Episode 175: Steve Martin / Tinnitus (Part 2)

[Music] today we'll have part two of our discussion of Steve Martin and we'll be discussing tenidis this is Doctor versus [Music] comedian I'm Dr ASF DOA and this is the doctor of laughs not a real Doctor Ali Hassan every episode I pick a topic for Ali from Comedy and entertainment and I question him about it then Olie picks a topic for medicine and health and grills me on that topic now last week we did part one of our discussion of Steve Martin and it was so long we had to divide it into two parts so today we're going to be talking about the latter half of Steve Martin's career he is still active and alive and you know doing entertainment and then because Steve Martin suffers from tenis in our medical section we're going to talk about that disorder right Ellie yes I knocked the out of my headphones and didn't hear the last 10 seconds what am I agreeing to exactly what was your last words we are going to be talking about Steve Martin and tened this is basically that I think we should just get started here guys you bet and you're still a little Sicky MF huh the doctor is sick the tables have turned exactly so apologize to everybody if my voice is a bit off I was sick then I got better then I got a sinus infection anyway this is probably too much information for for every future subject future subject sinus [Music] infections yeah Steve Martin you know partly because of his the work he's done in his life that this has been a double episode but also I think gossip and I are both pretty fascinated by this guy he really is an impressive impressive figure so our first episode you haven't heard it I definitely recommend that you we talked mainly about his his stand-up comedy and speaking of remarkable there are so many people myself included and I counted myself as a Steve Martin fan until I read his book born standing up by the way I didn't know the nature of his standup comedy when you talk about Robin Williams and Richard prior and George Carlin and all these superstars of the 70s somehow and I don't quite understand why but he gets left out but I guess he wasn't at the comedy store in La he wasn't at those clubs with these guys but he was doing Arenas and he just sort of existed in a in a in a world all of his own and his his fans were just super fans he transitioned to film in the late 70s with a movie called The Jerk you saw that did you o you know what I never saw it and I almost watched it for the first time in preparation for this I just ran outad of time and I think we should comment when we go through his filmography about ones that he wrote so he definitely wrote The Jerk so you've seen it what did you think about the jerk I've seen it I don't remember it that well but I remember being very amused by it certainly it's I don't think we had seen a character like that before I think I remember a combination of discomfort and amusement but I was also like you know I liked Steve Martin so I was I was watching it with an open mind and you know it's an interesting thing he started doing films because the road and that Arena life doing you know 50 Arenas in 60 days was exhausting and he got to that point you know a lot of musicians talk about this you're like man I don't it's all blending in together I don't remember what city I was in yesterday what city I'm in tomorrow and he said movies was a savior from that because he's like I don't have to go to people I just show up on set say align seven different ways and then boom you know he's obviously right very minimalizing it people come to me in other words they go to the theater and they watch and he doesn't have to go anywhere quote unquote compared to what he was doing the commute to a a movie studio was very minimal I think we'll do with his movies is we I'll just list like you know a couple of movies from different periods and you could talk about whichever ones you want so from the early 80s after the jerk it was Penny from Heaven very interesting this was like a musical that he decided to do a bit more serious sounds like it was a flop I never saw I remember it coming out he talks very openly about it being a flop but everybody around him had sort of built it up to be this incredible thing everybody was waiting for it it was going to be amazing and yeah it didn't land so he took a big swing didn't get that and by the way I'm going to take an aside right here there is a book out which they talk about a lot it's called number one is walking and this is Steve Martin's kind of as Ali said he did an a a biography which was born standing up this is kind of a biography of all his movies but done as cartoons he he works with a New Yorker cartoonist and they talk a lot about this so it's like an illustrated Memoir basically I didn't even know it existed honestly till I saw this documentary I totally want to get this it sounds like right up my alley I think I'm going to really enjoy it so I highly encourage people to check that out if they haven't read it already anyway we'll go through some of these movies P from we talked about dead men don't wear plaid was 82 the Man with Two Brains I don't even remember that one that I remember these coming out I never saw them uh the lonely guy and then 1984 though all of me did you see all of me OE I did not see all of me either oh my gosh I can't believe you saw it so all of me is this directed by Carl Riner and Steve Martin and Lily Tomlin again Lily Tomlin people maybe not remember she was a huge comedian at this time 70s and in early 80s and so it's a body switching comedy where they it's a long story about what happens but they basically transfer bodies anyway you've seen it you know back and bowl back and b anyway it's probably racist now but it's definitely worth I thought