Dear Dr. Roach: In 1966, my husband was in the military, assigned to artillery for a period of three months’ training. During this time, he and his fellow soldiers were exposed to close-range cannon fire. At the end of and during each operation, his ears would be buzzing. Ear protection was not provided.
My husband was 19 years old at that time, and since then he has continued to experience buzzing in his ears off and on. He was never exposed in civilian life to any loud noise, as his occupation was outside sales.
In 2013, the noise level in his ears (ringing and buzzing) increased, becoming constant. He also started to experience dizziness and imbalance. He saw an ear doctor for that issue, who tested his hearing and discovered that he now has a 10 per cent hearing loss in both ears and also diagnosed mild vertigo.
Could his exposure to artillery noise manifest years later in his loss of hearing, ringing and buzzing in his ears, and vertigo with dizziness?
Although loud-noise exposure clearly is a major risk factor for hearing loss, the effect of loud noises on dizziness is controversial. A 2001 study was done on male military personnel who had been heavily exposed to intense noises, and those in whom the hearing loss was asymmetrical (one side worse than the other) were likely to have symptoms of damage to their sense of balance, such as dizziness.
The combination of hearing loss and vertigo is suspicious for Meniere’s disease, which can be worsened by loud noises. That’s one possibility.
Since your husband’s hearing loss apparently is symmetric, I don’t have enough evidence to say that the military noise exposure was a factor for the vertigo, but it almost certainly was for the hearing loss, even if there are multiple causes.
Dear Dr. Roach: I am an 83-year-old man with chronic myeloid leukemia since March 2013. I take 300 mg Tasigna daily. I am considering having knee replacement on both legs. My concern is being 83 years old and having leukemia. Is it a good idea and safe to have the surgery?
I asked my cancer doctor, and he did not say “yes” or “no.” In 2006, I had open heart surgery.
How well does a person my age heal while having leukemia and metal parts placed in my body?
A person considering elective surgery needs to look at both the potential benefits and the risks of surgery. In general, the older someone is and the more serious the diseases or conditions he or she lives with, the more risky a procedure is. A patient of any age can be considered for a joint-replacement surgery, but risks do increase. The leukemia you have is, fortunately, usually very well-treated by the medication you are taking.
I don’t know whether you have any heart symptoms now related to your surgery in 2006, but that also may affect your risk. I suspect most orthopedic surgeons would be very cautious about performing surgery on someone like you.
You haven’t told me how much pain or disability you are having due to your knee problem. If your symptoms are fairly mild, I think most surgeons would recommend nonsurgical treatment. However, if your symptoms are very seriously affecting your quality of life, then I certainly would speak to your regular doctor and the surgeon to look at your individualized risks and benefits.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu.