Rx for Readers: Ringing in the ears

"I repeatedly hear whole orchestrated songs over and over again. Can anything be done to help me?"

I am a 78-year-old woman suffering from a serious case of tinnitus (ringing in the ears) that began several months ago. I didn't recognize it at first. It began by my being wakened in the middle of the night by the sound of what I thought was a motor or generator. I had thought it was from work being carried out on apartments being built next to our house. Then I realized this was not possible late at night and that it was in my head. Lately it has gotten worse. Now I repeatedly hear bars of music or whole orchestrated songs over and over again. One, which woke me at 3 a.m., sounded like "Happy Birthday" and continued to bother me through the next day. I really thought I was going crazy. Both my family doctor and ear doctor say there is nothing to do about it except use some kind of ear plug that plays tunes to block out the imagined ones. I don't want any music when I'm trying to sleep. My family doctor has rejected my suggestion that I see a neurologist. Can anything be done to help me? - J.L., Jerusalem Dr. Zvi Israel, a veteran neurosurgeon at Hadassah University Medical Center in Jerusalem's Ein Kerem, comments: Auditory perception in the absence of any sound is most commonly experienced as tinnitus. This annoying condition may present as noise, ringing or a monotone in one or both ears. Although most of us will experience this temporarily at some time, occasionally it may become continuous and troublesome, interfering with concentration, daily activities and sleep. We do not have a comprehensive understanding of the cause of tinnitus, although damage to the hearing apparatus or the neural pathways to the brain stem and brain are thought to be a major factor. Treatment for tinnitus has been disappointing. Drugs have been shown to be no better than placebo; noise masking offers partially successful relief. Some patients have benefited from behavioral and biofeedback treatments. Much interest has arisen recently concerning the potential of electrical brain stimulation by way of implanted electrodes, and initial results have shown success in a limited number of patients for single-tone tinnitus. It is far more unusual to perceive musical notes or entire orchestrated pieces of music. Oliver Sacks describes some patients with this complaint in his fascinating book, Musicophilia: Music and the Brain. I would recommend that you see a neurologist as soon as you can. I have a 30-year-old son who is suffering from sciatica. A friend of his has recommended that he wear a belt to hold the disc in. I myself, a past sufferer of this particular problem, was advised against using a belt, however I know that in England and America they are popular among people who suffer from back problems. Am I right in thinking that here in Israel the thinking among the medical community is not to use a belt to hold the disc in and realign the spine, as it can cause weakness to the healthy discs in the back? Which thinking is correct? - E.I.N., Givat Shmuel Prof. Meir Liebergall, chairman of the orthopedic surgery department at Hadassah University Medical Center in Jerusalem's Ein Kerem, replies: I can't give a serious answer to this question without conducting a medical examination and imaging scans of the patient. But in principle, a belt is not recommended because it is liable to bring about the weakening of supporting muscles. When there is a problem of imbalance or muscle tension, a belt has a relaxing effect. However, this of course does not return the disc to its proper place but may perhaps alleviate symptoms that usually go away as time passes. Rx for Readers welcomes queries from readers about medical problems. Experts will answer those we find most interesting. Write Rx for Readers, The Jerusalem Post, POB 81, Jerusalem 91000, fax your question to Judy Siegel-Itzkovich at (02) 538-9527, or e-mail it to jsiegel@jpost.com, giving your initials, age and residence.