WEBINAR: Message of Hope for Tinnitus Sufferers


>> NANCY MACKLIN: Okay. Good evening, everyone. Welcome to our webinar tonight with Glenn Schweitzer “A Message of Hope for Tinnitus Sufferers”. Before we get started I want to just thank Cindy Thompson of Alternative Communication Services for providing CART this evening. Thanks so much Cindy. It’s always a pleasure to have you provide CART for our attendees (Thank you!). >> NANCY MACKLIN: Glenn Schweitzer came to my attention, I saw a post that he did. And it really struck a cord with me.


And I invited him to present a webinar because this is such an important topic. Whether you call it tinnitus [\ˈti-nə-təs] or tinnitus [tə-ˈnī-təs\], it is a — it’s important issue for people who have it and Glenn is an entrepreneur, a blogger and author of “Rewiring Tinnitus” and also “Mind Over Meniere’s” and I know he has a lot of good information to share tonight.


And we also want to have a few minutes at the end for question and answers. You will — if you have a question for Glenn, just type it in the chat box and I’ll kind of keep track of those as we go along and post those questions to — pose those questions to Glenn at the end so that they then become part of our CART transcript. So without further ado, please go ahead and get started, Glenn, thanks so much again. >> GLENN SCHWEITZER: All right. Hello, everybody. Thank you so much for being here with me tonight and Nancy thank you for that wonderful introduction and I will be calling it tinnitus [\ˈti-nə-təs] rather than tinnitus. So today I’m going to talk to you all about something that so many people in the hearing loss community struggle with on a daily basis. Tinnitus. The medical term for ringing in the ears.


Now, it’s a much bigger public health problem than most people even realize affecting 10 to 15% of the general population by most estimates And unfortunately, as many of you know, there isn’t a cure. At least not yet. So for the hundreds of millions of sufferers all around the world, the sounds never stop and conventional treatments rarely work the way we want them to. Too many people are told there’s nothing they can do, that they just have to live with it and that’s never helpful advice but in the war against tinnitus few people have been let down harder than those with hearing loss because when you still have your hearing, tinnitus can completely ruin your quality of life but when your hearing is impaired or gone altogether it can be utterly devastating but if you suffer from tinnitus it doesn’t mean — if you suffer with tinnitus it doesn’t mean you’re going to live a life of pain and misery. Before we begin, I want you to understand one thing right now if you suffer from tinnitus, there’s hope. Even if you have hearing loss. I wish someone had told me that sooner because I suffered for a long time.


But today I’m happy to report tinnitus doesn’t bother me at all anymore. A few years back I stumbled onto a few techniques and exercises that completely changes the way I react to the sound of my tinnitus and almost overnight it stopped bothering me. So I’ll share my story with you all and by the end of this presentation I hope to get you a better understanding of tinnitus as well as a new coping strategy so that maybe you can find relief, as well. There may not be a cure for tinnitus but you can get a comfortable place that it stops bothering you and dramatically improve your quality of life. So my presentation is going to be split up into four separate sections. First I’ll explain my story and my journey with tinnitus and to a lesser extent my experience with Meniere’s disease and following that will be an examination and closer look at what tinnitus actually is; it’s more than just a sound.


Following that we’ll take a lot more than just sound. Following that we’re going to take a look at how I was able to eventually find a relief and I’ll share a technique for you all to try at home so hopefully you can get some relief as well and we’ll close it off with a look at some lifestyle changes you can make to even further improve your quality of life with tinnitus. So let’s dive in. So up first is my personal journey with tinnitus So I’ve had tinnitus for as long as I can remember. Now I can’t say for sure that I was born with it. But I also can’t really remember a time without it. For most of my life, the ringing was a constant by quiet high-pitched tone that never really bothered me. I always just assumed it was normal. It wasn’t until my early teens that I had any idea otherwise. I remember overhearing a conversation between my dad and his mother talking about their tinnitus that it occurred to me, hey, wait, I have that, too.


That’s not normal? I always assumed everyone could hear that high-pitched sound that I could hear when it was quiet. But the problem is it didn’t really really matter. It was just a — didn’t really matter it was just a part of me that I had lived with for so long. Well that first changed in 7th grade. I was 13 years old and several of my friends were having Bar and Bat Mitzvahs; if you don’t know, that’s a Jewish ceremony that signifies a child’s passing into adulthood and typically followed by an ex extravagant wedding-like party; they are a lot of fun but like weddings they can be very, very loud. So I will back up and explain that most people hear, temporarily hear, ringing in their ears and experience mild hearing loss at some point in their lives. Though usually only for a short period of time following exposure to loud noises typically lasts for a few hours maybe a day or two at most in most cases but what most people don’t realize when this happens that they are damaging their hearing a little bit and if you already have tinnitus to begin with when this happens it can make your tinnitus a whole lot worse.


So I remember driving home with my parents the first time this happens. It sounded like my ears were stuffed with cotton and the ringing was much louder than normal. I remember not being able to hear the car radio and asking my parents who were at the party with me if their ears were ringing too and I know they tried to explain it to me this is something that can happen when you’re around loud music but at the time I didn’t really understand and later that night, I had a lot of trouble falling asleep. The ringing was so loud and nothing I did would make it go away and I tossed and turned for half the night before I eventually got to sleep.


