Protecting? Overprotecting? Not Protecting?

Discussion in 'Support' started by Jiri, Mar 10, 2018.

    1. PeteJ
      Depressed

      PeteJ Member

      Tinnitus Since:
      02/2019
      Cause of Tinnitus:
      acoustic trauma?
      I don't believe that depression and stress/anxiety alone causes tinnitus. It doesn't make sense to me. I was depressed for a long time but never got it. I have it from loud noise/acoustic trauma. People are exposed to loud noises all the time and some people here have talked about 'hidden hearing loss.' I discovered that doctors and audiologists (the ones I talked to) have no clue what this is. These are supposed experts not knowing at all?
      I think people who are depressed and/or stressed/anxious had acoustic trauma along the way and the combined 'brain rewiring' which is assumed to occur with what depression/stress does instigates the tinnitus - in other words, made it worse. Many people have very mild forms of tinnitus - from hearing loss as they age or get exposed to loud noise/sound. As the hair cells are damaged or dying, it comes to a point in which too much damage occurs and the tinnitus worsens. This is just my theory from reading several reports on tinnitus and hearing loss.

      I suppose ototoxic drugs also plays a factor but I wish researchers/scientists would also look at prescription drugs and people's mental states as it relates to the formation or presence of tinnitus. It seems to me that the worse forms/cases of tinnitus is due to acoustic trauma combined with hearing loss.

      As for protecting ones ears - I realize that the hearing field/community/doctors say that you need exposure to sound and they often encourage tinnitus sufferers not to over protect but acoustic trauma to an already affected tinnitus sufferer is serious and dangerous. I have read posts of people who already had tinnitus being exposed to yet another loud noise and then posting about spikes and changes. I have also had this experience - I was over protecting but then decided to go into a store without plugs after an audiologist insisted that I should allow normal sound experiences. That turned out to be the worst advice possible which I have read on here so I disagree with those who said to not use plugs/muffs. It has ruined my life.

      The only reason that plugs/muffs might not be good is that it can cause inflammation - my inner ear canal is inflamed in my left ear from foam plugs. I also worry about what muffs might be doing. I am wondering what ear plugs are good to use that won't cause inflammation - from over use. I am not using them all the time but because random loud noises can happen at any time, anywhere, I wanted to use them at times to avoid potential setbacks and further damage. In this situation, as a tinnitus sufferer, the expression 'damned if you do, damned if you don't' comes to mind. :-(
       
    2. Ed209

      Ed209 Member Podcast Patron Benefactor Ambassador Hall of Fame

      Tinnitus Since:
      07/2015
      In short, nobody knows for sure. I’ve had tinnitus since around the year 2000 and it came on during an extremely stressful part of my life, but also a noisy part of my life too. None of my friends had it at the time I did, but we were all exposed to the same noises. I think there may also be a genetic factor as my dad also has it.

      I’ve read the literature quite extensively and there are indications that stress may play a very pivotal role in some cases. For example, many people get tinnitus during childbirth; this is well documented. People in the military are particularly at risk because they are exposed to both stress and noise which is likely the ideal scenario for tinnitus to be perceived in the brain. It’s also more likely if a person is mentally exhausted or burned out, and tinnitus can also be a sign of a nervous breakdown. I think the gating hypothesis has merit because it explains why some people hear tinnitus and some don’t, even though the same hearing damage is present. There may be a problem with the limbic system of those whose tinnitus has taken over, and this would tie in with the emotional significance it’s given and the way it’s perceived, etc.

      Having said all this, nobody is entirely sure what’s happening. We know from Dr Shore’s work that fusiform cells in the DCN can become hyperactive in brains that have tinnitus, and this can create synchronicity in other areas of the auditory cortex and brain which could create the perception of noise. However, Dr Rauschecker postulates that in order to perceive these noises our limbic system (more on this below) has to be malfunctioning as he believes that in a normal brain these noises are filtered out before they reach the higher functioning parts of our brain (which includes our conscious awareness). This essentially means that everyone with hearing damage has some form of tinnitus signal being generated within their brain, but only a certain percentage pick that signal up and tune into it. Once it is detected it seems incredibly difficult to un-hear it and fMRI studies (people like Fatima Hussain) have shown that people with tinnitus tend to light up other areas of their brain (compared to non-tinnitus sufferers) under certain conditions. There also seems to be involvement from various memory, behavioural, and emotional parts of the brain like the caudate and putamen (dorsal striatum), nucleus accumbens, ventromedial caudate, ventral putamen (ventral striatum), amygdala, hippocampus, etc. This suggests that the way in which a person deals with their initial experience of “hearing” tinnitus may have more longterm ramifications. This is why many people advocate the importance of relaxing, de-stressing, and utilising things like CBT, mindfulness and meditation. That’s not to say they will do anything, but calming your CNS down is always a good start; especially immediately after onset.

