Am I Overprotecting or Underprotecting?

Hi all, I know this is a controversial subject but...

After acoustic trauma in Nov. 2017 I have been pretty religiously protecting my ears since about Jan. Well, I guess not compared to some people here-- I don't wear ear plugs going outside or anything, but I do only watch TV on low volume w. closed captioning and have pretty much listened to no music at all. Ear muffs for things like vacuum, blender, etc. I sleep with a sound machine because with my left ear against the pillow I can hear my pulsatile tinnitus, which is only in that ear.

In general I feel my tinnitus has gotten a lot better! Definitely more periods where it is VERY quiet, sometimes hardly audible at all, and more just a hum and less pulsatile. But strangely, during this same month or so it's improved a lot, I have also found that I get ear pain more quickly from any slightly too loud sound (i.e. I come home and my husband has stereo on for like 10 seconds). No hyperacusis or increased tinnitus, just bad ear pressure in that one ear that takes awhile to abate.

So my question is, am I underprotecting or overprotecting? One thing I have to say: things that would give me ear pain if heard alone (music played at regular volume, TV at regular volume-- electronic sounds in general seam the most problematic) do not if they are masked by, say, the hubbub of people talking, or a rain storm outside. I can also be at VERY loud receptions or parties with tons of people talking and not have any problems afterward-- both this and the masked louder sounds often seem to have a GOOD effect on my T, making it quieter. (It's only a problem if the loudness of the event makes the person next to me start yelling to be heard close to my ear.) All this makes me think I should be exposing myself more, but with some kind of masking. I even bought a little hand-held fan! I thought perhaps I could use it in the back seat of the car while my husband played music up front.

Alternatively, I need to protect myself more if these small things are giving me ear pain. But I also do wonder if the reason they are has something to do with seasonal allergies?

It's so hard to know the right thing to do!

 

You're doing good from what I can tell. Keep it up!

 

What is Overprotecting? Does it even exist?
If I lie in bed in a totally quiet bedroom am I Overprotecting.? .. and all this long and repeated silence exposure on my ears would cause permanent harm?

 

Overprotection is akin to sensory deprivation. The silent room analogy doesn’t really go far enough because we don’t live our lives in silent rooms 24/7. And in fact, if we were to, we’d likely experience auditory and visual hallucinations just like prisoners do when they are put into solitary confinement.

When we continually block our ears, depriving our brain of input, it is known that there is likely to be an increase in auditory gain to compensate. This will make your ears more sensitive to sound when you are not wearing protection giving a sense that everything is too loud. The fact is, it’s healthy to hear our environments. It’s only toxic if we continually abuse our ears to dangerously loud noise, in which case ear protection should be used.

 

@Ed209
yes but this "auditory gain to compensate" phenomenon is only happening while we are in silent/noise deprivation etc.. environments. Once we are back in normal noise it stops.. seconds or minutes later

In other words, it is NEVER permanent.

We do have studies where people wore plugs 24/7 for a full week, started to experience T and H but all this went away once plugs were removed.

And no one here is wearings plugs 24/7 anyway..

So my question to you Ed209..why even worry about it ?

 

I was overprotecting my ears and was anxious around moderate sounds.

It resulted in me getting Tensor tympani syndrome. You can find more info on this forum.

Read through it... if it fits what you are experiencing, you may be happy to know that once I realized it was mainly my anxiety triggering it, not the sound... it got better.

Instead of overprotecting, it may be caused by being over-anxious.

http://hearinglosshelp.com/blog/do-i-have-tonic-tensor-tympani-syndrome-ttts/

 

Unfortunately, some do and are experiencing difficulties. I’m no judge here, I’m just providing my opinion. It’s pretty much unanimously agreed, amongst experts, that wearing ear protection all the time is an unnecessary bad habit which can have negative consequences.

 

Forgot to answer this part. I’d worry about it because of all the PMs I receive from various people who are crippled by their fear of sound.

I know many people who won’t leave the house without double protection. I know someone who was very anxious because he didn’t have his protection and he heard birdsong outside through an open window. Most of these people rarely go anywhere without their ear protection (usually double), and this includes the shower. All of them experience sound as being ‘too loud’ and often have many other problems as a direct cause of this. It’s not something you’d wish on anyone.

