Questions for Those Who've Recovered from Hyperacusis

I've made on and off threads about my struggle for over the past year with hyperacusis. It was around the middle of August in 2016 I first developed it, so it's been a little over 2 years since I acquired it. I really thought it would go away by then, but it hasn't. That isn't to say it for the most part hasn't. In October of last year, a threshold test exacerbated it to the worst it had ever been, and until around the end of April, it didn't seem to be changing at all. Until, per the suggestion of a specialist, I stopped wearing protection. Afterwards, my recovery was rapid, and aside from a couple of setbacks after trying ametriptyline for insomnia, my tolerance and sensitivity has been the best it's ever been since then, and my day to day life is only minimally impacted.

But it just won't go away. Even though I can tolerate nearly all situations people normally can, it's still there. I go through cyclical phases with it where it bothers me more during certain periods than others. There are various noises and irritants where it becomes very apparent I still have it. My tinnitus (which I've had since I was very young, although it had been barely perceivable) is still abnormal. I still can't listen to music like I used to, which has been the worst thing I've had to deal with. And as I've gone through this, I've come to recognize the psychological element to hyperacusis (atleast in my case) more than ever before. It's hard to readily describe, but there is a distinct perceptual element to this disorder wherein there's arguably more of a "recognition" of the symptoms than there is actually any physical manifestation. The further I've progressed with it, the harder it becomes to even recognize there's something like this going on, if I could put it that way.

But it's gone through so many phases and so many cases of apparent borderline recovery, that I really don't know exactly what it's going to be like when I'm actually almost on the verge of recovery, and what that will look like. So I have to ask, for people who've recovered, was it a sudden or gradual process? What did you notice most as you approached it? Did you experience anything predominantly psychological like I have? Do you feel you are more vulnerable to this occurring again? With what I've described, how much longer do you think I might have?

 

HI @Srebint

I once had very severe hyperacusis. So severe when in conversation with someone I had to ask can they please lower their voice as my ears hurt so much. That was 22 years ago. My hyperacusis was treated by wearing white noise generators, as part of TRT and it was completely cured in 2 years and has remained this way till this day.

I believe in the majority of cases hyperacusis can reduce significantly with or without specialist treatment using white noise generators and in a lot of cases be completely cured with or without treatment. You may have already read my post: Hyperacusis, As I see. I will paste it below all the same.

I advise you not to use headphones even at low volume.

All the best
Michael

Hyperacusis, As I See It.

Some members have asked for my opinion on hyperacusis as they are finding it increasingly difficult to live with. They want to know if there is a way of treating this condition so that their life can become a little easier? Or whether it can be completely cured? For a few it has become so distressing they have decided to only leave their homes when it’s absolutely necessary. This is because of the fear of making the symptoms worse, by subjecting their ears to the hustle and bustle of everyday road traffic noise and other environmental sounds that we are all familiar with.

Reading some of the posts in this forum, one can easily see that certain people daren’t leave their homes without first checking they have their earmuffs and an assortment of earplugs in various degrees of attenuation, in readiness for any potential environment that they happen to find themselves in. The cinema, nightclub, restaurant, or on public transport. If money is no object aspiring to custom made moulded earplugs for some is the way to go. It can bring the added assurance they will be getting the best hearing protection. Whether this is true or not doesn’t really matter because it’s what the person believes and this helps to give them that peace of mind which is something many of us strive for at one time or another.

The above may seem a little extreme until I tell you one member provoked a lot of discussion here, when he mentioned having the air bag in a car that he had just purchased disabled in case it was deployed in an accident. I suppose the thought of 170 decibels raining down on his auditory system and the possibility of his tinnitus and hyperacusis shooting through the roof was too much too bear and is more important than a potential life saving device. As strange as this might seem, others have discussed doing the same thing elsewhere on the Internet.

I am not an expert in this field but do have the experience of living with very severe hyperacusis that was brought on with the onset of my tinnitus twenty years ago due to loud noise exposure. It was so severe; conversation with someone at times caused immense pain. However, it was completely cured in two years with TRT and having counselling with a hearing therapist. I wore white noise generators for 10hrs a day and used a sound machine throughout the night until morning for sound enrichment. My tinnitus had reduced to a very low level.

Some people believe hyperacusis cannot be cured and if treatment such as TRT works then it merely suppresses the condition. In the event of future loud noise exposure it will return and the condition will be worse than before. I believe it's up to the individual to take care of their hearing and not subject themselves to loud noise exposure. However, accidents do happen as in my case. I have previously explained in this forum that my tinnitus increased to very severe levels in 2008 due to noise exposure so won’t go over it again. To my surprise the hyperacusis did not return and has remained the same till this day, completely silent.

