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allancurran

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 #1 

Dear Dr Nagler

I wrote to you seven weeks ago after playing my piano caused my tinnitus to spike.  I'm sure you'll probably remember the post.  [Yamaha state my piano can peak at 85 decibels or just above if being played at full pelt]

Over the past seven weeks things have largely remained the same although I am pleased to say I've had a couple of days each week,in the past couple of weeks, mainly at home, when my Tinnitus is fairly low level, not completely silent but certainly not piercing.

I've taken your advice and not completely avoided sound but I have noticed some sounds bother me personally, like plates and glasses clanking or car doors slamming when I'm in the car. 

What I have also noticed in a day, normally a working day, is that some environmental noises will cause immediate spikes, like being in the office and people are chatting around me or certain sounds and I can pinpoint the moment it spikes.  It'll go from 'eeeeee' suddenly to 'eeeeEEEEEEE' and then seem to stay at that level or go back to what it was.

What's going on here?  Is this 'reactive tinnitus' or the beginnings of hyperacusis?

I just want my T to settle back back down to the steady less piercing tone it was and get the old me back because I have to admit I'm very low and tearful...especially when I walk up early and it dark and things seem a lot worse than what they perhaps are.

What can you advise?  is there anything I should or shouldnt be doing?

 

Dr. Nagler

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 #2 
I will be happy to offer an opinion regarding what you should consider doing next, but please clarify three things for me ...

(1) You wrote [in part]:

          "I have noticed some sounds bother me personally, like plates and glasses clanking or car doors slamming when I'm in the car."

When you way those sounds "bother" you, do you mean that the sounds themselves are unpleasant to your ear and upset you, or do you mean they seem to aggravate your tinnitus? 

(2) You also wrote [in part]:

          "What's going on here?  Is this 'reactive tinnitus' ..."

Where did you pick up the term "reactive tinnitus?"

(3) On a scale of 1 to 10 where 1 is "I have tinnitus and I'd prefer not to have tinnitus but in the grand scheme of things I do not care much one way or the other because my tinnitus does not affect my life," and 10 is "I have tinnitus and my tinnitus has totally, completely, permanently, and irrevocably destroyed my life," where would you place yourself along that huge continuum over the past week or so? Please just give me one overall average number. 

Thanks -

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
allancurran

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 #3 

Hi Dr Nagler

1. Unpleasant to 'me',  as in the person.  Some sounds 'I think' seem to aggravate my Tinnitus - rooms with lots of chatting going on or female voices at certain pitches. 

2.  You guessed it - internet forums; Facebook groups...some web pages.

3.  Probably about a 7, if a 10 is 'has commited suicide' and 7 is 'thinking about it, starting to crack at work and cracks showed at home long ago'.

Are my prospects the same, now its 7 weeks on i.e. sit tight and hope this spike will settle. 

 

thanks

Allan UK

 

Dr. Nagler

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 #4 

Quote:
1. Unpleasant to 'me',  as in the person.  Some sounds 'I think' seem to aggravate my Tinnitus - rooms with lots of chatting going on or female voices at certain pitches. 

If an external sound is unpleasant but not by virtue of its loudness, that is more in line with misophonia than hyperacusis. I'm not making a diagnosis here; just painting in broad strokes.

Quote:
2.  You guessed it - internet forums; Facebook groups...some web pages.

The term "reactive tinnitus" came out of Internet boards where folks were trying to come up with reasons to justify why their tinnitus is so much more awful than anybody else's tinnitus. Most everybody has reactive tinnitus. Mine reacts to the spices in Thai food. I know lots of folks whose tinnitus reacts to stress or emotion. Some folks' tinnitus reacts to various sounds. Big deal.

Quote:
3.  Probably about a 7, if a 10 is 'has commited suicide' and 7 is 'thinking about it, starting to crack at work and cracks showed at home long ago'.

Regarding committing suicide, the incidence of suicide in the tinnitus population is no greater than in the general population. But I digress. If you rate yourself as a 7 on a scale of 1 to 10, then I think your next step should be to actually talk to somebody who is knowledgeable and experienced in addressing the needs of individuals with intrusive tinnitus so you can develop a plan.

Quote:
Are my prospects the same, now its 7 weeks on i.e. sit tight and hope this spike will settle. 

I personally think that hope is highly overrated. Why don't you just assume your spike will never settle down??!! Then if it does (as it likely will someday), you can be thrilled to have been wrong in your assumption. Isn't that better than hoping it will settle down and starting out each day disappointed when you discover it hasn't? 

All the best -

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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