Tinnitus

Another treatment for tinnitus

Photo credit: Dr. Craig Hacking and Prof Frank Gaillard licensed under CC BY-SA 4.0

by Daniel Fink, MD, Chair, The Quiet Coalition

This report from the University of California San Francisco discusses a Phase 1 trial of deep brain stimulation for tinnitus. A Phase 1 trial is a preliminary trial to see how a new treatment works. Then there are Phase 2 and Phase 3 trials.

Most treatments do not pass all the hurdles to be approved for regular use. And deep brain stimulation is expensive and risky.

By comparison, prevention of most forms of tinnitus is cheap, easy, and safe: avoid head trauma and noise exposure and one is unlikely to develop tinnitus.

That sounds like a much better idea than deep brain stimulation to me.

Dr. Daniel Fink is a leading noise activist based in the Los Angeles area. He is the founding chair of The Quiet Coalition, an organization of science, health, and legal professionals concerned about the impacts of noise on health, environment, learning, productivity, and quality of life in America. Dr Fink also is the interim chair of Quiet Communities’ Health Advisory Council, and he served on the board of the American Tinnitus Association from 2015-2018.

Motorcycle noise can damage riders’ hearing

Photo credit: Sourav Mishra from Pexels

by Daniel Fink, MD, Chair, The Quiet Coalition

Motorcycle noise is a problem for people in many cities, interrupting conversations, disrupting sleep, and being loud enough to cause auditory damage. But motorcycle noise is also a problem for riders. This online piece from a UK insurance agent discusses the dangers of motorcycle noise for riders’ hearing.

Noise comes from both the engine and from air moving past the riders’ ears. Wind screens reduced the noise somewhat, but it is still loud enough to cause hearing loss.

Many motorcycle riders aren’t aware that the noise can damage their hearing. But many of those who know about the dangers of wind and engine noise on their ears don’t want to wear earplugs because they want to hear what’s going on around them.  Riding a motorcycle is hazardous, and riders want to hear other vehicles that may or may not see them.

Filtered ear plugs, which allow transmission of lower frequency sounds while blocking high frequency wind noise, might be a good solution.  The best solution, of course, is to avoid the source of damaging noise, which will also benefit anyone who would rather not be exposed to motorcycle noise.

Dr. Daniel Fink is a leading noise activist based in the Los Angeles area. He is the founding chair of The Quiet Coalition, an organization of science, health, and legal professionals concerned about the impacts of noise on health, environment, learning, productivity, and quality of life in America. Dr Fink also is the interim chair of Quiet Communities’ Health Advisory Council, and he served on the board of the American Tinnitus Association from 2015-2018.

How to treat people with disabilities, visible and invisible

Photo credit: Anas Aldyab from Pexels

by Daniel Fink, MD, Chair, The Quiet Coalition

Having tinnitus and hyperacusis has made me more aware of what it’s like to have a disability. I am fortunate that my symptoms are mild and not life-limiting, but noise does bother me. When my wife asks for a quiet table at a restaurant, “because my husband has issues with noise” or “because noise bothers my husband,” I feel embarrassed and different. That gives me a very small insight into how difficult life can be for those with serious disabilities.

This piece by David Pogue in the New York Times discusses what different-looking people would like us to know before we stare. The bottom line, it seems, is that except for children it’s not okay to make comments about someone’s disability. It is okay if it appears that someone needs help to ask, “May I help you? If so, what can I do to help?”

Reading the article made me think about what those of us who have invisible disabilities, including auditory disorders like hearing loss, tinnitus, and hyperacusis, as well as disorders like PTSD or autism spectrum disorder, might like others to know.

For those of us with tinnitus and hyperacusis, I think we would like people to know that noise bothers us. It makes our symptoms worse, and can be downright painful.

For those with hearing loss, we need low ambient noise levels to be able to understand speech. Please look at us when you speak with us. Adequate lighting helps those who lip read understand what is being said. Speak slowly and distinctly, but don’t shout. That doesn’t help us understand what you are trying to say, and it can also be painful.

