Questions About Hearing Protection (I'm a Musician and Have a Music Major in College)

So, I have a quick question, as a musician and a music major in college, I am required to be in environments where I am surrounded by loud music. I use earplugs now in my recording class (cause our professor cranks up the volume to what my classmates like to call "Jesus level") and I'm planning to get a pair of musician's earplugs. But until then, when I need to listen to music when I go back to my living space, is there a way I can listen to music at a level where I'm able to practice and do my studies that wont make my T worse?

I'll admit I'm new to the T and I haven't listened to music casually or not outside of class for days now because I'm scared to... Help?

 

Hey I hesitate to give you advice about music because I don't know much about it. Loud music of course could be dangerous that's why I think you should see an audiologist who is experienced in t. Some people do fine with musician eard plugs so that Is an option. Just please see a professional this is your dream you need to know as much as you can about t. There are people who can help you with that. Don't see any old ent

 

I believe it is perfectly possible to have a long and tinnitus free career in music if one is mindful of noise levels from the beginning; this should therefore probably be the first lesson taught in any music major degree at university. Unfortunately most of us are not aware of noise safety standards ("we go with the flow", so to speak). And that's why it is important to recognize the first early warning signs of inner ear overstrain (= fullness in the ear). Fullness in the ear is often mistaken for "other things" such as an infection - even by experienced ENTs.

During the acute phase of tinnitus, it is possible to reverse some (possibly all) of the symptoms if the ears are allowed to rest. Our inner ear hair cells have slight regenerative properties, and will start to heal on their own if given the chance. This is true during the acute phase only.

It is possible to listen to music as long as it is at a very moderate level. Take breaks. There are no "official guidelines" when it comes to decibel safety levels during the acute phase of inner ear overstrain. All I can do is pass on the information that I got when I saw the "famous" (some would say, infamous) tinnitus specialist, Dr. Wilden, last year for an 8 week period: "the more you use earplugs, the more you will start to appreciate them". Dr. Wilden sees as many tinnitus patients in a year as the average GP does in a life-time. So he probably knows what he is talking about. My advice.

Take care.

 

How do I know if it is acute T? What exactly is acute T?

 

I believe by 'acute' what is meant is that it's new, and recent.

 

The "official" definition of acute tinnitus is tinnitus that has been present for less than 3-months. After that, it is considered sub-acute, and finally chronic. But those are really just definitions the ENT community has invented for itself. They have no real value, as I see it.

The practical definition of acute tinnitus is when it is "recent" (ie. days, weeks). See a doctor as soon as possible. Let him or her know what you believe to be the cause of your tinnitus so that the doctor doesn't start chasing false leads. An ENT doctor can only do/know so much; there is an equal responsibility from the patient to help the doctor make the right conclusion. So if you complain about fullness in the ear, the doctor may well suspect that you have an infection or blockage (when in fact the problem is something else eg. noise induced tinnitus). Tinnitus is tricky for an ENT to deal with - and so without the dialogue, it's difficult for an ENT to reach the right conclusion (and hence commence the proper treatment). Whenever tinnitus is recent, there is a window of opportunity where steriods can influence the outcome. Discuss the option with doctor (in case the doctor doesn't bring up the topic him- or herself). Be mindful of noise (from now on).

Our inner ears are a fine piece of biological machinery. We should all remember that.

 

@attheedgeofscience I'd like to ask you something else. What is up with the fullness/crinkling of the ears? I was thinking that was directly related to ear pressure/e-tubes/ear infection issue, but it seems like nearly everyone who gets T, has the crinkling of the ears, and it's very common, and not necessarily diagnostic of ear problems as such.

So what is the deal with the crinkling of the ears? I've never read anything on the net that addresses that, other than lots of people with ringing in their ears experience it. Why does T perhaps seem to cause it, rather than the other way around?

 

This maybe a defense mechanism?? I have never seen any clear answer about this
but it is common in most people with tinnitus. Sometimes nasal steroids help with this,

 

There are cells in the inner ear which are responsible for producing the inner ear fluid (= Perilymphatic liquid). When the inner ear is overstrained, the specific salt concentrations in the inner ear fluid cannot be maintained. Osmotic processes then kick-in, and that is what is felt as "pressure in the ear".