I could go on and on as some are now stuck in a very vicious loop because of their reliance on protection. Extreme anxiety, hyperacusis (or general sensitivity to sound), phonophobia, misophonia, depression, and social isolation are all outcomes of an over-reliance on protection. Once this turns into an obsession there’s a very real chance that this behaviour will also make ones tinnitus worse. Thoughts can turn inwards and then one often finds themselves ruminating.

Once this behaviour is established, you’ll often find people freaking out - overwhelmingly - if they hear a sound without their protection. And when I say sound I mean any sound.

 

Thank you all, and perhaps especially you, Pero-- that is very interesting to learn about the tensor tympani syndrome. In many ways it makes much more sense to me that it could be something like that; it just seems implausible to me sometimes that these small sounds could set off a genuinely problematic ear reaction. I do still wonder if this syndrome colludes with some existing ear stuffiness from seasonal allergies also.

I guess it's just that ear fullness was my first symptom after the trauma, before getting the annoying T! So when it happens, I always think, Oh no, I must be doing something that is bad for my ears, that could lead to my T increasing. That is of course my and everyone else's great fear, making the T worse.

I'd love to get back to normal life again, though! I don't even need to go hear live non-classical music anymore-- it amazes me to say this, since I used to be a DJ and rock critic and went to all kinds of VERY loud shows in 80s/90s (read: Dinosaur Jr.), but now that I am 51, I am pretty cool with entering into a new phase (especially since I seem mysteriously to have given birth to a kid, now 12, who only likes classical music!).

 

Whilst I do not advocate the use of earmuffs or earplugs to supress normal everyday sounds. When used with prudence, they can be beneficial especially when a person has suffered noise trauma as in your case. I don't think you are overusing hearing protection. In fact, I think you are doing what's right for you and realizing the benefits. Carry on using sound enrichment and in time your symptoms will improve further.

Well done.
Michael

 

Correct. I think dealing with hyperacusis, phonophobia etc. would be much much easier if we had studies or medical professionals (ENTs, audiologists who know smth about tinnitus), confirm that our ears are not now more susceptible to noise trauma than those of a healthy individual. Then you have the people you speak of suffering from depression or extreme anxiety who are taking psych. meds that mess with your brain and may even cause hyperacusis as a side effect.

Can ANYONE in his or her good conscience step up and again, confirm that it's ok to put aside ear protection for these individuals too, because these types of drugs don't have a bad effect on their auditory system?

 

It's likely that a study would show an increased susceptibility to damage, EVERY other organ in our body works this way when weakened. I don't understand why this is such a foreign concept to some people. Is ANYTHING, biological or mechanical, just as strong after being compromised? Of course not.

So let's say all the studies prove, without a shade of doubt (which I believe they would), that our ears are compromised. Well guess what? We still have the problem of "how much should we protect?". The study can't give you an answer on that, as folks have said, we're all different.

So where do we draw the line? See
now we're back to that question. The (hypothetical) study has answered nothing. At the end of the day it's still going to be an argument.

I'd say most people should be fine only protecting against loud noises such as (bars, clubs, loud blenders, loud vaccums, crowded noisy streets, etc). Pretty much anything over ~85 decibels. That, in my opinion, is a reasonable cut off for someone with damaged hearing (I say this as someone with VERY damaged ears).

This protocol, I believe, should be the "baseline" of protection, if you feel the need to you can of course make adjustments. Hyperacusis must be addressed first though. I feel like a lot of people who are complaining of spikes from moderate noise have it. This can bring about the thought process that their hearing is very fragile and damaged, when in reality, it is simply oversensitivity.

Another problem is anxiety, spending your time reading horror stories on tinnitus talk is not conducive to healing. After reading many threads about other people's spikes you can start to view your own hearing as being as brittle as glass, easily shattered by the slightest of noises. In the early stages I believe it would be beneficial to keep time spent on this site to a minimum for that reason.

So in conclusion, try to be reasonable with the protection. If you have hyperacusis and anxiety, get those resolved first, there's plenty of resources regarding treatment available online. I would bet that most of the people convinced that their hearing is destroyed will realize that most of that was simply phonophobia and hyperacusis.