When I woke up the next morning, the ringing still wasn’t back to its normal volume. It was better than it had been the night before. But I was still very uncomfortable and it took probably another 12 to 15 hours before everything went back to normal. Now, throughout my life, this pattern would repeat itself. Every loud concert and party and noisy sporting event or anything of the sort that I attended would always end the same way – a spike in the volume of my tinnitus, mild hearing loss, a sense of anxiety and panic followed by an inability to get to sleep. And ultimately a slow return to normal. — back in the day I didn’t know better and that’s a shame because I was damaging my hearing and had I known better I would have taken steps to protect my hearing.


Just to give you one specific example, this image here was taken at a music festival that I attended in my junior year of high school the HF festival as you can see it’s a crazy picture there were probably 80 to 100,000 people at RF stadium where Washington Redskins used to play and I remember standing too close to the speaker tower for the better part of the day and for the following three or four days everything sounded like it was being filtered through tin cans. I had moderate hearing loss and just it took about three or four days for everything to return to normal but having said that I know I did damage to my hearing that day I wish I could take it back.


I want to talk a little bit about Meniere’s disease, which was the cause of tinnitus for me. Now, most people will never know what it’s like to stair down the barrel of a complex medical diagnosis. That’s not to say they will never get sick they most likely will and it might be bad. But most of the time, there will be a clear idea of what to do next. The doctor will be knowledgeable, he’ll be able to explain the treatment options and you’ll have a general sense of confidence about how to move forward but for the unlucky few who are diagnosed are diagosed with a complicated rare chronic disease like I was, there are rarely any certainties. There’s very little understanding. There’s a lot of pain, and confusion and despair. So it will probably be helpful if I explain what is Meniere’s disease. Well, Meniere’s disease is an inner ear vestibular disorder or balance disorder, that has no known cause or cure.


The symptoms include violent attacks of rotational vertigo where the room it feels like the room is spinning around you, incapacitates you lasting anywhere from minutes to hours to days in severe cases. This is typically accompanied by fluctuating yet progressive hearing loss, a feeling of fullness or pressure or even pain in the affected ear or ears. And of course, loud tinnitus. Now, I suffered for months when my symptoms first arose without any kind of understanding. And I was getting worse every single day. At the time I was very much set in denial.


Convinced that whatever was going on with me was either going to magically get better or would improve over time. But as time went on that’s not what happened. I started having more frequent vertigo attacks; in between the vertigo attacks I was experiencing a constant sense of dizziness and lack of balance. My tinnitus was getting louder and louder. And I had a constant feeling of pressure in my ears. I was also experiencing secondary symptoms like brain fog and fatigue. And it culminated with me finally seeking help. After a particularly bad vertigo attack I broke down and finally went to the doctor. The problem was the doctor delivered the diagnosis like a death sentence. He was very cold and he refused to answer any of my questions. He didn’t understand that I was just scared and trying to wrap my head around this crazy thing he was telling me. And when I left his office that day, it was one of the scariest times in my entire life. I left there with no sense of hope, with no sense of a future that might be worth living. And I sank into a pretty deep depression but luckily it didn’t last long a few weeks later I was lucky enough to see a specialist at the University of Miami.


And he changed everything for me. He was patient with me. He was kind. He took the time to answer all of my questions. He told me stories of some of his other patients who were doing well. And he painted a picture of a world where I might be okay. And there was — as a result I eventually was. Up until that moment I didn’t know that hope was possible.


That it was possible to have a life worth living. Now today I’m happy to report that I haven’t had a vertigo attack in a very long time I still experience a lot of the other symptoms. But if your hearing loss or tinnitus is caused by Meniere’s disease, I encourage you — and you want to learn more I encourage you to check out my Meniere’s disease Web site mindovermenieres.com but I’ll address Meniere’s more through the presentation but that’s all I’ll talk about it for now. So moving on. Now, as my Meniere’s symptoms began to improve, my tinnitus was the one thing I couldn’t change and in fact to the contrary, as my Meniere’s symptoms got better, my tinnitus was getting worse and was starting to bother me more and more of the time. Now, my tinnitus is a loud high-pitched tone around 3500 hertz, a single frequency tone, although when Meniere’s symptoms flare up I do hear other tones too. Sometimes I’ll hear multiple sounds at once. I’ve heard lower pitch tones or higher pitch tones or whooshing and static noises, a roaring like a jet engine but the high-pitch tone was enough to bother me all on its own and during spikes it would become unbearable.


Like most of you who experience tinnitus, I tried every over-the-counter supplement and quote-unqoute miracle cure that I could find. I avoided silence like the plague. I listened to background noise at all times. I listened to music while I worked and a sound machine as I went to sleep that played the sound of a brook. And while the audio tools helped me to cope in the moment, it didn’t actually change anything. It didn’t make my tinnitus bother me less when I was not masking it. But eventually I did find something that actually worked. It was a simple exercise that changed everything for me. But before we get into the details I need to explain a few more things before all of this will make sense. So now we’re going to take a closer look at what exactly is tinnitus. Well let’s start with the medical definition. And this is taken from the Mayo Clinic. Tinnitus is the perception of noise or ringing in the ears. Tinnitus it isn’t a condition itself but a symptom of an underlying condition and unfortunately there are quite a few conditions that cause tinnitus.