For those with PTSD and other psychological or psychiatric or developmental disorders, and indeed for anyone with a disability and actually for everyone, with or without a disability, just be gentle and kind.

And the world will be a better place for all.

Dr. Daniel Fink is a leading noise activist based in the Los Angeles area. He is the founding chair of The Quiet Coalition, an organization of science, health, and legal professionals concerned about the impacts of noise on health, environment, learning, productivity, and quality of life in America. Dr Fink also is the interim chair of Quiet Communities’ Health Advisory Council, and he served on the board of the American Tinnitus Association from 2015-2018.

Doctors with disabilities? Yes, we are people too

by Daniel Fink, MD, Chair, The Quiet Coalition

This piece from NPR discusses how doctors and researchers with disabilities are changing medicine. When a problem is a secret, it is a source of shame and can’t be dealt with. If it is disclosed and discussed, however, it may still be a problem, but it can be dealt with and it is less of a source of shame.

When I spoke at the 2017 meeting of the Institute for Noise Control Engineering in Grand Rapids, Michigan, across the river from the Gerald R. Ford Presidential Library, I noted that his wife Betty Ford was a pioneer in discussing two formerly kept secrets–that she had breast cancer and had developed an addiction to prescription drugs. She fortunately survived her breast cancer to live many years more, and successfully dealt with her addiction. I then noted that I would publicly disclose that I had two auditory disabilities, tinnitus and hyperacusis, both fortunately mild and not life-limiting, but disabilities nonetheless.

I have mild hearing loss, too, again fortunately not life-limiting except in terms of understanding speech in a noisy environment.  Prof. Margaret Wallhagen in San Francisco has written about the stigma of hearing loss. Hearing loss should be destigmatized.

More importantly, noise-induced hearing loss should be prevented.

So avoid noise or use hearing protection if you can’t avoid it, because noise-induced hearing loss is 100% preventable.

Dr. Daniel Fink is a leading noise activist based in the Los Angeles area. He is the founding chair of The Quiet Coalition, an organization of science, health, and legal professionals concerned about the impacts of noise on health, environment, learning, productivity, and quality of life in America. Dr Fink also is the interim chair of Quiet Communities’ Health Advisory Council, and he served on the board of the American Tinnitus Association from 2015-2018.

New NIDCD Director announced

Photo credit: Debara L. Tucci, M.D., M.S., M.B.A. courtesy of the National Institutes of Health

by Daniel Fink, MD, Chair, The Quiet Coalition

This blog post from the American Speech-Hearing-Language Association contains an interview with the incoming Director of the National Institute on Deafness and Other Communication Disorders (NIDCD), Dr. Debara Tucci.  We hope that prevention of hearing loss, tinnitus, and hyperacusis will be among Dr. Tucci’s priorities for NIDCD.

Dr. Daniel Fink is a leading noise activist based in the Los Angeles area. He is the founding chair of The Quiet Coalition, an organization of science, health, and legal professionals concerned about the impacts of noise on health, environment, learning, productivity, and quality of life in America. Dr Fink also is the interim chair of Quiet Communities’ Health Advisory Council, and he served on the board of the American Tinnitus Association from 2015-2018.

The best headphones for children? None!

by Daniel Fink, MD, Chair, The Quiet Coalition

This post on the Parentology.com site discusses the best headphones for children in 2019. I disagree strongly. The best headphones for children are none at all! Why? Two reasons, one for auditory health and one for the child’s social and intellectual development.

First, for auditory health, headphones using the industrial-strength 85 decibel noise exposure level as a “safe” volume limit for a child’s tender ears isn’t safe. The UK’s Advertising Standards Authority ruled again Amazon advertising these headphones as safe for hearing because they’re not.

Second, allowing a child to isolate him or herself with headphones, first while watching a video on a device and then when listening to music when older, doesn’t allow the child to interact or communicate with others. And for the older children, the parent has no idea what the children are listening to.

Audiologists already report seeing younger patients with hearing loss and tinnitus instead of the senior population they are used to caring for.