Our inner ear hearing cells have a very high degree of specialization and cannot produce a pain signal in the same way that the nerves in other parts of the body can. Because there is no pain signal when the inner ear is overstrained, it is very important to interpret the indirect signals that the ear is telling us. But... most of us don't recognize those "indirect" signals in the same way that we would if we hurt our knee, for example. Pain is easy to recognize because... it hurts! But pressure in the ear is (obviously) different to most of us. And hence it often goes unnoticed until tinnitus breaks out. And then it is often too late...

 

@attheedgeofscience

Thanks for the reply. For myself, I've never felt much in the way of pressure or fullness, except maybe once in a good while, and never too bad. But the crinkling/crackling I've had for about a a year now, though the T has only been with me for a month. And my ears have never been very hardy, with respect to plane descents, and pressure changes and such. So someone like me would have more residual crackling than most in pressure-change scenarios. So I never thought to much about it when it seemed to start up with the crackling about a year ago or so. Since like you say, there's no pain or other obviously alarming quality to it.

Well I wish I could have known that earlier. Would have laid off the iPod. And I imagine now it's too late.

Can I pick your brain about one more thing? What are your thoughts on the notion of stress/anxiety itself causing T? Does that seem like a real thing? It sure seems like there's tons of anecdotal incidence of picking up T, with a terribly stressful/depressing episode in one's life as the immediate precipitating factor. And if it could, how so and what's the mechanism? Does anxiety destroy inner hair cells? Any thoughts you had on that would be much appreciated.

And I apologize for sidetracking this thread. To @derpytia Listen to ATEOS. And go find yourself as knowledgeable a T doctor/specialist as you can as soon as you can. And be well and keep your chin up.

 

I grew up with music all around me at home. Horns, drums, piano, fiddle, even a marimba. I was in concert and marching band all through school. I played loud electric rock when I was young. I'm so screwed. I've had T for 40 years. I don't like it. I live with it. But now the very thing I love most has been reduced to soft acoustic music and I had to give up playing many instruments.
No earplugs on the market, or wishful thinking, or drugs have helped. It gets worse year by year.
That's my story.
It makes me angry to hear of someone exposing young people to Jesus level. It's not funny. It's Tinnitus.

 

The first two paragraphs in this post should cover your questions:

https://www.tinnitustalk.com/threads/hypnotherapy.4386/#post-42978

 

I hope one day you can continue to play all types of music...if a cure came out and got rid of your T would you go back to playing electric, drums etc?

 

Oh ya.

 

How do you know all this?? What I mean is, if what you're saying is true, why don't any ENTs seem to know this? This isn't merely 'Tinnitus-specific' knowledge as such, which apparently so many ENTs seem to brush off altogether, this is just baseline knowledge about how the ear works at all. It's bad enough that there's no cure, but why don't more doctors know how the ear works at all?

And when you say *overstrained*, could it be from any number of causes? Noise stress, ear-infection, what have you?

 

The specific warning signals I have described are no different - in comparison - than the warning signals any half-decent pedeatrician would look for in newborns and toddlers when assessing their hearing capability. Indirect signals sometimes carry important information and a skilled physician would know what to look for. (I leave it as "an exercise" to figure out what those indirect warning signals are...)

Doctors and the medical institution have a history of arrogance. Example: when Joseph Lister started studying so-called ward-fever back in the 19th century, it was considered inconceivable that surgeons could somehow be the cause of their own patients' deaths (by not washing their hands and disinfecting the wounds). Having studied the works of Louis Pasteur, Joseph Lister felt he was onto something and persevered in his introduction of Carbolic Acid in the operating theatre. Eventually, he became known as the "father of antiseptics". But this did not just happen overnight. It actually took about 12 years before his treatment protocols were widely accepted. And who knows how many patients would have died in that time frame. In a certain sense, the medical institution is its own biggest problem.

Pioneers in any field - medicine not excluded - have never had it easy:

"All truth passes through three stages. First, it is ridiculed. Second, it is violently opposed. Third, it is accepted as being self-evident."
--Arthur Schopenhauer, German Philosopher

 

What i have learnt : Some cases in which T is caused by long term exposion of high volume, protection of ears for a while or having some break could help. However, while you are having ear rest, you should have a healthy diet, stay away from alcohol, cigar and stress. Detox, or foods which have antioxidants are also said to be helpful. For your case, there is a posibility that your cochlea could be only irritated, or your hair cells could be only knocked down, not dead.. Make yourself a good program and relax..

