We all know the expression 'it made my ears ring' but for one in 10 people sound in the ears is a fact of life.
Tinnitus is a sound perceived in the absence of any such sound being present in the surrounding environment. The sound is described as humming, buzzing, whooshing or ringing in the ear. It can be perceived in one ear or both and may be continuous or intermittent.
Occasionally tinnitus can have a musical quality, like a familiar tune or song. This is usually the case in older people with a strong musical interest. This is called musical tinnitus.
I am keen to dismiss the myth that tinnitus is a condition that is beyond being alleviated.
While there is no pill to cure the tinnitus, there are many interventions that can help. Do not let anyone tell you there is nothing that can be done!
Whilst we don’t know exactly what causes tinnitus, we do know that it is not a disease or an illness
When sound enters the ear it reaches the ear drum and then travels through the little bones of hearing (ossicles) to the inner ear.
Here the vibration is transferred into electrical impulses, which travel through the nerve of hearing up to the brain. Apart from sounds from the outside world there are some sounds generated in the inner ear as well. Together outside world sounds and sounds produced in the ear travel to the brain which decodes information.
As we are surrounded by sound, the vast amount of information presented to the brain is difficult to process in its entirety. Therefore the brain filters out unnecessary sounds, like the traffic noise. Sometimes, when there is hearing loss especially, the brain relaxes that filter trying to capture more information. This is how tinnitus is generated.
Many patients complain that their tinnitus is louder at night or in quiet environments and that interferes with their daily life. We use questionnaires to assess the severity of tinnitus impact on a patient’s well-being and all patients are offered a hearing test in order to pick up any hearing loss.
For some patients the reassurance that there is nothing terribly wrong with them and that the tinnitus is going to fade away in time is all they need.
Talking about the symptoms either with a health professional or patients similarly affected helps too. There are tinnitus support groups in east Kent where patients afflicted by tinnitus can share their experience and tips. More information can be found on the website of the British Tinnitus Association (BTA) at www.tinnitus.org.uk
In patients with hearing loss a hearing aid is very useful in amplifying the meaningful sounds around and masking the tinnitus.
In some patients, using background noise is a very effective therapy in distracting the brain from tuning into the tinnitus. There are a number of sound-enriching tinnitus maskers available and our audiologists with expertise are only too happy to recommend the most appropriate for patients. They are also available for children in a fun and age appropriate form.
Relaxation techniques such as mindfulness and cognitive behavioural therapy (CBT) have been proven to be of benefit and are available for people in east Kent.
Ms Codruta Neumann Consultant ENT Surgeon and Otologist
For many women, being diagnosed with diabetes in pregnancy can come as a shock.
This can be scary when you already have plenty of things on your mind as an expectant mum – so what does this mean for your baby and how can you keep yourself and baby healthy?
First of all, let’s be clear about the different types of diabetes you could be diagnosed with – it always helps to know what you are dealing with!
Gestational diabetes is diagnosed for the first time in pregnancy and disappears after birth if you manage a low sugar diet and follow guidance from your diabetic team. About two to four per cent of women develop gestational diabetes.
You are more likely to develop gestational diabetes if you have had it before, or if you have a close relative (mother, father, sister or brother) who has been diagnosed with diabetes. People from an Asian, African-Caribbean or Middle Eastern background tend to be more at risk of gestational diabetes, so do people who are significantly overweight.
A small number of women may already have had diabetes for a while, but don’t know about it until they are tested for it during pregnancy. Not in frequently women are found to have high sugar from early pregnancy and it is likely these women have type 2 Diabetes – a condition arising from obesity and lifestyle. Some women already have a diagnosis of ‘Type 1 diabetes’ which is a condition that that usually presents in early childhood.
Diabetes can result in the development of a large baby, which can make delivery more difficult. Your midwife will monitor baby’s size regularly and advise you if you may need to see a consultant to plan your delivery with you.
Diabetes can lead to more serious diseases, such as heart disease and stroke, and sadly, sometimes miscarriage and stillbirth. So your midwife will help you look after yourself and your baby – there are lots of things you can do to protect yourself and your baby.
It’s all about getting your body as fit as possible before pregnancy to provide the perfect environment for your baby to grow normally.
If you already know you have Type 1 or 2 diabetes you should let your GP and diabetic team know your plans before getting pregnant. Start taking folic acid as soon as you start thinking about pregnancy
If you smoke then seek help to stop smoking – speak to your midwife or your GP. Nicotine patches are safe.
You can also reduce your sugar intake, lose weight and exercise more. Simple things can help, such as walking to the shop or doing the school run by foot.
If you have any risk factors for diabetes you’ll be offered testing in pregnancy, and it’s important to have this test carried out.
If you are diagnosed with diabetes, you’ll be offered the chance to see either a specialist diabetic midwife or consultant. And you can also attend a hospital group education session, and meet other women with diabetes in pregnancy. The nursing team will teach you how to monitor your sugar levels.
