Tinnitus: Redefining the Condition

Medical practitioners often refer to tinnitus as "perceived" sound that has no external source. This definition of tinnitus causes the condition to be taken less seriously than it should be. Why? Because some people wrongly equate the word "perceived" with the word "imaginary."

People who don't have tinnitus have a hard time understanding the difference. This mindset leads to all kinds of problems and misconceptions by the people who know the tinnitus sufferer (including the treatment professionals). The mindset creates a gap.

Here is a classic case of the gap in action:
Tinnitus treatment professional: "Just ignore your tinnitus."
Tinnitus patient: "I can't. It has become too loud. It is affecting my work, my relationships, and my sleep."
Tinnitus treatment professional: "It is all in your head. Trust me. Just ignore it and it will go away."
Tinnitus patient: "You don't understand. It is just too loud to ignore any longer. Help me."
Tinnitus treatment professional: "Listen, it is a perceived sound. I've treated patients just like you and they just ignore the internal sound and it goes away."

Some people, who do not have tinnitus, can't seem to understand why a tinnitus sufferer cannot just distract his or her brain away from the perceived sound and be healed. In milder tinnitus, it is possible to distract the brain. In some severe chronic cases it may not be. Every tinnitus sufferer is unique. For example, maskers do not work for everyone. Sometimes a person's tinnitus sound is louder than the masker. In fact, the internal sound may be louder than workplace regulations would even allow. It can be downright maddening.

So, how should we redefine tinnitus? Well, let's take a look at how the brain and the central nervous system work together to communicate. Let's imagine that you go in for acupuncture and a needle is pushed into the bottom of your foot, right in the middle of the arch. Your foot's pain transmitter cells would send a signal to the brain, where pain is produced, and you would experience foot pain.

Imagine that a brain surgeon blocks the area in the brain that is responsible for that particular part of your foot and you experience no pain. Or imagine that you are in the brain surgeons office and he or she stimulates that area of the brain so that you feel pain as though a needle is entering your arch, yet there is no needle. Either way, the pain would be identical. One has an external source and the other does not. In the later situation, the needle is perceived but not the pain. Pain is pain. Sound is sound.

The sound that the brain produces to indicate cell damage in the auditory system is identical to sound from an annoying external noise producing object. There is no difference. Therefore, the word "perceived" should be dropped from the definition. It should be assumed that all pain and sound is "perceived" in the brain, whether the source is external or internal, which makes the need for the word "perceived" irrelevant in the definition of tinnitus.

Tinnitus should therefore be redefined as a sound that is generated by the brain to indicate auditory system cell damage. 

Why is this important? Because, the quicker medical practitioners get past the "perceived" notion that the internal sound is somehow different than an externally noise generated sound, the quicker we will gain traction for research and ultimately a cure. As long as people believe that chronic severe tinnitus is imaginary or somehow easily treated or curable (which it is not) then there is less of a drive for a cure. Those with severe chronic tinnitus want a cure. For now, we have to learn to manage it.

Let's try the treatment scenario under the new mindset:

Tinnitus treatment professional: "You say that you are experiencing tinnitus. Let's figure out what type of tinnitus that you have and work on some ways to manage your tinnitus. We have to prevent it from getting worse. We may have to experiment with diet, exercise, and medications to minimize it. It may take awhile to figure out the right combination necessary to minimize your specific tinnitus. Each person's tinnitus is unique. If your tinnitus is chronic and severe, there is no cure yet. But, researchers are working on a cure."

Tinnitus patient: "I understand. I'm willing to try anything at this point, the tinnitus is affecting my work, my relationships, and my sleep."

Tinnitus treatment professional: "I understand. The sound that you hear is your brain telling you that there is something wrong with your auditory system. It is very similar to pain. We have to figure out what is wrong first. Let's run some tests."

Tinnitus patient: "Thank you."

Tinnitus treatment professional: "You are welcome."

Tinnitus: Ice Vest Test Result

I tried the ice vest and it did not relieve my tinnitus at all. However, it was worth a try. The ice vest certainly did not make my tinnitus worse. As I've often mentioned on this site, everyone's tinnitus is unique to that person because the cell damage causing the tinnitus is unique for each person. It is like two pianos that are out of tune, each one needs to be uniquely tuned up. Although an ice vest did not work for me, it may work for you. Conversely, although Scuba diving temporarily relieves my tinnitus for a few hours, it may not work for you.

rTMS treatment looks promising. I'm keeping an eye on that technology.

Tinnitus: Ice Vests

Update: I tried an ice vest as a possible temporary relief source. It didn't work. But it was worth a try. The following post was written before the test. I do still believe that core temperature has something to do with the temporary relief (not cure) that I experience when I scuba dive. 

The role of the hypothalamus, in the brain, is to keep the body in a state of homeostasis. It is my theory that the hypothalamus may be the primary suspect in regulating the high-pitched ringing sound that people hear when their cochlear cells are broken or damaged. Think of it as an internal alarm.

I further theorize that it is possible to deliver relief from the ringing by cooling the body's core temperature down which causes the hypothalamus to react by arresting the internal ringing. To what temperature the cooling needs to take place to shut down the ringing, I do not know.

I do know that when I scuba dive I do experience relief when my core temperature drops and when my core temperature comes back up, after a dive, the ringing suddenly starts again (like a light switch has been turned off and then on again).

Fortunately, I wear hearing aids with maskers built-in and so I keep them close-by. I place the hearing aids in my ears almost immediately after the dive because I know how suddenly the ringing comes back. Recently, after a cold water dive, I exited the water and sat on some stairs looking out at the ocean and I had absolutely no ringing. I enjoyed the quiet. It lasted awhile before it suddenly started again.

Recently, I went diving in 74 degree water and only wore my 5mm sleeveless wetsuit. I was in the water for about an hour and as my body cooled down, at about 10 minutes into the dive I noticed the tinnitus was gone.

I spoke to a fellow diver about this phenomenon and she mentioned that her cousin uses an ice vest to treat MS. Perhaps ice vests may be a possible treatment option for people with tinnitus.  The following is a link to an ice vest. If you decide to try it, please let me know if you experience any results. I just ordered one and I will be sure to post my results on this site.

http://www.amazon.com/Flexi-Freeze-Ice-Vest-Navy/dp/B001P30358/ref=sr_1_1?ie=UTF8&qid=1350339794&sr=8-1&keywords=ice+vests

Tinnitus: Pilates

Many people with chronic severe tinnitus find it very difficult to participate in cardiovascular workouts because the workouts can raise blood pressure and raise AC current levels in the brain which causes the tinnitus to get even louder and then taper down a few hours later. When the tinnitus is louder it can trigger natural brain annoyance responses like depression and mood changes.

If you are doing jumping jacks, running, or bouncing your head in any way as part of your workout you should probably stop doing that because you are creating infrasound waves inside of your cochlea that could be causing more damage to your delicate cilia cells. 

Some medical providers do not know about the infrasound phenomenon and so they generally recommend cardiovascular workouts for tinnitus patients. You have to take control of your health and recognize that you have a choice. You have to know what makes your tinnitus worse and what does not. Avoid what makes it worse regardless of what anyone else recommends. You are the only person in the world who has your unique auditory damage. You are uniquely out of tune (like a piano).

Before my tinnitus became severe, I used to participate in triathlons. I ran, biked, and swam often for training. Now I cannot even imagine participating in a triathlon. But, if I don't exercise then my overall physical health will plummet and the tinnitus will get worse. 

Since I could no longer maintain a triathlete regimen I had to look for an alternative. The best alternative that I've found is Pilates. It does not cure my tinnitus or make me any less aware of the tinnitus. Pilates does keep me from becoming physically unhealthy and possibly prevents my tinnitus from getting worse.

If you live near water, go kayaking once in awhile just to get some fresh air and apply your new Pilates arm strength. Plus, the sound of water is a natural white noise that may mask your tinnitus while you are paddling. Biking is good. Focus on what you can do, not what you can't do.

Occasionally I will attend a stationary bike class but I inform the instructor beforehand that I will not be able to maintain the class pace. They are very understanding. It really is just to get my legs moving. I bring my Bose QuietComfort 15 to class with me. 