it was hilarious when I saw it you know 85% on Rotten Tomatoes it's quite a farce I don't know if it holds up again I saw it in the 80s I think I even saw in the movie theater somehow I don't even know how that happened anyway it was certainly fun back in the day I maybe a rewatch it to see but app you should rewat it I'm just looking at it and the character of Guru praa Lassa yes was played by Richard libertini you know I mean when you watch it you might be like what's going on here's yeah I think people know Richard libertini he's a character actor who's been lots of things anyway he is not an Indian guy and of course it's the Indian guys kind of powers I believe that are allow them to switch bodies anyway listen like I said the you know but the the physical comedy and the ComEd timing of Lily Tomlin and especially Steve Martin is quite good again from what I one of the biggest superstars of that time Lily Tomlin for sure started on stage as well just like Steve Martin similar Journeys in a way and her bits as well on stage very well remember we were doing the Bob newart episode a couple of episodes back Lily Tomlin comes to mind with a similar style as telephone operator character that she developed yeah and then Steve Martin has a string of about 10 movies I'm just going to list them and then we're going to talk about you know we'll select some to talk about them but this is between 86 and 1991 okay so not that long a time you're ready Three Amigos Little Shop of Horrors Rock sand Plaines Trains and Automobiles Dirty Rotten Scoundrels Parenthood My Blue Heaven LA Story Father of the Bride Grand Canyon this is like amazing because in this does a whole bunch of different things obviously little shop is uh musical comedies but then he does Grand Canyon right and My Blue Heaven he playing this like gangster right so it's an LA Story you know of the ones he wrote he wrote Three Amigos roxan LA Story out of those ones so Oli what do you want to talk about about Three Amigos we got to start with that one right go are with Three Amigos Netty netherlander that was Martin schar's first time in film and his first time think working with Steve Martin in in in that way right because as we talked about with Martin Short he only had one season on Saturday Night Live but he did so much we think it was six years he played exactly so yeah Three Amigos really sort of launched him and this Trio really worked very well together I don't know if it'll be as funny now yeah I was going to say I show my children I haven't seen it since I'm going to say the ' 90s maybe 2000s just one of those I saw it once I saw it once in the 80s I'm sure I went to the movie theater for it but yeah I don't know the reason I bring up will it stand the test of time I don't mean in in terms of like inappropriateness I just mean like will it be as entertaining we loved it because we knew these Three Amigos and they're together and it was amazing right and I also mentioned that cuz one of my favorite holiday movies and we don't talk about it enough because we always bring up Die Hard or Love Actually or Planes Trains and automobile is very much a holiday movie and I tried to show it to my daughters and they were so bored and I was like I'll I'll kill you both right we have to turn off this movie before I throw you both out of the house this is an fantastic movie but they just didn't have that same connection with it I'm willing to give it a try again in the house I'll try to punish them again one of my wife's favorite movies she loves that movie loves John Candy you know what that might help the kids if I tell them it's uh it's a yeah we should yeah we should maybe watch it our families together kid I can just picture our kids texting the words lame to each other in in text messages while they're watching you know we could talk about whichever other ones you want on that list that I got up to but the Father of the Bride was huge you know fun family comedy but I think like I said the ones he wrote Rock San where he's like how could I make the Sero de bersak you know modern and that was great but LA Story I loved LA Story man when they came out I thought it was just really really well done this idea of this guy kind of lonely in La the conceit was the signs the LA road signs we kind of talk to him and give him messages these automated signs I don't know I really enjoyed that La story was a sweet movie I will say the LA Story is 1991 I'm more I was more of a thinking human being by 1991 but 1986 was rockan you know the police had a song called rockan which I loved there was a girl named roxan in her High School a complete badass she was great person and I was already going in I I love the name Roxette this movie like I remember watching it really soon after it came out I I just remember feeling something very different the earnestness and the sweetness and the the kindness of this character and of course Daryl Hannah was so fantastic to be just such an endearing person you knew why somebody would be in love with with Daryl Hannah's character I remember that movie having such a profound effect on me I just remember being like wow this is acting this is something this is something different like this is not just a comedian doing things and of course I felt that again since Robin Williams there's many comedians who can do such great work on film but I really remember feeling like kind of emotional heartstrings being pulled and I was like I don't know what this feeling is but this guy did something with his acting that movie is very very sweet I mean really really well well done the acting is is phenomenal and even the guy who plays the Meathead I can't remember his name the guy who you know surrounded the bersak Steve Martin's character is speaking on behalf