So just to give you a little idea, hearing loss, including age-related and noise induced is known to cause tinnitus, injury to the ears, the head or neck, TMJ, circulatory system disorders, Meniere’s disease as I mentioned or other vestibular disorders like migraine-associated vertigo and semicircular canal dehiscence or SCDS, infection, various tumors and traumatic brain injury and certain medications and supplements are all known to cause tinnitus so the bottom line here is that a lot of roads lead to tinnitus. So what do you do about it? Well the first thing I always recommend is to find a good doctor a good way to do this is with a Web site called healthgrades.com I like health grades because you can search for local doctors by specialty and it provides results with a five Star Rating system that’s based on anonymous patients’ feedback. Had I known about this ahead of time I would have been able to avoid the low rating score of the first doctor that treated me so I’m a big proponent of Health Grades and the primary reason to find a great doctor is to rule out potentially treatable underlying causes Some of these underlying conditions are treatable to certain extents and if you treat the underlying cause tinnitus can improve in a lot of cases so for instance with hearing loss being fitted for hearing aids and treating the hearing loss can lead to improvements in the tinnitus.


But while this is a good description, it doesn’t exactly explain what tinnitus is. So it’s a sound. But it’s also an emotional, psychological, and physiological problem. And it starts with memory. Our sense of hearing and our memories are very closely linked. When we hear a sound for the first time, we assign meaning. And we react according to what that sound means to us. When we hear the sound again we remember what it means and how it made us feel the first time we heard it. This serves an evolutionary purpose primarily because we use sound to monitor our environment for threats. So sounds when we receive a sound as threatening it triggers a stress response within the body otherwise known as the fight or flight response.


When this happens it primes the body to either react to danger or get away safely. Adrenaline and other stress hormones flood our system. We can see more acute acutely. See more clearly. Hear more acutely. We can hit harder and run faster. But it’s not all about threats. Sounds can also carry a deeply positive association. That’s why babies will be soothed by the sound of their mother’s voice or why we find the sounds of the beach or nature in general so relaxing. The problem is our reaction to the sounds can become an automatic response. And in the case of sounds with a negative association, it can very quickly become a self-perpetuating vicious cycle.


When this happens, when we have this automatic response it’s activating the limbus system which triggers the nervous response and the autonomic nervous system which is a physiological response in the body all of this happens automatically without thinking at all. What does this mean for tinnitus? Well, when tinnitus is perceived as bothersome or annoyance or as a threat our body reacts automatically as if we were in danger and triggers a stress response but the truth here is that tinnitus is no more threatening or dangerous than the sound of a ceiling fan.


So again, what exactly is tinnitus? Well, we’ll take a look at this in the context of the neurophysiological model of tinnitus it was originally developed by Dr. Jonathan Hazel and Dr. Pawel Jastreboff in the early ’90s and has become the predominant model of tinnitus since then and it’s led to beneficial treatments such as tinnitus retraining therapy, which some of you may have tried or TRT for short.


And I’m not going to go into how the entire hearing pathways and how our hearing works but I want to address a few key issues here. So first I want you to understand that the cochlea is a small snail-shaped organ in the inner ear that is responsible for translating the physical vibrations of sound into the electrical signals that our brain can understand. It’s a noisy place. It contains 17,000 tiny hair-shared sensory organs called hair cells, which you may have heard of before. And all of the mechanical and electrical activities present within the cochlea actually produces measurable noises that can be picked up with sensitive microphones called auto acoustic emissions.


Now this is important to understand because under the right conditions, everyone is capable of hearing the sounds of tinnitus. Two scientists named Heller and Bergman first showed this in 1953 with a very clever experiment. They recruited college students with no history of tinnitus at all. And they led them to believe that they were having their hearing tested so the students were placed inside of a sound absorbing chamber given a set of headphones and a button and the students were instruct instructed to press a button any time they heard sounds being played through the headphones. Now this was a trick. There were in fact no sounds were in fact, no sounds being played at any time through the headphones yet remarkably 93% of the students pressed the button. And when questioned afterwards the students reported hearing various tones, buzzing, pulsing and whistling noises. The exact same noises reported by tinnitus patients. So in the context of the neurophysiological model of tinnitus, tinnitus is the result of the brain turning up the volume of natural sounds present within the body.


Now typically this occurs as the brain attempts to compensate for changes in sound environment like silence, hearing loss or sudden exposure to loud noise and to be clear this is an overcompensation but it’s a natural process nonetheless. I think it’s important to note that hyperacusis which is extreme sensitivity to sound is a closely related phenomenon that around 40% of people with tinnitus experience where the brain is turning up the volume of external noises as opposed to the internal sounds of tinnitus. Now I want to be clear that we still don’t really understand why tinnitus occurs or the specific mechanisms and pathways involved in the brain. Some theorize that tinnitus is similar to phantom limb syndrome where an amputee victim who loses a limb will experience pain or other sensations in the blank space where the limb used to be.


Some think that in a similar kind of way that when the brain experiences a sudden decrease in sensory input from the ears, the brain will compensate by as I mentioned before turning up the volume of the other sounds because the brain doesn’t like a drop in sensory information. But the bottom line and the key takeaway here is that the sounds of tinnitus are harmless, no matter how loud they seem or how intrusive they are.


Okay. So the answer to tinnitus is a mental process called habituation. The human brain is actually very good at eliminating annoying background noise from our conscious awareness with this mental process. It’s how we’re able to carry on a conversation in a noisy restaurant or how people are able to work and focus on their work in a noisy office. In a very real sense, the brain can turn down the volume of sounds that are not important so that we can focus on the ones that are.


