2 Firecrackers Blowing Up Just Now!

[Jiri]

I think it's entirely possible that some of the folks with repeated so-called acoustic traumas and resulting spikes have set themselves up for this through a cycle of increasing over-protection.

This makes good sense. If you have H and you keep protecting your hearing all the time than your brain will try harder to listen and recognize the sounds through your protection. Then once you don't have your protection on even a minor clank of smth or someone's louder laugh could potentialy lead to a spike.

So what's the conclusion? Protect or get your brain used again to the ordinary sounds of your surrounding?

 

[Aaron123]

What I had in mind is described by a simple model below.

time = 0
the population of new sufferers who join this forum is split between two groups - one protects against mild noises, the other one doesn't. If the number of people in the population is T, and a and b are the numbers of people in the two groups, then T = a + b.

time = 1
Let the fraction that don't recover in the first group be y, and let the fraction that don't recover in the second group be z. Suppose x<z. People who get better tend to leave the forum. For simplicity, assume that 100% of those who recover leave the forum.

It is likely that a<b, as people tend to maximize their short term well being over their long term well being (the evidence for this is that most people don't strive to get an A+).

So at t=2, the number of people from t=0 cohort that are still around is given by T(ay + bz). The fraction of people from the first group is ay/(ay+bz). The fact that a<b, and y<z implies that ay<<bz.

The model above is consistent with what an observation that we have been trying to explain.

That's not a particularly good model. Of course it is "consistent" with the result you want because you assumed that result and didn't allow for any other outcomes. Moreover, it includes a number of mistakes though they are not fatal in and of themselves.

First, when you say "suppose x < z" presumably you mean that y < z since there is no x in the model. Second, it's not clear whether there are 3 periods or 2 though it really doesn't matter. Third, the number of people remaining at the end of t=1 or the beginning of t=2 (depending on how you want to deal with timing) is not T(ay + bz). It is just (ay + bz). To see this suppose a = 30, b = 70, y = .2, and z = .5. In that case 6 (= ay) people from the first group and 35 (= bz) from the second group remain. So the total number remaining is 41. There is no need to multiple by T.

These are of course minor compared to the major problem. You say "Suppose y < z" and "it is likely that a < b…". Then you say "The fact that a < b and y < z…." These aren't facts, they are assumptions you made. I realize that this is a toy model, but the causal reader may not and may take this as some kind of proof which it certainly isn't.

Finally you say "of course what we really care about is whether y is less than z". In the context of your model, I agree with this. However, we can only know this from data, and these data do not exist.

Even if we had some data, it would be difficult to assign causality to the treatment you advocate. The problem is that assignment to a and b is not random. Individuals self-select into those groups. They may also choose other treatments which would confound any attempt to infer causality. Moreover, none of the interesting variables is measured in any consistent way. We don't have good measurements of tinnitus before and after, degree of protection, noise exposure, etc.

You also say

One negative experience proves that it is unsafe.

This is important because it is a fallacy that seems to underlie your advice on these types of issues. One negative experience does not prove that something IS unsafe. It does prove that it CAN BE unsafe. "Is" implies a universality that is not true. Since pretty much anything CAN BE unsafe, this really isn't interesting. Unfortunately some people apparently take your "is" at face value.

 

[Bill Bauer]

Third, the number of people remaining at the end of t=1 or the beginning of t=2 (depending on how you want to deal with timing) is not T(ay + bz).

I defined it as a number, but then later I thought about it as a fraction. Sorry.

Of course it is "consistent" with the result you want because you assumed that result and didn't allow for any other outcomes.

That was a model to explain what I was thinking when I used the words "seem to imply". I was trying to convey and should have used "is indicative" instead of "seem to imply".

This is important because it is a fallacy that seems to underlie your advice on these types of issues. One negative experience does not prove that something IS unsafe. It does prove that it CAN BE unsafe. "Is" implies a universality that is not true.

It looks like the reason we disagree has to do with how we define words "safe" and "unsafe". To me, something is safe if the probability of a bad outcome is 0%, otherwise it is unsafe. You seem to use the definition that something is "unsafe" if there is a 100% chance that there is a bad outcome.

