Tinnitus in School

[melburrito]

Hi everyone,

I recently developed tinnitus. I am in medical school, just like another story from Meecat that I recently read about. It started about 5 days ago. I just took my last set of exams for third year but I still have the board exams to take in the next month.

I don't exactly recall when it started but I've had occasional ringing that would go away, sometimes when I willed it to go away. I believe this time it was a gradual onset, and isn't associated with any other symptoms. I haven't had fevers, vertigo or migraines. I haven't been in loud concerts. Thus making me wonder why I started having it all of a sudden.

Since it's been about a week now, I notice that it's worse in the evening. It's worse esp when I'm studying, because I need quiet to concentrate. But the best part of the day is right when I wake up, and also from naps, I am able to enjoy about a good 5-10 mins of peace and silence.

I went to my PCP and got a whole lot of meds and am trying every single one of them. The T has decreased in volume, but the pitch has increased since I started taking the meds yesterday.

I am unsure if this is going to alter my path in med school, if I'll need to take extra time off, a month? two? three? half a year? before I can focus on my work again.

Please let me know your thoughts and thank you for reading.

 

[Job]

If I were you, I might take some time off, but no more than a semester or quarter, in order to find ways to cope. For example, you might want to see what sounds mask your T or make you feel comfortable. Perhaps establish better sleep patterns. I would work on setting up a schedule that minimizes stress (for example, stretching for an hour before bed, exercising in the morning, etc.) Also, do your research on the drugs you are now trying. Personally, I would stay away from benzos unless you are taking them for 2 weeks, tops. Look into treatments such as TRT and see if they interest you.

 

[Markku]

Have you had an audiogram? But since you don't have a habit of going to loud concerts/gigs/other events, then it's possible there's no measurable hearing loss. Very often some hearing loss is seen with tinnitus (and since most audiograms only go up to 8kHz and tinnitus pitch can be higher than that, audiograms don't always rule out the possibility of hearing loss unless the higher frequencies are also tested), but not always.

It could be stress too... tinnitus sufferers rarely get complete silence periods. It's a good sign, as far as I know. Possibly an indication of longer silent periods to come. Who knows.

Out of curiosity, what drugs were you prescribed?

I wouldn't take time off school unless you feel it's absolutely necessary. That may only increase your stress levels with worry how it all turns out and how you are left behind, and in turn makes your tinnitus worse.

And as Job said, look into masking techniques. Find some music/sounds that don't take your concentration away from studying, but help mask your tinnitus. Maybe nature sounds? Raining? Give different kinds of tracks a go and see how it goes.

Do you have a summer vacation from school, or do you need to study in summer too? It would be nice if a vacation coincided with this and you could try to learn some coping mechanisms.

All the best, and keep us updated!

Welcome to the forums,
Markku

 

[melburrito]

Hi,

I'm taking Predisone for about 1 week taperered dose, Antibiotics for 10 days, and OTC allergy and vertigo meds daily (Meclizine and Zyrtec).

I've been listening to meditation music online. It's definitely keeping me from mental/emotional breakdowns.

I've had quite a lot of issues since med school started - shingles, "paralyzed" leg needing me to wear a boot for a couple weeks, painful abdominal cramps, and writer's cramp having me to take steroids to reduce the pain - ALL of which have happened independently from each other. I hope this is another thing I can overcome...

Also I did take a month "break" to study for boards but it seems like I will have to take a day at a time and see how it goes. I am not sure if I can take my exams at the end of this month since I don't know when it'll go away. But staring into my books have not helped much lately.

I'll definitely take up your suggestion and try stretching/meditating during the day.

 

[Karen]

Hi, Melburrito,

I've just read that there may be a connection between shingles and tinnitus. I've attached a link to some information about it. Sometimes the facial muscles can be affected by shingles, which might also affect the ears. There is a syndrome caused by shingles that can actually cause facial paralysis. (see below)

http://www.nhs.uk/Conditions/Shingles/Pages/Complications.aspx

I hope you start to feel better. The combination of stress from med school, plus the other issues you've had, could have brought on the tinnitus. Take care, and continue to look for calming ways to manage your stress!

 

[Karl]

melburrito -
Tinnitus also has a psychological component which you need to understand. It's possible you are amplifying your auditory awareness, creating a psychological loop, listening to every nuance that you hear. Certain personality types are prone toward creating a viscious cycle.