of this firefighter Meathead even he was really good he was a great Meathead you know he did a great I don't know I I have to watch it again but I remember that movie having a really profound effect on me yeah no it it was great and like I said you know you look at the ones that he writes there is this idea that comes out in the documentary about him being a lonely person you know look at rockan he did a movie called The Lonely guy I mean you know there is this idea of him being very alone for most of his life he had various Partners throughout the years and he only really got married recently in the 90s to a New Yorker editor actually for the New Yorker because he would write a lot of pieces for the New Yorker and it was one of the editors that he worked with and now he has a daughter with her so it's very interesting the other thing that's very interesting when you think about Steve Martin life is he had a very let's say difficult relationship with his father and his father actually moved to California to become an actor like that's what his wife and him wanted for their family and he was a failed actor and that's something that he never really you know every time Steve Martin would get something you know see be in a big role or something he'd be yeah well you're not as good as this or oh you know this you know and yeah you could tell that really effective Steve Martin I don't think he would have said that years ago but that's probably one of the reasons why he's so closed off and and this idea of loneliness with him he never really got that good relationship with his father there's an interesting juer position too with the loneliness which they mention in the documentary that he's also been the father of something like I don't know what it was 70 different children in not but 20s something in on TV Oh I thought it was more because of Cheaper by the desert in Parenthood alone was yeah exactly but then he never had kids of his own until most most recently yeah exactly so then he did leap of faith a simple twist of fate Father of the Bride part two he did The Spanish Prisoner in 1997 did you ever see the Spanish Prisoner I don't think I great movie written and directed by David mammo great movie and David mammo it's all about this kind of confidence scheme that's going on these grifters very well done I really enjoyed that movie when I saw it back in the day and then he did a movie that Alie and I have talked about several times again he wrote this and he worked with Frank Oz again we talked about Frank Oz on our Jim Henson episode Frank O directed many many movies with Steve Martin they worked very closely together and I think Frank O has a very good handle on Steve Martin as an actor and as a person they seem to have a very good relationship but basically Bowfinger came out in 1999 and the idea is that Steve Mar plays B finger he's trying to direct a movie but he doesn't have any money so he tries to film in secret this movie star and that's the premise of it it's so much fun it's great uh Steve Martin Eddie Murphy I don't know if it gets as much credit as it probably should for being such a funny movie yeah yeah that was great it's interesting I had no idea that it was directed by Frank Oz how would I have ever known that you know Frank Oz lived in the shadows right when I was but yeah looking at you teren stamp and Heather Graham it's like all these people I have to watch this again it's very very clear that I remember enjoying it but I think as an adult and somebody who's interested in acting and this is really about you know producing his first movie and doing like method acting and this kind of stuff it's uh I'm sure I'll I'll enjoy it now he then did as Ellie mentioned Cheaper by the Dozen he did shop girl which I don't think I ever saw he also wrote that that was based on one of his novellas but I don't think I ever saw a shop girl Claire Dan is in that I believe then he did the Pink Panther movies he did Pink Panther one and two playing in Spectre cluso a bit of a big deal you know trying to take over such a legendary role I never saw those because this was he was kind of going into a bit more of the family stuff so I never saw did you see those H I saw the first one it was good you know I mean Peter sers those are big shoes to fill those are very big shoes to fill and it's tough to not make that comparison if you watch the UK office the first time time you watched the American office you know that feeling you had and it took like five episodes for you to be okay fine this is its own thing I feel like you that was my feeling with the Pink Panther I'm like okay clo there's only one cluso and you know by the end of the movie you're like okay fine he did a good job but it just takes so long for somebody like me who's just Associated one person with that role and played so brilliantly but I know it speaks to Steve Martin's own you know confidence in himself he probably did it as an Ode to Peter sers as well you know I'm sure he's he recognized Peter sers genius and just the fact that you'd do that you'd want to do that that's good for him yeah if you have no Peter cers in your brain you should definitely watch it let me just say that yeah exactly so the other thing he did which I think a lot of people don't know is he's also written lots of plays like we talked about he writes a lot he writes a lot of New Yorker articles but he wrote a play I don't know if you ever seen this one I saw it years ago maybe like 20 years ago or more Picasso at the pan ail which is a play that he wrote in 1993 I think I saw it produced probably in the late 90s and it features Albert Einstein and Pablo Picasso meeting at a bar which called the Leen ail in Paris and their conversation that kind of occurs it's really well