Advice Please: Use of Earplugs Outside All the Time?

I'm new to Tinnitus, two months, and also have moderate Hyperacusis. I live in a borough of NYC, visit Manhattan every week or two, and the streets are also noisy where I live as well. Should I wear ear protection whenever I go outside, until I either habituate or these conditions cease? I don't want to overdo it, but the "spike" stories on here are frightening to me. I've definitely made some progress, and don't know how I could cope if my T and H went back to the levels it was when this began. Today I wore a 20db "high fidelity" silicon plugs, when I was outside, the whole time. I've ordered 3M plugs, and some other plugs as well as backup. I already know, from reading the very good info on this board, that I must wear them in clubs, airports, underground subway stations, etc., but is a busy street, with traffic, horn honking, construction, sirens, etc., a threat strong enough to warrant the use of earplugs?

I don't want to develop a phobia, or cause other problems, but at the same time I want to heal and protect myself from further damage, especially "permanent spikes", etc. At the same time, I don't want to over-sensitize my ears, if this makes sense. This is all very unnerving.

Thanks, I appreciate any suggestions and/or support.

 

Get custom made musicians ear plugs with multiple attenuation filters (eg. 10, 15 and 26db) so you can use them in a variety of situations. They provide better protection than foam and other cheaper plugs and you avoid the occlusion effect.

That said, don't wear ear plugs all the time outside - or at least not long term. Over protection is a thing and can be detrimental in your recovery, though you will probably find others who will argue otherwise.

I had severe hyperacusis from 2013 through to towards the end of 2015 caused by barotrauma. I know how scary and difficult it can be to deal with - I was a mess and very scared of everyday noise. I chose not to over protect my hearing though.

When my hyperacusis was at it's worst I would wear my plugs when using power tools, and in cinemas, bars and in noisy restaurants. I was tempted to wear them in the streets but realized that was completely overkill in my situation. I kept my pair of musician's plugs with me though in case I was ever in a situation where I needed to pop them in. With things like sirens and construction sites I would just block my ears with my fingers they passed by. Over the span of a couple of years I gradually exposed myself to more noise and used my ear plugs less in an attempt to condition myself to handle loud noise better and it worked in my case. I don't have hyperacusis anymore thankfully!

Without getting too long-winded, I'm definitely against over protection but at the same time I realize everyone is different. I know New York can be a loud place to be so if you feel that you really need to be wearing plugs in the streets at the moment then go with your instinct. I'd suggest that you eventually try to use them less in everyday noise so that your ears can become accustomed to everyday noise again.

Also it's common to experience spikes and set backs, so try not to let that dishearten you. Happens to everyone. In my situation it was a roller coaster on my way to recovery but a positive mindset, healthy habits and being smart with protecting my hearing appropriately helped me immensely.

 

Hi @Luman - Welcome to the forum. I also live in Brooklyn on an avenue which is constantly busy with traffic and lots of noise. Whenever I walk in the street, I do not wear earplugs since I don't want to become dependent upon them and over-protect. Of course, when I'm out and about and the occasional ambulance screams by or a fire engine passes with sirens blasting it may be too late to place my earplugs in but I realize we can not protect from everything at all times. On the occasion of going to extremely noisy restaurants where the speakers are located near we are sitting and are very loud, then I will certainly place my plugs in to protect my ears. At times though, I will ask to be seated in a more quiet area.

 

Yonkapin, and Bobby7, thank you, your experience and advice mean a lot to me and I will definitely rest easier tonight.

I do plan on using silicon plugs when riding my bicycle in the street, which I did yesterday, at least for the rest of the season. I was sensitive to noisy tricks, cars, and motorcycles even before I had any T or H.

 

Speaking of blasting sirens i was on foot yesterday and a bloody fire truck blasted my left ear with it's 100 db siren, i managed to get my finger into my right ear but was holding something in the other hand so left ear copped it, my ear is ringing even louder than what is my new normal i hope the volume goes down but it probably wont, for the last 6 or so months every time ivé noticed a new sound or increase in volume it has stuck around.

It's mainly the trucks and motor bikes that are the dangers, i measured how loud the traffic was in a 50kmh zone and the trucks were about 70-85 db, the cars were up to 75 db, measured one bike and it was 80-85 db another bike i missed but it was even louder.

 

H

This is what I was talking about. I don't know if such an exposure would harm me, the first few weeks of bad T and H gave me symptoms that were beyond scary, it was a nightmare, at that point I was not wearing any earplugs outside or even in the underground subway.

Would you ever consider wearing protective earplugs whenever you're out walking on the street?

Thank you for responding, and I am extremely sorry to hear what happened to you. Hope your recovery is swift.

 

I would wear them on the subway, others may disagree but if your just being safe rather than sory while in a noisy environment i don't see the problem.

Depends on how loud it is, if it was a constant wall of sound over 80 db i would, where i measured the other day was on a 4 lane highway in a 50km zone and it was only when the louder of the trucks and the 2 bikes went past that it momentarily went above 80 db so that shouldn't be a problem.
What i do most of the time now is just try to find streets that are less noisy when walking and use them where possible.

 

When I search this forum for the word "siren", I get 7 pages of search results. I got the links below from the first page. By the way, many of these threads have other people posting Their horror stories. I say: wear earplugs when you are outside.

https://www.tinnitustalk.com/thread...permanently-damage-already-fecked-ears.23004/

https://www.tinnitustalk.com/threads/muffled-hearing-from-ambulance-siren.18157/

https://www.tinnitustalk.com/thread...has-been-damaged-by-an-ambulance-siren.20708/

https://www.tinnitustalk.com/threads/20-seconds-next-to-an-ambulance-siren-with-ears-plugged-—-ears-now-crazy.21096/

https://www.tinnitustalk.com/threads/stupid-fire-trucks-—-a-temporary-or-permanent-spike.21647/

https://www.tinnitustalk.com/threads/how-much-risk-—-ambulance-siren.9583/

 

HI @Luman

Please read the post below that I hope that you find helpful since you are new to tinnitus and hyperacusis. Please click on the links at the bottom of the page and read my articles which may also be of help. Some are quite long. Take your time and read them in full. I advise you not to use headphones even at low volume. You are right to be concerned about over protecting your ears using earplugs because it isn't a good thing. When used correctly they can be beneficial. If you must use them then use "noise reducing" earplugs that have filters in but try not to use them too regularly when away from home and in the outside environment, as dependency could set in and it's something that you don't want. I agree with advice @Bobbie7 has given you.

All the best
Michael

Hyperacusis, As I See It.

Some members have asked for my opinion on hyperacusis as they are finding it increasingly difficult to live with. They want to know if there is a way of treating this condition so that their life can become a little easier? Or whether it can be completely cured? For a few it has become so distressing they have decided to only leave their homes when it’s absolutely necessary. This is because of the fear of making the symptoms worse, by subjecting their ears to the hustle and bustle of everyday road traffic noise and other environmental sounds that we are all familiar with.

Reading some of the posts in this forum, one can easily see that certain people daren’t leave their homes without first checking they have their earmuffs and an assortment of earplugs in various degrees of attenuation, in readiness for any potential environment that they happen to find themselves in. The cinema, nightclub, restaurant, or on public transport. If money is no object aspiring to custom made moulded earplugs for some is the way to go. It can bring the added assurance they will be getting the best hearing protection. Whether this is true or not doesn’t really matter because it’s what the person believes and this helps to give them that peace of mind which is something many of us strive for at one time or another.

The above may seem a little extreme until I tell you one member provoked a lot of discussion here, when he mentioned having the air bag in a car that he had just purchased disabled in case it was deployed in an accident. I suppose the thought of 170 decibels raining down on his auditory system and the possibility of his tinnitus and hyperacusis shooting through the roof was too much too bear and is more important than a potential life saving device. As strange as this might seem, others have discussed doing the same thing elsewhere on the Internet.