Last year, Dez Dog posted this great link that explains tinnitus:
http://oxfordlearning.org.uk/westbe...ationswb/pdf/A/L_Waite_GP talk powerpoint.pdf

Not to oversimplify things, but tinnitus is a tricky condition. It usually happens at a lower brain level, which we have no control over. It can get reinforced by our conscious thoughts - if we let it.

It can be very difficult to reconcile what we have control over. Jastreboff says that when we learn to ignore it, it becomes an insignificant factor in our lives.

 

[mick]

Last year, Dez Dog posted this great link that explains tinnitus:
http://oxfordlearning.org.uk/westbe...ationswb/pdf/A/L_Waite_GP talk powerpoint.pdf

I like much of what the slides present, but I worry that it overemphasizes the psychological aspects almost as if saying that the suffer's response/attitude is the problem. The linkage to stress as an intiator presented in the slides in particular fosters the notion of tinnitus being largely a psychological problem, and creates a very slippery slope for practioners to slide down to the wrong conclusion (i.e., that it's the patient, not the disease), and another reason for them to not put forth effort helping sufferers. If ENTs and other doctors are in fact adopting the view that the problem is the patient, and not the disease, then that explains why so many T suffers get the brush off from doctors.

I don't disagree with the idea that many people have tinnitus that does not bother them. The difference, however, as has been pointed out by many, is volume. My tinnitus volume fluctuates tremondously from day to day, and even hour to hour at times. When the volume is low, it is easy to ignore, and I can function quite normally. When the volume is high, or when I experience ear pain and pressure, the story is quite a bit different. I've learned to manage the high volume periods much better than when it started (mostly by being aware that it the volume will very likely diminish again to a level I can tolerate) and am doing pretty well these days, but tinnitus is no different than any other ailment - it impairs one's ability to enjoy life and peform at an optimum level. Let there be no question about it - T has made me less productive in my job, and not as good of a parent. I rarely work at home anymore because I so often don't feel up to it. Where before T I often brought work home with me for no reason other than because I like the work I do. (I want to make that clear so that people don't think that work was one of the stress factors in me getting T. Believe me, work is the least stressful part of my life. I liked it tremendously before T, I like it tremendously now, and I miss being able to spend as much time doing it as I used to.) I also spend less time with my children, again because I don't feel up to it.

Tinnitus, like all ailments, has an ancillary psychological component it to it. Correct the ailment, and the psychological issues will disappear. Correcting the ailament should be the goal. I'm all for minimizig suffering. Addressing the psycholigical aspects can minimize the psychological suffering (dwelling on it, negative talking to oneself, if only it weren't for this ailment, etc.), and dealing with that can help one divert their attention from T, but it does nothing for the core problem which is physically, medically, biologically real.

Everyone, including doctors, recognizes that an illness like a cold impairs one's performance and ability to enjoy things. I've had some colds that I would say, for the time that I had them, were more debilitaing than tinnitus. The big difference is that my colds get better and I return my normal fully functioning self. Tinnitus doesn't get better and that is a huge difference. So far the only thing that doctors have to offer for tinnitus are things that perhaps make it easier to cope with it (neuromodulation, CBT, hearing aids, maskers) all of which fall way short of being free of the ailment to the same extent as being free of a cold when you're over it. If doctors can recogonize a cold as being debilitating, why can so many not recognize that something permanent like tinnitus is even more debilitating?

 

[Hudson]

Mick, I couldn't agree with you more.

If a person is suffering, and has control over the source, the logical thing is to remove the source of the suffering.

If a person is suffering, but has no control over the source, the only option is to try and change the way they think about "the source" in an attempt to remove the suffering that way.

Only addressing the suffering associated with tinnitus does everyone a great disservice. Just because there is no solution now does not mean that tinnitus is some existential philosophical problem with no answer. There is a solution, and we need to find it. Addressing the attitude about tinnitus is merely a coping mechanism until meaningful treatments can be found. I may be beating a dead horse here, but suggesting the problem is my attitude is offensive. The problem is the damn tinnitus.

 

[James White]

I personally can't remember a single moment of silence when i was studying, that's before tinnitus. I can't concentrate in silence, i need some music or something in the background.

Keep in mind that people without tinnitus use rain or ocean sounds to help them with studying, i absolutely love it and it makes me much more productive. Besides, i don't have much emotional attachement to my tinnitus. Sometimes i even like it, reminds me i'm alive.

 

[stantheman]

Mick - I agree with you 100%. My life IS different from what it was before I got tinnitus. I try to ignore it but it gets so loud I just can't. When the volume is down I can cope quite well otherwise I'm in tinnitus hell and just thinking pretty thoughts won't make it better. Tinnitus IS the problem.