Cannot find this info - noise exposure consequences

Discussion in 'Dr. Stephen Nagler (Archived Answers)' started by Martin Jensen, Nov 28, 2014.

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    1. Martin Jensen
      Fine

      Martin Jensen Member

      Location:
      Denmark
      Tinnitus Since:
      2011
      Cause of Tinnitus:
      Not sure
      Hi Dr. Nagler, i find it difficult to find any useful statistics on the internet about the following: we all know that having tinnitus and subjecting oneself to a noisy environment is ill adviced. I went to a cinema a couple of weeks ago and since, T has gone off the top. It really feels intrusive some days whereas on others more calm. But definitely different pitch and volume to my previous T. I spoke to an audiologist who said I was in an acute phase and that it would most likely subside. Which others on forum have suggested as well. Back to the opening statement. What do we know about the effect of noise exposure on existing T? Do we have any percentages to go with? Does it calm down in time for most people? I fluctuate between hope and despair, depending on my current intensity level. Should say I was 100% habituated both to reaction and perception before. Not done any TRT.
       
    2. Dr. Nagler

      Dr. Nagler Member

      Location:
      Atlanta, Georgia USA
      Tinnitus Since:
      04/1994
      @Martin Jensen wrote:

      "Hi Dr. Nagler, i find it difficult to find any useful statistics on the internet about the following: we all know that having tinnitus and subjecting oneself to a noisy environment is ill adviced. I went to a cinema a couple of weeks ago and since, T has gone off the top. It really feels intrusive some days whereas on others more calm. But definitely different pitch and volume to my previous T. I spoke to an audiologist who said I was in an acute phase and that it would most likely subside. Which others on forum have suggested as well. Back to the opening statement. What do we know about the effect of noise exposure on existing T? Do we have any percentages to go with? Does it calm down in time for most people? I fluctuate between hope and despair, depending on my current intensity level. Should say I was 100% habituated both to reaction and perception before. Not done any TRT."

      ...............

      Hi Martin -

      Sorry it's taken me a few days to respond to your inquiry. I've been thinking about the best way to go about it ... and nothing seems to be working real well because there simply isn't a whole lot of hard data on the subject.

      So I'm just going to tell you how I see it - with the understanding that you are getting opinion based on a lot of experience, but not based on a lot of science.

      Well let me start by dodging all the rotten vegetables that will surely be thrown my way when I respectfully disagree with your statement: "We all know that having tinnitus and subjecting oneself to a noisy environment is ill adviced." I see nothing wrong with subjecting yourself to a noisy environment ... as long as the environment isn't so noisy that it can potentially cause auditory damage. How noisy is that? Well, my dear friend Dr. Jack Vernon used to tell his tinnitus patients that if they found themselves in an environment such that they had to raise their own voice in order to be heard by a person standing next to them, then they should either use earplugs or leave the room. And so should everyone else!

      Implicit in Dr. Vernon's above "Rule of Thumb" is the concept that a person with tinnitus is no more susceptible to noise-induced auditory damage than the general population. I wholeheartedly agree with Dr. Vernon in this regard, but I can find no truly conclusive evidence one way or the other. I myself have screaming tinnitus 24/7, and I use earplugs at most once or twice a year.

      Now, what about those folks whose tinnitus itself gets louder when exposed to noise? They have a decision to make. Assuming that the noise is not loud enough to cause auditory damage, are they or are they not willing to put up with a temporary increase in tinnitus loudness? In other words, are they or are they not willing to allow their tinnitus to dictate their lives? And, if so, to what extent?

      But doesn't a noise-induced increase in tinnitus mean that they are damaging their ears? One would think so at first blush, but there are a lot of things that can temporarily increase tinnitus for some people - stress, fatigue, caffeine, whatever. I cannot see how stress that is severe enough to temporarily increase tinnitus does so by causing auditory damage, so why assume that noise is any different (as long as it is not loud enough to violate Dr. Vernon's threshold.)

      Martin, I am sure that my response is less-than-satisfying and may, indeed, have left you with more questions than it answered. But it's my very best shot.

      Dr. Stephen Nagler
       
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