The ENT Told Me Not to Protect from Everyday Sounds by Using Earplugs

Thanks for that. Although I'm kind of married to my existing setup/routine.

I just use simple Silicone ear plugs, which are tapered and stepped. Still . . . even though they're only basic . . . it's now second nature for me to be able to manually attenuate them in a split-second.

When I'm outside . . . depending on the environment, I either just have them resting in the outer part of the ear without being inserted at all . . . or fully in . . . or any amount of protection in-between. All adjustable in an instant . . . depending on what's happening around me.

That having been said, I'm always interested in knowing what kinds of things are available out there. So if you have a website or a link to something, I could check it out.

 

Wow! Makes me pleased I don't work out . . . or gamble.

 

Yes . . . definitely looks as though this is the way to go.

 

Thanks for the links. This all makes sense.

I can understand the MRI thing. Fortunately I didn't get a spike . . . but I had one with double protection as well . . . and it was still really loud.

 

@Arseny

I followed those links and while they weren't pleasant to read it's good to know. I know of at least two members of the forum who had a noise exposure that lead to t and then got t a second time later in life from a much smaller noise exposure.

I can also think of a member who was exposed to excessive noise exposure at a very young age who is dealing with continuing hearing loss.

@Bill Bauer

That was a great link too. A lot of the links on the link were dead but it definitely shows that loud noise and hyperacusis isn't a good thing.

_____

There's a lot to know about tinnitus and hyperacusis that goes against what is being taught in med school. The links above go against the grain of what is believed by most. Based on my experience they speak the truth.

 

Of the three links in the body of the text, I see that only the " 2200 posts on hyperacusis setbacks" doesn't produce the search results for 2200 posts. However, if you enter "hyperacusis setbacks" into the search field on the page that comes up, you will get 17 pages of search results. There are 30 threads per search page, so that works out to 510. Perhaps the author was talking about the total number of posts. Since there are more than 4 posts per thread, the number of posts is higher than 2200.

 

Hopefully tinnitus will go down/go away for all of us.

 

@Bill Bauer

I seem to have lost the dead links, I was probably several links deep by that time. The information you both gave backed up everything you've been saying all along and I've been learning the hard way. Those links made it all very clear including a quote by Jastreboff http://hyperacusisfocus.org/research/earplug-use-2/ (Go to underprotection and click on evidence)

“When [severe] patients are exposed to continuous high levels during pink-noise therapy, cumulative effects occur and tinnitus and hyperacusis are set permanently to a much higher level than before treatment began”

-Tinnitus Retraining Therapy by Jastreboff and Hazell

I believe this is why @Michael Leigh cautions us against using headphones and ear buds if noise was the cause of t.

 

@New Guy

Having had TRT twice which required wearing white noise generators for up to 10hrs a day, I believe the ears and auditory system, need a rest at night and they shouldn't be worn while asleep. Instead a table-top sound machine should be used by the bedside for sound enrichment. When wearing white noise generators, the volume should always be kept slightly lower than the tinnitus and not mask it. If the tinnitus is masked the brain cannot habituate to it.

I still use white noise generators as and when I need them. Based on my experience with "Noise Induced Tinnitus", corresponding and counselling people with this condition, it is my firm belief that a person that has it, should not use headphones at low volume under any circumstances even after they have habituated. Although some people with NIT use headphones and have no problems, I believe there is always a risk of the tinnitus increasing.

Many people in this forum and further afield, have contacted me regretting returning to using headphones, as their tinnitus has spiked and increased to a new and permanent level.

Michael

 

LOL... Yeah, bad habits both!

 

Work out at home with rubber dumbbells. Problem solved.

 

Michael . . . this 'renown' ENT I saw earlier in the week, wants me to get an in-ear WNG for my Hyperacusis..

I'm all in favor of this, due to positive outcomes of their use that I've seen on this Forum (especially yours).

However, one thing I've never quite understood for 'bad' H, which I believe yours was originally also . . . is logistically . . . how do you deal with being able to fully protect yourself from sounds that distress your H, either by their volume or frequency or whatever, when you have a device sitting in the ear which prevents you from being able to 'block' it?