What works for me may not work for you. Your tinnitus may be completely different from mine. You may have secondary conditions that might prevent you from certain exercises like Pilates. Your body is made to move. Excessively loud tinnitus is exhausting. It will make you not want to move. You have to compel yourself to do so.  

Tinnitus: Temporary Relief While SCUBA Diving

I've noticed some temporary relief from my tinnitus while SCUBA diving and for a few hours after each dive. When I leave the water and try to listen for the ringing sound it is completely gone. A few hours later, it suddenly returns. I have severe chronic subjective tinnitus.

My theory as to why this happens has to do with temperature. Pressure, at depth, can be ruled out as the source of temporary relief because the cochlea and the brain are fluid filled spaces.

My theory is that as brain temperature cools it causes the AC current, in the brain, to drop causing temporary relief. A few hours later, on land, as the brain returns to its normal temperature the AC current raises back up and the tinnitus suddenly returns. It is like a light switch being turned on and off.

Researchers should be looking at brain temperature control as a possible treatment option. The water that I dive in is typically 52-56 degrees. That is about the same temperature as iced tea. I wear a 3mm hoodie and a 5-7mm wetsuit which keeps me fairly warm but cooler overall than I would be on land. I typically dive in the 25-50ft. depth range.

Tinnitus: Infrasound Effects

Infrasound may cause tinnitus or make existing tinnitus worse. Infrasound occurs when the cochlea is shaken repeatedly for long durations. Normally, ears detect a noise vibration and the brain interprets the vibration as sound. However, with infrasound there is no noise stimuli. It is the fluid in the cochlea being moved back and forth due to being shaken repeatedly. A good example is sea sickness. There is no noise but the boat rocking and vibrating causes the fluid in the cochlea to move. The effects are obvious and immediate. Sea sickness is one result of infrasound overexposure. Some people are more sensitive to infrasound than others.

People who drive or ride in tanks, airplanes, buses, trains, or ships for long durations are exposed to infrasound. Over time, infrasound can begin to weaken the cilia (hairlike cells) of the cochlea which causes the brain to generate a sound (e.g. ringing, whooshing, crickets, crackling, thumping, clicking, popping). 

This may explain why hearing protection will not help some people to avoid tinnitus.
Here's an example, hypothetically speaking: A ship's captain or crew member may be wearing proper hearing protection and yet may still experience tinnitus during or immediately after an 18 hour boat ride. The vibration of the ship passing through the water has vibrated the liquid in the cochlea and caused the liquid to pass over the delicate cilia cells and mat some of them down (like blades of grass that have been trampled down) despite the fact that hearing protection was used. If the boat captain or crew  member is running tours everyday then over time the tinnitus cannot only become permanent but louder and more annoying and even debilitating.

The only protection against infrasound overexposure is to stop the activity altogether or reduce the exposure duration by limiting the activity to safe time limits or intervals. 

Tinnitus: Is Tinnitus a Disease?

Tinnitus is not a disease. It typically results from damage to the auditory system and or the mid-brain. Tinnitus is a symptom of the damage that has been done in the outer, middle, or inner ear, along the auditory pathway or in the brain. Tinnitus can be a symptom of Parkinson's disease, PTSD, heat stroke, environmental stress, physical stress, brain cancer, brain lesion, brain tumor, serotonin syndrome, Anti-NMDA receptor encephalitis or other more serious health conditions. Many tinnitus sufferers experience secondary conditions like insomnia or depression. Much of the depression stems from lack of sleep, excess serotonin production, and grieving that stems from not having a quiet moment for the brain to calm down. The brain of a tinnitus sufferer is in a state of constant excitation. The brain of someone without tinnitus is in a state of homeostasis.

Inhalation of toxic substances can also cause tinnitus. Volatile ultra-fine particles given off by some laser printers may cause tinnitus. Positive ion inhalation can cause tinnitus. Fine dust particles in the air can cause tinnitus.

Each tinnitus sufferer experiences a unique perceived volume and tone of internal sound (hissing, ringing, crickets, whooshing, clicks and pops are typical) depending on the extent of the damage to the sufferer's auditory system or mid-brain.

The level of annoyance of the tinnitus combined with the brain's natural response to the annoyance is what leads some people to debilitation. There are some noises that would cause anyone with an undamaged auditory system to flee an area. Tinnitus sufferers are no different. The sound is internal and the tinnitus sufferer cannot flee. This is how we become sleep deprived. In addition, tinnitus sufferers tend to be more sensitive to certain noise volumes and tones. Some tinnitus sufferers also have hyperacusis (amplification of certain sounds). Like chronic pain, tinnitus can flare up. There is no cure for chronic severe tinnitus. Acute tinnitus will usually clear up within a year.

Although there is no cure for chronic severe tinnitus, it can be managed. The reason that there is no cure is because tinnitus is usually the result of damage to the cochlear cells (which are non-regenerative). To put it into perspective, when someone says, "I cured my own tinnitus!"I know that it isn't true. It is like someone who says, "I lost my eye and I grew it back!" The people who say that they cured their tinnitus are suffering from acute tinnitus whereby the tinnitus would have been cured no matter what they did. But, they attribute what they were doing (e.g. taking vitamins or exercise) as "the cure."

If you have acute tinnitus and you are participating in yoga and then your tinnitus suddenly goes away you may actually believe that yoga cured your tinnitus. The fact that your tinnitus went away at all is the indicator that you were suffering from acute tinnitus whereby the cochlear cells were bent, like blades of grass, and over time recovered. Whereas the person with broken cochlear cells, dead cochlear cells, or brain damage in the mid-brain are not going to recover. These people are suffering from chronic tinnitus that needs to be managed. It takes work to manage chronic severe tinnitus. The sooner that they accept what has happened and begin the management process the better.

There is a known grieving process over the idea of never having a quiet moment again. That grieving process can be shortened, for some people, by Cognitive Behavioral Therapy (CBT) and medication if necessary. Grieving can flare up with flare ups. CBT helps tinnitus sufferers cope with the emotions associated with a flare up and recognize signs of grieving. Identifying the signs can help tinnitus sufferers to navigate the negative emotional waters until the flare up quiets down.

If you have chronic severe tinnitus it is important for you to learn how to manage your specific tinnitus. I openly share how I manage my tinnitus on this blog with the hope that my information will help other tinnitus sufferers to better understand the condition and I also want to encourage researchers to aggressively study tinnitus.

What works for me may not work for you. Your tinnitus may sound much different than mine.  The cause of your tinnitus may be much different than mine. General practitioners, hearing specialists, neurologists, psychiatrists, dietitians, physical trainers, and psychologists may be part of your treatment team if your tinnitus begins to get worse, especially if the tinnitus is affecting your judgement, work performance, sleep, mood, or relationships.

Tinnitus: Can Smartmeters cause tinnitus?

The known auditory system response range for exposure to RF is 200MHz - 3,000MHz. The Pacific Gas and Electric Company's (PG&E) Smartmeters are operating in the known RF auditory system response range at 450MHz-470MHz for about 45-60 seconds per day. It is therefore possible that Smartmeters could cause tinnitus and hearing loss for people who are extra-sensitive to RFR. It is also even more possible that the UHF television in the home could cause tinnitus and hearing loss because the amount of exposure time is greater.

If you live in California, you can opt out of the Smartmeter program (but you will pay more to do so). It would not surprise me if a large number of PG and E customers begin to show high frequency hearing loss and tinnitus. It may take years for exposure damage to present. Some people may be more sensitive than others.

On its website PG and E compares microwave ovens and wifi to its Smartmeter transmissions. It isn't really a fair comparison because Smartmeters transmit at a completely different frequency. That doesn't mean that those devices don't come with other biological risks.

PG and E has reassured its customers that the Smartmeters are safe based on FCC standards. The FCC admits that more study needs to be done in regard to the biological effects of operating in these frequencies. The FCC does not say that it is entirely safe to do so. For now, they allow it.

If you live in California, you will have to decide whether you are willing to pay more each month to be absolutely assured of safety or to accept the risk of allowing a Smartmeter to be attached to your home.

My goal is not to get you to opt out but to inform you of the possibility of auditory system damage, no matter how low the risk appears to be. Once chronic severe tinnitus starts it will not stop. There is no cure.

