Quieting the Noisy Silence

A recent news item on the BBC describes current research into treatments for tinnitus. For those of you without this unwelcome companion, tinnitus is a perceived but non-existent whistling, whining, buzzing, whooshing, squealing, or similar noise. It may be intermittent or constant. For many people it is downright annoying, but for some this perceptual problem is debilitating.

There is no cure for tinnitus, despite a plethora of nonsense being hawked on the Web. (Even treatments such as Auditory Integration Therapy don’t actually hold up well under controlled studies.) My tinnitus is a 14-17 kHz whine, like high-pitched piece of electronics or the whining of a particularly shrill radiator. Like other people with tinnitus, I had to learn to get habituated to the sound and try to ignore it, or will frequently mask the annoyance with fans or other forms of “white noise”, or with music.

One of the hidden problems is that the noise can interfere with listening to real sounds, and that because no one else experiences it, they don’t understand how utterly DAMN ANNOYING that constant, freaking unending whistle is! Worse, just when you are most tired and stressed and need rest, it is the most troubling, because there are fewer distractions when you are trying to get to sleep. The fact that the piercing noise is entirely subjective doesn’t help either; no one else thinks that someone should be bothered by something imaginary.

But although the sound is not real, the problems resulting from having a constant squeal either right next to, or inside your head, are quite real.

But for Kate Cook, a busy working mother of two and presenter of the documentary Longing for Silence, the effects of the condition are debilitating.
She has had a high pitched whistle inside her head for 25 years and the impact on her life is huge. It never goes away and when she is tired or stressed the volume swells to unbearable levels.
“After a long day you have got this incredible noise inside you. A whistling, squeaking, almost physical sensation in your ears. That is when you feel really really lonely. And because it is a silent symptom to everyone around you, there is this hopeless feeling of being on my own with it,” says Kate.

The article describes a few trials with magnetic or electrical stimulation, or even a transient relief from lidocaine anæsthetic. As hopeful as these may be, I still want to see data from larger numbers of patients. The testimonials of a few are even less useful here than they are for other kinds of treatment trials, because tinnitus is largely a subjective phenomenon, and thus the potential for placebo effects are greater.

You might well ask, what does it matter if it’s a placebo or real if the problem is gone? Because rarely does any kind of treatment, be it pharmaceutical or surgical, come without associated risks. I want to know that the likely results outweigh the likely risks. Nothing in life is guaranteed, but because I don’t believe in luck or magic, I want information with a level of reliability.

Not only that, any experimental treatment is expensive. I could not afford it, and insurance companies sure aren’t going to spiff for something unless they think it’s worth it. Unfortunately, I suspect that even a proven treatment for an “imaginary” problem would be dismissed by those hard-assed corporations with their eyes on the almight profit margin. Tinnitus is not a medical emergency, it’s just a bloody quality of life issue.

Hell, after all, who needs peace and quiet?

Advertisements