A lady explained,

I am 38 years old. I have no hearing loss, yet I experience Musical Ear Syndrome (MES). Over the last couple of years, I began noticing that when things are very quiet, like silent almost, I hear faint music. I describe it as hearing a radio station through a pillow. It will sound like a country station one night, a 50s style radio host the next night and maybe classic rock the next night. I can’t make out words or complete songs, but there is a form to the music. If I turn on a noise machine, which helps drown out my husband’s snoring, the MES tends to be louder.

I’m just wondering about experiencing these auditory hallucinations w/out any of the monikers usually associated with the syndrome. I have no hearing loss, I have 3 young children so I certainly don’t have a lack of auditory stimulation and although I have experienced tinnitus from time to time, I don’t think the frequency is any more than any other non-hearing impaired person.

Some people hear faint tinnitus when it is very quiet. Thus, I’m not surprised that you hear faint music when it is very quiet. I think that is your brain wanting to hear something—and when it can’t, it makes up its own so to speak.

I’m not surprised that your “noise machine” makes your phantom music louder. In fact, this is relatively common.

A continuous sound such as a fan running in the background—it could be a furnace, air conditioner, fridge, bedroom fan, etc.—seems to cause numbers of people to hear phantom music.

Somehow the brain takes this constant background sound and modulates it into music. Some people have specifically noticed they hear phantom music whenever their furnace/air conditioner comes on and goes away when their furnace/air conditioner cycles off. Your noise generator is doing much the same thing for you. This is a special kind of MES that is relatively common in people with normal hearing.

We hard of hearing people have to put out a lot of energy in order to catch what those around us are saying. This means we may come home from work exhausted—totally wiped out.

As one lady explained, “Sometimes people around us acknowledge that hearing loss is stressful. But hardly anyone mentions that it’s exhausting.”

Another lady chimed in with, “You are so right about hearing loss being exhausting, but try and tell your managers at work that it takes more out of you on a daily basis than it does for a hearing person.”

The truth is, hearing coworkers and managers don’t have a clue just how much we have to struggle to hear, and thus often don’t do the simple things we need them to do in order to make our communicating with them easier.

Mary had that problem—unsympathetic managers and coworkers. Fortunately she found a rehabilitation audiologist who had the guts to do something about it. This rehabilitation audiologist went to Mary’s place of work and conducted a sensitivity training for her coworkers.

As Mary explained, “I heard that the people where I work, after they had the sensitivity training by the rehabilitation audiologist, were exhausted because of the scenarios she put them through. I mean, she really put them through their paces because they were so unempathetic and it ticked her off.

Here’s what she did. First, she played a speech recording that nobody could decipher. Then she played it again as she mouthed the words so everyone could try to speechread her.

Next she played more mumbly speech recordings while mouthing the words and everybody had to write down what they heard. If they were writing, and didn’t see her mouth moving, and couldn’t figure out what had just been said, too bad! She did this over and over and over until everybody was exhausted themselves!

After it was all over she said, ‘There’s a taste of what it’s like for Mary every minute of her life!’” They were stunned and as Mary says, “they have improved a lot in their communication with me since then!”

Since it is almost impossible to simulate a severe hearing loss, we cannot expect hearing people to understand the struggles we go through in trying to understand them. All we can do is tell them what we need them to do so we can hear them better.

However, if they don’t take our needs seriously and try to ease our communications burden, perhaps they need to go through the “school of hard knocks” themselves. It can be an effective wake-up call as Mary’s coworkers discovered.

A lady asked me about a reported new drug cure for tinnitus. She wrote,

I wonder if you’ve heard anything about Caroverine? What are your thoughts?

She referred to an article published in Hearing Review on January 19, 2012 (1). This was in turn picked up from an article published back in November, 2010 that began, “Lincoln Pharmaceuticals Ltd. (LPL), an Ahmedabad-based drug manufacturing firm company today announced that it has launched Caroverine injection under the brand name ‘TINNITIN’ which is India’s first drug to treat Tinnitus – a disease commonly known as ‘ringing in the ear’.