Here is how to opt out:
http://www.pge.com/myhome/customerservice/smartmeter/optout/

More information:
http://docs.cpuc.ca.gov/efile/RESP/149398.pdf


Note: After I posted this I decided to opt out just to be on the safer side. PG and E was gracious about it. I do have to pay a small monthly fee.

Tinnitus: Does radar cause tinnitus?

Can you imagine a world without radar systems? I can not. Countries around the world have become dependent on radar systems. Countries even competitively develop radar systems for military and non-military use. Most countries are dependent on radar systems for military operations. Radar is here to stay. But researchers cannot ignore the possibility that overexposure may have negative biological affects on human beings.

Because radar development is a huge industry it has become somewhat of a sacred cow. No one seems to want to really approach the topic of radar effects on human beings. We don't seem to want the answer politically so we don't ask the questions. There have been a few studies about biological effects from radar exposure but not enough. Many of the studies are dated.

Radar in frequency from G-Band 200MHz up to S-Band at 3GHz may affect the auditory system, including the cochlea, the vestibular nerve, the auditory nerve, and the brain. It does warrant further study. Active radar jamming in the I and J Bands (8GHz-20GHz) should really be investigated.

Police radars operate in X (10GHz) to K(40GHz) Band which is nearly equivalent to military radar jammers in the I and J Bands. If a police officer gets tinnitus and it is not due to sirens or firing his or her weapon then we have to assume that something else in his or her environment is causing the tinnitus.

It is possible that the sirens or the radar are to blame. Here is a link to an investigation of police radar by OSHA: Click Here

Although tinnitus is not specifically mentioned in the study, cancer, and low sperm motility cases have led to the commission of the research. The main point is that there is enough evidence to suggest that overexposure to RFR can lead to a biological response to non-thermal radiation. One problem with the study is that the findings show that the radar is not powerful enough to illicit a biological response from human cells. They've got it backwards...the lower the power the greater the human body responds. That is why refraction of RFR is of great concern. Every time charged particles refract they release some energy into whatever object was struck. The power can decrease to the point of generating a biological response.

For illustration, try this experiment: Take a laser pointer and point the laser beam at your wall just below the ceiling in your home. You should see a more diffused and weaker refraction that is bouncing from the wall to the ceiling. If that were radar generated particles striking a human being at a weaker state and absorbed then we could see all kinds of biological effects.

Since the cochlear cells send electrical signals to the brain it may be possible to damage them with radar jamming equipment in I and J Bands or, in the case of police radar, the X to K Bands. It is my contention that a radar jammer that is powerful enough to jam military radar would also be powerful enough to knock out the electrical signals of the cochlea and even affect electrical transmission in the cerebral cortex. Damage in either area of the body can cause tinnitus.

Certain thermal radiation can heat up the brain which causes a shock wave to go through the auditory system to the cochlea.

For the 50 million Americans suffering from some form of tinnitus, 12 million of those having chronic tinnitus that affects their daily lives, and 2 million who have been debilitated by tinnitus, it is time to apply more scientific focus on radio frequency radiation (RFR) effects on the auditory system.

Researchers really should be asking the following questions:

• Is it possible that the cochlear electrical signals are scrambled by radars operating in a certain frequency? 
• Is it possible to disturb the fluid pressure inside of the cochlea and kill cochlear cells by use of radar? 
• Does microwave radar, at certain frequencies, affect the brain and or the cochlea?

I'm not saying that radar causes tinnitus. I am saying that it warrants further research. If radar is proven, without a doubt, to be a cause then there needs to be some type of protection for people at risk of overexposure. At a minimum, people at risk of overexposure should be informed that overexposure can lead to hearing loss and tinnitus as well as other physical damage.

I'd imagine that radar protective gear would be some type of head gear that resembles the deflection surfaces on the stealth bomber. A stealth helmet, if you will (as a protection against harmful signals) for military personnel or police officers. The best protection is simply not to radiate the radar system when people are in the vicinity of it.

Debate over the non-thermal biological effects of RFR was raging in the 1970's. In my view, researchers have to look at the human biological system through a different lens. Researchers have to be mindful of the fact that human beings are chemical, electrical, and hydro systems and as such we are conductors of electrical waves. Through that lens researchers can begin to consider the real potential effects of RFR on human beings.  Human beings absorb RFR.

We are no longer in the 70's. We now know that non-thermal radiation does have biological effects. Laser surgery is a non-thermal electromagnetic procedure that effects cells. Trancranial Magnetic Stimulation is a non-thermal electromagnetic procedure that effects neurons in the brain. X-Rays are non-thermal electromagnetic radiation that can effect human cells (hence the need for a lead apron). Radar is also a non-thermal radiation source that may be harmful to human beings who are overexposed. Clearly, non-thermal radiation overexposure can be dangerous. Is it dangerous to the auditory system?

Tinnitus: Diet

This is my tinnitus diet. The idea is to prevent the tinnitus from flaring up. This diet will not cure tinnitus.

No:
caffeine
alcohol
smoking
salt
sugar (especially in soda)
aspirin

I suspect that the items on the "No" list raise the oscillation level in certain brain cells and thereby cause the tinnitus to get louder.

Here are some things that will not likely cause a tinnitus flare up:
Sparkling water
Salad
Oatmeal
Berries
Eggs
Meat
Pancakes
Vegetables (broccoli and cauliflower)
Protein powder or shakes
Sea Food
Liquid Multivitamins (e.g. Max Effect)

Eating well will not cure tinnitus. The brain will produce the internal sound no matter what. A healthy diet will likely reduce risks of a flare up. A healthy diet is a tinnitus management strategy. Whereas a poor diet will likely make tinnitus worse.

Tinnitus can lead to insomnia which leads to more and more caffeine intake which leads to flare ups which leads to more insomnia. It is a loop that has to be broken.

Tinnitus: Hearing Aids

I've been using hearing aids with maskers built in. They are Resound Live TS. There are four settings. The first two settings have no masker. Amplification is able to be controlled. Setting three is the hearing aid amplification and masker. Setting number four is just the masker. I tend to use setting four most often. I can control the volume of the masker and I often adjust it depending on how loud my ringing seems to be.

The masker produces a white noise that sounds like television static. The masker is tuned directly to the frequency of my internal ringing sound.

The hearing aid masker gives me the option of either listening to high pitched ringing (my own internal sound without the hearing aid) vs. lower pitched television static sound (the masker). I don't get silence at any point in my life. I'd enjoy silence. I miss it. But masking is the next best thing.

I'm not sure that "masking" is the correct term. The maskers don't get rid of the tinnitus. Maskers do provide an alternate and less annoying sound for the brain to focus on. A more appropriate term would be a "detractor."

For some reason the tinnitus rings louder than the masker at night as I am trying to fall asleep and throughout the night. The masker does not help with sleep.  I wish that were the case.

Tinnitus: iPhone Noise Dosimeter Apps

There are noise dosimeter apps that are available for iPhone. These apps can help you to understand what noises in your environment may be affecting your tinnitus. You can use noise cancelation headphones plugged into your iPhone (Bose Quietcomfort 15 works for me) while you a walk around checking noise dosage.

I use "Sound Level Application." It seems to work well. If you are detecting a sound at higher than 85 decibels you should be cautious. The best thing to do is avoid noise volume at that level or above for longer than eight hours. If you have tinnitus then try to avoid noise higher than 85 decibels from now on. You are more sensitive than the average person because your ears are already damaged.

(Note: I'm in no way affiliated with Sound Level Application.)

Tinnitus: Noise Hypersensitivity

Are you hypersensitive to noise? You may have hyperacusis that triggers your subjective tinnitus.

Hypersensitivity to certain noises has increased, for me, as the tinnitus has become louder and more annoying since 2007 (markedly so since 2009). Lawn equipment, low flying aircraft, inflight noise, office printers, sirens, car alarms, crying kids, public announcement system feedback, high-speed traffic, screeching brakes and even vocal pitch of loud talkers are all things that cause flare ups for me. Sometimes the volume is too loud (e.g. an ambulance siren) and other times the tone or frequency is annoying even though the volume is low (e.g. an office printer).

