Accessing the correct medical care and professional advice can seem like a minefield and Tinnitus care is no different. Different NHS Boards / Trusts have different pathways dependent on your symptoms and availability of specialist services, and then there is the lottery of private provision and 'witch doctors' selling their magic balms and lasers on the internet. I often see clients who have been through various other professionals and gadgets with mixed success before they see me and in many cases these therapies, which they have paid significant money for, have worsened their tinnitus impact. In our first blog we talked about the power of words and how inaccurate advice or one flippant comment can actually be the fertiliser to worrying thoughts about long term tinnitus prognosis and its subsequent impact on quality of life. It is therefore essential to get the right advice at the right time. Unfortunately growing NHS waiting lists have meant that access at the right time is more difficult, however I would signpost anyone looking for good information at the start of their tinnitus journey to the Tinnitus UK website www.tinnitus.org.uk They offer webchat, telephone helpline and also information about different tinnitus therapies and their benefits and risks. There are also excellent online support groups and many in person support groups dotted around the UK. I help to host their Tinnitus and Sound Sensitivity Online support group and attendees find sharing experiences and information really beneficial to their recovery. As a tinnitus professional I have also learned a lot about the state of services nationally.
So there are free sources of information out there but these should not stand in stead of medical assessment. Firstly lets look at NHS provision. Your GP is the gate keeper to specialist services and your first stop if you develop troublesome tinnitus. In some cases tinnitus may be associated with blocking ear wax or an underlying ear infection. If this is the case you may need to look no further than your GP. Treating these underlying causes in many cases resolves tinnitus awareness with time. If treatment by your GP has not resolved your tinnitus awareness the next stop would be either your local Audiology Department or Ear Nose and Throat specialist. As mentioned earlier, which direction your journey takes may depend on your symptoms or available services in your area. If your tinnitus is in both ears or centrally in your head and a constant tone you will most likely be sent to Audiology. If however your tinnitus is in one ear or is pulsatile, that is like hearing your heartbeat, it may be more likely that you will be referred to ENT. There are now growing numbers of specialist tinnitus services within Audiology Departments which will see all tinnitus presentations and have the ability to request specialist testing such as MRI scans if felt necessary. An assessment for tinnitus should include a hearing test, ear examination and a thorough history at a minimum. Most tinnitus management takes place within Audiology services unless an underlying treatable ear condition such as middle ear infections has been identified. Most Audiology Departments have clinicians trained in Tinnitus management, these may be Audiologists or Hearing Therapists, and they would be able to provide hearing aids or tinnitus sound therapy.
The advantages of using an NHS route is that you should be guaranteed to see an appropriately trained professional in their field and assessment and treatment is for free. The disadvantages in many cases are the waiting times or perhaps not being referred on to the correct specialist. If you have seen an ENT consultant and no underlying ear condition has been found don't be afraid to ask if there is a tinnitus specialist within the Audiology team. Most ENT and Audiology departments have close links and onward referral between departments is a normal but check if it has not been offered.
Accessing help privately also has its advantages and pit falls. Usually waiting times for an appointment are a matter of weeks rather than months or years and many people now have health insurance through their employers which often covers some of the costs. However you do not always know that the individual you are seeing is appropriately qualified or experienced in tinnitus management. There are different terminologies used within the private sector and different qualifications required. You will see the terms Audiologist and Hearing Aid Dispenser (HAD) used interchangeably. It's important to know that the qualification route for these are different and only 'Hearing Aid Dispenser' is a protected title i.e anyone can call themselves an Audiologist but a degree qualified Audiologist cannot call themselves a Hearing Aid Dispenser without additional certification. If you are looking for credentials Hearing Aid Dispensers are accredited by the HCPC while Audiologists are accredited by ACHS (previously RCCP). Audiologists are trained in rehabilitation of conditions such as tinnitus, sound sensitivity, balance problems and also paediatrics. Hearing Aid Dispenser training is focused more on hearing assessment and the sale of hearing aids. It's important to note that an Audiologist can not sell hearing aids unless also a registered HAD. If you are looking for assistance with tinnitus or sound sensitivity privately do research the qualifications of the professional you are considering. Have they undertaken additional specialist training in the management of these conditions? Many HADs have done this so do not rule them out instantly but it is not a standard. It is important to know that if you have an underlying hearing loss hearing aids are beneficial for tinnitus but it is important that these are correctly tuned and tailored to your tinnitus experience and hearing loss. I have recently seen more and more clients with aids purchased from other private hearing clinics that have required their aids retuning to maximise their hearing and also utilise the excellent additional tinnitus management available within modern hearing aids. In many of these cases if they had been set correctly initially that client wouldn't have need to have looked for further help, at their expense, because the aids would have improved their symptoms.
Tinnitus awareness will generally improve over time with the help of correct information, the reassurance of medical assessment and management techniques such as hearing aids, Sound therapy and counselling but be aware of the negative impact of poor advice or not being able to access appropriate care.
There is something that can be done.
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