The Tinnitus Book: Understanding Tinnitus and How to Find Relief

By James A. Henry

This book is a resource for anyone who experiences tinnitus.

Tinnitus impacts the lives of 10% to 15% of all adults. Those seeking help for tinnitus are at a disadvantage because there are no standards to ensure competent clinical services. They may receive services or products that are not supported by

• Language: English
• Publisher: Ears Gone Wrong
• Release date: Dec 8, 2023
• ISBN: 9781962629058

Book preview

9781962629058.jpg

Contents

Foreword

Preface

Note to the Reader

Understanding Tinnitus

Elizabeth and Robert

Elizabeth

Robert

Where Do We Go from Here?

Suggestions for Getting the Most Benefit from This Book

The Big Picture

What’s Going On in My Head?

What Is Tinnitus?

How Is Tinnitus Pronounced?

Primary and Secondary Tinnitus

When Does Ear Noise Become Tinnitus?

Does Tinnitus Fluctuate?

What Does Tinnitus Sound Like?

What Can Make Tinnitus Seem Louder?

Can Tinnitus Be More Than One Sound?

Where Does It Sound Like the Tinnitus Is Coming From?

Is Tinnitus a Disease?

What is Somatosensory Tinnitus?

What Might My Tinnitus Be Like in the Future?

How Many Adults Have Tinnitus?

How Many Children Have Tinnitus?

Summary: What’s Going On in My Head?

How and Why Does Tinnitus Affect People?

Norman

Mary

Raquel

What Help Is Available for Norman, Mary, and Raquel?

It Bothers Me/It Bothers Me Not

Does It Have to Be One or the Other?

Different Ways Tinnitus Can Be Bothersome

Summary: How and Why Does Tinnitus Affect People?

What Can Be Done About Tinnitus?

How Is Tinnitus Evaluated?

Claudia

Jackson

Melissa

I Have Tinnitus—What Should I Do?

Evaluation by an Audiologist

Summary: How Is Tinnitus Evaluated?

How Is Tinnitus Treated?

Claudia

Jackson

Melissa

Claudia, Jackson, and Melissa Are Success Cases

Comments About Tinnitus Treatment

Cognitive Behavioral Therapy (CBT)

Tinnitus Retraining Therapy (TRT)

Tinnitus Activities Treatment (TAT)

Progressive Tinnitus Management (PTM) and Tele-PTM

Summary: How Is Tinnitus Treated?

Overall Summary and Wrap-Up

The Sound of Tinnitus

Effects of Tinnitus

Evaluation of Tinnitus

Treatment of Tinnitus

Final Suggestions

Parting Words

What Is Auditory Gain and How Does It Relate to Sound Therapy for Tinnitus?

Why Is Auditory Gain Important?

What Is Sound Therapy?

What Is Auditory Gain?

Sound Therapy, Auditory Gain, and Tinnitus

Summary

Need for Research

Self-Experimentation

Conclusion

Development of the Tinnitus Functional Index

Tinnitus Questionnaires

Announcement of Funding Available to Develop the TFI

Development of the TFI

Conclusion

Evaluating the Sound of Tinnitus²²¹

Perception of Sound

Tinnitus Matching

Maskability and Residual Inhibition

Are These Measures Important?

Conclusions

Clinical Evaluation with Tinnitus Retraining Therapy (TRT)

Treatment Categories

Summary

Clinical Evaluation with Cognitive Behavioral Therapy (CBT)

Clinical Evaluation with Tinnitus Activities Treatment (TAT)

How Do We Know If a Treatment Works?

Observational Trials

What Is the Best Way to Evaluate If a Treatment Works?

Conclusion

Third Wave CBT

About the Author

Acknowledgments

References

Index

Copyright

Foreword

Tinnitus is an intrusive sound—the ringing, hissing, or roaring that often is heard after an exuberant night of dancing or cheering with friends at a sporting event. Normally the sound disappears, and we think nothing more of it. We don’t realize the loud noise we were exposed to may have damaged our ears.

What if the intrusive sound doesn’t fade? You may decide you need professional help and end up on a journey meeting with one doctor after another. It can be difficult to find a healthcare professional who is competent in providing services for tinnitus.

A person may have various exams to rule out possible underlying medical conditions that can trigger tinnitus. The doctor’s report that nothing is medically wrong is good news, but what often follows that report is not. Without a cure for most cases of tinnitus, many healthcare providers tell their patients that they’ll have to learn to live with it, but they do not provide guidance on how that is done. That statement alone—learn to live with it—can be devastating for a person struggling with tinnitus.

