Upright Bass Player Hearing Loss Odyssey

Folks,
My March 30, 2018 launch to the planet Hearing Loss has been a one-way ticket with some carry-on baggage labeled Tinnitus, Hyperacusis and Diplicusis. The trip has taken me to some places many of you recognize:
- HearUSA, a place where an Audiologist administers an Audiogram as a prelude to prescribing hearing aids;
- Kaiser Permanente, a medical care provider in CA whose "standard of care" for hearing loss is the steroid Prednisone - which I took both orally (in pill form for three weeks) and intratympanically (three shots, through the eardrum!);
- House Ear Clinic, a world-renowned institute of research and clinical practice, where they prescribed Betahistine, Hydrochlorothiazide and a diet that includes bananas;
- USC's Keck School of Medicine, where I'm to be seen again next week for a treatment with Mannitol.

By the way: if you like Mariachi trumpets, you'll love Diplicusis.
Starting with the note A above middle C, and ranging up one octave, my right ear "hears" a Major Third above the fundamental. So, if I whistle "Cielito Lindo" (I do take requests, friends), I hear the melody note with a perfect Third above it. That's in my head only, of course, but that's a quality that Diplacusis shares with Tinnitus: we who experience them are in our own private hell. (Now I believe someone with D and/or T probably wrote the Xmas carol, "Do You Hear What I Hear".)

Meanwhile, like all of you in T-land, I've been reading a lot of info online - and enjoying the therapeutic benefits of reading in Quiet Surroundings, not at noisy Starbucks and not wearing 'buds or 'phones.

The consensus I gleaned was: protect your ears, but don't wear protection 24/7 because the brain might begin to "forget" how to hear.

So, first I bought a box of those little yellow cylindrical pillows made by 3M you can order from Costco's website, and they're cheap. I find you can re-use them for a couple of days before they turn gray and lose their elasticity (they have to be rolled into a tight stick and inserted deep enough to expand fully against the middle ear).

On my first post-hearing-loss gig - just electric piano and amplified bass - I believe I hallucinated, sans drugs: The piano was loud and irritating, the crowd (a terminally-hip birthday-party mob jammed into Spago's in Beverly Hills) deafening, and the bass nearly inaudible. The little 3M earplugs only caused distortion; I think because they are porous, they absorbed the incoming cacophony and released some of it against the walls of the middle ear. There wasn't a sense of vertigo, exactly, but I felt the room start elevating and turning slowly, like a merry-go-round that was powered by the nightmare of all that noise. I kept playing, even taking solos, but it was one of those bad dreams where I Could Not Hear a Bass Note. We played for about 90 minutes before someone stepped forward to a mic to make a speech. The spinning stopped, but the voices of the friends taking turns at the mic sliced through my right (worse) ear at the dog-whistle frequencies of a dentist's drill. I managed to stay outwardly calm through the ordeal, but I remember wondering whether this was my new reality. Once the gig finally ended, and my ears had a few days to rest, I decided not to quit just yet.

Knowing I had to up the ante, I first tried Westone earplugs, over-the-counter generics from Guitar Center. These did very little, and in fact increased distortion.

Then, I came across Westone's TRU series, had an Audiologist prepare molds of the middle ear, and waited two weeks for the custom-made earplugs to arrive. They do attenuate a lot of volume, and they come with little filters you can remove if you need to hear more.

My problem is mainly with the right ear - where the hearing loss is near profound levels in both the low and high frequencies. The left ear is damaged, but to a lesser extent.
My typical gigs are in quartets with and without singer. I use a 300W bass amp.
When I try wearing both plugs onstage, I can't hear my bass at all; I am essentially playing From Memory, praying that my intonation isn't noticeably awful. The TRU plug limits so much volume entering the right ear that I can scarcely hear a piano being played to my immediate right. I've tried one-plug-in, one-out, filter-in, filter-out. I began placing my amp on a stool just behind my left shoulder - but the bass notes were still undiscernible.

Then I discovered In-Ear Monitors. The best results so far have been with a single IEM plugged into the Headphone jack of the amp and plugged into my left ear - and the custom earplug into the right ear.
I do have some concern that pumping Bass-only volume into the 'better' ear might damage that ear further.

Last week I discovered the Promised Land: a recording studio. With some trepidation, I came with my little array of 3M pillows, earplugs, IEM's - and a list of apologies and excuses.
Fortunately, I didn't need any of that.
The studio had very high-end gear. Each player was in isolation. Each instrument was separate in the headphone mix.
Soon I found what worked best for me: low gain from drums, piano and horns in the right ear - and the left side of the headset shoved forward, off the ear completely.
Voilå! I heard my wonderful, 100-year-old Upright clearly and warmly and acoustically in the left ear, and the rest of the ensemble in the right.
Tempering my excitement somewhat was the ritual of the Play-back, when we all gathered in the control room to listen to what we'd laid down. Through even those high-end studio monitors, the bass nearly disappeared again! My hunch is that the fundamental of a low bass note fans out into midrange and higher frequencies like the bleeding colors of a Madras shirt. When the bass is amplified, my ears "lose" the individual pitch of the original low note, and the damaged "hairs" or cochlea can't discern the mid-range and high tones that spread out from the root.

