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bellringer

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 #1 
After suffering tinnitus for two months it came time to take a vacation with my family. My favorite getaway is spending a summer week in Mammoth Lakes in the Sierra Nevada. Mammoth is situated at an elevation of about 8000 feet, with hiking and lake activities at 9000 feet.  We live at an elevation of about 1500 feet so normally I need a day or two to get use to the higher elevations. This is my first time visiting with tinnitus. 

We left on Friday and made the five hour drive. I was doing really well on the drive and my tinnitus loudness was pretty manageable. The final 45 minutes we gained about 4000 feet in elevation. When we arrived at the condominium (8000 ft elevation) my tinnitus was actually a little lower for the first 20-30 minutes. Then hell broke loose and my tinnitus cranked up loud.  That night right after I laid down in bed my right ear (the one without tinnitus) suddenly started ringing and the volume exceeded my regular ringing left ear.

The next morning the right ear ceased ringing, but the left kept ringing as loud as the night before. We went up to 9000 feet and the left ear ringing became more intense. We came back down to the condo where the left ear continued ringing intensely.

My right ear once again started ringing during the 2nd night, but not quite as loud and ceased when I woke up.  The left ear is just as loud as the day before. 

I have five more days and five more nights left here. I am a wreck and this vacation has turned into a nightmare.  I have been considering going home early.

What is the relationship that causes tinnitus to get loud with elevation ascent?  Could I be creating a new level of intensity that will stick around after I drop in altitude?







Dr. Nagler

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Bellringer posted [in part]:

I have five more days and five more nights left here [at altitude]. I am a wreck and this vacation has turned into a nightmare.  I have been considering going home early.

What is the relationship that causes tinnitus to get loud with elevation ascent?  Could I be creating a new level of intensity that will stick around after I drop in altitude?

.............

A significant change in barometric pressure can result in a temporary conductive hearing loss that can, in turn, exacerbate tinnitus. Typically this phenomenon settles out over time as your Eustachian tubes serve to equalize the pressure. The problem is that on occasion, through absolutely no fault of their own, some people will "lock on" to their tinnitus, which then initiates the "vicious circle" that auditory neurophysiologists talk about, a vicious circle involving the limbic system, the auditory cortex, and the autonomic nervous system.

So what does that all mean from a practical standpoint? Here are my thoughts:
  • Nothing you describe has resulted in auditory damage, which means that things should all settle back down in time. How much time? That can be variable - but the more you focus on it, the more of a challenge it can become due to the aforementioned vicious circle.
  • Whether you stay five days more or whether you go home early will not result in more damage or less damage, because no damage was done in the first place.
  • If you are so totally miserable that you cannot enjoy your vacation in any way, shape, or form, then you might consider going home. On the other hand if you can stay and derive even a little pleasure out of spending a week on vacation with your family in the beautiful Sierra Nevada, then I would not give my tinnitus the satisfaction of terminating a family trip you have really been looking forward to. But that's a personal decision. There is no "right" answer!
  • Lastly, as I have said many times over the years, "The only predictable thing about tinnitus is it's unpredictability." So as best you can, resist the temptation to try to "figure" out your tinnitus. (Everybody does it anyway, but at least try not to!)
Hope this helps more than confuses or frustrates.

Dr. Stephen Nagler
Atlanta Tinnitus Consultants, LLC

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