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Living With Tinnitus and Hyperacusis 10 Good Faith Suggestions - Robb - April '10

Living With Tinnitus and Hyperacusis 10 Good Faith Suggestions - Robb - April '10

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Living with Tinnitus: Top Ten Good Faith Suggestions for Conquering Tinnitus and Hyperacusis. By Michael J. A. Robb, M.D., Member, ATA Board of Directors and Scientific Advisory Committee

Living with Tinnitus: Top Ten Good Faith Suggestions for Conquering Tinnitus and Hyperacusis. By Michael J. A. Robb, M.D., Member, ATA Board of Directors and Scientific Advisory Committee

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Published by: American Tinnitus Association on Jan 08, 2013
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Tinnitus Today | Spring 2010
Tinnitus and hyperacusis (abnormal sound sensitivity)are extremely challenging symptoms to address,primarily due to the complexity of the brain.Fortunately, the brain is capable of making new oraltered connections even if the ear is permanentlydamaged. The human body has an amazing abilityto heal itself and recover from injury. A patient canchallenge the brain to accomplish the seeminglyimpossible task of neutralizing tinnitus and improvingsound tolerance. I hope that this list of suggestionswill empower you and help you find renewed hope,control and relief.
It is for educational purposes andis not intended to diagnose or treat any reader’scondition.
An established formal patient-doctorrelationship is the place to discuss symptoms andpossible treatments.
1. Consultation.
Seek medical and surgicalconsultation for pulsatile tinnitus (a whooshingsound in sync with your heart rate). Do thesame if you experience a clicking or tickingtinnitus in either a rhythmic or staccato, synco-pated fashion. A vascular problem is often thecause. A specialist can usually remedy theseproblems through medication or surgicallycorrecting ear and brain abnormalities.
2. Hearing Aids.
Try one or more hearing aidsover the course of three to six months if yourhearing test reveals hearing loss, regardlessof whether you think you have a hearing prob-lem. Do not give up until you find an amplifierthat helps you hear better and reduces yourtinnitus. You have a greater than 50 percentprobability of obtaining some tinnitus reliefwith well-vented digital hearing aids. For many,hearing aids can be the closest thing to a cure.
3. Sound Therapy.
Ask yourdoctor about daily broadbandsound therapy, which canweaken the relative strengthof tinnitus and neutralize it.There is tremendous long-term therapeutic valuein associating distressingtinnitus with a harmless,benign sound, such asrunning water, rain, white orpink noise or other dynamicsources that stimulate low,
Living with Tinnitus:
Top Ten Good Faith Suggestions for Conquering Tinnitus and Hyperacusis
Michael J. A. Robb, M.D., Member, ATA Board of Directors and Scientific Advisory Committee
middle and highfrequencies of the earand brain. Patientscan wear devices inthe ear, on a belt, in apocket or loaded ontoa computer, digitalmusic player or hand-held phone. They can setthem up in various roomsat home or in the office. Thereis something for everyone on any budget. Seewww.ata.org/for-patients/faqs (question 6).
4. Sound Therapy and Counseling.
Sound therapyworks best when used in conjunction withskilled, directive, individual, supportive andactivities-related counseling. This approach istime and labor intensive but critical for tinnitusrelief. Discuss with your trained tinnitus specialisthow and why the various tinnitus therapies work,how the ear and brain communicate and thepotential outcomes of the therapy. Understandingthese issues may help you comply with treatmentand maximize your success.
5. Evaluation of Overall Health.
Your body –during sickness and health – is like a competitiverace car; it needs periodic precision tune-ups.Conquering tinnitus distress puts high energydemands on your body’scells. Ask, or respectfullydemand, that yourphysician ordersroutine bloodand urinetests for acomprehensiveunderstandingof your health.Also, check yournutritional andhormonal levels.A well-balanced diet,regular exercise and balancednutritional supplements optimized for yourparticular health needs are all important tokeeping your ears, brain, heart, immunesystem and body healthy. This precision tune-upapproach may require assistance from otherhealth and alternative medicine professionals.
