Why Is My ENT Doctor Useless?

Why is my ENT Doctor useless?

Over the years I have read many posts at tinnitus forums. Therefore, it is of no surprise to see familiar questions and comments recurring especially by those that are new to this condition. Understandably, some people are in distress and are seeking help. They want reassurance that all will be well. Many want to hear the right answers to their questions or at least their version of it because anything less doesn’t compute. Will it go away? How long does it take to habituate? Will I get my life back? When will a cure be found? The list goes on.

In addition to this, I often hear people say that their ENT doctor doesn’t understand their tinnitus or what they are going through. After all, they are supposed to be the experts right? 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 having various tests have been done on their auditory system only to be told by their doctor, that no abnormalities where found. The advice given is to leave things as they are for now and see what happens.

Some people don’t believe in the wait and see approach and have even said their ENT doctor is completely useless when no help has been offered. Whilst everyone is entitled to an opinion, I don’t agree with this statement. However, I do understand how one can come to this conclusion, especially when the bedside manner of some doctors leaves a lot to be desired. This needs to improve if a patient is to feel proper care and consideration is being afforded to them, because we know that tinnitus can be very debilitating when severe and can affect one’s emotions considerably.

The ear is a very delicate organ and if there is no underlying medical condition causing the tinnitus, such as: pain in the ears, deafness and dizziness or balance problems. The advice to wait and see what happens is usually correct. Many people learn to habituate within the first six months sometimes a little longer and it has been known go completely away. Too early an intervention could make matters worse.

In the early stages of tinnitus, it is not unusual to experience stress, anxiety and even some depression. These symptoms usually improve with time. Having a word with your GP about this can be beneficial, as medication can be prescribed to help you cope and they don’t have to be taken long term. I am a believer in using sound enrichment; during the day and especially at night. Whether this is via a dedicated sound machine or playing low-level non-intrusive music by the bedside. The volume level set to just below the tinnitus.

ENT doctors are important health professionals and I have a lot of respect for their skill and expertise. They know all about the anatomy of the ear and are able to treat it medically or surgically. However, in my opinion they are not tinnitus experts, which I believe calls for another set of skills that the majority of them don’t have. This is the ability to know, understand and empathize, with what a tinnitus patient is going through when the condition is loud and intrusive.

My consultant is an Audiovestibular physician whom I have a lot of respect for. She once told me that I know more about tinnitus than her. She explained because never having experienced it. For this reason, when there is no underlying medical condition causing the tinnitus a person is sometimes referred to a Hearing Therapist or Audiologist trained in tinnitus management.

This can involve counselling, wearing devices such as hearing aids or white noise generators. Treatments such as TRT, CBT and Mindfulness and relaxation therapy can also be helpful. These health professionals help their patients by showing them a way forward and demystifying a lot of the negativity that surrounds this condition. Not surprisingly, this level of understanding and empathy doesn’t always come from training alone, for some of these people also have tinnitus. Over the years I have met quite a few Hearing Therapists and Audiologists at tinnitus Internet forums helping people. At some point they have relayed to me that they have tinnitus or were born with it as my hearing therapist was.

Michael

 

It's kind of funny in a sad way. A lot of tinnitus sufferers are so knowledgeable about tinnitus, they read about it obesseively, know there's no cure, and then make an ENT appointment and get mad their ENT can't fix them. wtf?

 

This is a wise and thorough post, @Michael Leigh, and I thank you. I think the "all ENTs are worthless" comments come out of frustration, especially if you are new to tinnitus and don't understand exactly what is involved.

The only thing I will add: Some ENTs are very ill prepared to handle the emotional tidal wave that comes with telling patients that this condition driving some of them to panic may be permanent, that there is nothing they can do, and they will "have to learn to live with it." My initial diagnosis came from an ENT who was dismissive and, then, angry when I continued to express how I didn't understand how I was going to be able to live with this condition. He basically said, "you'll get over it," indicated the appointment was over -- and then left on a three-week vacation with no follow up. At that point, I considered suicide my best option. Thanks, doc.

ENTs need to be trained on the proper way to deliver a tinnitus diagnosis and to let their patients know that, while there are no cures, that there ARE things than can help them effectively manage their condition. CBT, sound therapy, meditation, masking, etc. Refer them to Tinnitus Talk, for goodness sake. Be supportive and comforting. If the docs are uncomfortable with all this touchy feely human stuff, then they should designate and train someone on their staff to do it.

Again, thanks for the support and information you offer to all here. Michael.

 

Well, when they are of no use , they are kind of useless...right ?
There seems to be common complaint amongst T sufferers that their ENT's are dismissive and of no help, apart from not being able to heal T, they seem to offer nothing at all.

One ENT I went to said , " here , take these pills , they will relax you...promise that you will not kill yourself by eating all of them, lots of people kill themselves because of Tinnitus".

That was sort of useless info .