      There are also studies (on mice) looking into the effects that various potassium channels may be having, particularly in relation to the excitability of one’s fusiform cells in the DCN. Danny Boy managed to calm his tinnitus down by using Trobalt (Retigabine), but this, unfortunately, gave him terrible side effects, especially with his eyes. At the moment, Prof Thanos Tzounopulous is seeking to control this compound by eliminating the side effects to make a better more viable drug. He recently received some funding from the US military for this.
       
      Last edited: Mar 12, 2019
    3. Lucifer

      Lucifer Member Podcast Patron Benefactor

      Tinnitus Since:
      2017
      Cause of Tinnitus:
      Ear Infection
      Recently I have developed severe hyperacusis and I was wondering what is the best method for it to have the highest chance of improving.

      Should I protect my ears or not?
      E.g., showers or driving.

      Many people are saying different things but I'm not too sure what to do.
       
    4. Arseny
      Wishful

      Arseny Member

      Tinnitus Since:
      2018
      Cause of Tinnitus:
      Possibly from problems with blood flow
      How is this possible?
      82-85 dB is the level of noise in the car unless you're driving a luxury sedan.
      By this logic virtually anyone would damage their hearing by commuting everyday to work.
       
    5. Orions Pain
      Dreaming

      Orions Pain Member Benefactor

      Tinnitus Since:
      2019
      Cause of Tinnitus:
      Loud music
      I’ve recently come to the understanding that my H is more of the problem than my tinnitus. I’m 3 1/2 months in and the symptoms keep progressing despite my best efforts to follow advice online

      -avoid clubs, bars, loud places
      -protect in moderately loud places (restaurants)
      - not overprotect

      Each time I try to live “normally” I experience set-backs. I’d love to hear some critical advice as to what I’m doing wrong here

      I work in an office which is an open concept place so people often talk over each other, drop things, etc. I also take about (10) phone calls a day which usually don’t exceed 5 minutes.

      I drive to work everyday (about 20 min). I go grocery shopping or to places like target and don’t wear ear plugs.

      My sensitivity extends to things like the toilet flushing in the morning, lots of people talking close to me, kids screaming, very busy common areas in malls and crowded restaurants and cafes.
      I don’t experience “pain” but everything just sounds extra loud. I was at a park one day which lots of young people go to to drink and picnic on the weekends. It’s a huge park and tends to fill up. I measured the dB level and it got was around 75-80 there, and I just recall being overwhelmed by the sound at some point.

      My scariest symptom is the TTTS in one ear only. At its worst it was a vibrating, buzzing, constricting feeling in my ear for about 6 hours. It lingers around but these days it’s mostly a tap tap microphone testing sensation that comes and goes without a pattern. Doesn’t seem to react to noise for now.

      I’m at a loss of what to do. Do I wear ear plugs more often? Do I quit my job and move home and live in absolute silence for 6-12 months? I know people tend to improve with time but I fear of swaying in the other direction as some members on here have mentioned living “normally” ended up terribly. I also realize it’s all very individual, but I would like to make the right decisions here and be on the path to recovery.

      Some say don’t go out at all
      Some say it’s okay with ear plugs
      Some say do whatever you want and retrain your ears (within reason)

      Any advice or input would be appreciated. At this point I am absolutely terrified and don’t know how to move forward.
       
    6. Mister Muso
      Creative

      Mister Muso Member

      Location:
      Scotland
      Tinnitus Since:
      2007 / April 2019
      Cause of Tinnitus:
      Loud music
      I tried not protecting, and my tinnitus got worse.

      Then I tried protecting, and my hyperacusis got worse.

      So it's heads you lose, tails you lose. I probably would have ended up with similar problems anyway, whatever strategy I chose.

      As with lots of things in life, it's about finding a middle way that works for you. Things do ease off, or get easier to handle, over time for most people anyway.
       
      • Agree Agree x 1
    7. Mister Muso
      Creative

      Mister Muso Member

      Location:
      Scotland
      Tinnitus Since:
      2007 / April 2019
      Cause of Tinnitus:
      Loud music
      @Orions Pain

      I would suggest slightly increasing your earplug usage until the TTTS symptoms stop, then ease back on the earplugs. Try watching TV or listening to music in the evenings and gradually increasing the exposure as per advice from @Bill Bauer.
       
