Saturday, September 30, 2006

Tinnitus on the rise due to increase in noise levels

It is no wonder that tinnitus is on the increase, especially amongst younger people. Our ears are assailed daily by noise levels that they were not designed to cope with. It is often said that we have a stone-age body in a 21st Century world. Our ears are capable of picking up tiny sounds that were important for survival in the natural world, for example awareness of prey or predators some distance away.

But if you look at the chart below you can see that many every-day noises such as busy city-centre traffic or even a lawnmower can produce noise levels which, if you are exposed to for too long, can cause hearing damage or even tinnitus. If we take more extreme examples such as a rock concert or nightclub then you can see that hearing damage can occur very quickly. It will come as no surprise then to discover that many performers and disc jockeys suffer from hearing loss and tinnitus.

The chart shows noise levels measured in decibels (abbreviated dB) so here is a brief explanation for anyone unfamiliar with the terminology. The term actually comes from the name of the inventor of the telephone, Alexander Graham Bell, and the measurement has to take account of the huge variation in intensity of the range of sounds we can hear. So if we take a really quiet sound like a watch ticking or leaves rustling and compare with a loud jet like Concorde at takeoff, then the difference in the power of the sounds is about 1,000,000,000,000 times!

So on the decibel chart, 0dB is near total silence but 10dB is ten times more powerful and 20dB is 100 times more powerful, 30dB is 1000 times more powerful, and so on. A hairdryer at 80dB is one hundred times as loud as normal conversation at 60dB. A rock concert of 120dB is a million times as loud as normal conversation.

Any noise above 80dB can cause hearing loss and the loss is related to the power of the sound and the length of time you are exposed. It is no accident then that from February 2006, the new noise regulations lower threshold for the workplace, when ear protectors must be made available, is reduced from 85dB to 80dB. However, legislation will not apply to the music and entertainment industries until 2008 so avoid excessive noise if you are off to a rock concert and take earplugs with you. This particularly applies to existing tinnitus sufferers. Earplugs can improve the clarity of the sound in these conditions and make conversation easier.

Any exposure to noise above 140dB will cause immediate hearing damage.

Despite the risks, it is amazing what lengths some people will go to in order to create deafening sounds. The current fashion is to install stereo systems in cars with more amplification power than the Rolling Stones used to use to fill a stadium. The stereo is probably worth more than the car but we can predict with certainty that the owners will have hearing problems later in their lives.

Diagnostic Approach to Tinnitus


I've found a comprehensive article about Tinnitus diagnostic on a level of doctor of general practice. Few accents: vibratory tinnitus: vibrations from adjacent tissues are transfered to cochlea. pulsating t. arises from vascular disorders: aneurysms, acquired arterio-venous shunts Pulsatile t., unilateral t. and t. associated with other unilateral ear problems speak for an organic cause. Subjective t. (heard by patients only) mostly arises from the same condition as the hearing loss: eardrum perforation, noise exposion... Some other causes: Psychologic, Anemia, Thyroid disorder, Drugs: Aspirin, Gentamycin, Furosemid. Lead, mercury. Multiple sclerosis, nerve tumors. Objective t. (heard with stethoscope): Patients tipically have vascular abnormality, neurologic disease or eustahyan tube dysfunction. Diagnostic: otologic examination, sound tests, audiometry. Blood tests (minerals, cells, hormones), MRI (tumors) Notice: *Not all subjective tinnitus have a psychologic cause.* Read the article.

Friday, September 29, 2006

Varying success for medications to relieve Tinnitus

Many medications have been tried to relieve tinnitus with varying degrees of success. Tricyclic antidepressants, such as amitriptyline and nortriptyline, have been used with some success, but these medications have troublesome side effects, such as dry mouth, blurred vision and constipation.

Two recent clinical trials found that the migraine medications gabapentin (Neurontin) and acamprosate (Campral), a drug used to treat alcoholism, are effective in relieving tinnitus for some people.

Treatments with limited results
Some other treatments that have been tried, but which have had inconsistent results, are:

  • Acupuncture
  • Hypnosis
  • The herb ginkgo
  • Cochlear implant, an electronic hearing device
  • Electrical stimulation
  • Medications, such as benzodiazepines (nervous system depressants) and baclofen (a muscle relaxant)
  • Hyperbaric oxygen chamber, a therapy to get a high level of oxygen in your blood
  • Zinc

Prevention of Tinnitus

Because tinnitus and hearing loss can be permanent conditions, precautionary measures are advisable. If a ringing in the ears is audible after exposure to a loud environment such as a concert or work place, it means that damage is being done. Prolonged exposure to noise levels as low as 70 dB can result in damage to hearing . If it is not possible to limit exposure, wearing earplugs or ear defenders can be advantageous. For musicians and DJs, special musicians' earplugs can lower the volume of the music without distorting the sound and can prevent tinnitus developing in later years.