Yes, I realize that under my definition, everything is unsafe. I only use that definition of safe and unsafe when thinking about things that I have to ensure do not happen. Things like getting burned alive, getting paralyzed from the neck down, getting a life sentence, or permanently increasing my T. I Might consider taking a small risk of those things happening if success was very likely and implied enough money to allow me to retire. Many of the things I enjoy in life involve driving a car (and of course driving a car exposes me to the first two risks on my list), so that is an exception I am willing to make. I bought one of the safest cars I could buy, though.

 

[Fangen]

Hi Jiri!
So sorry that you had to experience this as well (I know it's been pretty crappy for you with the car accident and all lately), I hope for a quick recovery and that you feel better soon!

As you know, I was also exposed to a firework going off, but I was much closer outside. I think my T went back to baseline within a week or two, however, I came down in a cold so it spiked again pretty quickly after that so it's been a lot of spiking for several reasons. You were safe inside, I know it can still be pretty freaking loud, but since I got out of my firecracker spare in more or less in one piece, you shouldn't worry too much! My ENT told me that you'd have severe spike immediately if it was damaging for your ears, but it seems it did not? Not to confuse with anxiety driven spikes but in terms of sudden loudness and increase. I had a bit of that, which was scary but it wasn't like my hearing got worsened, so that was an indication of both anxiety (and reactive T) that really made the spike even worse.

 

[linearb]

If you just go about your 'normal' life with tinnitus and basically ignore hearing protection, there's a risk of further damage. If you go hog-wild with wearing earplugs and muffs for every little thing, there's a risk of getting into some really unpleasant and unnecessary psychological states as a result.

These two risks are not equivalent. Negative psychology can be reversed over time; further damage cannot. So, as much as @Bill Bauer might suggest things which seem excessively cautious to me, I think the actual risk of excessive caution is far less than the risk of insufficient caution.

Many of the things I enjoy in life involve driving a car (and of course driving a car exposes me to the first two risks on my list), so that is an exception I am willing to make. I bought one of the safest cars I could buy, though.

I think that philosophically we're on the same page, and that to the extent we disagree, that's being informed by our differing life experiences. Arguments that are purely math or stats based tend to run off the rails instantly, because we're not all the same. There are genetic factors to this that we do not understand; we still don't really understand why some people get tinnitus and others don't in the first place, so it's really hard to have clarity on "general rules" about what is or isn't safe. For me, personally, my rule of thumb is "if it doesn't cause any ear pain, discomfort, or threshold shift that I'm aware of then it's fine, and if it does then it wasn't fine and should be avoided."

If I'm in a restaurant that's not blasting loud music, but is very busy and full of noisy eaters, if I wear an earplug on one side and not the other, and then leave the restaurant and remove the earplug, the ear that was protected sounds very crisp and clear, and the other ear sounds slightly "muddy" for 10-15 minutes. I've learned where that threshold is for myself, and I try to avoid behaviors that lead to any muddiness.

To bring this back to the issue at hand -- it seems to me that noises in the class of "fireworks 30m away, through glass/building wall" are not really possible to avoid. Anyone who chooses (or is forced) to live in or near a city, is going to be exposed to sounds at that volume level on a regular basis. Also, once the exposure has happened, it's too late to prevent it, and obsessing about it is definitely prone to causing tinnitus to temporarily seem worse. So, I'd say "keep calm and carry on"... with one further caveat.

I strongly believe that much/most of what we call "age-related hearing loss" is actually cumulative noise-induced hearing loss from being around the machinations of civilization. I'd say that overall my hearing is a lot less "reactive" and problematic after a year and a half of living in the woods, than it was at any point when I lived in a city. So, it's very complicated... most people who live in cities don't tend to worry about the noise exposure, but they also don't tend to worry about all the additional air pollution they're exposed to, and water contaminants, and all the other things that kill you in cities. On the other hand, out here in the country, your odds of getting into a head-on vehicle collision are higher, and having just had that happen a week ago that's not any fun either.

So what's the conclusion? Protect or get your brain used again to the ordinary sounds of your surrounding?

I think it's somewhere in between and comes down to 'are the ordinary sounds of your environment loud enough to be physically damaging to you, based on the specifics of your life and genetics'. Unfortunately that's a really hard question to answer.