done it's smart it's funny there's an appearance by a uh certain musical celebrity in the at the very end of the uh play did you ever see it Olie no I didn't I feel like you can spoil who the musician is Elvis and like a spaceship that occurs at the very end but anyway it's it's a lot of fun you can do a spoiler of a play from 1993 there's not really any way that you know I mean I didn't know this he made a musical called bright star himself and Edie burel and that it debuted on Broadway in 2016 and it got a lot of praise it or got five Tony Award nominations and he got a Grammy award for best musical theater album so pretty accomplished he also did a comic play called meteor shower which apparently is like quite funny and was performed originally with Amy Schumer and ke and Michael K so I don't know he's very accomplished from a writing point of view as well like I said I didn't even know about this book that he had with these cartoons he does a lot of these cartoons with this New Yorker artist and then by the way he did returned to standup in 2016 he basically opened for Jerry sefel just did a low-key impromptu 10-minute set and then turned the stage over to Seinfeld these guys are also quite good friends and then he realized he he obviously he's been friends with Martin Short for years since the early 80s and they just decided to start doing a two-man show that you guys may have seen there's a special on Netflix which I watch recently which is a lot of fun I definitely one of my goals is to try and see them live together if possible and he liked working as a team I think he thinks it's less stressful it's more fun for him the it's basically them just insulting each other the whole time and making jokes about each other exactly but they also get to do some musical stuff because Martin Short loves the stage and Broadway Type theater so he get do he's a great has a great voice he can really sing and Steve Martin does a lot of his banjo stuff as well because we didn't get into that but he's also a very accomplished banjo player and plays with a whole bunch of bands and has albums out it's quite amazing really yeah if you go to think so you know you mentioned that that show with uh Edie brel and Edie brel you would know from it's Cowboy Junkies no no she's the Edie brel the new Bohemians new B and she's married to Paul Simon now but that's not how most people know her but anyway a very accomplished musician who who I have not whose band I have not committed to memory but I know her from her solo work the New York Times review of that show of that Musical that he did it was called bright star it says The Shining achievement of the musical is its Winsome country and Bluegrass score with music by Mr Martin that's Steve and Miss brel lyrics by miss brel the songs yearning ballads and square dance romps rich with fiddle piano and banjo beautifully played by a nine-person band provides a buoyancy that keeps the momentum from stalling and as you said five Tony Award nominations and Steve Martin received his own you know best book of musical best original score think about how much work goes into just that just the rehearsals with a nine-person band making it a musical making it a a musical that is like worthy of a Tony I mean that's that's a year and a half of your life if I just think about how much work that is leading up to it writing it creating it and then you know rehearsing it and then doing it this guy is quite a machine and I think in that itself just it really suggests how accomplished and talented he is and it's it's almost offensive to me that he started the documentary by saying I have no talent I have no natural talent I know but if we take him at his word that's just even more impressive it means he has to work very hard at everything and he has and it's it's really off well and then we could talk about his most recent Endeavor which is only M which is the reason my children know him basically yeah and he came up with only murders in the building with co-creator John Hoffman and we've talked about this show before on the podcast but it's basically a trio of strangers who all live in a highrise in the Upper West Side in Manhattan so Steve Martin Martin Short and Selena Gomez and basically investigating a murder in their building and of course as subsequent episodes more murder or subsequent Seasons more murders happen it's going into its fourth season coming up I think at the beginning of September it's coming out so again he wasn't going to start in it he just kind of developed this he thought it was a lot of fun but then basically he was convinced to perform in it what do you think about only murders in the building there I mean I think this was one of those shows if I'm not mistaken it was renewed for a second season before the first episode even aired you know what I mean like it was very very soon if not before maybe right after the first episode people watch it and they were like yeah instant hit the just the the dynamic between these three is immediately something that's compelling and you want to watch it and yeah it's like quite an interesting you know the fact that my wife and I can sit there and watch it on one level and every one of our kids who are in different age groups can also sit and enjoy it and then ask for it like I think it was released you know one every week so it's one of those things it's old school television style where we're waiting anticipating the next episode oh isn't it Thursday tonight the new episode is come out of that like it really it United us together as a family and it was very entertaining even though it's ridiculous why what's going on in this building why are there so many murderers in this building it doesn't matter they have a way of letting you you know suspend