I am not an expert in this field but do have the experience of living with very severe hyperacusis that was brought on with the onset of my tinnitus twenty years ago due to loud noise exposure. It was so severe; conversation with someone at times caused immense pain. However, it was completely cured in two years with TRT and having counselling with a hearing therapist. I wore white noise generators for 10hrs a day and used a sound machine throughout the night until morning for sound enrichment. My tinnitus had reduced to a very low level.

Some people believe hyperacusis cannot be cured and if treatment such as TRT works then it merely suppresses the condition. In the event of future loud noise exposure it will return and the condition will be worse than before. I believe it's up to the individual to take care of their hearing and not subject themselves to loud noise exposure. However, accidents do happen as in my case. I have previously explained in this forum that my tinnitus increased to very severe levels in 2008 due to noise exposure so won’t go over it again. To my surprise the hyperacusis did not return and has remained the same till this day, completely silent.

This summer I went onto the Brighton Pier and into the arcade. The place was a hive of activity and many people were using the slot machines. Music was playing and mixed with loud laughter so everyone seemed to be having a good time. I had my sound level meter and also a sound App on my mobile phone. Just in case things got too uncomfortable I had my noise reducing earplugs with me that reduce sound levels by 18 decibels. This was a test and not something I normally do or recommend anyone else to try.

The sound level in that place remained constant at just over 100 decibels. My ears didn’t feel uncomfortable and I felt no pain. I stayed at the venue for 30 minutes and then left.

The next morning my tinnitus was silent and I experienced no symptoms of hyperacusis. I do not believe that it is a good idea for someone with tinnitus or hyperacusis (or both) to wear earplugs or noise-reducing earplugs with filters too often, because it’s possible for the auditory system to become hypersensitive. In some cases it could make matters worse and cause a condition called phonophobia. This is literally having a fear of sound.

I used to counsel someone that had phonophobia like symptoms although she wasn’t diagnosed. This person had hypercausis that gradually got worse and at every opportunity she kept away from sound. This got so bad going out the front door because of the noise was a problem. Her ears couldn’t tolerate the sound of the microwave, dishwasher or the washing machine. She even complained of the sound of rain falling on her conservatory roof that was made of glass. Fortunately she has improved.

There is much discussion on this in the medical field from experts saying that the overuse of hearing protection isn’t good and therefore discouraged as it will lower loudness threshold and I completely agree with this. I think if one isn’t careful they can become paranoid over sound making their hyperacusis and tinnitus worse and I don’t think it’s healthy.

I believe the answer is to seek proper treatment. If TRT is unavailable then start using a sound machine by the bedside at night for sound enrichment. This usually helps to desensitise the auditory system. Try going out for long walks and getting used to everyday sounds instead of keeping away from them by staying at home. I don’t normally recommend anyone to use white noise generators unless they are under the care of a hearing therapist. However, if your tinnitus is under control and you have habituated but experience hyperacusis, that some call: Reactive tinnitus. Then white noise generators could be the way to go. Two should be used to keep the auditory system in balance and set the volume level low, preferably below the tinnitus. This will help to desensitise the auditory system and treat the hypercusis.

Hearing protection is important and does have its place. If I am going to venues where I believe noise level could become loud then I have my earplugs with me. Night clubs, parties etc. I would always use them at the cinema although I haven’t been to one in years. Reading some of the posts on this forum people say those places can be very loud.

When I use my petrol lawn mower or electric power tools for those DIY jobs around the home, I always use my ear defenders. I want to live life and enjoy it. Not to be living in fear of hearing a fire truck or ambulance siren coming towards me and I have to panic and quickly insert earplugs or reach for earmuffs to protect my hearing. I just think this is overkill.

Michael

PS: There is a condition called: vestibular hyperacusis. This is where the sound can cause a person to fall, lose balance or experience dizziness, and will probably require more professional help.

https://www.tinnitustalk.com/threads/tinnitus-a-personal-view.18668/
https://www.tinnitustalk.com/threads/new-to-tinnitus-what-to-do.12558/
https://www.tinnitustalk.com/threads/tinnitus-and-the-negative-mindset.23705/
https://www.tinnitustalk.com/threads/tinnitus-answers.22554/
https://www.tinnitustalk.com/threads/the-habituation-process.20767/
https://www.tinnitustalk.com/threads/is-habituation-possible.12758/
https://www.tinnitustalk.com/threads/from-darkness-into-light.22234/

 

Michael, I might be missing something, but the only objective fact in your post is the fact that you were exposed to noise and it didn't cause a spike. The rest seems to be your subjective opinion.