 

[dpdx]

Hi Jiri!
So sorry that you had to experience this as well (I know it's been pretty crappy for you with the car accident and all lately), I hope for a quick recovery and that you feel better soon!

As you know, I was also exposed to a firework going off, but I was much closer outside. I think my T went back to baseline within a week or two, however, I came down in a cold so it spiked again pretty quickly after that so it's been a lot of spiking for several reasons. You were safe inside, I know it can still be pretty freaking loud, but since I got out of my firecracker spare in more or less in one piece, you shouldn't worry too much! My ENT told me that you'd have severe spike immediately if it was damaging for your ears, but it seems it did not? Not to confuse with anxiety driven spikes but in terms of sudden loudness and increase. I had a bit of that, which was scary but it wasn't like my hearing got worsened, so that was an indication of both anxiety (and reactive T) that really made the spike even worse.

I have a massive spike from a fire alarm going in the library. I didnt wear earplugs at the time because well-its the library! I been dealing with a spike since Wednesday. I couldn't sleep last night how bad it was. People protect your ears!

 

[Jiri]

@Bill Bauer I lost all of my conversations and there's always an error whenever I try to contact someone, so I'll just answer your question here:

Sure.

1. A toilet seat dropping down making a loud noise.
2. Clanking plates while washing the dishes.
3. Yesterday my detergent slipped and fell in the sink.
4. Microwave oven being now loud to my sensitive ears.
5. Other people clanking or dropping things in the house, especially when they're cooking.
6. Objects suddenly falling to the ground like umbrellas (doesn't happen much too often tho)
7. And the WORST people slamming the doors shut and not just doors indoors but car doors while u're inside.

This happened e.g. today. I'm on a medication that prevents me from driving myself and there is no bus or other connection to the rehab place with the HBOT therapy. So the ambulance takes me there. After the HBOT therapy was finished, I go sit into the ambulance and the driver literally slams the sliding door shut loud! How much could that be, approx. 100 - 105 dB? I had my Peltor Bull's Eye I on so that - 27 dB but still...

See what I mean? There's no escape and my ENT who I just saw today wants me to reduce or stop using my muffs and get my brain and hearing used to the normal surround sounds again....

There are minor and bigger shocks every day - setbacks.

 

[Aaron123]

You seem to use the definition that something is "unsafe" if there is a 100% chance that there is a bad outcome.

Not sure where you got that idea.

 

[Jiri]

My ENT told me that you'd have severe spike immediately if it was damaging for your ears

That is a valuable piece of information! Thank you for that.

I think my T went back to baseline within a week or two, however, I came down in a cold so it spiked again pretty quickly after that so it's been a lot of spiking for several reasons.

First off, I'm really happy to hear that your T spike went to its baseline after that fireworks show and I'm sure that as soon as you recover from your cold it'll be back to where it was before the explosives going kaboom

I have a bad H and even normal sounds can scare me badly, I think this is mostly due to my T so you can imagine.

Anyway, I'm happy you got better.

P.S.: I wasn't really happy with the Toennesen earmuffs. It's says on the box -34DB Noise Reduction but tbh we examined them with a friend and 1. They don't fit properly and 2. The inner foam absorber was thin and rubbish.

I wish you well,

Jiri

 

[Jiri]

Not sure where you got that idea.

You reminded me to stay on topic on the other thread. So why don't you now follow your own advice and start you own thread with Bill where you can argue (discuss things in more detail)?

 

[Aaron123]

You reminded me to stay on topic on the other thread. So why don't you now follow your own advice and start you own thread with Bill where you can argue (discuss things in more detail)?

Happy to respond to your issues.

See what I mean? There's no escape and my ENT who I just saw today wants me to reduce or stop using my muffs and get my brain and hearing used to the normal surround sounds again....

There are minor and bigger shocks every day.

There is no escape from sound, and continued overprotection is very likely going to result in quieter and quieter sounds causing the problems you are experiencing now.

 

[Jiri]

I think it's somewhere in between and comes down to 'are the ordinary sounds of your environment loud enough to be physically damaging to you, based on the specifics of your life and genetics'. Unfortunately that's a really hard question to answer.