It is also important to check medications for potential ototoxicity. Ototoxicity can be cumulative between medications, or can greatly increase the damage done by noise. If ototoxic medications must be administered, close attention by the physician to prescription details such as dose and dosage interval can reduce the damage done

Tinnitus : Masking for symptomatic relief

A sound with higher decibel can mask the low decibel sound of tinnitus. This can be illustrated below:

Sound from surrounding Environment: A TV programme running in the background is often helpful when the tinnitus is disturbing.

Some examples of masking due to environmental sounds are:

Playing with friends, surfing on a beach, festival and other celebrations.

A "Walkman" or “Ipod” can be used with plug-in-ear earphones; which can be switched on when resting.

Modern hearing aids incorporating latest technological advancement are very effective at submitting the usual soft environmental sounds around you, and helping to get tinnitus mask. Older aids were not useful for this purpose. They can be programmed to amplify the whisper like sound around you without amplifying loud decibel sounds (thus avoiding noise induced hearing loss), and thus mask the annoying unwanted irritating tinnitus sound.

Tinnitus maskers : They are not hearing aids in true sense but generate some pleasing sounds in the ears which are not disturbing. They in no way can be used for people with hearing loss. But its use for masking is very limited as most of tinnitus affected age group are of old age with hearing loss and so hearing aid is a better option..

Thinking, Emotions and Tinnitus

Let's say that someone decides to discover the cause of his tinnitus. He already passed all diagnostic, which discovered no organic base, so it obviously has something to do with his life attitudes: habits, relationships, understandings...

In desire to find a solution he can use: thoughts, logic, emotions, consciousness.

Thoughts: 'I can try that drug...or...The traffic under my window causes my tinnitus...I will find solution alone, I will never..., I have to say her...' Thoughts are many, can be confusing. It is good to find good thoughts....
Logic is finding a correlation between thoughts, events. 'If that tea didn't help to others, will also not to me...'
Emotions: anger, peace, fear...are excitations of the heart. They always appear as heart's response to an event, a thought... Emotions disappear after a while. They can give a taste to our life and help us.

Sometimes is good for us if we are persisting in particular emotins, sometimes is not. How to distinguish this?

Intuition is commonly described as 'power of knowing without reasoning'. It can be compared with consciousness. Consciousness has two meaning: a - awareness, b - a voice which tells use what's right.

With awareness part we can observe and see that particular thoughts revoke particular emotions. We CAN find out what causes peace in us. But peaceful feeling can be tricky. True peace is permanent. This doesn't mean that we will feel a permanent emotion. It means that whenever we check our plans we will feel peacefully if the plans are good and we will lost peace in time if our plans are bad.

There is a voice on the end which will tell us 'yes' or 'no' (to do something).

We don't need to understand that voice. If we find peace with that voice it is enough to listen it and do what it tells us.

Tools
Actions
Solutions

Thursday, September 28, 2006

Tinnitus retraining therapy

Tinnitus retraining therapy (TRT) is a form of habituation therapy designed to help persons who suffer from tinnitus (ringing ears). TRT uses counselling to explain to the patient how a combination of tinnitus retraining and sound enrichment can first end their negative reaction to the tinnitus sound, and then reduce and eventually end their perception of it. Because there is no known cure for tinnitus, this therapy offers hope to sufferers that are willing to take the time and make the effort to learn and implement it in their lives. It is estimated that there are 7 million in the US who suffer from this condition.

Relaxation and Meditation to relieve Tinnitus

Relaxation and meditation techniques can help some people temporarily relieve tinnitus and are particularly effective if used as part of a comprehensive treatment program that includes medication, broad-band noise generators (commonly known as white noise machines), hearing aids and other therapies, says Pawel Jastreboff, Ph.D., professor of surgery and physiology at the University of Maryland School of Medicine and director of the University of MarylandTinnitus and Hyperacusis Center, both in Baltimore. Dr. Jastreboff says stress makes it harder for a person who has tinnitus to ignore the annoying ringing in his ears. Relaxation counteracts that.