The company developed Caroverine injection under research and development collaboration with Phafag AG, a Switzerland-based drug manufacturing firm, a release from LPL said.” (2)

Here are my thoughts. Like all the other tinnitus treatments out there, this drug treatment works for some people and not for others. Furthermore, it doesn’t cure tinnitus as such, it just reduces it while you are taking this drug. When you go off the drug you can expect your tinnitus to come back.

However, Caroverine should not be taken in the long term as it has other side effects on your body. Basically it is a Glutamate antagonist. “Glutamate is very important to many bodily functions and must not be inhibited long-term. Glutamate is an amino acid and one of the most important building blocks of proteins. It is also vital for metabolism and brain function.” (3) Therefore, if you suppress too much glutamate activity in your body or brain, nasty things will happen.

Thus, in order to be effective, researchers have to find a way to make this drug only work on the glutamate receptors in the auditory circuits and not everywhere else in the body. (Researchers are currently trying micro-catheters but these have their own problems.)

I find it interesting that although this drug has been around and used for about 40 years, it is still not approved in the USA—the drug capital of the world. That alone, should tell you something about the safety/efficacy of this drug.

If you want to learn more about tinnitus and what you can do to help bring it under your control,  check out the new 5th edition of “When Your Ears Ring! Cope with Your Tinnitus—Here’s How“.

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(1) First Pharmaceutical Cure for Tinnitus Reportedly Launched in India. Hearing Review Jan 19, 2012.

(2) Lincoln Pharma launches India’s first drug for Tinnitus. November 16, 2010.

(3) Barry Keate. The Promise of Caroverine for Tinnitus.

I am sometimes asked: “Are generic drugs the same as brand name drugs?”

The simple answer is “yes” and “no”. Let me explain.

To receive FDA approval, generic drugs must meet a variety of criteria, including:

• A generic drug must have the same active ingredient or ingredients as the brand-name drug.
• A generic drug must have the same strength as the brand-name drug.
• A generic drug must have the same route of delivery (oral, topical, injectable, etc.).
• A generic drug must have the same dosage form (capsule, tablet, etc.). (1)

When you look at this list, you might think it tells you all you need to know—that generic drugs are essentially identical to brand-name drugs, but this is not the case.

You need to understand that when the FDA says that the active ingredient needs to be the same in both generic and brand-name drugs, what it actually means is that the allowable amount of the active ingredient in the generic drug must be within 5% of what’s in the brand-name drug. Furthermore, the amount of the active ingredient in a generic drug that gets absorbed in your bloodstream needs to fall within 10% of what’s absorbed from the brand-name drug. Thus, a generic drug may be a bit stronger or weaker than a brand-name drug. “This means that when compared with a brand-name drug, you could potentially absorb 90% of the active ingredient in the generic drug…or 110% of it…or any amount in between.” (1)

Typically, having a little bit more or a little bit less of the active ingredient in your bloodstream usually doesn’t matter. It’s no big deal unless you are taking one of the few drugs that are considered critical-dose medications such as lithium. With those, you may need to stick with a brand-name drug.

The other thing to consider is that although the active ingredient(s) is the same in both brand-name and generic drugs, the inactive ingredients may be different.

Don’t let that term “inactive ingredient” fool you. This does not mean that it is not “active” or otherwise harmful, it simply means that it does not cause the desired therapeutic effect that the active ingredient does. Many inactive ingredients are NOT benign—they have their own side effects. Thus, when taking a generic drug rather than a brand-name drug, you could have different side effects caused by the different inactive ingredients.

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(1) Generic Lipitor—What You Need to Know. Bottom Line’s Daily Health News. February 9, 2012

I came across an alarming statistic recently—37 million children in America have hearing loss. (1) That’s a lot of our kids that can’t hear well.