I just came back from a 'nature walk', where I was able to have my ears unprotected for the majority of the time. However, I walk through a couple of 'suburban' blocks to get there . . . and on the way back I was approaching a building site where they were cutting through some steel pipe. My ear plugs were already 'resting' in the bottom of my ears (but not inserted at all) . . . and I was able to quickly put them in. Then I actually waited where I was until they stopped. Then quickly passed by the site.

If I was wearing a WNG in an instance such as that . . . would I have to remove it . . . then get an ear plug from my pocket and temporarily put it in? Or should I be carrying ear muffs around with me . . . and putting them on over the top of the WNG if necessary?

The ENT seemed to indicate that the WNG had the ability to somehow screen-out loud sounds . . . but didn't elaborate beyond that.

I'm just wondering whether you are familiar with the specific technology he is referring to? If so . . . is it something that someone with H would be able to safely rely on?

 

That sounds like it would work. It takes a lot longer to insert the earplugs (and for them to expand), than to put on muffs.

 

That's what I assumed.

Although, I've never actually used 'foam' plugs. I use tapered Silicone ones, which just push straight in.

However if carrying muffs around turns out to be the best option . . . that would be a bit of a pain. I really like to 'travel light' when I go for a walk.

I know I could just carry them around my neck . . . but I already have Bose SoundWear on when I'm out walking. Not that I'm able to really 'listen to music' anymore, as such. But I miss it so much and don't use buds or headphones now . . . so playing some smooth jazz on the SoundWear (with the volume so low that I can barely hear it) is about as close as I can get, these days.

 

I also miss the carefree days before the onset of T. Now I always have to carry a cloth bag with me that contains my muffs. I wish I didn't have to do that, but it is what it is.

 

HI @Martin

Thank you for your kind words they are much appreciated.
I found your post very interesting as you have raised some important points that I will try to answer and hopefully be of some help to you.

I agree with your ENT doctor that white noise generators are to be used if you want to treat Hyperacusis and cure it, in most cases such as mine for the last 22 years. They will also treat the tinnitus. Although most people will benefit from using WNGs, each person is different so a 100% cure for hyperacusis may not always be possible but it is likely the oversensitivity to sound will be reduced as much as possible.

Please be aware that wearing white noise generators is just one part of the treatment. In a lot of cases a person will also need "counselling" talk therapy with a Hearing Therapist or Audiologist trained in the treatment and management of tinnitus and hyperacusis. Not having counselling a person might not achieve good results. Tinnitus and hyperacusis can affect one's mental and emotional wellbeing quite significantly. This needs to be addressed and mustn't be overlooked or pushed to one side as unimportant for I assure you that it isn't!

You must not under any circumstances be wearing ear-muffs or other forms of ear protection when using white noise generators. Again, I agree with your ENT doctor that the WNGs will screen out a lot of the surrounding noise from the environment. Once you start wearing them you'll soon realize how gentle and therapeutic white noise can be for your ears and auditory system, when done correctly using the right equipment designed for this purpose.

Please do not become reliant upon earplugs and earmuffs for they often instil panic and fear and will prolong one's oversensitivity to sound problems. Earplugs or rather "noise reducing" earplugs have their place but mustn't be overused and certainly not to be worn when wearing white noise generators. WNGs should be put on in the morning and left alone as I have described in many of my posts on TRT treatment that you will find in the links below.

All the best
Michael

PS: If and when you start wearing white noise generators, I advise you not to discuss your treatment in tinnitus forums and it would be best to keep away from them completely until the end of treatment.

https://www.tinnitustalk.com/threads/trt-as-i-see-it.19555/

https://www.tinnitustalk.com/threads/what-is-trt-and-when-should-it-be-started.19024/

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

 

Have you read those publications? It says that early sound exposures (causing tinnitus or not) in mice may accelerate AGE RELATED hearing loss. If it can be applied to humans it concerns everyone, not simply tinnitus sufferers, we are almost all exposed to dangerous levels of noise in the first years of our life. Anyway this is off topic.

 

Michael . . . thanks very much for your response.