And an epidemic of noise-induced hearing loss and other auditory problems appears to be certain in the near future.

Dr. Daniel Fink is a leading noise activist based in the Los Angeles area. He is the founding chair of The Quiet Coalition, an organization of science, health, and legal professionals concerned about the impacts of noise on health, environment, learning, productivity, and quality of life in America. Dr Fink also is the interim chair of Quiet Communities’ Health Advisory Council, and he served on the board of the American Tinnitus Association from 2015-2018.

Another possible treatment for tinnitus

Photo credit: This photo is in the public domain.

by Daniel Fink, MD, Chair, The Quiet Coalition

Tinnitus is “ringing in the ears,” or, more technically, the perception of sound when there is no external auditory stimulus. The current theory is that tinnitus is located in the brain, possibly abnormal electrical patterns, although the exact locus and lesion are not known.

This report from Finland describes the use of trans-cranial magnetic stimulation to treat patients with severe tinnitus. Like most similar reports, it is very preliminary.

Tinnitus has many causes, but the most common cause is noise exposure. This may be via a one-time exposure to loud noise or associated with noise-induced hearing loss caused by chronic noise exposure. In either instance, tinnitus can be prevented by avoiding noise exposure.

While it’s exciting that there is a potentially promising treatment for tinnitus in the offing, I must point out that avoiding the need for treatment is always the better option.

So remember: if it sounds too loud, it is too loud. Protect your hearing.

Dr. Daniel Fink is a leading noise activist based in the Los Angeles area. He is the founding chair of The Quiet Coalition, an organization of science, health, and legal professionals concerned about the impacts of noise on health, environment, learning, productivity, and quality of life in America. Dr Fink also is the interim chair of Quiet Communities’ Health Advisory Council, and he served on the board of the American Tinnitus Association from 2015-2018.

Zoos learn that some visitors need hearing protection

Photo credit: Dj1997 licensed under CC BY-SA 3.0

by David M. Sykes, Vice Chair, The Quiet Coalition

This story by WLNS.com News looks at Potter Park Zoo in Lansing, Michigan, where ear protection is available to visitors who may be bothered by “sensory overload.”

Sensory overload affects many people, including autistic children and adults, and people with auditory conditions such as tinnitus and hyperacusis.

Kudos to the Lansing Zoo! This is a wonderful idea, and we hope many other zoos and public venues will follow their example.

In addition to serving as vice chair of the The Quiet Coalition, David Sykes chairs several professional organizations in acoustical science: The Acoustics Research Council, American National Standards Institute Committee S12, Workgroup 44, The Rothschild Foundation Task Force on Acoustics, and the FGI Acoustics Working Group—a partner of the American Hospital Association. He is the lead author of “Sound & Vibration 2.0 (2012, Springer-Verlag), a contributor to the National Academy of Engineering report “Technology for a Quieter America,” and to the US-GSA guidance “Sound Matters”, and co-founded the Laboratory for Advanced Research in Acoustics (LARA) at Rensselaer Polytechnic Institute. He recently retired from the board of directors of the American Tinnitus Association. A graduate of the University of California/Berkeley with graduate degrees from Cornell University, he is a frequent organizer of and speaker at professional conferences in the U.S., Europe, Asia, and the Middle East.

What to do if you hear sounds that others do not

Photo credit: bruce mars from Pexels

Finally, David M. Sykes, Vice Chair, The Quiet Coalition, addressed a query from a woman who said she heard a sound in her living space that her partner insists wasn’t there:

by David M. Sykes,Vice Chair, The Quiet Coalition

The Quiet Coalition recently received an inquiry from a woman who said she hears “a nearly imperceptible high-pitched sound” in her living space. She states that she can hear the sound, but her partner insists there is no sound. “Could a smartphone-based sound-meter app isolate and identify this sound?” she asked, adding “if so, which one do you recommend?”

First, I must note that the fact that this woman hears noise but her partner does not means nothing at all. Her partner could simply have much less sensitive hearing!