I try to avoid these annoying noises and frequencies as much as possible because they cause what are known as cowpaths of cochlear cell damage over time. These noises can make the tinnitus permanently worse. Sometimes I get into situations where the noise is unavoidable and I now bring my Noise Pollution Reduction System (NPRS) with me to reduce the noise through a recorder before it becomes sound in my ears. See my other posts on NPRS.

Tinnitus: Responses

I've had some interesting responses over the past few years when I tell people that I have severe chronic tinnitus. I thought I'd share some of them because it truly demonstrates a lack of general tinnitus awareness. It is why I started this blog to raise awareness.

Responses:

The people who believe that all tinnitus is the same usually respond this way:
1: Oh, my uncle has tinnitus and he simply ignores it.
2: I have tinnitus. I just deal with it.
3: I have tinnitus. I just use a fan to block it out.
4. I have tinnitus. It just comes and goes.
5. I had tinnitus for a few weeks and then it went away.

Each tinnitus sufferer is different. Based on the level of damage to the auditory system, the level of loudness and annoyance can be higher in some people and lower in others. What works for some tinnitus sufferers may not work for others. Also, tinnitus can get worse over time.

The doubters:
1. You look perfectly healthy to me.
2. Why is it that you seem to hear just fine?

Tinnitus is a non-visible disability. The damage is at a microscopic level. You may look physically healthy to other people but your auditory system is damaged and constantly annoying you 24 hours a day, seven days a week. It is exhausting, annoying, and frustrating.

Tinnitus doesn't cause hearing loss. The cause of the tinnitus is likely the cause of the hearing loss (e.g. noise exposure or head trauma). People with tinnitus don't necessarily have hearing loss. I do have hearing loss but it is not obvious to other people.

The unaware:
1. I hope that you get better soon.
2. No one has ever died from tinnitus.
3. You just need to think positive.
4. You just need to relax and it will go away.
5. You just need to learn to appreciate all that you have.
6. If you just work harder it will distract you from the tinnitus.
7. You just need to focus on something else other than the tinnitus. Just ignore it and it will go away.

Tinnitus is like being constantly subjected to an LRAD device 24/7. Except that we cannot run or hide from it. LRAD is used by police and military to disperse crowds. It works because it drives people crazy. They feel that they must flee the area to get away from the annoying sound. Tinnitus can't kill you but the secondary conditions can lead to death. That is why severe chronic tinnitus needs to be managed.

Every day is different for severe chronic tinnitus sufferers. Some days we are full of energy and other days we are totally exhausted.

Imagine people in a crowd being subjected to LRAD: Does it matter whether the people in the crowd think positive? Does it matter if they focus harder on their work? Does it matter if they learn to appreciate what they have? No. They feel that they need to flee. That is all that they are thinking about.

Regarding responses three through six above, the reason people respond this way is because my voice is louder than it should be sometimes because I'm trying to talk over the tinnitus and the exhaustion shows up in my non-verbal communication. I look angry when I'm actually just tired from nights of sleep deprivation. You may find that your tinnitus causes you to project non-verbal behavior that is misinterpreted by people around you.

Severe chronic tinnitus typically remains at the same level of annoyance or gets worse. If you've had severe chronic tinnitus for more than a year then it is likely to never go away. People have told me that I'm being negative when I say that but it is the truth. False hope and disappointment can lead to deeper depression. It is important to be realistic. You do want to remain positive and hopeful of a cure. There is more research going on now than ever.

The prescribers:

1. Have you tried homeopathic remedies?

2. There's a new pill that cures tinnitus.

Every few years there's a big marketing push for a new placebo to cure tinnitus. The marketing is very powerful and the talking points get into the minds of friends and family. Suddenly everyone around tinnitus sufferers are telling us about this new miracle cure. Inside, we think to ourselves, "Here we go again." 

The insensitive:

1. Now that I know this about you I'm going to make even louder noise.

2. I have trouble sleeping. We all have trouble sleeping. What's the big deal?

3. Okay, so you have this condition. There's no need to whine about it. Is there? I mean, it's not like you have cancer.

Insensitive responses lead to stress and stress can cause the oscillation in the brain to raise to a level that is intolerable for the tinnitus sufferer.

If you are a friend or family member of a tinnitus sufferer you may be wondering what is the appropriate response. The appropriate response is to allow the tinnitus sufferer to tell you how tinnitus has affected his or her life and what you can do to help. Be an open sounding board of support. If you love someone then you support them.

The tinnitus sufferer may be trying to tell you things that you can do to help but you are not taking him or her seriously. If you respond inappropriately then tinnitus sufferers typically lose trust in the relationship, clam up, and separate ourselves from the relationship entirely. This is the beginning of social debilitation for us.   

The important thing for tinnitus sufferers to keep in mind is that people generally mean well and sometimes what seems like joking to them is actually hurtful to you. They are not this way because of ill-intent but are rather this way because of a lack of awareness and sensitivity about your condition.

People around you cannot respond appropriately to a condition that they know little to nothing about, so they tend to poke fun or downplay the condition. Some people have a hard time relating to non-visible chronic conditions. People with chronic pain experience similar issues regarding relationships. 

The appropriate response:

1. How has tinnitus affected you?

2. What can I do to help you to prevent your tinnitus from getting worse?
3. I'm on your side.

The best response that I've heard was, "Let's talk about your condition. I am on your side. I want to help." I was so relieved to hear that response. Just the words, "I'm on your side." were incredibly relieving for me.

That individual referred me to the American Tinnitus Association (ATA) where I found people who are also on my side against tinnitus. Remember that the tinnitus is the enemy, not the people who respond inappropriately to it. I hope that you will also help to raise awareness so that the responses become appropriate more often in the future. I'm on your side.

Tinnitus: Map Theory

Inner ear cells Credit: Hertzano et al

Tinnitus really is a paradise for researchers. Many tinnitus sufferers are waiting for a cure. For example, a researcher could map each cochlear cell to its brain receptor, dendrite, or axon. 

Each one of the hairlike cells of the cochlea depicted in the photograph above generates an electrical signal when stimulated by noise. Each noise signal is transmitted to the brain by a nerve that resembles coaxial cable. When the signal arrives at its destination, in the brain, the noise is converted to sound. 

Imagine that some of the hairlike cells above are amputated at the base. What would happen? The answer is that the electrical noise signal that would typically be sent from the cochlea through the vestibular nerve and the auditory nerve, to the brain for interpretation, would not be generated. It is as if a postal employee decided to go on strike and left the mail sitting in a bin. Eventually, an intended recipient would start complaining about his or her missing mail. Tinnitus is like the intended recipient. It is complaining that it has not received a signal. 

When the signal is not sent to the brain, the brain interprets the absence by generating its own alarm (ringing, whooshing, buzzing, clicking, etc.) by oscillating. I realize that people with severe tinnitus believe that the ringing or buzzing sound is in the ears. It certainly feels that way. But it really is inside of the brain. The amputated cells of the cochlea are non-regenerative which is why the ringing does not stop once it is identified as chronic. Currently, there is no way to bring the cells back from the dead. Birds are able to regenerate these cells but humans are not able to do it.

In the future:

I theorize that the type of sound that the brain generates may help researchers to determine exactly where in the auditory center of the brain the connection is being lost and pinpoint the exact location of the specific receptor and interpretation neurons are located. 

If I am right, a pinpoint map should be able to be drawn, similar to how an electrician determines electrical panel malfunctions. It may look something like this...

If a ringing sound is heard then the damage is likely column X, row Y of the cochlear cells which connects to the auditory center of the brain at location Z. Z must therefore be inhibited.

If a buzzing sound is heard then the damage is likely column A, row B of the cochlear cells which connects to the auditory center of the brain at location C. C must therefore be inhibited.

If a clicking sound is heard then the damage is likely column D, row E of the cochlear cells which connects to the auditory center of the brain at location F. F must therefore be inhibited.

If such a map could be drawn then it may be possible, in the future, to inhibit the exact spots pinpointed for each patient. Such a map would lead a researcher down a few areas to explore. Using the map a researcher could try to trick the brain into responding to an artificial electrical signal that matches the signal of the specific cochlear cells that are damaged. 

Another option would be to completely shut down the associated dendrites and axons responsible for generating the alarm. As far as I know there are currently no microscopic instruments to create such a map. In the future, it may be possible to do so. I hope someone reads my map theory and is inspired to explore. 

