Dr. Nagler's Tinnitus Corner
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tomrobey

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 #1 
Dr. Nagler, 

When looking at decibel level charts, is there a typical distance objects are measured from? E.g., a jackhammer might be listed at 110 db. But the level of sound will be different when my ear is one foot away from it versus 30 feet, right?

Also, at the receiving dock at work recently, a driver caused a three-foot folding metal ramp to fall from the dock and crash-rattle onto the pavement below. I was around eight feet away and it was of course loud. Admittedly, I immediately voiced a profanity and felt my ears have a slight closing sensation. Over a week later, my tinnitus is still up. I know it's the db level and time of exposure which are intertwining factors and realize that should not be the cause here. So are there other underlying anatomical or auditory responses that come into play with loud noise exposure - versus the oft thought damage to hair cells thinking - that could aggravate tinnitus?


Thank you.
tomrobey

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 #2 
meant to have this as an addendum in my last post...

I currently work at a local hospital. The pay is on the low end, the hours are not full time, and as the job has been much more physical than just stocking shelves with medical supplies, I've since developed plantar fasciitis. My job has been great in other respects, with moving around often and focusing on things like stocking the supplies. 

But I've been applying to full time jobs, with more pay, etc. The thing is these roles involve sitting at a desk a lot, using a computer.

I need a job like this from a 'survival' aspect, but I am scared at the same time, that sitting at a desk all day is going to be really challenging, with my tinnitus going nonstop.

Advice about being in the labor force with this condition?


Thanks again.
Dr. Nagler

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 #3 
Quote:
When looking at decibel level charts, is there a typical distance objects are measured from? E.g., a jackhammer might be listed at 110 db. But the level of sound will be different when my ear is one foot away from it versus 30 feet, right?

You are right in that dB levels fall off the farther you are away from the source. You might want to google "Inverse Square Law." And there absolutely should be a standard distance from a source that should be clearly stated on decibel level charts, but there almost never is. In fact, I do not ever recall seeing one. Dr. Jack Vernon (1922-2010) used to say that if the sound in a room is so loud that you have to raise your own voice in order to be heard by somebody standing next to you, then it is too loud for you ... and for everyone else! That way you don't have to worry about things like charts and distance. :-)

Quote:
Also, at the receiving dock at work recently, a driver caused a three-foot folding metal ramp to fall from the dock and crash-rattle onto the pavement below. I was around eight feet away and it was of course loud. Admittedly, I immediately voiced a profanity and felt my ears have a slight closing sensation. Over a week later, my tinnitus is still up. I know it's the db level and time of exposure which are intertwining factors and realize that should not be the cause here. So are there other underlying anatomical or auditory responses that come into play with loud noise exposure - versus the oft thought damage to hair cells thinking - that could aggravate tinnitus?

Tinnitus intensity is an incredibly poor reflection of hair cell status. There are emotional, autonomic (fight-or-flight), and other subconscious factors that play a far greater role.

Quote:
I currently work at a local hospital. The pay is on the low end, the hours are not full time, and as the job has been much more physical than just stocking shelves with medical supplies, I've since developed plantar fasciitis. My job has been great in other respects, with moving around often and focusing on things like stocking the supplies. 

But I've been applying to full time jobs, with more pay, etc. The thing is these roles involve sitting at a desk a lot, using a computer.

I need a job like this from a 'survival' aspect, but I am scared at the same time, that sitting at a desk all day is going to be really challenging, with my tinnitus going nonstop.

Advice about being in the labor force with this condition?

Not trying to be evasive here, but that really depends on the degree to which your tinnitus affects your life and why. Interestingly, it has almost nothing to do with how loud your tinnitus is!

Hope this helps more than frustrates.

Stephen M. Nagler, M.D.

__________________

The best way to find yourself is to lose yourself in the service of others.
- Mahatma Gandhi

No bird ever soared in a calm. Adversity is what lifts us.
-
David McCullough quoting Wilbur Wright
tomrobey

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 #4 
All great and highly welcomed insights Dr. Nagler!

I will certainly use Dr. Vernon's commentary regarding noise level that you shared. That will be a useful layman's guide to help in determining how noisy an environment is, so to speak. 

Quote:
Tinnitus intensity is an incredibly poor reflection of hair cell status. There are emotional, autonomic (fight-or-flight), and other subconscious factors that play a far greater role.


I have had tinnitus for almost six years and this was not something I was aware of, so this statement is greatly appreciated. I will keep that in mind.


Best regards, 
Tom Robey






Dr. Nagler

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 #5 
Quote:
Originally Posted by Tom
I have had tinnitus for almost six years and this was not something I was aware of, so this statement is greatly appreciated. I will keep that in mind.

Glad to help.

Here's something really amazing. Several years ago there was a study where they performed tinnitus loudness matches under carefully controlled conditions in an audiology booth. There were 1630 participants, all of whom had tinnitus that was so severe that it led them to seek help at a major university tinnitus center. Turns out that 40% of these folks had loudness matches measuring 3dB or less over their threshold of hearing! We are talking here about LOUD SCREAMING tinnitus in many cases, yet when carefully measured under controlled conditions it was 3dB or less over their threshold of hearing! Almost 70% of them had loudness matches of 6dB or less over their threshold of hearing! And 84% had loudness matches of 9dB or less over their threshold of hearing! Just think of all the havoc a few measly dB can cause when subconscious factors are taken into account. Now being subconscious, we have little or no conscious control over those factors - it's not like we can wish them away or try harder somehow - but the numbers do not lie!

Stephen M. Nagler, M.D.

__________________

The best way to find yourself is to lose yourself in the service of others.
- Mahatma Gandhi

No bird ever soared in a calm. Adversity is what lifts us.
-
David McCullough quoting Wilbur Wright
tomrobey

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Posts: 7
 #6 
WOW! That is something else! That was another bit of information I never ran across. It certainty causes me to shift perspectives on things. Not to mention approaches/ideas to consider for tinnitus mitigation purposes. 
 
Thanks for providing the data element, too. I do believe in Data. 
 
Lol, yes, I find the wishing it away treatment hasn't really worked for several things in my own life. 😉
 
Dr. Nagler

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 #7 
Regarding information and data, you are welcome.

And remember: Since tinnitus has no physical correlates, the only power your tinnitus can possibly have over your life is the power you yourself give it. That same thing is true for any non-physical sensation (e.g., smell, taste, vision, touch, sound) except pain and temperature, which have unique neurological pathways.

So take the power you have unintentionally given your tinnitus back - and keep it with you, where it belongs. All the best with it.

Stephen M. Nagler, M.D.

__________________

The best way to find yourself is to lose yourself in the service of others.
- Mahatma Gandhi

No bird ever soared in a calm. Adversity is what lifts us.
-
David McCullough quoting Wilbur Wright
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