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"Tinnitus" Chat Transcript Guest Speaker: Dr. Michael Seidman November 12, 2008 Moderator Good Evening, The Hearing Loss Association of America (HLAA) is proud to present live moderated chats, featuring the nation's leading experts in hearing loss and hearing loss issues. This is your opportunity to ask a question and learn more about hearing loss from leaders from a variety of disciplines associated with hearing loss. Moderator This is a moderated chat and you may submit your questions in the box below and click on “ASK”. We will be answering questions live as well as questions that were previously submitted. The doctor is running a little late but he is on his way. Will be here shortly. Moderator Tonight HLAA welcomes, Dr. Seidman, Director-Division of Otologic/Neurotologic Surgery in the Department of Otolaryngology-Head and Neck Surgery for Henry Ford Health System (Michigan), Director of Otolaryngology Research Laboratory, Co-Director of the Tinnitus Center, Chair of the Center for Integrative Medicine for Henry Ford Health System, Director of Product Development (nutritional science/projects) for ViSalus Sciences, and past President of the Michigan Otolaryngology Society. Dr. Seidman is also an HLAA Medical Advisor. Moderator Welcome Dr. Seidman We probably have more questions than we will have time for so let’s get started with the first question. Dr. Seidman Good to be here. Moderator Regarding Genes for hearing loss; could you please tell me where to go to find out scientific information as to whether or not specific genes for hearing loss have been isolated and identified? Ann, South Carolina Dr. Seidman If you Google your question you will find significant amounts of information. If we are speaking about things like Connexin 26 gene mutations that are responsible for at least 50% of non-syndromic deafness, there is a plethora of material written about this. Several of my colleagues are also working on novel strategies using Gene therapy to grow hair cells, much progress has occurred. Would recommend the work of Yehoash Rapheal, PhD. Moderator Does tinnitus get worse (as it seems to get louder) during changes in barometric pressure? Dr. Seidman There are certainly some patients of mine who note that changes of seasons and pressure or weather changes can adversely affect their tinnitus. You are not alone! Moderator I am deaf with a cochlear implant. Why is it that if I make a gurgling sound, my hearing improves? JoAnn, Maryland Dr. Seidman Tough question to answer, but perhaps you are swallowing or moving your jaw in some way that opens the Eustachian tube and changes your perception of hearing. Moderator Just over a year and a half ago, I was on a float in a St. Patrick's Day parade and apparently I was too close to a speaker. An hour into the parade, my hearing in my left ear completely went out. After many doctor's visits and attempts to regain my hearing, it has now been concluded that I suffered a sensorinueral hearing loss and this type of loss is permanent. To make matters worse, I developed severe tinnitus as a result of the hearing loss. While I have become more adjusted to the constant ringing and to living my life with one good ear, that doesn't mean that it does not bother me every day. In my opinion, the worst part of it all is knowing that I am only 27 years old and there is a good chance that I will live this way forever. My question to you is: In your opinions, do you believe that within my lifetime, I have a chance of being part of medical breakthroughs in hearing restoration, and/or silencing tinnitus. I do understand that you are doctors and do not want to provide false hope. But I would like to know your honest opinions. If you feel like you can answer this question, I would really appreciate it. Thank you for your time. Daniel, Louisiana Dr. Seidman I do believe there should always be hope. Our lab and others around the country are working hard on these problems. It is like trying to find a “cure” for pain. There are likely different sources for that pain/tinnitus. Thus, while there are currently no “cures” for tinnitus there are many things that can be done to help. This is a commercial site www.bodylanguagevitamins.com (you DO NOT HAVE TO BUY anything), and on this site are a HUGE list of EDUCATIONAL RESOURCES (a task