The alarm (ringing, buzzing, whooshing, etc.) is telling us that something is wrong. The alarm occurs in the auditory center of the brain (and can be as far down as the brain stem), not in the ear. The alarm needs to be turned off at a precise location in the brain specific to each tinnitus sufferer's unique damage. I believe that there is a code to turning off this alarm for each person and researchers just haven't identified the code...yet. 

Some researchers have identified a general area of the brain for further study but it is not mapped to the specific damage for each person. Researchers are looking into using drugs to inhibit the general area of the brain that has been identified. Scalp electrodes have also been used. I don't think that either will work long-term because the precise location has not yet been mapped. If researchers use a drug to inhibit a general area in the auditory center then hearing loss may be a possible result because the researcher is treating healthy auditory system connections while attempting to treat unhealthy auditory system connections. If one cochlear cell is amputated then that cell should be treated, not the healthy unbroken cells. This should be done one at a time until the tinnitus sufferer is tuned up, theoretically. 

(The photograph above is from inside of a mouse cochlea. The principles are the same. The photographer has no affiliation with me, this blog, or my theory.)

Tinnitus: Aspirin is Ototoxic

Aspirin can cause tinnitus. Aspirin can also make existing tinnitus worse. If you take aspirin regularly and you don't know why your ears are ringing there is a good possibility that the aspirin is causing your tinnitus or amplifying it. The damage may or may not be permanent. If you are taking aspirin for sore muscles you may want to try icing the muscles instead of taking aspirin.

If you are taking aspirin to prevent a heart attack then it makes sense to keep taking it. In that case, tinnitus is the lesser of two evils.

More information:

http://www.ncbi.nlm.nih.gov/pubmed/18225604

Tinnitus: Eye Strain

There does seem to be some correlation between eye strain and my tinnitus flare ups. I used to be an avid reader of books. Even with the right prescription lenses, I stopped reading books when I noticed that concentrating or focusing on reading for too long would cause my tinnitus to flare up.

I honestly felt depressed at the thought of no longer enjoying a good book. If you have chronic severe tinnitus you may have noticed this correlation yourself.

I have overcome the eye strain issue by purchasing a Nook tablet. The Nook allows me to expand the lettering and, because the background is lit up, I am no longer straining my eyes.

Tinnitus: Acupuncture

I have heard mixed reviews as to whether acupuncture has any affect on tinnitus. Since I didn't know, I thought I'd try it out. I saw an acupuncturist today.

Theory:
Since the auditory center of the brain is like an electrical circuit board I could imagine that inhibiting or stimulating certain nerves would possibly work to provide temporary relief. Acupuncture wouldn't fix the damaged cells in the cochlea but it could feasibly stop the ringing by inhibiting the brain from continuing to generate the ringing sound.

The ringing is generated by the auditory center of the brain and is an indicator that my cochlear cells are damaged. The acupuncturist focused on the brain and not the ears. The cochlear cells are damaged and non-regenerative therefore acupuncture will not repair the cells. The cochlear damage is a constant. The ringing, however, may prove to be a variant if it is somehow able to be switched off or reduced.

Is acupuncture the right tool to switch off the ringing sound that is generated by the auditory center of the brain?

Practice:
I spoke with the acupuncturist and explained exactly what I was hoping to accomplish. She showed me a map of nerves that affect the brain. She identified the brain's temporal lobe nerves located on the left and right ear lobes. She stuck pins in my ear lobes at the mapped locations.

It only hurt for a half a second. The pain was very mild. She also placed pins in my hands, feet, and forearms. I barely felt them. She left me alone in the room for 15 minutes. Nothing happened to my tinnitus. It didn't get worse or better. It just stayed the same.

Just because acupuncture didn't work for me does not mean that it will not work for you. Everyone's tinnitus is different because we chronic tinnitus sufferers are all uniquely out of tune. Give it a try.

"Never ever doubt what no one is sure about." - Willy Wonka

Tinnitus: Cure

There is no cure for auditory system failure due to cochlear cell damage that results in tinnitus. Many companies are claiming to have discovered a cure in order to gain research grant funding, investment monies, or exploit people who are new to severe chronic tinnitus.

These companies realize that there are 12 million people with chronic severe tinnitus. Many of the people who are new to tinnitus assume that there is a magic pill or miracle cure. They inevitably fall for the cure claims and end up disappointed or depressed to learn that there is actually no cure only after spending the money.

The cells of the cochlea are non-regenerative. Tinnitus can be managed. There are best practices that can help the tinnitus sufferer:

Best practices include:

• Communicating the Condition
• Preventing the Tinnitus from Getting Worse
• Anticipating Flare Ups
• Maintaining Healthy Relationships
• Improving General Physical Health
• Socializing with People Who Have Tinnitus
• Using Chronic Pain Management Techniques
• Staying Informed
• Minimizing Secondary Conditions

Tinnitus: Military Issues

Military environments can cause tinnitus even when the service member uses hearing protection. If the hearing protection provided is inadequate then the auditory system may sustain damage. According to the American Tinnitus Association the military hearing protection provided in the past was not adequate to reduce some industrial noise (e.g. jet engines and gunfire) to a healthy level. The result, tinnitus is the number one problem facing the Veteran's Administration today.

Auditory System:
Noise is simply vibration of air until it hits the eardrum, passes through the auditory system and becomes sound when it is interpreted by the brain's auditory center. Some hearing protection may help to reduce the level of noise entering the outer ear but may be inadequate in protecting the auditory center of the brain from unhealthy vibrations or percussions. A bomb blast could percuss the auditory system and cause tinnitus despite the fact that the military member had protected the outer ear with ear plugs or a headset.

Combat:
A service member may decide, in combat, not to wear hearing protection because he or she wants to be able to hear the enemy and would prefer living with ringing ears for the rest of his or her life rather than losing his or her own life entirely.

Fear:
Some military members are afraid to report their tinnitus because they don't want to lose the career that they've worked so hard to earn. They feel that they are in a Catch 22 situation. They also fear not being promoted if they report the tinnitus.

Sensitivity:
Noise induced tinnitus is the result of an amputation of the hair cells in the cochlea. It can be just as debilitating if not more debilitating as an amputation because it has no cure and there is no prosthetic that can be used to overcome it.

Infrasound:
Infrasound occurs when the ears and brain are shaken repeatedly. There is no noise that is moving the fluid in the cochlea but physical vibration of a vehicle is simulating noise and affecting the auditory system. Sea sickness is one result of infrasound. If service members are inside of a vehicle that is producing infrasound for too long then auditory system damage may occur. Tanks, aircraft, and ships all produce infrasound at various levels. For example, being at sea in a ship and continuously exposed to infrasound for months could lead to hearing loss and tinnitus. Hearing protection will not help to prevent infrasound damage. The only safe solution is to reduce the harmful activity or avoid it altogether. Some people are more sensitive to infrasound than others.

ELF:
Military scientists have studied the effects of ELF. As a result, most militaries make every effort to not operate in Extremely Low Frequency (ELF). However, according to a Canadian Professor (Persinger), lightning generates ELF. Service members operating on ships at-sea who are exposed to open ocean storm systems while working topside may be unknowingly overexposed to ELF which could cause tinnitus and hearing loss. Further research is needed on this possibility.

Final Thought:
I don't think that these issues are simply issues for the United States military but rather all militaries around the world.

Tinnitus: Dizziness, Disorientation and Vertigo

Dizziness, disorientation or vertigo is possible with tinnitus, especially if the tinnitus is caused by crystal deposits in the otolith organs of the inner ear coupled with cochlear damage. A head injury could cause tinnitus and dizziness, disorientation or vertigo. It is not likely that the tinnitus is causing the dizziness, disorientation or vertigo. People with severe chronic tinnitus due to damage to the cochlea typically do not suffer from long-term dizziness.

If your auditory system damage was caused by sudden loud noise exposure then it is possible that you may experience short-term dizziness, disorientation, or vertigo immediately after the event. These symptoms should go away. If your tinnitus is caused by high blood pressure/hypertension then you may experience short-term dizziness, disorientation, or vertigo from time-to-time until your blood pressure drops a bit.