Spring 2010 | Tinnitus Today
The neurology of aging is challenging and bestaddressed with a holistic medical approach.
6. Sleep Studies.
Undergo a sleep study if snoring,fatigue, daytime sleepiness or weight is an issue.Many patients report louder tinnitus after a napor a poor night’s sleep. Worse yet, many patientshave not enjoyed a night of rejuvenating sleepfor years! Sleeping pills are not ideal; they mayprevent deep sleep and mask underlying sleepdisorders. A dual nighttime sleep study is best –night one for diagnostics and night two fordetermining effective therapeutic devices.Untreated obstructive sleep apnea increasesthe risk for heart attack and stroke. Do notdelay. Good sleep is extremely important.
7. Physical Therapy.
Seek physical therapy foryour jaw, neck and shoulders when indicated.Some people report tinnitus for the first timeafter sustaining a whiplash injury.Physical therapy can help reduceneck and shoulder muscle toneimbalances and possiblyreduce tinnitus loudness.Temporomandibular joint(TMJ) disorders are common;many patients who grindtheir teeth at night, or have jaw clicking, popping, painand limitations in motion,experience fluctuations oftinnitus loudness. Nervescarrying information from the jaw,head and neck can send signals tothe hearing center in the brainstem. Thisincreases or decreases tinnitus loudness duringa particular muscle contraction, which physicaltherapy and/or oral splinting may improve.Some patients have reported tinnitus afterundergoing forceful, rapid neck manipulations.Gentle chiropractic manipulations are preferred.
8. An Active Brain.
Keep your brain active withdifferent types of activities, for example: speakingforeign languages, mathematics, puzzles, reading,writing, singing, social interaction, new adven-tures, outdoor activities or pursuing a passion.Tinnitus perception usually diminishes as one’ssurrounding space enlarges. So get out there.Exercising outdoors and the sounds of naturecan be very good for the body and mind – plusafford tinnitus relief.
9. Ear Protection.
Use appropriate, well-fitted earprotection. However,
do not overprotect
yourears all day long – this can worsen hyperacusis.Try to reduce unwanted noise: 1) replace yournoisy hair dryer with a quieterone; 2) have your air condi-tioning and heating systemscleaned and serviced; 3) putfelt pads on all cabinet doors;4) upgrade your TV speakersfor better clarity at a lowervolume; 5) pay attention to theacoustics in your home; 6) turndown your cell phone volume;and 7) be very careful aroundlive bands, weddings, sportingevents, outdoor festivals, fire-works, hunting expeditionsand even MRI scans andcertain audiology tests.
10. Cognitive Behavioral Therapy.
 Seek cognitive behavioraltherapy (CBT) if you are motivated to tackleyour tinnitus intellectually and you feelemotionally well balanced. This type oftherapy challenges distorted thoughtsabout tinnitus. Patients gain insightinto over 20 different ways theirminds might catastrophically viewa particular problem. They thenlearn how to substitute accuratetherapeutic thoughts to calm theirtinnitus perception. See the NationalAssociation of Cognitive BehavioralTherapists (NACBT) online roster ofcertified therapists at www.nacbt.org/searchfortherapists.asp.
11. medication.
Consider medication only as alast resort, once you’ve tried hearing aids, physicaltherapy, nutrition, diet, lifestyle modification andsleep interventions. Medications have no nutri-tional value; can deplete the body of nutrients;are often loaded with side effects; and have thepotential for drug dependency and drug tolerance.They can be a crutch that prevents you from reallyknowing whether habituating to your tinnitus ispossible. For those who do require medication,a discussion with your tinnitus specialist aboutrisks, benefits and alternatives is essential.If one approach does not work for you, another justmight
in time.
Do not give up on the power of yourbrain and nerves to make new connections necessary toovercome tinnitus distress. With appropriate counselingand sound therapy, the meaning of tinnitus can beneutralized and the brain stops constantly monitoringthe tinnitus. Lifestyle changes plus balanced dietary andnutritional support can offer additional health benefits.
Do not be discouraged;countless peopleovercome physicaland mental adversityto accomplishamazing goals.
Michael J. A. Robb, M.D.
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