Yes. Precisely, a really hard question to answer. I think a good idea would be to still wear some sort of a protection while outside and slowly decrease the NRR of the protection. Otherwise, if you use your earmuffs on a daily basis and wear them all the time (which is what I do except for when I'm in my room) your brain is still trying to compensate and focus more so it just may happen that one day you take them off and a motorbike or smth passes by and you get a mad spike. 3M guide seems to be helpful in this respect.

Please, find it attached to this post.

 

[Bill Bauer]

Happy to respond to your issues.

There is no escape from sound, and continued overprotection is very likely going to result in quieter and quieter sounds causing the problems you are experiencing now.

That hasn't been my experience at all.

 

[Jiri]

@Bill Bauer
I honored your question by answering it. "Thanks" for responding to it.

 

[Bill Bauer]

@Bill Bauer
I honored your question by answering it. "Thanks" for responding to it.

If the question was asking for a list of minor events that ended up causing a spike for you, then it is the people who will hopefully learn from our mistakes who will be thanking you in the future. I am of course also glad that you answered this question - thank you.

 

[Jiri]

If the question was asking for a list of minor events that ended up causing a spike for you, then it is the people who will hopefully learn from our mistakes who will be thanking you in the future. I am of course also glad that you answered this question - thank you.

You know what, that doesn't even matter anymore. I was prescribed on Friday 19. 1. CILOXAN (Ciprofloxacin) for some redness in my ear cannals and just found out - not in your brochure but in the book I sent you that this type of antibiotic ear drops is very ototoxic and can cause a tinnitus. I was putting the drops in both of my ears as the doctor suggested for 4 days 3 drops 2 times a day and just today when I returned from my HBOT I put again those 3 drops in my bad ear, laid on the side so any of the fluid wouldn't leave the ear and after an hour I woke up with a mad tinnitus spike. It subsided after 2 - 3 hours but still... so yeah, I am now literally F*CKED for life.

http://hearinglosshelp.com/blog/is-ciprofloxacin-cipro-ototoxic/

 

[Bill Bauer]

still... so yeah, I am now literally F*CKED for life.

At least it has subsided.

It is disturbing that the drug wasn't listed in the brochure. Sounds like the book is more informative than the brochure, after all.

 

[dpdx]

You know what, that doesn't even matter anymore. I was prescribed on Friday 19. 1. CILOXAN (Ciprofloxacin) for some redness in my ear cannals and just found out - not in your brochure but in the book I sent you that this type of antibiotic ear drops is very ototoxic and can cause a tinnitus. I was putting the drops in both of my ears as the doctor suggested for 4 days 3 drops 2 times a day and just today when I returned from my HBOT I put again those 3 drops in my bad ear, laid on the side so any of the fluid wouldn't leave the ear and after an hour I woke up with a mad tinnitus spike. It subsided after 2 - 3 hours but still... so yeah, I am now literally F*CKED for life.

http://hearinglosshelp.com/blog/is-ciprofloxacin-cipro-ototoxic/

STAY AWAY FROM Antibiotics that end in -cyn. I will give a detailed sheet of what makes Tinnitus worse soon.

 

[Jiri]

It is disturbing that the drug wasn't listed in the brochure.

It is disturbing that despite all of my efforts to make my tinnitus less bothersome I eventually use some stupid ear drops from a doctor I trust that might have now maken my tinnitus much worse and irreversible with 0 prospects for a recovery! I'm so so mad. I checked in your brochure, nothing there and now discovered that this is the exact type of antibiotic drops or pills that may cause severe tinnitus in some cases viz my previous post.

That's what's really disturbing!

https://fqresearch.org/permanent-hearing-loss

 

[Aaron123]

not in your brochure but in the book I sent you that this type of antibiotic ear drops is very ototoxic and can cause a tinnitus.

The book is a joke. cipro is rarely associated with tinnitus. (http://www.medicines.ie/medicine/14417/SPC/CILOXAN+3+mg+ml+ear+drops,+solution/#UNDESIRABLE_EFFECTS)

STAY AWAY FROM Antibiotics that end in -cyn.

This is not true in general.

I put again those 3 drops in my bad ear, laid on the side so any of the fluid wouldn't leave the ear and after an hour I woke up with a mad tinnitus spike. It subsided after 2 - 3 hours but still... so yeah, I am now literally F*CKED for life.