Tics, Tinnitus, Tremor...

Tics, tremor, nistagmus, tinnitus, cramps...
...can all appear as standalone symptoms or as a consequence of a proven disease.

Tics are uncontrolled muscle twitches or sounds (blinking, clearing the throat, grimacing, sighing...). They can appear at 3 years and are often prominent between 9 and 13 years of age. They can be aggravated by stress, anxiousness or drugs like Ritalin in Attention Deficit Disorder. They can be part of Tourrette's syndrome which runs in families, but it still hasn't a clear cause. Tics in most cases vanish until early adulthood.

This occasional and stress related nature of tics strongly suggests a psychic origin. But it is also interesting how tics stop - children being solved their psychic troubles or not.

Tinnitus on the other side usually starts in adults.

Few tinnitus sufferers had tics in childhood. It seems that the cause - which is obviously not organ-fixed - remained, only the symptom changed. Other symptoms with possibly psychic origin: tremor (as shaking or shivering), nistagmus (rapid eye movements), behavior or speech disorders, depression, anxiousness, asthma, allergies, phobias, panic attacks, cramps, palpitations, digestion/bowel problems, peptic ulcer, headache, migraine, backache, muscle/bones pains, angina pectoris.

Wednesday, September 27, 2006

This and that

I was trying to find some definitions, causes...about tinnitus. I thought that I'll found one 'main' tinnitus site quick and will find all data there. But I didn't. There is one t. association here and another one over the sea, few forums, but I had a feeling that things are scattered around, not orginised.

If you are looking for diabetes, you'll find dozens of huge sites and forums with a lot of members. Maybe no real interest is out there for tinnitus. Maybe people just know...that they don't need this.

But I'm enjoying in discovering new things. I have almost a kind of mania to collect all info about some matter on one place -- and then introducing it to others...

On this point I'm asking contributors and visitors of this blog: What should a blog about tinnitus be? What should be it's goal?

Tuesday, September 26, 2006

Attention, please!

Pimples
Tinnitus
Stuttering

are three things an average person doesn't need. Some people fight them. With a success or without a success?

I had pimples (Acne Vulgaris) when I was 15. I tried some creams and teas. And I still had pimples at 25. I had almost burned skin from using one strong retinal cream. Then I just forgot all, continued living with those embarasing albeit not life threatening bumps.

So what if you try to forget tinnitus? Funny enough?

After some years I became aware (what I knew for a long time though) that I feel the need to change my food habits. The trigger was banal - not so big budget...Well, I dropped: all sweets and all milk products. I was doing this a couple of months - and once I just "found out" that my pimples were gone. Completely, silently.

I'm not saying here that food cures or causes pimples.
I only think that pimples are consequence of some unhealthy habit. Not unhealthy in general, but what is unhealthy for you. Some food. Some place. Some people.
But the story continue...

O.K. What about stuttering?----- None of my business.

Low Blood Pressure and Tinnitus

When you get up from the bed in the morning, do you hear a hiss within your head (or in the ears)? Do you feel like you'll faint?
It can mean that you have a low blood pressure (BP).

In healthy adults BP is between 140/90 and 90/50 mm Hg. Normal BP level varies from person to person, so more than absolute value the change of BP level is important. Fall of BP for 20mmHg in a short time can cause hypotension symptoms even if the absolute value of BP is within normal range.

How low BP causes a hiss?
Low BP leads to low pressure within the head (intracranial pressure) consequently changing the pressure in an ear cohlea fluid (endolymph), which affects the normal way of stimulation of hearing receptors what results in a hiss. In addition: blood supply to inner ear vessels is not sufficient what results in inappropriate operation of the inner ear.

Other causes of hiss related to vessels/blood:
High blood pressure
Atherosclerotic artery or thrombotic plug in veins near the ear causing turbulent blood flow.
Brain artery aneurysm
Changes in blood composition (anemia, leukemia...)
Dehydration

Monday, September 25, 2006

Do You Need Tinnitus?

What? Noooo!!
Well, why then you still have it?
I tried all: medications, remedies...
Did you try to remove the cause?

I went through all diagnostic...they didn't find anything!
...

Are you happy with your life? I don't mean if your life is without worries, but do you think you are doing what's proper? What's proper for you...
Did you do anything wrong? Is this bothering you, or you are still continuing in wrong direction?

