tinnitus

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Phantom noise 

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Your Health - Dr. Gita Mathai

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Noise can be loud and irritating. The good thing about external noise is that it can be shut out. Phantom noises — ringing, buzzing, roaring or hissing — varying in intensity and pitch continuous or intermittent, in one or both ears can only be heard by the affected person. They are called tinnitus and cannot be shut out. Sometimes it feels like an insect is trapped in the ear. The sound is disconcerting, and distracting. It is a common problem. The risk of developing tinnitus is higher in men and in smokers. About 25 per cent people experience it by the age of 70.

Tinnitus may be caused by a variety of reasons. It may be due to age. A type of hearing loss called presbycusis often accompanies it. This may be because the fine hair (cilia) in the inner ear die or are damaged. The bones of the inner ear may be damaged. This is called otosclerosis and may run in families. The nerves may not conduct sounds as efficiently. Atherosclerosis and high blood pressure may also cause tinnitus. It may be something as simple as the ear being blocked by wax.

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Temporary tinnitus can occur with sudden exposure to a blast of loud noise. This may be accompanied by pain in the ear. Continuous long-term exposure can make the damage permanent. This occurs in younger people who continuously blast music from electronic devices.

Changes in the fluid pressure in the inner ear can occur on one side. It can cause a feeling of vertigo and tinnitus. It is episodic and can be accompanied by hearing loss. It usually goes away on its own in a year or two.

The temporomandibular joint is situated at the angle of the jaw next to the ear. Muscles used in chewing, the ligaments of the jaw and nerves transmitting sounds share some common entities with this joint. Pain, swelling, arthritis or dislocations of this joint or an accident, especially if there has been injury to the head as well, can aggravate tinnitus. 

Tumours in the head and neck or the eighth cranial nerve that transmits hearing can cause tinnitus. This can be picked up with CT scans or MRI.

We live in an era where antibiotics are prescribed for the mildest infections. Some of the commonly used antibiotics like erythromycin and gentamicin, and some of the higher ones like vancomycin, polymyxcin and neomycin can affect hearing and cause tinnitus. Diuretics like furosemide (Lasix) and quinine used for malaria can cause similar effects. Aspirin is one of the oldest medications prescribed for pain. In high doses (twelve 300 mg tablets or more) it can cause tinnitus.

Tinnitus is investigated with a hearing tests, CT scans and MRIs. No real cause is usually found. This is depressing for the patient as the continuous sound interferes with sleep and concentration.

Medication does not work well for tinnitus. The irritating sound can be masked with white noise (sounds of waves or rainfall) playing continuously. Hearing aids will help if there is deafness as well.

Some yoga exercises like the triangle pose, camel pose and downward facing dog are found to be beneficial. You can also stimulate the eight nerve by blocking the ears with the forefingers and making an “ooh” sound. Couple this with walking or jogging for 40 minutes a day, light weights and exercises to strengthen the head and neck.

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Dr Mathai is a paediatrician and author of 
Staying Healthy in Modern India. Mail your
questions to yourhealthgm@yahoo.co.in

Bye-bye bellyhttps://www.telegraphindia.com/1170529/jsp/knowhow/story_153930.jsp

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Your Health - Dr. Gita Mathai

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Everyone wants a flat and toned six pack abdomen: the youngster trying to zip up a pair of pants, the middle aged executive trying to hold his stomach in and the mother squeezing herself into a "shaper" and blaming childbirth for her loss of form. No one wants a paunch or potbelly.

You know you have a paunch when you:

• Are no longer able to see your toes when you stand straight

• Swing your arms across your body while walking and not side to side

• Have BMI (body mass index: weight divided by height in meter squared) greater than 27

• A waist circumference more than 35cm (women) or 40cm (men)

• Are able to pinch up more than inch of subcutaneous fat on the back of the arms or abdomen.

The bad news is that after the potbelly, which is aesthetically undesirable but fairly harmless subcutaneous fat, fat starts getting deposited around the organs inside the abdominal cavity as visceral fat. It is a risk factor for diabetes, hypertension, stroke, gall bladder stones, arthritis, some cancers and dementia. The effective area available for breathing decreases as the abdomen pushes up against the chest. This causes sleep apnoea and snoring.

Once you start gaining weight, the area where fat is deposited is genetically determined. Hips and thighs usually increase in size first, followed by the paunch. In some unfortunate individuals, any increase in weight first shows up on the belly. The abdominal contents are held in place by muscles. These get stretched during pregnancy. The "core muscles", the entire group of muscles between the chest bone and hip bone, have to be strengthened for good posture and a flat abdomen. Weak abdomen and core muscles contribute to the protruding belly.

Very rarely, the sudden appearance of a paunch may be due to accumulation of fluid in the abdomen or a tumour. It is worth visiting a physician if the change has occurred within a short span of time.

There is no food supplement, medication or miracle exercise to get rid of just the paunch. Without overall weight loss, crunches will only strengthen your muscles, not get rid of the paunch. Also during the weight loss process, weight from other areas such as the cheeks, neck and arms may go before it makes a dent in the paunch.

Men require around 2,500 calories a day and women 2,000. A person with a sedentary lifestyle needs only 1,800-2,000 calories. If you can maintain a caloric deficit of 500 calories a day, it will result in weight loss.

Weight loss diets succeed when they are close to your normal food habits. Reduce intake of snacks, fat, aerated beverages, and refined carbohydrates. Serve all the food on the plate and estimate the calorie content. Do not have a second helping no matter how tasty the food is.

Dieting needs to be combined with exercise to prevent loss of muscle mass. If you have the time then try an hour of brisk walking, jogging, cycling or swimming at least five days a week. If there is no time, you could do 10 minutes of HIIT (High Intensity Interval Training) or stair climbing. Remember to run up the stairs but walk down. Climbing them two at a time is also a good idea. Exercises using light weights, crunches and core strengthening are essential and beneficial.

Losing a paunch and keeping it off is a lifetime commitment.

Dr Mathai is a paediatrician and author of Staying Healthy in Modern India. Mail your questions to yourhealthgm@yahoo.co.in