Tinnitus: A Terror in Your Ears
It started mildly in his mid-twenties but soon disappeared for two decades—only to return with a vengeance. The maddening whistle in 52-year-old Chennai artist Farhad Farjad Fard’s head rises and ebbs. “It left me sleepless, paralyzed my social life and affected my creativity and concentration. For long, I had to stop working,” he says. “I’d become so desperate, I even wished I could die.”
Nobody could help Farhad, who drifted from clinic to clinic. Although it was clear to doctors that he had a condition known as tinnitus, they couldn’t offer any real solutions.
So what is tinnitus?
It is a noise, sometimes mild but often unbearable, such as a ringing, whistling, buzzing or hissing, with no external source. Tinnitus [pronounced “tini-tess”] derives from its ancient Latin name tinnitus aurium, which means ‘ringing in the ears.’ Ayurveda calls it karna nada which, too, suggests a flowing sound in the ear. In the 18th century, one sufferer was the European philosopher Jean-Jacques Rousseau, who described it as “a buzzing in my ears that has not left me, not even for a minute these last 30 years.”
According to reports, some 6 million adults are affected in the UK (Action On Hearing). Indeed, some patients have only minor symptoms, or tinnitus may often stop on its own in days. Others use willpower and learn to simply ignore it and lead a normal, productive life.
However, there’s been a steady rise in the number of reported cases in recent years, especially in urban areas.
Beware of anyone who claims to cure tinnitus, where the underlying cause cannot be detected or removed. They’re bound to be frauds
Symptoms and Causes
Of the many causes of tinnitus, the most common one is possibly noise pollution: from road or air traffic, machines at the workplace, blaring TVs or stereos at home, loudspeakers in the neighbourhood. In young people it may be caused by frequent headphone use or disco visits, which probably explains why some start suffering in their teens and early 20s.
The inner ear, which transforms sound waves into nerve impulses and sends them on to the brain, where they are interpreted as auditory signals, is extremely sensitive. Accordingly, it is easily damaged by noise, or an ear infection that was not treated promptly. Once auditory cells are destroyed, they cannot be repaired or replaced. The damage caused by, for example, a single explosion of a firework at close quarters is called a “noise wound.” Most people thus wounded suffer a gradual loss of hearing, which is bad enough. For some others, the consequences are perceived as a permanent noise of tinnitus.
Dr Rosemary Leonard discusses the relationship between loud music and ear damage:
If such problems cannot be located, or if they cannot be fully treated, many physicians will try a holistic approach. The aim is to help the patient adopt a more relaxed inner poise, and thereby take out the fear of tinnitus. If that succeeds, the condition is not seen as a threat any more.
In order to achieve this, patients may be made to alter something at work, as with defence personnel who may be exposed to explosives and artillery, or at home so that the underlying cause is then no longer so central. The artist Farhad, for instance, found that using a mobile phone worsened his tinnitus, so he now uses his mobile only on speaker mode.
He also patiently conditioned himself to tolerate the noise. “There were days when it was softer, more bearable, so I would get work done at those times,” he says. “Sitting down or lying down made the noise worse. So I switched from designing stained glass to painting on canvas. I would stand and paint for long hours on good days, although my knees hurt and I developed backaches, but I didn’t mind as long as it kept the noise in check.”
Tweaking Your Psyche
An additional problem sufferers face is that partners, friends and colleagues have more difficulties in understanding tinnitus than they would a broken leg or even a heart attack. This means that tinnitus patients are often afraid of not being taken seriously, and this in turn leads to increased anxiety.
It’s very important to discuss the illness, Counselling is integral to the treatment. Once chronic sufferers learn to get past the fear of the noise and, instead, alter their attitude to it, it no longer disturbs them so intensely
Reaching that point is hard, but tinnitus retraining therapy (TRT, a holistic, interdisciplinary approach), habituation techniques, respiratory and music therapy, relaxation exercises and yoga may help. Sometimes, more socialising can help.
Drugs and Technology
Many doctors prescribe drugs to manage a sufferer’s insomnia, anxiety, or the other secondary conditions resulting from tinnitus. However, there is no drug that can actually cure the tinnitus. Today, steroid injections for tinnitus are also available, though these have side effects such as giddiness and nausea. The steroids suppress the activity of the tiny hair cells in the cochlea, the inner ear, but this helps only if the tinnitus is due to inner-ear disturbances, which are hard to diagnose. Many doctors claim the results too are unpredictable.
There is a yet another dimension to tinnitus therapy, given that most tinnitus patients also suffer some hearing loss. “Technology has truly transformed treatment for hearing loss,” says Prathiba Dawson, an implant audiologist, referring to today’s advanced cochlear implant hearing equipment. In many cases, with improvement in one’s hearing, tinnitus becomes less troublesome. Yet, be warned that in other cases, tinnitus could worsen following an implant procedure.
And there’s the tinnitus masker. No larger than a conventional hearing aid, it emits a noise that matches the pitch of the tinnitus-induced ringing, and can mask the undesirable noise of tinnitus. If hearing loss is also experienced with the condition, a hearing aid is often sufficient.
Depending on the diagnosis, a tinnitus-specific hearing aid (that combines conventional hearing aid and a sound/music generator) has been found to be beneficial in some patients. It may also be used in combination with TRT, which involves counselling, psychotherapy and noise supplied through a hearing aid or a specific instrument called a noise generator. It may help many sufferers avoid an all-too-common trap—hopping from doctor to doctor, even faith healers, acupuncturists, magnet therapists—while looking for the elusive cure.
Another form of sound therapy called fractal music therapy involves constantly playing music that is proven by research to have a relaxing effect on humans. The music is played continuously, or as long as the tinnitus episode lasts, often allowing people to concentrate better or sleep more soundly.
“Learning to live with tinnitus is challenging, but depending on your willpower and inner strength, it can be achieved,” assures Dr Ravikumar. “It’s important to be patient with yourself and have a positive outlook.”
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