Tinnitus is the sensation of noise or "ringing" in the ears - a common problem that affects approximately 15 to 20 percent of individuals, so roughly 1 out of 6 people suffer from it. With those kinds of numbers, we feel it's a topic worth exploring, and in fact, it's an important part of our practice at Tinnitus & Hearing Center of Arizona. The Rohe Method® of Tinnitus Treatment was created as a unique blend of Cognitive Behavior Therapy (CBT) and Tinnitus Retraining Therapy to facilitate retraining the brain. Retraining activates plasticity in the brain, which allows the nervous system to change its function in various ways, typically for learning or self-repair.
Tinnitus is not an actual condition; it is a symptom, instead of some type of underlying condition, such as an ear injury, circulatory system disorder or age-related hearing loss.
Although tinnitus is annoying and can be incredibly frustrating, in the majority of cases it is not normally a sign of anything physically serious. It may worsen with age, for some individuals; if treated, tinnitus may improve. Sometimes it helps to treat an identified underlying cause such as a hearing loss or TMJ disorder, which a trained audiologist can help identify. Other treatments mask or reduce noise, which can make tinnitus less intrusive and bothersome.
The Two Types of Tinnitus
There are two types of tinnitus: One type is called subjective tinnitus, which is the type of tinnitus that only can be heard by you. It is the most common form of tinnitus. This may be caused by problems in the inner, middle or outer ear. It may be caused as well by problems with the part of the brain where nerve signals are interpreted in the form of sound (auditory pathways) or with the hearing (auditory) nerves themselves.
Objective tinnitus is the type of tinnitus that your doctor is able to hear when she or he performs an examination. It is a non-ringing sound - more typically rushing, clicking, thumping, or other atonal sounds. It is a less common type of tinnitus that might be caused by vascular issues such as turbulent blood flow through blood vessels in the neck or abnormal muscle contractions (activated by grinding your teeth for instance) that compresses some part of the auditory system. This type of tinnitus more often has an identifiable cause and may be treatable.
When you should visit your Audiologist about your Tinnitus
What Causes Tinnitus?
Cell damage of the inner ear hair is one of the most common causes of tinnitus. Delicate, tiny hairs within the inner ear known as the cilia move in relation to sound wave pressure. That triggers cells to release an electrical signal via a nerve in the ear (auditory nerve) over to the brain. Those signals are interpreted by the brain as sound. If the hairs inside of the inner ear are broken or bent, random electrical impulses may be leaked to the brain and cause tinnitus.
Other issues that cause tinnitus include chronic health conditions, other ear problems and conditions or injuries that affect the hearing center inside the brain or the nerves inside the ear. Many health conditions may cause or even worsen tinnitus. An exact cause, in many cases, is never found.
Other Tinnitus Causes
Some less common causes of tinnitus include the following:
Pulsatile Tinnitus and the Link with Blood Vessel Disorders
A blood vessel disorder may cause tinnitus in rare cases. The type of tinnitus is referred to as pulsatile tinnitus. The causes may include the following:
Medications that may cause tinnitus
There are a number of different medications that may worsen or cause tinnitus. In general, the higher the dose of the medication, the worse the tinnitus will become. Frequently, the unwanted noise will disappear once you stop using the drug. Some of the medications that are known to cause or make tinnitus worse include the following:
Also, some herbal supplements may cause tinnitus, and also caffeine and nicotine.
Anybody may develop tinnitus. However, the following factors can increase your risk:
The Impact of Tinnitus
Tinnitus may have a significant impact on your quality of life. Although it can affect various people in different ways, if you develop tinnitus, you might experience any of the following as well:
Treating those linked conditions might not directly affect tinnitus, but can improve how you feel.
Tinnitus in many cases is caused by something that cannot be prevented. However, there are still precautions that may be taken to help prevent certain types of tinnitus from developing.
What To Do About Your Tinnitus
Tinnitus can be successfully managed and thankfully there are a variety of therapies and tinnitus treatments that you can read about in detail here. These include:
It's worth mentioning here that Dr. Rohe is currently the only audiologist in the US that is trained and experienced in both audiology and Cognitive Behavior Therapy, making him uniquely qualified to address all aspects and options for your tinnitus treatment, whether in his Tempe AZ clinic, or online via Skype conference.
To schedule a consultation, call Tinnitus & Hearing Center of Arizona at (480) 831-6159, or use their online scheduler here.
