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Scott Webb: Tinnitus or a ringing in our ears is a common condition. It is often associated with hearing loss, and though it is common, it's also treatable in the form of hearing aids and other therapies. And joining me today to explain tinnitus and how he and audiologists can help us, is Dr. Matthew Surburg. He's a Board Certified Family Physician with the Franciscan Physician Network.

This is the Franciscan Health Doc Pod. I'm Scott Webb. Doctor, it's so great to have your time today. We're going to talk about tinnitus and it's one of those things, it maybe it presents or manifests differently in some people, ringing in the ears, whatever it might be, but it's great to have your expertise. So just as we get rolling here, what is tinnitus and what can people expect if they're trying to figure out if they have it? What are some of the signs and symptoms?

Dr. Matthew Surburg: So tinnitus is a persistent ringing in the ears, and it can show up in a variety of different ways. It can be a ringing or a rushing or a roaring. It can be high-pitched or low-pitched. It's worth noting that tinnitus is a very common problem. In fact, as many as 50 million people in the United States today, experience this and it can interfere with activity for a quarter of those.

And in fact, it's interesting also, that tinnitus is a problem that's been around for a very long time. In fact, there was a 19th century composer, Smetana, who had such profound tinnitus toward the end of his life as his hearing was growing, that he literally wrote it into one of his string quartets.

So this is something that many, many people experience.

Scott Webb: Yeah, you're so right. Many people do and, you know, I host a lot of these, and a lot of times I find out that, you know, our youthful transgressions or those sprained ankles lead to arthritis in our ankles later. So in the case of tinnitus, is that one of those things that's sort of is a bill coming due as we get older that, going to loud concerts when we're younger or cranking up our headphones or things like that, are we at least partially responsible for tinnitus?

Dr. Matthew Surburg: Unfortunately what you say, there's some truth to it. Yes. Hearing loss is one of the more common causes of tinnitus, and yes, exposure to loud noises is a common cause of hearing loss. In fact, because of the way the hearing apparatus works, for any of us, if we were in absolute total silence, which almost never happens; we would notice a ringing in the background. For most people, just ordinary sounds, whether it's the wind of the trees, traffic noises, the swishing of your clothes, you just don't notice it. But it is something that's always there for everyone. And so hearing loss is one of those things that will tend to bring it to the fore.

Scott Webb: Yeah, I see what you mean. It's sort of the irony of tinnitus, which is that as our hearing begins to go, as we lose our hearing, that if we have tinnitus, we notice it more, of course, and unfortunately we hear, or the, we hear the ringing, but maybe not the other things that we'd like to hear. So in terms of after you've diagnosed and we think about treatment, is this something that will, you know, sort of resolve itself or do people usually need, in order to have any sort of relief from tinnitus, do they really need your help?

So in other words, what sorts of treatment are available?

Dr. Matthew Surburg: So, when somebody has tinnitus, in some cases it will resolve on its own, but usually those are very brief episodes. If it is persistent, however, that is usually something will require at least some kind of evaluation, in the office. The physician will do a thorough history and then a careful examination to see if there are any causes that we can identify, such as a big plug of earwax in the ear canal that, you know, can take care of it. But, oftentimes that simply is not going to be the case. When that happens, one common treatment can be hearing aids, especially if it's due to hearing loss, but it is important to realize that other things that sometimes can happen are conditions that we need to make sure that we identify and can evaluate for.

There are other conditions, however that can cause tinnitus such as certain medications. Chemotherapy medications, for instance, are a common culprit here. Sometimes infections and even certain types of benign tumors or certain types of strokes can cause tinnitus.

So it's not always just hearing loss that does it.

Scott Webb: Interesting. Yeah. And none of us can outrun our family history and genetics. So if there's a, a history in our family of hearing loss, well then that's something for us to know and to note and to share with our providers.

Are there things that we can do? Avoiding loud noises, protecting our ears, cleaning our ears. I've hosted these before Doctor on tinnitus, and the doctor told me, she said, you'd be surprised at what we find inside people's ears. And I'm sure you can share in that experience. So maybe you could just give us some idea. I know there's a wide range of things that could cause tinnitus, but in terms of things that we could do, what can we do?

Dr. Matthew Surburg: So tinnitus is something that is relatively difficult to prevent other than, as you alluded to, avoiding loud noises. Actually cleaning your ears is generally not something I would encourage people to do, especially in the sense of using Q-tips in the ears. Because Q-tips will get a little bit of wax out, but what they don't get out, they just pack it in there and they actually tend to make things worse. For people that do have a lot of buildup in the ears, there's some eardrops that can help with that, and then oftentimes I'll just advise people, you know, your ears do a pretty good job of cleaning themselves out, so there really isn't a lot that needs to be done there. For somebody that is experiencing tinnitus, again, if it's persistent, really the most important thing is to get it evaluated and see, okay, is there something else underlying that's contributing to this, and if not, oftentimes hearing aids will give people relief. And I couldn't tell you how many people I've had tell me, gee, I wish I'd done this before. I had no idea how much I was missing when they, you know, got hearing aids and finally had some of their hearing loss not necessarily reversed, but at least compensated for.