It's only about tinnitus...

Tinnitus can help you. Tinnitus is reminding you all the time that you have to consider some attitudes in your life. Why are you working? Do you do the proper things to people around you?

Psychosomatic Pain vs. Tinnitus

Pain is considered as a helpful sign in medicine. It tells us there is something wrong with our body or with our life...It suggests us to check and remove the cause.

Pain can be a consequence of a disease arising from the body or from environment (e.g. ear pain from noise).

All other causes of pain arising in person's relationships, memories, life attitudes...are referred as psychosomatic. Headache, migrain, stomach pain and backache are examples. Tinnitus - felt as pain or not - can fit in this group also.

These pains are not imaginary, they are true. If you feel tense, muscles will be tense and if this lasts for some time, the pain will be felt. Excessive activity of an auditory nerve caused by psychic tension is a physiological explanation for the tinnitus, where no other causes are found.

Have you ever experienced a headache after sitting in the front of a computer for a long time? I think that such a headache is a nice warning that you are doing something bad to your eyes and to your life maybe. Thus the solution (on a long term) is not in taking some analgesics, but to make a break, go to sleep or on a walk. And to consider - is it O.K. that I use computer so much?
And have you ever experienced your eardrum is twitching in an exciting situation where you were feeling that you were doing something wrong?

Sunday, September 24, 2006

Tinnitus Treatment Options

Treatment of tinnitus depends on the cause.

If the tinnitus is due to age-related hearing loss or damage to your ears by exposure to excessive noise, no treatment can reduce the noise. Your doctor may be able to take steps that could reduce the noise, such as removing impacted earwax. Tinnitus resulting from a vascular condition often can be corrected by fixing the underlying problem. If the tinnitus results due to adverse effect of a medication you are taking, your doctor may recommend discontinuing the drug or switching to a different medication.

Drugs like gabapentin (Neurontin) and acamprosate (Campral) are effective in relieving tinnitus for some people.

Other treatments that have been tried, but with limited results, are:

Biofeedback

Hypnosis

The herb ginkgo,

Cochlear implant

Electrical stimulation

Medications, such as benzodiazepines (antidepressants)

Hyperbaric oxygen chamber

Amplification using hearing aids

TMJ (temporo-mandibular joint) treatment

Remember : ATA (American Tinnitus Association) does not recommend any tinnitus treatment.

Screening and diagnosis

Once you feel you are suffering from Tinnitus (hear constant irrelevant annoying noices ) , Its better to take an appointment with an experienced ENT surgeon ( Oto - Rhinologist ). Provide your doctor with correct information like -- when they started, their severity and what can make them worse.
A detailed history will be taken and a number of tests may be carried out. The Doctor will first examine your ears with an otoscope to see whether any local condition (like ear-wax, tumor etc. is causing the tinnitus or not. He may also refer for various investigations like x-ray lateral view of head, blood tests,tuning fork tests, and sometimes a CT (computerized tomography) or an MRI (magnetic resonance imaging) scan to come to a correct diagnosis.

Saturday, September 23, 2006

What can Affect Hearing Process



I will explain here a hearing process and what can affect it.

Sound waves come through ear canal, reach eardrum and swing it. Vibrations are carried via three hearing bones (in the middle ear) toward the cohlea and causes the liquid within to oscillate. This stimulates hearing receptors. At this point mechanical vibration is converted in nerve excitation which propagates via auditory nerve through brainstem and reaches the brain. Excitation of brain cells in auditory area is recognised by a person as a sond.

**At all this points a sound can be impaired by objective and subjective causes**.

Objective causes:
A foreign body, injury, infection... in ear canal.
Broken eardrum..
Inflammed inner ear, changed pressure in Eustahian tube (diving, changing altitude fast, also at throat inflamation).
Impairment of inner ear.
Any procees which press on auditory nerve on his path toward the brain (tumors, injuries, bleading, ...).
Changes within the auditory nerve: inflammation, sclerosis multiplex, nerve impairment due to lack of vit B ).
Vascular (aneurysm) or blood disturbance (thrombosis, policythemia).

Subjective causes:
Psychic tension, Pain...
Tension can cause the muscles in the middle ear to contract, which can objectively affect the perception of loudness.

All these causes can not only prevent hearing but can also distort a sound or can pruduce tinnitus.