I provided links to people sharing the how they were exposed to noise and ended up with spikes. What this seems to imply is that the Probability that one gets a spike is non-negligible.

If one wears earplugs 24/7, one's H could get worse. But if one wears earplugs outside, and doesn't wear ear plugs at home, when watching TV programs at medium volume, etc., there seems to be no reason to be concerned about H.

 

Maybe not, but the sudden, unexpected ambulance siren at 120 db probably is.

I was caught by one myself this Saturday, going to the gym. At the time, I was wearing both foam earplugs and earmuffs*. I'd rather not take such noises flush if I can avoid it.

*Peltor Optime II, in fact. They're fairly bulky, but as I still felt quite startled, I'll get myself something even heavier from now on.

 

Hi @Bill Bauer

It is nice to hear from you again and I'm feeling much better. It is always good to reply to your posts/questions as you are always polite, unlike some people that visit this forum. I wish they would read some of your posts then they would learn how to conduct themselves properly with manners and respect.

You are correct my post is based on my subjective opinion but it doesn't rest there. I have a experience counselling people with tinnitus and hyperacusis and corresponding with people with these conditions in forums. All my advice as my artictle: Tinnitus, A Personal View, is mostly to do with tinnitus and hyperacusis that was caused by "exposure to loud noise" I have concluded based on my personal experience having had very severe hyperacusis. Once it has been cured and I mean completely, a person's auditory will return to normal and no longer be hypersensitive to sound. In many of the links that you have posted you will see most of those people are new to tinnitus and hyperacusis. Their auditory system is therefore hypersensitive to sound.

When I have corresponded with people at tinnitus forums, by email and on the telephone that have "noise induced tinnitus and hyperacusis" I have found the majority of these people who have spikes in their tinnitus or are sensitive to sound even after having the condition for over a year, have never received treatment via a Hearing Therapist or Audiologist that practices the tinnitus and hyperacusis treatment and management. Unfortunately this is largely to do with the financial outlay that the treatment cost. Once a person is referred to ENT and tests are carried out on their auditory system. If the tests show no abnormalities yet the person still has difficultly coping with tinnitus and hyperacusis, often they are not referred to a Hearing Therapist or Audiologist as I've mentioned above. In the case of hyperacusis (sensitivity to sound) the only way to cure this is by using sound therapy as I've indicated in my post above: Hyperacusis, As I see It. Hyperacusis, can get better naturally without treatment but in more severe cases treatment such as TRT (which is what I had) is what is needed.

I was fortunate to get TRT for free and the treatment last up to two years with regular counselling. This evolves wearing white noise generators for up to 10 hrs a day to desensitise the auditory system and at night using a sound machine by the bedside. Regular counselling is also very important as this treats a person's negative thinking that is often associated with tinnitus and hyperacusis. Over time negative thinking is dispelled and demystified. It is a complex process and one not easily fixed without professional help when tinnitus and hyperacusis are severe.

It is for this reason there are so many people walking around with this hypersensitivity to sound because the condition has not been treated. Either by trying to help themselves as mentioned in my post or being able to afford professional help at audiology. If hyperacusis isn't treated and cured a person will always have problems with sensitivity to sound which causes spikes in their tinnitus and some refer to as: Reactive Tinnitus.

Hope this helps.
All the best
Michael

 

I would disagree with this. Wearing ear plugs all the time except for when you're at home would reinforce phobias to noise and would hinder one's ability to improve their tolerance to everyday noise.

In my case, I believe it was absolutely essential that I gradually exposed myself to louder noises and environments over a period of time, and think it was a huge factor in my recovery from hyperacusis. If I had chosen to use my ear plugs every time I stepped out of the house, I'm certain that I would still be suffering from hyperacusis and that many of the previous anxieties I had about everyday noise would still bother me greatly to this day.

