Suggestions for Good ENT Departments for Tinnitus in London?

I understand everything that you are going through @volterra, much more than you think because I have been there. I have lived with tinnitus for 26 years.

In April 1996 I developed severe tinnitus and hyperacusis from listening to audio at too high a volume through headphones over a long period of time. My hyperacusis was so severe that during conversation I had to ask people to lower their voice as my ears were in severe pain. The whole of my head was completely numb and this was due to the severe noise trauma to my auditory system. I could hear but it felt like my head was completely under water. This was so frightening I wouldn't divulge this to friends or members of my family. All they knew was I had severe tinnitus and hyperacusis.

My appointment at ENT was 6 months away. I had no Internet access so learnt what I could about tinnitus from books at the library and joined the BTA. Fortunately, I met an herbalist that was very knowledgeable about noise-induced tinnitus. She understood everything that I was going through and advised I take Magnesium citrate for at least 2 years. Apparently, Magnesium helps to repair nerves. Since the auditory system consists mainly of nerves, this was the right thing to do. In addition to this, she recommended taking Ginkgo Biloba. I suspected my hearing was impaired but by how much, I didn't know.

I desperately wanted to be seen at ENT as 6 months was too long to wait. I pleaded with my GP to recommend a private clinic. My GP was very understanding and said, I will get the best help and long-term aftercare for tinnitus under the NHS. 26 years on, I have found this to be true. When I was seen at ENT, the doctor asked if I had been taking anything as my hearing was way above normal. I explained about the Magnesium and Ginkgo Biloba. He agreed and mentioned he advised all his tinnitus patients to take Magnesium and Ginkgo Biloba. Fortunately, the numbness all over my head had cleared up. I had TRT for 2 years with counselling.

My experience with noise-induced tinnitus and hyperacusis, has enabled me to correspond and counsel people with these conditions and hopefully be of some help. Please take things slowly and wait for your appointment. I know this isn't easy. Talk to your GP who may be able to prescribe some medication to help you feel less stressed.

Please go to my started threads and read: New to Tinnitus, What to Do?, Tinnitus and the Negative Mindset, Acquiring a Positive Mindset, From Darkness Into Light, The Habituation Process, How to Habituate to Tinnitus.

All the best,
Michael

 

My left ear is slightly worse in this audiogram, but it feels a lot worse. The tinnitus in the right ear has never been reactive, although it has been getting worse because I've been doing unilateral plugging.

Thanks for taking an interest @CRGC. Yeah, hopefully the custom earplugs will be more comfortable and let me go outside more at least. I haven't seen any signs of the hyperacusis getting better on the long term yet.

 

If you pay out of your own pocket, you end up having much less done due to the sheer cost. What you describe is £3000 worth, not £1000.

Even a consultation where they do nothing is going to be £300 minimum, then £200 per each 30 minutes. Just an educated guess but probably not far off the mark. When insurance is paying - they will want to do everything they can justify in order to maximise profit.

The NHS has no profit motive - and treatments and tests which have marginal justification tend not to be offered. I like it this way - as I don't want unnecessary treatments and tests which could lead to problems.

I had only an audiogram and MRI offered - but then I was not complaining about catastrophic debilitating tinnitus.

Yes, I avoided the MRI as I had read about how loud it is plus I had a 1% belief it would reveal anything. From reading forums etc - it is very rare for anyone to say - yay, they found a tumour pressing on my auditory nerve. In fact, I don't recall any.

 

So @Michael Leigh, you didn't have any hearing loss on the audiogram, which means we can't really compare our situations.

 

I didn't have any hearing loss @volterra but I suggest that your hearing loss isn't causing the problems that you are experiencing. It is noise trauma to your auditory system and the fact that you think you accidentally made it worse. This might be the case, but experience tells me this is merely temporary and you will improve, just give it time.

At the moment your mental and emotional wellbeing is in a high state of alertness because your brain is focusing on a strange new sound (tinnitus) that it hasn't heard before. If you follow my advice and read my articles, starting with Tinnitus, a Personal View, you will begin to understand what you are going through. Then you will notice your stress will start to decrease and this will have a positive impact on the tinnitus.