Also , I have been to 4 ENT´s so far , none of them seem even mildly interested in following any advances in this field , all are dismissive and utterly useless.

 

@LadyDi
Thank you for your kind comments LadyDi. I am sorry to hear of the experience that you had with your ENT doctor. I fully agree with you that more understanding and an improved bedside manner from ENT to patient would go a long way in making people have more confidence in them. As I have previously mentioned, I respect ENT doctors for their knowledge of the anatomy of the ear and are able to treat it medically or surgically. However,the majority of them know nothing about tinnitus as my consultant admitted to me . I have known her for many years and have much respect for her as an Audiovestibular physician.

However, I believe the true tinnitus experts are the Hearing Therapists/Audiologists who help tinnitus patients to manage the condtion better using a variety of treatments that are available. It is not unsual to find most Hearing therapists/Audiologists, that treat tinnitus patients also have tinnitus. I believe people that are knowledgeable about this condition can be found in forums like Tinnitus Talk. In these places they are able to give advice that will hopefully help others.

Michael

 

Were I a Junkie I'd be wanting to see this guy. mmmmm. pills.

 

Some ENT's are really just nose and throat doctors that put the E at the front because NT doesn't sound as cool.

 

I've been to two ENT's and 3 neurotologists. The neurotologists were very knowledgeable as they worked in tinnitus research. One of the ENT's was helpful offering me prednisone and even IT prednisone. The 2nd ENT seemed more concerned about my deviated septum than the acoustic trauma that I had just endured days earlier.

 

I laughed out loud when I read the title for this thread. It doesn't surprise me. I'm a nurse. There are good and bad doctors in every field. I don't expect my ENT to fix my tinnitus, just tell me if there is any obvious damage and if not I will move on to the neurological factors that could be involved.

 

The things that come out of some peoples mouths...

 

Last March when I first got tinnitus, I went to the ENT about a week after I joined this site and foolishly thought he could wave a magic wand and get rid of my tinnitus. Once he checked my ears and said "all clear", that pretty much eliminated his role in helping me.

Unless an ENT is also a researcher, they know about as much about tinnitus as you the reader does; they cannot offer a cure. Basically, what they do tell you is to live with it, aka "habituate" - and I did.

 

I just hate to admit my life is over, Ive survive breast cancer and know That, I'm 57 and not anyone cares that this noise in my head and ear is making me want to die.I believe in God, but even cancer their is some help.I just want to die to stop this.No Hope. ENT say live wit it,. I'm not living and hearing loss, don't know what the hell Gon happen

 

@Brenda Gander

I've had t for just under 3 months. It's not as bad as it was the first month but it could be better. Give it some time and things can improve. t is going to test you every day for a while and you have to do your best to stay strong but accept the times when you're not. Right now try to focus on what you can do to make it through the day. Don't think about yesterday, don't think about tomorrow. Just get through the day. People on the forum with t a long time assure me that in time we'll get our life back. I wish you success.

 

Brenda Gander , I see you wrote viral infection as your cause. I seem to have cut my T in half by using Acyclovir 800 mg a day along with 6 lipo flavanoid a day , 400iu Vit E , 500mg Vit C , 1000iu Vit D. If you can't get access to acyclovir you can do L-lysine . Just saying what has recently worked for me. Only took 3 days and it's been a week of low T after 14 straight months of very high T. I don't think it's a coincidence. Everybody is different. You may want to explore the herpes -tinnitus connection. If anything keep reading and reading till something resonates. Stay busy as possible. You will habituate , usually takes a year. Your mind will learn to shut it out when your busy . Protect your ears at all costs from loud noises. Even vacuuming the floor were ear plugs.

 

@Brenda Gander
I am so sorry to read your suffering so much.
Firstly, congratulations on surviving cancer. You are a warrior.
Tinnitus is mentally challenging especially in the early days.
Thing will get better, people told me this when I first got tinnitus, but I couldn't see how. I am so much better. I was suicidal as well, I can't believe I felt so bad, but I did!
If you have hearing loss, a pair of hearing aids might help to reduce the tinnitus.
An anti depressant might help if you are really struggling, but it's still early days for you.
Take care and fight on. You can do it.

 

HI @Brenda Gander

Many doctors do say "learn to live with it" Brenda. Please go to your GP and explain how you are feeling and hopefully, more understanding will be given to you and you'll be prescribed something to help with your moods. You are in the early stages of tinnitus and this can be a difficult to cope with but things usually improve with time. Please read the post below and click on the links.

Hope you start to feel better soon.
Michael

New to tinnitus what to do?

The onset of tinnitus can be difficult for a lot of people to cope with. It comes in many forms and intensities and no two people experience it the same. When it is mild, moderate or occasionally heard in quiet surroundings it is usually not too bothersome and a person can go about their daily affairs quite happily and unperturbed by this anomaly. This type of tinnitus usually comes on gradually and in some cases it’s associated with hearing loss, as we get older and the usual treatment is the wearing of hearing aid/s.

