tips for managing tinnitus

# Tips
# The first steps to take
# Possible therapies

Courtesy of www.ata.org


* DO NOT panic. Tinnitus is usually not a sign of a serious, ongoing medical condition.
* CHECK things out. The sounds you hear may actually be normal sounds created by the human body at work.
* SEE an audiologist or ear, nose and throat specialist (ENT) interested and experienced in tinnitus treatment.
* REVIEW your current medications (prescription, over-the-counter, vitamins and other supplements) with your medical professional to find possible causes of your tinnitus.
* BE WARY of a hopeless diagnosis or physician advice like, “There’s nothing you can do about your tinnitus. Go home and live with it.”
*BE a detective. Keep track of what triggers your tinnitus.
* KEEP UP TO DATE about tinnitus. More and more research by the best and the brightest is bringing us closer to successful treatments and cures for tinnitus.
* EXAMINE how you live to find ways to eliminate or reduce some stress in different parts of your life; stress often makes tinnitus worse.
* PAY ATTENTION to what you eat. One-by-one, eliminate possible sources of tinnitus aggravation, e.g., salt, artificial sweeteners, sugar, alcohol, prescription or over-the-counter medications, tobacco and caffeine. (Do not stop taking medications without consulting with your health care professional.)
* DON’T GIVE UP on a treatment if it doesn’t work right away. Some can take quite a while to have a positive effect.
* PROTECT YOURSELF from further auditory damage by avoiding loud places and by using earplugs when you can’t avoid loud noise.
* DO NOT create any negative forecasts for your tinnitus, such as “This is never going to get any better.” Counting on a better future can help you create one.
* DO NOT WASTE time blaming yourself for your tinnitus. The causes of tinnitus are varied and difficult to determine.
* EDUCATE your family, friends and co-workers about tinnitus; tell them about the conditions and settings that are difficult for you; and ask them for their support.

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Step 1
Take note of the details surrounding the onset of your tinnitus
Were you using a new medication when it first began?
Were you injured or exposed to excessive noise right before it started?
Is the tinnitus in one ear, both ears, or perceived to be somewhere in the head?
Does it fluctuate or is it constant in tone?
Do you have a hearing loss?
These are valuable pieces of information that can potentially lead your health care provider to a solution and you to a relief.

Step 2
Visit a medical doctor
There are several physiological causes of tinnitus such as high blood pressure, an underactive thyroid, excessive ear wax, and in rare cases a tumor on the auditory nerve. Control of these medical problems can bring tinnitus relief.
When a pathological cause of tinnitus is ruled out, some medical doctors refer patients to audiologists for additional tinnitus evaluation and treatment.

Step 3
Have your hearing checked
An audiologist is a hearing specialist with advanced degrees. Audiologists can perform all audiological tests and hearing evaluations. They can also dispense hearing aids, tinnitus maskers and tinnitus instruments.
Some audiologists offer counseling, relaxation strategies, biofeedback, and tinnitus retraining therapy which combines directive counseling with the use of in-the-ear broadband sound generators or other devices to enrich the patient’s background sounds.
Medical doctors and audiologists can perform diagnostic audiological tests to better determine middle ear and inner ear function.
Hearing aid specialists: they are trained and licensed to fit hearing aids, to perform audiometric tests and hearing aid evaluations, and to offer assistive devices such as beside maskers or audio tapes for masking. Many offer hearing aids and tinnitus devices on a trial basis.
Not every doctor, audiolgist, or hearing aid specialist is able to provide all of the services listed. There are, in fact, many heath professionals who are not yet familiar with treatments and testing protocols for tinnitus.

Step 4
Talk with your health care provider
Communicate your feelings and concerns to your doctor or audiologist. This can help you understand your options, and can give you the assurance you need. The following are some suggested questions to ask.
What tinnitus treatments do you use in your practice?
What is your exact diagnosis?
What is your treatment plan for me?

Step 5
Try something!
Hearing aids, maskers, drug therapy, tinnitus retraining therapy, and other treatments have all been used with success.
- Counseling can help. Depression and/or anxiety occasionally accompany tinnitus in its early stages.
- Cognitive therapy is used to alter the way patients react to their tinnitus by identifying and eliminating negative thought and behavior patterns.
- Biofeedback therapy enables patients to consciously control their breathing, heart rate, blood pressure, and muscle tension through electronic monitoring. This treatment is usually coupled with counseling and other stress reduction techniques.
- Some tinnitus cases appear to me of TMJ origin. A dentist specializing in TMJ can perform an evaluation. Therapy may include orthodontia or a removable in-the-mouth appliance.
Try something again. A treatment that didn’t work the first time might work the second time. And for many patients, a combination of therapies is more effective than a single therapy.

