Tinnitus and Medical School

Hello everyone,

I am 28 years old and I have an interview for a top 50 medical school in March. However, I'm worried that my tinnitus would distract/stress me too much to achieve my goal of being a doctor. However, I have a strong support system and will do my best towards that goal. Throughout my future medical career, I will attempt to educate my colleagues about the physical and mental effects of tinnitus so that they can better treat patients of our condition.

What are some very helpful tips that may help me cope with my tinnitus better so I can study for classes/exams? What are some strategies that worked with you? Which sound therapies would you recommend?

My tinnitus started after a severe cervical neck injury due to a gym accident. My tinnitus was raging at first but subsided to half its volume. I had an MRI of my neck done and turns out I had a lesion in my cervical spine from the injury and the inflammation spread to the brainstem. If I could give some insight, I believe my tinnitus damaged the auditory nerve that connects to the brainstem, more specifically the inferior colliculi. The inferior colliculi is responsible for filtering out background or nonimportant noise so your brain can focus on what is important.

The initial damage to the nerves can lead to inflammation in the brainstem region to damage the nerves. Inflammation is your body's response to foreign objects but also to injury to removed damaged tissues/cells. Inflammation in the brain or spinal cord can lead to a prolonged fight or flight response as nerves are damaged. Inflammation near the auditory nerve by the brainstem can most likely lead to tinnitus and hyperacusis as neural connections are broken or damaged. That is why Prednisone is so effective early on for tinnitus, it stops the inflammation process to prevent further damage and promotes healing of the nerves(steroids are often given to spinal cord injury patients after a trauma). Once the inflammation decreases, then the fight or flight response starts to go away and healing can presume. However, these neural connections may take months or years to return.

Going back to my earlier point. Since I likely damaged my auditory nerve or my inferior colliculi due to my injury, my brain's ability to filter out background noise has been affected. This can lead to my hyperacusis as my brain can't shut down or ignore background noise as well. Lost connections from auditory nerves in the brain to the hair cells in the inner ear can lead to inner hair cell death and feeling of fullness in the ear due to an inflammatory response (removed dead cells). My theory on why everyone's tinnitus is different(some more severe than others) is because those with greater exposure to noise such as those who go to concerts often, those with age-related hearing loss, have increased ability to filter out noise due to increase activity in the inferior colliculi from experience. I believe everyone is habituating to very minuscule amounts of tinnitus throughout their life as their inner hair cells die due to different reasons. However this process is so small that we never really hear it or are aware that it is happening. However, as the brainstem/auditory nerve is damaged, the ability of the brain to filter out noise through decades of habituating is diminished.

The good news is that... I believe the brain can start this process all over again through neural plasticity and rearrangement. Hopefully...

 

Hi @Tiumix.

Tinnitus is a very common condition that comes in many forms and intensities and no two people will experience it the same. Many people have it mild to moderate and able to carry on with their life doing everything that they want to. Mention tinnitus to a friend, work colleague or family member and a typical reply will be: "I have that and just ignore it". "I only hear it at night when it's quiet". "I learnt to live with it". Some people jokingly say theirs plays a funny little tune and so the story goes on.

Tinnitus can seriously disrupt some people's quality of life and this may require professional medical help with managing it. You have said that you have good support system so that is in your favour. It all depends how severe your tinnitus is and whether it is intrusive enough to prevent you from studying? This is something only you can determine. Don't let difficulty stop you from pursuing your goals because it's better to try and fail than not to try at all.

Some time ago my ENT consultant told me one of her medical students has tinnitus. Although he has missed attending some lectures because of it, she is very understanding and told me, she admires his determination and tenacity to forge on and not give up. I suggest you try doing the same. Life is problematic and we all have problems. Often we are a lot stronger than we think. Try to focus on the positive things in your life and this will help to remove and dispel negative thinking and worries that can hinder or completely stop a person from reaching their full potential.

Please go to my started threads. Read and and print the following posts and refer to them often. This will help to reinforce positive thinking: New to Tinnitus, What to Do? Tinnitus, A Personal View, Tinnitus and the Negative Mindset, Acquiring A Positive Mindset, Is Positivity Important? From Darkness into Light, The Habituation Process. Inspiration, The Big Picture, Staying Positive with Tinnitus.

I wish you well.
Michael

 

To Tiumux:
Your very knowledgeable display of anatomy, physiology, etc. clearly substantiates your comment about eligibility for Medical School.

Pay no attention to Michael Leigh's hackneyed, sententious drivel (especially his laughably overweening instructions to "refer to his posts often", as if they contain something of inestimable value). He has virtually no legitimate medical (or otherwise) credentials for dispensing advice. I am sure that you have already covered for yourself his tiresome preaching that you need to be exponentially stronger to cope with this. And please, do not be influenced if he starts insisting on his TRT quackery.

Have you had a hearing test? Hearing Aids may actually reduce or even cover the tinnitus sound, although they are really a crapshoot; the spectrum of responses has ranged from complete elimination to a worsening of the tinnitus.