 

The subject reasons for spiking, hyperacusis, ASD or additional hearing loss is broad. Besides pressure changes, medications, diet, dehydration, under or over use of protection, lack of sound therapy, emotional well being and on and on - other physical problems may be a concern. Some of the other physical concerns include posture and movement - neck hinging, heart problems and arteries within the neck that can reflect to the ear. It's recommended that those with physical problems to limit decibels to 75 and this isn't a small group.

 

I do think it’s a fallacy to believe our auditory systems never recover. In general they do. The body is an amazing thing. The only thing that doesn’t recover is lost hair cells in the ear and we know this really has nothing to do with tinnitus.

 

@Greg Sacramento
It is a foreign concept because even specialists on the topic cannot agree whether 'yes' or 'no'. Just to give an example:

Q: Are you more susceptible to noise damage, if you already have intrusive tinnitus and hearing loss?

A1 by a Dr. in Otolaryngology, Head and Neck Surgery at Private Medical Practice (2001-present): "Yes. People who have tinnitus usually already have some type of hearing loss. Many times its high-frequency hearing loss that they cannot detect themselves. The nerve of hearing is laid out with little tiny hair cells. Those cells get damaged over time. It's like a forest that loses its trees. Somebody who has ringing has already lost some trees more than everyone else. Exposing yourself to more sound will accelerate the process."

A2 by an audiologist, MA Audiology, Case Western Reserve University Alumni: "No. Tinnitus means you may already have hearing loss. Everyone is susceptible to noise damage ( lawn equipment, hair dryer, rock music) but one is not more susceptible."

Source: quora.com

It is like going to different doctors and getting different or mixed diagnosis. One of the ENTs I saw said "Yes, your hearing is now more vulnerable to hearing damage.", the other ENT said "No, you lost some hair cells, there has been damage done but your hearing is not now more vulnerable to another hearing damage compared to a healthy person." There is no consensus on whether one is more susceptible to hearing damage when hearing loss and tinnitus are already present. If there was, and the answer was clearly: "one is not more susceptible to hearing damage after already having hearing loss and tinnitus", there would be far less cases of people suffering from hyperacusis, phonophobia, or misophonia, in my opinion. Overprotecting in general. If you want to make the right decision you need to have a sufficiently accurate piece of information first. Especially when it comes to health issues.

This is what I'd like to believe.

 

@Ed209
none of these things you mentioned as "worrying behaviour " are irreversible.

These are just temporary states when people freak out but everyone goes over these in due time, and H due to noise trauma will slowly clear out provided we give the ears a good time to heal - hence the protection needed.

Since its very hard to judge which noises are harmful at what stage of the recovery, and also hard to predict sudden loud noises which can set you back real fast, a little of over- protection will naturally be the norm while in noise un-controlled environments.

As for me, yes taking a shower after my noise trauma felt like being inside Niagara Falls, so I used silicon plugs each time for over a year but my H got better and better and no need now, no big deal, this did not make me a type of mental case.

 

Yep same here. Seriously do not freak out about noise, it can give you a whole lot of other problems like hyperacusis, ear fullness, emotional response to noise etc. etc. I had this happen to me

 

How would it reduce hyperacusis, phonophobia, and misophobia though? If anything having a scientific confirmation that our ears are move vulnerable would make people even more likely to overuse hearing protection out of fear.

The problem is that a lot folks come this the forum with mild hearing damage. They read all the horror stories (Bill Bauer is kind enough to compile all these stories in the form of quotes for new members, how thoughtful) and end up living life like they're one loud noise away from extreme T and deafness.

You don't need to leave the house wearing double protection for mild T, this is something brought on by stress and anxiety. Most of the people engaging in this behavior need professional help, but instead they hang around the forum and only make things worse by reading fear driven threads and quotes all day and night.

Some will prevail inspite of this flawed ideology but many will end up stuck in a cycle of spikes and a constant state of worry. This is what @Ed209 is always referring to, our sense of self preservation can do just the opposite in this situation.

 

Can someone explain this , because of auditory gain , is it same to sleep with no noise generator. Can your T get louder from seeping in a quiet room.

 

Sorry, I was talking about a scientific confirmation that our ears are not now more susceptible to another hearing damage compared to a healthy individual. I've got hyperacusis. This kind of information would then help me manage better my anxiety levels and have more confidence in 'letting go' of hyperacusis & phonophobia.

I believe, this would then also apply to many others suffering from the same health issue.