If your tinnitus was caused by a traumatic brain injury. such as a car accident, then you may experience tinnitus and dizziness for the rest of your life.

The best thing to do when you are struck with short-term spells of sudden dizziness, disorientation or vertigo is to stop what you are doing, use deep breathing to bring your heart rate back to normal. See a doctor if the dizziness, disorientation, or vertigo lasts beyond what you know to be normal for you. 

Tinnitus: Pain

I very seldom feel pain from the tinnitus. Sometimes it feels like the nerves are tugging in towards the brain and making a sound like heavy traffic...vroom...vroom...vroom sound. Other times it will sound like one car passing through my head from left ear to right ear....vroooooom. It only happens when I am sleep deprived or highly stressed.

There is a high degree of annoyance associated with this phenomenon because it is compounded by the constant ringing that I normally experience 24/7. If I add eye droppers to dilate my eyes for an eye exam I instantly get the vrooom vroooom sound.

Other than that discomfort I don't experience pain. The ringing is like pain. Internal sound generated by the auditory system is like pain in that a part of your body is malfunctioning and your brain is trying to tell you that fact. I have felt pain during and after an MRI. The tinnitus was so loud that my ears ached afterward for three days.

Typically, you should not experience pain with tinnitus. On some occasions it is possible but it is usually temporary. But, for the most part, no pain.

Tinnitus: Stress Management

If you have chronic severe tinnitus you may experience that your tinnitus gets louder and more annoying when you are stressed, particularly if you have pulsing tinnitus. Some stress is unavoidable. Other stress is optional.

Setting unrealistic goals, over promising and under delivering, poor diet, lack of sleep, loud or repeated noise, lack of exercise and even other people can be stress inducers.

1. Be realistic. Your capabilities have changed. You likely sleep less because of the tinnitus. Don't set goals based on what you used to be able to do. Set goals based on where you are at presently and where you will be at if and when the tinnitus gets worse. 

You may be experiencing varying energy levels throughout the day. Tinnitus can be exhausting. Don't place yourself in harmful situations whereby grogginess can lead to personal injury for you or anyone else. 

2. If you are not on a normal sleep pattern then it is difficult to stick to any plan that involves arriving early in the morning. I make all of my appointments for the afternoon (after the grogginess has worn off). I absolutely do not drive when I'm groggy.

3. Don't eat salt. Don't drink coffee. Don't drink alcohol. Don't smoke. Salt and caffeine directly affect your cochlear hair cells. Salt is like taking a saw to the base of your cochlear cells. Alcohol affects your auditory system in the brain and in the cochlea by being carried through the blood stream to those areas and disrupting normal function of the cells. Smoke can reduce the oxygen levels in your blood stream and deprive your auditory system. You may have developed habits. A habit starts with a mindset. Change your mindset. If you are on a sleep med, you absolutely don't want to mix alcohol into your system. 

4. Lunesta is my preferred sleep aid. I don't sleep at all without it. When I use it, I sleep for about four hours per night on average. The rest I make up at varying times throughout the day when I can. Some days my tinnitus is so loud that I cannot make up the sleep.  

5. It is important to exercise regularly. Don't overdo it though. Too much cardio can raise your blood pressure and make your tinnitus worse. I highly recommend a personal trainer. Explain to your personal trainer that you have tinnitus and that you don't want it to get worse.

6. Reduce loud and long-term repeated noise, flee from it or r stop the noise if you can. If it aggravates your tinnitus don't just sit there and take it. 

7. People who intentionally stress you out have no place in your life from now on. You have to confront these people and give them an opportunity to stop. If the person continues to stress you out, doesn't believe you, ridicules you just keep in mind that may be a normal response due to a lack of tinnitus awareness. But, you don't have much time and you may have to end the relationship to preserve your own health.  Your cochlear cells may fall like trees and once gone they will never grow back.

I have always been a forgiving person. My cochlea are not as forgiving as I am. The preservation of my ears forces me to point out the elephant in the room. 

Tinnitus: Daily Living

A Taoist Proverb:

A man was walking through the woods and he noticed a tiger hiding in the bushes. He picked up his pace and walked faster and then began to run. He heard the tiger running behind him. He reached a cliff edge with a sheer drop down. He stopped and turned around. The tiger swiped at the man with his paw and barely missed him, the man fell backward head over heels over the cliff edge. 

As the man tumbled, he was able to barely catch a berry bush halfway down the cliff wall. The berry bush had one ripe berry on it. The man looked up and saw the angry tiger snarling above him. He heard a noise below. He looked down and saw a second tiger below him. The second tiger was huffing, pacing and looking up at him. This tiger began to leap up to try to catch his heel. The man was just out of reach of the tiger and holding tightly to the bush. 

The man reached out with his other hand and plucked the berry and put it in his mouth. He savored the berry as he swirled it around in his mouth. He appreciated the berry. It was the best tasting berry that he had ever eaten in his life. 

The Moral as Applied to Chronic Severe Tinnitus:

The moral to the story is that the first tiger represents the past (what you used to be able to do before tinnitus). The second tiger represents the future (the fact that you will likely never have another quiet moment for the rest of your life and that there is no cure for auditory system damage resulting in tinnitus). The berry represents the present (what you can do today).  

Daily Living:

For people with tinnitus, living moment-to-moment and focused on today is difficult but we really don't have much choice. We can't live in the past or focus on the future or the results can be harmful. 

If you have chronic severe tinnitus it is important for you to adopt the right mindset. Many people in third world countries have adopted the philosophy of living for today. 

If you are a Christian, it is a Biblical principle to not worry about tomorrow. Also, it is good to live out a quiet peaceable life that is well pleasing to God. 

Shakespeare penned the phrase, "What is done cannot be undone." We have to accept tinnitus and live. We don't have to plan activity upon activity, filling up our calendars with stress...especially since we don't know whether we will get enough sleep on any given evening. 

I find that in planning I make sure that I communicate to stakeholders that I may not make it because of the tinnitus. I don't ever drive groggy. If I didn't sleep, then I don't participate. It disappoints people sometimes. It makes me look unreliable at times. But, I cannot concern myself with the consequences of a health condition that cannot be undone.

If I did get enough sleep, the night before the activity, then I go to the activity as I originally intended. I eat the berry.

Tinnitus: Isolation

There are 12 million people with chronic severe auditory system damage known as tinnitus. As the tinnitus increases, many of us have to fight against a sudden desire to isolate ourselves from family, friends, and co-workers. Why does this happen?

I think that the reason that it happens is because we do not want our tinnitus to get worse. We have experienced times where we were placed in situations that we cannot escape from without some social reprisal or ridicule if we leave. So, we stay and suffer and the tinnitus gets worse. Examples include birthday parties, crowded restaurants or bars, weddings, all-staff work meetings. We also have to explain why we are leaving the event so soon. We do a lot of explaining. Living with chronic severe tinnitus is exhausting.

When the tinnitus reaches a point where it is so loud that we can no longer handle any noise that might cause a flare up we decide that we will avoid social events and people altogether. I think this happens subconsciously. It simply starts to happen and I found it hard to articulate it to other people while it would happen.

We also get tired of explaining. We seek out places that we know will not cause a flare up and that is usually at home, a walk, perhaps a trip to a quiet retail store. The main thing is that you protect your ears from getting worse. Secondary to that is to keep your relationships intact.

If you have chronic severe tinnitus you do have to balance home life and interaction outside of home. I use a system to enable myself to be able to control noise pollution and I'd have to say that it is very effective for me so far. I could attend a wedding, fly, and go to a movie with NPRS. However, I couldn't attend an air show, a rock concert, music festivals or car racing events with the system. I field tested it at a music festival. I paid the price of louder ringing and no sleep.

My system, depicted below, is called the Noise Pollution Reduction System (NPRS) and you can purchase the pieces on your own. I do not sell the system or the components. I use Bose QuietComfort 15, a Zoom H2n Recorder with a wind screen, and Resound Live TS hearing aids. The headphones reduce the noise. The recorder allows me to moderate noise before it becomes sound. Hearing aids mask the ringing a bit (not completely).