Also, visit an Audiologist and check out the Hearing Aid Manufacturer Widex. They offer a set that provides a white noise masker sound. I have these, and often in a quiet setting such as a library or lecture room they cover the irritating tinnitus sound with a soothing, pleasant one. It will blend in with, for example, the sound emitted by the overhead HVAC System. Although this is only a sporadically effective palliative, it has enabled me to endure exposure to many deeply quiet environments that I would otherwise have been forced to flee from.

Since you exhibit the real knowledge of a Med Student, I ask you this: I have Migraines, and amazingly when one develops the tinnitus disappears for the duration of the Migraine episode. Any theories about why?

 

How would "tinnitus damage a nerve?"

Explain that, doc?

I would argue that tinnitus can be the result of damage to auditory nerve. Maybe you meant that?

I speculate here: damage from acoustic trauma, physical trauma of some kind and if ototoxic products damage hair cells or?

 

Hi @Tiumix,

Your ability to thrive in medical school will be completely determined by the severity and type of tinnitus you suffer.

Your question regarding strategies to help with concentration during study will be universal to all but the mildest of tinnitus sufferers, so you've come to the right place for help with that.

Personally, my approach to remedying the distracting nature of tinnitus has been to do "nothing" and just listen to it as often as possible, without masking. After a couple of months of listening to my tinnitus in quiet rooms 24/7, I was able to read books again without problem.

That said, there are others here who use fans (and other forms of masking) while studying/reading to help take the edge off. So that might be something to try before committing to my approach.

There is however a bigger issue here highlighted by your question, which addresses my earlier point of exactly what type of tinnitus you suffer from.

You see, I myself was encouraged to go to medical school in my early 20's, however by that point I was already suffering severe reactive tinnitus and hyperacusis. As I said, concentration wasn't an issue, as I was fully habituated, but the reactivity served as a massive obstacle.

The more I spoke to past/current medical students, the more I realised this route would be an impossibility for me, due to the requirement of having to work in an actual hospital during my training.

Suffering from reactive tinnitus, my time spent in hospitals as a patient and a visitor has been unpleasant enough, due to the noise levels experienced within them.

I don't know what hospitals are like where you're at, but over here in the UK, the internal noise staff are exposed to daily has become nothing short of an occupational hazard: Hospital noise levels growing worse, say researchers - BBC News.

So, for me, completely off the cards. For you, I don't know. If your tinnitus is (mostly) static, unaffected by external noise and concentration is your biggest concern, then go for it. Because studying/working despite the noise in your head is something that most of us can master over time. Not having our tinnitus made worse by our environment on the other hand, is something we have no control over.

Let us know what happens.

 

Congratulations! I know how tough MCATs are. I took one years back and failed.

Download 2-3 white noise apps on your iPhone and see what works for you. Pink noise works best for most.

White noise will be your best friend in school.

Can you hear tinnitus when people are talking? I am just thinking how you would handle lectures.

My 2 cents. Never go to concerts or live music events. I made the mistake of going once and my tinnitus came back with vengeance. I was lucky that it subsided after 3-4 months.

Best of luck.

 

This happens to me frequently.

When I'm having a migraine I'm glad (if you can put it that way) because I get to take a break from the annoying tinnitus.

I guess one discomfort/pain cancels the other because the brain can't focus on both of them at the same time

 

To aura:

Very insightful regarding the brain's capacity to only have "room" to be preoccupied with one massive assault at a time.

I finally have a (sort of) solution for tinnitus.

MSG (Monosodium Glutamate) will trigger my Migraines. The product Accent is a flavor enhancer that is essentially comprised of this chemical compound. Perhaps I should purchase several containers and regularly ingest this; the inception of the Migraine will cancel out the tinnitus sensation.

I can then regularly take the drug Maxalt, which eliminates the Migraine pain.

After I have published these findings in a Medical Journal, perhaps I will even be awarded the Nobel Prize for Medicine in having proposed such a novel, innovative method.

 

I’d imagine all the COVID-19 hospitalization that were/are happening haven’t made it any better...

It’s a shame regarding your previous path to medicine though... Dr. Damocles sure has a nice ring to it, no pun intended...

 

@Tiumix, best to you on your application to med school. I am in doctoral program in a different field. I have talked to my physician several times about my tinnitus and he said he also has tinnitus. He does well with his practice and has said he has had tinnitus for several years. He has a happy demeanor and seems to function very well I hope this encourages you as you pursue your goals.

twa

 

Nobody-nothing.

Migraine and tinnitus fighting over my mental health.

Brain: "One at a time, boys, one at a time! The night is still young!"

Smooth. Maybe you should apply for medical school too.

 

@twa, how are you feeling these days?

 

@twa, congratulations on your doctoral program.

You always show pleasantry towards others.

 

I'm doing pretty good most days. I have some other things with arthritis and dizziness, but I keep pressing on. I do what I can to adapt and practice circumlocution (see my post on accommodations/modifications).

Hope you are doing well!