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Cristian

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 #1 
 
 
Hi Dr. Nagler,

Thank you for the effort and time you put in helping all tinnitus sufferers.

My name is Cristian, I am 34 years old and I live in Romania. Have tinnitus since 2011 from going to a loud club music. First months were very hard for me, I visited several ENT's, all told me that I have to live with it, one of them prescribed me Betaserc 24. When the panic and anxiety disappeared I started to feel better, the level of tinnitus went down so much that I barely hear it in a silence room. I continued to live my life, going to work, listen music, going to gym, travel, reading.

First bad spike was in 2014 after going to a loud bar without wearing earplugs my tinnitus increased to a level that stayed highed more than 2-4 days that I used to. It was  masked most of the time by ambient noise at work and out. The challenge was at night because was very loud in both ears. I was very tired but unable to fall asleep for 4 days. I tried with TV and radio on, white noise, falling water, rain. Nothing worked to masked it because I like to sleep in silence. My doctor prescribed me some lorazepam meds and I could sleep a few days. I don't know if i call it habituation but after 3 months a miracle happened, my negative reaction disappeared and wasn't bothered by tinnitus again. I stopped to read tinnitus forums. I was able to sleep in silence and do usual activities like before. 

On 31 July 2016, I invited a girl to have a drink to an outdoor restaurant. Near the restaurant was an outdoor wedding, loud music. To get into restaurant we had to walk on a road that was 30 m away from the wedding place. I thought it was a safe distance and being embarrassed to protect my ears with my hands I walked like that. Next day in the morning  I noticed a high pitch different from what I had before. I thought it wil go back to the usual volume I'm used to but after two months it doesn't get better. I can hear it now almost all the time. The only good thing  is that I can sleep with sleep application on my phone that makes crickets noise. Strange think is that I went to a walk in the forest in silence, in august and barely hear the tinnitus. 
I am frustrated now for making such huge mistake and  frightened that I will not be able to habituate again.

It's possible this short exposure (about one minute) to damage my hearing?

You said in a post: That said, some groups of individuals tend not to do as well as others with TRT. Many of these individuals do, indeed, succeed in TRT; it is just that their success rate is not as high. People whose tinnitus markedly increases in intensity upon exposure to noise do not do as well if that marked increase in intensity lasts more than 24 to 48 hours.

I don't have acces to TRT but what you said means it's harder for me to natural habituate if my tinnitus increased due to noise exposure? It scares me a lot.
Dr. Nagler

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 #2 
Hello Cristian. And welcome. I am sorry to hear that you are having a difficult time of it, but I am very glad that this board could be here for you to try to separate fact from all the myth.

You asked:

Quote:
It's possible this short exposure (about one minute) to damage my hearing?

You spent approximately 60 seconds exposed to loud wedding music emanating from a source approximately 30 meters away from your location. I can absolutely understand why you might be concerned. But your concern is based in emotion. So let's look at the reality. The typical noise level in the front row of the audience at a loud rock concert is approximately 115dB. Let's assume that however loud the music at the wedding place was, it was not as loud as a rock concert. Now add to the equation the fact that energy dissipates quite rapidly so you move away from the source, specifically the energy at any point x is inversely proportional to the square of the distance between point x and source y. Finally add into the equation the fact that auditory damage is related not only the noise level at point x but also to the length of time exposed to that noise level. Cutting through all the physics and math, what this mouthful means is that it is virtually impossible that you could have suffered any permanent auditory damage as the result of your spending a minute walking on a path 30 meters away from a wedding reception. So I do not think you made a huge mistake and the physics bear me out on that. Long story short - your emotion-based concerns are not justified by the realities.

The question, of course, is why is your tinnitus louder if there was no auditory damage. And all I can say in that regard is that tinnitus intensity is a multifactorial entity that is hard to pinpoint in a forum such as this. But that said, since the increase in intensity is not due to permanent auditory damage, it should be easier to address in the clinical setting should the situation not resolve on its own to your satisfaction.

Quote:
You said in a post: That said, some groups of individuals tend not to do as well as others with TRT. Many of these individuals do, indeed, succeed in TRT; it is just that their success rate is not as high. People whose tinnitus markedly increases in intensity upon exposure to noise do not do as well if that marked increase in intensity lasts more than 24 to 48 hours.

I don't have acces to TRT but what you said means it's harder for me to natural habituate if my tinnitus increased due to noise exposure? It scares me a lot.

My comments were related to the kindling and winding-up phenomena. The type of increase in tinnitus intensity you describe is something entirely different and should not affect your chance for successfully habituating your tinnitus with or without TRT.

