As a follow up to my recent post...and to recap, 6 months into Tinnitus that started following performing at a gig with excessively loud stage volume....on Mirtazipine for 4 months (hoping to taper off in August) and 10 CBT sessions in......
I currently take care with noise, wear hearing protection - £800 custom mould in ear monitors which allow me to control the level and frequencies of sound that reach my ears - in theory....the reality is that bone conduction in extremely loud scenarios means my head is subjected to quite high dBs regardless, at times (bone conduction I guess).
Wearing these devices can make my Tinnitus come to the fore and reduces my enjoyment of rehearsing / performing.
One school of thought is that there is a causal link between my music and the tinnitus. Even though my ENT said it was unrelated....but I didn't find him empathetic or helpful.
I did have a hearing test that showed a subtle loss of hearing loss over 8k, but not sufficient to warrant hearing aids. The also don't test much above 8k which isn't helpful as I can hear those frequencies, and my brain can perceive them....and the lack of them.
The other is that the hyper focus on protecting my ears is causing a degree of hyperacusis and thwarting my enjoyment of the main hobby and social connection in my life - playing in bands.
So, do I continue with the hyper vigilance and avoid band scenarios where the volume gets high, even with hearing protection......or do I just live my life and enjoy it?
On the one hand, it would be foolhardy to worsen my Tinnitus.
On the other hand, is the hyper vigilance keeping the Tinnitus at the fore of my mind (Jastreboff loop) and therefore counterproductive?
I'm really unsure right now.
I could drop all my bands and hope a quiet life improves things.
I could continue with the hyper vigilance and hope the Tinnitus improves anyway.
I could use bog standard ear plugs (Loop 2) and just play regardless of the volume.
I guess the issue is that we just don't know for sure what we are dealing with....
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It's hard to separate how loud it is from my focus on it. I started keeping a scale from 1 to 10 of how much it was bothering me. But some days it got be louder and not bother me as much, and that is probably where the CBT is helping me. There are quieter days too. I haven't been tracking it long enough to give a definite answer...I am generally less bothered by it than I was pre Mirtazapine and CBT....but I started the CBT quite soon after the Mirtazapine so it's difficult to separate them.
My other recommendation is mindfulness. I use the Calm application on my phone and I particularly like the 'Daily Trip' sessions from Jeff Warren. I find his approach relaxed and his voice works for me....
My friend, I have so much to say on this! Also a musician here in a similar situation. I've had mine for around 3 years. Also, triggered by that one 'extra loud' gig - or was it?
As time has gone on, I realise I've had a lifetime of noise exposure being a pro muso. The T was probably building up in the background all along. After each gig I was probably getting some short term ringing anyway, but just didn't think too much of it. It was only when it hit a certain threshold on that one gig I suddenly noticed it.
After that, life was awful. I thought about it ALL THE TIME! Why? Because it's our life, our career, our means of connecting and surviving in the world. It's an existential crisis! This is what our brains tell us anyway. It means you focus on it all the time. Sound familiar?
I've had various hearing tests, seen ENTs etc etc. No hearing loss like yourself.
So, what to do?
I look at it this way. If something is not a damaging hearing level then I don't need the earplugs. So if I strum my acoustic guitar and sing acoustically, I'll often do a 1 hour care home gig, no earplugs. I just refuse to believe this level is going to damage my ears. Still afterwards I get ringing, sometimes a few pings etc. But this goes away. That's the body reacting in a perfectly normal way, as anyone's would. We just notice it more.
Loud gigs (for me this is with backing tracks), generally I'll start without plugs and try to connect with the music/audience while things are not too loud (75-90db) for a couple of songs. Once things start getting louder I stick my plugs in. Mine are custom moulded passive filtered ear plugs (25db filter one side/total block the other side to help with occlusion effect I get in left ear).
It's harder to connect, but I've got used to the sound and I'm kind of ok with it. It's sustainable. I do a lot of short small gigs in care homes btw.
Louder gigs/jazz band/jam session/singers night - I dont do many of these so when I do I just put in my Macks 33db soft foam earplugs. Roll them up and they go very deep. These are great as actually I find it pretty easy to hear still!
Extra note - I find T is worse when suddenly going from one audio environment to another. So if I'm cycling and then come home to a quiet room, I really notice the T. So I mentally prepare myself to ignore it in advance.