The 2000 census counted 72.3 million children in the USA under the age of 18 (2) and no doubt that figure is even larger now. 37 million out of 72.3 million works out to 51.2% of our children with a hearing loss. In other words, on the average, conservatively every second child you meet has some degree of hearing loss. Shocking, isn’t it! And scary too—especially when you realize that hearing doesn’t come back, but typically continues to get worse over the years. This means we are raising a whole generation that can’t hear properly now, and in a few more years will be adults that can’t hear well either.

Add to this the 55 million adults and 16 million seniors that already have a hearing loss (2) and you have a whopping 33% of the population hearing less than normally. That’s one in every three people you meet!

What this means is that everyone needs to start practicing good hearing conservation now before it is too late!

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(1) Think Tank Improves Deaf Education. The Hearing Journal. Volume 64, Number 12, December 2011. p. 39.

(2) Hearing Loss Much More Common Than Previously Thought.

A lady asked,

I was wondering if I can make phone calls using the Music Links? If not, can I listen to music using the T-links. I don’t want to buy both, I just want to buy one. Can you help me with this?

The Music Links are designed as their name implies, to listen to music. With them you can hear in true stereo. They plug into any standard 3.5 mm (1/8″) audio jack.

On the other hand, the T-Links are designed for talking on the phone in place of using another headset. They include a built-in microphone. Thus they have the 2.5 mm (3/32″) plug used for headsets.

Thus, normally you’d have to buy both if you want to listen to music (Music Links) and use the phone (T-links).

However, if you have one of the new smart phones that uses a 4-pin (4-pole) plug (the plug has 3 separators and thus 4 separate metal sections on the plug) AND is the standard audio plug size (3.5 mm or 1/8″) then you are in luck.

What you do is get the Music Links and listen to music the normal way. When you want to use the phone for phone calls you listen via the Music Links (just like you do for music), but you have to speak into the phone’s mouthpiece like you normally would if you weren’t using the Music Links.

This works because on 4-pin (4-pole) phones, when you plug in a 3-pin (3-pole) plug like the music links has, it does not switch into headset mode (which would disconnect the phone’s internal microphone) like it would with a 4-pin plug. As a result, you get the best of both worlds. You can listen to music with your Music Links AND also use your Music Links to listen to the other person while you are making a phone call.

If you do not have a 4-pin phone, you’ll need both the Music Links and the T-links. You can see the Music Links here and below them, the T-Links.

A man asked,

What are some reliable methods and words I could use to find the self-confidence I need to be a better self-advocate for my hearing loss?

This is an excellent question. Too often, people with hearing losses find it very difficult to advocate for their needs. Thus learning about proven hearing loss coping strategies that work for others will give you some tools to put in your toolbox. Then you can pull them out and use them when needed.

Marcy has a great coping strategy tool for letting people know that she is hard of hearing and that, as a result, they need to change their communication habits in order for her to understand them.

She explained,

I always start by saying, “I am hard of hearing.” Then I say, “I am not sure if I already mentioned this before. If not, these are a couple of things that would make my life a lot easier. Would you be willing to help me?”

Then I stop and don’t say a word. (I will wait forever if need be for them to respond. Yes, it can get quiet, but you need to give them time to take in what you just said.)

Usually, they respond with, “I am so sorry, how can I help?”

I say, “Nothing to be sorry about! This is what you can do.” Then I give them two or three specific things they can do in that situation. These are short and simple tips—nothing too long—for they will forget (people have a lot on their minds).

This works for me every time. I now do it on the phone too. It works the same way.

When I first started doing this, my problem was remaining silent, waiting for them to respond. You have to wait. Sometimes I miss their response because I can’t hear them. That is okay. They will say it again…louder.

Now that you know this simple little coping strategy, you need to practice it. Remember, don’t rush in to fill the void. Wait for the other person to break that “pregnant pause”. This sort of “forces” them to be on your side. It works for Marcy. See how well it works for you.

You are in a noisy venue and say to yourself, “Wow! It sure is noisy in here. I wonder just how loud it really is?”

