Monday, November 28, 2016

TMJ Disorder and Tinnitus

As noted in a previous post I have been suffering with acute tinnitus (often referred to by sufferers as simply "T") for nearly 5 months.  It started out truly debilitating, but has now gone to a manageable level and trending better.  Here is an overview for other sufferers out there, and a warning to others to make sure you don't suffer from night bruxism.
Doctors chased my T around as an inner ear problem for several weeks, which makes sense when dealing with phantom ringing (mine is a piercing 9 KHz and usually pulsates with my heartbeat).  T is most often a problem with the inner ear, but can also be caused by things outside the ear, such as the nerves, blood vessels or joints.
The Temporomandibular Joint (TMJ) is a ball-and-socket joint where your jaw comes into a receiving area in the skull.  When your jaw moves, the end of your jaw rotates around this socket.  As you can see from the image the only thing separating this socket from your inner ear is a little piece of cartilage.  And if that cartilage gets pinched or deteriorates, your inner ear gets impacted, which can cause everything from tinnitus to vertigo.
The set-up for my T started out with orthodontics 35 years ago that set my jaw too close my skull.  This crowded and removed any "guard band" for the cartilage cushion.  Over the years, day and night bruxism (grinding of the teeth) kept compressing this space until it deteriorated, causing tinnitus. 
Figuring all this out too two brilliant doctors, who I feel lucky to have found.  Most tinnitus comes with hearing loss, which I didn't have.  TMJ usually comes with pain, jaw clicking or other symptoms, which I didn't have. So I had T and few other concrete symptoms except: the level of T changed when I turned my head or pushed on the side or back of neck, and the T seem to come down some when I drank alcohol.
It took a very old, nearly retired ENT to figure out from these two symptoms I had some sort of TMJ Disorder.  It took another old, and a bit wacky, TMJ Dentist to figure out the why, and come up with a treatment plan.  The insurance companies consider TMJ Disorder a "dental problem", not medical, and there is no dental plan in the world that is going to cover all the expenses with TMJ.  People with this disorder have to dig deep into their own pockets.
After four months of treatments with "orthotics" (bite plates for sleeping and eating), and a few months of massage therapy around my neck and jaw, my T has gone down significantly.  The inflammation of the TMJ area, which caused the T to change when I turned my head or pushed on my neck is gone.  But now I can’t touch my back teeth any more (I haven't had anything firmer than sushi July).  Once my jaw was "relaxed" to a more natural state that took pressure off the TMJ, it didn't want to go back.  So at nearly 50 I am now back in braces to restructure my entire bite.
The hope is that in 12-18 months a new bite will allow me to chew again, plus allow the inner ear/TMJ area to heal completely and remove my tinnitus.  I am hopeful of the treatment plan due to the progress so far, but I know there is a good chance that I could have low-level T the rest of my life.
For dealing psychologically with T, that will be another post.

Monday, November 21, 2016

American CEOs Should Put Americans First

Tuesday, November 15, 2016

Why "Tech" Changed from Conservative to Liberal

I have worked in tech for over 25 years, and way back when I started the vast number of people in tech were conservative.  Of course back then tech companies actually designed and manufactured things you could touch and feel (and they were still mostly manufacturing in the US).

These "real" tech companies had to employ engineers who had to deal with trade-offs, limited resources, and the real-world consequences if their devices failed.  They had to be grounded in the real world, which gave them a conservative outlook on things.  Engineers know there is no such thing as a free lunch.

So last week when I was reading about "liberal" Silicon Valley's reaction to the election, I had to stop and think why there was a change from conservative to liberal.  A few thoughts came to mind:

  • A Lot of Silicon Valley is Not High Tech - Facebook and every other social media company are not technology companies, but media companies. Salesforce and the other "cloud" companies couldn't engineer themselves out of a paper bag.  They didn't build the phones or computers users read them on.  They didn't design the networks.  Or sever farms.  Or much of anything else.
  • Software Isn't Engineering - Software engineers don't recognize trade-offs.  Ever wonder why your computer needs just a little more memory, a little more processor power, and a little more bandwidth to run that software program?  It's because the software engineers didn't bother to deal with the resource tradeoffs.  They did what they did, and let the users deal with the consequences of their bad planning, just like liberals. 
  • Riches and Wealth - Back in the day people did tech because it was cool.  It was interesting.  And you made an okay living.  It paid better than manual labor, but less than medicine or law.  Today people rush into tech to get rich.  These people have fewer principles other than themselves, and people who receive millions of dollars in stock options in their 20s or 30s have no concept of the real world.  Political policies and laws that hurt others have no affect on them.  They are free to virtue signal how great they are, and have money left over for an overpriced Tesla and a vacation in Europe. 
  • More Women (and not in engineering) - The few women engineers I've encountered are either conservative or too far over the Asperger curve to care about politics.  In the mean time the HR, PR, Legal and Marketing departments have gotten stuffed with women, mostly as a result of companies trying to make their "numbers" look better.  The number of women in engineering will never match the number of men in engineering since it is just a simple fact of nature that men are better in math and science.  That same nature also makes women trend more liberal than men.
  • H1B Visas - Those of you outside of tech or Silicon Valley have no conception of the broad abuse of H1Bs visas by the Silicon Valley titans.  I have walked through company corridors for meetings thinking I had landed in another country.  And it has nothing to do about "finding talent". It is all about lower wages.  If it was about talent you would see a broad spectrum of H1B workers at any given company.  But it is not that way.  At a given company it is all from a single country: All Chinese.  All Indian.  All Pakistani. And these slave wage earners care nothing at all about the US or other Americans.  They want to keep what is (to them) the gravy train, and that won't be with a firmer immigration system.
  • Disconnect from The US and Reality - The last thing about Silicon Valley (I don't work there, but work in tech and visit there), is that they are totally disconnected from the US.  The average worker there lives in extreme poverty compared to lower class people in, say, Texas.  They pay well over a million dollars for a 1500 square foot crap-shack and commute over an hour each way to go to a job that pays over $100K, but they live this crap lifestyle thinking they are not only better than anyone else in the US, but that they will get that multi-million dollar payoff one day. 
In short, Silicon Valley has become disconnected from the US and from reality.  I don't see it getting better without a yuge and long correction in tech stocks and VC malinvestment, which means no time soon.