You will receive ultrasound scans to monitor your baby’s growth, and you’ll receive advice on diet and whether you need further medication to control your sugar levels.
But remember that the key is to reduce the chances of getting diabetes. And if you do have the condition, it’s always best to make sure you receive expert advice that will help you and your baby.
Needing the loo in the night can signal prostate problems, but how do you differentiate between having too much to drink and needing to see your GP?
First things first, what is the prostate? It’s exclusive to men: an organ around the size of a walnut, deep in the pelvis below the bladder, that produces some of the fluid in semen. It increases in size with age, hence the urban myth that men wee more as they get older. It’s also the cause of the most common cancer in men in the UK.
Men with prostate cancer can find it difficult to empty their bladder, urinate frequently or slowly, and get up at night to go to the loo. Sometimes there may also be blood in the urine.
These symptoms are also very common with benign, non-cancerous growth of the prostate or other bladder conditions, so rather than worry or go into denial, the best thing to do is get it checked out by your GP.
Around one in eight men will be diagnosed with prostate cancer in their lifetime. Like many cancers, if picked up early, it is very treatable, and the prognosis (predicted outcome) for disease that hasn’t spread out of the prostate is very good. Some tumours may not be harmful and may not even need treating.
The majority of men that are diagnosed with prostate cancer have no symptoms at all.
Any man can ask to be tested but it’s particularly important for those who are at increased risk of the disease – if you have a family history of the disease, if you are from Afro-Caribbean descent, if you are obese or showing symptoms.
Your GP will feel your prostate and ask you to have a blood test called the prostate specific antigen test (PSA). If these are abnormal, you would need to attend hospital for a MRI scan and biopsies (where we take a small piece of your prostate tissue so we can examine it in a lab).
The biopsies tell us how aggressive the disease is. Over the last 10 years we have learned a lot about the disease and we now know that a lot of the lower grade tumours don’t grow rapidly and may not be harmful. Therefore we choose not to treat a lot of prostate cancers diagnosed, but just opt to observe them and only treat if they show signs of growing.
For men with more aggressive or more advanced disease, or who have a long life expectancy, we may choose to offer treatments. Again, over the last 10 years, there have been major advances in treating prostate cancer.
Many of these new treatments are available in east Kent. We have a team of expert cancer nurse specialists, oncologists, radiologists and uropathologists, who provide individualised care for patients, taking into account their own treatment goals and quality of life issues.
In 2011 we introduced our Robotic Surgical Programme for prostate cancer and have rapidly become one of the most experienced centres in the UK for robotic surgery, carrying out more operations than most other centres. This has dramatically improved the recovery of patients undergoing surgery and has lessened the impact that surgery has on men’s lives.
If you have any concerns about prostate cancer please discuss them with your GP or urologist.
For more information about prostate cancer, visit www.prostatecanceruk.org
Palpitations are a common symptom, usually caused by a person becoming aware of their heart beating. Most fast and regular palpitations are not due to a serious condition, but if someone collapses, or has a family history of a young relative dying suddenly, or of certain heart conditions, we need to investigate their symptoms carefully.
Palpitations that last for several minutes, with a sudden start and stop, might be due to a less serious group of conditions called supraventricular tachycardia, or SVT. This is not a structural problem with the heart, but an electrical short circuit misbehaving. Whilst seldom life-threatening, it can be very disruptive. I offer curative treatments for this, including a treatment called ablation.
The largest group of patients I see is people with atrial fibrillation (AF). This can give symptoms of irregular and chaotic palpitations, but sometimes has no symptoms at all. This condition is more common as you age, and will affect around 25 per cent of the population. It is important because it can increase of risk of stroke, especially in people with other problems like diabetes or high blood pressure.
The greatest challenge is identifying those who have the condition, and often just a simple check of your pulse can do this. If needed, ‘blood thinner’ tablets, known as anticoagulants, are used to reduce the stroke risk. In those who also have uncomfortable symptoms, there are a range of treatments available to either control the heart rate or keep the rhythm normal in the longer term.
Hearing how problems such as palpitations and atrial fibrillation can have such an impact on someone’s daily life, it is very satisfying to be able to tell patients what treatment options are available, and even more so when I see them after having carried out a procedure to see they are cured!
I started my cardiology training over a decade ago, which included a year spent in east Kent, working with inspirational colleagues and learning from some very skilled and experienced cardiologists, physiologists and nursing staff.
I have since spent several years working in large centres across the UK to gain more experience and I'm very excited to have come back to east Kent as a senior clinician to use this knowledge in bringing new services to local people.
When I was training in Margate ten years ago, we began implanting cardiac devices in patients. Before then, patients would have had to travel to London, sometimes waiting for several weeks in hospital for this procedure. Today, I still implant the cardiac devices that I learnt when I was last here, but I'm now able to offer arrhythmia assessment and a whole range of treatments that haven't previously been available to the local population. I really enjoy what I do.
Dr James Rosengarten, cardiologist and electrophysiologist, specialises in treating heart rhythm disorders and is based at East Kent Hospitals.