Coping with Reactive Tinnitus

Does anyone have advice on how to cope with reactive tinnitus?

My tinnitus gets louder with constant noise, such as the sound of air conditioning coming through vents, which I have to listen to all day at work; also the noise in restaurants or anywhere there are lots of people. The noise doesn't have to be excessively loud, just constant. I don't have hyperacusis because the noise doesn't hurt, it just turns my tinnitus into a very loud whistle sound.

Is it possible to habituate to this kind of tinnitus? Is there anyway to deal with this other than wearing earplugs?

 

I had the exact same thing, it ended up going away after 3 months but it was very difficult and somewhat debilitating. I would say it's 95% gone, maybe 100%, but I wouldn't know for sure unless I go to a night club or something. I don't know exactly what helped it but here is what I did.

In essence I would expose myself to the sounds for as long as I thought I could without it reacting, then give my hearing a break for about 30', then re-expose to the sounds. I walked a fine line between maximizing exposure without causing a reaction. We have a fridge and HVAC at work that caused mine to react, so I put a headset on a couple of times throughout the day, I know this may not work for some since it makes there T louder. In the car I would wear earplugs for half the drive, then take them out.

The first month was awful, it seemed like every other week I was adding more sounds/places that I couldn't tolerate. The second month I could cope by avoiding or wearing earplugs, still not fun. Towards the end of the second month I really tried exposure with occasional breaks, I had read about the risks of overprotection. By the end of the third month I could tell it was improving so I took the gloves off and really pushed my auditory system by exposing it to all the everyday sounds that everyone else tolerates. The loudest was being on an airplane with no protection, I put plugs in after 2 hours because I could sense a little reaction, but after a short layover I took the next 2 hour flight with no protection and was fine.

I hope it never comes back.

 

I am sure that others will have a different view on this subject, but I think that it would be very difficult to cope with tinnitus that gets markedly louder on exposure to noise.

Sounds awful. I do not have "reactive tinnitus," so I can only imagine what it would be like. I feel for you.

Oh. Absolutely you can habituate to it. I do not see how you can cope with it, but many people habituate to it. That's a totally different story.

Earplugs only make it worse in the long run. Yes, it's a quick fix ... but it has some significant long-term consequences. I'm not sure I'd go that route if I were you.

All the best.

 

I have worn earplugs a lot lately and this got me thinking: What kind of consequences?

 

Here's a way to totally cure it, get keppra. My reactive tinnitus/hyperacusis is gone when I used it.

 

If you overprotect your ears - either because you have hyperacusis or because you have "reactive tinnitus" - then the inevitable result will be even greater sensitivity to sound when you stop overprotecting your ears.

Let me offer you an analogy. But please keep in mind that no analogy is perfect.

So when I was in college there was a very popular bar near to the campus called "Nick's English Hut." I just googled it - and, sonofagun, Nick's is still there in the same location 50 years later!!!

Anyway, back in the 60s Nick's was a very very dark place - lumen-wise, I mean. Maybe the owner didn't want his customers to know how dirty the place was. I don't know. So I would walk into Nick's in the mid-afternoon, have a few beers with my buddies, and head to the library an hour or so later. (I was a pre-med student at the time and actually had to study. I don't know if my friends ever left the place!)

So I would leave this incredibly dark bar while it was still afternoon - and the sunlight would absolutely blind me. I would have to "shade" my eyes with my hand until I got used to it. In physiological terms, "getting used to it" means that the pupils of my eyes would in relatively short order contract to let in less light ... whereas while I was in the dark bar, they were fully dilated in order to let in more light. I was just fine walking from the daylight into the bar - but that same daylight was blinding to me as I left. Those of you who have been to Nick's ... or to any of the millions of Nick's across the globe will know what I am talking about. In fact, I understand that in the UK, dark pubs are the equivalent of national monuments!

Well, the auditory system works pretty much the same way ... except the auditory system has no pupils!!! Which means that the effects of overprotection (i.e., hanging out in that dark bar) can gradually over time be cumulative. And even relatively soft environmental sounds can become challenging over time.

I hope this clarifies more than confuses. Now on that note I'm gonna go grab a beer! Care to join me?

 

I have struggled with this issue as well. Mine has gotten better with time. I still use ear plugs when I am in any situation in which a person's voice has to be quite loud to be heard... or when I run the vacuum cleaner, etc...

My ear still reacts, but not to the extent that it did on the onset of tinnitus.

 

Oh you are so lucky!!! I wish mine had disappeared after 3 months. I'm almost 7 months in and it's still giving me trouble despite my valiant attempts to not wear ear plugs and expose myself to sound everyday. The baseline tinnitus is not that loud and when it escalates it isn't exceptionally loud either, but the tone shifts and become quite intense coupled with pain which feels like someone is pressing on both my ear drums from the outside...that underwater feeling. Whilst I return to baseline in the morning after sleeping my ears for the next day or two after an escalation are more sensitive and prone to pain/tonal shift.