We at The Quiet Coalition agree that the best step is to try to measure the sound. There are free or inexpensive sound meter apps that you can install on your smartphone, so start there. Some are better than others, but thankfully, experts at the U.S. Centers for Disease Control and Prevention have tested and rated smartphone sound-meter apps, which we reported on last year.

But a smartphone app may not be sensitive enough to pick up the sound. What should you do if this is the case? The only alternative could be to find an acoustics engineer to visit your residence and use professional equipment to identify the noise and then help you identify the source. That person can also suggest some ways to address the problem—which could be a neighbor’s electronics. The National Council of Acoustical Consultants offers advice on how to select a professional, licensed acoustical engineer.

There is, however, another possibility that must be considered: hearing a high-pitched sound that no one else hears COULD mean that you have a hearing disorder called tinnitus or an acute sensitivity to sounds called hyperacusis. Tinnitus can be identified by first finding a truly quiet place, such as a library, or on a weekend retreat in the countryside, to see if you still hear the noise when you are away from the circumstances where you are aware of the sound.

40 million Americans have tinnitus (myself included), so it’s quite common. And many of us spent years assuming that the “background noises” we heard were actually coming from the environment and that everybody heard the same thing!

So we recommend that you pursue both of these steps, because exposure to noise can be stressful, can cause sleep loss, and can have other health effects.
First try to determine where an unseen source of high-pitched sound in your environment is coming from. If the sound cannot be isolated, then consider that the cause of the sound could be tinnitus or another hearing disorder that should be attended to.

Frankly, the best result would be that there really is an unseen source of high-pitched sound in the immediate environment. Why? Because that can be fixed once the source is identified. But tinnitus cannot be cured, though there are techniques for managing it—which include avoiding the kinds of exposures that may have caused it in the first place. And know that the onset of tinnitus can be quite sudden.

To learn more about tinnitus check out the American Tinnitus Association‘s website and the Clinical Practice Guideline for Tinnitus published in 2014 by the American Academy of Otolaryngology–Head & Neck Surgery.

In addition to serving as vice chair of the The Quiet Coalition, David Sykes chairs several professional organizations in acoustical science: The Acoustics Research Council, American National Standards Institute Committee S12, Workgroup 44, The Rothschild Foundation Task Force on Acoustics, and the FGI Acoustics Working Group—a partner of the American Hospital Association. He is the lead author of “Sound & Vibration 2.0 (2012, Springer-Verlag), a contributor to the National Academy of Engineering report “Technology for a Quieter America,” and to the US-GSA guidance “Sound Matters”, and co-founded the Laboratory for Advanced Research in Acoustics (LARA) at Rensselaer Polytechnic Institute. He recently retired from the board of directors of the American Tinnitus Association. A graduate of the University of California/Berkeley with graduate degrees from Cornell University, he is a frequent organizer of and speaker at professional conferences in the U.S., Europe, Asia, and the Middle East.

Consumer Reports tackles tinnitus

Photo credit: Frmir licensed under CC BY-SA 3.0

by Daniel Fink, MD, Chair, The Quiet Coalition

This article by Hallie Levine in Consumer Reports discusses tinnitus. The advice is generally sound, with one exception–the article states that “any noise over 85 decibels can damage hearing.” This isn’t accurate.

The auditory injury threshold is only 75-78 A-weighted decibels (dBA), and 85 dBA is the National Institute for Occupational Safety and Health Recommended Exposure Level for occupational noise, not a safe noise exposure level for the public. I wrote about this in the American Journal of Public Health and the NIOSH Science Blog also covered this topic.

But the basic message is correct: avoid loud noise, protect your hearing, and you won’t develop tinnitus from noise exposure.

And remember, if it sounds too loud, it IS too loud.

Dr. Daniel Fink is a leading noise activist based in the Los Angeles area. He is the founding chair of The Quiet Coalition, an organization of science, health, and legal professionals concerned about the impacts of noise on health, environment, learning, productivity, and quality of life in America. Dr Fink also is the interim chair of Quiet Communities’ Health Advisory Council, and he served on the board of the American Tinnitus Association from 2015-2018.