Introduction to Tinnitus February 25, 2019 Jane Doe Hearing Center. Chicago, IL

Session Overview Introductions Hearing Hearing loss What is tinnitus? Treatments for tinnitus Helpful options Self-help Jane Doe Hearing Center. Chicago, IL

Introductions Your first name What does your tinnitus sound like? (ringing, humming, etc.) How long have you had tinnitus? Jane Doe Hearing Center. Chicago, IL

Jane Doe Hearing Center. Chicago, IL

Jane Doe Hearing Center. Chicago, IL

Jane Doe Hearing Center. Chicago, IL

Jane Doe Hearing Center. Chicago, IL

Jane Doe Hearing Center. Chicago, IL

Nerve Activity Nerve activity carries information to the brain Vibration of bones causes fluid in cochlea to move This causes tiny hairs on top of cell to move There is a chemical reaction between the hair cell and the nerves which causes the nerves to become active The nerve activity goes to the brain Brain interprets nerve activity as sound Loud sounds activate more nerves than soft sounds Jane Doe Hearing Center. Chicago, IL

Testing Hearing Testing typically shows the softest level one can hear at different frequencies (pitches) Results are mapped on an audiogram Jane Doe Hearing Center. Chicago, IL

Frequency in Hertz (Hz) Hearing Level in Decibels (dB) Jane Doe Hearing Center. Chicago, IL

Jane Doe Hearing Center. Chicago, IL Hearing Loss Jane Doe Hearing Center. Chicago, IL

Jane Doe Hearing Center. Chicago, IL

Common Sounds and Speech Jane Doe Hearing Center. Chicago, IL

Whisper Refrigerator Normal Conversation Ambulance siren Dishwasher 30 dB Whisper 40 dB Refrigerator 60 dB Normal Conversation 75 dB Dishwasher 110 dB Chain saw Rock concert 120 dB Ambulance siren 140+ dB Firecracker Firearms 85 dB Heavy city traffic School cafeteria 95 dB Motorcycle 100 dB Snowmobile Jane Doe Hearing Center. Chicago, IL

Causes of Hearing Loss Jane Doe Hearing Center. Chicago, IL

Damaged Hair Cells = Hearing Loss Jane Doe Hearing Center. Chicago, IL

Jane Doe Hearing Center. Chicago, IL

Jane Doe Hearing Center. Chicago, IL Tinnitus Causes Prevalence Mechanisms Reactions Jane Doe Hearing Center. Chicago, IL

What do you think caused your tinnitus? Your Turn What do you think caused your tinnitus? Jane Doe Hearing Center. Chicago, IL

Causes of Tinnitus Noise Head Injury Medications Age Disease Many of the same things that cause hearing loss also cause tinnitus However, hearing loss does not cause tinnitus, nor does tinnitus cause hearing loss An individual may have hearing loss but not have tinnitus OR may have tinnitus but no hearing loss Jane Doe Hearing Center. Chicago, IL

Prevalence of Tinnitus 10 in 100 people have tinnitus (10%) 20 in 100 people over 60 have tinnitus (20%) 1 in 100 people are bothered by tinnitus (1%) Millions of people have tinnitus, ranging from mild to severe Our Goal = To help you move into the group of people who have tinnitus that doesn’t negatively affect their life. Jane Doe Hearing Center. Chicago, IL

Nerve Activity Revisited Jane Doe Hearing Center. Chicago, IL

Nerve Activity  Hearing Vibration of bones causes fluid in cochlea to move This causes tiny hairs on the top of the cell to move There is a chemical reaction between the hair cell and the nerve, which causes the nerves to become active The nerve activity goes to the brain Brain interprets nerve activity as sound Loud sounds activate more nerves than soft sounds Jane Doe Hearing Center. Chicago, IL

Nerve Activity  Tinnitus Tinnitus is likely the result of an increase in spontaneous nerve activity People with tinnitus have increased spontaneous activity Brain picks up activity, not knowing that it’s random/extraneous The brain interprets the activity as an external sound, leading to tinnitus Jane Doe Hearing Center. Chicago, IL

Hearing Loss w/o Tinnitus Condition Nerve Activity Result Normal Hearing Hearing Loss w/o Tinnitus Tinnitus Hear Silence Hear Sound Jane Doe Hearing Center. Chicago, IL

Important -- Tinnitus DOES NOT Make you deaf Lead to senility Imply mental illness Jane Doe Hearing Center. Chicago, IL

Your Turn What is the biggest problem you have that you believe has resulted from your tinnitus? Jane Doe Hearing Center. Chicago, IL

Common Reactions to Tinnitus Troubled Thoughts Difficulty Hearing Insomnia Inability to Concentrate Jane Doe Hearing Center. Chicago, IL

Your Turn For partners: For those with tinnitus: What is the most difficult thing to explain to your partner about your condition? What could your partner do to help you the most with your tinnitus? For partners: What have you ben able to do to help your partner with their tinnitus? Jane Doe Hearing Center. Chicago, IL