Few people own sound level meters to measure the volume of sounds around them, but wait—you have a smart phone don’t you? With the right app, you can use your smart phone as a fairly-accurate sound level meter.

Here are three good apps (1)—two for your iPhone and one for your ‘Droid so you can get a good idea of the volume of the racket that is assaulting your ears.

iPhone Apps:

1. dB Volume Meter

2. TooLoud?

Android App:

3. deciBel SPL Meter

Now that you have measured the sound level around you, look at the result. The magic number you want is 80 dB. If it is below 80 dB, then all is well. However, if it is greater than 80 dB, if you’re smart, you will take steps to protect your precious hearing. This may mean limiting the time your ears are exposed to sounds louder than 80 dB, or wearing ear protectors.

To know how long you can expose your ears to louder sounds without permanent hearing loss, see my article, “What Are Safe Sound Levels?” Remember, these times and sound levels are for the theoretical “average” ears. Your ears may be more or less robust than the theoretical average—but it is a good place to start.

One more thing—when you leave a loud venue, if you notice that sounds are now somewhat muffled and/or that your ears are ringing, you know that you overdid it. You need to be more careful in the future.

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(1) The Best Phone Apps to Measure Noise Levels.

A lady explained,

I am a 41 year-old woman who was diagnosed with otosclerosis in my left ear during my first pregnancy at age 35. (My grandmother was fully deaf in her left ear by age 20, and hard of hearing in her right ear, so it wasn’t a total shock.) The hearing loss gradually spread to my right ear, though that impairment was minimal, and I have hearing aids for both ears now. I know I should be asking my ENT or audiologist for information, but both seem fairly uninformed—the ENT had never heard of any possible connection between pregnancy and otosclerosis, and seemed astonished that my tests showed both conductive and sensorineural hearing loss.

I am currently halfway through my second pregnancy, and have suddenly noticed a serious worsening of the hearing in my right (formerly my better) ear. I have had a cold for several weeks, and first began to notice it starting to worsen during this time, but it is suddenly as if I have about 5 cotton balls in my right ear (normal for me is more like 2-3 in my left and 1 in my right). My family doctor saw no signs of an ear infection when I went in to have a strep test. My question is this, is this more likely to just be a side effect of the cold, or maybe an infection starting to develop, or is it probable that this is a permanent worsening of my condition which would necessitate a visit to the audiologist to have my hearing aids adjusted?

I find that hard to believe that your ENT is so ignorant about otosclerosis. ENT’s are supposed to know about such things! It is well-known that for women with otosclerosis, hearing loss commonly occurs at puberty and that further loss occurs with each pregnancy, with the last flare-up occurring during menopause.

Your doctor should have known that there are two types of otosclerosis—the middle ear version that causes conductive hearing loss and the cochlear (inner ear) version that sometimes occurs when the otosclerosis grows into your inner ear. This results in sensorineural hearing loss in addition to the conductive hearing loss.

Obviously, your otosclerosis has grown into your inner ear. That is why you have the sensorineural hearing loss component on top of your conductive middle ear loss.

There are two possibilities as to why you suddenly have more hearing loss now. One possibility is that your otosclerosis is flaring up (true to form) with your current pregnancy. The other possibility is that your cold virus has attacked your inner ear causing additional sudden sensorineural hearing loss.

Even though your family doctor saw no signs of a middle ear infection, it is possible that the virus was in your inner ear—and did not cause a secondary infection in your middle ear.

Your question is, “How can I tell whether my hearing loss is from my otosclerosis or from a virus?

I think a wise move is to have your hearing tested by an audiologist again. That will answer some of your questions.

I would specifically ask for the pure tone testing, both air and bone (conductive), and then compare the new results to your old audiogram to see where your hearing loss is increasing. If it is all sensorineural, it could well be a result of the cold virus attacking your inner ear, although since your otosclerosis has grown into your inner ear, you can’t rule it out either.

If all the increased hearing loss is conductive, you know your inner ear is ok at this point. Thus it could be the otosclerosis coming into play again and there is nothing much you can do about that.

