Swiss ENT Visit Today — 13.11.2018

Ecip

Member
Author
Nov 8, 2015
687
Edmonton, AB/Switzerland
Tinnitus Since
4.11.2015
Cause of Tinnitus
Still unknown... possibly noise exposure?
@brownbear I tagged you because this may be of interest to you.

So, after having recently experienced another spike and having gone to my family doctor here in Switzerland for some kind of wise words (I dunno why...), she referred me to an ENT here in Landquart, Switzerland.

First impressions of the doctor: know it all, seen it all, bought the T-shirt, I'll dismiss your knowledge.

That said, the whole visit/procedure of diagnosis went quite a bit differently then it did in Canada, where I was in and out within 15 minutes tops, and all I got was a MRI this, X-ray this, and learn to live with it.

He did an examination of the TMJ, ears, nose, throat. He took blood to be analyzed for magnesium and vitamin D levels. He also did an audiogram up to 16'000 Hz as well as a noise sensitivity test, and an ear pressure/reflex test; all in house. See attached audiogram. The bottom lines show the sensitivity test, clearly showing that I'm not a fan of noise. Normal range, from what I remember him saying, is between 120 and 100. Low frequency sensitivity being at 70 dB confirms, to me, my suspicions that it is indeed the low frequencies that are most bothersome to me, which also seem to aggravate my tinnitus the most.

audiogram 13-11-2018.JPG


Then I filled out a bunch of questionnaires; the pretty standard forms checking whether you are depressed, and how tinnitus is affecting your life.

We chatted briefly about drugs; I mentioned whether he would be willing to Rx me Klonopin for those times when my tinnitus is unbearable, but he says that since there is no depression, and unless I want to become dependent, that he would not.
We've had a quick chat about Lidocaine IV, however, according to him, they've tried this 20some years ago, and the results were that it did not improve peoples tinnitus symptoms, and any improvements were surely placebo effect. This is contradictory to the reports that I've read to date.
He did offer me a lidocaine nerve treatment, however, which I agreed to and he administered. Basically, there are 4 points around the ear that are injected with lidocaine, in the hopes of freezing nerves, and seeing whether tinnitus improves. Apparently one would know right away. There didn't seem to be a large noticeable difference for me.

I explained to him how since the middle ear infection with otitis media that the tinnitus in my left ear is now louder and has developed a new tone; it is also now more sensitive to noise exposure. His response was that, from what he sees, that the tinnitus didn't get louder, but only my perception of it. I cringed at that answer. I know it's bullshit. I'm sure @brownbear can attest to this, now being an ENT with first hand experience of this shit fuck bullshit tinnitus.

Moving on; he asked about Ginkgo Biloba, as my family doctor wrote in the referral that she suggested me taking it. I have been taking the supplement now for a month, and just like last time (2 years ago) when I tried it, it didn't show any beneficial effect. Maybe a bit better with the ol balance? I don't know. ENT suggests to discontinue with Ginkgo, as it didn't show any benefit.
He did, however, give me this other supplement to try. It's called relaxane, and is used for nervousness and anxiety. Supposed to calm you down, or something. I'll give it a shot, what could be the worst that will happen..

Lastly, he said, that since the audiogram indicated a sensitivity to noise without any substantial hearing loss that this is usually indicative of a psychological problem, and that I would be the expert in this, and will have to ask myself what it is that is bothering me, and that this would be an area of treatment to be explored (yea i tell you what's bothering me internally... TINNITUS...). He suggests that things like this are usually expressed in dreams, and that I keep a pen and paper handy on my bedside, and if I wake up at night and remember a dream to write it down. I am to bring it with me for my next appointment in 1 weeks time, and he'd go through it with me, and also discuss the lidocaine nerve treatment to see if there were any positive results.

So, this is where I am at now. Certainly, there was more time taken during the visit to this ENT (probably 1 to 1.5 hrs) VS the 15 minutes with the ENT in Canada.
I am, however, disappointed with lack of... I don't know.. empathy (?) by him. As well as the repetitious "Ohh your tinnitus isn't louder, just the way you perceive it".
I do appreciate him taking his time though, and, although I'm not a big believer in the whole psychological cause of tinnitus, I am willing to explore that route, and to dig through my psyche to release the gremlins.
 
He also did an audiogram up to 16'000 Hz as well as a noise sensitivity test, and an ear pressure/reflex test; all in house.

Playing with fire here!


We chatted briefly about drugs; I mentioned whether he would be willing to Rx me Klonopin for those times when my tinnitus is unbearable, but he says that since there is no depression, and unless I want to become dependent, that he would not.

So he offered you an option to occasionally get some relief when it gets to crazy, but then denied you?

We've had a quick chat about Lidocaine IV, however, according to him, they've tried this 20some years ago, and the results were that it did not improve peoples tinnitus symptoms, and any improvements were surely placebo effect. This is contradictory to the reports that I've read to date.