I want to be clear that all of the people who have — who live comfortably with their tinnitus have habituated to the sound so — it’s entirely possible. But there’s a big problem. It is impossible to habituate to a sound that we interpret as annoying, threatening, dangerous, or if it carries a negative association of any kind and there’s a very good reason for this. You would never want to not hear the sound of something actually dangerous. So if we deconstruct this for a moment, it’s our reaction to the sound of our tinnitus that is the root of the problem. And the very thing that is preventing us from being able to tune it out and find relief. We react to the sound emotionally as if we were in danger. And because our brains can’t tell the difference between real danger and an imagined threat like tinnitus or to give you another example, public speaking, which people get very anxious and they have the same kind of stress response, the reaction is the same.


We have this stress response. And it never ends because our tinnitus doesn’t just go away So how did this happen? Why do we have this terrible reaction to the sounds of our tinnitus if it’s not actually dangerous? Well, it starts with fear. The sudden onset of a loud noise that nobody else can hear is terrifying. You know most people can tolerate a temporary problem but when it doesn’t go away after a couple of days, the fear starts to build It also doesn’t help that many people are told that they just have to live with it. That — it only serves to further enhance the fear and doesn’t add anything constructive. Now, most peoples’ first reaction is to try to ignore the sound of their tinnitus, either by force of will or by distracting themselves or by — you know with background noise.


And while it can help to cope somewhat in the moment, it doesn’t actually change anything in the bigger picture. And if you have hearing loss you won’t be able to take advantage of this at all. So a key point that I want — a key thing I want to say here is that emotional, physical and psychological problems all get worse when we ignore them. So why do we think that it will be any different when it comes to tinnitus? The good news is that we can change the way we react to the sound of our tinnitus. In fact, it’s the one thing that we actually have the power to change. And when we accomplish this, it stops bothering us. And the habituation process can occur naturally and we can start to tune it out. So now we’re going to talk a little bit about finding relief. And obviously finding relief is going to be about getting — about changing the way we react to the sound. Now, I’m going to teach you all a simple exercise that you can try at home.


But first I want to give you a little bit more background and context. So when I was first diagnosed with Meniere’s disease, my doctor didn’t mince words and said you have to lower your stress levels; stress is a big trigger for Meniere’s disease and tinnitus as well and if I was going to have any hope of getting a handle on my symptoms I needed to find a better way to manage my stress and anxiety. The only issue is I have suffered with anxiety for most of my adult life and being diagnosed with a rare complicated uncurable chronic illness is not an easy pill to swallow so it’s safe to say I did not handle it well for a long time. Now, to fast forward a little bit I eventually was able to get a handle on my stress levels and meditation was the thing that worked. But when I first came to meditation, I was very skeptical. And initially I also found it very difficult. In fact I’m surprised I stuck with it though I’m also very grateful. In the beginning I experimented with many different kinds of meditation.


I tried you know mindfulness meditation. Mantra meditation. All of these different approaches and I really struggled with it and I love this quote. Dan Harris an anchorman for ABC News and the author of a wonderful book that I highly recommend called “10% Happier” sums up my skepticism — my initial skepticism perfectly and offers a beautiful solution to that skepticism in this quote. He said, “Meditation suffers from a towering PR problem largely because its most prominent proponents talk as if they have a perpetual pan flute accompaniment.


If you can get past the cultural baggage, though, what you’ll find is that meditation is simply exercise for your brain.” So we’re going to dive into this a little bit. So simply put, meditation is the practice of quieting the mind. Now, this typically involves focusing your attention onto a single point of awareness such as the sensation of breathing or a mantra, which is a mentally repeated word or phrase. Now, it’s an incredibly simple practice but it is not easy and I’m sure that many of you can — if you have any experience with meditation can relate to that.


But it has — it offers many benefits in the short term it triggers a physiological relaxation response in the body that calms the nervous system and lowers stress levels. In the long term it can lead to an overall reduction in stress levels, increased ability to cope with stress and center yourself more quickly when stress occurs. It can improve your focus and concentration and your ability to fall asleep and this is just to name a couple of things. The benefits are a multitude here But tinnitus makes meditation — meditation difficult I know I wouldn’t have coped with Meniere’s disease as well as I was able to were it not for meditation but like I told you before, as my Meniere’s symptoms improved my tinnitus kept getting worse and it completely destroyed my meditation practice.


It was impossible to focus on the sensation of breathing with the sound of sirens blasting in my ears. Now, I’m sure some of you can relate to this. Well, fast forward a little bit. And one night I was laying in bed struggling to meditate. And I suddenly had an idea. If meditation involves focusing your attention onto a single point of awareness like your breathing like I was trying to do what would happen if I stopped fighting to ignore the sound and focused instead on the sound? Now at that time it seemed like a crazy idea to focus on the thing that was driving me crazy but I tried it.


And it changed everything. Now, just to give you a little bit more context, anything can be used as the focal point or the object of meditation. Now in mindfulness meditation people are encouraged to explore sensation — meditation people are encouraged to look at pain or boredom in this way. Dan Harris in “10% Happier” explains advice on handling boredom I find very relevant to what’s going on in the context of tinnitus and meditation so he says, “The advice here is similar to how you should handle pain and fatigue investigate how does boredom feel like how is it manifested in the body whatever comes up in your mind can be co-opted and turned into the object of meditation. it’s like in judo where you use the force of your enemy against him.” So when I first tried to do this, it was much more difficult than I expected. But for reasons that I did not expect. The first thing that happened was my mind started wandering immediately. Now this happens to everyone, especially people new to meditation. And the goal of meditation is not to keep a perfectly clear mind the entire time.