You might want to search for threads about tinnitus being louder after waking in general and naps in particular.

You also might want to think more carefully about what you rely on for evidence.

 

[dpdx]

The book is a joke. cipro is rarely associated with tinnitus. (http://www.medicines.ie/medicine/14417/SPC/CILOXAN+3+mg+ml+ear+drops,+solution/#UNDESIRABLE_EFFECTS)


This is not true in general.


You might want to search for threads about tinnitus being louder after waking in general and naps in particular.

You also might want to think more carefully about what you rely on for evidence.

http://american-hearing.org/disorders/gentamicin-toxicity/

 

[Jiri]

You might want to search for threads about tinnitus being louder after waking in general and naps in particular.

You also might want to think more carefully about what you rely on for evidence.

First off, what makes you think that the book is a joke?

Second off, the evidence: ciprofloxacin belongs in a group of antibiotics (fluoroquinolones) that are known to cause a hearing loss AND tinnitus.
http://hearinglosshelp.com/blog/is-ciprofloxacin-cipro-ototoxic/
https://www.facebook.com/groups/floxies/
Here is the FDA warning on floxie drugs (including Cipro). It is very recent so most doctors are not aware yet:
http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm513183.htm

Third off, that wasn't a coincidence that I put three drops of those antibiotic drops in my bad ear and woke up with t spike almost as bad as I had upon my onset of tinnitus. I belong among the group of people who feel actually better after taking a nap or waking up in the mornings. It's only the evenings that are bad.

I provided evidence.

 

[Aaron123]

http://american-hearing.org/disorders/gentamicin-toxicity/

Never said gentamicin isn't ototoxic. More broadly I was thinking of -mycins; the article in your link discusses naming issues, and the brand name of gentamicin is Garamycin. Macrolide antibiotics ending in -mycin are not generally considered to be ototoxic.

 

[dpdx]

Never said gentamicin isn't ototoxic. More broadly I was thinking of -mycins; the article in your link discusses naming issues, and the brand name of gentamicin is Garamycin. Macrolide antibiotics ending in -mycin are not generally considered to be ototoxic.

ok.

 

[dpdx]

First off, what makes you think that the book is a joke?

Second off, the evidence: ciprofloxacin belongs in a group of antibiotics (fluoroquinolones) that are known to cause a hearing loss AND tinnitus.
http://hearinglosshelp.com/blog/is-ciprofloxacin-cipro-ototoxic/
https://www.facebook.com/groups/floxies/
Here is the FDA warning on floxie drugs (including Cipro). It is very recent so most doctors are not aware yet:
http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm513183.htm

Third off, that wasn't a coincidence that I put three drops of those antibiotic drops in my bad ear and woke up with t spike almost as bad as I had upon my onset of tinnitus. I belong among the group of people who feel actually better after taking a nap or waking up in the mornings. It's only the evenings that are bad.

I provided evidence.

That is scary. Doctor prescribes you drops that can potentially cause hearing loss, tinnitus, and even vestibular damage.

 

[Aaron123]

First off, what makes you think that the book is a joke?

Well, the author has no background in any medical field, and it lists basically any medicine that has any report of a hearing issue. This isn't evidence. You can search on amazon or other places for his other books. He does have degrees in forestry, ancient astronomy, and theology.

http://hearinglosshelp.com/blog/is-ciprofloxacin-cipro-ototoxic/

This is by the same guy who wrote the book.

Here is the FDA warning on floxie drugs (including Cipro). It is very recent so most doctors are not aware yet:
http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm513183.htm

The black box warning is for tendon ruptures, not hearing. It's also not what I would call "very recent".

I provided evidence.

I stand my statement that you would be well-served by thinking more critically about who/what you rely on for evidence.

That is scary. Doctor prescribes you drops that can potentially cause hearing loss, tinnitus, and even vestibular damage.

EVERY drug has the potential for side-effects. There are problems with cipro, and I have in fact provided my doctor with a copy of the FDA black box warning and elected not to use cipro in a case where there was some uncertainty about whether it was needed due to concerns about tendon rupture.