bar), there are BMI calculators, scientific updates, Word docs (that talk EXACTLY about your problem-sudden sensorinueral hearing loss) and PowerPoint documents that you might find interesting. I have also written a book called “Save Your Hearing Now” published by Warner Books. While on Good Morning America ~ 2 years ago and while presenting to Congress re Operation Iraqi Freedom (OIF) re our men and women coming home with hearing related issues etc, we have spoken about our science and our patented formula that MAY (no guarantees) be of some help for age, noise and medication induced hearing loss. Our studies were done primarily on ANIMALS so we do NOT know for sure that this will translate to humans. However, I do have ~ 500 patients that have tried some of our novel strategies and have noted some help (not all respond positively). Hope this helps. Moderator Hi, doc. Question: Do you or any of your patients have any experience with Lipoflavonoid? What are your thoughts is it worth taking? Dr. Seidman I have patients who have tried lipoflavonoids with success and others not so lucky. Worth a try for sure, be sure to do for 3-4 months before determining full effect. Moderator I have about 50% (somewhat variable) hearing loss in my left ear and tinnitus (constant light whistling sound). Diagnosis from audiologist is: NEURO VIRAL LABYRINTHITIS. Any info on this would be appreciated. I take 20mg a day water pill. Diagnosed in 2000 with CLL (stable) CKD III - (stable) Liver problem (stable) Constant problem with gout due to my body not getting rid of uric acid as well high bilirubin. ONLY thing that helps with this is Prednisone. James, New Jersey Dr. Seidman There are many, many things one can do for tinnitus. What helps person A will not necessarily help person B. I typically recommend a) dietary modification, i.e. no salt, caffeine, alcohol, simple sugars, (i.e. sweets, candies etc), aspartame, NutraSweet, MSG, food colorings etc (sometimes this helps, sometimes not), then I recommend Arches tinnitus relief formula (combination pack). I suggest 3-4 months to see if this will help (I am a minor share holder in this company –less than 5%, so this is a conflict of interest for me, but I do find this helpful for some of my patients). From there I talk to my patients about TRT, neuromonics, other sound therapies. If this interferes with sleep or affects activities of daily living then I move on to centrally acting meds i.e. Xanax, Baclofen and Klonopin-in combination, Neurontin, Memantine, Campral etc. I have also developed a brain surgical procedure where I implant electrodes to the brain after mapping tinnitus with fMRI and MEG (Magnetoencephalographic studies). Then I place an implantable pulse generator into your chest to drive electrical current to the brain (this is for patients who are 10/10 on my tinnitus scale). I have done 5 such procedures. We essentially “cured” the first patient, had one pt with NO benefit and the other three were 35, 50 and 80% better. Thus still in its infancy. Another option is repetitive Transcanial Magnetic Stimulation which is helping ~ 40% of patients, University of Arkansas has an ongoing study. Other options include acupuncture, St John’s neuromuscular therapy, mind body therapies, i.e. hypnosis etc etc. If you go to www.bodylanguagevitamins.com (you DO NOT HAVE TO BUY anything), and on this site are a HUGE list of EDUCATIONAL RESOURCES (a task bar), there are BMI calculators, scientific updates, Word docs (that talk EXACTLY about your problem) Hope this helps, Michael Moderator I had very bad dizzy spells that came with nausea, and it lasted for 2 years. What was that all about? I’m so thankful I don’t have it anymore. Mary Ellen, New York Dr. Seidman There are many causes of balance disorders. You can have any number of about a million issues with your EYES that can cause issues, a million problems with your brain –down to your feet that can cause balance issues, about 5-6 problems with your inner ears that can cause balance issues and about a million metabolic issues that can affect balance. If you go to www.bodylanguagevitamins.com (you DO NOT HAVE TO BUY anything), and on this site are a HUGE list of EDUCATIONAL RESOURCES (a task bar), there are BMI calculators, scientific updates, Word docs (that talk EXACTLY about your problem) Moderator Dr. Can tinnitus be measured? If