Many of us have experienced a ringing in our ears at some time or another - perhaps after a rock concert, or from sitting too near a loud speaker in a pub or club for example. But imagine if you could hear ringing in your ears on a continual basis, or another noise, such as buzzing, hissing or clicking. Imagine if you could hear this all the time and nobody else could.
This is what a person with tinnitus must learn to deal with. Tinnitus is the experience of sound in the ears or head in the absence of any appropriate external stimulus - in other words the sound is not being caused by a source outside of the person.
The sounds described by tinnitus sufferers include ringing, whistling, rushing, whining, hissing, grinding and rumbling, while some liken it to that of industrial machinery, a vacuum cleaner or a jet engine
According to this study, which was carried out on behalf of the Irish Tinnitus Association, it is now accepted that tinnitus is not an illness in itself, but is instead a symptom of some form of dysfunction in the auditory (hearing) system. The majority of cases appear to start with some sort of disorder in the ear, such as an infection or noise damage.
The study's author, Pat Naughton, is only too familiar with this condition - he has had it for 12 years and is the chairman of the Cork Tinnitus Support Group.
"In my case, I can hear a high pitched hiss in one ear - usually my right - all of the time, it never stops. At one stage, I could hear up to three or four noises at the same time, but now I just hear the hiss", he explained to irishhealth.com.
In the beginning, the noise was 'quite low', but after a bout of flu, it became louder. Pat found this in particular very difficult to cope with and in the following few months, suffered depression and insomnia as a result.
This unfortunately is not unusual - in fact many of the problems associated with tinnitus are psychological. Sleep disorders are common with troublesome tinnitus, as are feelings of anxiety, frustration and helplessness.
This is not helped by the fact that there appears to be little information or support available to sufferers in Ireland, something which is clearly shown in the study.
It surveyed 73 people on their experiences of tinnitus, covering such issues as the effects of the condition during the early stages and satisfaction with the responses of various medical professionals.
It found that the GP is almost always the first professional attended. However when asked if they were happy with the response of their GP, one-third of those surveyed said they were not. A further one-third said they were satisfied, however most of these qualified this by saying that they believed that the GP had done all that they could. The remainder did not express an opinion.
It appears that the vast majority of people who attended their GP in the first instance were referred on to an ENT (ear, nose and throat) consultant or audiologist. This highlights the lack of options open to GPs in terms of treating tinnitus, according to the study.
Some of the comments made by those surveyed in relation to GPs included:
-My GP knew little about tinnitus and said 'you'll have to put up with it'.
-The doctor said I was just imagining the noise.
-He said 'we must accept things like this as part of ageing'.
-My doctor had tinnitus himself and was a good example of someone living with it.
-He was a great help and support and sourced leaflets for me.
-She was supportive but powerless to help.
"We do not want to blame medical professionals. We know that for example GPs are under increased pressure today - they have less time with their patients. In the absence of a cure, many feel that they cannot manage the condition", Pat explained.
For those who attended an audiologist, the survey found that while some people were fitted with hearing aids or maskers, few reported success with these. Comments made indicate that audiologists generally confined themselves to audiometric assessments and diagnosis of hearing problems, but gave little or no advice on tinnitus.
Experience with doctors
Four out of five of those surveyed sought the opinion of an ENT specialist. While one-fifth said they were satisfied, more than twice as many declared themselves dissatisfied with the response they received. Comments made by them in relation to these specialists included:
-He said 'I'm busy, I don't have time to listen to your tinnitus story'. His manner was quite offensive.
-He said 'go away and get used to it'.
-He said 'you're getting old, put up with it, it won't do you any harm' (to a woman aged 55).
-He did everything he could and sent me for X-rays.
-He offered reassurance and said that I would live with it.
-I was happy enough with him.
The study points out that a large part of international efforts in developing tinnitus therapies is in the area of counselling. However the fact that just 12% of those surveyed here sought help from a psychologist, psychiatrist or counsellor is not surprising 'given the virtual absence of treatments in Ireland to date'.
Just over half of those surveyed (51%) sought some sort of complementary therapy, with acupuncture being the most common treatment. Other therapies included reflexology, yoga, aromatherapy, Reiki and osteopathy.
"Given the chronic character of tinnitus, it is not surprising, that in the absence of any structured medical treatments, many people seek out alternative or complementary therapies…The common evaluation of these therapeutic approaches was that they had little or no beneficial effect on the tinnitus, although many respondents did claim that they felt better or more relaxed after treatments", the study said.
Ridicule and suspicion
The study refers to people's present situation and 'habituation', which is the term used to describe getting used to tinnitus. Of those surveyed, 22% said they had never been troubled by their tinnitus, while 18% said initially they had not been troubled, but had later become distressed.
A further 44% said that initially they were troubled but have now accepted it (habituated). However 16% said that they have never accepted it and continue to struggle.
One theme that emerged a lot was the fact that the majority of people with tinnitus do not talk about the condition to others. Most of those surveyed felt that others did not understand, while a few felt that talking about noises in their head left them open to ridicule or even suspicion
When asked what services they thought were needed for tinnitus sufferers, 19% called for a clinic where diagnostic and treatment options would be available.
A further 19% called for mutual support of various kinds, 12% wanted to be able to attend a medical person with an interest in tinnitus while 11% wanted to see a counselling service set up.
The study made a number of recommendations, including:
-The establishment of clinics at a number of regional centres, which would provide services such as audiological assessment, access to hearing aids and counselling.
-A programme of public information and education about the condition.
Pat Naughton also points out that there needs to be a study done to determine how prevalent this condition is in Ireland.
"Research indicates that 1% of the population are affected but we need to see exactly how many people have this condition. This could be done, for example, through GPs. There is help available for people with tinnitus, but it is currently not structured or co-ordinated", he added.