK. Doesn't help the T though in your case. I didn't know about HL making T permanent. Not sure if that's true. I hope not.

Lynn

 

@grate_biff
It's high pitched, like whistle or tone, in my right ear. It feels like it's inside my head. I think it's from a head injury I sustained back in January. He didn't check in the higher frequencies as he didn't believe it was necessary.

@glynis Unfortunately my audiologist experience wasn't much better...

@Michael Leigh I looked into tinnitus retraining therapy and things like that. It's, unfortunately, out of my price range. I did see an audiologist but she didn't really know what to do with me aside from test my hearing and feel sorry for me.

I appreciate all of the responses. Basically there's nowhere to go but towards habituation from here. I'm giving up on finding a medical cause for the tinnitus, there's obviously no point.

 

@light rain Very true. At least from a physical standpoint all appears to be well. I guess I should look at it glass half full. I hope you improve with your symptoms

 

HI @RonnieCarzatto In my opinion, it is it is far too early for you to even consider TRT or CBT for that matter. Please click on the link below and read my post on TRT. You may not even need it. Give yourself time to adjust to the tinnitus, as many people naturally habituate to tinnitus within 6 months to a year. Use sound enrichment at night, I explain more about this in my article: Tinnitus, A Personal View. For now please click on the link below.

https://www.tinnitustalk.com/threads/what-is-trt-and-when-should-it-be-started.19024/

 

@Michael Leigh Currently reading now

 

Thanks.

Try to grab on to whatever positive you can to salvage your bad experience.

If you've had a known injury maybe a different route like a neuro or some other kind of specialist. It can be hard though with ins, ded, and copays.

 

RonnieCarzatto, I'm so sorry you had such a horrendous experience with your ENT.

I waited 6wks to see an ENT and was in and out in under 12 minutes. He was arrogant and am convinced has NO clue how difficult the struggle of tinnitus can be, due to his condescendingly smug statement , "yeah, I've heard some people kill themselves over this". He sounded disgusted and exhibited not once ounce of empathy. I wasn't expecting a cure, but tinnitus was fairly new to me and was just becoming severe, and I expected a bit of compassion and some potential resources.

That said, I've found a wonderful Audiologist who also has tinnitus and has been very helpful to me and a great listener. He found that I have a significant high frequency hearing loss and has fitted me with hearing devices which have proven helpful with both issues.

Still praying for a cure as my tinnitus has become severe ...

 

Ronnie if your up for continuing the Canada hospital merry go round id go the Otologist route like I did in London

.....mind you after all their tests their weapon of Choice ..one useless steroid nasal spray

"Otology is a branch of medicine which studies normal and pathological anatomy and physiology of the ear (hearing and vestibular sensory systems and related structures and functions) as well as their diseases, diagnosis and treatment."

 

@Hadassah
It's all good. I was raging angry about it yesterday, but in hindsight, how could I be? I very rarely read positive ENT stories on this forum. I know some have been lucky to either get some compassion, guidance, or even answers, but for the most part that doesn't seem to be the case. Why would I be different? I just wish he took some time, not go through the motions in a rushed manner like I was taking time out of his day. It sounds like your experience was almost like mine. He wasn't arrogant or condescending, just rushed and obviously annoyed. I agree. They don't grasp just how severe this can be. I pray for your relief soon. I'm truly glad you at least have an audiologist who can sympathize.

@carlover Haha, an avenue I may look into, but I think I'm done with the merry go round for now. Thank you for the head's up dude!

 

The whole diagnostic process for hearing disorders seems to be one big hit-or-miss wherever in the world we are. @Michael Leigh aced a good quality holistic service on the Public Health in the UK, but his story seems to be more the exception, which is a shame given that it appears to be a very good model of care for tinnitus of the (presumably) more common non-surgical kind. Do you think they'd offer the same level of care these days Micheal?

 

Ronnie, if you had a concussion, you should check your neck. I thought I only had a concussion last Sept but actually I had a whiplash also.

 

@G61 Does a GP check your neck? Or only like a chiropractor?

 

You can do both. You cannot tell your GP that you want an Xray or MRI on your neck because you have tinnitus. But if you feel neck pain, then you can.

For chiropractic treatment, look for upper cervical specialist such as NUCCA/Blair.

 

@G61 I will do that. I've been to a few chiropractors and they did some back work but no relief. They didn't really focus on the neck very much. I'll look into NUCCA. Thank you.