Should have asked him where he got this because current research has shown that is does reduce or eliminate tinnitus in some people for a short time

He did offer me a lidocaine nerve treatment, however, which I agreed to and he administered. Basically, there are 4 points around the ear that are injected with lidocaine, in the hopes of freezing nerves, and seeing whether tinnitus improves. Apparently one would know right away. There didn't seem to be a large noticeable difference for me.

I never heard of lidocaine nerve treatment? Is this something different than typical Lidocaine injections, which has reduced peoples T?

His response was that, from what he sees, that the tinnitus didn't get louder, but only my perception of it. I cringed at that answer. I know it's bullshit.

Oh lord, I would have given him a talking to if he said this bullshit to me.

He did, however, give me this other supplement to try. It's called relaxane, and is used for nervousness and anxiety. Supposed to calm you down, or something. I'll give it a shot, what could be the worst that will happen..

Do some research before taking it. Did he sell it to you directly from his office? Sounds like a conflict of interest.

Lastly, he said, that since the audiogram indicated a sensitivity to noise without any substantial hearing loss that this is usually indicative of a psychological problem, and that I would be the expert in this, and will have to ask myself what it is that is bothering me, and that this would be an area of treatment to be explored (yea i tell you what's bothering me internally... TINNITUS...).

Did this doctor get his degree in triggering people? lol

He suggests that things like this are usually expressed in dreams, and that I keep a pen and paper handy on my bedside, and if I wake up at night and remember a dream to write it down. I am to bring it with me for my next appointment in 1 weeks time, and he'd go through it with me, and also discuss the lidocaine nerve treatment to see if there were any positive results.

Oh, I didn't realize this guy is an ENT and a psychiatrist. Seems like psychiatry is out of his field of practice since he is an ENT. Idk how he thinks he can be a psychiatrist too if he doesn't understand something in his own field like tinnitus.

I do appreciate him taking his time though, and, although I'm not a big believer in the whole psychological cause of tinnitus, I am willing to explore that route, and to dig through my psyche to release the gremlins.

I agree that our emotions play a big roll in tinnitus, I don't think this guy is the right person to see for that. Best not waste your money going back and see a real psychiatrist if you want help with the emotional aspects of tinnitus.

I don't mean to be sassy in my response to your story. I am just angry that "doctors" still act this way instead of admitting they don't fully understand it. Medial doctors need to be educated about it just as much as the general public.
 
I don't mean to be sassy in my response to your story. I am just angry that "doctors" still act this way instead of admitting they don't fully understand it.
THIS. If medicine doesn't know some things yet, so be it. But don't make stuff up and present it as gospel, doc! That ruins lives!
 
THIS. If medicine doesn't know some things GS yet, so be it. But don't make stuff up and present it as gospel, doc! That ruins lives!

Majority of doctors I know has a superiority complex where they have to know everything. If a patient brings up something they don't know or something that might questions their knowledge they shoot it down regardless if it is valid.
 
So he offered you an option to occasionally get some relief when it gets to crazy, but then denied you?
No, he never offered anything, other than MAYBE a sleep aid when I can't sleep due to a spike.

Should have asked him where he got this because current research has shown that is does reduce or eliminate tinnitus in some people for a short time
Apparently he was involved in the research.

Do some research before taking it. Did he sell it to you directly from his office? Sounds like a conflict of interest.
Yes, but all medications are directly given to you at the doctors offices in Switzerland, unless they don't have it in stock, in which case you can go to a pharmacy.

Oh, I didn't realize this guy is an ENT and a psychiatrist. Seems like psychiatry is out of his field of practice since he is an ENT. Idk how he thinks he can be a psychiatrist too if he doesn't understand something in his own field like tinnitus.
Well, he would refer me to a shrink.

Majority of doctors I know has a superiority complex where they have to know everything. If a patient brings up something they don't know or something that might questions their knowledge they shoot it down regardless if it is valid.
Very much so.
 
Calls himself a "tinnitus specialist"...

ENT doctors are not "Tinnitus specialists" they are physicians, that treat the Ear, Nose and Throat. In most cases they are able to treat an underlying medical problem within the auditory system which is causing the tinnitus. Many ENT doctors have never experienced tinnitus. If they have it is unlikely to be anything long-term or to the severity that most people who visit tinnitus forums experience. Therefore, they can never fully understand or be able empathize with what someone goes through that has moderate, severe, intermittent or fluctuating tinnitus.

When there is no underlying medical problem causing the tinnitus, a patient should be referred to a Hearing Therapist or Audiologist that specialises in the treatment and management of tinnitus and hyperacusis. There are a variety of treatments available. It is not unusual to find, some of these health professionals were either born with tinnitus or acquired it at some time in their life. They will be able to empathize and have an understanding of tinnitus that an ENT doctor will not have, especially when counselling /talk therapy is involved.

Michael
 
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