your disbelief and just give in the the entertainment of it and it's good I really do enjoy it and I'm excited to watch the fourth season yeah it's totally fun I must admit I am not caught up I watch season one and two I have to watch season 3 so try and get that done before the new season starts I really liked it and you know we talked about Selena Gomez on a previous episode I really didn't know a lot about her other than my kids liked her music and I really she made me a fan from this show really like I think she's a good actress I think she's a lot of fun solid actor absolutely and M short again like you know he is funny in this but he's not quite playing himself and and he there is a lot of sadness with you know his character which I really like and Steve Martin as well again like speaking of the Lonely guy and it's funny right he he a semi-retired actor who just kind of coasts on his one star role in the show Brazos and so anyway it's t tons of fun and I'm really happy for them he did say that this is probably it for him in terms of what he's going to do he'll finish only Ms in the building I don't think they've said if this season's the final one I believe I'm not sure but Steve Martin does say in the documentary like this is probably it for him yeah he's got a young daughter to raise he's got a young family at age 76 I think he wants to to be around for her and his wife and you can't fault them yeah because he lives in New York and he said the only way he's doing this is if it's said in New York so it wasn't initially said in New York but they did that so he didn't have to travel and yeah you know it's very interesting just to finish things off with him his daughter is probably about 12 years old old now and it's interesting he didn't allow her to be shown in the documentary so they kind of just animate a stick figure over her if she's ever in a shot which I think is good I think he's being responsible for that I always question people who put their kids you know in the Limelight and I think he's being pretty responsible for that so listen man I don't know else we can say about Steve Martin is seems like a good person and as we talked about so intelligent and really unbelievably accomplished comedian an actor yeah and hardworking I think if anything magic probably teaches you the importance of repetition and hard work just over and over and over again until you master a trick right and I I really believe that that was a foundation that was necessary for Steve Martin to become the person he is as much as magic doesn't do it for me and as I said reading his autobiography I almost gave up after the second chapter about magic I was like I don't another more magic at a County Fair somewhere it's not for me but I'm glad I pushed through on that and the documentary is very much worth watching it's a two-parter as we had said two very different distinct documentaries all under the umbrella of one documentary name but yeah definitely two thumbs up over here [Music] now to add to the impressive things about Steve Martin he does everything he does all of it that requires you know white an ear whether it's music or listening on set or on stage or whatever you're doing it requires him to be very in tune with his surroundings and he does it all with tentis also known as tenius right yeah medicine we usually say tenidis again there's two reasons I know what tenidis is one my aunt had it and then my mother had it so I always wonder does it run in the family my mother's cousin and then my mom in in their later years my aunt a little earlier so I had a you know cursory understanding of what it was as my mother described it to me and then Joe list is a terrific comedian who talks about tenet as he has it as well and he has this joke he goes to the doctor and the doctor says all right I'm going to test your hearing and Joe's like no no my hearing is great I hear everything plus ringing I have this superpower hearing if you think about it I'm hearing things that aren't even in the room my hearing is fantastic and the doctor goes okay let me just take a look at your ears and make sure it's nothing obvious which then jool list is like what did you think you were going to find an alarm clock in there what is not obvious inside my ear so he says it's nothing obvious and then he goes maybe it's your overbite that's it no science he just picked something that I'm self-conscious about and he presented me with that a very funny bit that also suggests how little we know about ttis we don't even know what the proper pronunciation is that's the first thing and the second thing is of course I will tell people before you have a chance to tell people as if we don't know enough about why it's happening but Steve Martin has had it since 1986 since the Three Amigos he attributed to it or it's been attributed to filming this pist shooting scene in Three Amigos but then since then he said that he believes or maybe he knows it's from years of listening to loud music and performing in front of noisy crowds I mean if that's the case we're lucky if 30% of the world's population doesn't have idus and and certainly most entertainers but so let's back up and talk about what it is exactly I've suggested it's a ringing but let's get some science and medical stuff in here huh okay okay yeah so it's the perception of sound heard in the ears that's what it is so it's commonly ringing but it doesn't have to be and in fact it comes from the Latin word tener which means to ring so it's commonly ringing but it doesn't have to be I'll give you some examples in a second and most of us have probably experienced it you know if you've been exposed to a gunshot but that's not that common for most people usually it's a loud concert right that's what if you've