Saw ENT Today — Is He Correct?

[John CC]

I saw my ENT today, and wow, did I every feel like a piece of meat with a number on it. I had the feeling that to him tinnitus, not that exciting, nothing you can do. He set up an MRI as a 'just in case', will be a couple of months, goodbye. He didn't even talk about the results of my hearing tests. I told him I have sick bank at work and can take off the first month or two of school to help me heal. He said 'sure if you want' but he would not sign a note saying it is necessary. Basically, it won't make any difference to your healing and tinnitus if you are in school or not.

Is he correct?

I pointed out that it is a loud school, that when I go out and sit at a quiet coffee shop, or drive for more that 15 min. I hear about it later. I felt like it was nothing to him. However, I have to be open in my thinking. I though that by staying relatively quiet and protecting my ears the first couple of months was important, (my tinnitus overall has lessened, though very loud at times, generally not as long, and periods of noise are shortening) and going back too soon = not good.

Is he correct and staying in quieter areas, or going to work, will make no difference with the healing of tinnitus?

I am confused?

Seeing my GP tomorrow, should I approach him with the same idea of time to help heal, or is the ENT right?

 

[JohnAdams]

most so-called doctors today are just FDA approved drug dealers. they aren't independent, they aren't researchers. the end. sorry.

 

[dpdx]

Staying in quieter areas will help you heal but not too quiet, have a sound oasis machine or place some youtube videos of raindrops falling.

 

[Luman]

The reaction of your ENT is not unusual, they generally do not pay much attention to tinnitus. I had a visit with an ENT in NYC last year, a couple of months after the onset of my tinnitus. He told me that he has it, as well. The doctor didn't recommend an MRI, because he didn't think that anything would be found, but offered to set one up for me if I wanted, for my own peace of mind. I took his advice and didn't bother. I have since found out that nearly one hundred percent of MRI tests for tinnitus fail to show anything. Interestingly, when I received the invoice from the hospital where I saw the doctor, they only charged me for the co-payment for my short, but worthwhile, exam and visit.

Hearing your tinnitus as louder, after coming home from a trip, is normal.

My advice is to protect your ears with plugs or muffs when necessary, but don't make the mistake of overprotecting them, as this can make your hearing ultra-sensitive.

 

[Bill Bauer]

Basically, it won't make any difference to your healing and tinnitus if you are in school or not.

My ENT told me that "it might be a good idea to be easy on your ears for a while" (he was talking about not exposing myself to too much noise).

Keep in mind that there had been no studies of the factors that can have an impact on one's tinnitus "trajectory". According to the posts I read on this forum, it would appear that people who are exposed to noise at work risk getting their tinnitus to spike (which I imagine is a sign of their healing and recovery being interrupted). One teacher used to post here, and she mentioned incidents like getting spikes following having to be present at some event at the gym where the kids from the whole school were clapping.

I felt like it was nothing to him.

You have to see it from his point of view - he can't back up signing such a note with any peer-reviewed studies. He doesn't want to put his lucrative career that (he had worked so hard to benefit from) at risk.

Seeing my GP tomorrow, should I approach him with the same idea of time to help heal

You have nothing to lose. The doctor has his/her medical license to lose, but hopefully s/he won't see it that way. If I were you, I would try asking the doctor for help (but I wouldn't bet on him or her being able to help me).

 

[TuneOut]

I saw my ENT today, and wow, did I every feel like a piece of meat with a number on it. I had the feeling that to him tinnitus, not that exciting, nothing you can do. He set up an MRI as a 'just in case', will be a couple of months, goodbye.

That's why they get paid the big bucks. I wish I could do nothing at all and have people pay me for it. Sounds pretty sweet.

 

[Luman]

That's why they get paid the big bucks. I wish I could do nothing at all and have people pay me for it. Sounds pretty sweet.

That is often true, at least for tinnitus, however the ENT that I wrote about, above, who has tinnitus, did not charge me his full fee at the hospital where he works, only the co-payment, which saved me a bundle because I had not met my deductible for my medical plan. If there is a cure of any sort in the future, he'd be the one I'd go to see.

 

[85dB T]

My ENT is board certified in Otolaryngology and Neurotology. He knows there is nothing he can do for my tinnitus. I assume this conflicts with his ego so it isn't something he has much to talk about.

His Audiologist, she gets a better image of the sounds I hear and don't hear. She is sympathetic to the severity of my tinnitus but can only offer hearing aids.