This summer I went onto the Brighton Pier and into the arcade. The place was a hive of activity and many people were using the slot machines. Music was playing and mixed with loud laughter so everyone seemed to be having a good time. I had my sound level meter and also a sound App on my mobile phone. Just in case things got too uncomfortable I had my noise reducing earplugs with me that reduce sound levels by 18 decibels. This was a test and not something I normally do or recommend anyone else to try.

The sound level in that place remained constant at just over 100 decibels. My ears didn’t feel uncomfortable and I felt no pain. I stayed at the venue for 30 minutes and then left.

The next morning my tinnitus was silent and I experienced no symptoms of hyperacusis. I do not believe that it is a good idea for someone with tinnitus or hyperacusis (or both) to wear earplugs or noise-reducing earplugs with filters too often, because it’s possible for the auditory system to become hypersensitive. In some cases it could make matters worse and cause a condition called phonophobia. This is literally having a fear of sound.

I used to counsel someone that had phonophobia like symptoms although she wasn’t diagnosed. This person had hypercausis that gradually got worse and at every opportunity she kept away from sound. This got so bad going out the front door because of the noise was a problem. Her ears couldn’t tolerate the sound of the microwave, dishwasher or the washing machine. She even complained of the sound of rain falling on her conservatory roof that was made of glass. Fortunately she has improved.

There is much discussion on this in the medical field from experts saying that the overuse of hearing protection isn’t good and therefore discouraged as it will lower loudness threshold and I completely agree with this. I think if one isn’t careful they can become paranoid over sound making their hyperacusis and tinnitus worse and I don’t think it’s healthy.

I believe the answer is to seek proper treatment. If TRT is unavailable then start using a sound machine by the bedside at night for sound enrichment. This usually helps to desensitise the auditory system. Try going out for long walks and getting used to everyday sounds instead of keeping away from them by staying at home. I don’t normally recommend anyone to use white noise generators unless they are under the care of a hearing therapist. However, if your tinnitus is under control and you have habituated but experience hyperacusis, that some call: Reactive tinnitus. Then white noise generators could be the way to go. Two should be used to keep the auditory system in balance and set the volume level low, preferably below the tinnitus. This will help to desensitise the auditory system and treat the hypercusis.

Hearing protection is important and does have its place. If I am going to venues where I believe noise level could become loud then I have my earplugs with me. Night clubs, parties etc. I would always use them at the cinema although I haven’t been to one in years. Reading some of the posts on this forum people say those places can be very loud.

When I use my petrol lawn mower or electric power tools for those DIY jobs around the home, I always use my ear defenders. I want to live life and enjoy it. Not to be living in fear of hearing a fire truck or ambulance siren coming towards me and I have to panic and quickly insert earplugs or reach for earmuffs to protect my hearing. I just think this is overkill.

Michael

 

Hi Michael,

During that time you had h you also had issues with constant pain?

 

HI @1000

Often I would experience pain but this was mostly caused by "sounds". This was 22 years ago I took to wearing earplugs when in situations where I thought certain sounds would irritate my ears or cause pain. When I wasn't exposed to sounds, in quiet environments my ears didn't hurt. Fortunately I did not keep away from normal everyday sounds, as some people do that I mention in my post above. Hiding away from sounds and overusing earplugs and other forms of hearing protection will often make hyperacusis worse.

Hope this helps.
Michael

 

my ear hurts all the time... Worrying me a lot. I can't even sleep...

And I get the burning pain as well more likely caused by sounds..

Sound therapy should resolved this over a year or 2?

 

You need to be seen by an ENT doctor for tests to find out if there is anything else that is causing the constant pain that you describe. This is not typical signs of hyperacusis although each person will be different. See an ENT doctor and if there is no underlying problem within your auditory system causing the pain, then it's likely it is hyperacusis brought on by "noise trauma". In this case because your symptoms are severe I think it's best you get a referral to a Hearing Therapist/Audiologist that specialises in Tinnitus and Hyperacusis treatment and management.

If your symptoms do not improve with my suggestions in my post: Hyperacusis, As I see it, then you need specialist treatment I'm afraid, and the best is wearing white noise generators and you may need counselling too. I know this sort of treatment is expensive but there are few options open to you if self help doesn't work.

Best of luck
Michael

PS: If you are not using a sound machine by your bedside at the moment, I advise you to start doing so as soon as possible.