been to a concert and you leave and then you have this ring in your ears usually what what happened I I would go to a concert when I was younger and then you go home to bed you're like oh my gosh I have this ring in my ears and then the next morning it's kind of gone right so goes away in a few hours so the one thing to remember and this is why the joke that you're saying by Joe list is true it's actually very commonly associated with with hearing loss which seems like a strange thing from his joke and from what you were saying but it commonly is and when you look about how common it is it occurs in about 10 to 15% of the population which is crazy which is like 30 to 40 million people say in the US and it does increase with age though in kids you can see it in as common as 133% of kids so it's funny we do hear that as a complaint sometimes in kids so it's not uncommon at all so what do you think why is it happening with kids if you know Steve Martin was around Pistols that was one Theory and then he was around loud crowds and loud music why is it happening with with young folks I mean kids today I mean listen like earphones and let's be honest Alie earphone technology has increased so incredibly since we were younger right so we have in ear earbuds we have noise cancelling headphones I think that's a huge problem with that you know a lot of phones will tell you if you're listening to music too loud and the warnings come up all the time you know for kids so I think that's a huge issue I think that's something definitely that needs to be monitored over time for kids but again then we want to see that associated with hearing laws okay so do we know what causes it that's a good question Ali and really it is but it really comes down so actually different types of tenis and the cause depends on what type okay okay that's why it's interesting so there's objective tenus and again like I know Joe list was making these jokes but the doctor was of course right because there's tenis that other people can hear so the doctor can hear it so it's not just something you can hear that's insane so objective tennis is very different than subjective tennis subjective tennis only you can hear okay so that's the more common kind but let's talk about this objective one because I think you'll find it kind of interesting so it's quite rare but it's because something in your body is making this sound so you could have what's called a muscular tenus because you have degeneration of muscles often occurs in people with ALS and again we have a whole episode on ALS you guys can listen to because you have muscles in your ear and they can deteriorate and you can get a repetitive flutter or what we call myoclonus myoclonus is a little jerk like movement of a muscle you know when you have a little muscle twitching you know in your eyelid sometimes do you ever get that I know about jerks awkward yes I do know about that twitching we all know about that always bioc clonus so if you get that in some of the muscles that are in your ear then you would be able to not just you hear it but other people could hear it okay so that's what the doctor was talking about and sometimes there is like a surgical treatment if that's the cause okay there's also something we see in neurology called patal myoclonus so this is a muscular induced clicking kind of idus that results from abnormal discharges in an area of the brain it's called the inferior very nucleus you don't have to worry about exactly what that is but that causes this discharges in your pallet okay the back part of your mouth and it could be do a lot of things like a stroke or multiple sclerosis and sometimes you could see that as well and then so you will hear it clicking as the patient and then when we examine their mouth we'd see their pallet kind of moving up and down involuntarily and that will be causing that so that's another kind of sometimes you can actually inject Botox into that area to help relieve that and the last type of objective tendis is you can have an abnormality of your cored artery and so you can basically the artery takes a torturous kind of root and it creates some turbulent flow and this turbulent flow can actually be heard with each heartbeat and that's what people are hearing in their head so those are these very rare causes of objective tus but because some of them are treatable or potentially serious it's important for doctors to kind of make sure that's not what's going on for that objective tenis but of course like we talked about the more common type is this subjective ten so that's this perception of sound in the absence of auditory stimulation so objective idus probably comes and goes right because there's something causing it whereas subjective could it just be all the time they both could be all the time because the objective one even like you'd have to treat the underlying cause in order to maybe get it to away yeah but yeah these things both occur all the time which could be very distressing for people right yeah there's there's anecdotal reports of people taking like an ice pick and shoving it in their ear trying to like Rel the tenis you know so you asked about the causes I did we don't know the cause of subjective tenness but there is an idea of what may happen so the area where you're hearing area in your ear is the CIA right that's What receives sound and if that's damaged we know that the CAA like it's just like our hands right our hands we have nerve endings and our nerve endings go all the way up to our nerves up into our spinal cord up into our brain and they're mapped on our brain right so similarly our hearing is also mapped so we have our nerves that go to our caua and they go back up into the brain St the back part of the brain and then into the