Start using low-level sound enrichment especially at night. Read all the articles that I have mentioned. If you are able to print them, please do so rather than reading them on your phone or computer screen, as you will absorb and retrain the information better. Tinnitus is a learning process and you're in the very early stages. Please listen to what I'm saying. If your hearing loss is significant, it can be corrected with a hearing aid(s). At the moment this isn't the main cause of your problem, so try not to worry about it.

My advice is to start taking Magnesium Citrate and Ginkgo Biloba. These can be bought from Holland & Barrett. I recommend Ginkgo Biloba, made by Avogel, it comes in 50 ml and 100 ml bottles and is high quality. It can also be bought from Amazon.

Michael

 

Should I be concerned if an ENT doesn't know the medical connotation for 'trauma'? Apparently my ENT (middle-aged) from a few years ago didn't. She said she had never heard the words 'acoustic' and 'trauma' together and her mental capacity was such that she couldn't work it out.

 

@Michael Leigh, have you been listening to what I've been saying?

I find sound painful, I have a limited sound budget each day, there's no way I'm going to waste it on sound enrichment. I use my limited budget to talk to people and watch TV.

I take Magnesium and I did order Ginkgo Biloba once but it never arrived mysteriously.

 

I would switch ENTs as soon as possible!

 

Hi @Michael Leigh. This is only happening in very limited areas of the country now. It is the exception rather than rule. Your positive experience is not that of most. I have a friend who is a neurologist at Coventry University and he has been candid about the changes that have been taking place in the 'NHS' service over the last decade. Reciting your personal experiences are useful for some, however most people are not able to access that level of treatment. To further support this, I had a private conversation with a member of staff from the British Association of Audiology (some sort of accredited training provider) on matters. To keep it short, there is a lack of audiologists in the NHS, let alone those with skills in tinnitus. Many finish their degree and head to the private sector. There are also less coming from abroad.

And finally regional trusts now have tight control of their budgets and therefore patients travelling out of location for treatment is frowned upon.

The upshot - it's changed since 2010 - apart from being a postcode lottery winner.

 

I hear everything that you're saying @volterra. Do not be too quick to dismiss my advice. I appreciate that you may have a limited budget. Therefore, use your phone for low-level sound enrichment at night and keep it at a low level. Go to YouTube and download or play directly nature sounds. There are many and some are made specifically for tinnitus - don't use music.

The idea is to supply your brain and auditory system with low-level sound enrichment throughout the night until morning. This takes at least 6 to 8 weeks to get used to. Keep the volume at a level that the sounds can be easily ignored and not drawing attention to itself.

Sound enrichment will help to treat the tinnitus and any oversensitivity or hyperacusis that you may have. This takes time and isn't a quick fix. It is up to you @volterra. If you want to get better, then you have to be prepared to put in the work. It took me 4 years to habituate to tinnitus for the second time.

If you are able to watch TV, then you are able to use low-level sound enrichment, during the day and at night. Remember, my ears were once so painful I had to ask people to lower their voice during conversation.

It is up to you.

I have already explained that ENTs do not treat tinnitus because this is not their area of expertise. Most, but not all, know very little about noise trauma. They are highly skilled physicians and treat underlying medical problems associated with the Ear, Nose, and Throat. If there is a medical problem within the auditory system that is causing tinnitus, they will try to treat it medically or surgically.

If no medical condition is found to be causing the tinnitus, as is the case with noise-induced tinnitus, the patient should be referred to an audiologist that specialises in tinnitus and hyperacusis management.

Michael

 

There's a slight hum from the road outside, I listen to the fan of my laptop 8 hours a day, there's wind, there's rain, aeroplanes fly above my home. Why aren't these forms of sound enrichment enough? It doesn't make any sense.

My tinnitus isn't my primary issue, sounds being physically painful is the problem.

 

Anyone who speaks English should be able to pick it up, or else their English is quite poor. Although I might have used the term "acoustic shock"... I think I did.

 

What you describe is sound enrichment, but my advice is not to focus on the fan or any of the other sounds, because the idea is to have sound enrichment playing in the background without drawing attention to itself. It is a learning curve and takes time to acquire. Have you taken the time to read any of my articles? Please do and not just skim through them. As I said, print and take your time to read them, then you will fully understand what I mean. I appreciate that the tinnitus may make it difficult for you to concentrate on reading at the moment, so take your time and read in small segments.

