Just How Far Should You Push Reactive Tinnitus? Should I Protect My Hearing More?

Did you do any hearing protection in the house? I do not. I am not running a vacuum or a blender and it’s just me, my husband, and my dog (she’s not a barker, thankfully). I’ve been doing pretty well with normal kitchen noises and TV on low, doesn’t really spike me or add any new tones. I can even talk on the phone for a short period of time on speaker and it doesn’t make anything go crazy. So, I guess the main trigger I need to consider is driving and going into stores. No new tones have been added, but reactivity is triggered with those activities and it can take some time to calm down.

 

Dr. Gladys Akinseye, an audiologist for Audiological Science in Harley Street. She has since moved to set up her own practice which I believe should be available soon. A Google search may help you locate her.

 

I do about about 2-3 hours of sound enrichment from the tap and late evenings I go to a park right next to me and listen to birds chirping and cars passing by. i don't use speakers for my sound therapy.

Yes, now I can handle doing the dishes and running the tap without protection. Today was a good day because I had zero spikes from a few pots banging together. Usually my hissing would spike so I'm making good progress.

 

Two big questions I forgot to ask you, if you don’t mind! You have been so helpful to many here.

1. At what point (timeline wise/months out from onset) did you experience enough improvement that you felt you were back to living life at a normal enough capacity where you were not consumed in the depression or fear of it? Do you feel working with a a TRT specialist helped you immensely with this mental part? I feel like I just need someone to make me feel safe, that I can improve, and that they can help me. There is a very well known/top rated TRT specialist in my city (Pittsburgh) and I am thinking of setting up an eval with her.

2. Did you take any meds or do anything in the beginning that you feel helped get you through the scariest times? For mood or sleep?

Thank you

 

About taking a step back... I don't have social life anymore, I don't work or study at the moment (for about a year now) and was just going out sometimes on the weekends with earplugs to some park, museum or a café without any worsenings. I realized that living like a monk (in my case) was aggravating my hyperacusis. Even one of my «setbacks» ocurred at home, when my husband dropped a metal chair right beside my ears... I felt horrible, like I was protecting for nothing. Before that metal chair episode, I had even taken a little trip and went to a very calm restaurant without earplugs and no spikes.

My situation was caused by an acoustic shock, so maybe that’s why different things work for you?

I know that I need to find an equilibrium (don’t protect too much but don’t expose too much) and this is the most difficult part. I saw the post from @Darrenb111 and I’m really thinking about doing TRT too!

Thank you for the answer and I hope you continue improving!

 

I would say the initial 3 months were the worst. It took me this long to be able to get the anxiety and fear under control. This was a combination of protecting my ears, guided meditation (Spotify!) and also CBT sessions with a lady that was experienced in CBT for tinnitus patients. Once the mind and body were calmed, it was a lot easier to plan and deal with life. The sleeping improved, the daily focus improved and I could start to spend time with family albeit still under hearing protection. But this all helped hugely with the anxiety and fear of the situation.

The TRT specialist wasn't a significant part of the mental and emotional side, but was a big part in the overall recovery.

Ben Thompson - an audiologist with Treble Health in LA, who is popular on YouTube, talks a lot about the success of TRT - may be worth watching some of his videos.

I didn't take any meds at all, the doctor and ENT I saw at the beginning were clueless and I was pushed from person to person with no answers and therefore was not prescribed any medicine. Looking back that was a good thing I guess.

Your comment of wanting someone to help you and make you feel safe is so true. The feelings of despair you can have at the beginning are hard to deal with and the feeling of complete hopelessness can wear you down but I would say finding the right tool set to deal with the day to day living is key. Keep strong minded and know that one day it WILL be easier than it is right now. Read success stories and don't delve too deep into other people's problems on these boards. Do everything possible to keep yourself out of stressful situations, use hearing protection when you need to and look after yourself above all others in these early stages.

 

Thank you for all of this. I just hit 4 months today and I am still in the depressive/panic of it all.

In those first 3-4 months before the TRT specialist was part of your situation, how much/when did you protect? In the house all the time? Sleeping? Did you keep distance from your daughter? Did you not drive? Or did you drive and go to a store with earplugs in? What form of protection (i.e. foam earplugs, custom earplugs, noise cancellation headphones)?

Home for me is pretty quiet, as it’s just me my husband and dog (not a barker). So I don’t protect at home and I manage the normal home sounds pretty well, but even on a day like today the wind is howling so loud (northeast area) and that alone is sending my hiss and tones crazy! And I only drive to go to therapies and store and have not been protecting. I’m just so torn on the protection aspect as I don’t want to develop worse hyperacusis than what I have with reactive tinnitus.

 

Being torn on this aspect @ErikaS is very common, and it's a challenge. A challenge that seems very different from individual to individual. Only you would know best. But I know the feeling. It is difficult, no question about that.

I would buy some custom made musician's earplugs. You need to get them molded specifically for your ears, and you can get different dB filters.