higher parts of our brain which are organized for our hearing so they think that when you have an area of the C it's damag you have these projections that kind of modify themselves because of this lack of stimulation because of the damage and this pattern of organization in your brain is altered and then you also get a loss of what's called Central inhibition so you have areas of the cortex that are active things your feedback mechanisms are kind of out of whack because of this damage and then you end up starting to hear sounds that aren't really there so that's kind of the theory about what's going on Theory now we know like I said it's very commonly due to hearing loss so you want to look at hearing loss other causes so what else could cause this damage so what they're saying is hearing loss again you've heard loud sounds or something like that then you've damaged your hearing okay so then you're getting 10 it says a result of that or there's some drugs that can cause either hearing loss or tenis so some of the ones you may have heard of aspirin and other nonsteroidal anti-inflammatory drugs diuretics these are things we use for people to like you know make them pee more to get fluid off them like furosemide and that can do it there's some chemotherapeutic agents that can do it and you may have heard about we can do a separate episode on this you may have heard about people who have Miner's disease have you yeah our friend vickram had it yeah yeah so this is where you'd have attacks of dizziness and hearing loss and Tanis alt together and sometimes even in between you could still have some of these other symptoms in between attacks so that's another thing that people would look at the other thing it's not really a cause but like there is an association between tenness and anxiety and depression right so in one study 26% of adults with tennis reported anxiety problem and in another study 25% of people with tenis reported depression and the issue with that is of course what's the chicken and what's the egg right are you anxious because you have tenis or is the tenis causing anxiety or similarly to depression right like it becomes a bit hard to know interesting Ali it's one survey from 2011 that found that regular marijuana use may be linked to prevalent tenus okay again it is hard to know because why are you using marijuana is it because you're anxious or depressed and like you know so what is going what is causing what here but it just because it's correlated doesn't mean it's caus it but it's an interesting finding so I'm very embarrassed here this a very bad husband moment but while we were talking I was like wait a minute my wife has this and so I just texted her I said do you have tenidis she said it's not doctor diagnosed he gave me a sinus spray that didn't work and then I never went back for it but the ringing is always is there oh my gosh I know she doesn't talk about she's not really a complainer and I'm a terrible husband so not only did my mother and my aunt have it my wife has something similar anyway yeah yeah yeah yeah yeah yeah she says she says the summers are good because the buzzing of the cicas overrides the ringing in her ears I don't know if that's a solution that's not a life worth living but anyway terrible okay let's talk about how it's diagnosed then basically because this is a good segue that my wife inadvertently created that she went in and got a sinus spray that's what was done that's what was offered to yeah I mean I I I guess you could try that I think the key is you'll see your doctor they'll look for other causes see if there's objective tenus right so they examine your head neck torso look for anything that could be the origin of the tenis you can get hearing testing and that's probably recommended most people because most people are aware of the tenness and they're not aware of the hearing loss so that might be a suggestion for your wife is to get a hearing test a lot of people don't want to have to go for a hearing test or you know they think that's associ getting older and of course what do you do if you have hearing loss we'll talk about that in a second usually you don't need to do any Imaging or anything like that MRI unless you have the objective tenis or sometimes if you have a pulsatile Tanis which pulsatile would mean it's like d d like related to your heartbeat then it could be something with a vascular problem so then your doctor may want to do that so what is the treatment or maybe management of it what options do you have yeah so it's tough It's very difficult and so there's a whole kind of philosophy around tenus some people think it's more of a chronic disease which it is or maybe even a psychologic disease that should be managed and maybe cure is not quite possible possible but you really have to help people cope with it so what a lot of doctors say is you shouldn't say ah too bad you just have to live with it right because like what about depression what about anxiety all these things that can be associated with it so that's maybe not the best way to do it but it's very important to know that there's nothing that cures tintus unless you happen to have those rare objective tintus signs and the American Academy of autology which is the ear nose and throat doctors have released some guidelines so they say you know what should you do first stress reduction stress doesn't cause tenness but it can make it worse you can imagine and you can get into a vicious cycle of that cognitive therapy is also important you know so for example some people liken it to itching right and you know if you keep scratching an itch you're just going to make things worse and worse and worse so they'll use some examples like that sometimes I find hearing aids do help people if they do have