so can any audiologist or ENT do this test on me? What is the name of the test? My tinnitus is so severe that I barely sleep at night. I also have recruitment. I tried maskers but I cannot hear them so that not a question. What should I do? Danielle, New York. Dr. Seidman Yes it can be measured; we can do pitch and tone matching, done by an audiologist. Same answer as above (for tinnitus). Moderator I have tinnitus in my left ear for about two years. I now have hearing loss in that ear. I thought the tinnitus caused the hearing loss, but my doctor says that the tinnitus probably started because of the hearing loss. How does this work. Which came first? Judy, California Dr. Seidman We are not entirely sure, but generally speaking we believe that tinnitus occurs because of the hearing loss. It is essentially like a “Phantom Phenomenon” (but very real). There are episodes where people have lost their entire arm (for example) and say that their THUMB hurts, how could this be possible. The answer is because there is still a place in the brain that correlates to the thumb. The same logic applies to the ear. If there is hearing loss there are poorly functioning or dead hair cells. Normally the hair cells send INHIBITORY info to the brain. If the hair cells die then this inhibitory process is lost and the brain interprets this as a sound. If you go to www.bodylanguagevitamins.com (you DO NOT HAVE TO BUY anything), and on this site are a HUGE list of EDUCATIONAL RESOURCES (a task bar), there are BMI calculators, scientific updates, Word docs (that talk EXACTLY about your problem-tinnitus) Moderator If you reduce your salt intake, would that help to alleviate your tinnitus symptoms? Laura, Massachusetts Dr. Seidman There are people who are indeed salt sensitive and notice improvement when they restrict their intake of sodium. Same can be said about other potential trigger foods, i.e. caffeine, alcohol, sweets, MSG, aspartame, etc etc. Some people eliminate these foods and find no benefit. Moderator As prescribed after ear surgery I am taking one aspirin a day 81mg. Is this having any affect on my hearing (profound in both ears)? Joe, New York Dr. Seidman Probably not helping nor hurting. It is allowing your platelets to be less sticky and therefore reduce the likelihood of clots. Moderator Twice recently I had a sudden drop of hearing lasting from 5 to 24 hrs. But also can't really delineate if ALL my hearing has come back. I do have allergies that I take Allegra for and feel allergies are well controlled. Rarely get colds. It is confusing for me to figure out if the drop is me or my hearing aids. I have a severe loss anyway, so during this time, I can't function. Aside from bringing aids to audio. Each time, how can I tell if it's me? And if it is, should I be on something to unblock my ears besides my allergy Rx? I take nasal Rhinocort & Astelin with the Allegra. I dislike taking Rx! Laura, New Hampshire Dr. Seidman If there is truly a fluctuating hearing loss, you should get in to see your Otolaryngologist-Head and Neck Surgeon and audiologist to objectify your loss. It is possible that this is middle ear dependent and related to Eustachian tube dysfunction. It is also possible that this relates to a meniere’s like phenomenon and this should be documented. You do not have to go in every time, just once really to diagnose the fluctuation loss. Moderator My 6 year old son has a bilateral sensorinueral hearing loss. He wears hearing aids. Just recently, he is complaining about a low whistle when his hearing aid is off and he is not hearing as well in the one ear. We ruled out wax build up and ear infection and we are testing him on Wednesday for hearing. Could this be tinnitus? Dina, New Jersey Dr. Seidman Any sound perceived to be coming from the head or the ears WITHOUT an external sound source is by definition tinnitus, so perhaps. Hopefully his hearing is stable. I will be thinking positive thoughts for your son. Moderator donna_nicol asks Is there any relationship between smoking and tinnitus? Donna, Dr. Seidman Tobacco products have nicotine, nicotine is a POTENT vasoconstrictor (narrows) blood vessels. This has a NEGATIVE effect on the body including the ears. There are certainly smokers who do not have tinnitus, but we do believe between the nicotine, and the other additives, there are better things