Casie Keaton treats people with tinnitus, a persistent ringing or buzzing in the ears. She runs an audiology clinic in Collierville that specializes in the condition. She travels widely to study it, speaking at a conference in Denmark last year and spending several days this year learning from advanced specialists in England.
“What I want people to know is there are very passionate people out there working on solutions to tinnitus,” she said. “There’s more research now than ever before.”
Keaton, 36, grew up in several places around the South as her father took different human resources positions with a plastics company. He hoped his daughter could get a good job later in life and began training her in math at an early age. “It all started when I was 3 or 4. Every night before I would go to bed, my dad would have me do 10 or 15 math problems.”
She grew to love math and later, science. She was studying chemical engineering at Auburn University but wanted more interaction with people, so she searched for a new major and found audiology, the study of hearing, and later earned a doctorate in the subject from University of Florida.
One of her early jobs was at a clinic outside Charlotte, North Carolina. She remembers one patient in his early 30s who suffered from extreme tinnitus. She recommended some treatments. “But he really needed a formal management approach and in my training, it wasn’t something that was really emphasized.”
The case made an impact. “I did not want to be faced with that again — to sit in front of someone who desperately needed help and I didn’t have what he needed.”
She went to work for several years for Neuromonics, a company that provides sound devices for treating tinnitus. About three years ago, she moved to the Memphis metro area to be closer to her parents and launched her own clinic, first in Fayette County, then near the Collierville town square. It’s called Thrive Hearing & Tinnitus Solutions.
The name of the condition is pronounced “tin-it-iss” or sometimes “tin-ITE-iss.” Some people experience tinnitus as a ringing — others hear sounds such as buzzing cicadas or even a heartbeat.
The most common cause of tinnitus is damage to the auditory system, particularly the hair cells that transmit sound waves into electrical signals to the brain. Loud noise can damage these hair cells, she said. Many of her patients are hunters exposed to gunshots or musicians exposed to loud noise.
The brain compensates for the damaged input by creating extra electrical activity, she said. That’s where the ringing, buzzing or other noise comes from.
She compares it to the “phantom limb” pain that some people experience if they’ve lost a body part. “So the hand is missing, but the patient may report that it itches or there’s pain there. And we understand that the same mechanism is at work (in tinnitus.) The brain is starving, trying to get that input and recognizes that it’s not there.”
Sometimes tinnitus is harmless. In other cases, tinnitus can interfere with work and sleep and cause severe psychological pain. For people with severe tinnitus, the brain incorrectly labels the buzzing or ringing sound as something harmful or threatening, she said, and the person reacts with a “flight-or-flight” stress response.
Some of the treatments for tinnitus involve feeding the brain the sounds that it’s hungry for. For instance, some patients may benefit from hearing aids that amplify the sound in the environment and may also play ocean sounds or other soothing background sounds.
Some tinnitus patients may sleep better by listening to nature sounds at night, such as recordings of the ocean.
Donna Russo is 66 now, and said she’s had tinnitus since she was about 14. In her case it was associated with Meniere’s disease, a pathology of the ear.
“It just sounds like there’s this little buzzing like flies or something in my ears,” said Russo, an information technology professional who lives in Collierville. “I’ve had it for so long I have to stop and think to listen to it.”
The disease also caused dizziness, which was treated with drugs and then later with a surgery to her right ear, the only ear affected. The surgery also wiped out most of her remaining hearing in that ear, she said.
She said other specialists told her she wasn’t a good candidate for hearing aids. But she said Keaton found a way to use hearing aids to boost the hearing in her left ear and channel some of the sound to her damaged right ear. It helped.
“And now I can hear things a lot crisper and like I said, the tinnitus is practically gone,” she said. She said she wishes she’d done it earlier.
At the moment, Keaton said it’s difficult to get insurance companies to cover the tinnitus treatments, though it sometimes happens. Many of her treatments involve counseling rather than giving the person a hearing device. “And there’s no code to bill for that.” She charges a $125 consultation fee and says she typically spends an hour to an hour-and-a-half talking with the patient.
Going forward, she’s hoping to work with the University of Memphis on tinnitus research.
For more information on tinnitus, visit the American Tinnitus Association at ata.org or the British Tinnitus Association at tinnitus.org.uk. Another resource for patients is the Tinnitus First Aid Kit. Keaton’s office number is 316-8851.