Katelyn was on I-95 driving home from visiting friends and family when another car crossed two lanes of traffic and struck her vehicle. The next thing she knew she was on the side of the road covered in glass, calling the police.
At first the 31-year-old Pennington resident felt lucky that she walked away with some glass cuts and whiplash. But as the weeks went on, she began developing a string of neurological issues, including slurred speech, vision problems and numbness in her hands and feet. But one of the biggest problems was her hearing.
Katelyn began hearing a constant ringing in her ears. And ordinary everyday sounds were suddenly amplified to an intolerable degree.
The radar detector in her boyfriend’s car sounded like an air horn. She could hear someone whispering from three rooms over. She couldn’t stand to have the television on the lowest volume settings.
“I felt like I was at a concert in the front row all the time,” Katelyn says. “My head was pounding, my ears were throbbing. It was like a sensory overload.”
Katelyn was suffering from a combination of tinnitus and hyperacusis, two hearing conditions that can be caused by accidental head trauma as well as certain medical conditions and normal degeneration of the ear.
Tinnitus is a phantom sound that is continuous, usually described as a ringing sound by most sufferers.
“When it’s temporary you hear ringing in your ears that stays on for a few seconds and goes away,” says Lorraine Sgarlato, Au.D, audiologist at Robert Wood Johnson University Hospital (RWJ) Hamilton. “The type of tinnitus that’s problematic is when it doesn’t go away and people can’t ignore it.”
Hyperacusis is a condition where the ear becomes very sensitive to sound, and loud sounds are heard as extremely loud/intolerable. Normal sounds like a bell, whistle and loud voices become very painful to the ear.
“It changes the brain’s interpretation of sound,” Dr. Sgarlato says. “What would normally be considered loud is instead perceived as excruciatingly loud.”
The combination of both conditions made normal everyday activities nearly impossible for Katelyn. Despite wearing ear plugs and noise-canceling headphones, she wasn’t able to go to work, continue teaching Zumba classes or even leave the house some days.
“My boyfriend is a professional musician. I thought I would never be able to go to a show again,” Katelyn said. “At his sister’s wedding I was essentially in the lobby the entire time after I ate. I had to listen to speeches through the wall.”
Retraining the Brain
Katelyn came to RWJ Hamilton in May of 2014 and began working with Dr. Sgarlato to try and find a treatment for her conditions.
First they attacked the tinnitus using a sound therapy device similar to a small iPod with ear buds. The device emits a sound that can be matched to the pitch of the noise the patient is hearing as closely as possible, and then set to a more pleasing sound like white or pink noise, or even rain falling.
“You brain is always going to gravitate towards what sound is most pleasant,” Dr. Sgarlato says. “The goal is to put the tinnitus sound away from your attention and in the background so you can go throughout your whole day and not hear it anymore.”
Katelyn wore the device for several hours a day and over the next year and a half found that her brain was gradually retrained to ignore the ringing from the tinnitus.
In February of 2016, Katelyn and Dr. Sgarlato started addressing the hyperacusis by using another device similar to a hearing aid that distracted her brain from the excruciatingly loud sounds.
“We shut off the amplification and added the sound therapy and this worked perfectly for her,” Dr. Sgarlato says. “We gave her the option where she was able to change the volume based on what she was doing and even change the sound itself.”
Slow but Steady Progress
There is no cure for tinnitus or hyperacusis, only treatment to alleviate the symptoms. And the process can be frustratingly slow.
“It’s definitely a progressive thing. You’re retraining the brain,” Katelyn says.
She has hit small milestones: Returning to work. Exercising at the gym. Even seeing her boyfriend perform.
Katelyn says about the advancements in sound therapy, “It really shows how fortunate I am.”
One of the things that helped Katelyn during her therapy was tracking her progress in a log. Just a few sentences a day provided comfort and encouragement on days where Katelyn had difficulty believing she was making any improvements at all.
“The treatment takes so long that you might have days where you say ‘I still don’t see a difference,’” Katelyn said. “But if you can go back and read what you wrote a month ago, you might say ‘Well I’m not there yet, but this is definitely a significant change.’”