to do than smoke! Moderator I just had surgery to remove my CI Implant. The last 6 months I've been very sick with MRSA - from an open stitch behind my ear after surgery. Has anyone heard of such thing? My doctor said I was one in a billion? Is that something? or what? I'm still clueless if I can have another one implanted. Roseann, California Dr. Seidman The real question is why did they remove it. There must be a reason they removed it MRSA is a real problem (you did not need me to tell you that). I am sorry you got this, but there are certainly meds to treat this. Moderator I was just diagnosed w/Meniere's Disease. I have the vertigo under control. The tinnitus I am experiencing is loud and consistent on a daily basis. I already wear two hearing aids. What can I do to mask the sound of the tinnitus? Arlynn, Maryland Dr. Seidman Meniere's is a fairly common problem, and tinnitus is certainly part of the quadrad of symptoms. If we can help with the hearing loss, sometimes we can help with the tinnitus, but no doubt it is a problem. I would refer you to the answers above as to how to mitigate the tinnitus Moderator Every once in a while , when I am in bed not quite asleep yet, I get this beep beep sound in my left ear where I wear a CI... what might cause it? Cynthia, Virginia Dr. Seidman I wonder if somehow you are getting some bizarre interference. Not to be silly but there are no trucks backing up near you (ok a poor try for humor after a long day). Seriously, there just may be something going on with the implant, a warning etc. Moderator What does diet have to do with hearing loss...Are there any foods that can cause hearing loss? Jimmie, New York Dr. Seidman I am not aware of any specific foods that directly cause hearing loss, however if you have menieres for example, salty foods, alcohol etc CAN cause hearing loss Moderator Are there devices I can wear to mask the sounds I hear. Or, Can my hearing aids be adjusted to accomplish that? Gordon, New York Dr. Seidman There are many devices that can mask your tinnitus. They can be maskers alone or in combo with hearing aids, we also recommend tinnitus retraining therapy and Neuromonics as great forms of sound therapy that help many people Moderator I recently had a second Cochlear Implant, in my right ear. I'm experiencing severe tinnitus that comes and goes, plus pain in my eardrum and jaw that seems to increase the longer I wear the processor on that side. Is this common? Any solutions? Diane, California Dr. Seidman Congrats on the 2nd implant. Sorry about the problems. I am cautiously optimistic that it should get better, but please be sure to discuss with your doc. who did your surgery. Moderator What is your opinion of the Premier Micronutrient product "Hearing Health" endorsed by The EAR Foundation? It seems to be heavily advertised. Kathleen, Pennsylvania Dr. Seidman Do you sell this stuff! They have taken my patent (biggest form of flattery), modified a few things, put in some vitamins and they sell the product. I do not have anything against it, other than that they are using my research! Moderator What are the two products for which Dr. Seidman has a patent to help age related hearing loss? Do you need a prescription? Everett, Florida Dr. Seidman No script necessary. When people ask what I recommend it is a LAUNDRY LIST. I take everything and it is ~ 14 pills each day. I do not take for my hearing per se I take for what I believe is good health, the same website above www.bodylanguagevitamins.com will get you there and I recommend: 1. Antiage/energy formula (2 pills per day) 2. Antioxidant formula (3 pills/d), 3. MVI formula (3 pills per day) and the 4 Essential oils formula (4 pills per day). Cannot make any guarantees, wish I could Moderator What can you tell me about the use of steroids in improving hearing in some hearing impaired individuals? Tressa, California Dr. Seidman Steroids may have some affect for folks with sudden hearing loss or people who have fluctuating hearing loss from an autoimmune process. Yes absolutely, I see this relatively often (2 people per month), usually SOMEWHAT treatable with steroids, and other meds might have an effect Moderator Does one's age have an affect on an amount of tinnitus, resulting from hearing loss? Thomas, Ohio Dr. Seidman I have 100 year old patients without tinnitus and 4 year olds with