Use them when YOU feel you need them, but don't get used to use ear protection as sort of a protection from what may occur. This will eventually drive you into more sensitivity, and a fear of noise and worsening.

What kind of therapy are you going to?

 

Couldn’t agree more!

Once you can get the anxiety and constant panic under control, I firmly believe the human body’s nervous system will naturally start healing. You stop wondering if any little noise will trigger a spike and eventually unexpected noises don’t bother you anymore. The first 1-4 months I remember constantly being triggered by the slightest noises. Anything dropping on the floor heavier than a feather sent my ears into spasms and spikes.

 

It was so bad at the start and I had no guidance so I think I might have overdone the protection. I bought a pair of ear defenders, like you see airplane runway staff wear and I wore them around the house a lot. I kept away from everyone, it was Christmas also so I was very sad to be hiding away all the time. I then bought a pair of silicone earbuds from a company called Loop. These worked great and lowered sound around me enough for me to interact and not be in silence. They are really comfortable and I still use them to this day when I want some peace from the kids. I had to wear them in the supermarket which helped but I remember that they didn't help when driving. Maybe it's the vibrations of the car that can aggravate the ears, I'm not sure.

 

Thank you @MindOverMatter. I hate how it’s so up in the air, I have not been over protecting at all as I rarely even wear hearing protection, I let all my home sounds in from kitchen sounds to heating systems, but also being very mindful of not going to restaurants, bars, large social gatherings, only driving when I have to, and not going into noisy stores. Yet I just hit 4 months and my reactivity isn’t any better, and I still have multiple tones. I was hoping it would be somewhat improving by now so I could know what I’m doing is okay, but when you see no improvement, you question everything.

I currently am trying cranial sacral therapy to help calm my nervous system down as well as Neurofeedback for tinnitus. I also do remote regular therapy. I have a TRT eval in the beginning of February.

 

So I deal with 2 distinct variations of reactive tinnitus, although one of them to a lesser degree now. There’s the spiking variation (most common here) where my tinnitus undergoes a lingering spike after being exposed to all manner of noise (trivial or significant). Spikes can last hours, days, or weeks. This variation appears to be strongly correlated with loudness hyperacusis based on my experience. My susceptibility to spiking became more and more prevalent as my sound tolerance got progressively worse. At my worse point, my tinnitus was spiking to the most trivial of sounds. I was gifted quite a few tones (some semi-permanent) during this phase.

But once my sound tolerance and sensitivity began to improved, the spiking started to dissipate as well. I began to notice less occurrences of this reactive variation overtime. While the spiking is less prevalent now, it can still happen. As far as I know, the only thing that still spikes me is driving (even with hearing protection on) similar to the OP. Car rides lasting more than 30 minutes will result in a significant spike. And just like the OP, the nature of my tinnitus completely changes when spiked and my tinnitus will also increase in volume. The good news though is that I have assurance (most of time) that the spike will reset itself back to baseline by next morning.

Now the second variation is what I like to call ‘competitive reactivity’. This one’s cute. This reactivity is instantaneous and will depend on certain kinds of continuous noise in your surroundings. It’s the kind of reactivity that instantly overlaps with external sounds and will grow more louder and intense if the external sound itself (that’s triggering the reactivity) gets more louder too. The tinnitus tones that’s reacting will match however loud the sound source is. It’s like a competition to see which one can overwhelm the other hence why I dubbed this variation of reactive tinnitus as ‘competitive reactivity’. Trying to mask these reactive tones becomes a whole another challenge. Almost impossible at times.

The key thing to understand about this variation is that the reactivity will recede instantly once the noise ceases. In other words, your tinnitus tone(s) will immediately go back to down to a more low and familiar baseline once the external sound that’s triggering the reactivity is removed. There are NO lingering spikes.

I still experience this variation almost daily and it is mostly triggered by white noise like air conditioning or showers. The louder the AC gets (in terms of fan speed), my tinnitus will match its dB level. I’m not sure if this variation has any relationship to hyperacusis at all. There’s no way I can run away from this reactivity. This kind of reactivity gets triggered even in hearing protection. It often gets confused with distortions/dysacusis, but distortions is more about how the external sounds around you are being perceived, usually unnatural and strange. It’s a hearing issue.

Now on the topic of whether you should push reactive tinnitus or not and when to use hearing protection. This is a tricky answer and most of it will depend on the individual’s experience with reactive tinnitus. But as others have already pointed out, there’s needs to be a good balance. I think you have the right idea OP. I personally wouldn’t wear hearing protection in the house unless it’s warranted, but maybe you should start wearing some when you head outside in the meantime. If your tinnitus is spiking after noise exposure, then I personally would take some precaution until the spiking starts to ease up. If you experience the competitive variation of reactive tinnitus, then I wouldn’t worry too much about pushing it too far. It’s hard to avoid anyways.

