“ringing in the ear,” not just a senior problem

I THINK I’ve experienced tinnitus, “ringing” in the ear, but I can’t be certain, because I tried to ignore whatever it was. My mom often spoke of it, so I thought only elderly people heard “ringing” in their ears. And, of course, I was trying really hard not to get older. Looks like my reaction was the right thing to do.

According to an article in today’s Wall Street Journal, “A Most Annoying Ringtone,” many causes can be blamed for tinnitus. It can result from “hearing  loss-due to aging, exposure to loud noise, accidents, illnesses, auditory nerve tumors, wax buildup, drug side effects, history of ear infections, brain injuries from explosive devices, head and neck trauma, TMJ (temporomandibular joint disorder), or hormonal balances.” 

Tinnitus, from the Latin root word for “jingle,” is the perception of an external sound when none is there. It varies for people. Some hear a high-pitched buzzing, others hear a “ringing, roaring, hissing, chirping, whooshing or wheezing. It can be high or low, single or multi-toned, an occasional mild annoyance or a constant personal din.” Experts surmise that when hearing is lost in certain frequencies, the brain attempts to fill the void with noise that’s imagined or remembered. Audiologist Rebecca Price, who treats tinnitus in Durham, N.C., at Duke University’s Health Systems, says “Those auditory centers are just craving input.”

The CDC, Centers for Disease Control, estimated that 16 million American adults experienced frequent bouts of tinnitus in 2009. An estimated 2 million are unable to function normally when sleeping, working, concentrating, and interacting with family. Thanks to baby boomers, the elderly population is rising in numbers, as are the incidents of tinnitus. Remarkably 12-year-olds are also complaining of the ailment, according to Jennifer Born, speaking on behalf of the American Tinnitus Association, a nonprofit education and advocacy group. The culprit it seems might be “personal music players cranked up high.” Vets from Afghanistan and Iraq also suffer tinnitus, the “No. 1 service-related disability,” as a result of brain injuries from explosive devices.

Treatment for tinnutis runs the gamut from hearing aids to antidepressants. “The first step in treating tinnutis is usually to determine if a patient has hearing loss and to identify the cause…ear-wax buildup…infections, accidents, aging, medication side effects and noise exposure.” If loss of hearing is reduced, chances are it also dramatically reduces tinnitus, or at least makes it more tolerable for the sufferer, according to Sujana Chandraskhar, a otolaryngologist in New York and chairman-elect of the American Academy of Otolaryngology-Head and Neck Surgery.

Surgery can help as in the case of 42-year-old, New York, pipefitter Frank Scalera, who’s suffered tinnutis since age 15, when a firecracker blew out his eardrum. After 10 surgeries his hearing is restored, and the ringing he’s experienced for 30 years has lessened. Hearing aids help about 40% of patients because they restore “sound in lost frequencies, so the brain doesn’t need to fill in the void. But some also have hyperacusis–in which normal sounds seem unbearably loud–so a hearing aid may be uncomfortable.”

Sound therapy is another treatment option. Soothing external sounds are used to drown out the internal ringing. Some people  are relieved by running a fan, a humidifier, or a machine that emits the sound of waves or waterfalls. At night when tinnitus is most noticeable, thereby disrupting sleep, some even prefer to listen to the static on a radio. Hearing aids also intermix soft “shhhsssing” tones to mask the ringing. But these are not usually covered by insurance and are expensive at $2,500+ per ear.

More sophisticated, and costlier at $4,500,  is the Oasis by Neuromonics Inc. A device that is similar to an MP3 player, it “plays baroque and new age music customized to provide more auditory stimulation in patients’ lost frequencies as well as a ‘shower’ sound to relieve the tinnitus.” According to the company, the brain is gradually trained to filter out the internal noise. “Users listen to the program for two hours daily for two months, then the shower sound is withdrawn for four more months of treatment.” Duke University political science professor Michael Gillespie, claimed the device helped him after he got tinnitus from an ear infection. He says he became accustomed to hearing the music, and then his brain filled in with less irritating sounds.

Some people find tinnutis a cause for anxiety. As mentioned earlier, I identified the “ringing” in my ears with old age. I would’ve dwelt upon other illnesses associated with the elderly, making me a captive of my own fears. Luckily my bouts of tinnitus only last several seconds. “Researchers long theorized–and have now seen on brain scans–that the limbic system, the brain’s primitive fight-or-flight response, is highly activated in some tinnitus sufferers. Patients often have generalized anxiety disorder or depression and a few become suicidal; but its unclear which came first.”  Antidepressants or anti-anxiety medication can bring relief for some. Stress can bring on tinnutis, so that alternative health practices can be helpful, like yoga, acupuncture, deep breathing, biofeedback or exercise.  Supplements such as ginkgo, zinc, magnesium, as well as other over-the-counter remedies are advertised to relieve tinnutis, but are not supported by scientific research.

RTMS, repetitive Transcranial Magnetic Stimulation, a new magnetic pulse treatment has served to treat severely depressed patients for years. Some found that it also stopped the ringing in their ears. Patients feel the treatment is “like a mild tapping on the head and brings no harmful effects.” Brain scans are done to identify tinnutis. Those with severe cases are found to suffer abnormal “communication between parts of the brain responsible for hearing and maintaining attention.” Dr. Jay Piccirillo, a otolaryngologist at Washington University in St. Louis, likens rTMS to “shaking an Etch-a-Sketch to erase an old picture.” Pulses are sent through the skull by a magnetic coil that is placed over the auditory cortex outside the head, to disrupt the faulty communications.

Cognitive behavioral therapy has been found to be one of the most effective treatments for tinnutis. Patients are treated for their emotional reactions to the ailment, not the noise itself. ” ‘The goal is to make your tinnitus like your socks and shoes–you’re wearing them, but you’re not actively thinking about them,’ says Dr. Chandrasekhar.” Or as one patient, Mark Church, an entrepreneur and investor, put it ” ‘It’s like living near an airport. After you’ve lived there for a while, you don’t pay attention to the planes…’ ” Having lived with tinnutis for 11 years, Church favors being in his shower, where the water drowns out the noise. Duke University Medical Center psychologist Michelle Pearce, begins therapy by having her patients identify “the automatic negative thoughts they have about tinnutis.” One claimed no one would marry her, while others felt their lives were over. Working with them, Dr. Pearce helped them realize that their lives didn’t revolve around tinnutis, that it was only one aspect which could be managed.

The local, evening news ran a segment about the growing effects of tinnutis, especially amongst youngsters. At fault it seems is the ramping up of noise levels with the invention of  iPods and the like. Looks like what use to be an old age issue is now open to all ages. It’s not something I want for myself at 61, so it’s unfortunate that 12 year olds can now suffer “ringing” in their ears as well. It took me 50 years to experience what can affect them in their youth… if they’re not careful.

before their time, here’s hoping youngsters don’t get old…hugmamma.

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hugs for sharing some brief thoughts...and keeping them positive

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