There are several potential drawbacks or risks that come with buying hearing aids online or in a "megamart" store. We get asked if "Costco hearing aids" are any good, and our answer is the same: there are many factors to consider, and your hearing and quality of life are at stake. While we at Tinnitus and Hearing Center of Arizona don't have "cheap hearing aids," we do offer affordable hearing aids from the best brands on the market (in our experience) that have impressive and significant investments in research and leading technologies.
Cheap doesn't always get you what you need
In our opinion, it is best to buy hearing aids from a local provider who will be able to provide ongoing adjustments and service for the lifetime of the hearing aid (normally the purchase price includes this). Free unlimited office visits on the life of the hearing aid are offered by Tinnitus and Hearing Center of Arizona if you purchase the hearing aid from us.
A hearing aid is a type of medical device. There are many reasons why you should not buy one online. You should get tested before you buy hearing aid so that you know what your hearing loss is. Hearing aids are also custom and must be adjusted. If you buy hearing aids online, a majority of medical professionals will not be able to program your hearing aids. It is recommended that you consult with a professional before you make a decision on any of your medical needs, including hearing aids.
The greatest risk, which is something you should be concerned about, is your overall hearing health. Without proper evaluation and testing, you will not know why you have suffered a hearing loss. Without that knowledge, you easily could mask serious problems that could potentially put your health at risk. It could potentially be an undiagnosed medical problem that is causing your hearing loss that could even result in death. Even if you don't have a medical issue that has to be addressed, a hearing aid that is improperly adjusted could damage your auditory system, and lead to even more hearing loss. You should take your hearing aid device purchase very seriously and realize that hearing sciences training is necessary for treating hearing loss properly. I recommend that you find a reputable local audiologist (us, preferably :) ) who can treat your loss properly and who is available for future adjustments and follow-up. When it comes to your hearing health, you definitely get what you pay for.
With hearing aids, it is important to allow your brain to adjust to being able to hear sounds again. If it is the first time you have used hearing aids, be aware that often they will need to be set lower and adjusted several times until you are accustomed to hearing sounds accurately and comfortably according to your preferences (and everyone is different).
You can't just take your hearing aids and be done
It is important to have a good service program with an actual audiologist so that they can be programmed properly for your specific hearing loss, and help you make the adjustments to them. To ensure they are working properly, you need to visit your audiologist regularly for checkups and cleaning. When you purchase hearing aids online or from a supermarket bulk store, chances are you won't be getting service from experts that are necessary when you buy hearing aids.
The following are a couple of "regrets" we hear from customers that bought hearing aids online:
1. Sound is really personal. If you had visited an audiologist instead and gone through the process with them, you might have picked out a different hearing aid than the one you bought online.
2. When you purchase through an internet provider, you can only buy instant fit CRT aids. You might need custom aids or custom tips.
3. Although they might suggest having an audiogram with the hearing aid, what about Real Ear Measurements, over-all levels, feedback, and more? Just sending a hearing aid and audiogram to a patient is not an actual fitting.
It is essential for hearing aids specifically be programmed for the person's individual ear that is based on an audiometric test. Therefore, the first issue is to ensure that the hearing aids are programmed using a current hearing test.
While there are numerous places online that sell hearing aids, some do this without the manufacturer's permission. One manufacturer sent a letter out that stated it wouldn't honor the warranty for any of the hearing aids that were sold through a specific company (second risk).
Although mild hearing losses may be accommodated through an initial fitting, a majority of hearing losses need to be fit by programming the hearing aid below the loss followed by the hearing aid amplification being increased over time (and over several different office visits) as the person's brain continues to accommodate the increased hearing level.
This is not done by online companies themselves. Some contract with a local provider to do the initial fittings and a certain number of follow-up visits. There are other online companies that don't provide any local service.
That leads to the third risk, and it is a major one. Hearing aids all need periodic maintenance and readjustment in order for the patient to get the best results. Even if some initial support is provided by an online company, usually it is not for longer than the first year. You are completely on your own after that and will need to find someone who is willing to work on your hearing aids that they didn't sell to you. That means you will have to pay for each office visit from that point forward. That can cost up to $150 per visit as a single fee and as much as $1,500 to $2,000 for lifetime services. Even warranty-covered repairs require that a licensed dealer send the hearing aid to the manufacturer so it can be refitted. After the hearing aid has been repaired it is then returned, but you will then have another office visit to pay for.
Here are more reasons to avoid cheap hearing aids.
Guest post by Scott Novak - patient of Tinnitus & Hearing Center of Arizona
In Part 1 of this article (found here), I mentioned an elderly couple that I approached on my bike that didn't hear me. As you might have noticed, I theorized several reasons why that man might be resisting getting hearing "assistance." Since then, I started thinking more about the possible association with hearing loss and simply being elderly.