 

[Vincent R]

One negative experience does not prove that something IS unsafe. It does prove that it CAN BE unsafe. "Is" implies a universality that is not true. Since pretty much anything CAN BE unsafe, this really isn't interesting.

There's a difference between something that empirically has show itself to cause problems and something that theoretically could.

 

[dpdx]

Well, the author has no background in any medical field, and it lists basically any medicine that has any report of a hearing issue. This isn't evidence. You can search on amazon or other places for his other books. He does have degrees in forestry, ancient astronomy, and theology.


This is by the same guy who wrote the book.

The black box warning is for tendon ruptures, not hearing. It's also not what I would call "very recent".

I stand my statement that you would be well-served by thinking more critically about who/what you rely on for evidence.


EVERY drug has the potential for side-effects. There are problems with cipro, and I have in fact provided my doctor with a copy of the FDA black box warning and elected not to use cipro in a case where there was some uncertainty about whether it was needed due to concerns about tendon rupture.

That's true. I wouldnt use it though if i have T..too risky

 

[Jiri]

Well, the author has no background in any medical field, and it lists basically any medicine that has any report of a hearing issue. This isn't evidence. You can search on amazon or other places for his other books. He does have degrees in forestry, ancient astronomy, and theology.

That's fair enough.

However I did provide some evidence. Want more? You can ofc say it's all bs and has no medical background. And what about the group of floxies - they DID get tinnitus and a hearing loss from this type of antibiotic - that is indisputable. Want an actual medical doctor affirmation that this drug can cause a tinnitus?? Read here:
https://www.tinnitustalk.com/thread...innitus-can-lexapro-make-tinnitus-worse.4329/

+ I didn't make anything up. I'm a livimg example that these ear drops or tables or i.v. type of antibiotic drugs DO exacerbate your tinnitus. Sometimes, unfortunatelly, permanently.

Don't get me wrong I wish you were right so hard but this was my experience and this is what I see on the internet:
https://fqresearch.org/permanent-hearing-loss

I might be able to find more proof for you later on if you're still not convinced.

 

[Aaron123]

However I did provide some evidence? Want more? You can ofc say it's all bs and has no medical background? And what about the group of floxies - they DID get tinnitus and a hearing loss from this type of antibiotic - that is indisputable. Want an actual medical doctor affirmation that this drug can cause a tinnitus?? Read here:
https://www.tinnitustalk.com/thread...innitus-can-lexapro-make-tinnitus-worse.4329/

Let's be clear about something. I never said that it CAN'T cause tinnitus. I said it is rarely associated with tinnitus. Dr. Nagler, whom I respect on these issues, used "occasionally" instead of "rarely". That also appears to be in the context of oral cipro.

+ I didn't make anything up. I'm a livimg example that these ear drops or tables or i.v. type of antibiotic drugs DO exacerbate your tinnitus. Sometimes, unfortunatelly, permanently.

Not sure what "tables" means, and I didn't know you took an i.v. drug. Again, I would replace "DO" with "CAN" and we are in agreement. The reason for this is that, assuming you are correct, you have evidence that they can cause tinnitus (but that isn't new news), but that doesn't mean that they will in all people or even in many or most people.

this is what I see on the internet:
https://fqresearch.org/permanent-hearing-loss

This is what I mean about thinking critically about what you see on the internet. I have no idea what was going on with these few people (e.g., why were they taking antibiotics?). Moreover, it doesn't say anything about the likelihood of it happening for any given individual.

I might be able to find more proof for you later on if you're still not convinced.

You seem intent on proving to me that it is possible for someone to get tinnitus from taking a particular drug, but I don't need proof of that since I have already provided information that suggests it can happen a small percentage of the time ( < 1/100).

By the way, when you can find them, the best statistics come from clinical trials. What is interesting is that in some cases, some of the people taking the placebo report onset of tinnitus. What you are looking for there whether there is a difference in incidence between the treatment and control groups. I haven't found that level of detail for cipro, but I found an article ("Safety of oral ciprofloxacin. An update based on clinical trial results." Am J Med, Nov 30, 1989) where 3 people out of 9473 reported tinnitus (4 reported hallucinations!). But as I said, some people who get placebo report tinnitus so this is an upper bound.