The goal of meditation is to notice it when your mind is wandering and begin again. But this time when my mind wandered I suddenly realized it wandered away from the sound for this brief moment of time it hit me that I hadn’t noticed my tinnitus at all. As I continued to do this once I had stopped fighting to ignore the sound I was experienced with meditation at this point and was able to get into a much deeper — excuse me — meditative state And when it was over, my tinnitus didn’t seem as loud. Now in hindsight I realized that it wasn’t actually quieter, it just wasn’t bothering me as much.


So it didn’t seem as loud. My perception of it wasn’t as loud. What I didn’t understand at the time was that my brain was beginning to associate the calm and relaxation of meditation with the sound of my tinnitus and it was starting to overwrite my previous conditioned response of stress and anxiety and frustration. And within a couple of weeks of daily practice, my tinnitus for all intents and purposes stopped bothering me entirely. Okay. So I’m going to now describe the basic technique. It is fairly simple. But like I said it’s not easy. And since coming up with this original technique it’s evolved somewhat. There’s various variations of the meditation techniques that involve aspects of visualization and other similar things.


And there’s also other ways to make it easier but I wanted to leave you with something today so I’ll walk you through the basic tinnitus focused meditation techniques. So Step 1 is simply so sit or lay down in a comfortable place. You don’t need to sit cross legged on a yoga mat chanting om, you just need to get comfortable and set a timer if you’re trying this for the first time I recommend 5 to 10 minutes, a small easily attainable goal but if you’re experienced with meditation or you find yourself comfortable with the exercise feel free to extend the time period. Just set a timer and try to stick to the time limits. Step 2 is to — is a physiological relaxation routine so the mind and the body are intimately connected.


What you’ll find is that when you make an effort to relax the muscles and the tension in your body, the mind tends to follow and you tend to experience a mental relaxation that comes with it. So I encourage people to do a progressive muscle relaxation routine prior to actually getting into the meditation so all of this involves is consciously working your way through your body, relaxing muscle groups one at a time. So you start with your feet and toes and let all of the tension go and let muscles be completely relaxed and then move on to your legs and consciously focus on your legs and allow the muscles to become completely relaxed. You slowly work your way through your entire body and you can do large muscle groups like I just described.


Once you’re done and you find yourself feeling more relaxed, simply shift your focus and attention to the sound of your tinnitus. Now, I find it’s helpful to maintain a mindset of curiosity when doing this like you are a scientist observing some interesting new phenomenon for the very first time. And just remember to breathe naturally while you do this. And lastly, when your mind wanders and I promise you, it will, notice it, and start again. As I said before, everybody’s mind wanders during meditation. Catching yourself when it happens and starting over is the exercise. And the calm and the relaxation state that happens is a result of that exercise.


So this is something you all can try at home. And hopefully you’ll be able to experience some of the same results that I was able to experience even with just this basic technique. Now, I want — as I mentioned a minute ago what started as this accident has evolved now into a more structured practice and normally when I talk to people about this I suggest using audio-based strategies like partial masking which is taken from tinnitus retraining therapy and the idea of using background noise to partially block the sound of your tinnitus thereby reducing its volume somewhat when your tinnitus is at a lower volume it’s easier to focus on and meditate to and there’s other audio-based strategies that I recommend, as well. But obviously if you have hearing loss, this won’t work. So I wanted to take a moment to address some of the challenges of hearing loss and tinnitus meditation.


Now, I want to be clear that this practice is as easy as it sounds can be very challenging, especially when you’re just starting out and especially if you — in more severe cases of very troublesome or very bothersome tinnitus. But you can do a few things to make it a little bit easier. The first thing you can do is utilize your other senses to try to bring yourself into a relaxation state before you start the meditation practice.


So setting up your room with relaxing scents. Or candles. Or imagery can be very helpful. As can recalling — you know closing your eyes and recalling a soothing memory of somebody you love or care deeply about maybe a pet and really immersing yourself in a memory that gives you that warm feeling that can help you to relax mentally a little bit and emotionally before you try this technique. And so can like I mentioned before, relaxing your — physically relaxing your body. So taking a hot bath or getting in the sauna or really any physically relaxing activity prior to tinnitus meditation will make it easier so I encourage you to try some of these things if you have a case of tinnitus that is very bothersome. Okay. Now, so the last piece of this presentation is I want to talk to you a little bit about lifestyle management. So as I mentioned in the beginning, there are a lot of lifestyle changes that you can make to enhance your progress and further improve your quality of life with tinnitus.


I’m not going to go into a lot of detail on all of these. But things like discovering what’s triggering your tinnitus and avoiding it when possible. Coping with stress, getting better sleep. Exercise, mental health, improving your diet. These are all things that can help to improve your quality of life with tinnitus. So we’re going to take a look at a couple of these. First and foremost, though, is tracking tinnitus to discover what’s triggering it Now, even though it may not seem like it, the sounds of tinnitus are rarely constant.