 

I hope the spike you suffered as a result of the siren is only temporary and you will feel better tomorrow. I see you have tinnitus since 2007. If I may ask, how have you been managing all these years? I gather you have been doing well thus far since you have had tinnitus for a quite a while now. Take care.

 

i live in ny as well...i wear custom fitted musician plugs (15 db filters) when i am in the city and on the subway. When I am back at home where its not as crazy as the city I never wear them outside. There is always a firetruck or a cop car going by with the crazy sirens and the cars are always honking their horns. Especially if you are down by the trade center where there is always some type of construction going on as well.

 

Hi Bobbie, when i first got 24/7 T with a volume of say 6/10 about 10 years ago it was annoying and a little distressing for about 2 years, then for another 2 years it was no longer distressing but still annoying, about 4 years in it became less of a problem as i could go days at a time without noticing it, it was still there all the time but didn't bother me much even when i did hear it and seemed to have gotten quieter around a 3-4 and that's how it was for the next 6 years.

Late last year my GP diagnosed me with an ear infection in both ears and started me on antibiotics, and for the next few months everytime i saw him he would tell me i still had the infection and more antibiotics, it got to the point where i insisted on seeing an ENT because i told the GP that my tinnitus was getting very loud and he responded by laughing, i had told the GP before that time i wanted to see an ENT but he said he was more than capable of treating an ear infection.
Well i saw the ENT and he looked in my ears and said you don't have an ear infection and it will be the antibiotics that have made your tinnitus so severe and caused the nerve damage and hearing loss.

For the last 6 and a half months my tinnitus has been so loud it has been a living hell, i recently saw an audiologist in Melbourne who does T assessments and she told me that my T is the most severe she has come across, i am unable to mask it without using sound that is loud enough to cause potential hearing damage.

So yeah i was doing very well for a long time but now my T is so bad and i have not been able to make any inroads into adjusting to it and to be honest at the moment i'm not too hopeful that i ever will.

 

Thats terrible man....If there was anyway to sue that idiot doctor i would. I hope things improve for you.

 

Hi @Screamin Ears -

I am so very sorry to hear of your present plight and the misdiagnosis by your GP which resulted in your taking many courses of antibiotics which exacerbated the tinnitus, nerve damage and hearing loss. What an insensitive person your GP is to have laughed at the discomfort you were experiencing at that time. I hope something can be done to help alleviate your suffering. I wish I could offer helpful advice but, unfortunately, I am limited in this area.

I believe our far more experienced and knowledgeable members such as @glynis @Michael Leigh, and @billie48 and many other members can offer suggestions which might serve to help you. If they are available, I trust they will see this and respond to your post.

Sending my very best wishes and hoping you find some much-needed relief soon. Take care.

Best wishes,
Barbara

 

My hyperacusis was moderate. It began improving only after I started to protect my ears. I spent the summer working at home. My home is quiet. I would protect my ears whenever I would venture outside. I am free of H now.

By the way, I would imagine that the noise one would get exposed to when one walks down the street in New York while wearing ear plugs is probably louder than the noise one would have to deal with when walking down the street in my town while not wearing any ear plugs.

 

Thanks, Bill. I believe you are right about the noise levels in NYC and I'm still in a quandry about what to do. I wore 20DB earplugs outside for a few hours yesterday, and I don't believe this was a good idea, based on the way I felt today, I think that it over-sensitized me, and I experienced some disturbing symptoms last night and this morning. I will use the plugs on the subway, in extremely noisy environments, etc., and I'll see how that goes.

 

I wear earplugs more or less the entire time I'm in Manhattan, but I only go there every couple years. It's mind-bogglingly loud to me.

I very rarely wear earplugs outside in my day to day rural life.

What I saw as unreasonable, dangerous environmental concerns (noise, pollution, general fast pace and stress of life) were some of the biggest reasons that I moved from a major metro area into the woods. Big cities seem like an expensive stress pit to me, and I do not want to raise a child in that environment.

I have clocked overhead airplanes at >85db within a block of where I used to live outside DC.