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My T is probably getting slightly worse with age anyway, but also my ability to ignore it is getting better. At the moment it's not bothering me too much.
My basic philosophy is this : my body tells me when something is too loud. You know. Your ears start to feel fatigued. This can even be in a noisy pub. The threshold is actually quite low for me. This is the warning sign to protect your ears. If you are playing in a quiet part of a gig and don't feel you need plugs yet. Don't use them . This establishes the link between my body giving me messages and me taking action.
Anyway, totally understand your plight. Any questions please just ask - very happy to help!
Hi, lots of what you say resonates with me - excuse the pun...
I absolutely try to avoid wearing earplugs in everyday life. I have a dB meter on my phone but haven't used it for a while.
I'm not a pro but I do play an awful lot....and what I thought was my greatest plan - turning my single garage into a soundproofed rehearsal space so people would come to me.....my well have contributed to the T. Loud drums in a space that size....
When I'm rehearsing with the Country band, working out songs, I can sometimes get away with standard loop 2 ear plugs.
When it gets louder with 3 part harmonies competing in the front room where we rehearse (electric drum set) I go to my ASI 3DME in ears. I don't feed in audio like standard IEMs - I actually don't like them used that way, very brittle sounding....but as an active filter, they are generally pretty good asiaudio.com/pages/3dme I did go back to them in the US to get custom moulds, but they did them twice and made a bad job of it... I need to find somewhere in the UK I can visit in person to get that done.
I also have some IEMs from read-audio.com/pro-inear-mo... They are the best IEMs I've tried, but I still much prefer the sound of guitar straight into my ears than via those......I've even tried using a condensor mic as the sole sound source into them, but haven't get it working right just yet. I've just bought a rack eq to see if I can find a guitar eq profile that works for me.
I imagine it must be even harder when you sing which I don't. I find the occlusion effect and hearing your own voice even louder when wearing in ears extremely off putting.
Anyhow, I'm getting better at dealing with the T generally, but when I have a lovely quiet day like yesterday followed by a louder day like today, it's still a bit wearing.
Hi, yes I think you are in a much better position as someone who doesn't sing.
Lots of good options! I looked up those ASI 3DME IEMs; very interesting!
It gives me some hope that as time goes on, more products will come to market to deal with this. Also, I think solutions for the problem of tinnitus in general will come about.
Sounds like you are really active with your music anyway, great stuff! Wishing you all the best for now.
Sorry to learn of your quandry. Tinnitus can become a viscous circle. Mine seems very loud at times, but I kind of live with it. And yes, excessively loud live music can deffo be a problem. Many other musicians have the dreaded T! My bro is a sessions drummer and plays for the punk band Zounds, amongst others. If I remember correctly he has mild T. But I've done noisy jobs over the decades so I blame that for it. Even so, I'm totally aware that tinnitus causes our nervous system to "over listen" and stress out a bit, which doesn't help. I also have hyperacusis, (just added that to Firefox dictionary), which doesn't help.
But when I'm concentrating on something, T definitely recedes significantly. So I say keep doing what you enjoy my friend, and maybe try and find some sound management type ear buds/plugs?
Hi, yes, I agree. I do have all manner of ear plugs, monitors etc.....and yes concentrating on other things, T often recedes....however....at times with the ear protection, the T is the prevalent thing and is distracting...
I think we have to negotiate a fine balance between doing what we want and protecting ourselves from spikes in tinnitus. If you are being hyper vigilant you could be inadvertently telling your brain there is danger and all your high alert mechanisms will come into play. How about meditation? There is a support group for musicians run through Tinnitus UK which might be of help. Also Mindear run some great sessions Dr Fabrice Bardy facilitates these and there is a lot of helpful research and self management tools.
I am having a spike at the moment and it is very frustrating. I go with your "live life and enjoy it" belief. I hope you find relief soon.
Hi, I already do a 10-minute daily mediation via the Calm app which helps. Could you point me to the musicians support group please? I've found the Mindear website, is that what you meant?
Here is the booking form for the support group (there are others too which may be of help)
I am not sure how I found out about the masterclasses but am on the MindEar mailing list which is where I see the info. It looks as though the Team administrator is Dr Fabrice Bardy so hopefully you can find it through him.
I also meditate every weekday morning with mindfulness unleashed which is good if you need more mindfulnessunleashed.com/dr...
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