So Confused! Can Anyone Shed Some Light?

Hi there,

First of all I’d like to say thank you to everyone on this forum for the supportive and insightful discussions that take place here. Discovering this website at the onset of my tinnitus really helped me stay afloat.

I’m a 26 year old professional musician. I play the drums and perform regularly in my band, and to be honest, was expecting to encounter hearing loss/T at some point in my life. I take a lot of care to protect my ears, practicing and performing with in ear monitors (universal fit, rated at 26dB attenuation) and wearing 15db molded earplugs at concerts.

I noticed a ringing about a month ago, after teaching a couple drum lessons without earplugs. I only teach about an hour and a half of drum lessons per week, and its only loud for about half of that. I didnt think much of it, and expected it to go away. I had a couple of shows coming up and performed without an issue.

I started getting worried about a week later after experiencing some pain in my ears, sometimes sharp and other times a dull ache. I scheduled a hearing test, expecting to see loss of hearing and thinking years of drumming had finally caught up with me. Much to my surprise, I have great ears! Nothing below normal hearing range, with a notch at 6kHz where my T seems to sit. I scheduled an appt with an ENT and they gave me another hearing test, which tested me up to 10kHz with no loss detected.

The ENT didn’t strike me as someone great at his job, but he ordered some tests which I’m waiting on now. I’ve never experienced vertigo and the pressure in my ears is normal apparently ruling out allergies according to this guy. Does anyone have any idea what might be causing this? The best i could come up with is the fact that I struggle with anxiety and have been in an extremely stressful state of mind for the better part of a year. Some people seem to think that might have something to do with it, although the ENT seemed dismissive of the idea that stress might be a cause/catalyst.

I would love to hear your thoughts, thank you!

 

What were the tests?

 

While your tinnitus might have come from loud noise exposure, it can definitely be induced by the stress and anxiety. If your ENT doesn't think stress can cause T, then he is wrong on that. Stress and anxiety play a hard part in triggering or aggravating tinnitus. Reading these forums for years, I can tell you that stress and anxiety can be one of the most common causes of tinnitus.

 

My bet is on this:

Good luck! (from another drummer)

 

@LiquidDrummer

The fact that you have just a hearing loss notch at 6KHz seems a good sign. Maybe your T will respond better to sound therapies or go away since the hearing loss is small. One remaining issue is how you are going to protect yourself (given your job) in order to avoid further damage.

 

HI @LiquidDrummer

Although tinnitus can be caused by stress and anxiety, the most common cause of this condition is exposure to loud noise. I believe the comments in your post make it a strong possibility that this is the likely cause. It doesn't matter if you wear the best moulded earplugs that money can buy the simple truth is this: If external sound is loud enough it will pass through your head/skull and be transferred to your inner ear by bone conduction and irritate the cochlea. I realize your enthusiasm and passion as a musician and wanting to play the drums. However, It is my belief if you continue to subject yourself to loud sounds or be in such an environment your symptoms will get worse. Sorry to sound so sobering but I'm telling it how I think it is.

Some people will be quick to dismiss what I'm saying and will advise you to go a head and live life to the full doing everything that you want to. Indeed, why shouldn't you? Please keep the following in mind. What you are experiencing at the moment could be just a warning and if you change your ways or take action now, to reduce your exposure to loud sounds your symptoms are likely to improve. Please do not underestimate the seriousness of tinnitus and hyperacusis. They can be ruthless and very unforgiving. If you listen to audio through headphones I advise that you don't not even at low volume.

You are young at just 26 and it would be a shame to let exposure to loud noise affect your ears and auditory system in such a way life becomes a misery. Please do not underestimate your ENT doctor either. He is a highly qualified physician and know all about the anatomy of the ear and can treat underlying medical problems associated with it, medically or surgically. They may not have an in-depth knowledge of tinnitus and hyperacusis for this is not their field of expertise although they are associated with the ear and auditory system. It is Hearing Therapists and Audiologists, that specialise in these conditions that can help with tinnitus and hyperacusis management.

