No Idea What to Do (New to Tinnitus / Hyperacusis)

Hey, I got my issue for an acoustic trauma 3 weeks ago in the first ever concert I went to in my life following friends (stayed for 30 minutes).

I took cortisone for a week starting 48 hours after the trauma.

Over the last week, trying to somehow restart my life I have noticed:

If i stay in complete quietness, tinnitus is low enough, and even disappear for a few hours at a time.

Full hearing keeps coming and going.

If I stay home and keep to low sound activities, it does become slightly worse over the day.

I try watching TV, but the sound quickly become uncomfortable/hurt slightly.
Then T spikes and my ears are sensitive and any sound can hurt (even people talking, fan, of sound of a clock).

A few days ago, went to see an ENT, had ear plugged for the drive but it still made my ear sensitives, and simply him talking to me spiked T again.
He thinks I have H and need TRT.

Yesterday, tried to go out near the sea in a place with very little people (again, plugs to drive there).

I remove the plugs, the sea sound was fine and relaxing, but after about 1 hour, i noticed it became uncomfortable.

Went home as T was spiking again.

I just woke up and T is back to its normal low level.

I'm not sure what exactly to do.
Should I try to stay home most of the time? Not much of a life.
Should I keep trying to get out (terrified that one of the spike might become permanent).
To wear earplugs everywhere, even in quiet natural places? Not a great thing either.

 

Please try to live your life as normal as you can and please don't overuse earplugs. Just a little advice from someone who has had this for 6 years.

 

Are you saying that eventually he will stop having spikes? Are you are saying that eventually he will habituate to the spikes?

How bad was it for you in the early weeks? How loud was your T?

 

HI @flobo

In the early stages tinnitus isn’t easy to cope with and most people that have had it for a while will tell you this. I have had TRT twice and It is one of the best treatments for tinnitus and hyperacusis but I do not think it is the right treatment for you at this moment. Your anxiety and stress levels which have been caused by the tinnitus need to be under better control.

I advise putting off trying TRT for at least four months preferably six months. Many people habituate to tinnitus within the first six months to a year without any treatment. As I have previously mentioned to you, have a word with your GP and try an antidepressant if it is advised. You could also try an alternative St John’ Wort. Please read the post below: What is TRT and when should it be started?

What is TRT and when should it be started?

Some people have been sending me private messages asking if TRT cures tinnitus?
TRT or Tinnitus Retraining Therapy, is what it implies: Through regular counselling sessions there is a gradual retraining of the way a person thinks about tinnitus and to treat it as non life threatening. There are two parts to the treatment. Counselling and sound therapy. Sound therapy is supplied by wearing two white noise generators and then using a “sound machine “ at night by the bedside for sound enrichment. If hyperacusis is present the sound therapy will treat it and also the tinnitus.

At first the therapist discusses with the patient how the tinnitus makes them feel and how it has impacted on their life. Often people say they have lost interest in the things they once liked doing, which is perfectly understandable. The main goal here is to gradually help them look at life differently and with a more positive outlook. Over time the negative thinking that is often associated with tinnitus and hyperacusis is gradually dispelled and demystified.

The Hearing Therapist does this in a controlled and precise manner so that the patient feels relaxed and not pressured. In many instances the tinnitus is gradually pushed further into the background making it less prominent. Therefore, it must be stressed and understood, this treatment takes time. To complete a course of TRT takes approximately twelve to twenty four months and in some cases longer. The duration of each counselling session is left to the discretion of the Hearing Therapist. Typically, these can last up to one hour or more. The amount of appointments required will be different for each patient, but it is quality rather than the quantity of the counselling that really matters.

There are a few misconceptions about this treatment and the way it is administered that some people misunderstand which I want to address. If a patient is given one white noise generator to wear this is not TRT. When two wngs are issued and no tinnitus counselling is offered on a regular basis, it is not TRT. I am not saying that a patient will not gain any benefit from the above treatments; I only want to state they do not follow the proper Tinnitus retraining therapy protocol.

When should TRT be implemented or started?

The following is based on my own opinion and therefore is not professional medical advice. The onset of tinnitus can be quite an emotional roller coaster for a lot of people, and I believe a person needs time for this to settle. Many people habituate within the first 6 months to one year of the onset of tinnitus without any treatment. If a person just has tinnitus without any additional symptoms, such as dizziness, deafness or balance problems. I think a period of six months should elapse before starting a long-term treatment such as TRT.

Michael

 

If it was simply a constant low T like it is now, i think i could habituate.

But even getting out of the house, or trying to watch tv make it spike for a while. And spike are terryfing.
While getting to the beach yesterday made me feel way better, I'm now terrified of doing it again in case it would spike again and this time not come down.