They may change in the quality of sound, in the volume of the sound or even in the number of sounds. And these fluctuations are typically referred to as tinnitus spikes. And though they may seem to happen randomly, they are oftentimes triggered by something external in your environment or something internal within you. And identifying these variables that exacerbate your tinnitus is important because when you can avoid them you can reduce the number of spikes and work to improve your tinnitus. Now, there isn’t science necessarily and research linking these triggers to tinnitus. But anecdotal anecdotally many people report the following to trigger tinnitus, so for example, certain noises in certain frequencies. Loud sound exposure is a big one. Stress is a big tinnitus trigger for just about everyone.


Sleep deprivation. Certain medications, supplements and vitamins. Dehydration . Having too much sodium in your diet or too much sugar in your diet. Caffeine. Nicotine in all its forms , including vaping and e-cigarettes, alcohol and recreational drugs are triggers for some people especially stimulant drugs, food sensitivities and allergies, pollution, TMJ which we mentioned before, and even specific changes in the weather like changes in barometric pressure are all known to trigger tinnitus. Now, everyone is going to experience this differently. So identifying what is triggering you specifically is going to be important And the way to do this is with journaling and there’s a very good reason for this. If your tinnitus spikes in the afternoon because of something that happened or something you ate in the morning for breakfast, your brain is probably not going to make that connection automatically. But with the right information in front of us, it’s very easy to find the patterns.


Now, as you can see here I’ve listed several different things that are good to keep track of. But just to make this easy for you all I’ve created a one-page principle PDF tool that will help you to track all of the right variables. You can just print out a stack of these. And it’s pretty straightforward. You fill one out each day. And once you have data to look back on, you compare the days when your tinnitus was at its worse to look for the patterns but you can also use this tool to compare the days when your tinnitus wasn’t bothering you at all or bothering you very little and try to figure out if there was something in common those days to help your tinnitus you can download this free tool at rewiringtinnitus.com/journal.


Okay. That tool is free for you. You can download it and start taking advantage of that right away. So I want to talk a little bit about coping with stress because stress seems to be a trigger for just about everyone. Now there are a lot of different aspects to dealing with stress and I’m only going to touch on a few of them here but first I want to talk about counselling and therapy I’m a big proponent of counselling because I find that tinnitus can be very traumatic.


Especially if you have suffered for a really long time. Like having to find the right doctor, finding the right therapist is going to be extreme extremely important to making this work and the right therapeutic style. Traditionally cognitive behavioral therapy is popular with tinnitus patients. But ultimately I feel like the personality of therapist is a better indicator of whether it will be helpful or not and in addition to helping you work through the issues related with tinnitus it’s also an excellent tool to help manage stress and issues that come up in daily life. Support groups can be extremely helpful too if you’re not interested in counselling or therapy or if you don’t have the budget for it and a lot of great support groups can be found online, in person and on Facebook as well if you search tinnitus on Facebook you’ll find many different support groups with thousands of people.


Okay. So physical stress management and we talked a little bit about this is going to be important to reducing your overall stress levels. Stress finds its way into our bodies as physical tension and aches and pains and it’s a very insidious type of tension too because we don’t even notice it until it appears as pain. But any therapy that reduces physical stress and tension will be very helpful at managing stress levels which in turn can help you improve your quality of life with tinnitus. So things like professional massage. I’m a huge proponent of massage I’ve seen a lot of great results with that . If — but also with trigger point massage or self-massage using a lacrosse ball or a foam roller or other mobility type exercises can be very helpful for breaking up the fascia and reducing physical tension and stress as can acupuncture and again hot baths or saunas . Really any physically relaxing therapy is going to help here.


And of course exercise. Exercise is not a magic bullet that will make the tinnitus go away but it is an important aspect to being healthy and it doesn’t have to be intense to reap the benefits. Walking is more than enough to trigger a release of endorphins which are our body’s feel good stress relieving hormones. I encourage people to exercise outside whenever possible. And I also like to encourage people to trio ga because yoga combines aspects of exercise and flexibility. And I’ve found it to be a complement to the tinnitus meditation practice. Okay. And lastly I want to talk to you about improving sleep because sleep deprivation seems to is a big trigger for a lot of people. So the first thing I like to recommend is to improve your sleep routine, so what does that look like. For starters I encourage people to go to bed and wake up at the same time every day; if you’re going to bed and waking up at different times it can induce a state similar to jet lag and it can have an impact on our stress levels and in turn on our tinnitus.


So getting yourself on a routine can be helpful. Also instead of the typical 8 hours I like to recommend people trying for 7.5 or 9 hours of sleep which corresponds to the end of a sleep cycle. We sleep every night in these repeating 90 minute sleep cycles and if you wake up at the end of a sleep cycle rather than in the middle you’ll end up waking up feeling much more refreshed, revitalized and have a lot more energy and it will have an impact on your stress level so 7.5 to 9 hours is a great target for sleep. I also encourage people to do the same thing every night before you go to bed. When you have a routine, your brain can begin to associate that routine with falling asleep and very quickly just doing those things will get you to start yawning and get you ready for bed. Also avoid caffeine for at least 8 hours before bed if it’s a trigger for you, avoid it entirely at least until you habituate but if not at least 8 hours give yourself a caffeine break.


