Dr. Nagler's Tinnitus Corner
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sactinn

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 #1 
Hello Dr. Nagler.

First, I hope that your recovery continues to go well. 

Second, thank you so much for helping me during a great time of need. You were so kind to speak to me (on a Saturday!) about my issues and reassure me that treatment was available should things not improve. I am happy to report that, while the sound is still ringing away, I have been able to resume most of my normal life. 

My question: Whenever I see a specialist, the first thing I am asked is, "Do you hear the sound in the left or the right ear? Or both?" I am always baffled by the question because I really don't know the answer. It seems as though the sound is coming from the center of my head, but I cannot be positive. Is there a way to tell for sure which ear is "hearing" it? Why is this question important?

Thanks from Sacramento.
Dr. Nagler

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 #2 
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Originally Posted by sactinn
First, I hope that your recovery continues to go well.

Thank you. I cannot begin to tell you how ill (and frightened!) I was, but the worst is definitely over. I am quite sure that the good thoughts the folks on this board were sending my way made a difference.
 

Quote:
Second, thank you so much for helping me during a great time of need. You were so kind to speak to me (on a Saturday!) about my issues and reassure me that treatment was available should things not improve. I am happy to report that, while the sound is still ringing away, I have been able to resume most of my normal life.

Glad to hear it. 


Quote:
My question: Whenever I see a specialist, the first thing I am asked is, "Do you hear the sound in the left or the right ear? Or both?" I am always baffled by the question because I really don't know the answer. It seems as though the sound is coming from the center of my head, but I cannot be positive. Is there a way to tell for sure which ear is "hearing" it? Why is this question important?

So tinnitus always comes from the brain. We usually hear it in our ears because that's where we hear everything. (It would be really weird to hear it in our kneecaps, no?) When we hear tinnitus in one ear only, it is usually because our threshold of hearing in that ear is worse. As Mr. Jonathan Hazell says, "Our brains tend to put our tinnitus in our weaker ear."

All that said, there are only two reasons to ask a patient where he or she hears tinnitus:

First, if a patient has unexplained unilateral tinnitus (i.e., the tinnitus is only heard in one ear and there is no established explanation for it), that allows for the remote possibility of a tumor along the auditory nerve running from the cochlea on that side to the brain as the cause for the tinnitus. Such tumors are quite rare and are benign (non-cancerous), but in the presence of unexplained unilateral tinnitus, they should be looked for - usually with an MRI. (And even when you do an MRI, it is usually normal.) I say "unexplained" because, for instance, tinnitus in the right ear that began immediately after somebody set off a firecracker next to that ear would obviously not require an MRI to rule out a tumor in the first place.

Now as for the second reason, I can only speak for myself here, but I spend a lot of time asking patients that sort of question for the purpose of pointing out how unimportant it is. My patients have already seen an ENT (usually many) before they ever make their way to my clinic - so that type of history really does not contribute to any decision-making regarding establishing an effective strategy for moving forward from my point of view. But in order to establish that concept, I do ask all sorts of questions about pitch, loudness, location, etc. - and then go on to state that while it is important to the patient, it is not important to me. And then, with a kind and compassionate smile, I go on to explain why.

Hope this helps.

Dr. Stephen Nagler
Atlanta Tinnitus Consultants, LLC

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The best way to find yourself is to lose yourself in the service of others.
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No bird ever soared in a calm. Adversity is what lifts us.
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sactinn

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 #3 
Thank you for the thoughtful reply. Very helpful to know!

I have one other question, but it's not a medical question: When I tell people about my tinnitus (which I rarely do!), I can tell that they don't consider it very serious. Or they will make offhanded comments about "I had that once, no big deal."

Since you have been through it all, how do you convey the seriousness of the condition? At it's worst, I have been completely disabled and terrified by the ringing. But there is no way to convey that without sounding insane. 

Again, thank you.
Dr. Nagler

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 #4 
Sactinn, maybe I'm missing your point here. If, so, I apologize.

But why do you feel you owe anybody any explanations?

stephen nagler

__________________

The best way to find yourself is to lose yourself in the service of others.
- Mahatma Gandhi

No bird ever soared in a calm. Adversity is what lifts us.
-
David McCullough quoting Wilbur Wright
sactinn

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 #5 
That's a good question and I think I just need to let it go. 
Dr. Nagler

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 #6 
Well said! You owe no explanations to anybody.

stephen nagler

__________________

The best way to find yourself is to lose yourself in the service of others.
- Mahatma Gandhi

No bird ever soared in a calm. Adversity is what lifts us.
-
David McCullough quoting Wilbur Wright
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Dr. Nagler's Tinnitus Corner is provided for education and information only. It is not intended for the purpose of providing medical care and should in no way substitute for appropriate in-person consultations with qualified healthcare professionals. By using this site, participants agree to hold Dr. Nagler and Atlanta Tinnitus Consultants, LLC harmless with respect to any loss, injury, claim, liability, or damage arising from following the postings herein.