Why? Because a scientific or professional explanation that is generally accepted amongst a group of specialists on the topic (consensus) will outweigh anecdotal stories shared here on TT.

If it's the opposite case scenario, then yes. It will most likely lead to overuse of hearing protection out of fear.

You say, 85 dB is the cut off. Ok. Other notable members here say 80 dB. Now what? Define, please, 'mild', 'moderate', and 'severe' tinnitus. Is there a reliable scale reflecting t. lvls that you drew upon, or would that be your own definition?

I agree with you that sharing anecdotal horror stories on a friendly tinnitus support board is no good. It will create more anxiety, fear and phobias, that can lead to overprotecting or worse. On the other hand, since we don't have any scientific or pro evidence as I tried to point out earlier, then what? People will ofc listen to what hall of famers here, or other more experienced users have to say, read the unbelievably sad stories in the support section and the story continues.

Better safe than sorry, right?

Different people, different individualities, often in pain and fear. The outcome is then apparent. That is why, once more, we need a scientific or pro based consensus on what's right and whats's not. It's a vicious circle otherwise.

 

Ok let's assume, for the purpose of this conversation, that the medical community confirms that our hearing is compromised. How does that help you with your hyperacusis? You and I both already believe they are more susceptible, so how does an official statement benefit us? Like I said, it's not like they will be able to tell us an exact decibel limit. All it does is confirm what many of us already know.

The 85 decibel limit is what I believe should be a baseline, if you have extreme damage than you should probably cutoff lower than 85. Most T sufferers don't have extreme damage though, they come here with mild T that they got from a nightclub or something. How many folks on here have profound damage? Not many. In real life I only know two other people besides me with profound loss, both veterans, the rest are mild, yet they ALL live their lives like normal people. How is this possible? They don't read horror stories on the internet all day.

The problem with tinnitus talk is that you end up with a bunch of scared, paranoid, stressed out T sufferers together and all hell breaks loose. All of a sudden folks are using double protection just to go to the store because that's what other people do here. People feed off each other, sometimes for better, sometimes for worse, the latter applies in this situation.

 

@Jiri Most get hearing loss from loud noise that damages hair cells, but there's other things that can cause hearing loss. Some of those in the loud noise group could also have compromise border line hair cell damage. Others that get hearing loss from noise may also have physical conditions and disease that places them into a high risk group. For those with a physical condition where blood pressure, cranial nerves, nerve and fibers beyond the ear have influence may need to be careful with loud noise.

Bending the head will curve hair cells. https://treningogrehab.no/wp-content/uploads/2017/12/14296-004-75118A1C.gif A full discussion is at training and rehabilitation com where I have posted the link recently.

For those with hearing loss just from loud noise with no involvement of other conditions may be fine at the 80-85 decibel protection level. If other conditions exist, then the protection level may be 75 decibels or lower and this is stated by the World Health Organization.

 

@AZeurotuner
Fine. For the purpose of this debate we will assume that the medical community is certain that our ears are f*cked, and so is our hearing, we've got hearing loss, tinnitus and what not, so in conclusion we are more susc. to hearing damage.

That doesn't help with anyone's hyperacusis one bit. It has the opposite effect. I will now protect my ears even more, seeing the pros and experts have all agreed on this, resulting in more fear, anxiety and overprotection.

In my case, that doesn't even matter as much anymore. I am now more concerned with all the psychiatric drugs my body is loaded with and which I'm trying to wean myself off (excitotoxicity → new NIHL → worse tinnitus → fill in the blanks). Back to the topic, tho. When you said "you and I", then please speak just for yourself. You may have found your threshold of tolerance when it comes to dangerous noise levels. I didn't. Still in the early stages to know, may be? I was always taught to believe in facts and evidence. That is why I stated earlier:

This is a never ending story. A merry-go-round topic of a discussion. Should I be worried even more now that my hearing is possibly extra susceptible to hearing damage bec I'm in a drugs w/d (quite a lot of ppl are on this site btw)? Or that that may not even matter anymore because as one clever person on this site said, quotting: "The most likely causes are the down regulation of your gaba receptors. Once they up-regulate during withdrawal you can have a glutamate storm that induces excitotoxicity and can lead to hearing loss." See? It is all about getting the right piece of information so that you can then put all the pieces together to solve the puzzle.

