Tinnitus: World of constant sound

“You get used to it ... or you go crazy.” — Actor and author Steve Martin

Once thought to be the affliction of rock stars, pneumatic drill operators and press room technicians, the medical condition known as tinnitus now is a cross borne by a great many Americans.

I’m one of them.

And no cure may ever be possible.

“If you’re lucky, you just get habituated to it,” actor and tinnitus poster boy William Shatner once told me in an interview. “If not ...”

Tinnitus (pronounced “tin-EYE-tus” or “tin-uh-tus”) is defined as “the perception of sound within the human ear in the absence of corresponding external sound,” most often a case of noise-induced hearing loss resulting in irreparable nerve damage. It can manifest in one ear, or both.

For some, the constant, unrelenting ringing or buzzing in the ears is supportable — barely. Work and other daily activities distract you from its discord. Sleep-inducing sound machines or the soft purr of room air purifiers help mask the din long enough for sleep to come. Recorded audio of music or masking sounds also are available for use in waking hours. Your chief enemies: loud noise (concerts, movie theaters) and the once-relaxing but now inimical absolute silence.

For others it becomes all-consuming, intolerable, literally maddening.

Tinnitus also can be a symptom of other conditions that range from ear infections, foreign objects or wax build-up in the ear, an inability to equalize in pressurized aircraft cabins, nasal allergies or the aging process, as well as being a side effect of some medications and congenital hearing loss.

In some cases, a clinician can perceive an actual sound emanating from the patient’s ears. This is called objective tinnitus, and can emerge from muscle spasms that cause clicks or crackling around the middle ear. But generally speaking, tinnitus is a subjective sensation, almost impossible to measure via objective tests. And while no end of “cures” have been touted for it, few have held up to scrutiny, and none can claim to be breakthroughs in treatment.

Some medications — aspirin is one, even taken in moderation — may “amplify” tinnitus for a period of time. Caffeine and nicotine are thought by some researchers to fan the flames of tinnitus, while others believe tinnitus can be induced by reducing one’s intake of caffeine or by quitting smoking. Alcohol consumption has been found to both increase and decrease the severity of tinnitus. Thanks.

Clinicians rate tinnitus on a scale from “slight” to “catastrophic” based on the practical and/or emotional impairment it exerts.

The genuinely frightening thing, especially for those who have more or less come to terms with the condition, is that it can get worse. Permanently.

The cause of my tinnitus was not a single ear-shattering noise or long-term exposure to concert speakers, but a flight from Boston back home to Charleston in 1990. I made the critical mistake of flying when sick. Congested, I could not equalize pressure as the plane continued its long, gradual descent, seemingly gliding forever at an altitude my ears found excruciating. And that was that. Unlike earlier episodes, when my ears experience a temporary muffling of sound accompanied by ringing, it did not go away.

The ringing has never stopped. It waxes and wanes from time to time, and it’s worse on those days when I’m short on sleep. But it never disappears.

Colleagues know when I’m about to go on a vacation that involves flying. I get paranoid, because if I get sick, I cannot fly. Period. Vacation over. And many of those prepaid, unrefundable travel expenses go down the drain. Travel insurance companies dislike covering pre-existing conditions. So sniffle or cough in my proximity and be consigned to banishment.

Don’t misunderstand, compared to life-threatening conditions or the extremes of chronic pain, my tinnitus is a trifle. But that’s small comfort when the ringing’s so loud it becomes your world.

If you experience tinnitus for any length of time, consult your doctor and do get tested by an audiologist. Rarely, symptoms may suggest Meniere’s disease, a disorder of the inner ear that can affect hearing and balance, with progressive hearing loss.

The best advice I can give is to avoid tinnitus in the first place. Protect your hearing. Turn down the iPod. Avoid high decibel levels. Prolonged exposure to sound/noise levels as low as 70 decibels can result in damage to hearing.

For those who are afflicted, know that you have the company of as many as 50 million fellow Americans. Seek out tinnitus support groups online, but beware, many sites are simply selling products. And try to find that level of accommodation Shatner and others apparently have found.

Reach Bill Thompson at 937-5707 or bthompson@postandcourier.com.