tinnitus. GENERALLY speaking as we get older we get more hearing loss. This does NOT guarantee more tinnitus Moderator How do you go about either considering or dismissing TMJ issues as a factor in a particular patient's tinnitus? Tom, Florida Dr. Seidman Several studies have clearly shown an assoc between TMJ and tinnitus. One nice study treated 1000 patients with tinnitus and TMJ and 1/2 improved. I have MANY patients who can adjust their tinnitus (turn it up or down, or alter the sound), by thrusting their jaw, moving their eyes, pushing on their head etc. Moderator Would you please send a suggestion of two or three pamphlets or booklets on tinnitus? William, Virginia Dr. Seidman Thanks for the opportunity to PLUG our book Save Your Hearing Now, I had the opportunity to discuss the book with congress and Good Morning Am, so that is one source. The American Tinnitus Assoc is a great resource as is your HLAA; lastly our website has 1600 hours of educational resources you can look at. Moderator I have constant air leak sound in both ears. I have two hearing aids but they don't seem to help. Why do I have this and what can I do to stop it? George, Michigan Dr. Seidman Sounds as if you have poorly fitting aids. I would advise seeing your audiologist and having them ck and perhaps do a "re-fit" Moderator I have read that there is research going on to try to re-grow hair cells. What do you know about that? If you could re-grow hair cells, would that have an effect on tinnitus? Dr. Seidman Absolutely, this has been going on for at least 15-20 yrs. One of my favorite scientists in this arena is Yehoash Rapheal in Ann Arbor, brilliant man. There are also many other very smart folks working on this. I do believe one day it will have a positive effect on both hearing loss and potentially tinnitus Moderator Can acupuncture be useful for treating hearing loss? Is there any research being done in this matter? Dr. Seidman Acupuncture can be effective for a number of things. It has been studied for tinnitus (helps ~ 40%), hearing loss, that is a diff story. I am an Assoc Editor for the Am Journal of Chinese Med and I have yet to see it used purely for hearing loss Moderator I had a cochlear implant in June. My tinnitus has increased tenfold. Will it stay, or will it decrease? Dr. Seidman So sorry to hear this. Usually tinnitus decreases in up to 80% of patients. Perhaps a re-map may help, I will think positively and so should you! Moderator Does motion have an effect on tinnitus? Dr. Seidman Hmmm, motion and tinnitus, I can tell you that patients will note that when in car their tinnitus might get better or worse (seen it go both ways). Motion alone...now that is interesting and believe it or not, I have not truly seen motion per se affect tinnitus Moderator Have you heard whether bio-identical hormones help alleviate tinnitus? Dr. Seidman ahh bioident H and tinnitus, interesting question. I gave a huge talk on biodent hormones (ck our website again in ed resources). Long story short, if you are going through menopause and tinnitus has spiked, SOMETIMES as bioident H help the other symptoms, they might help the tinnitus Moderator Is tinnitus somewhat related to otoacustic emissions? Dr. Seidman Fascinating question. There are several studies that have shown Patients with NORMAL hearing that have tinnitus might have spontaneous otoacoustic emissions as their root cause of tinnitus. Thus, in these patients (rare breed). I will offer HIGH dose Aspirin i.e. 325 mg two pills 3-4 times a day! (the amount that is often used for arthritis), it is also an amount that can CAUSE tinnitus, ahh the perfect paradox. Dr. Seidman Thank you so much for logging on tonight. I greatly appreciate the opportunity to "hang out" with you! Have a terrific evening and a happy and healthy holiday season. Best regards, Michael Moderator Thank you Dr. Seidman for joining us today. A transcript of this chat as well as previous chats, tomorrow at www.hearingloss.org Please join us December 11 at 7:00 pm ET and meet Expert Psychologist - Dr. Sam Trychin discussing Surviving the Holidays with Hearing Loss. Make a donation today and support our website and the chats. Make your donation now at http://hlaa.convio.net/donate Hearing Loss Association of America 7910 Woodmont Ave, Suite 1200, Bethesda, MD 20895 301.657.2248, Fax 301.913.9413, www.hearingloss.org