For most of us musicians, Recording is a wonderful thing for various reasons. I confess: each time I put my playing "out there" on a recording adds an extra lightbulb on the Vanity mirror. Just as importantly now, being able to hear the bass clearly in the studio environment is a reaffirmation that I ain't done yet - that I can continue to play until they carry me off draped across the body of Bertha, the bass.

On upcoming gigs in the "real" world outside the studio, I'm going with the IEM left and earplug right.
I should make a side-trip to Best Buy for an extension wire because the IEM cord is pretty short between amp and ear.

In closing, I'll second the motion of the fellow who advocated "distraction" as a way to suppress tinnitus.
While writing all this verbiage, I've been blissfully unaware of Mr T.

If anyone has a similar combo platter - two ears with dissimilar hearing loss, low-end difficulty in one ear - please share your good results. I'll be (almost) all-ears.

 

Did you do a hearing loss and what were the results like what DB at what khz ?

To give you an example I have 20db a cross the scale with a dip of 30 at 4hz then back to 40db at 8khz going to 60 at 12khz and no hearing above 12khz

 

Bobby,
Your numbers 'sound' enviable, if I understand them correctly.
My right ear scores 60dB at both 125 and 150 khz.
It rises gradually: 55dB at 500khz, 45dB at 750, 30dB at 1000khz, 20dB at 1500 khz.
It peaks at dB/2000khz.
Then comes the precipitous drop: 60dB at 3000 khz.
It recovers slightly to 50dB at 4000 khz, and finishes up at 50 and 45.

The left ear numbers remain mostly between 25 and 15 dB, but as with the Right, there are low numbers at either end.

You seem to know more about this stuff than I do. What do you make of these numbers?

What practices or devices have you tried, and what works best in dealing with the loss?

Thanks.

 

Typically noise induced hearing loss will hit the high frequencies a lot more and leave the ones under 8khz less affected besides the famous 4khz dip

But I'm no expert what did caused all this ?

 

There was no explosion, blast of feedback, screeching guitar or other sudden burst of volume. Can only guess that 40 years of playing music suddenly caught up with me.
Yes, "typically" the high frequencies are hit hardest; that's one reason why the hearing aid industry makes nearly all its devices for people with high-end hearing loss.
No audiologist or head and neck surgeon has yet come up with an explanation for the unusual loss of low-end hearing, and so dramatically in just one ear.
Today's hearing test confirmed my suspicions: the right ear got worse in the past 6 weeks.
dB numbers from left to right across the chart: 65, 65, 65, 60, 50, 60, 60, 50, 55.
Will keep playing until it isn't fun any more.

 

Do you have an air-bone gap?

 

Not sure.
Is that something an MRI would reveal?
I did have an MRI, and the doctor who looked at the results said there was no sign of a tumor, etc.
The audiologists I've seen simply administer the hearing test with headphones over the ears first, and then a "conductive" pair that are placed at odd angles against the side of my head and jaw.
What light can you shed about an air-bone gap? Do you have one? How do you deal with it with respect to hearing loss?

 

I used to have one yes.
Please see answers to your questions here: https://www.dizziness-and-balance.com/disorders/hearing/conductive.htm

 

H'mm...this is all above my pay grade. I don't think I have conductive hearing loss.
I don't identify with any of the causes. They did puncture my eardrum to give three shots of Prednisone, but the hole in the eardrum is healing as evidenced by a scab.
My left (better) ear seems to have conductive hearing loss, but I can live with it.
The right (bad) ear is awash with the roaring of Niagara Falls or an ocean striving relentlessly towards shore.
(As tinnitus goes, this is not as irritating as what others report in the way of whistling, white noise, etc.)
Are you now wearing hearing aids?

 

They come even if you don't think you're part of a "risk class": ask me how I know. Many of these causes are idiopathic.
It's easy and painless to measure it. It should be done as part of your hearing test, and it shows on your audiogram. Do you have an audiogram that you are comfortable sharing here (blank out personal info)?

On one side yes. I've also done surgery (which resolved the conductive hearing loss)

 

Yes, the audiologist includes a test of conductive hearing at the end of every visit: she puts a separate device on my head at an angle - skull-to-jaw - to measure conductive hearing, presumably. The results are indicated on the audiogram as 'letter C's'. Attached is the latest test. What it doesn't show is the sensitivity factor - how the right ear recoils and craves protection from anything above moderate volume. That 'hyperacusis' - and the hearing loss itself, I'm told - would only worsen if a hearing aid is used. It amplifies everything in the environment.

 

You do have an air-bone gap.
Has anybody talked to you about otosclerosis?
I don't want to go into details about stapedial reflexes, Carhart notch and other goodies, but it may useful for you to talk to your ENT about it. A CT scan can sometimes reveal signs of otosclerosis activity.

Of course, you do also have an important amount of sensorineural losses, and if it is O, then perhaps you have - like me - mixed losses.

At any rate, if you do have O, the sooner you know the better, as there are some meds you could take to try to slow down the progression of the disease.

Good luck!