 

[Michael B]

It was apparent to me that I was losing sleep and unable to function 100% soon after getting tinnitus. I was diagnosed with severe tinnitus and I was suffering. My primary doctor was very understanding and signed off for 6 weeks of catastrophic leave. Best thing I could have done for myself. While my tinnitus didn't improve, I was able to better manage with much needed time off from work and sleep.
Mike

 

[Michael Leigh]

He said 'sure if you want' but he would not sign a note saying it is necessary. Basically, it won't make any difference to your healing and tinnitus if you are in school or not.

Is he correct?

HI @John CC

Please read my article : Tinnitus, A Personal View (again) particularly the part where I mention what happens when a person sees their ENT for the first time. Your doctor has probably consulted with hundreds of tinnitus patients. He and other medical professionals get a six sense about people and part of their job is reading a patients body language and listening closely to what they're are saying. This is very important especially dealing with something like tinnitus which can be very debilitating when it is severe and this level of intensity is sustained. This can affect newbies a lot in the first few months and beyond.

It is true that the bedside side manner of some doctors leaves a lot to be desired and I fully understand your reference to feeling like a piece of meat. However, your ENT doctor has probably picked-up that your tinnitus is not severe enough (debilitating) to prevent you from working and thus for his cavalier and nonchalant approach. If you were showing more distress or clearly in a state of emotional unease I suspect his attitude would have been different.

I have spoken to many people on the telephone about their tinnitus and within a few minutes, can pickup a fairly good understanding on how the tinnitus is affecting their mental wellbeing and emotional state. Whether they are able to carry out normal every day functions as they would usually do. People that have loud intrusive tinnitus and find it debilitating have difficulty hiding it if they wanted to, as the distress would clearly be apparent on their face, body language and tone of voice etc. They would most probably been on medication to help with stress and anxiety.

The ear is a very delicate and sophisticated organ. Most ENT doctors prefer to leave it a lone as this is the best treatment in the early stages, as long as there are not additional symptoms such as: deafness, dizziness, pain in the ears, balance problems, as this can indicate other underlying problems within the auditory system that would need prompt investigation. For straight forward tinnitus the best treatment is to do nothing and wait and see what happens. Sound therapy, counselling and medication can be used for treatment in the early stages.

please read my article again.

All the best
Michael

 

[Bill Bauer]

your ENT doctor has probably picked-up that your tinnitus is not severe enough (debilitating) to prevent you from working and thus for his cavalier and nonchalant approach.

I saw an ENT three days after my T had turned on. When he asked me "How are you?" I burst into uncontrollable tears...

 

[Michael Leigh]

I saw an ENT three days after my T had turned on. When he asked me "How are you?" I burst into uncontrollable tears...

And what was the reaction of your ENT doctor? An understanding doctor if doing their job correctly, should have enquired further on how you are coping daily and would probably advise medication and a referral to a Hearing Therapist for counselling. This is what happens in the UK but I don't know the procedure for other parts of the world. In any case, anyone that breaks down due to the distress of tinnitus needs further care as in Bam's case.

There will be people in the UK reading what I've said, and can't wait to disagree saying this is not case but I assure you in most cases that it is. Rarely would a patient's GP ignore this. ENT doctors are not counsellors but should have some degree of understanding and care towards their patient that is in a clear state of emotional distress, otherwise they shouldn't be practicing medicine.

Michael

 

[85dB T]

I forgot to mention, my ENT did prescribe Amitriptyline, Brand name: Elavil. A nerve pain medication and antidepressant.

 

[Bill Bauer]

And what was the reaction of your ENT doctor?

He used that to justify NOT giving me a prescription for Prednisone that I asked him for. He said that I appeared to already be stressed out and that Prednisone will possibly make me more stressed out. Can you imagine - comparing some discomfort for a fortnight to a possible lifetime of stress due to him denying Prednisone to me? In any case, he basically used the fact that I broke down crying against me...

Before my visit, I got 5 Prednisone pills at the ER. They told me to ask the ENT to give the rest of the prescription to me. Back then I didn't know much, so I didn't insist/didn't try to change my ENT's mind. It is something that I still regret, 1.5 years later...

An understanding doctor if doing their job correctly, should have enquired further on how you are coping daily and would probably advise medication and a referral to a Hearing Therapist for counselling.

He told me that my ears appeared to be healthy, and that there was nothing he could do to treat T. When I asked him whether it will be permanent, he said "not necessarily." Then he told me that it will likely be permanent if it is still there a year after onset. This is something that I now know to not be true. According to the medical literature, T is considered to be chronic 2 years after the onset. One useful thing that he told me was "to be easy on my ears for awhile".

He did mention some private firm that I believe is doing TRT. He said that I don't need a referral to get help there.