 

Thanks for the reply. I can certainly say from my own recent experience with doctors that I can't disagree with you too much. Arrogance, and also a sort of careerist indifference. At least in my limited recent experience. I've largely completely healthy my whole life, so I can't really say. But I haven't had the best encounters in my limited experience.

 

Hey @derpytia I'm a full time musician / music teacher who's living with T right now. If you need somebody to vent to or ask questions ...I'm here! Just hit me up. Hope you are doing better and I know what you're feeling about the career thing 100%. I'm going through the same thing.

 

@derpytia, getting fitted with custom-made musician's earplugs is an excellent idea. A number of musicians have used musician's earplugs for years in loud settings. Classical musicians use musician's earplugs in practice and during performances to protect their ears.

Depending on your instrument, it may be a good idea to use musician's earplugs when you practice. Some instruments can be awfully loud in the upper registers.

Listening to music for fun won't affect your tinnitus. Just use a little common sense and play the music at a moderate level. You will be fine! Try not to let tinnitus dictate how you live your life.

Don't be too concerned about categorizing your tinnitus. In most cases, giving tinnitus its own category is like granting honorary knightship to a potato.

Living with tinnitus so that it no longer has an impact happens for some folks when some time passes. Other folks need a little help to get to the same place, but most do. Hang in there!

@Littlebailey, the crackling sounds you are describing might be stapedius myoclonus. Good thing to discuss with your doctor. If you don't have confidence in your ENT, please know there are some very good ones.

@attheedgeofscience, aural fullness can be a symptom of Eustachian Tube Dysfunction, of Meniere’s Disease, Hydrocephalus, superior canal dehiscence syndrome, Chiari I malformation, and a number things, really!

Aural fullness is not a forerunner of tinnitus.

It isn't so that when tinnitus is recent, there is a window of opportunity where steroids can influence whether it goes away. Oral steroids (sometimes in combination with intratympanic steroids) are used for sudden hearing loss, not for tinnitus.

Shim et al. wrote that the use of alprazolam and an intratympanic dexamethasone injection was more effective than treating certain tinnitus patients than with alprazolam alone, but this conclusion that has never been confirmed by others, to my knowledge.

here2help

 

Yes Musicians plugs are the way to go. You may even want to get two sets of molds cause changing the filters in them is kind of annoying. I have the ER-25 filters and use them on all my gigs. I also have foam plugs that i use when the volume gets really high (NNR 33)

 

Definitely get proper protection.
One thing is the risks of improper protection another is of overprotection.
Many here will tell you to protect your ears as Much as possible, they have not experienced hyperacusis+t.
Hyperacusis (oversensitivity to sounds) is a known side effect of overusing hearing protection.
Many join the forum because of t, but also due to having followed the notion of protecting as much as possible. Know that overprotection will greatly highen the odds of getting h, which obviously is one more disorder to add.
Many would find 'protecting as much as possible' a dangerous advice as it will enforce further sensitivity, you need to protect yourself from dangerous loud sounds, not overprotect.
As you attend to a musical institution, let your professors and perhaps leaders of the school know of this issue, if not knowing how should they be able to respect it .. In a sense they should already I'd assume. Let us know what you do

 

I've only told two of my professors and have asked them not to tell the other ones until I'm ready to tell them myself. I haven't told them because I feel ashamed to have it, especially when they took the time at the beginning of the school year to warn us all about Tinnitus (talk about foreshadowing!). I just feel like they'll all give me the pity look, or they'll judge me silently, or they'll lose their respect for me, or (even worse) they wont see any potential I have anymore. I want to be successful, but I can't do that if my professors lose respect for me or feel that I can't do something because of this. One of my professors adjusted volume levels in my class and my peers have been very understanding about the whole thing. It's just my professors I'm worried about. One of them (my advisor) has already given me the pity look and that's the most painful thing to see really.

 

How can I change my profile within tapatalk?

