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Noises No One Else Can Hear

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TIMES HEALTH WRITER

If hearing loss can have a huge effect on people’s lives, so, too, can a strange, unpleasant hearing “gain.” Imagine constantly living with buzzes and hums that sound perfectly real and yet only you can hear. Imagine never being able to escape those sounds, no matter how far you travel into the wilderness or however silent the outside world.

This odd condition, in medical lingo, is known as tinnitus. Beethoven (though he’s better known for going deaf) was afflicted by it. So was the composer Smetana, who incorporated the note he heard into one of his string quartets. Michelangelo had it too: “A spider’s web is hidden in one ear, and in the other, a cricket sings throughout the night,” he wrote of his affliction--and no wonder he resorted to metaphors. Tinnitus can be hard to explain to people.

“Often they’ve never heard of it,” says 42-year-old Denise Williams. “So I tell them, ‘It’s this noise I hear in my head,’ and right away, they’re thinking: ‘Psycho!’ ”

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Alternatively, she says, they may be wondering what the big deal is. After all, many people know what it’s like to briefly hear a high-pitched tone they know isn’t coming from anywhere. But there’s a big difference between a soft sensation of sound that visits for a moment, and a loud, intrusive one that stays for months or years. Never mind that the sound isn’t “real”; it doesn’t sound any more pleasant for that. And it can drive people to despair.

“There have been times, particularly at night, when the ringing was so loud that I felt like I was going to lose my mind,” says Cyril O’Reilly, 42, who’s had tinnitus since 1998. “You can’t get away from it. Plugging up your ears doesn’t help. I’ve yelled into my pillow. I’ve turned the music up so loud it hurts the ears.”

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An estimated 40 million to 50 million Americans have some degree of tinnitus, often accompanied by some hearing loss. The condition is commonly brought on by damage to the ears through exposure to loud noise.

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O’Reilly, for instance, was acting in a shoot-’em-up movie when his tinnitus first started: Explosives strapped onto his body (to simulate a gunshot) blew up with such force they made his ears ring. No one had given him earplugs. His ears have been ringing ever since.

And 44-year-old Susanne Osborne got her tinnitus during a super-loud Black Sabbath reunion concert at the Great Western Forum in Inglewood. Ever since that day in January 1999, she hears a high-pitched “eeeeee” in her right ear and a lower tone plus a rattle in her left.

Condition Remains Somewhat a Mystery

But noise, while a common cause, is by no means the only cause. Tinnitus can also result from ear or sinus infections, an inner ear disorder called Meniere’s disease, certain medications, head and neck trauma, circulatory problems or misalignment of the jaw. In rare instances, a serious condition such as a tumor can cause these phantom sounds, so anyone experiencing tinnitus should see a doctor.

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Scientists don’t really understand what creates the false sensation of sound. The condition is similar, they suppose, to sensations from a phantom limb (feelings of pain, or an itch, from a leg or an arm that’s been amputated). The illusion lies not in the ear, but in the parts of the brain that interpret sounds. In some strange way, in response to some kind of damage, the brains of tinnitus sufferers have rewired, telling them they hear noise when no noise is there.

Fortunately, say medical specialists, roughly 75% of tinnitus sufferers aren’t seriously bothered by their sounds (which are variously described as high-pitched hums, hisses, chirps, whistles, roars or ringing of bells). The other 25% are bothered enough to seek medical treatment--and of those, about 1 million say that their condition seriously disrupts their normal lives.

Sometimes, it’s unclear why tinnitus is so awful to one person but tolerable to another, says Billy Martin, director of the tinnitus clinic at the Oregon Health Sciences University in Portland, Ore. He contrasts two men at the clinic: same age, same degree of hearing loss, similar tinnitus. Yet one of the men is extremely stressed by his condition, while the other is not very stressed at all.

What can people do if the noises are making their lives miserable? Sometimes, tinnitus goes away on its own. For some causes, there are remedies. But if it looks like it’s here to stay, there are ways to get relief.

Barry Kurtz and Larry Schreier knew little about how to cope with the noises in their ears until they discovered the Los Angeles Tinnitus Group, a support group run by Nelly Nigro, a retired pharmacist who has suffered from the condition since 1982. Just knowing that someone can live with it that long can encourage people who are new to the problem, says Nigro. And talking with fellow sufferers and sharing strategies and feelings help as well.

“Tinnitus can be very isolating,” she says. “And when you isolate yourself from the world, you tend to focus on the problem. That makes it huge.”

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Thus, a crucial part of tinnitus treatment is to help the sufferer put his complaint in perspective, to realize that while the noise is aggravating, it is not life-threatening, says Robert Folmer, a neurophysiologist and tinnitus expert at the Portland clinic.

Anti-anxiety drugs can also help, as can antidepressants in combination with counseling, since tinnitus appears to be more severe in people who are depressed. Many of these drugs also induce sleepiness--and this is helpful. Night is often the hardest time for tinnitus sufferers, and lack of sleep just adds to the stress. (Sleep medications, either prescribed or over-the-counter, can be useful for the same reason.)

Changing one’s lifestyle to help lower stress can also make a difference, though the nature of that change will be highly individual.

Tinnitus sufferer Laverne Sims, 71, finds that attending Bible study at church helps, as does call-blocking on her phone so she’s not bugged by telemarketers. Kurtz, a civil engineer, goes mountain biking for relaxation--and for distraction, which is also key to coping. Others try biofeedback, meditation, yoga or other forms of exercise.

Learning to Block Out the Noises

Silence, ironically, can be an enemy: It brings the tinnitus into sharper focus. Music, tapes of environmental sounds such as waterfalls and even special devices that fit onto one’s ears like hearing aids can generate soothing, distracting sounds that bring relief. So can hearing aids, if the person with tinnitus has some hearing loss.

Schreier was recently fitted for hearing aids and finds that regular sounds--things like creaking doors, which he hadn’t heard for years--make the tinnitus easier to ignore.

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Some doctors, meanwhile, recommend a special program known as tinnitus retraining therapy, in which a patient listens to white noise for hours a day over many months. The idea is that the noise blocks out much of the tinnitus, training the brain to eventually ignore those sounds.

While some tinnitus sufferers have turned to herbal remedies for relief, studies suggest that herbs such as ginkgo biloba don’t help banish the noise. Nor does cutting the nerve that runs between the ear and the brain--an extreme course of action that some desperate sufferers have opted for in the past. The strategy doesn’t work because the brain, not the ear, is concocting the sounds. Such patients lost their hearing. They didn’t lose their tinnitus.

As time passes, specialists and sufferers both agree that the noises get easier to tolerate.

Osborne says she was so angry when her tinnitus started after the ear-splitting Black Sabbath concert that she considered filing a lawsuit. Instead, she says, she’s trying to live her life the way she always did. And make some kind of peace with the phantom noises.

“For me, learning to cope with tinnitus was not running away but looking it straight in the face,” she says. “I lie there and listen to it and try not to react. It’s tough. But psychologically that’s how I get through it.”

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The Los Angeles Tinnitus Group meets every third Saturday of the month (except July, August and December), from 10 to 11:30 a.m. at the UCLA Rehabilitation Center, Room A6-60, 1000 Veteran Ave., Westwood, CA 90024. For more information about tinnitus, contact the societies and clinics listed in this special section.

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