CLEVELAND, Aug. 6 (UPI) -- At first Carol Brook thought she was a little bit like the "Bionic Woman" from the 1970s TV show who had a high-powered artificial ear that could detect sounds no one else could hear, but when she realized she could hear the electricity flowing through power lines high above the ground, her superhero fantasies were replaced by real life dread.
It wasn't just the sound of electricity that was pounding in her ears, Brook said. Her refrigerator sounded like heavy machinery, her microwave was excruciating and even the sound of her husband's electric toothbrush was too much for her to bear.
Worse yet, these background sounds of daily life began to take on the rhythm of other sounds that seemed to be locked inside her brain.
"Sometimes it was a constant hiss-click-hiss in one ear and a click-hiss-click in the other," Brook told United Press International. Other times, it was "a bongo drum, so the refrigerator noise would go to the beat of the bongo drum."
It was, she said, enough to drive a person crazy, which is exactly what many people thought had happened to her. "My husband had me admitted to a mental ward ... to learn coping skills," she said.
Before Brook ended up in a psychiatric unit, she had endured a long and costly odyssey, searching for someone who could stop the noise. Her journey is not all that unusual -- although she had the resources to carry it much further than many sufferers of the condition called tinnitus.
Tinnitus, according to the National Center for Health Statistics, affects about 32 percent of the general population at one time or another. It consists of the classic "ringing in the ears" that often follows exposure to loud sounds. Curious, hearing experts say, tinnitus is even more common among people who have some hearing loss with as many as 70 percent of people with hearing impairment reporting some tinnitus.
It also is an equal opportunity ailment that numbers among its more famous sufferers actor William Shatner and former First Lady Rosalyn Carter.
Tinnitus (pronounced either TIN-it-us or ti-NITE-us) refers to more than just ringing in the ears. It includes all head noises that occur independent of an external source and its sounds are as different as its sufferers: bells, drums, ocean waves, buzzing, hissing, clicking and so on.
In Brook's case, tinnitus was only part of the problem. She also had hyperacusis, which means her hearing was so acute she routinely heard sounds that go undetected by most people.
For example, most people are unaware of the sound of a running refrigerator but to Brook the sound was so loud --"like a piece of heavy equipment" -- and so frightening she thought the refrigerator actually was "running after me," she said.
Dr. Pawel Jastreboff, professor and director of the tinnitus and hyperacusis center at Emory University's School of Medicine in Atlanta, said although Brook had severe symptoms, she is not unique. As many as 15 percent of people who are exposed to explosions, fireworks, or gun fire can develop hyperacusis. While several studies have linked hearing loss to constant exposure to loud noise, such as music at rock concerts, neither tinnitus nor hyperacusis "is related to attending loud concerts," he told UPI.
In terms of prevention, there really is not much to be done, Jastreboff said, adding that he advises hunters to wear ear plugs, which he thinks might reduce risk. However, people in really high-risk professions, such as soldiers and police officers, do not have the option of wearing ear plugs because "they obviously need to hear what is going on," he said.
Brook suspects her hyperacusis is the result of a serious car collision that occurred about four years before the onset of her symptoms. Jastreboff agreed this is the most likely explanation for Brook's symptoms.
When Brook talks about Jastreboff, it is clear she regards him as a life-saver. The reason is a treatment called tinnitus retraining therapy, or TRT, which Jastreboff developed. The treatment can be used for both tinnitus and hyperacusis. "There is no 'cure' for tinnitus, but this treatment alleviates the symptoms," he said.
Most people with tinnitus simply tolerate the symptoms without changing their daily routine or being unduly troubled, Jastreboff explained. However, about one of every four tinnitus sufferers is affected severely, enough to interfere with his or her daily life. The Center for Health Statistics estimates 1 million Americans have disabilities related to tinnitus. For these people, Jastreboff said treatment can relieve symptoms and allow individuals to return to normal, productive lives.
At present, there are two university-affiliated centers in the United States that evaluate tinnitus/hyperacusis patients and offer TRT therapy: the one at Emory and another at the University of Maryland, Baltimore. But Jastreboff said there are about 300 hearing specialists -- audiologists, ear-nose-threat physicians and some psychologists -- who have been trained in TRT techniques and who are providing TRT. In Europe, there are roughly 700 TRT-trained practitioners.
TRT, said Jastreboff, consists of two parts: a thorough education program that explains the way the brain processes sound, and a re-training program in which the patient learns how to re-train the way brain cells detect and process sound.
Re-training works, said Jastreboff, because tinnitus sufferers have experienced a neural short-circuit, in which the conscious brain directs attention to the tinnitus sounds. TRT re-trains the conscious brain to ignore those sounds and send them to the unconscious. He likens this re-training to "driving. When a person who has been taught to drive a car on the right side of the road goes to a country where people drive on the left side, he or she has to re-train the conscious driving skill but the underlying skill remains."
In some cases patients are retrained using sound generators, while other patients require the use of hearing aids or sometimes special devices that combine sound generators with amplifiers. This retraining process, which requires use of the devices for several hours a day, takes a little over a year, but Jastreboff said improvement is usually noticeable after three months.
He noted health insurers usually will not cover TRT, although most will cover the hearing tests and assessments that are part of the initial evaluation. The initial evaluation costs about $1,500 and TRT treatment with instrumentation can cost an additional $2,000 to $6,000, depending on the device used. He said about 80 percent of patients enjoy significant improvement, meaning no symptoms after treatment, and most patients do not relapse.
"A study from German investigators reported no relapses five years after treatment," he added.