I also think it’s a good idea to turn off your screens 90 minutes before bedtime your TV, your tablets, phones, computers the issue here is at nighttime our brains secrete melatonin which signals to our body that it’s nighttime. But the bright blue lights that are emitted from various devices mimic sunlight and blocks the production of melatonin now obviously people like to watch TV and play on their phones before bed so I wanted to give you a few alternatives if turning off the screens is not an option: one you can see here blue light blocking glasses this pair here if you search that on Amazon you’ll find a multitude of pairs this one here is under $10. There are also blue light blocking apps you can get for your computers and phones and tablets. And now a newer Android devices and iPhones and iPads and Apple computers have this feature built in so you can take advantage of the software approach to remove the blue light spectrum from your screens and that can help you get sleep And lastly, you can optimize your bedroom.


So there are a few things you can do to your bedroom that will make it easier to fall asleep. When it’s pitch black it’s easier to fall asleep so this can be achieved with either blackout curtains which are available at any department store. Or even simpler than that is a sleep mask wearing one to cover your eyes. Keep in mind if you don’t wear a sleep mask you want to cover all sources of ambient light so cable boxes, night lights, anything emitting light in your room you want it to be as dark as possible.


Also research has shown the ideal temperature for sleep is 62 to 68 degrees Fahrenheit. Now this I know is much colder than most people realize and it has to do with a process called thermal regulation.When we’re going to sleep our bodies experience a drop in core temperature as we initiate sleep. And when it’s warm in the room, it makes it difficult for that to happen so reduced — lowering the temperature a little bit can be very helpful although you don’t want to be cold under your covers so wearing socks might be a good idea. You want to be warm and comfortable under your covers but having a colder ambient room temperature can be very helpful and lastly, of course, if you still have some of your hearing, background noise or white noise or sound therapy can be very helpful and not just to mask the tinnitus but also because it will create a wall of sound that will prevent you from hearing other noises that may have woken you up temporarily throughout the night.


Okay. So the big question, will there ever be a cure for tinnitus? Well, I often wonder what life would be like without tinnitus. Though I do believe that one day science and researchers will answer that question. But right now, all over the world there’s research and studies underway looking for a cure. Pharmaceutical companies are testing and developing new drugs and drug delivery systems. For the first time I really do feel like there is hope for a cure. But a part of me also realizes that ultimately it doesn’t matter because we can habituate to the sound. And if the sound stops bothering us, it’s not actually a problem anymore. I truly believe that at the end of the day, we don’t need a cure. At least not to be healthy, happy and productive members of society. Because a solution already exists inside each and every one of us. From time to time I still do struggle with my tinnitus. But today it’s never like it used to be. If it spikes now a few minutes in tinnitus meditation is all I ever need to find relief.


So no matter where you are with your tinnitus, no matter what setbacks or adversities you might face on your journey, you can start taking the steps to habituate and even baby steps will get you there eventually. You can learn to live with this crazy condition and find the relief that you deserve. So I want to wish you all the best of luck on your journey and above all else I want you to remember that there is so much hope. You can and will habituate to the sound of your tinnitus so thank you so much everybody I’m going to open it up now to questions. And if anyone wants to learn more you can visit my tinnitus site rewiringtinnitus.com or mindovermenieres.com.


>> NANCY MACKLIN: That was great I can tell by the comments it’s too bad you’re not coming to Salt Lake City to present but I’m going to twist your arm for next year for sure. >> GLENN SCHWEITZER: Thank you. >> NANCY MACKLIN: The first question comes from Jane and she says I presumes this technique would help with hyperacusis since it’s similar? >> GLENN SCHWEITZER: Yeah, so hyper– I’m less familiar with hyperacusis than tinnitus if only because I lack the personal experience, I don’t have hyperacusis at least not to any crazy extent. But meditation will help reduce your reactivity, your emotional reactivity overall. And that can you know just experiencing that — these states of relaxation and calm can help to improve the reactivity and sound sensitivity that come with hyperacusis. Although that would apply to any type of meditation I would imagine. >> NANCY MACKLIN: Does age play a factor in tinnitus? Does it go away at all as you age? Or are we stuck with it for the rest of our lives, even though we can manage it? >> GLENN SCHWEITZER: Good question.


Well, so what I’m seeing is that some people — many people, over time do habituate naturally. Now even if it starts to bother — even if it bothers you very intensely some of these people do over time it bothers them less and less they get used to it and they habituate. Now it doesn’t necessarily mean it goes away but what I have found when you fully habituated, it’s so far in the background of your awareness that it’s really not an issue in you know throughout your day-to-day life. Now again there are very specific things that prevent this from happening when it’s bothering you so if you’re suffering from tinnitus and you can’t ignore it like I mentioned before there’s a very good reason for that but everyone is different it can go away over time but for some people more direct action is needed if that makes sense.


>> NANCY MACKLIN: Albert asks, why does my tinnitus be at its loudest when I awaken after a night’s sleep? >> GLENN SCHWEITZER: That’s a question I’ve gotten before and the short answer is I’m not really sure. My gut instinct, I mean it’s just — I have no research or science behind this. But because TMJ, which is tempero mandibular joint dysfunction it’s a jaw issue it’s a — and there’s nerves that project to a part of the brain that’s been identified with being associated with tinnitus in and around the jaw and when people are under stress or even not under stress people tend to clench their jaw some people clench their jaw or grind their teeth at nighttime and my gut says that maybe if you tense your jaw sometimes you can hear changes in the loudness of your tinnitus.