Perhaps the best place to start would be by reading my articles on Tinnitus 101 and Barriers to Habituation.

Hope this helps.

Dr. Stephen Nagler
Atlanta Tinnitus Consultants, LLC



__________________

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
Cristian

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 #3 
Thank you for the quick reply. I know tinnitus is unpredictable. After this episode, I was overwhelmed by frustration and anger because I put me is such situation. May have been a shorter distance, as 15-20m. I guess that not change anything in instance. 
From 2011 since i got tinnitus, sometimes I might find it difficult to understand other people when they talk in enviromental noise. Though, I tested my hearing every year and audiologist says nothing is wrong wity my ears. Dow you have an explanation for this?


Dr. Nagler

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 #4 
Quote:
Thank you for the quick reply.

You are welcome.

Quote:
I know tinnitus is unpredictable.

Yes, it is indeed unpredictable. You are absolutely right. I often like to say that the only predictable thing about tinnitus is its unpredictability.

Quote:
After this episode, I was overwhelmed by frustration and anger because I put me is such situation.

I understand. And that only compounds the problem. Here is a very simplistic example of what I mean. A wind-up clock by your bedside (like THIS ONE) makes a very soft ticking sound. But imagine if I hammer the windows of your bedroom closed, bolt the door shut from the outside, and tell you that the clock is actually the timing mechanism on a bomb. Pretty quickly the ticking sound gets all your attention and becomes thunderous - even though it is producing the same number of dB. Moreover, once that happens you cannot get it to "quiet down" no matter how hard you consciously try because the mechanisms involved in magnifying the ticking sound are primarily subconscious. Well, in your case this overwhelming frustration and anger you describe are part of what is making your tinnitus sound so loud!

Quote:
May have been a shorter distance, as 15-20m. I guess that not change anything in instance.

Correct.

Quote:
From 2011 since i got tinnitus, sometimes I might find it difficult to understand other people when they talk in enviromental noise. Though, I tested my hearing every year and audiologist says nothing is wrong wity my ears. Dow you have an explanation for this?

Many possibilities. The important thing for you at this point in time is to realize that since your hearing is fine and since your difficulty is a "sometimes" thing that might occur in certain situations, it really isn't worth being concerned about. As I see it, anyway.

stephen nagler

__________________

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
Cristian

Member
Registered:
Posts: 3
 #5 
Hello again Dr. Nagler,

I managed to habituate since our last talk. Not fully but 80% of time didn't bother me. I could even stay and sleep in silence. I wish I wasn't in this situation again to ask for help but something bad happened again.
I was to ski Saturday. On the base of the slope some background radio music singing. Not so loud, I could hear the person next to me. Didn't feel necessary to put my ear drops.
We leaved the ski resort at dark. At home, I was so tired that I fell asleep right away.
I wake up in the morning with a new aggresive T that overwhelmed me. I have two nights without sleep. I can hear it over the traffic noise, music car and background noise from work. Neither the cricket application is not helping me to sleep because I hear the T over it. 
Is exhausting again and drive me crazy. I dont know what to do, please help me.



Dr. Nagler

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 #6 
Quote:
I managed to habituate since our last talk. Not fully but 80% of time didn't bother me. I could even stay and sleep in silence.

That's really wonderful. It took you only four months to achieve such great improvement. Excellent!

Quote:
I wish I wasn't in this situation again to ask for help but something bad happened again.
I was to ski Saturday. On the base of the slope some background radio music singing. Not so loud, I could hear the person next to me. Didn't feel necessary to put my ear drops.
We leaved the ski resort at dark. At home, I was so tired that I fell asleep right away.

I don't see anything bad about any of that. It's called "living."

Quote:
I wake up in the morning with a new aggresive T that overwhelmed me.

Well that's unfortunate, but I certainly hope you don't think it was because of some sort of damage caused by the music. It wasn't - because no damage was done.

Quote:
I have two nights without sleep. I can hear it over the traffic noise, music car and background noise from work. Neither the cricket application is not helping me to sleep because I hear the T over it. 
Is exhausting again and drive me crazy. I dont know what to do, please help me.

You have already proved to yourself that you can habituate. So whatever worked for you before, do it again. And this time you get to do it with the added confidence of knowing that it will be successful.

All the best -

Dr. Stephen Nagler

__________________

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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Dr. Nagler's Tinnitus Corner is provided for education and information only. It is not intended for the purpose of providing medical care and should in no way substitute for appropriate in-person consultations with qualified healthcare professionals. By using this site, participants agree to hold Dr. Nagler and Atlanta Tinnitus Consultants, LLC harmless with respect to any loss, injury, claim, liability, or damage arising from following the postings herein.