The Audiologist is getting back to me to arrange a time for an appointment. I told him that initially I'm going to have a LOT of questions (regarding hearing tests, frequencies, TRT, available devices etc.) . . . and said that I may very well take up a whole session just with questions alone, without even progressing beyond that. He said that would be fine.

This is the kind of thing I need to know. So, that being the case . . . I work in a sales office attached to a very noisy factory. It's involved in manufacturing and is full of lots of metallic clanging, grinding etc. (where even 'normal' people wear hearing protection).

If I go ahead with getting a WNG fitted . . . how do I deal with the fact that I'm either going into the factory or at least passing through parts of the factory, numerous times throughout the day?

Sounds good. Although one of the questions I intended on asking the Audiologist was about white noise vs. pink noise. I've come across a number of articles that seem to favor pink noise for Hyperacusis . . . including the following comment from http://www.hyperacusis.net/what-to-do/white-noise-and-pink-noise/ . . .

'Pink noise closely matches the spectrum of sound that we hear in our everyday world. That is why it is most important to increase our tolerance to these frequencies. White noise has equal energy to all frequencies. Since hyperacusis patients are more sensitive to high frequencies, white noise is not the sound of choice for therapy. It tends to slow our progress on re-establishing our tolerances because of the high frequency content in white noise'.

Because they're called 'White' Noise Generators . . . does that mean that is all they are capable of outputting? Or if it was determined that a different colored noise would be more suitable for a particular individual . . . are they able to accommodate that as well?

Sorry . . . one more question. This is also something I planned on discussing with the Audiologist, but thought I'd also get your opinion if I could, due to your familiarity with the use of WNG's.

My left ear is the main problem . . . and the ENT is talking about only fitting a device to that ear. I thought I remembered reading here (possibly in one of your posts) that they should be used in both ears simultaneously, regardless?

So as I was leaving . . . I said to the ENT . . . should I be getting one for each ear, for balance or something? He said "yes . . . you could . . . but I don't think it's necessary". I said "so if for instance, my left ear is 100% bad and my right ear is 15% bad . . . are you thinking that the left ear should be treated by itself first and then look at the right ear on its own after that?" He replied that there was a good chance the right ear may have resolved by that time.

I mean I have nothing against just having one . . . so long it's it's not going to be detrimental in any way. I assume it's going to be less expensive . . . unless you think there could be a specific downside to doing this?

Sorry for the barrage of questions. I'm just trying to make sure I'm taking the right steps . . . as I really need to find some kind of relief.

Thanks a lot.

 

HI @Martin G

I have read some of your previous posts and would like to give you some advice, and hope you give it some thought.

It is good that your Audiologist will be accommodating and happy to answer any questions that you may have. I personally don't think it is necessary to go too far in this because you can overcomplicate matters if you're not careful, and this can cause undue stress. Similarly, reading too much information on websites regarding Tinnitus, hyperacusis, TRT and the use of white noise generators.

On my "sound generators" I can select white or pink noise, to be honest there is not much difference between them. Pink noise sounds a little softer to me and that's all. I think too many people overcomplicate the difference between white and pink noise and I don't think it's necessary certainly not when they are used on "sound generators" intended for the treatment of tinnitus and hyperacusis.

I do not agree with your ENT doctor on wearing just one WNGs. Two should be worn to keep the auditory system in balance even if the tinnitus is in one ear - Professor Jastreboff recommends this and I agree having used WNG for over 20 years.

To be honest Martin I don't think you need white noise generators and believe you'll do just fine on your own with time. You are able to work which a positive thing as this means you're well on your way to making a good recovery. You do have some hyperacusis that's problematic at the moment, but I feel using "noise reducing" earplugs occasionally and not overused, your auditory system will desensitize in time and you'll probably make a full recovery. I say this because you mentioned working in a noisy environment adjacent to a factory I believe? Therefore, you are being subjected to the hustle and bustle of everyday life even if it's a little hectic at times, but I think you'll be able to manage this with a some care and not get too stressed over the noise. Perhaps this is all the daily sound enrichment that your auditory system needs to help you get back on track. I would back this up with using a "sound machine" at night by the beside.

Please follow some of my suggestions in my post Hyperacusis, As I see it, and I think you will do just fine in time without WNGs. I also advise that you do not use "headphones" of any type even at low volume for the foreseeable future.