At the same time, I’d suggest having a tympanogram to be sure your middle ear is not congested. A type “A” tympanogram would indicate all is well in this department. This would further suggest that your otosclerosis is the culprit.

If you show a type “C” tympanogram, it could indicate that your cold is affecting, and clogging up, your middle ear. If that is the case, your hearing loss hopefully will be temporary—and will return to “normal” when your middle ear and Eustachian tubes clear after you get over your cold.

If you have ever looked at the numerous side effects that can result from taking a given prescription drug, perhaps, like me, you have wondered how one drug, such as the antidepressant Sertraline (Zoloft), for example, can, in addition to causing a number of psychiatric side effects, also cause diverse side effects such as tinnitus, acne, constipation, hair loss, back pain, muscle weakness, coughing, thirst, vertigo, hypertension, sexual dysfunction and leg cramps. Notice that these side effects are all totally unrelated to the condition this drug is supposed to “fix”, namely depression. Why should a drug taken to help depression cause all these other side effects that affect the whole body? What is the common denominator that can result in all these different side effects?

Here’s the surprising answer. You have two “kinds” of nervous systems in your body—the central nervous system, which consists of your brain and spinal cord, and your peripheral nervous system.

Now here’s where it gets scary. Many prescription drugs affect your peripheral nervous system. Peripheral neuropathy is the fancy name for drug-damage to the peripheral nerves. Your peripheral nervous system is the vast communications network that transmits information from your brain and spinal cord (central nervous system) to every organ and part of your body. Peripheral nerves also send sensory information back to your brain and spinal cord. Damage to the peripheral nervous system interferes with these vital connections. Thus, when drugs affect your peripheral nervous system, they can affect every organ and every part of your body.

Now follow this. Because every peripheral nerve has a highly specialized function in a specific part of your body, a wide array of symptoms can occur when peripheral nerves are damaged. (1)

Unfortunately, doctors often do not fully understand all the various side effects that may result. As a result, in many ways every time you take a drug you are the guinea pig. Furthermore, unforeseen side effects are the rule rather than the exception.

For example, there are more than 300 different side effects associated with the use of the cholesterol-lowering (Statin) drugs. According to Dr. Mercola, this is likely only the tip of the iceberg. As he says, “Among one of the more well-known risks is harm to your muscles and peripheral nervous system with long-term use.” (1)

Furthermore, according to the National Institute of Neurological Disorders and Stroke, “Symptoms are related to the type of affected nerve and may be seen over a period of days weeks or years”.

Did you notice that? You may see these side effects pop up in a matter of days in some cases. In other cases, it may be weeks, months or years later before the damage becomes apparent.

Thus you cannot say that because you have been taking a certain drug for a number of years without any obvious side effects occurring that the hearing loss or tinnitus you now experience is obviously not related to that drug. The sad truth is that it could be.

In fact, I’m seeing this more and more. For example, Atenolol (a beta-blocker class of drug) may not cause any apparent side effects for a long time, then out of the blue five years later it starts causing serious ear problems such as massive hearing loss or loud tinnitus.

Dr. Mercola cautions, “If you take Statins for two years or more, nerve damage appears to be the rule,” not the exception. (1) Thus you are risking your ears the longer you stay on a Statin (and many other) drugs.

Now you know why the same drug that causes your ears to ring may also be causing your indigestion, sexual dysfunction and pain in your toes for example. These apparently unrelated symptoms are all caused by the same drug because it affects the peripheral nervous system.

Consequently, I urge you to be cautious when taking any prescription or over-the-counter drugs. The desired beneficial effect of the drug may easily be overshadowed by myriads of serious, unwanted side effects that turn up days, weeks, months or years later.

This is why it is so important for you to establish good health practices now, rather than expecting to rely on drugs to solve your health problems in the coming years.

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(1) Is Nerve Damage the Rule, Not the Exception with Cholesterol Meds? Dr. Mercola. January 25, 2012.