Without guidance from a knowledgeable healthcare professional on how to live with tinnitus, the anxiety, insomnia, and depression that often accompany the condition can lead to a greatly diminished quality of life that few people without tinnitus can imagine.

That’s where this book comes in. The Tinnitus Book: Understanding Tinnitus and How to Find Relief by James A. Henry, PhD, is the book that should be made available to anyone seeking answers for tinnitus. Dr. Henry dedicated decades of his career to conducting research focused on helping people who are distressed by tinnitus. He himself has lived with tinnitus for much of his life, and he understands the challenges involved in managing this condition.

This book can be shared with loved ones and friends, so they too can understand this condition and how it affects people. This understanding may help them to empathize and be more supportive of what you’re going through.

I think the answers you need will be found in this easy-to-understand and complete road map that Dr. Henry has laid out. Let him help you navigate your tinnitus journey.

Torryn P. Brazell, CAE, CFRE

Chief Executive Officer, American Tinnitus Association

Vienna, Virginia USA

Preface

This book is all about tinnitus—ringing in the ears. I have had tinnitus for 45 years, and studying it turned into my life’s work over 30 years ago. If interested, you can read my tinnitus story below.

The goal of this book is to provide answers and hope to people with tinnitus. It is a condition experienced by millions of people. For some, tinnitus is a minor irritant. For others, it’s the biggest challenge they’ve ever faced. For all, it’s something we wish were not there.

My sincere wish is that this book will serve as a valuable resource to inform anyone with tinnitus as to what it is, why it affects people, how it is evaluated and treated in the clinic, and how to live a normal life despite its ongoing presence.

This is my tinnitus story. In my teens and twenties I played guitar in rock bands. I remember often lying in bed after a performance and noticing the roar in my ears. I didn’t think much of it, but performing became more and more uncomfortable—the loudness of the music was beginning to hurt. I started stuffing wet toilet paper in my ears to block the sound (I knew nothing about earplugs). The roaring in my ears didn’t quit—I had tinnitus.

After playing music I worked as a carpenter. So I went from one loud occupation to another. Every day I was exposed to hammering, power tools, and all forms of loud machines. I had no idea what I was doing to my ears. Eventually I started wearing earplugs, but it was too little, too late. My tinnitus was persistent.

After four years of carpentry, I decided to go back to school to become an audiologist. (My daughter Erin, who is deaf, was the impetus for me to study audiology.) Following school, I was hired at the Veterans Affairs (VA) hospital in Portland, where I became a research audiologist. My VA job triggered an avid interest in research. I went back to school and earned a doctorate in behavioral neuroscience, which enabled me to start my own line of research.

Part of my doctoral program was at the Oregon Health & Science University (OHSU) Oregon Hearing Research Center, which housed the OHSU Tinnitus Clinic—the first comprehensive tinnitus clinic in the world. This facility was directed by Dr. Jack Vernon. That experience created the spark in me to pursue a career studying tinnitus.

After graduation, I wrote a grant proposal and received my first funding from the VA to conduct a tinnitus study. In the subsequent years, I was the principal or co-principal investigator for 43 research grants, with total funding of 28 million dollars. I authored or coauthored 240 publications, including 130 published in scientific peer-reviewed journals, and five tinnitus-related books. I gave lectures and presentations nationally and internationally to present the findings of my research.

I wish I could say all this time and effort expended led to a cure for tinnitus, but it did not. (It should be noted that there are those who have claimed to have a cure for tinnitus, but according to the research I have seen, that claim cannot be substantiated.) This is unfortunate because that’s what we really want—a cure. In the meantime, while we wait for that cure, much can be done to make tinnitus less of a problem. That is what this book is about.

James A. Henry, PhD

Note to the Reader

This book is intended to provide educational information about tinnitus and related auditory problems. It cannot be construed as providing any form of therapy or treatment. If you have any of the symptoms described in this book and feel that professional services are needed, you should meet with an appropriate healthcare provider.

Part 1

Understanding Tinnitus

Chapter 1

Elizabeth and Robert

Elizabeth

Elizabeth is a 32-year-old single mother. She works hard and juggles many responsibilities. One day, about two years ago, she woke up hearing a strange noise. She looked all around the house, then outside the house, but could not figure out where the noise was coming from. She finally realized it was coming from inside her head.