 

I have an app of pink noise and white noise playing at the same time.

I went to the ENT, they could not see anything wrong with the ear well mild hl and the subjective symptoms. I will see one more and searching for TRT.

 

Very gradual. Almost imperceptible.

Without a doubt.

Have you been forcing yourself to tolerate those situations, despite your body doing all it can to convince you that this is not a good idea? Have you tried protecting your ears from all of the noises that you found to be unpleasant as a result of your H?

 

How many months have been experiencing this? It is possible with time and self help the hyperacusis will improve. It all depends how you have had this. All it says on your profile is tinnitus since 2017.....

 

10 month's

 

@Michael Leigh

Yes, I have read your case multiple times in threads such as these. I do not feel there is any need to use noise generators at this point, and I don't think my case was ever as severe as yours, except for certain periods during the 6-month threshold increase. I really do not think I will need to avoid using headphones ever again, but I will have to see. I more than likely will need to not use the specific audio equipment that caused this ever again, though.

@Bill Bauer

You developed hyperacusis only a year and a half ago. When exactly did you recover from yours? Why do you feel you are more vulnerable? Have you consulted with a specialist on this?

Well, the thing is is that there really aren't many situations I've encountered where this is readily the case. The only times this has really happened these past 4 months has been in the following situations:

-The bathroom of the gym I go to has an extremely loud toilet and the hand dryers are very loud as well (which were installed only pretty recently.) Until about 4 months ago, I would always cover my ears at the sound of the toilet flushing. Now I don't, and I use it as a barometer of sorts, but it is still more unpleasant than it normally would be, and it seems to be worse when I'm actually walking around. Similar story for the hand dryers.

-Earlier this summer, I briefly worked at an Amazon (I did not insert this hyperlink, it was inserted automatically) plant that I left for another health-related reason. It was unsurprisingly a loud job, but for the most part it never really bothered me. The only time it seemed to actually bother me was from after it had been exacerbated I believe the day before from trying to test my thresholds at home.

And to elaborate on that, I have at times over these past 4 months tried testing my tolerance by listening to generally abrasive, dissonant music at loud volumes off my speakers. I had thought this might be actually increasing my tolerance, but I don't think it was actually doing anything now since I've become aware of the psychological element. It would at times appear to worsen my hyperacusis/tinnitus for the rest of the day, though, and that probably wasn't the best thing. It doesn't seem to have caused any long-term issues with recovery though. The only thing that actually seemingly made it worse was taking amitriptyline.

I have also started drinking coffee again, which I have seldom had these past 4 months or so out of fear of exacerbating it (I had actually been regularly drinking coffee until I stopped wearing protection, I think.) I really don't think caffeine does much of anything to affect my H/T at this point though, atleast nothing I can notice. If anyone thinks I should stop taking it altogether until recovery, let me know.

Also, since reading this thread today, my H/T has gotten worse.

 

HI @Srebint

I have corresponded with you a number of times about your tinnitus and hyperacusis. Since you are still having problems with hyperacusis, I think you do need more specialist help in form of white noise generators and under the care of a Hearing Therapist/Audiologist. You should have habituated by now and hyperacusis shouldn't be giving you so much problems after this amount of time. If you have been using headphones even at low volume, or listening to music at high volume, I feel this has contributed to the hyperacusis still being problematic. However it's your choice what you want to do.

You may remember that I am also an Audiophile and enjoy my music listening to it through high quality speakers and touch wood haven't had any problems. When I first got tinnitus 22 years ago, I regularly used high-end Beyer Dynamic headphones that eventually caused the onset of my tinnitus. My fault as I didn't realize I was listening at too high a volume. I have never used headphones since.

All the best and I wish you well.
Michael

 

Sometime between 6 and 12 months after onset.

After reading the posts on this forum for the past 19 months, I see that for many people it doesn't take much to get H to return (and to make T louder). Noises that the healthy people won't even notice can forever change our lives.

Since there had not been any scientific studies into what aggravates T/H, those specialists know less than we do. There is a poll on this forum that indicates that fewer than 15% of the respondents found the advice of their ENT more useful than what they learned here.

 

Loud concert small club...

 

More information is needed. What month did it start? Audiogram? Is your hearing muffled?

 

It took you 2 years for you to recover with therapy, while I have undergone little. I want to emphasize that in day-to-day life, hyperacusis affects me minimally and it's still only really things like headphones or certain artificial audio sources I have issues with. It's really a narrow scope of things that effects me. What I want to ask though is, was it exactly two years for you, or a little over that? Why do you say I should have habituated myself if I've suffered it for about the same period you did, and have progressed this far with minimal therapy?