When I turned 42, I noticed my eyesight getting blurry when I would read printed material or the computer. Okay, I thought, I'm probably going to need glasses. There's a certain "resistance versus resignation" to getting older that I think we all struggle with. We can't fight Father Time though, as much as we try. Perhaps admitting to a hearing loss is also admitting to getting older, and even to one's own mortality.
So why not take every opportunity to maximize the enjoyment of every day? Every minute? Why do some people resist going to a hearing doctor (an audiologist) and explore options for hearing aids, but are perfectly fine going to an eye doctor and paying for glasses? We talked about that in the last article, but I wanted to explore the idea of the hearing loss stigma a little more, and found some interesting research.
The Impacts Caused By The Hearing Loss Stigma
Despite how prevalent hearing loss is (around 20 percent of Americans report that they have hearing loss to some degree), the stigma still persists. Whenever people are ashamed of having a hearing loss, they might refuse to acknowledge their problem. There was another study that Southall, Gagne, and Jennings conducted where participants experience a high level of stress when attempting to conceal or deny their hearing loss. Both professionally and personally they were afraid of being labeled and put off going to see an audiologist.
Even after they visit a doctor, an individual may reject hearing aids since they are afraid of looking old, and feeling inferior or ashamed, or view hearing devices as being signs of weakness and being handicapped. Unfortunately, failing to seek treatment may cause long-term effects.
Untreated hearing loss can result in lower signal quality inside of the brain (which can be held to higher cognitive load), behavior changes, social disengagement, changes in the brain's structure, and health problems like anxiety, fatigue, depression, and dementia.
Fighting the Stigma
How can we effectively fight the hearing loss stigma? Education is the key. By educating the public (including individuals with hearing loss) about the various challenges involved with hearing loss as well as the benefits that treatment can provide, empathy can be fostered which can lead to a more positive outlook for hearing health.
Finally, if you are suffering from hearing loss, don't allow the stigma to hold you back. You might feel as if a hearing aid makes you look old, but it actually will help you in many ways in maintaining your youth. After all, young people who have excellent hearing do not continuously ask other individuals to repeat themselves constantly. They don't respond in conversations inappropriately because they are unable to hear the other part of the conversation. They don't disconnect socially because they are struggling to hear the conversation.
These days, hearing aids are very effective and can help you maintain your mental faculties, your social life, and maybe even your career. Modern hearing aids are also very inconspicuous and small, so you won't have to worry that you will stand out in a crowd. If you really want to hide the fact that you are suffering from hearing loss, then check out the discreet styles such as receiver-in-the-ear (RITE) and completely-in-the-canal (CIC) hearing aids. Also, search for a hearing aid that comes with an inconspicuous remote, to allow you to not draw attention to yourself whenever you are wanting to press the program button or change the volume. There are some devices that connect to a smartphone, which makes them technologically savvy and very convenient. Whenever you need to use your hearing aid's control center, it will just look like you are using your cell phone.
Get a dang hearing test already!
If you have been procrastinating having a hearing test, you are not alone. Most people wait, on average, almost seven years from the time when they first notice there is a change in their hearing before they actually seek out help. Seven years worth of strained relationships at work and at home, missing out on so many of the sounds all around you, and risking health problems that are associated with hearing loss.
Keep in mind that it is critically important to treat hearing loss for your future and current health. Rather than hiding your struggles, help to reverse the hearing loss stigma by using hearing devices and helping to encourage other people that you know to go see an audiologist.
I'm so glad that I listened to my wife and scheduled a hearing test with Dr. Allen and Amy Rohe. Not only were they knowledgeable about their craft, but hey were just genuinely kind people, so the hearing test and conversation about options was very casual and friendly. I was able to try a pair of hearing aids for a week or so, and Dr. Rohe actually let me try a few other pairs until I got the set that I loved. Who does that? Having those options and such an enjoyable interaction is plenty to highly recommend Tinnitus & Hearing Center of Arizona.
If it's any consolation, my wife is happier that she doesn't have to repeat herself all the time, and I'm happier knowing that I can hear most any conversation now. And that, to me, is priceless.
If you're interested in hearing aids in Tempe or the surrounding Phoenix metro, it's worth a call to Tinnitus and Hearing Center of Arizona: (480) 831-6159 or use their convenient online scheduler so you can book online and see what times are available.
Tinnitus and Hearing Center of Arizona, LLC
2034 E. Southern Avenue, Suite I
Tempe, AZ 85282
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Dr. Rohe is a nationally-recognized audiologist specializing in Tinnitus Therapy and other hearing conditions.