It's the pain and tone that get me. It just makes me wince!

@Dr. Nagler Thought I would let you know I am off to see Grant Searchfield on Monday 25 May. He doesn't see patients these days, so I am quite lucky in that regard.

 

That's wonderful, Mark. How did you manage to get an appointment with him if he is no longer seeing patients?

 

I asked for him specifically and mentioned that you had recommended him to me. I have the privilege of meeting him and another audiologist or for the price of one. I am quite blessed in that regard. So thank you!

Just a question for you Dr, in your experience of people with sound induced changes to tinnitus perception, has that gotten better with time? When I read 3 month recovery from the original poster it has the effect of a punch to the gut as far as my progress has gone.

 

You are very welcome, Mark. They say that even a broken clock gives the correct time twice a day. So I am glad I got this one right! Dr. Searchfield is a good man; I'm very pleased that you will be seeing him. And it makes me smile inside to know that I may have played some small part in it all!

Mark, you are asking me to walk a bit of a tightrope here - so I will do the very best I can and be as honest as possible. You want to know about my experience - but pretty much all of my experience is with TRT. And using TRT I have found that people with sound-induced changes to tinnitus perception do very well indeed. The problem is that there really isn't much in the way of TRT in New Zealand. And moreover my friend Grant Searchfield is not a particular fan of TRT. So where does that leave you? Well, since there really isn't any good TRT in New Zealand, the fact that Grant is not a particular fan of TRT is really irrelevant! What is very much relevant is the fact that if anybody in New Zealand can help you, it's Grant Searchfield. Grant is the best of the best - in terms of knowledge, in terms of humility, and in terms of integrity. So my sense is that you will do just fine if you listen to him and follow his suggestions. I am very excited for you!

Here's a photo of Grant, his charming wife Leslie, and me in a restaurant in Auckland back in 2002!

 

Thanks Doc.

 

Mark-I hope it gets better for you, it was very difficult to deal with. I didn't have the pain or tone shift, I can only imagine. I know everyone is different and has their own timeline, hopefully your timeline will end soon.

I have two categories of sounds, the reactive part essentially created static and ringing and would match the offending sound in volume, this category is much better. I still have a pulsating hiss in my left ear and a hissing in my right ear that sounds like I am walking in snow when I walk. Each side behaves differently, louder or quieter, when I move my head or push on parts of my head.

I was hoping that the improvement I saw in reactive T meant everything was improving, but not so much.

I'm still considering some type of treatment, masking device, or something.

 

Interesting thread, now I know what I have. I was calling mine "competitive" but perhaps reactive is the better term. If I go into a noise rich environment, the tinnitus merely ramps up in intensity. It is aweful.

 

If everyone would actually listen. Keppra can cure all of that. Read up on the hyperacusis thread. Let me tell you, it will help you! It can't totally cure tinnitus, but it can get rid of the static noise, the reactive part and hyperacusis. Hope that helps.

 

Actually I think "reactive tinnitus" is an absolutely terrible term. I mean, my tinnitus doesn't react to noise ... but the spices in Thai food ramp up the intensity incredibly. So since my tinnitus reacts to Thai food, I guess I have "reactive tinnitus" too, right?

 

Correct me Doc, I think it's really called "winding up" when relatively soft sounds over a period of time causes T to spike or "kindling" if louder sounds do. But I think kindling means the spike lasts for more than a day.

I only use the term "reactive" because more people seem to use it.

 

"Winding up" is a significant worsening of tinnitus and/or hyperacusis due to exposure to low levels of sound for a fairly long time. "Kindling" is a prolonged exacerbation of tinnitus and/or hyperacusis due to exposure to moderate or loud sound for a fairly short time.

These two phenomena are not all that uncommon. But if either lasts more than 24 hours on average, that decreases the success rate of TRT. I do not know how they impact the success rates of other treatment approaches.

I understand, pilot. A lot of people use the term "irregardless" too, but that does not make it right!

Anyway, irregardless of whether or not you have reactive tinnitus ... I hope you will have quieter days ahead!

 

Can you be subject to both "winding up" and "kindling"?

Mine gets louder from exposure to sounds for a fairly short time, e.g. 10 minutes at the lunch table can cause the perception of tinnitus to change and become more disturbing. So this would be "Winding Up"?

After "Winding Up" my tinnitus tends to stay at that level until I sleep. Would that therefore be the "Kindling" effect that you describe?

So in other way to describe my tinnitus would be to say it is subject to "winding up" and remains "kindling" until the next day?

I could describe it to Dr. Grant Searchfield this way and he would understand?

 

If you are asking my opinion, Mark, I wouldn't do that at all when you meet Dr, Searchfield. Just tell him basically why you are there, answer any questions he asks, and let him figure out what terms to use. That's his job!