Jane Doe Hearing Center. Chicago, IL Tinnitus Treatments Myths Facts Jane Doe Hearing Center. Chicago, IL

What have you tried? What has been successful? Your Turn What have you tried? What has been successful? Jane Doe Hearing Center. Chicago, IL

Curing Tinnitus… At this time, there are NO widely accepted cures for tinnitus There are NO studies that have shown a cure that have used appropriate research designs and that have been replicated by others Jane Doe Hearing Center. Chicago, IL

Medication Treatments There are NO drugs, medications, or supplements effective for treating tinnitus at this time There ARE effective medications for sleep, anxiety, and depression which may be helpful to tinnitus sufferers if their tinnitus leads to these problems. Jane Doe Hearing Center. Chicago, IL

Excellent Options DO Exist… Counseling and sound therapy Individualized Tinnitus Activities Treatment Hearing aids Tinnitus devices Jane Doe Hearing Center. Chicago, IL

Tinnitus Activities Therapy Individualized for YOU Focus in areas of: Thoughts and Emotions Hearing Sleep Concentration Activities, conversation, homework, review Jane Doe Hearing Center. Chicago, IL

Counseling Private consultation in Tinnitus Clinic (1 hour = $xxx) Private multiple sessions (three, 1-hour sessions = $xxx) Jane Doe Hearing Center. Chicago, IL

Counseling One purpose of tinnitus treatment is to alter our negative thoughts and emotions brought on by tinnitus. The brain can “learn” a response to a sound, and can then learn a different response to the same sound Depending on the context and interpretation of what’s going on, the brain produces a different response to the same sound Jane Doe Hearing Center. Chicago, IL

Reactions to Sound Neutral Response Doorbell Doorbell Angry neighbor Anxiety Response Doorbell Flower delivery Happy Response Jane Doe Hearing Center. Chicago, IL

Do any sounds make your tinnitus less noticeable? Your Turn Do any sounds make your tinnitus less noticeable? Jane Doe Hearing Center. Chicago, IL

Sound Therapy Hearing Aids Improve hearing Improve communication Reduce stress of intensive listening Often help tinnitus Less stress, facilitates positive reactions to tinnitus Background noise creates partial masking Our hearing aid center provides excellent service! Jane Doe Hearing Center. Chicago, IL

Sound Therapy Non-wearable sound TV Music Sound machine Wearable options Hearing aids Noise generators Tonal sound generators Processed music Jane Doe Hearing Center. Chicago, IL

Tinnitus and Low-Level Noise In quiet, the tinnitus signal is enhanced and the brain has nothing else to distract it from “hearing” the tinnitus With low-level noise in the environment, it becomes harder for the brain to keep track of/detect the tinnitus The low level sound interferes with the brain’s detection of tinnitus-related neural activity As your emotional reaction to the tinnitus is reduced, the brain will interpret the tinnitus the same way it does other insignificant background noise and filter it out Jane Doe Hearing Center. Chicago, IL

Tinnitus and Low-Level Noise Tinnitus in Low-Level Noise Jane Doe Hearing Center. Chicago, IL

Tinnitus and Low-Level Noise Tinnitus in Low-Level Noise Jane Doe Hearing Center. Chicago, IL

Tinnitus and Low-Level Noise The goal here is to decrease the prominence of your tinnitus. Imagine a small candle in a dark room – very noticeable. When you turn the lights on, it’s not as noticeable. The candle has not gone away, but it’s significantly less prominent. Jane Doe Hearing Center. Chicago, IL

Jane Doe Hearing Center. Chicago, IL

Summary Hearing loss and tinnitus are related Tinnitus is a change in spontaneous nerve activity There is no cure for tinnitus Management options include: Counseling and sound therapy Hearing aids Tinnitus devices Jane Doe Hearing Center. Chicago, IL

Stages of Management 1 = Medical clearance 2 = Group session 3 = Decision Counseling Sound therapy device(s) Both 4 = Individualized care Jane Doe Hearing Center. Chicago, IL

Individual Sessions Audiogram Measure your tinnitus Tinnitus-related questionnaires Discussion of results and options for next steps – counseling, hearing aids, devices Jane Doe Hearing Center. Chicago, IL

As You Exit… How do YOU want to manage your tinnitus? Focus on other areas of your life and put tinnitus in the background Use low-level sound in your environment (sound machine, music, TV, etc.) Use wearable tinnitus noise generators Begin tinnitus counseling Hearing aids with maskers for both hearing loss and tinnitus Jane Doe Hearing Center. Chicago, IL

Thank you for attending! Questions? Thank you for attending! Jane Doe Hearing Center. Chicago, IL

Jane Doe Hearing Center 555 Michigan Ave. Chicago, IL 01010 (555) 123-4567 jane@janedoehearingcenter.com Monday-Friday 9:00 AM to 5:00 PM Contact Us Jane Doe Hearing Center. Chicago, IL