I understand the problem of sound being physically painful. I have explained this in my thread: Hyperacusis, As I See It. This can take many months to improve and may require the wearing of white noise generators. Take your time. Talk to @Eleanor89 on this forum. Last year she was suffering with very painful hyperacusis. She followed some of my suggestions and has improved in leaps and bounds. I commend her for her courage and determination and never giving up!

Take your time and you will see improvement.

Michael

 

I have heard this since 1996 @Nick47 when I first got tinnitus. The NHS has a lack of funds, there is no treatment for tinnitus etc. I had 2 years of TRT with counselling and wearing white noise generators. I heard the same story again in 2008 when I suffered my second noise trauma. It's near on impossible to get any treatment for tinnitus under the NHS. I had TRT for the second time for the full duration of 2 years with white noise generators. When I was having a lot of difficulty coping because my tinnitus had changed to variable, my ENT consultant often saw me in clinic at short notice.

@Eleanor89 and a few other UK members in this forum are having treatment for tinnitus under the NHS. I correspond with people throughout the UK who are having treatment for tinnitus under the NHS. Treatment will vary between hospital trusts. However, as I have previously mentioned, if a patient is prepared to travel, their GP will be able to refer them to any NHS hospital that is willing to treat them. Usually, some form of help will be offered.

One can be issued with white noise generators and have the best audiologist or hearing therapist for tinnitus counselling. However, the patient has to do their share of the work. This means incorporating and reinforcing positivity into one's life. Find a hobby or take up a new interest, go out and socialise. I am not saying it's easy, but it can be done. This is explained in my threads: Tinnitus and the Negative Mindset, Acquiring a Positive Mindset.

Michael

 

No doubt yourself, Eleanor and a few others are enjoying this treatment. What I am putting across is this is not the case for many in the UK. It certainly is not a universal experience in this country. If all had this equality of opportunity, then certainly your advice holds merit as it may help some.

I would love to socialise and practice my hobbies, however I am not at a stage where I can do this with the hyperacusis.

Advice citing your own experiences is useful, yet not all encompassing, due to people's unique situation.

Take care,
Nick

 

Hi @Nick47.

I understand the difficulties and trauma tinnitus and hyperacusis can inflict on a person's life. Have another talk with your GP and see what help is available. Most GPs care about their patients and I'm sure something can be done. If you are able to travel to a hospital outside of your area for treatment, suggest that.

I think you are under a lot of stress which is understandable. Perhaps your doctor can prescribe something to help lower it.

I wish you well,
Michael

 

You didn't answer my question. Natural background noise should be as effective as sound enrichment for desensitising the auditory system, but you claim there is something magical about artificial sound enrichment. It might work in loudness hyperacusis or for non-reactive tinnitus but for true pain hyperacusis from noise damage, no background sound is going to help.

You are being irresponsible getting people to try sound enrichment which has a decent chance of spiking their hyperacusis. Prolonged silence is the only thing that has a chance of healing pain hyperacusis. After a long period of healing sound enrichment may be useful to get one comfortable mentally with sounds again or to mask tinnitus.

 

You are being disrespectful and have the wrong attitude. If you don't change your ways, you will not go far when you are seen at ENT and possibly Audiology.

Good-bye and I wish you well,
Michael.

 

I hope you realise that your current feedback and old posts are pretty much based only on your unique experience and often not applicable to most cases. I am sure that you mean well to help others, however, you might end up harming others. Also, most people on this forum are experiencing anxiety and depressive symptoms to a certain degree, which is understandable.

Please refrain from providing advice/telling people to go to their GP to get medication/therapy when they have not asked you for it. It comes across as passive aggressive.

 

People that visit this forum seeking help and advice for their tinnitus are often at a loss what to do. Some are feeling stressed or depressed because they are unable to treat themselves. I have lived with tinnitus for 26 years and know how debilitating it can be. It can make some people want to cause their early demise. In order not to reach such a critical state, in my opinion it's best that a person talk to their GP and if needed, medication should be administered to lower stress.

I will continue to express myself in the way that I see fit and will not curtail my language, in order to please the likes of you.

Good day,
Michael

 

Hello @Nick47 and @volterra.

I have received help privately off the NHS, however, I did ask to be referred to Dr. Bernadette Parker at Coventry hospital NHS. I speak to her every three months via Zoom, regarding in ear sound generators etc. She is a scientist that specialises in hyperacusis and tinnitus.

Another I recommend privately is Penny Stannard from the Private Ear Clinic. She is excellent, as she also has had hyperacusis and tinnitus and has recovered. It took seven years. She is also an audiologist. She costs £60 per an hour. She totally understands.

There is also Dr. Neil Bauman who you can contact via his website and give a donation for his appointment. I speak to him regularly. He’s also written an amazing book on hyperacusis and tinnitus.

I hope this helps x

 

Thank you ever so much. I'm certainly trying and have asked GPs and ENTs if there is any support I can access. There was silence each time. It seems a postcode lottery. Due to the severity, I cannot work at the moment as the hyperacusis reacts and elevates to external sound. First I noticed a lot of people online they could not access any support through Audiology. Then I experienced it myself. On top of that, there is evidence of a big drop off of referrals to Audiology.

"The ‘This Is My Silence’ report from the British Tinnitus Association, which includes the findings from a new survey of more than 2,000 people with tinnitus, was compiled in consultation with healthcare professionals across a range of disciplines.

It was identified in the report that there has been a 22% drop in the number of tinnitus patients offered a referral to specialist care by their GP since March 2020 - despite a climb in cases, links with anxiety and depression, and new National Institute for Health and Care Excellence (NICE) guidance emphasising the importance of referrals."​

So it's well known about and is possibly getting worse. The upshot being that the advice @Michael Leigh gives may help some people, but perhaps he is not aware of the wider scenario across the country.

 

I hope you are able to find the help you need @Nick47. Please do not contact me in future and I will do the same.

Thank you,
Michael

 

Was I rude? I will put that down to a bad day you have experienced :-/

 

If British GPs are not referring on patients who are presenting with tinnitus - it may be they hold the view that there is no treatment available. Or they may be evaluating how significant the problem is to the patient. I am fairly well convinced that GPs have a very strict set of criteria in order to refer on - since the NHS is continually stretched to breaking point - and marginal cases which are not potentially life threatening - are not referred on.

I was initially offered a referral to an audiologist only who could recommend maskers. However - I pressed on and asked if I could see an ENT.

 

I received some very honest and candid information a few weeks ago from a training provider to audiologists in the UK. I will not name the provider nor the staff member.

I will summarise in bullet point form:

• No training provided to audiologists to support people with tinnitus, barely touched upon in their degree
• They were devastated at sudden death of Professor David Baguley
• Debbie Featherstone is one of a few with a good track record for CBT and operates on a private basis
• Huge drop off in audiology degrees
• Most graduates go straight to private sector due to better salaries
• Huge drop off of overseas audiologists
• Government funding now at low levels

All of the above was sent to me in a private conversation. Obviously we are not privy to the mechanics.

 

I think he confused you with another poster. It is easily done.

I often see things I disagree with and I try to be subtle the way I disagree and leave some room for myself being wrong. We all have our own ways.

 

No @Stuart-T, I assure you I made no confusion. I just wanted to clarify this to you.

Take care,
Michael

 

@Stuart-T, maybe an idiosyncratic expression of heterogeneous personalities he harbours.

 

I had a sort of epiphany regarding the reasons for Michael Leigh's insufferably rude behavior after I read his post about how his lower back and sciatic nerve pain made it difficult for him to walk.

If you want to know how excruciating sciatic nerve pain is, please remember that the Spanish Inquisition applied it frequently by beating on the soles of the feet (which as a torture is still used in the Arab World, and called the Bastinado).

I used to be very irritated by him, but after considerating how he at times has sciatic nerve pain, lower back pain, and very severe tinnitus (perhaps all at once) I only now feel tremendously sorry for him.

I defy anyone to have the granitic fortitude to remain emotionally unaffected by the overwhelming invasiveness of any combination of these three terrible conditions.

The writer Graham Greene once said that hatred is really due to a failure of the imagination (which simply means that once you understand why a person is behaving this way, your end reaction is one of real compassion).

His reaction is entirely about him and not at all about you.