 

This is my point @flobo. The habituation process takes time. I have experienced what you are going through and believe me a lot more. For the first 4 to 6 months my whole head was completely numb and everything I heard it felt as if I was listening under water, it was a frightening experience because I thought I had completely blown my hearing. I was experiencing trauma to my auditory system caused by headphones. You will improve but it takes time. Continue using sound enrichment at night and during the day, this is very important.

Michael

 

But that's my point. Sound enrichement makes T worse.
As soon as i go back to silence for a period of time, T lessens.

 

The spiking is caused by "Hyperacusis" It is not a good idea to "stay at home" all the time. Buy sound noise-reducing earplugs, the kind that have filters built-in. Do not use foam earplugs. Use the noise reducing earplugs for a while. As soon as your hyperacusis starts to improve stop using the earplugs.

 

You must persist with the "sound enrichment" keep the volume very low. You are setting it too high. Unless you use sound enrichment your hyperacusis will not heal. Trust me on this I know.

 

I try, i keep moving between putting on and removing my noise free helmet.

That way, T goes up a bit, then down when in silence, and so on.

The issue is that the longer i stay in noise (even very low noise), the higher T becomes.

And it takes a while for it to go back down with the helmet.

 

I have been experiencing the same phenomenon.

 

What is a noise-free helmet? It doesn't sound very comfortable.

 

Peltor Optime 3, sorry about the bad english.

So far, using this has been the only way i have been able to take naps during the day (i hardly sleep at night), since T slowly decrease in there.

Did yours stay like this over time ?

 

Your tinnitus is fairly new, it is scary and uncomfortable. It is and was like that for all of us, it takes time to adjust to it. over-using ear plugs just makes your ears more sensitive, or it can. I went to my audiologist and did some kind of training that helped with the hyperacusis.

Not all sounds are bad, loud ones are bad. Tinnitus can affect how we think and how we feel, try to remain calm and just take it easy...

 

How long have you been experiencing it? How do you cope with it?

 

Well, things kinda started going downhill after an acoustic trauma over a year ago. But it's been particularly bad maybe the last 6 months. I cope by avoiding sound that significantly spikes my tinnitus. Particularly long duration noise that progressively spikes it. I do not know if this is the right course of action.

 

Keeping away from sound is not a good idea as you will make the hyperacusis worse. The best treatment for this is the wearing of white noise generators normally used as part of TRT. By subjecting the auditory system to low level white noise administered by the WNG, over time will desensitize your auditory system "closing down" the auditory receptors or gateways that have been opened up by noise trauma. I advise using low level sound enrichment at night using a sound machine. More is explained in the link below: Hyperacusis, as I see it, if you wish t pursue this route. I also suggest you see a Hearing Therapist or Audiologist whose trained in tinnitus and hyperacusis management.

Michael

https://www.tinnitustalk.com/threads/hyperacusis-as-i-see-it.19174/

 

@Michael Leigh

Thank you, Michael. To quote Fox Mulder, I want to believe. Though when I expose myself to more "normal" sounds, my tinnitus spikes. And therein lies the problem. Do I continue exposing myself to more sound despite the often prolonged spikes? If a spike lasts a few days or more, and it happens every few days then it is, in effect, permanent. At what point might I expect the increases stop? I fear it leading to a permanent increase. It's very clearly worse than it was even a month ago. I am afraid.

 

Hi @TuneOut

Your noise trauma seems to be quite severe but given time should recover. The way I see it there are three choices you have.

1. To do nothing and hope that your auditory system improves naturally with time. There is no guarantee of what is going to happen by choosing this method. In the process you might experience a lot of spikes due to your sensitivity to sound. I have always said that if hyperacusis doesn't cure naturally or isn't treated spikes in tinnitus will continue to be a problem. Some people call this "Reactive tinnitus"

2. You could try the methods I've explained in Hyperacusis As I see it. Using sound enrichment at night (something I strongly advise) and using it during the day.

3 Seek professional help with a Hearing Therapist or Audiologist whose trained in Tinnitus and Hyperacusis and their treatment, using TRT.

I believe hyperacusis can be completely cured and my own experience is evidence of this. However, in severe circumstances professional help will be needed to cure the problem. If I were in your situation, I would first try using sound enrichment as described. I would also use a "standard" pair of noise reducing earplugs and use them appropriately. This doesn't mean to overuse them which can make your sensitivity to sound worse. Just use them when you feel it necessary to avoid your tinnitus spiking. Your experience with tinnitus should help here. Hopefully in time the hypercausis will cure. I advise not to use headphones and when listening to audio through speakers - whether in the car or home keep the volume at a moderate (comfortable) level.

In my opinion the worst thing to do is keep away from natural daily environmental sounds. Therefore, use noise reducing earplugs, just until you notice improvement then stop wearing them unless in very noisy surroundings. Use sound enrichment at night. I suggest buying an Oasis sound machine. Model S-650 is popular.

Michael