Staying Fit
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In the fall of 2006, I traveled to Beijing on a reporting assignment. The smog got so thick during the week of my visit that flights were delayed, sections of three expressways were closed, outdoor school activities were canceled, and buildings across the street from my hotel were visible only as silhouettes in a mustard-brown miasma. I caught a bad cold, which got worse on the long flight home, and then got much worse. I felt as though someone had poured concrete into my head and was now gradually tightening a belt around my temples. My sinuses didn't fully clear for a month. Eventually, I stopped coughing. And, when I did, I noticed a ringing in my ears.
At first, I assumed that the ringing would go away, as my cold had. But it didn't. After six months of fluctuating anxiety, I made an appointment with my doctor. “Tinnitus,” he said. (Medical professionals, almost without exception, place the stress on the first syllable, as they also do with angina; civilians, in both cases, tend to stress the second and to make the i in the middle long.) Most of the 50 million or so Americans who have tinnitus also have at least some hearing loss, and both problems are most often caused by exposure to loud sounds. My internist tested my ears by holding up a vibrating tuning fork and asking me to tell him when I could no longer hear it. After a while, he leaned forward to make sure the tuning fork was still humming, since he himself could no longer hear it. (We were both in our fifties.) Tinnitus is the leading cause of service-connected disability claims made by military veterans; hearing loss is second.
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Treatments (or, rather, lack of them)
Some kinds of hearing loss can be reversed surgically, and when the surgery is successful the associated tinnitus, if there is any, usually goes away, too. But I didn't have that kind of hearing loss. Tinnitus is sometimes caused by earwax, and can be cured by its removal. But I didn't have an earwax problem. There's a form of tinnitus that manifests itself as rhythmic pounding, throbbing or whooshing, typically synchronized with the heartbeat. It's called pulsatile tinnitus, and, unlike all other forms, it's sometimes audible to people who are not its sufferers. But I didn't have pulsatile tinnitus, either.
For the kind that I and most other people have, there's no known cure. A friend of mine who's had it for longer than I have told me that one day his had become dramatically worse. “I tolerated the hissing, but when the beeping started I went running around the house, trying to find the appliance that was making the noise,” he said. His doctor referred him to a well-known tinnitus expert in New York City. “He listened patiently as I told him about my condition and described everything I'd heard or read about tinnitus,” my friend continued. “When I finished, he smiled, and said, ‘Here's the truth. I don't know. They don't know. Nobody knows. What are you doing for it?’ I said that when I was unable to sleep I took an Ativan. He said, ‘That's fine. You can do that for the rest of your life.'”
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Living with tinnitus
In some ways, the lack of a cure is a relief. If I could make my tinnitus go away by losing 30 pounds (let's say), I wouldn't necessarily be happier, because then I would be angry at myself not only for having damaged my ears with years of exposure to rock concerts, lawnmowers and power tools but also for failing to lose the weight. My main course of action, my doctor said, should be to continue making my best effort to pay no attention to the illusory sound in my head. And I've gotten pretty good at doing that — unless I'm lying awake in bed or, as I discovered recently, writing about tinnitus. My doctor also said that I should be extra assiduous about using ear protection, in the hope of preventing things from becoming worse.
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