By Nadia Badarudin | nadia_badarudin@nst.com.my
There’s no cure for tinnitus which can strike anyone who is exposed to loud sounds, including loud music, writes Nadia Badarudin
NICK Nasril (not his real name), 37, has been the drummer of a local metal band for over 10 years. He takes pride in his chosen vocation. Double pedal drumming is his forte. Sometimes, he moonlights as a sound engineer, operating stage monitors at gigs and concerts.
About a year ago, Nick began to suffer from non-stop ringing in his ears. Initially he thought the sound came from the construction site near his house, but it didn’t go away even at night.
“I knew something was wrong when I was the only one hearing the noise. The ringing never subsides and I’ve been having sleepless nights since that day. It’s excruciating and really bothers me,” he says. Nick’s condition is experienced by many musicians and performers including Sting, Lars Ulrich (Metallica), Eric Clapton, Pete Townshend, Thom Yorke (Radiohead), Barbra Streisand and Chris Martin (Coldplay).
The condition is known as tinnitus, often referred to as “ringing in the ears”. It is said that Beethoven was the first known musician to have this condition in the 1700s.
TINNITUS DEFINED
TINNITUS DEFINED
There are numerous songs that mention the experience of tinnitus. Remember Led Zeppelin’s Stairway To Heaven? It is said that the line “Your head is humming and it won’t go in case you don’t know” refers to this condition.
Pantai Hospital Kuala Lumpur ear, nose and throat consultant Dr Asha Gupta says tinnitus is a perception of sound in the ear in the absence of any external acoustic or sound stimulus. In other words, only the patient can hear the annoying ringing when no actual sound is present. It can happen in one or both ears.
“It can also be buzzing, hissing, ticking or clicking in different frequency and intensity. The sound can be heard by the patient continuously or intermittently,” she adds.
She says tinnitus can strike anyone.
“Apart from musicians, people who are likely to get tinnitus are those exposed to temporary or prolonged loud sounds, such as industrial and construction workers as well as airline staff.
“Those who listen to loud music through headphones or earphones over an extended period, go to rock concerts or are regularly exposed to gunshots or bomb blasts are also likely to get it,” she says, adding that most of her patients are former servicemen. People with long-standing diabetes or thyroid problems and those on certain medications are possible tinnitus patients too.
TRIGGER FACTORS
Dr Asha explains that there are two types of tinnitus — objective, and subjective.
Subjective tinnitus, she says, is the most common where only the patient can hear the phantom sound. It is triggered by the same conditions that result in hearing loss.
“On the other hand, objective tinnitus is rare in which another person, such as a physician, can perceive the actual sound emanating from the patient’s ear,” she says.
Tinnitus can result from various factors, but most commonly, the cause is unknown. It happens when the hearing pathways are damaged, blocked or irritated.
“Objective tinnitus can arise from tumour or muscular or vascular causes. Subjective tinnitus may be due to excessive and loud sound, wax buildup in the outer ear canal, sinus, ear infection and certain drugs like aspirin, antibiotics as well as some cancer medication,” she says.
She says hormonal changes can cause temporary tinnitus in pregnant women. An inner ear disorder called miniere disease (that combines episodes of dizziness, reduced hearing and low-pitched tinnitus) is another trigger factor.
What about that irritating sound in the ear after a flight has descended? That is also tinnitus, and the symptom will get worse if the person has sinus irritation or flu during the flight. The tube that connects the ear and nose is supposed to equalise the pressure, but when it is congested, the pressure can’t be equalised. This can cause the painful, annoying sound,” she explains.
TREATMENTS
Tinnitus affects a person’s quality of life. Besides sleep deprivation, it leads to various psychological and emotional impacts. The effects may be so severe to some patients. A sufferer, Robert McIndoe, apparently committed suicide in 2011 after a battle with he condition. The Daily Mail reported that the 52-year-old rock music fan “was unable to sleep for three months after attending a concert in the UK that left him with a permanent ringing in his ears”.
Dr Asha says treatments vary according to each patient’s condition. “Besides advising patients to wear ear protection such as earplugs, giving the ears some rest may help some patients.
“However, there is no absolute cure or medicine to stop tinnitus, so some patients will be prescribed with anti-anxiety or anti-depression medication that deals with the effects,” she says.
She adds that tinnitus retraining therapy is a form of habituation treatment that helps patients to adapt (habituate) and end their negative reaction to the sound. It involves sound generators or devices that send stimulus to contrast the perceived sound.
“Tinnitus maskers, in the form of CD or bedside noise generators, are used to help sufferers sleep or relax. The devices send natural or artificial sounds to mask the ringing,” she says.
Prevention is always better than cure. However, if the onset becomes persistent, it is advisable to go for an early diagnosis and treatment, says Dr Asha.
“After obtaining the patient’s medical history, a hearing test will be done. Some patients may have to undergo a CT scan or MRI if it is suspected that the tinnitus is caused by a serious condition such as a tumour.
NO REMEDY FOR HEARING LOSS
METALLICA’S drummer Lars Ulrich used to play the drums without ear protection. Soon a loud noise began to follow Ulrich off-stage. At first, Ulrich said the ringing in his ears was barely perceptible. But the problem got worse during a 1988 concert tour, oddly, while he slept.
He recalled: “I would fall asleep often with the television on, and I would wake up in the middle of the night to go turn the TV off, except it wasn’t actually on. When I realised that I was doing that frequently, I realised that maybe I had some issues.”
His issues developed over time, after several long, loud tours with Metallica. As he began suffering hearing loss and tinnitus early in his career, he decided to protect his ears with ear plugs while performing. While his condition still nags him, he said the tinnitus could have been worse; and over the years he has learnt to tolerate it.
Ulrich said he is concerned about young people, the so-called iPod generation, who listen to loud music and may not be as vigilant about protecting their ears.
“If you get a scratch on your nose, in a week that’ll be gone,” Ulrich said. “When you scratch or damage your hearing, it doesn’t come back. I try to point this out to younger kids ...once your hearing is gone, it’s gone, and there’s no remedy.”
Source: Adapted from edition.cnn.com, Dec 28, 2009
Source: Adapted from edition.cnn.com, Dec 28, 2009
A CLEAR EAR
Here are Dr Asha Gupta’s tips on preventing tinnitus:
• For musicians: Wear ear plugs when performing. Go for hearing tests regularly and give the ears some rest for a day or two in between concerts
• Avoid any sound which is more than 90dB.
• Wear ear plugs or earmuffs when necessary.
• During a concert, try to be away from the sound system.
• For musicians: Wear ear plugs when performing. Go for hearing tests regularly and give the ears some rest for a day or two in between concerts
• Avoid any sound which is more than 90dB.
• Wear ear plugs or earmuffs when necessary.
• During a concert, try to be away from the sound system.
Tinnitus is a perception of sound in the ear in the absence of any external acoustic or sound stimulus.
How to live with Tinnitus