Tinnitus can be also be caused by an underlying medical problem, build up of ear wax (cerumen). Jaw problems. Some medications and even irregular blood flow through the body causing Pulsatile tinnitus. One of the most common causes is exposure to loud noise or music that has been played at high levels that can affect the cochlea in the ear. This type of tinnitus can be loud, intrusive and very debilitating. Often leaving a person at a loss and not knowing which way to turn to escape the noise. I fully understand how difficult it can be for someone new to this condition to take this in and believe it to be factual.

If you are having difficulty sleeping you might have been advised to try a nighttime sedation or an ant-depressant to help cope with the stress and anxiety that often accompanies tinnitus. These medications can be helpful especially in the early stages and they don’t have to be taken long term, so it’s something to consider. They can act as a safety net so you don’t become too down.

A referral to ENT will usually be recommended. In the mean time try to keep occupied with something you like doing, as it helps to distract the brain from focusing on the tinnitus. Avoiding quiet rooms during the day by playing low-level non-intrusive music such as classical in the background can be helpful.

At night a sound machine placed by the bedside playing nature sounds or listening to favourite mp3 tracks or Cds are good. Keeping the volume just below the tinnitus is ideal and set to play throughout the night until morning. It takes time to get used to sound therapy so please stay with it. Whilst in a deep sleep it supplies the brain and auditory system with sound enrichment. Over time the tinnitus is pushed further into the background helping to make its perception less noticeable during waking hours.

In the early stages of tinnitus, if one chooses not to use sound enrichment sleeping can sometimes be difficult and there is also the chance of the tinnitus becoming more intrusive as sleeping in a quiet room can allow the brain to increase it’s own background activity. In doing so it will also increase the tinnitus making it more intrusive during waking hours.

There is a tendency for newbies to try and cure their tinnitus which is quite understandable. There are many remedies, treatments and concoctions out there. Some affordable others quite expensive. I am not averse to trying to help myself but want to say, there are charlatans and con artists eager to relieve someone in distress of their money so please be careful. Even tried and tested treatments I wouldn’t recommend a person try until they have been seen at ENT. Often a person after been seen at ENT is advised to wait a while.

Many people habituate to tinnitus within six months sometimes a little longer and it has been known to go away. The ear is a very delicate organ and many Doctors prefer to wait before investigating further and then suggesting a treatment. If other problems are experienced such as: pain in the ears, deafness, dizziness or balance problems this is of more concern and a person will usually been seen quicker.

It is best to have a word with your GP if you’re feeling stressed or depressed in any way, as previously mentioned there are treatments available. Leaving things alone until your ENT advises you of the next step is the best thing to do in my opinion. Don’t try to fix anything or throw large sums of money at treatments that you have no way of knowing whether you’ll get any relief.

I advise not to listen to audio through headphones even at low volume especially if the tinnitus was "noise induced" and keep away from loud sounds. By all means go out but anywhere that plays loud music then wearing noise-reducing earplugs, the type that has attenuation filters would be a good idea. 18 to 30 decibels reduction should suffice. While reducing external sound they will not impair sound quality.

Michael

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

https://www.tinnitustalk.com/threads/is-positivity-important.23150/

https://www.tinnitustalk.com/threads/tinnitus-and-the-negative-mindset.23705/

https://www.tinnitustalk.com/threads/acquiring-a-positive-mindset.23969/

https://www.tinnitustalk.com/threads/the-habituation-process.20767/

 

@Brenda Gander

Please take Michael's Advice about Sound Enrichment. It saved me when I was new(er) to t and couldn't stop focusing on it. Get yourself a Sound Oasis S5000 for the bedside and perhaps an S650 to bring with you in the house. Eventually you may not need them but right now they will help you make it through.

The S5000 makes going to sleep something I look forward to assuming I'm tired. You can just zone out and listen to your favorite sounds. I like the stream.

Brenda, you're going to get through this. You're going to do it.

 

Some wise words there from Michael L. In my own personal experience, ENT doctors have limited time with patients and are happy to refer to the audiology team for tinnitus (and hyperacusis) management. (Most) patients are content with this, reassured that there is nothing physically wrong with their ears (or if so, have the necessary investigations) and appreciate the time spent by audiologists.

Obviously it depends where you are and what expertise is available locally. Many ENTs are general consultants whilst others sub-specialise in otology, rhinology, throat and voice, balance disturbance etc. Then there are SpRs and SHOs who form part of a consultant's team. And again, some are more knowledgeable or interested than others.

Again, in my experience, many ENTs don't really want to counsel patients with hyperacusis or TTTS and are happy to leave these to audiologists.

Sadly, the expectations of many patients are too high and therefore are more disappointed if a physical cause can't be found for their symptoms