Friday, November 11, 2016

Tin"ah"tis or Tin"eye"tis it Still Sucks

I woke up with tinnitus (I say it with "eye" in the middle, both ways are acceptable) on July 16, 2016.  This began a remarkable journey to discover what I had, why I had it, and how to get rid of it.
For those who don't know what it is, tinnitus is a constant ringing in the ears.  You hear it at all times: when you go to sleep, when you get up, when other people are talking.  There is no escape from it.  No drug will turn it off.  It is constant and unending.  
To imagine a bad case of it: suppose someone attached a fog horn on each of your ears and turned them on 24-7.  You have no way of lowering the sound or turning it off.  Now imagine how long you could last knowing that there would be no relief from it for the rest of your life.
Many who have T at a very loud level over an extended period of time commit suicide.  Others at a high level are debilitated as it prevents conversation, sleeping, reading or any other normal activity. 
Tinnitus is caused in several ways:
  1. Noise Induced Inner ear damage - The vast majority of T is the result of loud noises like explosions, gun shots, or even very loud music (Ozzie Osborn and other musicians have it).  It can also be caused by extended occupational noise like a jackhammer.  In these cases the ear becomes deaf only at one frequency, and the brain tries to make up for the missing signal by turning that pitch constantly "on".  In the case of sudden noise induced T (gun shots, concerts), sometimes the T will go away on its own in a matter of weeks or maybe months, but if it is chronic there is no cure.  In most cases the only relief is for the suffer to adapt, or use sound therapies such as hearing aids that pump in alternative sounds.
  2. Drug Induced Inner Ear Damage - The inner ear is very delicate and can be can also be damaged by "ototoxic" drugs, most of which can cause permanent damage, but some are temporary (like aspirin).  In the case of permanent damage, these people are in the same category as the noise-induced sufferers above.  (Note: Be VERY careful of antibiotics, many of which can cause permanent tinnitus).
  3. Somatic Tinnitus - This is tinnitus caused by some sort of problem surrounding the inner ear, such as problems with the blood vessels, tumors, or the temporormandibular joint (TMJ).  It is estimated about 80% of somatic tinnitus sufferers can get cured.  Sometimes somatic tinnitus pulses with the heartbeat, and gets the name "pulsatile tinnitus".  In rare cases a doctor can actually hear the tinnitus as well if it is caused by a constricted blood vessel or structure, making it "objective tinnitus" (a sound both the sufferer and another can hear), rather than "subjective tinnitus" (only the sufferer can hear).
So like "fever", tinnitus is not a condition it itself, but a symptom of an underlying problem.  And the ones I listed are just the main ones.  There are a few other rare causes and diseases of the ear (like Meniere's disease), and a huge number of people at the support site Tinnitus Talk have no clue what caused their problem, even after many years of searching.  But to address the T and find out if it is permanent, you need to figure out what is caused it. 
At first I didn't know what caused mine, only what it was like: a high-pitched, piercing whine at 9Khz, like the sign-off signal of TV stations way-back-when.  Most people with T experience a whine like mine, but some experience "whooshing", "crickets" or other noise.   The noise level can be so low that it can be ignored (I'll call a Level 1), to being so loud it is the only sound the person hears (Level 10).  Anything 7 or above is incredibly debilitating, and it is when it is chronic at this level that leads to suicide.  I had peaks of 7 at the beginning, but today am a 2 and hoping to get lower. 
I said my T started July 16, but that is actually when it was "on" all the time.  The fact of the matter is that I experienced low level tinnitus for a long time but ignored it.  Before July 16 it was either too low to notice (Level 1) so I heard it only when absolutely quiet, or it only happened in certain situations (when I yawned, when I turned my head sharply in one direction).  Like a sore joint I just thought it was apart of aging and ignored it since it didn't bother me.
On July 16 the T was not too low to ignore.  It was equal in volume to general conversation, Level 3-4.  And it did not go away.  In fact it seemed to be increasing in volume.   I was worried.
I went to the doctor and they said "swimmers ear" and gave me drops.  A week later they said I did not have swimmer's ear and that "tinnitus happens".  Don't EVER let a doctor tell you that!  Always, always get a second opinion.   
It took me two weeks before I could see an Ear Nose Throat Doctor (ENT), and during that time my worry and anxiety only got worse. The T continued to increase and I was convinced I was going deaf.  My T was now peaking at a 7 and I couldn't work, read or concentrate it was so loud.  I would sit across the table from my wife at dinner and see her mouth move, but all I could hear was a high pitched whine.  It was quite horrible.
The ENT took an audiogram (hearing test) and my hearing was perfect.  Usually when there is inner ear damage causing T, there is related hearing loss at that frequency.  So I did not have nerve damage.  It was not caused by loud noises.  I work in an office so there was no occupational issues.  The doctor was stumped as we sat and discussed it. The "ah hah!" moment came when I told the doctor that my T changed in loudness when I moved by head up, down, left or right. I also noted that the T reduced somewhat when I drank alcohol.
Based on these two issues, the doctor said that my T was caused by temporormandibular joint disorder, called TMD, but often referred to by just the joint name "TMJ".
So I had a cause, but what was the cure?  How would I get my tinnitus down?  That is for another post.

Thursday, November 10, 2016

A CEO (President) Doesn't Run the Company (Country), the Staff Does

One of the reasons I am so thrilled about the election is not Trump himself.  Now I think he's great, but as "true conservatives" have pointed out no one would have called him a "conservative" before the election. 

But the fact of the matter is that a leader's white-tower philosophy is not what counts, it is the goals he sets, the people he puts around him, and the culture his team creates.  And those goals and culture flow all the way down to the worker-bee level to decide what gets done and what doesn't.

The federal bureaucracy is made up of 100s of 1000s of people.  Each day they make literally millions of decisions: Of all these immigration applications, do I push on the Muslim ones and let the others wait because I know the top guy wants that?  Of all these EPA rules I see broken today do I enforce the obscure rule that some rancher in Wyoming broke, or the toxic dumping by the company whose CEO is chummy with Obama?   Do I hold this illegal immigrant and send him back, or do I let him slide since I know the very top guy is open borders?

The President doesn't run the country.  The bureaucracy does.  And for the past eight years they have collectively enforced social engineering (like trannies in the military), open borders and mass Muslim inflow rather than the collective interests and culture of the people they are supposed to serve because that is the culture Obama created.  Those were the goals he set. 

Now there are new goals, and even before Trump announces his cabinet, the bureaucracy knows what his goals are.  So I am hoping that the worker-bees in all the thousands of government offices across the US are already looking at their inbox and making "Trump decisions" about which paper to push, which law to enforce, how to stop being sloppy on immigration.  They know who the CEO will be in two months and what work will be rewarded.