“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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an expert, in my opinion

Since I’ve no other authors on my blog, from time to time I may reprint someone’s opinion other than my own, especially when my thoughts run parallel to his or hers. I’m a member of the AARP, having joined when I was invited some 6 years ago. We all have to place our faith in something, someone; I choose to believe that this organization is working for the overall benefit of people my age. AARP may not serve my specific interest in every instance, but who does? If I’m never served by them, then I can opt to make my voice heard, or opt out. So I share the following, which appeared in the Editorial Section of today’s Wall Street Journal, because I’m in favor of helping ALL seniors. In this economy, we may have bread on the table today, and be standing in the “bread line” tomorrow. So I opt to share my “bread” with the not so blest, now. Someone may share theirs with me, tomorrow. I think it’s called “paying it forward.” Wasn’t there a movie by that name? I think it garnered populous praise.

Obama Care Will Help Most Seniors

“How Seniors Will Pay for Obamacare” by John C. Goodman (op-ed, Sept. 23) provides a grossly misleading analysis of the health-care law’s effect on seniors and the value of Medicare to 45 million older Americans.

Of course, Medicare is not perfect. But the new law significantly improves it, with better benefits for prescription drugs (phasing out the ‘doughnut hole’) and the elimination of co-payments for a range of preventive services and screenings. It also advances high-quality care in traditional Medicare through an array of pilot programs that seek to improve patient safety, care coordination and treatment of chronic illness.

That is the big picture. These improvements can help all seniors, not just those who have opted for the private, government-subsidized plans known as Medicare Advantage. New quality bonuses, which we support, will also reward those Medicare Advantage plans that provide quality care.

Those who share our concern for low-income households should support the improvements to Medicare that help all needy seniors. By strengthening and improving traditional Medicare, we can ensure a more competitive marketplace that offers genuine choice to health-care consumers of all incomes.

No one understands better than AARP–or has worked harder to fix–the gaps in Medicare coverage. Despite widespread misunderstanding, the Patient Protection and Affordable Care Act takes major steps to achieve this goal.

John Rother, Executive Vice President, AARP, Washington

for ALL seniors, hugs…hugmamma.

hugmamma,m.d.

Here’s a bit of medical trivia. Just to set the record straight, I’ve returned to self-diagnosing my condition of a few days ago. Given my very close proximity to the patient, whose symptoms I’ve watched with extreme interest, it seems, in my “expert” opinion that I’ve been suffering from symptoms of “dry mouth.” Referring to my copy of  “The Merck Manual of Patient Symptoms”, it seems likely that my dry eyes, dry skin, rash on my eyelid and neck, and decrease in saliva may be owing to “dry mouth.” In my case it is probably due in large part to Claritin, an antihistamine I’ve been taking for a couple of months to combat allergies. Under GERIATRIC ESSENTIALS, the book claims that “…dry mouth becomes more common among the elderly,…probably due to the…many drugs typically used by the elderly rather than aging itself.” And I am getting elderly.

A walk-in-clinic physician at Philadelphia’s airport had prescribed Claritin. I’d been suffering allergy symptoms for some time, without realizing it. I know I’m affected by seasonal changes, but they seem to occur without my taking notice. Only after I’m forced to see a doctor for relief, am I aware that allergy season is in “full swing.” Not wanting to ruin my trip to Venice, I did as the doctor prescribed. Claritin was added to my daily intake of vitamin supplements. Who could know that it would cause an altogether different ailment, like “dry mouth.”

In the recent visit to my own GP, the symptoms hadn’t yet fully developed. So my doctor felt I was still suffering allergy symptoms and prescribed Benadryl when needed, in addition to continuing the Claritin. So after doing what I was told by 2 physicians, and still not  finding relief from the problem, I’ve decided to follow my own advice for now. I discontinued taking both antihistamines. We’ll see. As of now, my diagnosis and prescription seem to be working. Oh, and I should probably be getting more sleep, according to Merck. Well, that may be a difficult pill to swallow with my recent appetite for blogging. It’s now 2 a.m. 

I don’t take medical conditions lightly, although I address them with “tongue-in-cheek” humor. But I am a proponent of being an active participant in my own well-being. I heed expert advice, but I question it and continually assess my symptoms to make certain that my health is improving. Doctors offer their best-educated opinions in the moment, but they are not experiencing it first-hand. I know what I’m feeling all the time. I wish my medical team lived with me 24/7, but they don’t, so I’m the next best thing.

I can see the next patient now…hugmamma