If you limit reading up on information about tinnitus and hyperacusis, particularly at websites you will begin to focus less on your own symptoms. This will reduce any stress and anxiety that often accompanies tinnitus and hyperacusis. Similarly, keeping away from tinnitus forums I believe would be very good for you. My advice still stands: if you decide to use white noise generators or start any tinnitus or hyperacusis treatment, keep away from tinnitus forums as they often have a negative effect on a person's progress.

All the best
Michael

 

Michael . . . thanks for the additional question-answering and advice.

Don't worry . . . I haven't been doing anything over the last 6 months to cause undue stress. All my stress is completely 'due'. As far as websites go . . . when my symptoms first presented, obviously I went nuts, looking at everything I could find. But that was just the first few weeks. Nowadays, this is really the only site I look at. Even then, it's only to follow the Neuromod thread . . . and anything else about similar devices on the horizon.

Thanks . . . I've taken on-board your advice regarding the 'colour of noise', as well as the number of WNG's which should be used.

Funny you should say that. The exact same thing had crossed my mind. I do actually consider it fortuitous that I work in an environment that has an ambient noise level which kind of acts as automatic sound enrichment.

For nights . . . I'm afraid I don't own a dedicated 'sound machine'. I know it's not the same thing . . . but at the moment I'm sleeping using a hi-fi system, in an effort to at least have something. It's also hard to find a 'suitable' sound to play. In the early days . . . cicadas and crickets were my salvation. But since my symptoms worsened . . . I can't even bear listening to them. Now they don't even sound like anything 'natural'. They sound harsh and mechanical. So far . . . a track of waves lapping on a beach is the only thing I've found which is tolerable.

Don't worry. I stopped using ear-buds long ago . . . and although I sometimes quickly throw on my Bose Noise-Cancelling Headphones to do a noisy task, if they're handy . . . I don't actually turn them on. And I definitely don't play music on them. It's hard to imagine ever doing that again, even after 'recovery'. I think if I was ever able to enjoy music again . . . it would just be on Bose SoundWear at a low level, since they aren't 'in' . . . or even 'on' the ears.

I understand what you said about my possibly not even requiring WNG's.

To be honest . . . the awkward situation I find myself in is that my Boss made the appointment with this ENT for me. Obviously it's awesome to work for somebody who has real concern about my condition. However it does kind of make me feel obligated to some extent, to go along with the ENT's diagnosis. I'm not necessarily saying I will . . . but it makes things a little tricky.

Anyway regardless . . . for now, I really appreciate your input . . . and I'll update you with whatever the eventual outcome turns out to be with the WNG's.

Cheers,
Martin.

 

HI @Martin G

Although I have said I don't think you need WNGs. If you decide on using them your habituation progress will be quicker. Ideally, one should have counselling as I've indicated in my posts with a Hearing Therapist or Audiologist that's trained in the treatment and management of tinnitus and hyperacusis, particularly if the symptoms are severe. It is not unusual to find, these therapists were either born with tinnitus or acquired it at some time in their life. It is for this reason, I believe a person that does not have tinnitus, cannot fully understand it and the way it affects a person's mental and emotional wellbeing. Therefore, it is my belief they will be unable to give high quality counselling, something that is essential in helping people with this condition.

Best of luck
Michael

 

Cool . . . good to know. I'll definitely factor that into the final decision.

I agree 100%. It's impossible for anyone to relate, if they haven't experienced it themselves.

In fact this latest ENT did not ask one, single question about my Tinnitus or my Hyperacusis. It's almost as if he wasn't aware of all the different types of sounds and sensations and severities and volumes and behaviours these conditions can present. Didn't ask me anything at all about how it affected me or how I was dealing with it (although I did volunteer a bit of that info). Didn't even ask me to fill out any kind of questionnaire or form or anything.

He simply diagnosed that a WNG was the answer . . . due to the fact that he noticed I had ear-plugs with me when I sat down in his office. Once he saw them . . . he didn't even mention my T. He just launched straight into the whole 'stop wearing ear-pugs. You're making you Hyperacusis worse' routine . . . and that was that.