I like that your listening to classical musical. I found it to be very therapeutic and this is unrelated, but I like to believe it helped return some of my distorted hearing that I was experiencing during onset. If you aren’t bothered by classical musical, I would stick with that in the meantime.

Reactive tinnitus is a bitch in all its sophisticated forms and it can easily drain you. It feels like it has a mind of its own at times. But try to be patient and start taking some precaution when it’s necessary for the time being. It’s a long process but the reactivity should ease up at some point. Rooting for you and your recovery.

 

You know you're desperate when you ask for a sound generator for Christmas. I have started using it with running water sounds at 30-35 decibels. Right now the tinnitus is reacting to it and staying louder. I'm not anxious; more in despair now. My logic is 30-35 decibels does not cause inner ear hair cell damage so...

I don't protect in the house or outside but I certainly avoid any loud environments like pubs, bars, gym classes etc. I had pain reactions to sounds for 4 months after an acoustic trauma, while wearing noise reducing earplugs with severe tinnitus as well.

 

Define "warranted"? What louder(er) sounds around the house did you consider merited the wearing of earmuffs? Toilet flushing, kettle, dishes?

With reactive tinnitus you're suggesting it's ok to allow it to rise (to which i agree is almost impossible to avoid anyway). Can you give some examples from around the house where you allowed some reactivity to cause temporary increase in your tinnitus?

 

@ZFire's description of spiking and competitive reactivity matches my experience quite well as I also have both. It took me a while to recognize that both components were at play. Once I did, I gained confidence on when to protect and when to expose.

It took trial and error, but I noticed that certain noises only caused the competitive reactivity to react. For me, these were noises like fans, air purifiers, AC, heater, rain sounds. All those cause my competitive reactivity to whistle, but never spike. So I learned that I can go about without worrying about spiking, even listening to them all night while I slept. And stepping away from these noises would allow the reactivity to settle, on the order of minutes.

Other noises, like dishes and silverware clanking and other my pitched noises like shopping cart wheels and high pitched noises that occur in supermarkets and restaurants and during driving cause my spiking tinnitus to react. Here, I learned that it was a matter of exposure time. The longer I expose to these sounds unprotected, the louder the spiking reactivity gets. If it goes too long, like 20 minutes, it spikes for the day (and resets after a night's sleep). If I manage to remove myself in time, the spike settles back down to baseline in 30 minutes to an hour. These kinds of sounds are what I wear ear plugs to protect myself from.

 

Anything you find uncomfortable and that might spike your tinnitus. Toilet flushing and kitchen work are decent examples. If there’s any outdoor noise that you find bothersome (lawn work or construction noise for instance) while at home and you think it’s going to spike your tinnitus, then plug up. But I think most normal everyday household sounds should be embraced at some point down the line.

I don’t think wearing ear protection 24/7 in the house is good either. No telling how that will impact the reactive tinnitus. It wasn’t good for me and there are a lot more others who would feel the same as well. If you completely deprive yourself of sound 24/7 for months using 30+ dB NRR hearing protection, you will likely be even more sensitive to higher frequencies (8 kHz). It’s likely reversible, but you’re just making things even more difficult than they already are especially if you’re dealing with loudness hyperacusis too.

I mean, there’s a study out there about sound deprivation leading to irreversible hearing loss. Some well known member posted the study about a year ago. I believe the mice were subjected to 1 year of complete sound deprivation to which cochlear degeneration was observed in some of these test subjects. I’ll see if I can find it when I have more time.

Now whether you agree or not, ears do serve a purpose and by depriving it of its functions completely, I think you run the risk of making the whole auditory system go haywire. Protect when you feel it’s necessary, but don’t go overboard with it.

Some of my tinnitus tones instantly react to white noise, so air conditioning, radiator, running water (shower, water faucet, outdoor rain), ceiling fan, and the refrigerator. When these noises are turned off, my reactive tones will go back down to my familiar baseline immediately.

Hearing protection don’t offer much help for this kind of reactivity. Sure you can block it if the noise is quiet, but I could wear ear muffs right next to a shower and I would still be able to hear my tinnitus react to the shower. So I see no point in wearing them. Doesn’t change anything. Might as well embrace it.

@Joe Cuber, my sentiments exactly.

 

Wearing earplugs at night can give you tinnitus?

 

Hi @Jupiterman -- I only regularly use earmuffs for two things: blending and vacuuming. I use them for other things that I do way less often, like using a hammer, snowblower, or something similar.

 

I got help from app called "Oto". I think it is available on iPhone and Android. There are courses that you can listen to, for example when walking. Those courses helped me on the mental side. Bad thing is that those courses are not free but the price is small.

My tinnitus was also reactive at the start but it faded away almost completely in about one year. I now always protect my ears in places where the volume is high. Keep up the good spirit. New and stronger you will come out of this whole thing, trust me

 

Following up on this post. Found it.

Sound deprivation leads to irreversible hearing loss

Make of it what you will.