Noise and Tinnitus

Hello Dr. Nagler,

I have had T for 8 weeks. Would you have any advice on what I should do for T that gets louder with noise?

Last weekend my T finally got a bit lower after pretty much 7 weeks of screeching noise. As soon as I went back to my noisy office my T gets loud and screeches again. I have severe high frequency hearing loss and my hearing aids help me a lot as far as understanding speech, but I cannot wear them anymore because they turn my T sound into a high pitch loud whistle sound. I don't know what is the best way to handle this kind of T. I've been wearing ear plugs but am afraid I will get hyperacusis if I wear them too much. I don't have trouble sleeping at night because my T seems to get lower in quiet situations. I would really appreciate any advice you can give me.

Thank you for all the advice you have given on this forum. It has helped me so much.

 

Barbara, you must feel like you are walking a tightrope. You have sound-sensitive tinnitus, and you require hearing aids for communication. Sort of the ultimate damned if you do and damned if you don't scenario - at least as far as your auditory system is concerned. So you ask an interesting and moreover important question. I'll do my best to help you put things together.

I really want to congratulate you on realizing that if you fall into the trap of using earplugs too much, you risk developing hyperacusis, which on top of the hearing loss and sound-sensitive tinnitus is just about the very last thing you need!

Well, when anybody walks a tightrope, it's a balancing act. There are a lot of starts and stops - and it will take a while to find the right formula. So for goodness' sakes, don't be afraid to fall off and start again. Very fortunately your tightrope is just an inch or two off the ground; it's not strung across the Grand Canyon. I hope you will keep that analogy in mind. This will take some time. This will take some trial and error.

In my opinion the first step would be to see your ENT for another examination if you have not had one since the onset of your tinnitus. I generally recommend an ENT exam for anybody with tinnitus of at least six weeks' duration. It is unlikely, but maybe the ENT will find that you have one of the "fixable" causes of tinnitus or one of the extremely rare causes of tinnitus that can represent a health risk and that might therefore require attention in that regard. You will also want to see your audiologist for a repeat audiogram, etc. In terms of your hearing aids, your audiologist can add some "compression" that while preserving the amplification function in the range of conversation can at the same time take the edge off the louder sounds so they are not amplified to the same extent. Your audiologist might also be able to add a wearer-adjustable "white noise" program to your hearing aids (depending on brand and model) that will allow you to very gradually begin a process of desensitization so that over time your tinnitus will be less and less reactive to sound. It is quite possible that given a bit more time your tinnitus may begin to resolve on its own or you may begin to habituate on your own. Should that not be the case, if desired at some point on down the line, the same white noise program can be used for the sound therapy component of TRT. At night, even though you do better in silence, do try to keep some soft sound around you from a tabletop device or possibly using a Sound Pillow Sleep System - www.SoundPillow.com - so that the desensitization process can continue even at night.

So there's lots going on and lots you can do. I have given you some very general ideas of where to start, but I honestly feel that given your "tightrope" situation, you would be best off in the hands of a hearing healthcare professional with considerable knowledge and experience specifically in treating tinnitus patients and who can help you walk through the maze of therapeutic options.

You are most welcome.

stephen nagler

[Disclosure: I have no financial relationship with the manufacturer of the Sound Pillow Sleep System, either direct or indirect.]