 

Let me know how it goes. I did not have neck pain initially. So that, it took me a long time to figure it out.

 

Hi @PaulBe

The care for tinnitus patients in some parts of the world after seeing an ENT doctor for the initial consultation and tests, doesn’t seem to be very good for people. From what I’ve read, in many cases the only way they can get treatment with a Hearing therapist or Audiologist for example, they have to pay privately as it doesn’t appear to be covered under medical insurance. The type of treatment I’m referring to that has to be paid for is: TRT, CBT, counselling, mindfulness, white noise generators and hearing aids. Although in some parts of Europe this doesn’t always seems to be the case. When hearing tests, MRI scans and blood tests show there is no underlying medical condition causing the tinnitus, which is typical for a lot of people and they are unable to habituate naturally without treatment. A referral to a Hearing Therapist or Audiologist trained in tinnitus management is usually recommended. As mentioned above in many cases (but not all) a patient has to pay for treatment privately.

In the UK this is not the case. Once a person is seen at an NHS hospital ENT department all treatment is free. From initial consultation with an ENT doctor, tests and referral to a Hearing Therapist or Audiologist for tinnitus management. Depending on what treatment is available as mentioned above, none of this has to be paid for. The NHS isn’t without its problems the same as any large organisation. When a person is referred to an Audiology department and sees a Hearing Therapist or Audiologist for tinnitus management. The treatment and what is available for tinnitus can differ considerably across the country. Some hospitals offer no CBT or TRT. However, when tinnitus is caused by hearing loss for example, hearing aids are usually provided. Counselling is given if available at that particular hospital. The way I understand it, any hearing disorder that a person has, if it can be treated medically or surgically this carried out by ENT.

In most cases some sort of aftercare for tinnitus is given when a patient is referred to Audiology. A person can be referred to any hospital of their choice providing they have the means to get there. I now live in Brighton and will be travelling to London next week to my hospital ENT department that has been looking after me for 21 years. The distance is approximately 50 miles.

I have said in many of my posts that in my opinion, ENT doctors are not tinnitus experts, they are physicians. They know about the anatomy of the Ear and are able to treat it medically or surgically. It is for this reason, the majority of people people say their ENT doctor doesn’t understand their tinnitus or has any idea of what they are going through. Sometimes it can leave a person feeling desperate and at a loss, not knowing what to do or where to go for help. This realisation comes after various tests have been done on their auditory system only to be told by the doctor, that no abnormalities where found. The advice given is to leave things as they are for now and see what happens.


ENT doctors are important healthcare professionals and I have a lot of respect for their skill and expertise. They do not help with tinnitus management nor are they tinnitus counsellors. This is the role of the Hearing Therapist or Audiologist that is trained in this field of expertise. They are able to understand and empathize with what someone with tinnitus is going through. Not surprisingly, many of these healthcare professionals were either born with tinnitus or acquired it at some time in their life. It is my opinion, if a person is referred to a Hearing Therapist or Audiologist for tinnitus counselling, TRT, CBT. Unless the therapist has experienced tinnitus they can never fully understand or empathize with their patient and know what they are going through or give good counselling. They may have some knowledge of the condition through training but this is far as it will go. Furthermore, a patient will soon pick this up during a counselling sessions that the person they are seeing has little knowledge of tinnitus.

Many people that I have spoken to that have been referred to Hearing Therapist or Audiologist for tinnitus counselling have told me the specialist they are seeing also has tinnitus, as my Hearing Therapist who was born with it. People have contacted me who have been referred to a psychotherapist or some other health professional for counselling because they are stressed or depressed. They often tell me the first thing they are told by the healthcare professional is: “ I know nothing about tinnitus”.

Michael

 

Not knowing is fine it they are prepared to listen and learn, but that is culpably rare among medical practitioners here. The medical field is increasingly driven by "Best Practice" algorithms and criteria with one result being the collapse of independent, critical thinking and its replacement with arse-covering group-think.

 

My ENT was actually not that bad. But essentialy it came to the same as your answers. No hearing loss, actually perfect hearing. Probably sensitive hearing which made me T prone in the first case. He told be I had a good chance or something. Physical and psychological healing. Which sounded like habituating but he told me people could physically improve from noise induced T even in my case (prolonged). It would probably not decrease entirely but seeing my age it should improve if I take care of my ears.

My T cycles a lot and buzzes 95% of the time. My audiologist told me that she saw multiole patients recovering from an ever changing T. She had a constant T from fireworks herself.