Imo, there are two approaches to this, fishbone's:

Or just gather as much information as possible from healthcare professionals, scientific journals and knowledgeable tinnitus sufferers whose advice you trust. Do your own stats, weigh the pros & cons and then decide. The problem is, as I demonstrated in my post No.15 in this thread, that even said experts cannot seem to agree on what's still ok and what's overkill. So now what again?? Stuck in a place. At least for me.

I don't agree with this statement. I ended up in a nuthouse when I first got it. Had it been mild T, I'd not have even bothered looking up peer support on online tinnitus boards. I define 'extreme' damage by chronic pain & distress.

That is to be expected on a tinnitus support board, isn't it? That is why again, it's a vicious loop of people arguing among each other what's ok and what's not on and on and on again. We, as the scared, paranoid, stressed out T sufferers together deserve better than that. That's why we have 'Research News' and 'Treatment' sections here plus the handful of people who genuinely care about well-being of others and try to support them.

How can you be so certain about this? You don't live in other folks' shoes to be making such claims. As a hard-up student I am still trying to help out here financially by making donations every now and then, share what I've learnt with others or give emotional support when I see someone else struggling. Even tho I'm f@cking dying myself inside as of now to tell you the truth. My T hurts badly and that ain't no lie. Who's helping me? I got loaded with tons of meds and then yeah, go lead your life as you see fit. Cya! Hope based on information, information, information from good, reliable sources... and occasionally a shoulder to cry on when the pain's overwhelming and there's nothing you can do about it.

Ok. I'd only be repeating myself at this point. No hard feelings, Ross. I hope you get my point.

@Greg Sacramento I fully agree with your post.

 

@Jiri What you said above and what I said above does show that this topic is a complex subject. Someone can't fix into another's shoes unless they have the same size feet. Knowing what shoe size someone has is often an unknown for us here.

 

Reading comprehension is paramount... I was agreeing with you that our ears are likely more compromise, that statement had nothing to do with noise thresholds.

This is irrelevant in terms of actual damage. I had an Ex that has cried over a stubbed toe before, whereas I've seen professional fighters straight up compound fracture their toe and keep fighting like it was nothing. Does this mean that a stubbed toe is more damaged?

How you chose to deal with it is on you, and yes I do understand mental issues, adhd at age 10, diagnosed with bipolar at age 14, and I have ptsd from things we won't even talk about on here. Life can suck, we all deal with hardships, you've had enough time to feel sorry for yourself it's time to move forward. I understand that I might come off as the devil for saying this but it needed to be said. In this day and age we coddle folks too much, tough love is needed sometimes.

Well first off, because this is forum is full of "don't understand why I have tinnitus, audiogram shows no hearing loss" threads. If you had profound loss you would know it, it takes a LOT of damage to get there, ask me how I know. Not only that but the audiologist I visited told me that my level of damage is very rare at my age, which didn't make me feel too great but it proves my point. Severe damage is much less common than mild to moderate, I can only think of a few members on here that fit that category. Have you taken a hearing test Jiri? I'd be will to bet that you don't have much, if any, hearing loss.

Here's the thing, I know you care, but until you resolve your hyperacusis, it's the blind leading the blind as far as you helping people. I speak the truth, and I don't hold back, it pisses people off but that's ok, I do it help them. I've read too much "advice" on here since joining and almost became victim of it myself. People... GET YOUR HYPERACUSIS RESOLVED, YOUR HEARING ISN'T DESTROYED YOUR AUDITORY SYSTEM IS JUST HYPERSENSITIVE. If you want someone to hold your hand and tell you everythings gonna be ok it ain't gonna be me, go find glynis or something, what I will do is hold the door open for you to start your life again.

 

@AZeurotuner I like your post above. I think that Glynis understands that some have different condition levels. She has certainly been understanding towards my conditions.

 

There's so much wrong with your post that I don't even know where to begin contradicting it. Seriously, what are you even doing on a supportive forum...

It's not about feeling sorry for myself. It's about the constant pain and searching for a solution. I'm beginning to think you have very little idea if that's your reasoning.

Roughty-toughty fighters with ruptured anything. You know the difference? Ruptures are perfectly curable. Brain damage mostly isn't.

The argument ends right here.

Nice talking to you..