Step 6
Take care of yourself
Use hearing protection (earplugs or earmuffs) in noisy surroundings. Excessive noise exposure can worsen tinnitus.
- Learn how to relax best. Exercise, yoga, meditation and environmental audiotapes (rainfalls, ocean waves, ecc.) can promote relaxation and reduce fatigue. You might find that tinnitus is better tolerated when you are relaxed.
- Get sleep. Many people are able to fall asleep by listening to FM radio static, an electric fan, or a bedside maskers. Caffeine, alcohol, cigarettes and some drugs can interfere with falling or staying asleep.
- Be patient with the therapy you are trying. Many therapies require an investment of time to be effective.

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Alternative Treatments

Some people have taken minerals such as magnesium or zinc, herbal preparations such as Ginkgo biloba, homeopathic remedies, or B vitamins for their tinnitus and found them to be helpful. Others have experienced tinnitus relief with acupuncture, cranio-sacral therapy, magnets, hyperbaric oxygen, or hypnosis. A few of these therapies have been researched in an attempt to verify the anecdotal claims. But the results have not conclusively identified these treatments as helpful for tinnitus. Your doctor might give you clearance to try them for tinnitus anyway given that they generally carry little risk to health and some people find them helpful.

Amplification (Hearing Aids)
Some tinnitus patients with hearing loss experience total or partial tinnitus relief while wearing hearing aids. There are many variables that determine success. However, if a patient has a hearing loss in the frequency range of the tinnitus, hearing aids may bring back in the ambient sounds that naturally cover the tinnitus. [back to top] Biofeedback Biofeedback is a relaxation technique that teaches people to control certain autonomic body functions, such as pulse, muscle tension, and skin temperature. The goal of biofeedback is to help people manage stress in their lives not by reducing the stress but by changing the body’s reaction to it. Many people notice a reduction in their tinnitus when they are able to modify their reaction to the stress in their lives.

Cochlear Implants/Electrical Stimulation
A cochlear implant has two components: 1) an electrode array that is threaded into the cochlea, and 2) a receiver that is implanted just beneath the skin behind the ear. The electrode array sends electrical sound signals from the ear to the brain. Because electrode implantation destroys whatever healthy hair cells were left inside the cochlea, these implants are prescribed to deaf or near-deaf patients only. In one study, half of those who had tinnitus before their cochlear implants experienced tinnitus relief after their cochlear implants. Why do cochlear implants help tinnitus? There are two possible reasons: 1) The tinnitus might be masked by the ambient sounds that these devices bring back in. 2) The tinnitus might be suppressed by the electrical stimulation sent through the auditory nerve by the implant. Some forms of electrical stimulation to the ear can stop tinnitus briefly.

Cognitive Therapy
Cognitive therapy is a type of counseling that is based on treating a patient's emotional reaction to tinnitus rather than the tinnitus itself. To accomplish this desired change in perception, a counselor will help the patient identify negative behaviors and thought patterns, then alter them. Counseling programs are individually designed for patients and are most effective when coupled with other tinnitus treatments, such as masking or medication.

Drug Therapy
Many drugs have been researched and used to relieve tinnitus, but there is not a drug that has been designed specifically to treat tinnitus. Some drugs that have been studied include anti-anxiety drugs like Xanax, antidepressants like nortriptyline, antihistamines, anticonvulsants like gabapentin, and even anesthetics like lidocaine. All successfully quieted tinnitus for some people. We cannot recommend which treatment, drug or otherwise, is right for you. This is for you and your health care provider to determine. Remember to talk to your provider about side effects and about other medications you currently take. Because side effects can happen with any drug or drug combination, patients have to decide for themselves if an undesirable side effect is worth the trade off of tinnitus relief. Many people ask why pharmaceutical companies aren't actively researching a drug designed specifically for tinnitus. Partly, this is because of the cost-prohibitive nature of prescription drug development. A report in the December 2003 Wall Street Journal reported that large pharmaceutical companies spend an average of $1.7 billion to develop a new drug therapy. This price tag includes the creation of the drug, testing, approval from the Food and Drug Administration, and marketing. Creating new drugs involves a certain level of failure. Only about one out of eight drugs tested on animals actually make it to the consumer market.

Sound Therapy
Various treatment strategies use sound to decrease the loudness or prominence of tinnitus. Sound therapies include both wearable (hearing aid-like devices) and non-wearable devices (such as table-top sound machines or even a whirring fan). Often, sound is used to completely or partially cover the tinnitus. Some people refer to this covering of sound as masking. Sound therapies should always be combined with counseling.

Treatment Tinnitus can be a symptom of a jaw joint (temporomandibular joint, or TMJ) dysfunction. This can happen because muscles and nerves in the jaw are closely connected to those in the ear and, under the right circumstances, can interfere with the ear's nerves. Dental treatment or bite realignment can help relieve TMJ pain and associated tinnitus. See your dentist if you think you have this problem.

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