This is not a cure for tinnitus. It will not help you to fall asleep. NPRS may help you to reduce the chances of your tinnitus getting worse or flaring up due to environmental noise. As a result, it may improve your ability to socialize again. This can result in improving your quality of life and possibly reduce your level of depression. That is my theory.  

It has its limitations because noise generates vibrations that can affect the auditory center of your brain. There have been studies that show that certain frequencies cause behavioral disorders and depression. You may have protected your ears but the noise is so powerful that the vibrations cause problems in the brain's auditory center.  Since you may be hypersensitive to certain sounds you may be triggering a natural depressive response, in your brain, to noise frequencies from your environment. Therefore you have to control your environment. 

Tinnitus: NPRS Field Test Results

Noise Pollution Reduction System (NPRS):

• Resound Live TS hearing aids with maskers
• Bose Quietcomfort 15 headphones
• H2n Recorder with Wind Screen

A few weeks ago I announced that the system depicted in the photograph helps to reduce noise pollution and may help to isolate noises that cause tinnitus to flare up or get worse. I tested the device at the loudest event that I could find...the local Scottish Festival.

While wearing the system I was able to successfully control the sound of large crowds, entertainers, bagpipers, and low flying aircraft without my tinnitus flaring up. I found myself using the mic gain on the recorder frequently throughout the day. It worked.

There is one problem. Last night my tinnitus was really loud. It was impossible to fall asleep. My theory is that even though I successfully protected my ears from noise discomfort I may not have protected my auditory center of the brain from the vibrations of the sounds around me through my skull. Imagine 20 bagpipers and four drummers. It was very loud.

My guess is that the skull bones can attenuate the damaging sound vibrations. Therefore, the sound vibrations still pass through the brain. Imagine the brain as a bowl of jello placed next to a loud speaker at a rock concert. If loud enough, the sound vibrations would jiggle the jello despite the fact that the jello cannot hear. Vibrations probably have a similar affect on us even if our outer ears are protected. We may not instantly feel the effects.

The problem with tinnitus is that the brain's dendrites and axons are oscillating (like a car stuck in idle). If vibrated it may cause the oscillation to increase.

I can't imagine how to stop damaging sound vibrations from passing through the brain short of inventing a light-weight double airspace helmet (that no one would want to wear at work or in public).

The lesson learned here is that the NPRS could be used for certain events but other noise events that generate extremely loud noise vibrations should be avoided.

I've used NPRS to go to the movies and a little league game and it worked great with no increase in tinnitus. That was not possible just a few weeks ago. So, there is success. You may find that the system reduces cabin noise in an aircraft and other noises that you could not tolerate before due to hypersensitivity.

In a previous post I recommended that you may be able to take the system to a concert. Now I would say that you should consider the noise vibration issue and be cautious. Touch the exterior of the headphones to feel the vibration level. If it seems excessive to you then leave the event to protect yourself.

Tinnitus: OSHA? We Have a Problem

In the United States OSHA has established a noise threshold level of 85 decibels for an eight hour period for workers. However, that is only for people who do not already have auditory system damage. The OSHA threshold exists to prevent healthy ears from damage. It does not exist to protect already damaged ears from more damage.

What about people who already have auditory system damage (e.g. cochlear cell damage that causes tinnitus or hyperacusis)? Our ears are much more sensitive and, in reality, our threshold is less than 85 decibels because of the hypersensitivity to certain noise specific to the unique damage to our auditory system.  

This scenario can happen: A person with tinnitus works in an open office. He or she notices that the tinnitus is getting worse while at work. Certain noises in the office cause flare ups. He or she notifies the occupational safety officer who tests the office equipment and industrial noise at less than 85 decibels. In the mind of the safety officer, the office environment is well within OSHA standards and therefore nothing needs to be done. The safety officer offers a pair of ear plugs in an attempt to remedy the situation.

Ear plugs and other standard hearing protection will not work with people who have tinnitus because it makes the tinnitus even more noticeable. 

I suggest that OSHA broaden the standard to allow for accommodations for people who already have auditory system damage that causes hypersensitivity to sounds at less than 85 decibels and at less than eight hours duration.

For someone with severe chronic tinnitus, a noise exposure that causes a flare up for any duration at any decibel level is intolerable. The employee, with tinnitus, has to be separated from the cause of the flare up. By separated, I don't mean punitively. It has been proven that continued exposure to certain sounds over time can lead to even more auditory system damage.

According the American Tinnitus Association there are 50 million people in the United States afflicted with some form of tinnitus. Over 12 million of those people have severe tinnitus like mine. My guess is that most of those 12 million people are hypersensitive to certain sounds at less than 85 decibels for less than eight hours a day. 

OSHA standards link:

http://www.osha.gov/SLTC/noisehearingconservation/

Tinnitus: Hearing Loss

People with tinnitus often show some loss of hearing on hearing tests. The pattern is typically shaped like a roller coaster hill with a notch in the track. This can be an indicator of damage in the hairlike cells of the cochlea (or another part of the auditory system). The auditory system can become hypersensitive to certain sounds. This causes the tinnitus sufferer to flee situations that cause the tinnitus to get louder and more annoying.

It is just as likely that someone with tinnitus will not show any hearing loss, especially if the tinnitus is a result of a traumatic brain injury, tumor, or neck injury. If the cochlear cells are intact then there may be no discernible loss of hearing that shows up on a hearing test. That does not mean that the damage does not exist. The tinnitus sufferer is hearing well and in addition to hearing well he or she also hears high-pitched ringing, clicking, or hissing.  Somewhere in the auditory system there is damage. That is the case for many tinnitus sufferers.

Hearing test results are not the determining factor as to whether someone has tinnitus.

Tinnitus: Analogies That Aid Understanding

People who do not have tinnitus often find it hard to understand the issue. It is also true that people who have not studied Physics have a hard time understanding it. Physicists often use analogies to accelerate learning. Likewise, people with tinnitus can use analogies to raise awareness and accelerate understanding. Here are some analogies that I've used. Analogies creates a word picture.

Blades of Grass: Defining Tinnitus
This analogy may help you to explain your tinnitus to someone.

Imagine that the hairlike cells inside of the cochlea (middle ear) are like blades of grass submerged in fluid. The grass blades flow with the fluid. When a sound event happens, the fluid flows over the blades and stimulates particular blades to send signals through a coaxial cable called the vestibular nerve to the auditory center of the brain, where the signal is interpreted as sound.

If some of the grass blades are cut then the brain tries its best to interpret the absence. The brain often produces a ringing sound, a cricket sound, or a wind sound. This is tinnitus. The sound that the brain produces will continue until either the auditory center of the brain is inhibited from producing the sound  or the blades can re-grow. The problem lies in the fact that the grass blades are non-regenerative. They will not grow back. No pill will make them grow back. There is no surgery to replace the blades or inhibit the auditory center of the brain.

We know that the sound is generated by the brain as a result of the damaged auditory system because there was a study that called for the participants, who suffered from tinnitus, to have their vestibular nerves cut. The researchers disconnected the cochlea from the brain by cutting the coaxial cable that connects them. The result was deafness and louder ringing. Why? Because the brain was detecting no grass blades at all and was signaling a bigger problem.

Just because the brain is the culprit of the sound does not mean that the sound is imaginary. We have to think of the brain as part of the auditory system. Only then are we seeing tinnitus through the proper lens.

Trapped in the Car: What It Feels Like to Have Tinnitus
This analogy may help you to explain what it feels like to have chronic severe tinnitus, to someone else.

Imagine being trapped in your car and it is wedged in between rocks. It is inaccessible and inescapable. The car alarm is sounding. Your well intended friends, family, co-workers, and treatment team come by and try to offer you advice on how to escape. One friend says, "Just think positive!" That doesn't help you to escape. A treatment team member shouts, "Go to your imaginary happy place!" That doesn't help. A co-worker shouts, "My uncle Joe was in the same situation once, he just ignored the sound and it magically disappeared! Try that!" That doesn't help you to ignore the annoyingly loud car alarm. Another member of your treatment team manages to get pills into the car for you. The pills don't help you to escape the car or remove the sound of the car alarm. You begin wincing in agony. Another person shouts, "See what happens when you don't wear hearing protection. This is your fault! You got yourself into this situation." That certainly doesn't help at all.