Scott Webb: Yeah. You know, anecdotally, my experience with this is that as you say, it doesn't really bring your hearing back, but it helps, it compensates. And so as it compensates, it makes people feel like they can hear more and hear better, the tinnitus tends to go down. So maybe you could just talk about the process. I know for my dad it was a long journey of finding, you know, the perfect hearing aids and I know they're a bit costly and everything involved. So maybe just generally speaking though, the value of hearing aids.

Dr. Matthew Surburg: So, the first step in getting hearing aids would be to have a formal hearing test with an audiologist, and that will help determine what frequencies are the areas where somebody is having trouble. Oftentimes, higher frequencies will be more of a challenge, and so that will show up in certain particular sounds that we make C's and K's that have higher frequencies associated with them.

And oftentimes people will say the voices of small children are also more difficult to hear but getting the hearing test done is the first part, and then the audiologist can work with the results of the hearing test to see what is the best setting for the hearing aid that will help restore a person's hearing as much as possible.

Scott Webb: Yeah. And I know that with the advances in technology, whether folks are controlling their hearing aids from their phones, from an app, or my dad has a little remote that he keeps in his pocket, you know, and , he'll turn them down, he'll adjust things before he goes into a loud environment because it's just too much. Of course, I had to teach my dad how to work the remote, but that's a different podcast, a different conversation.

Dr. Matthew Surburg: Yeah.

Scott Webb: I guess what I want to ask is when do folks begin to suffer or begin to notice tinnitus? Is it something that doesn't happen until our fifties, like all the other bad stuff? Or can it happen to folks when they're younger as well?

Dr. Matthew Surburg: It can happen for younger people, but generally this is something that's going to become more common as birthdays accumulate. It also is more common in men. Smoking is another risk factor that contributes to tinnitus and to hearing loss. So, you know, in terms of what can we do to prevent it, certainly avoiding or quitting smoking is one way to help. The other part that I'd say, especially for people that have tinnitus aside from hearing aids, is, if hearing aids aren't helping or if it's something else that's causing it, there are other treatments that are available.

And the goal there is to lessen the awareness and to improve quality of life. So that would be treating sometimes underlying depression or insomnia. And there are some other therapies geared specifically toward tinnitus, such as biofeedback or cognitive behavior therapy. Or there's even some specialists that use what's called tinnitus retraining therapy to again, help the person simply be less aware of this persistent and disruptive sound.

Scott Webb: Yeah, I see what you mean. Sort of notice the ringing less and maybe hear more of what we actually want to hear. All good stuff. And you know, as we wrap up here Doctor, I think that tinnitus is one of those things that folks, like so many things we just allow ourselves to suffer from, either because we don't know that there are remedies and folks like yourself that can help or we just drag our feet, whatever the reasons are. Maybe, you could just sort of underscore the importance of folks reaching out, speaking with providers, being referred to specialists, that they don't have to suffer, that they don't have to have that ringing necessarily, that they could notice it less and hear more of what they want to hear.

Let me hear it from you, doctor, from an expert.

Dr. Matthew Surburg: So for somebody that is struggling with tinnitus, I would say the most important thing to realize is they don't simply have to suffer with it. Oftentimes, if there are specific conditions that we can identify that are contributing, then it may be something that we can treat successfully. And if not, there are other ways of being able to help a person not have to have it be as disruptive for them. And you know, also hearing aids can give them some relief so that they can simply get back to enjoying their lives.

Scott Webb: Yeah, that's well said. And I think one of the main reasons I love doing these is that just trying to get the word out, right, trying to educate folks. And if you've been suffering from that ringing in your ears, and you don't hear other things that you do want to hear, there is help available.

You just need to reach out, like Doctor said today. Reach out, meet with an audiologist, figure out what's going on, what the underlying causes may be of the tinnitus, and go from there. So, Doctor thanks so much for your time today. You stay well.

Dr. Matthew Surburg: Thank you. It's been a pleasure.

Scott Webb: And for more information, visit franciscanhealth.org and search ear, nose and throat. And if you found this podcast helpful, please share it on your social channels. And be sure to check out the full podcast library for additional topics of interest. This is the Franciscan Health Doc Pod. I'm Scott Webb. Stay well, and we'll talk again next time.