Goal of ther­apy for tin­ni­tus is to lessen symp­toms

Prince Albert Daily Herald - - OPINION -

alone have chronic (last­ing longer than six months) tin­ni­tus.

It is thought that brain cells in the hear­ing-pro­cess­ing area of the brain are re­spon­si­ble for the sen­sa­tion. Any con­di­tion that re­duces hear­ing, such as re­peated ex­po­sure to loud noise, tu­mors of the cochlear nerve (the nerve that goes to the ear) and med­i­ca­tions that dam­age hear­ing can pre­dis­pose a per­son to tin­ni­tus. About 10 per­cent of peo­ple with tin­ni­tus state that it se­verely af­fects their qual­ity of life.

Un­for­tu­nately, for most peo­ple, there is no cure for tin­ni­tus. The goal of ther­apy is to lessen symp­toms and to treat any as­so­ci­ated con­di­tions, es­pe­cially de­pres­sion and sleep dis­tur­bance, both of which are com­mon in peo­ple with se­vere tin­ni­tus.

I re­viewed the avail­able med­i­cal treat­ments for tin­ni­tus, and also did an in­ter­net search for nat­u­ral treat­ments for tin­ni­tus. Un­for­tu­nately, many of the ad­ver­tised nat­u­ral treat­ments have been stud­ied and not been found to be ef­fec­tive: ginkgo biloba, mela­tonin, bioflavonoids and var­i­ous vi­ta­min and min­eral sup­ple­ments have not shown any ef­fec­tive­ness.

I don’t rec­om­mend any med­i­ca­tions for treat­ment of the tin­ni­tus; how­ever, peo­ple with anx­i­ety, de­pres­sion or sleep dis­tur­bance from tin­ni­tus may ben­e­fit from phar­ma­co­logic or other treat­ments of these con­di­tions.

I strongly rec­om­mend the web­site of the Amer­i­can Tin­ni­tus As­so­ci­a­tion, www.tin­ni­tus.org, for more in­for­ma­tion.

DEAR DR. ROACH: After see­ing your re­cent col­umn on pace­mak­ers, I am won­der­ing if you would ex­plain the dif­fer­ence be­tween a pacemaker and ICD. I had an ICD im­planted in my chest a year ago. Is it to shock and start the heart if it stops? -- J.W.

AN­SWER: An au­to­mated im­plantable car­diac de­fib­ril­la­tor is in­tended to sense ab­nor­mal heart rhythms. It is put in peo­ple with a his­tory of dan­ger­ous heart rhythms, or those at high risk for life-threat­en­ing heart rhythms, such as peo­ple with se­vere heart fail­ure. AICDs have been proven to save lives, when cho­sen for the ap­pro­pri­ate peo­ple.

An AICD has a sys­tem for sens­ing ab­nor­mal heart rhythms, and a large bat­tery for the de­fib­ril­la­tor.

Un­like a pacemaker, which uses a trickle of elec­tric­ity to start the nor­mal car­diac im­pulse, the AICD de­liv­ers a sig­nif­i­cant elec­tric shock to the heart, in or­der to “re­set” the sys­tem and stop the ar­rhyth­mia. I have wit­nessed this many times, and some peo­ple de­scribe it as mildly an­noy­ing, whereas oth­ers get sig­nif­i­cant pain and dis­com­fort, and a few can de­velop anx­i­ety disor­ders or even PTSD after mul­ti­ple shocks. The AICD must be prop­erly pro­grammed, as it some­times can be mis­taken about the heart rhythm, and de­liver a shock un­nec­es­sar­ily.

Newer AICDs also have the abil­ity to be a pacemaker as well as de­liver the po­ten­tially life­sav­ing shock.

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