The Sound in my
Head - Five years of living with Tinnitus
As with everything on this blog, this entry is
written from my own perspective as a patient with an interest in their own
condition, rather than as a medical professional. The strategies I use
for managing my tinnitus are those which I have found work for me, but they may
not work for anyone else. If you have developed tinnitus please go to the NHS website (linked here) for details on
what to do, as while tinnitus can be benign - as detailed here - it can be a
symptom of more serious problems. For more advice on coping
with tinnitus see the guides from the British
Tinnitus Association.
I haven't heard silence since 2016. I've lived for the last four
years with a constant high pitched tone in my left ear. A high pitched,
single, never ending tone. For the first six months the sound drove its
way into my thoughts at every hour of the day, twisting my thinking, and
damaging my mental health. In this entry I discuss my tinnitus diagnosis,
and the tips I have used to help live with the condition.
I was referred to the Audiology department at my Local Hospital - who
carried out a battery of tests to see whether it was a result of damage to the
ear, or to the eustachian tube was damaged in any way - causing an internal
sound.
The Eustachian Tube, named for Bartolomeo Eustachi - a 16th century
anatomist and one of the founders of the science of anatomy, connects the
middle ear to the nasopharynx, and is normally collapsed, but opens on
swallowing and positive pressure. Equalising the pressure within the ear
by opening the tube (since the air within the ear is not exposed to the
atmosphere and can be subject to pressure differences) can be achieved by the
Valsalva maneuver - by breathing out against a closed airway. The
person carrying out the procedure closes their mouth and nose with their hand
and attempts to breathe out, which forces the Eustachian tube to open. It
is commonly used to equalize the pressure between the air in the ear canal and
the surrounding atmosphere. The procedure is named for Antonio Maria
Valsalva - a 17th century Italian anatomist.
The tests showed no internal source of the sound - concluding it to be tinnitus.
There was no damage to the ear itself, but since tinnitus can emerge as a
symptom of underlying problems with the brain - including brain tumours - and
my own history of brain injury - it was decided that some further tests would
be necessary. In this case I spent another hour in an MRI machine having
scans taken of my brain to ensure there was no fresh scarring, no tumour,
etc. The MRI showed no new changes to my brain - confirming that the
tinnitus was independent of the damage. So what was the cause?
We explored multiple causes over the months and none which would require
additional treatment were found. My own personal theory is that it may be
the result of an interaction between two of my medications - both of which have
tinnitus as a relatively rare side effect - particularly since the symptom
developed approximately a month after starting treatment with a new medication
replacing one I had previously been on for some years. However at this
time we cannot easily change this medication to see if the tinnitus subsides
after withdrawal.
So how do you live with a constant high pitched sound similar to
feedback in a sound system playing in one of your ears? It's not easy,
but I've developed some strategies over time. So here are my thoughts, as
a patient, about ways which can help you cope with this.
Tip 1: Music
The audiologist noted, after I mentioned the exact tone of my tinnitus,
that tinnitus appears to be slightly more common amongst - and frustrating for
- musicians and audio professionals. For me this was one source of my
frustration - since when I worked in sound engineering I had always taken
proper precautions to take care of my hearing, using hearing protection and
being careful to avoid long exposures to loud sound. Like both my parents
I have relative pitch, and degrees of absolute pitch (sometimes called perfect
pitch) which means we experience music in a slightly different way to most
people. In my case I also have associations between sound and
colour. However music can still be key to helping live with tinnitus
particularly when it comes to sleep. Instrumental music can be useful
especially at low volume, as it allows the brain to tune out of the constant
sound and focus on the one that in is changing even if you are not necessarily
consciously listening. My personal go to tends towards classical music
and post-rock - I'm particularly fond of the composer Camille Saint-Saëns,
the bands God is an Astronaut, Sigur Rós, Nox Arcana, and Signal
Hill. The first time I used music was actually a track used as backing to
the first website of the band The Birthday Massacre, which was called the Night
Loop. There are a vast number of artists producing instrumental and
ambient music which can be useful as low level background noise to help tune
out the tinnitus tone. At the right volume (which you can generally find
by experimentation) the tinnitus tone becomes lost in the other sounds as your
brain identifies the music and disregards the tone.
Tip 2: Noise Generators / Noise Apps
Another way of compensating for the tinnitus tone is through noise
generators or noise apps. There are a large number on the market -
including a number of free apps and samples on YouTube. Most produce
either white noise (familiar
from those old enough to remember TV signal interference), pink noise. or brown noise. These are sounds across
differing frequencies with the same intensity - as with music they effectively
allow the tinnitus tone to get lost in the general sound. I personally
find brown noise to be slightly unnerving (which may well be a reflexive
response). The other options are noise generating apps such as those
which offer a variety of rain sounds. I find these to be particularly
useful as they give you a variety of options such as rain on a window or roof,
heavy rain and thunder, or light rain. Others are marketed as being for
helping babies and young children to sleep, producing such background noise as
the sound of a washing machine, dishwasher, car engine etc. I tend to
find the noise and rhythm of the sound of trains helpful. Many of these
apps are freely available on Android and Apple devices. Of course one of
the earliest services of this type were the websites RainyMood.com
and Coffitivity.
Tip 3: Noise Cancelling Headphones
This might sound
initially counter intuitive - since the purpose of noise cancelling headphones
is to block out ambient sound and background noise - but I have found that a
good pair of headphones with active noise cancellation - when paired with the
above two tips - is one of the best things I have found for helping cope with
my tinnitus when I need to concentrate on a particular task. My personal
favourite set are from Skullcandy (the Venue model which retails at around
£100), but a good workable and reliable set from MPow, available on Amazon,
retail for around £40 and are as affective. By blocking out other ambient
sound they allow you to replace it with the soundscape you want - allowing you to
fine tune your background noise to help with concentration. While they
are an expensive purchase for me they are more than worth the
investment.
Tip 4: Clockwork.
There is a lot to be said for following a routine when it comes to
getting to sleep and it has been shown that a routine helps sufferers of
tinnitus when it comes to tuning out the tone enough to sleep. Impact on
sleep is a major issue for many people with tinnitus - and the BTA sells a
number of devices which help with background noise generation for sleep -
including specialist headphones to be worn while sleeping. I have found
that one thing which helped a lot was a simple purchase of an old fashioned
bell alarm clock - which, along with having a loud alarm, also has a
distinctive regular tick. The repeated sound helps break up the sound,
and can itself be soothing in this respect.
These four tips have helped me cope with my tinnitus on a day to day
basis, both when I'm relaxing, sleeping, or working on my thesis and other
research. I hope these tips may be useful to anyone struggling with
tinnitus, or those who struggle with concentration more generally. As
said in the note at the top of this entry - if you have tinnitus check the NHS
website, and in the UK if needed see your GP who can help with some initial
examinations to identify potential causes (one cause of tinnitus can be earwax
build up for example) which can be treated simply, or refer you to the relevant
clinic. It can be hard to live with but it can be done.