 

Hi again @Luman - I do agree that it is certainly best when traveling on the subway to use your earplugs as the noise in the New York City subway system is way too loud and almost seems deafening. Brooklyn is way more quiet than Manhattan, that's for sure.

Wishing you a peaceful day.

 

I find 3m earplugs + Peltor muffs (35 dB noise reduction) to not provide a lot of noise reduction. So it would seem that 20 dB noise reduction would be almost unnoticeable. It is surprising that you would experience over-sensitization in less than 24 hours. Having said this, I am a strong believer in the practice of listening to the signals we get from our bodies.

 

@Screamin Ears, it is quite unfortunate for you to have such a GP doing the damage to your ears and nerves. If your ENT can backup the assessment that you don't actually have an infection, and that your tinnitus is really as a result of the antibiotics, then this can make a case of malpractice suit against the GP. Perhaps consult a lawyer for it. This may distract your brain so much that your T will probably be tamed for a while. Lol. Reading your doctor laughing at your suffering of T reminds me of my own ENT during the darkest moment of my T suffering. He said "the only way I can stop your ringing is to SHOOT you". If I had offed myself following his suggestion, my wife could have surely sued this idiot of a doctor.

For your T, perhaps try some natural calming products to see if they can help tame the T to a lower level, or to calm the hyperactive neurons, such as Gaba, Lemon Balm, Valerian, Hops, Catnips, Passion Flower, Chamomile, Lavender, Kava, etc. You can do google search or check Amazon.com for each of them to know how people review these products, and see if you can take them as a supplement. Check out this site on using natural herbs for helping to sleep or to calm the nerves.
http://www.christopherhobbs.com/lib...ealth/herbs-and-natural-remedies-for-insomnia /

You can also try the diet approach or use some supplements to help. For diet, people sometimes find cutting off excess salt, sugar, caffeine, alcohol, MSG etc. will help. For supplements, members often recommend NAC, magnesium, zinc, B12, D3 etc. Also try to get good REM sleep as sleep deprivation can aggravate T. Take good care. God bless your recovery.

 

@micheal leigh .. I respectfully disagree with you. There are so many people on the board getting spike after noise exposure. getting spike because of siren or loud noise has nothing to do with H.
You get spike because your ears get " irritated " because of loud noise.

you should not wear plugs 24/7 but if you are going to walk near main street why not wear a plug? A loud car might go from next to you and will cause torture for long time.

 

Hi @Screamin Ears,
My ears blast 24/7 and it never stops so I understand what your going through.
My tinnitus is not noise induced but due to Menieres I also have TMJ.
I only use plugs if around extra loud sounds just as a precaution .
We are all different and we all know our own bodies and get to know what our ears don't like and when we need to protect them with out sounds becoming a phobia.
If a sound aggravates our ears but not really loud then work towards building up time around it.
Love glynis x

 

I'm beginning to think that there's no "one size fits all" answer to the question of wearing earplugs when outdoors. From my very limited knowledge and experience with this subject, it's apparent that there are many, many factors involved. It seems highly unlikely that a high percentage of the many millions of people who have, or had, tinnitus wear earplugs, unless they're using power tools, at a loud venue, etc. This is not to imply that it has no place for any of us, as I am certain some do need this protection. I just think it's all very much dependant on the condition of each individual as to the use of plugs.

 

This Might (or it might not) explain why many people take a long time to get better, or never heal.

 

That is a good possibility, but from what I have read the habituation rate is very high, in the upper 90% range.
Most people with T don't even join a message board, they just habituate and move on. The American Tinnitus Association, for those with hearing loss and T, recommends the exact opposite of using earlplugs, they recommend hearing aids with or without masking aids. Seems to me that if you wear earplugs often, it increases the amount of time that you're hearing the T, rather than outside sounds.

Of course there are exceptions. Here's an interesting web page which might been used on this board before.

https://www.ata.org/managing-your-tinnitus/treatment-options/hearing-aids

 

But what we really want is silence (or lower volume, or lower pitch) and not habituation...

This is one way to decrease the time it takes one to habituate.