hearing laws you can also get devices that Mas that create a masking noise and some of them look like from my understanding they look like hearing aids and you put them in your ear and they kind of make a masking noise and that kind of takes attention away from the thing okay so this is like what the cicas are doing for my wife they're creating another noise that takes away these are awful solutions by the way this is the old school like my knee hurts then don't touch your knee or like here let me bang your ankle then your ankle will hurt and you won't think about your knee this is like real like Flintstone stuff here but anyway that's where we're at guess well I mean you know there's things that have been tried there's things like magnesium or aneal cysteine and they've been tried but it's very difficult to know if they work the Melatonin has also been talked about but it's so hard to know because it's a subjective thing whether it's a placebo effect whether these really work there are some studies that look doing like a brain stimulation or even a magnetic stimulation to the brain the science is still a bit out there but there are some retraining kind of programs so there's Tinus retraining which can be done with an audiologist specialist and they help you to adapt to hearing the tenus and there's also something called neuron omics which work with you to help you to ignore the tenus so the other thing is some doctors have used like medicines like Adavan or xanax to treat tenis because they're like well if it's related to anxiety those medicines help anxiety but we've talked about these medicines before medicines like benzo beines can have an addictive kind of potential so you kind of want to avoid that so you might want to prescribe people an anti-depressant if they have a lot of anxiety or depression and not a benzoin what we talked about before on the podcast like ssris those might make a bit more sense I will say that this doesn't all sound super impressive I mean if you have idus I guess any small relief is well welcome I suppose but you know in a world where we're looking for Solutions these are half half Solutions this masking thing do people use that a fair amount yeah those masking devices yeah I mean there are a couple limitations right you don't want to use it in someone who has a hearing loss right because if you do that then it's just going to create more white noise and and probably interfere with your hearing even more right so I think first of all that's one thing to remember you should go get checked if you have tenis make sure you don't have hearing loss because maybe wearing hearing aid would help tennis okay that's one thing second thing is behavioral therapy which you can look into and then the third thing like we talked about is a masking so do people use the masking yeah I mean usually they say wear it during waking hours but people who really like it will wear it 24 hours a day but if you look at patients who were referred for a masking device 2third investigate the possibility a third actually rent the device and only a sixth wear the device for a significant period of time and find it helpful so you know why is that is it because the other you know 56 really just wasn't useful or they're not that bothered by it they don't want that someone to see that they have something in their ear I'm not sure but I think it's worth trying you know it's it's unfortunate there's not a lot of treatments but like they said it's something that again you don't want to tell people just to live with it but if people can approach this more as a chronic condition or something that you have to give people tips on how to deal with over time that's kind of the philosophy okay you go to tell your wife that I am I mean right now she's doing this self-prescribed cicada treatment which seems to be working once those things die off yeah we'll see but obviously know I think her going for a hearing test is the next step you know my father was heart of hearing her father's heart of hearing and we're like we grew up in homes where it's like you know where's The Rake The Cake The Rake The flake it's just like insane and is just not something we're looking forward to living with so I think that's probably stopping her from going for a hearing test too probably sto me as well but I think that has to be you have to at least rule out the basics right that's the sinus spray didn't work check ni try something else nice try [Music] that's our episode for today let us know what you guys thought again we split up the Steve Martin topic just because it was so big let us know what you guys thought about that Dr V comedian at gmail.com drv commed on Twitter Facebook Instagram we are everywhere let's know what you guys thought about tenis as well a lot of people suffer from it and do you have any solutions that you've uncovered definitely let us know I'm sure the medical here I'm very much in this episode and I'm you know staring directly into asf's nostrils and stuff but you sort of as your listen you've got a bigger picture if you have questions that did not come up here definitely reach out love to hear your questions love to hear your suggestions and Ali again just to recap in September you have this comedy special recording in Toronto two shows 700 p.m. 900 p.m. on September 26th at the comedy bar Danforth looking forward to it like I said I will most likely be there so if you guys are there stop by say hi and enjoy the comedy of Mr Ali Hassan but remember that day and every day although I'm a doctor I'm not your doctor medical issues we talk about are for your interest in information only and they're not medical advice please consult your medical professionals for actual medical advice thanks for listening bye-bye a [Music]