“What is the Sam Harris Disease™?” I hear you ask (no pun intended). Let me explain…
Two months ago, I began to experience a slight decrease in hearing and a very faint ringing in my left ear. This has never happened before, and I thought it would spontaneously remit, as spontaneously as it started. For the first couple days, I recognized that the ringing would come and go, and was more noticeable when the room was silent. Initially I shrugged it off as being a figment of my imagination, flashing back to my medical school days when we would question whether we had a serious pathological disease at the slightest symptom. When it continued for over a week, I mentioned it to my wife, who suggested I call an Ear Nose and Throat (ENT) colleague for a checkup.
I called the ENT, who suggested I come in for an exam including audiometric testing. In the couple days before the appointment, I went through an exhaustive differential of things it could be, obviously ranging from hatched cockroach larvae squirming in my ear to benign idiopathic tinnitus that I would have to live with for the rest of my life. I was able to rule out quite a few diagnoses fairly immediately. First of all, our apartment is free of egg laying pests. More importantly, I have no medical conditions, am on no medications, did not have any trauma to that ear, and do not use any illicit drugs. I only have seasonal allergies, exacerbated by tree pollen, although I had no allergy issues that month.
The ENT looked into my ear, and confirmed that my ear canals bilaterally were free of squatters, and the ear drums were normal in appearance. No build up of any wax, or inflammation noted. I was then given an audiometric exam – aka a hearing test. My acoustic reflexes were normal, the tympanogram was normal, although the hearing test itself revealed a slight decrease in high range frequencies on the left. The test itself is where you sit in a sound proof booth, have headphones on, and the audiologist says words at different volumes that you have to repeat, then you have to press a button whenever you hear a tone. The results of the exam did not surprise me, and confirmed that I heard a bit less in that ear. I then spoke with the ENT who suggested a couple things – that it may be what is called spontaneous hearing loss, as well as the tinnitus (ringing), which may have been caused by a viral infection, and that it may get better with a short course of low dose oral steroid taper. He suggested that little is known as to the etiology, that this type of thing is not rare, and that I should return in a week after taking the steroids.
The prescription was for six days, and my hearing indeed did improve. I noticed a dramatic improvement by the third day of treatment, and a significant reduction in the tinnitus. By the end of the week, the hearing loss was remedied, and the subsequent audiometric exam verified the results. The ENT reported that everything was improving, and that I should return in three weeks to ensure the benefits gained are sustained. He mentioned that the controversy surrounding getting an MRI to document a lack of structural brain pathology (think brain tumors etc) was not something he would subject me to. I really enjoyed my conversation with him, as he was able to help me rule out a number of diseases by the fact that it was only on the left. Most diseases would afflict both sides, and a brain tumor, for example, would not respond to a six day course of very low dose of oral steroids. The loss of high range frequencies is not typical of auto immune disorders. He mentioned that 100 different doctors will have 100 different theories on why this type of thing happens, and that there has been no good data to suggest what the cause is. I asked him about cell phone use, and bluetooth headset use, and he replied that there was no conclusive evidence either way. He also said that if I was worried about one ear, that I should never use any of those things with either ear, and that would not be necessary as we just do not know why it happens. I was told to cover my left ear during any loud noises to facilitate any healing occurring in the nerves in that ear, but to otherwise live my life as before.
I am still waiting for my follow up ENT appointment, and while my hearing is back to baseline, the tinnitus tends to recur – it is much quieter than before, but is still there. I will mention this to my ENT, and see what I will need to do next.
Tinnitus is a perception of sound in the absence of an external source. Over 50 million people in the US have it! It can be in one or both ears, and can be a ringing, buzzing sound, that can be constant or pulsatile. I found out that there is an American Tinnitus Association, which I may become a member of. I have been coming up with so many hearing puns and jokes that I will need a bigger audience.
As an avid Sam Harris fan, I happen to know that he too suffers from tinnitus. It was when I mentioned this fact to my wife that she coined the term Sam Harris Disease™. I then decided to trademark it – hehe. I am aware that tinnitus is a symptom rather than a disease, however calling it the SHD has made every day with this symptom much easier. I feel closer to the author it was named after, and suggest we replace the term tinnitus with SHD instead.
The SHD I have is mild, and unlikely linked to anything serious. I will not go into a long list of what tinnitus, I mean, SHD, can be caused by. I will note that SHD can be disabling, and should be followed by an ENT, as it may be a symptom of a genuine disease, especially if it is pulsatile – sEARiously.