      • Like Like x 1
    8. Adaś
      Curious

      Adaś Member Podcast Patron Benefactor

      Location:
      Switzerland
      Tinnitus Since:
      02/2013
      Cause of Tinnitus:
      Headphones, Stress, Rock concerts
      Sorry for digging this up, but it is a very informative thread and I really value @Ed209's posts here.
      Yes it can, tinnitus is one of the statistically significant symptoms in depression AFAIK. I have a friend that had tinnitus from depression, it went away after proper treatment. Nevertheless my tinnitus was triggered when I was in very stressful period and I "blasted" my headphones (around 105 dBA measured with dB meter) just for 2-3 sec. Not something extremely loud as 105 dBA is sound levels of some small clubs where ppl (including myself when I was younger) spend hours in. So I strongly believe stress combined with moderate acoustic shock can trigger tinnitus.
      Again very good example of combination of stress and loud noise. I really support the gating theory that once limbic system is weakened (e.g. by stress) then the tinnitus signal can sneak through to the awareness even with a moderate acoustic shock. Once it is there, it gets harder to become unaware of tinnitus, still it often happens.

      Now going back to the main point if to protect or under-/over-protect. Do you believe that NIOSH levels are too high once our bodies are compromised? What about OSHA levels that are legally binding and much less conservative?

      I can see lot of people asking if having shower which is (what 75 dBA?) is safe, or flushing toilet is safe? (80 dBA) Worrying about 75-80 dBA seems extreme to me. Even if we subtract -20 dBA (which is a lot - 10 times energy!), 80 dBA would mean it is safe for 15 minutes a day.

      NIOSH-OSHA-Standards.gif
       
      • Like Like x 1
      • Informative Informative x 1
    9. PeteJ
      Depressed

      PeteJ Member

      Tinnitus Since:
      02/2019
      Cause of Tinnitus:
      acoustic trauma?
      Lots of people are stressed. Stress and depression is present in lots of people's lives.

      I think acoustic trauma is more of a factor.
       
    10. Adaś
      Curious

      Adaś Member Podcast Patron Benefactor

      Location:
      Switzerland
      Tinnitus Since:
      02/2013
      Cause of Tinnitus:
      Headphones, Stress, Rock concerts
      Certainly, but then how else you could explain that some people don't get tinnitus after acoustic trauma, while some other get tinnitus after moderate acoustic shock (not really a trauma), like myself. I think stress plays a pivotal role here, see other post with some recent article explaining role of stress:

      https://www.tinnitustalk.com/thread...s-a-comprehensive-overview.42251/#post-542821

      I agree that stress is present in most people's lives nowadays, but so is noise. Some people deal with stress better, some worse. I think these who do not cope with stress well are at much higher risk of developing tinnitus. How else you explain the stories that "I have tinnitus, but my friends that have same lifestyle as me don't have it". Genetic factors?
       
      • Agree Agree x 1
    11. Lane

      Lane Member Hall of Fame

      Tinnitus Since:
      February, 2018
      Cause of Tinnitus:
      Ototoxic Drug
      Have to agree with that...

      I suspect electrosensitivity plays a far greater role in stress response and tinnitus intensity than most people realize.
       
    12. GaryTH

      GaryTH Member

      Tinnitus Since:
      03/2020
      Cause of Tinnitus:
      noise exposure, stress, NSAIDS, eabuds, shingles vaccine
      I constantly hear people on here warning others not to over use earplugs or earmuffs, as they have been known to increase the level of noise sensitivity in people. Googling it has only given me websites that state the same thing, but never a link to a reference.

      I'm all for anecdotal evidence, but can anyone point me to a single controlled study which shows that overprotecting ears causes worsening noise sensitivity, hyperacusis, sound phobias, etc or anything else? Also is this a temporary worsening or is it permanent?

      I want answers in scientific studies, not about what happened to you or your neighbor.
       
    13. Orions Pain
      Dreaming

      Orions Pain Member Benefactor

      Tinnitus Since:
      2019
      Cause of Tinnitus:
      Loud music
      I don’t believe there are many that link prolonged ear plug use to permanent or prolonged sound sensitivity. There is one study that seems to show a very temporary threshold shift (I don’t have access to the full article) but it looks like here whatever sensitivity did appear from ear plug use disappeared within 24 hours.

      https://asa.scitation.org/doi/10.1121/1.4835715
       
    14. Ed209

      Ed209 Member Podcast Patron Benefactor Ambassador Hall of Fame

      Tinnitus Since:
      07/2015
      I discussed aspects of this on the Bryan Pollard podcast thread here:

      https://www.tinnitustalk.com/thread...g-hyperacusis-research-—-bryan-pollard.38131/

      In short, there was a small study conducted which showed a change in the acoustic reflex threshold after wearing earplugs for 4-7 days.

      https://www.sciencedirect.com/science/article/pii/S030645221930168X?via=ihub
       

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