On Tinnitus

Today I want to talk about tinnitus. It sucks. Everyone has experienced it to some degree. But I’ve learned that it doesn’t sound the same for everyone.

You know that high pitched whistle you get in your ear that comes and goes pretty quickly? Some people have that all the time.

I still get those small occurrences of whistling. They come and go just as they always have. But my lasting tinnitus doesn’t sound like that whistle we’ve all heard.

It’s very hard to explain. And I sympathize with those who struggle with chronic pain or other invisible issues because when others can’t see it, it makes you feel like maybe you’re crazy. If you can’t explain it, maybe it isn’t really happening. Maybe you are making things up. But I tell you my friends, this noise in my head is real; I know when it is there and when it isn’t. I'm no hypochondriac and tend to downplay pain or discomfort. So when I say this is legit, I mean it.

I had a couple of instances earlier this year where the noise lasted for most of the day. I wasn’t sure what to make of it. Then it really started kicking in in August, around when I started my job.

Since everyone experiences it differently, here’s what the Mayo Clinic says about what you can hear: 

• Clicking. Muscle contractions in and around your ear can cause sharp clicking sounds that you hear in bursts. They may last from several seconds to a few minutes.
• Rushing or humming. Usually vascular in origin, you may notice sound fluctuations when you exercise or change positions, such as when you lie down or stand up.
• Heartbeat. Blood vessel problems, such as high blood pressure, an aneurysm or a tumor, and blockage of the ear canal or eustachian tube can amplify the sound of your heartbeat in your ears (pulsatile tinnitus).
• Low-pitched ringing. Conditions that can cause low-pitched ringing in one ear include Meniere's disease. Tinnitus may become very loud before an attack of vertigo — a sense that you or your surroundings are spinning or moving.
• High-pitched ringing. Exposure to a very loud noise or a blow to the ear can cause a high-pitched ringing or buzzing that usually goes away after a few hours. However, if there's hearing loss as well, tinnitus may be permanent. Long-term noise exposure, age-related hearing loss or medications can cause a continuous, high-pitched ringing in both ears. Acoustic neuroma can cause continuous, high-pitched ringing in one ear.
• Other sounds. Stiff inner ear bones (otosclerosis) can cause low-pitched tinnitus that may be continuous or may come and go. Earwax, foreign bodies or hairs in the ear canal can rub against the eardrum, causing a variety of sounds.

I mostly experience the second one, but also the fourth one in a way. It’s not so much a change of position that affects it. You know when you’ve heard your heart beat in your ear? That whooshing pressure sound? It’s not like that. It’s almost like a bathroom fan is on in my head. Or the hum of a public drinking fountain (have you actually paid attention to how loud those things are?). Or a refrigerator that just started running. It’s just a constant steady noise.

It simultaneously drowns everything out, and amplifies everything. I don’t know how that is possible. But I can be standing at the fridge getting water out of the dispenser, and have to tell my roommate to hang on because I can’t hear her voice over the water dispensing and over the noise in my head. Same thing at the kitchen faucet. But then with certain sounds or loud voices, it makes a really intense vibration in my ears, and is painful. Like I went on a quick walk just now, and when I walked back in the office, the copier was running. That sound is irritating me immensely right now. Or sometimes male voices talking at a standard volume really irritates me. My blender is especially awful when tinnitus kicks in. The only way I found to deal with it is to put headphones in and turn some music up pretty loud. It drowns out the noise in my head, as well as the external noises that make it worse.

I’ve had my episodes last as long as 36 hours. It usually lasts about 24. And it almost always starts right from the moment I wake up. I live with it during the day and hope that when I wake up the next morning, it’ll be gone. It is usually in both ears, probably more in my right than in my left. But it’s not even really in my ear; it’s more like on a certain side of my head. Because where the whistling sound you hear does sound like it’s in your ear, the vibrating white noise I hear feels like it is in my head, making my hearing more sensitive.

It is loud and has been debilitating at some points—causing me to stay home and not do certain activities because the constant noise makes me feel exhausted. But I have found that it is actually better to stay busy and distracted, almost disregarding it, like an elephant in my room (or a fridge in my ear).

Now, everything I’ve read about tinnitus basically says it has no cure. You can make changes to your lifestyle and see if any of it helps.

For lifestyle changes, the Mayo Clinic suggests:

• Reducing exposure to loud noises, caffeine, and nicotine
• Covering up the noise with other white noise to mask the sound in your head
• Managing stress
• Reducing alcohol consumption

Since I don’t drink or go to loud concerts regularly, that left the issues of caffeine and stress. Stress I try to deal with as best I can; I can certainly do better (part of why I’m writing so much this month). But caffeine was something I could directly control. So I cut it out. In the periods where I have given up caffeine, my tinnitus occurrences have basically disappeared or vastly decreased. The instances where I’ve had flare-ups recently have been with accidental ingestion of caffeine (thank you, Starbucks).

I kept careful track on a note in my phone of when it would occur, how long it would last, and later on started paying attention to which ear was more affected. I went to the doctor before my Hawaii trip, right after my insurance became active. He checked for various things and didn’t see a need for earwax removal. He wanted me to get a hearing test done because tinnitus usually comes with hearing loss (like you see in the movie A Star is Born). I got my hearing assessed, everything came back in the clear. They told me everything looked great, and they’d pass the info along to my doctor.

I haven’t heard from my doctor since, but knowing there really isn’t much he can do for me makes me not want to follow up. I guess it’s good enough to know there’s no real damage, and that I can mostly control it by eliminating caffeine.

Having pretty well confirmed that it is caffeine that activates these flare-ups, I don’t really have a hard time keeping away from it. I’d rather not have caffeine than to have this horrible noise in my head. Sure, I sometimes could go for an extra boost in the late afternoon (read: our species’ 3pm nap time). But I can definitively say I’d prefer not to experience the consequences. So I don’t drink it. I even bought a stim-free pre-workout for myself. (Also does anyone want my leftover Gu packets?)

I miss Diet Dr. Pepper, Coke Zero, and matcha tea. I can get the former two caffeine free but have to buy it specially in the cans—it’s not available just at work or in vending machines. I’ve relied on Sprite Zero and Fresca when I need something more widely accessible (like on an airplane). But we do what we have to do so we can feel our best, right? So it goes.