 

[glynis]

@John CC ,
I work in a school also and know how loud they can be.
I'm on our big 6 week holiday at the moment before our New term starts.
You could try some noise reduction plugs to use at work if your ever out on the school yard see if it helps.
love glynis

 

[Michael Leigh]

He did mention some private firm that I believe is doing TRT. He said that I don't need a referral to get help there.

I am sorry that you have been treated in this way @Bill Bauer It is true the bedside manner of some ENT doctors leaves a lot to be desired. I have a very good ENT doctor excellent in fact as she helped bring me back from the depths of despair that I refer to in my post: My experience with tinnitus, on my started threads. This was back in 2010, when my tinnitus would reach excruciating levels of severity that I just couldn't cope with even with my many previous years of experience with the condition.

No GP or ENT doctor will prescribe Predisone to a tinnitus patient in the UK. If any patient were to suggest it or any other medicine, I assure you it wouldn't go down well for a number of reasons. The doctor would feel the patient is telling their job which is not a good idea. If one were brazen enough to do so, they would most likely be told: "You tell me your symptoms, and I make the diagnoses". I know some patients overseas request certain medication from their GP or what is known as primary care doctor. This is just not done in the UK and would immediately get a doctor's back up.

Your ENT doctor rightly mentioned alternative treatment in the form of TRT. Again, our health system is different. A patient in distress with their tinnitus in the UK, would be offered some form of help, which would include: medication, counselling, CBT, TRT where available.

Michael

 

[Bill Bauer]

I assure you it wouldn't go down well for a number of reasons. The doctor would feel the patient is telling their job which is not a good idea.

I brought a printout of a paper published in a medical journal where they described that one of the treatments following an acoustic trauma is a course of steroids...

I guess it depends on a doctor. I remember how one doctor I saw in the past had confronted me with a "Are you a doctor?" [this was before I became a doctor of philosophy ] Most other doctors I had a chance to do this to had been more agreeable...

 

[Michael Leigh]

I guess it depends on a doctor. I remember how one doctor I saw in the past had confronted me with a "Are you a doctor?" [this was before I became a doctor of philosophy ] Most other doctors I had a chance to do this to had been more agreeable...

It seems some of the doctors overseas share the same views as UK doctors. As I said, no doctor in the UK will prescribe Predisone for tinnitus or noise trauma. If any patient were to have the effrontery to bring a print out of a published journal, showing Predisone helps with noise trauma this would not go down well. I have always had good treatment with my doctors as I show humility and don't try to tell them their job. I know the practice in other countries are different and that's fine, I'm just saying in the UK it wouldn't be acceptable.

Take care
Michael

 

[glynis]

@Bill Bauer ,
I was like you at first and broke down in ENT but was for all the Menieres symptoms and wanted answers but it took over 12 months for a diagnosis but when I first got seen by Audiology I was in tears and Jane did a tick chart and my mood was low and had white noise generators given to me.
I went back a few weeks later and did another tick chart and she said the maskers must be helping and that was it and discharged from Audiology but not my Meniere's consultant.

Jane and I have seen eachother many times at other places due to tinnitus supporting others and can remember sobbing in her arm's when we first met many years ago and now lovely friends.
love glynis

 

[Bill Bauer]

it took over 12 months for a diagnosis

This is so messed up...

My dad has had a similar experience. He has had some Classic brain cancer symptoms (as we learned later at oncology/radiotherapy/chemotherapy waiting rooms, chatting with the other patients who had the exact same early symptoms), and it turns out that brain cancer is not uncommon, and still it took years before he got his diagnosis.

 

[glynis]

It's just waiting for tests and results that takes time and we put so much in seeing a consultant to come away feeling better.
I have only been let down once so I can not fault them when I was referred to the wrong person for ear infections instead of my normal consultant...admin error.

l think Tinnitus Talk is a great place to come for support as their is not enough support in the early weeks or months for counselling till been seen by ENT.
love glynis

 

[John CC]

If I were you, I would try asking the doctor for help (but I wouldn't bet on him or her being able to help me).

Great advice. I saw my doctor today, spoke with him and shared how it is affecting me. He agree that more time could help, and as such, he gave me a note for time off from work to heal. Your information was timely, and appreciated, and I intend to use the time (an extra month or two) to heal, any suggestions?

 

[coffee_girl]

I have T and have only visited an ENT once since i've had it, there is no cure for T...there is no reason to come back. All you're getting are the same answers and the same procedures that loop back to the same thing. Just wasting money to end up back at square one. If there is a 1-size-fits-all treatment it would have happened already.

Best bet is to sit tight, wait until something that works and has been confirmed by hundreds of others to cure T and then maybe wait a few years to see if there are side effects before taking the plunge.

 

[Bill Bauer]

any suggestions?

I am drawing a blank.