She needed answers, so she went to the internet and searched for ringing in the ears. She started to learn about tinnitus and wondered if this was what she was experiencing. On the internet she found a multitude of treatments, remedies, and cures. She didn’t know where to begin. She saw an attractive website advertising pills that claimed to eradicate tinnitus. The website included many convincing testimonials, and she felt she had nothing to lose. So she ordered the pills. Once she got the bottle, she took the pills diligently for the next month. She waited for her tinnitus to subside, but to her dismay it persisted, and she grew increasingly anxious. This new condition was just adding to her current life challenges. She shared her story with a friend, Maggie, who suggested she might need help from a professional.

Elizabeth found a local ear, nose, and throat (ENT) doctor (also known as an otolaryngologist), waited for her appointment, and hoped for some good news. After the doctor examined her, he explained what she had suspected: You have tinnitus, and at this point there is no cure. You will need to learn to adapt and live with it. Leaving the office, she felt discouraged and unsure of what to do about this annoying sound. Living with it did not seem like something she could accept. She determined not to give up looking for answers. Her friend Maggie suggested that maybe a second opinion was needed.

Maggie said her brother-in-law was an audiologist, so maybe he would know someone who specialized in tinnitus. Elizabeth called the audiologist, who told her he had recently been trying to learn more about the condition. He found out about the American Tinnitus Association (ATA) and had recently subscribed to Tinnitus Today (the ATA’s magazine). A state-by-state list of tinnitus patient providers was included in the back of the magazine, and he told Elizabeth that another audiologist in their town, Dr. Smith, was on the list.

Elizabeth met with Dr. Smith, who tested her hearing and performed a brief tinnitus evaluation. Dr. Smith explained that her hearing was normal, but she might want help for her tinnitus. He recommended sound therapy and counseled her on how to use sound in different ways to assist whenever her tinnitus was bothersome. He also recommended that she meet with a psychologist who specialized in cognitive behavioral therapy (CBT) for tinnitus. There was one available in the area, and Elizabeth met with that psychologist over a number of sessions. During those sessions she learned techniques for relaxation (stress reduction), doing things that would help take her mind off her tinnitus, and changing her thoughts about tinnitus to shift her emotions in a positive direction. All of these strategies paid off. The tinnitus persisted over the next year, but Elizabeth had learned numerous things she could do whenever the tinnitus was bothersome. She thanked her friend and said, I still have tinnitus, but I’m living a pretty normal life.

Robert

Robert is a 63-year-old man who is married with grown children. He has worked in construction all his life and is an avid hunter. When he was in his 50s, he started noticing a chirping in his ears while lying in bed after a long day at work or coming home from a hunting trip. He didn’t pay much attention to the sound because it always seemed to go away after a few days.

While on vacation with his wife, he noticed the sound was always there, not only at night but during the day. He became very concerned, and when they returned home from vacation, he made an appointment with an otolaryngologist. The otolaryngologist told him that he most likely had noise-induced tinnitus, meaning the tinnitus resulted from the construction and hunting noise and was possibly a chronic condition because it had persisted for almost three months. The otolaryngologist sent him to an audiologist who tested his hearing, which revealed a moderate degree of hearing loss. The audiologist recommended hearing aids to address the hearing loss and told Robert that the hearing aids might also make the tinnitus less noticeable. Robert didn’t want to wear hearing aids, but he decided to give them a try.

During his follow-up appointment with the audiologist about six weeks later, Robert mentioned that he was getting used to the hearing aids, but that his tinnitus was still troubling him. The audiologist told him the hearing aids included a built-in sound generator (sometimes referred to as a masker), which might be helpful. The audiologist adjusted the sound generator to emit a constant sound that Robert described as soothing. The sound also seemed to reduce the loudness of his tinnitus, and it made the tinnitus less noticeable.

When he was not wearing the hearing aids, his tinnitus sounded the same as before. Robert, however, had discovered the value of using sound as therapy for his tinnitus. He therefore made sure to add sound to every environment. For example, he put a bedside sound generator in his bedroom, which helps him to fall asleep and stay asleep. When he again returned to the audiologist, he reported that he could hear better and that his tinnitus was no longer a significant problem.

Where Do We Go from Here?

These two case examples are typical of stories I’ve heard repeatedly throughout my decades of working in the tinnitus field. Of course, every story is different because everyone’s circumstances are different. And the experience of tinnitus can be very different for each person, as we