In the early stages of tinnitus which you are in, the best treatment is to do nothing. Please click on the links below and read my posts.

All the best
Michael

https://www.tinnitustalk.com/threads/new-to-tinnitus-what-to-do.12558/

https://www.tinnitustalk.com/threads/tinnitus-a-personal-view.18668/

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

 

Just had it yesterday and will be booking a follow up with my ENT this week. It was a test involving nerve responsiveness I think. They had electrodes on my face and had clicking sounds playing in my ears. I'm not sure the exact name of the test, probably should've asked for that haha.

I was told that my nerves are healthy but I do have some fluid build up in my inner ear but the audiologist said it would be up to my ENT to determine if that was an issue.

 

Thank you so much for affirming this. I think my stress and anxiety is playing a major roll in this and may be the overall cause. I've been suffering from daily panic attacks since January and the stresses of getting an independent band off the ground has made it incredibly difficult to make any strides towards recovery. I'm blocking off the next month to work strictly on reigning in my stress levels and am hoping that will have some affect, even if only on how I respond to the T day to day.

 

Fluid in the inner ear is normal (perilymph, endolymph).
It's fluid in the middle ear that the audiologist was probably talking about.

 

Thanks! I figured the notch was due to the fact that since the T was sitting in that range it was obscuring the tones I was being tested with, therefore registering as an inability to hear that frequency very well. Keep in mind, even with the notch I'm well within normal hearing range and the follow up test (since my T has calmed down) didn't register a notch there at all!

As a drummer, I'd love to know what you do to protect your hearing. I have no plans on quitting music, I have invested too much and come too far to stop now.

 

Thanks for the response! I'm really hoping that the T goes away given that I haven't had it for very long, and it's already started to reduce in volume/perceived intensity. My plan to protect myself is to move from universal in-ear monitors to molded ones, as well as start using a stereo instead of mono mix. I've also ordered 25db molded earplugs for use at concerts rather than my 15's that I've been using up till now. If you have any other suggestions I would love to hear them!

 

I'm using an e-kit, so I can control the volume.
I think many professionals use custom-molded in ear monitors that isolate them from outside sounds while giving them control over volume.

 

Drumming without ear protection obviously caused hearing loss. Hearing loss related to synaptic damage causes distortion and does not show up on a standard audiogram of 10k. Stress + hearing loss seems to be a common trigger for tinnitus.

Do you know notice any smearing in the high frequencies combined with background noise? That is unfortunately a problem I have and it does not show up on a pure tonal audiogram up to 8, 10000hz

Hidden Hearing Loss: M. Charles Liberman PhD

Stay calm and do not use headphones. Hope the tinnitus goes away, hope future research like Frequency Therapeutics active clinical trial can regenerate damaged hearing hair cells thus reducing tinnitus.
http://frequencytx.com/
https://www.tinnitustalk.com/threads/frequency-therapeutics-—-hearing-loss-regeneration.18889/page-45
https://cochlearpro.com/
for more info about active research on tinnitus and other inner ear disorders

Seek mental health therapy if tinnitus is bothering you enough. Melatonin can help reduce the volume temporarily but it's also a sleeping supplement.

 

Hi Michael! Thanks for your opinions here. I appreciate your advice and want to speak to a couple of your points.

First of all, I might've been a little harsh on the ENT, I'm sure he knows what he's doing, but I was unhappy with the way I was rushed through my appointment and the way he downplayed my personal experiences and information about what might be impacting my situation. One of the first things he said was that in his opinion, noise exposure is not the cause of my T, probably based on the hearing tests. Again, I took this with a grain of salt, but doing so seems contradictory given your post. Should I listen to this guy or not haha!

I have stopped listening to audio through headphones. Since in-ear monitors are essentially molded headphones, I want to limit my exposure to that kind of sound input to performances and rehearsal only. I have every intention of doing everything I can do limit my exposure to loud noises and hope that in doing so, as well as reigning in my stress levels, I will see an improvement or at least stop the T at the point it currently is.

I read your first link and want to shed some light as to the severity of tinnitus I'm experiencing: My T at this point is incredibly manageable, unlike the first few days when I noticed it (although it may have been the same then, with the novelty/my own fixation on it causing my to perceive it as much louder than it was). I can't hear it at all 95% of the time due to external sound, and even the whirring of the fans inside my iMac are enough to drown it out. I only really notice it late at night if I'm watching TV at a very low level, or when I'm lying down with my right ear against a pillow. It's for this reason that I feel I can continue in my career with the correct preventative measures applied, and have been advised as such my the technician where I had my first hearing test, who both has T and apparently specializes it in.

I really hope I'm not coming off combative here. I really respect your opinion and am taking your words seriously. I also just want to make sure I don't prematurely abandon a career I have spent the past 10 years building. I recognize that my emotional involvement may cause me to seem antagonistic. I really hope that's not the case. Thanks again!

 

You're probably right! I may be misremembering, I'm still pretty nooby with this stuff

 

My custom IEM's from JH audio are in the mail! I've been using the universal Westone Pro 20's for the past two years with the foam plugs that are apparently rated at 26db attenuation. I know the foam isn't perfect though and the custom molds are the way to go, I was just limited by funds but at this point I'm going to spare no expense.

I've thought about going electric at least for practice and have small kit at home rigged up with triggers and mesh heads connected to a Yamaha DTX Multi 12. It's fun to mess around with but I can't get any kind of feel out of anything but acoustic cymbals. Some of the more high end kits do a good job but I can't spent 8 grand right now haha.

 

Thanks for your reply! How would I test for something like this?

Thankfully my tinnitus is so minimal at this point I barely notice it. It's really only noticeable in extremely low volumes such as control rooms in studios and lying in bed just before sleeping. If I can keep it at this level my quality of life is not really affected at all, so I'm just in maintenance/preventative mode at the moment.

 

My tinnitus came on from stress and a back injury.

Drums could be the cause or contributed, or have little to do with it, i wouldn't rule anything out too soon but also don't feel like you have to know right now.

Because from what I've seen so far all causes for tinnitus are either theory or speculation, besides hearing damage, tmj, brain injury, stress, and some other direct links, many ideas about its source seem like a best guess to me.

Like my best guess from my stress and back injury, though my back is mostly better and my stress is not the same its still here.

When i workout and stretch eat healthy and avoid stress and loud noises it helps a lot though.

 

It's a general rule of thumb (but there may be exceptions) that the volume of tinnitus is related to the amount of hearing loss.

Low tinnitus = mild hearing loss
Extremely Loud = Severe hearing loss


I immediately realized that I had trouble hearing high pitch noises (music was distorted) immediately after my acoustic trauma, because I gave my hearing a huge break I did recover to an extent getting back high frequencies I fretted were lost forever. (but they came back distorted)

 

Some (sadly few) ENT test that keep up to date with new coming research test for speech discrimination in background noise. Various tones, and speech combined with background noise will effectively test for hidden hearing loss.

Hearing loss does not work like turning down the volume on a television.
It works through distortion and muffling of noises before the actual inability to hear a certain frequency occurs.

 

Same with my initial acoustic trauma. I couldn’t hear music the same. This settled within a year

 

Some recovery must be occuring naturally such as damaged hair cells and synaptic connections straightening naturally. I'm hypothesising I don't know

There was a paper from the 1960's (sorry I can't find it i'm looking) that showed soldiers with hearing loss made amazing recoveries. But make no mistake some permanent damage always occurs.

 

That would be consistent with my experience. Tinnitus has remained. As has some hyperacusis and general anxiety around noise.

The initial ‘tinny’ sounds that would result from listening to music settled, however