Friday, September 22, 2006

Sound related Terms

The Sound is a propagation of vibration (with 20-20,000 Hz frequency) through the medium (air, liquid solid matters). It is a mechanical force which causes vibration of the tympanic membrane (eardrum).

Loudness of a sound is determined by pressure of sound waves puts on an eardrum. Measure unit is decibel (dB).
Hearing threshold is at 0 dB.
Normal Talking at 1m distance ...40-60 dB.
Major Road at 10m distance... 80-90 dB.
Prolonged exposion to 85 dB can cause hearing imparmient.
Short exposion to 120 dB can cause hearing damage.
Plane on the airport...120-140 dB.
Treshold of Pain...135 dB.

Hight of the sound is determined by frequency of sound waves.
High frequency means high sound.
The hearing range is between 20Hz to 20,000 Hz and it changes with age. Old people usually can't hear sounds over 16,000 Hz.
Sound out of this frequency range cannot be heard. Sound over 20,000 Hz is called Ultrasound, below 20 Hz is Infrasound.

Tone is a sound of a particular frequency. 'Middle C' has 262 Hz, 'high C' has 512 Hz.
Monophonic sound is composed from one tone
Polyphonic sound is composed from two or more tones.
Hiss is a sharp sibiliant sound like sustained 's'.
Noise can be defined as unwanted sound.
Resonance is a relatively high amplitude of vibration produced when a frequency of some source matches the natural frequency of other object.

What Happened to the Experiment ?

A few months ago I started an experiment using a tinnitus formula. The formula involved was in fact a high dosage of Gingko Biloba ( 240mg). I was advised to take 2 caps a day for a period of approx. 3 months. I did receive a lot of feedback from people and friends advising not to experiment using drugs but after careful thought and consultation with my doctor I decided to try anway. I figured "nothing from nothing leaves nothing" and since I had nothing to loose anyway I stated taking the capsules on a daily basis. So after 3 months of downing 2 tabs a day without missing any out, the results left a lot to be desired. I must admit the capsules did not harme me in any way but regardless of this the tinnitus remain sunchanged.
So...where does this leave me?
I have been speaking to many tinnitus victims lately and they all have one thing in common. Whenever taking tinnitus remedies or other drugs and therapies a pattern develops which is evident in the majority. Most tinnitus victims tend to be unpatient and expect results quicker than can be expected. This is no surprise when you stop to think of what these people are listeng to on a 24/7 basis. It is a fact that when someone taking capsules which promises Tinnitus relief they will expect something to happen which in fact beats the object itself. Waiting for results can be frustrating for someone who has paid anything in excess of $ 100,00 for their tinnitus remedies. When taking taking remedies or going through therapy one adapts an attitude of "great expectations". I found myself ckecking the tinnitus sound after only 5 days to see if it was changing. After 1 month I couldnt detect any difference but kept taking the caps anyway. I do remember even trying hard to detect a difference, in fact I even once made myself believe that the caps were having an positive effect on the tinnitus. After 3 months I conceeded and gave up. I still have the caps here but I think I´ll throw them and forget the whole matter.
This doesnt mean that a tinnitus remedy wont work for you though, it just didnt work for me.
I would strongly reccomend anyone to think about what they are doing and what results they expect before embarking on a tinnitus remedy therapy and be ready to accept the fact that taking caps MAY not work. Thats the thing about tinnitus I hate so much. One is always on the lookout for new therapies. One is always good bait !

Thursday, September 21, 2006

Definition of Tinnitus

Tinnitus is a perception of a sound in one or both ears or in the head when no external sound is present. It is often described as ringing in the ears but also as hissing, roaring, whistling etc. - but common to all - as a completely different sound as previously experienced from their external environment.
It can be intermittent or continuous; occasional or long term symptom.

Objective tinnitus has mostly physical/physiological origin e.g. noise injury or arterial aneurysm in the brain. It is thereby only a symptom and not a disease itself. The sound can be heard by an observer (with using an stethoscope or other sound recording device). It is treated by eliminating the cause.

At subjective tinnitus no sound can be detected by an observer. An abnormal auditory nerve activity is the only recordable change. It is a standalone disturbance which is not physical/physiological but rather arise from psychic tension. Medications or other physical measures rarely help. Personal approach toward the patient (understanding, discussion) is needed.

What cannot be considered as tinnitus:
-any external sound
-sounds caused by change in external air pressure (at diving or quick changes in altitude (car on mountain road, plane...)
-"voices" as psychiatric patients describe them.