 

@derpytia when I hear that I feel so embarrassed on your professors behalf, he/she should be ashamed of himself. It's a good idea that you tell them yourself and despite all reason there can be applied I still feel how one can be ashamed, I got it from being in the music industry too and yet as so many has it, I feel shameful about telling it, and judged by many for getting it. In some moments of clarity I realise though that the situation is much worse of if I don't tell people, without knowing many will get the impression that I'm a whiner, usually I've either met understanding and if I get a pity look coupled with a "ah come on, you dj'ed and spend a lot of time in loud venus, it's your own fault" I lose quite a portion of respect for them, them losing respect for me on the grounds of them not understanding doesnt count for much. Everyone has spend too much time at loud venues/concerts, so by that logic it is everyone's fault had they ended up with it. Screw genetics, screw the venues accountability, screw an institution's responsibility - telling peers to be careful in the start of the school for then to have the institution's own professors crank up the volume, let's be reasonable..
I don't know how good you are, but I do know seeing one doing as well as the others while knowing that one has a thing like tinnitus, earns quite a lot of respect from my part. I can definitely follow why losing the respect from the professors, if that's even going to be relevant at all, is a problem though.
You should try look up rates on how many in orchestras have tinnitus (+h perhaps), I remember reading it once and it was quite striking, and my point is if a professor looked down on that I'd consider consider it an insult to his own professorship.

 

True. But all of those conditions can be diagnosed either directly or indirectly (eg. Meniere's disease). The fact is that many patients have aural fullness without any of those conditions. And are left without a diagnosis.

No doubt you are a doctor.

As with most people who develop tinnitus, my doctors failed to help me when I needed them the most. For the past year or so, I have therefore had to become my own doctor, and devise my own treatment plan for an incurable condition. A condition which is often idiopathic - and hence making it even harder to treat (even if there was a cure). I therefore had to educate myself on how to establish a correct diagnosis and how to treat the corresponding condition (not easy for an incurable pathology). This has a led me onto a long journey into the world of experimental medicine. My treatments have been self-chosen, the treatment protocols self-devised, and the treatment expenses self-financed. Indeed my treatments have been "so unique" that only a handful of people in a world of seven billion have experience with the treatments. I have essentially taken a 10-year leap into the future of medicine. Regenerative medicine, to be exact. I don't therefore expect anyone - doctors or otherwise - to really understand the topics I cover on this forum. Nor the way I cover them. Unique treatments provide unique insights. My own GP has perhaps 10% of my combined knowledge on tinnitus. For the same reason, the consultations I have had with her, have been somewhat one-sided. But then again, I don't really need her; actually I don't need her at all (since I have done everything without her knowledge or approval). Basically, I have just kept her in the loop of my various activities.

When I later on this year go to see a Swiss professor of neurosurgery for yet another unique treatment, it will be the first time - in a long time - that I return to the role of being a patient. Something I am looking forward to. After all, being a doctor is not really my job. It is just something I had to do, because the doctors couldn't...

 

I understand about the stigma attached to T in our industry. Use your best judgement and tell those who you trust...
They will understand and just talk to more people. You'll find others have it too.
Your fellow musician friend

 

Awesome, I've been looking for information about this everywhere. The fullness and crackling is very irritating.

I know the fullnes is in my "bad" ear, the one that is a bit retracted. I am wondering if this is from a loss of the middle layer of the tympatic membrane due to noise trauma, or thinning of the membrane, resulting in a floppy eardrum that is no longer able to react normally. I'm hoping LLLT therapy will be able to help this. I do not know though if LLLT therapy can heal tissues like the eardrum itself? I also can't remember if I posted something about this already

So determined to try to figure this out!

@attheedgeofscience I also had floaters (still have them) and was told they are idopathic/nothing to be done, what a cop out... I got these when I had an immune disorder with other terrible symptoms (many have subsided! Thank goodness, so happy about that). I was 22 at the time (24 now) with all of these crazy symptoms, including floaters, with an obvious immune dysfunction, and so many doctors shrugged it off. Very frustrating. I finally found a couple of skilled doctors that listened and we worked at a team so that I could regain my health! So thankful. I am going to try to fix this floater thing someday now since I read your post. Amazing you figured this out too...

 

Okay, so this is an old thread but I have to mention it's estimated 50% of musicians have T. 1 in 4 have some deafness. There is nothing to be ashamed of. Pete Townshend, Ozzy Osbourne, Chris Martin, and Beethoven to name a few.