Suddenly, you see firefighters arrive and you feel relieved. You think that you are going to hear those magic words, as in, "Don't worry. We will have you out of the car and away from the alarm in no time. We can do this." Instead a firefighter leans toward the car, shakes his head left to right, and says, "We can't get you out. We are sorry. None of our tools work. But stay hopeful. Someday we will be able to get you out when the right tool is invented. Until then, just stay put."

You are stunned. Imagine in this day and age that there is no cure for chronic severe tinnitus. It is true.

That is what it feels like to have chronic severe tinnitus. You never really escape from the car alarm. You never have a quiet moment. The quieter the room, the louder the tinnitus. This is why insomnia, depression, and a weakened immune system can be the results of the stress of being trapped in the car with the car alarm. It is also why some people with severe chronic tinnitus begin to struggle socially. We are trapped in a car at every family event, at every celebration, at every business meeting, at every social event and we have to act like we are not in order to keep our careers and our relationships in tact.

Two Guitars: Why Tinnitus is Different for Everyone
This analogy may help you to explain why your tinnitus is different from someone who has a milder form. These are the people who say, "I have tinnitus and I just ignore it." or they say, "I have tinnitus and I just use a fan to mask it." (P.S. I used to be one of these people until my tinnitus became severe in 2009 and has not relented since). What they are really saying is, "What is wrong with you? Why can't you just be...MORE LIKE ME?"

Every tinnitus sufferer has an annoyance threshold. If the tinnitus gets louder it becomes harder, if not impossible, to simply ignore. It may get beyond what a masker can safely mask without doing more damage. Without further a due...

Two Guitars:
Two guitar players pick up guitars to begin playing together. Each guitar is out of tune. Each guitar has to be tuned by a player. Each guitar needs unique tuning, specific to how out of tune that it is, before it can be played.

The auditory system can be likened to a guitar. Each tinnitus sufferer has a different level of damage and in different parts of the auditory system. The auditory system may be functioning properly regarding all sounds except a certain range.

When that unique range is stimulated by certain sounds it can make the tinnitus worse, temporarily or permanently.

Therefore, it makes sense that tinnitus is different for everyone. It makes sense that some people's tinnitus is louder than others and that some cases of tinnitus are acute (short-term) and others experience chronic (long-term) tinnitus. It makes sense that some people are sensitive to certain sound frequencies. It makes sense that people respond differently to their tinnitus. It makes sense that each tinnitus sufferer experiences varying levels of hearing loss.

Each tinnitus sufferer has one thing in common, our ears are simply out of tune. The level to which we are out of tune is the variable.

Tinnitus: Acid Reflux

Many people with chronic acid reflux turn to medications to treat the problem of stomach acid thrusting upward and into the esophagus. People who suffer from acid reflux are concerned about destroying the lining of the esophagus and so they seek help in the form of medications. There are some acid reflux medications that can negatively affect tinnitus as a side effect.

I started looking for an alternative natural solution to acid reflux so that my tinnitus doesn't get worse. I've discovered that doing core strengthening exercises and eating one pink grapefruit a day makes acid reflux virtually disappear.

How does pink grapefruit work?
Pink grapefruit signals the stomach receptors that enough acid has been produced and the stomach slows acid production down, preventing the acid from thrusting upward. Relief can be felt almost immediately.

Also, a slice of fresh lemon squeezed into cold water can be beneficial. Cold water is absorbed into the body very quickly and lemon is also acidic. Eating salad with squeezed lemon juice on it instead of using salad dressing can be beneficial.

Over days of eating pink grapefruit and core exercising, the stomach will likely begin to adjust and start producing acid at a normal rate.

If you have severe medical issues, like ulcers or heart problems, talk to your doctor about all of your options. You may need to be on acid reflux medications due to the cause of your acid reflux. Once you are on those medications your tinnitus could get worse and the damage to your ears can be permanent. Be sure to ask your doctor and do your own research on the drugs that are prescribed to you for acid reflux.

In my opinion, the mildest medication that is least likely to worsen my tinnitus is Gaviscon. It is available over-the-counter. Gaviscon treats the issue nearly immediately. Since I can't carry a pink grapefruit everywhere that I go, I bring a few Gaviscon in a plastic bag for backup.

Tinnitus: Freaking Out About Fireworks?

If you have chronic severe tinnitus and your whole family has just invited you to a fireworks show, you may be freaking out. Your ears are now more sensitive to the sounds and could get permanently worse if you decide to go to the show.

But, you don't want your relative's feelings to get hurt. Formerly, I would have recommended that you don't go. Now I'm pleased to say that you could go and bring your noise cancellation headphones (Bose Quietcomfort 15) plugged into your recorder (H2n Zoom). This system should reduce the sound of the fireworks to a tolerable level. It works for me.

Keep in mind that the vibrations from the fireworks could still be harmful as they pass through the skull bones and the neurons in your brain. If your tinnitus is caused by auditory center damage resulting from TBI or tumors then you should be cautious. The grand finally may still prove to be too much for you, even with this system.

You can control the sound level striking your outer ear and middle ear using the mic gain and volume on the recorder. So, don't freakout about fireworks.

I've provided some links below. I am in no way affiliated with the makers of the products.

Links:
Bose Quietcomfort Link
H2n Recorder by Zoom
Resound Alera TS

Tinnitus: Taking Control

We live in a noisy world. For someone with tinnitus, who is more sensitive to certain sounds, it can be exhausting to try to avoid unsafe sounds that are being forced upon us. I use a number of existing technologies to reduce noise pollution. This is particularly affective at movie theaters, ceremonies, baseball games, even on an airplane. I want to prevent further damage to my sensitive cochlea. This system does not help me sleep nor does it stop the ringing sound but it does keep me from avoiding important events.

Noise Pollution Reduction System (NPRS) Components:

(Note: I do not sell any of the components. The hearing aids, headphones and recorder are sold separately. Amazon.com is where I purchased the recorder. I purchased the headphones from the Apple Store. The hearing aids can be purchased through an audiologist referral.)

1. Insert hearing aid maskers into the ears (I use Resound Live TS) and turn on the masker. 
2. Then plug a pair of noise cancellation headphones (Bose Quietcomfort 15 for example) into a high-quality recorder (I use H2next ZOOM). 
3. Place the headphones over ears and cover hearing aid maskers. 
4. Turn on the headphones and adjust the recorder volume and mic gain to your specific safety and comfort level. 

Check in with your hearing specialist before you use this innovation. He or she will explain safe parameters of use. If used properly, this system may help you to take control of noise pollution and prevent further damage to your ears. 

Innovator credit:

Steven Lucas and David Werkheiser

Tinnitus: Symptom or Cause

Is tinnitus a symptom or a cause? It is both. That is why I refer to it often as a condition. It is not a disease. Although it can be just as debilitating.

Tinnitus is a symptom because it is an indicator that something is wrong in one or a combination of the following parts of the body:

• Brain (possibly due to TBI) - Something is short-circuiting the auditory center of the brain. 
• Cochlea - The cilia (tiny hair-like electrical transmitters) are damaged or destroyed, due to sudden loud noise exposure or long-term exposure to a certain noise that creates "a cowpath" of destroyed cilia. 
• Vestibular nerve - The cable running from the cochlea to the auditory center of the brain is damaged. 
• The heart - High blood pressure can cause a certain kind of tinnitus called pulsatile tinnitus. The sound pulses with the heart. 

Tinnitus is also a cause. It can cause secondary conditions and socialization issues for the tinnitus sufferer:

• Chronic depression
• Insomnia
• Immune system issues

Tinnitus is the stimuli and the secondary conditions are the response. The louder the tinnitus, the more prominent the secondary conditions become.  The reverse is also true. Therefore, tinnitus is a direct cause of the secondary conditions.

As an analogy, tinnitus is the fuel of the fire. The fire represents the secondary condition. When more fuel is added the fire grows larger. If the fuel is gone, the fire goes out. In the case of chronic severe tinnitus, the fuel is never completely gone. It is always burning to a greater or lesser degree twenty four hours a day. Therefore, the secondary conditions can flare up at any time that the tinnitus flares up.

A problem exists when the generally accepted perception of tinnitus is as though it is merely a symptom. Under that mindset, tinnitus can become under treated and underestimated as a debilitating disability.