 

Everyone is different @Srebint but I believe your use of headphones and probably other exposures to certain sounds have caused your hyperacusis to persist. It took two full years for me to habituate and my hyperacusis to be completely cured the first time. In 2008 my tinnitus increased to insurmountable levels. I suspect is was listening to a Haydn symphony late one evening through my HI-FI system which is quite high-end. I turned up the volume but didn't experience and discomfort. The next morning my tinnitus increased with a vengeance but the hyperacusis did not return and has remained silent till this day.

It took 4 years for me to habituate and this included another 2 years of TRT. My tinnitus has changed considerably and is now variable: Silent, mild, moderate, severe and can reach very severe levels.

I believe if you were to stop headphone use completely in time your hyperacusis will improve. Unless you do this I think your problem will persist and if you are not careful become worse.

I wish you well.
Michael

 

I have barely used headphones in months. I tried them some weeks ago but realized I still couldn't handle them. What I am wondering is you think the persistence I've exhibited is abnormal, but it's been about the same time period as yours and with minimal therapy. Was it exactly 2 years in your case, or a little longer than that?

Did you ever consult with any specialists about your increased susceptibility to hyperacusis? I think this is the first time I've read that people who've recovered it are at increased susceptibility to developing it later, and that you've expressed to me your had a serious bout of tinnitus over 10 years later- and that you had to undergo another 4 years of recovery/therapy. And it still persists in some ways.

 

Have you done an audiogram? above 8khz
DPOAEs?

 

Then why are you worrying so much?

 

Because it's really, really prevented me from enjoying music like I used to, which used to be one of my main enjoyments. It's been horrible going 2 years like this, and it still won't go go away. I also really, really do not want this to ever redevelop.

If I could give a bit more detail where I'm at now, I feel like my hyperacusis is more "contained" now. When I experience irritation with it, the sensation feels like it's in a more compact perceptual area, to the point where my normal sense perception and sensation of hearing surrounds. I don't exactly know when this developed and if I really noticed it to begin with, perhaps similar to what Bill Bauer described.

 

HI @Srebint

I have had good treatment for my tinnitus and I'm still registered as an out-patient with my hospital after 22 years. I do not experience any hyperacusis at all. My ENT consultant is an Audiovestibular Physician and has told me, she rarely meets anyone with my type of tinnitus since it changed in 2008. I can live quite comfortably with my tinnitus now and have habituated fully. I still have problems with it when it reaches severe levels and occasionally I take clonazepam to calm it down. As I have mentioned on my thread: Hyperacusis, As I see it, in reply to @dpdx which I will paste below. This is how I view tinnitus and life.

All the best
Michael

When tinnitus becomes intrusive it has the ability to affect a person's mental wellbeing considerably. Add hyperacusis into the mix. Stress, anxiety and all sort of problems start to appear over time. This can be quite damaging and a person needs to seek professional help to prevent themselves spiralling downwards into oblivion.

Life is problematic and very few people go through it without having problems and that's just the way it is. There will always be twists and turns that we have to learn to navigate and in doing so we gain experience, which can enable us to face bigger challenges as we progress through life. If this were not so then we would never learn and mature and probably not reach our full potential that is designed for us. Unfortunately some people get more than their fair share of problems and in some cases, this is self inflicted or the result of bad decisions. All we can do, is dust ourselves down get up and keep trying.

There is nothing wrong in being negative but the important thing is not to let it become all consuming, as this can prevent us moving forwards and reaching those goals that we desire. Acquiring a good job, travelling the world, a nice car and significant other, are all good but each come with their own set of problems for us to experience, mature and master.

For me tinnitus is a condition that I have had to learn to master as well as other things to progress through life. I believe it has made me into a stronger and more judicious person. For it requires patience will power and the tenacity to never give up. Even though I have fallen and haven't felt my best at times, I refused to give up by keeping that imaginary light alive in my mind I call positivity.

Michael

 

I myself have not fully recovered. However I can tolerate almost everything. Even anything over 80-85 db but I get a delayed spike. But that's unrelated. I've never fully gotten better which is a shame. But what's important to me is that I've gotten my life back.

 

You are young... You should still keep improving.

 

Hyperacusis and hearing after hyperacusis change over time, but you have to try to appreciate the things in life that you can do and still enjoy. This is valid for any condition, not only hyperacusis. There are always things you can do.