Anyhow . . . thanks again for your assistance with this. I'll let you know how it goes.

 

You are welcome @Martin G .

I would like to mention a few things that you and perhaps other people may not be aware of. ENT doctors are physicians they are not tinnitus experts. They know about the anatomy of the: Ear, Nose and Throat and able to treat these organs medically or surgically and this I believe the majority will do well, for this is their area of expertise. Tinnitus and hyperacusis are an entirely different matter and requires the intervention and referral, to a Hearing Therapist or Audiologist that specialises in the treatment and management of these conditions. ENT doctors are not counsellors.

The above was told to me by an ENT Registrar. When there is no underlying medical problem causing the tinnitus that an ENT doctor is unable to treat, the patient is usually referred to a Hearing Therapist for treatment as mentioned above. This is the way tinnitus is treated in the UK. My Hearing Therapist is excellent, not surprisingly she was born with tinnitus.

Take care
Michael

 

Hi, I wondering if there are any opinions regarding the use of ear plugs? Is it better to play it safe and overuse, or is smarter to use them only in situations with very loud background noise or music? Thank you very much.

 

Although I'm still new to tinnitus I dont tend to wear earplugs, unless I know its going to be very noisy environment or the sound is bothering me.

 

In my opinion (based on reading this forum over the past 23 months) the above is safer. I am assuming the above means wearing earplugs when there is a chance that you will be exposed to a loud noise (e.g., when you walk along a busy street).

Those are the situations that I advise getting away from as fast as you can. You don't want to willingly be around loud noise as hearing protection often provides a False sense of security. Wearing earplugs when the background is somewhat loud is sensible.

You don't want to wear earplugs 24/7, you might eventually get an ear infection that way. Make sure that your home is quiet and that you take out your earplugs whenever it is quiet (e.g., your home, a park).

You might also want to get exposed to some moderately loud noise - set your TV to the loudest noise that you know you can listen to for hours and not get any problems afterwards (also make sure the noise doesn't feel bad to you) and listen to it daily. Doing this will ensure that you don't get, exacerbate H.

To motivate you to follow the advice above, check out the first post on
https://www.tinnitustalk.com/threads/learn-from-others-mistakes.29437/
That thread also contains one of the arguments Azeuro had referred to above. See what side makes the most sense to you.

 

overuse is safer. but why would you only pick between two extremes. learn your boundaries.

 

Use earplugs if you’re going somewhere loud, otherwise, you don’t need them. If you spend most of your day thinking about sound you will become obsessed with it and this can lead to phonophobia (do not underestimate this, it can ruin lives), hyperacusis, and/or it can make your tinnitus worse.

Listen to what Ross O’Neill says on the Neuromod video at 20 minutes in:

https://www.tinnitustalk.com/threads/q-a-tinnitus-hub-meets-neuromod-lenire.32369/

Ultimately, you need to do your own research and make your own decision as they are your ears. I used to overprotect and I was miserable and it made my ears and life worse. As soon as I clawed my way out of this toxic behaviour I felt a million times better.

You will hear vastly different opinions on here but they are mainly driven by fear which is not good for tinnitus.

 

Defining everyday sounds can be a bit ambiguous. For example, it´s winter here and the snow plows are an everyday thing. Most people don´t mind (or cover their ears) while there´s a snow plow removing the snow from the road or from the sidewalk, even if they would pass less than a meter away. I don´t consider a 12 ton wheel loader or a dump truck with a 3meter wide bucket scraping the slush off from asphalt an everyday sound that I need to hear. So I take few steps back and cover my ears and wait until the snow plow passes by.

 

Since it is something that can turn your life into living hell and make your body uninhabitable, in my opinion, it is ok to be obsessed with it (and not ok to not be obsessed with it).

Protecting against what can make your T worse is NOT going to make your T worse. It will reduce the probability that it will get worse.

I used to underprotect, my T got worse, I got miserable - so I started to protect and my H is gone and I got better.

First of all, it is ok to fear scary things that can change your life forever. This is like saying that trying to build bridges that will have a low likelihood of collapsing is driven by fear. Second of all, my opinion is driven by what I learned after reading this forum for the past 23 months.