So my thought would be maybe you’re grinding or clenching your teeth at night and that tension around your jaw is causing a temporary fluctuation but impossible to say and I really don’t know is the truth. >> NANCY MACKLIN: Marilyn says, what do you think of hearing aids that have tinnitus masking programs? >> GLENN SCHWEITZER: So I am for them. But I still think that it’s important to — the approach that I described today involves focusing — taking the time each day to sit with the tinnitus and actually focus on it rather than trying to ignore it at all times. Now, as long as you’re doing that kind of work, this is what I normally will tell people when I’m explaining all of this, anything that helps you to cope in the moment is going to be a good thing. Now, masking is typically — the maskers are typically a part of tinnitus retraining therapy and the idea is if you can reduce — mask a part of the sound thereby reducing the volume that it’s less bothersome and through working with a therapist and having at a lower volume it will bother you less and over time you can slowly habituate and it does address the underlying principles that prevent habituation that I was discussing earlier the way we’re reacting to the sound.


It just — the problem is it can take a very long time to experience relief. But the short answer is that anything that helps you cope in the moment, I’m for it. >> NANCY MACKLIN: Okay. I think I’ve scrolled through and I think I have all of the questions posted to you. Everybody has said what a great presentation this is and you definitely have made on impact. People are going to start right away tonight. That’s great news. >> GLENN SCHWEITZER: Okay, great. I want to say one more thing, too. If anyone — I should have included this in the presentation. If anyone wants to reach out and connect with me, you can reach me at Glenn@rewiringtinnitus.com. I love to connect with people. I’m happy to answer any questions. I’m always around so feel free to reach out and chat with me. I just wanted to add that in here before we wrap up. >> NANCY MACKLIN: Okay. Actually, I see one more question that just came in.


>> GLENN SCHWEITZER: Okay. >> NANCY MACKLIN: What about sounds that could be actual external sounds or which could be tinnitus? I have at times gone to search for a source of sound only to discover later that it was tinnitus. >> GLENN SCHWEITZER: Okay so, well, I think a lot of that is going to be paying attention to it and learning — discovering what — exploring your tinnitus a lot of what I wrote about in the book is like the first exercise I teach is typically this journaling exercise where people examine — having people examine their tinnitus very closely in a way they probably haven’t before so paying attention and getting to know your body and how your tinnitus is manifesting is going to be important. I’ve actually had the opposite experience where I heard a noise — a higher pitched tone thinking I was having a tinnitus spike trying to do this meditation only to find that it was like a light fixture that was malfunctioning it was an external noise so I think you can — the experience goes both ways.


>> NANCY MACKLIN: And then — then just one last comment from Dr. Lucy. She says my tinnitus definitely worsens with fatigue and stress. So does my vertigo. Both seem to be harder to deal with as I age. I’m near 80 now and I’ve had it all my life but coped better when I was younger . >> GLENN SCHWEITZER: Yeah. So if she’s experiencing vertigo, she likely has some sort of vestibular disorder I don’t know if it’s also Meniere’s disease. But I think the fatigue is going to be a result of the stress. And so I think taking this — you know the holistic approach to stress that I’ve been describing by trying to improve it you know physiological relaxation and physically relaxing therapies like massage, doing meditation , taking steps to improve your sleep, taking steps to, you know, all of these different things I discussed to discuss stress levels as much as you can do and as many aspects of your life to work on stress is going to be helpful here.


There isn’t one magic bullet unfortunately. And everyone is going to respond and — everyone is going to respond to different therapies and different things in a different way. So just experimenting and trying lots of different things and you know is going to be very helpful . But it’s not an easy problem. Chronic stress is a big issue in today’s modern world. So it’s tough. But you know, the more ways you can try to address stress, the better off you’ll be. >> NANCY MACKLIN: Okay.


One last question, on average how quickly do foods — how quickly does food trigger results in spikes? >> GLENN SCHWEITZER: Okay so if you find that you are triggered by a food or you know food sensitivity or something like that, I think it varies from person to person. Now, for me, one of my big triggers for Meniere’s disease and as a result tinnitus is sowed yunl so managing my sowed — sodium so managing my sodium levels and sodium intake and keeping sodium levels constant throughout the day is an important part of ongoing lifestyle management and maintaining a sense of health for me and if I eat a meal that’s too high in sodium I will start experiencing my Meniere’s symptoms within ten minutes — within minutes. Usually I’ll experience it as like — my tinnitus will get louder I’ll become more sensitive to noise I’ll start to experience a little bit of fatigue and brain fog and if I — my discipline falls in all — and all of the various things I do in the name of lifestyle management my symptoms would progress and ultimately back to vertigo.


But it varies from person to person. I mean, some people it doesn’t manifest until later on so tracking is going to be helpful here. Tracking and seeing the bigger picture is going to be how you figure out those connections and that tool again I encourage everyone to go download that tool at rewiringtinnitus.com/journal . >> NANCY MACKLIN: Great. Thank you again so much. >> GLENN SCHWEITZER: My pleasure thank you so much for having me.


>> NANCY MACKLIN: It was a wonderful presentation and thank you again to Cindy Thompson, our CART provider tonight. >> GLENN SCHWEITZER: Thank you, Cindy. >> NANCY MACKLIN: Check us out at hearingloss.org we have a lot of great information on there. And join us, come join us, we have great resources for you. This webinar has been recorded and we’ll do our best to get it posted on the webinar page. It usually takes us about a week to do that. So thank you again Glenn and thanks, everyone, for participating in tonight’s webinar. Take care, good night, everybody.>> GLENN SCHWEITZER: Thank you everybody for joining us. Have a great night..

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