Acoustic Shock Disorder

[whale]

I may have this ASD, but there is very little information on it.

http://www.hyperacusis.net/other-factors/acoustic-shock-disorder/

I've read other peoples post and feel they have it to but don't know what going on.

Let me know if you think you might have Acoustic Shock Disorder and what you know about it.

 

[PaulBe]

Look up the Dineen Westcott website. They are an Australian Audiology group who specialize in just this field and its offshoots, and they have a lot of info on their website about acoustic shock.

 

[PaulBe]

If you look up Myriam Westcott you'll see a number of papers and presentations she has done about this area.

 

[Reinier]

Reading about the symptoms I could have ASD.
My NIHL incident was seriously traumatic.
This ASD could exasperate my symptoms. But at the end of the day it is the inner ear damage that is the reason for my hearing problems. That is how I see it. Perhaps too simple?
What puzzles me is how they distinct between ASD and plain and simple inner ear damage because of the exposure to loud noise.
I will start reading more about this ASD. I think it is interesting.

 

[PaulBe]

It is well known among telephony workers, call centres and such.

 

[whale]

Reading about the symptoms I could have ASD.
My NIHL incident was seriously traumatic.
This ASD could exasperate my symptoms. But at the end of the day it is the inner ear damage that is the reason for my hearing problems. That is how I see it. Perhaps too simple?
What puzzles me is how they distinct between ASD and plain and simple inner ear damage because of the exposure to loud noise.
I will start reading more about this ASD. I think it is interesting.

I think what is a bit different about ASD is there was little no no hearing loss with the subjects. They all wear under a great deal of stress. I wondering if under stress the tonic tensor tympani is tighter than normal. perhaps from clinching or just a stress response, then combined with irritating noise or noise anxiety. the inner ear muscles spasm for a prolong period of time creating a condition for ASD. perhaps its a combination of issues with the emotional state, nervous system and inner ear hitting at the sametime.

 

[Reinier]

I think what is a bit different about ASD is there was little no no hearing loss with the subjects

Although there also where instances where people did have hearing loss.
It does not seem to be a contributing factor.

perhaps its a combination of issues with the emotional state, nervous system and inner ear hitting at the sametime.

I agree. I read the documents (http://www.dineenwestcottmoore.com.au/specialist-services/acoustic-shock#what-is-as) and I am more interested in this TTTS than I was before. TTTS apparently not always means you hear low frequency sounds because of this small muscle. It also could mean hyperacusis because you anticipate sounds.
I distinctly remember I jerked my head at the time of the explosion. It was extreme. It would surprise me if this AS would be confined to people working at call centres. Why would it not apply to incidents outside this group of people? The sound level I was exposed to was higher than any headphone could have generated and totally unecpected.

Quote: and if they persist or escalate, secondary and long term psychological symptoms can develop. These can include auditory hypervigilance, anxiety, depression, post traumatic stress reaction/disorder, fatigue, and anger.
End quote. This is very recognisable for me. I do realise however this could be the case for many people and does not necessarily mean I suffer from a form of ASD. But it did fuel my interest in this ASD.

 

[whale]

Although there also where instances where people did have hearing loss.
It does not seem to be a contributing factor.

I agree. I read the documents (http://www.dineenwestcottmoore.com.au/specialist-services/acoustic-shock#what-is-as) and I am more interested in this TTTS than I was before. TTTS apparently not always means you hear low frequency sounds because of this small muscle. It also could mean hyperacusis because you anticipate sounds.
I distinctly remember I jerked my head at the time of the explosion. It was extreme. It would surprise me if this AS would be confined to people working at call centres. Why would it not apply to incidents outside this group of people? The sound level I was exposed to was higher than any headphone could have generated and totally unecpected.

Quote: and if they persist or escalate, secondary and long term psychological symptoms can develop. These can include auditory hypervigilance, anxiety, depression, post traumatic stress reaction/disorder, fatigue, and anger.
End quote. This is very recognisable for me. I do realize however this could be the case for many people and does not necessarily mean I suffer from a form of ASD. But it did fuel my interest in this ASD.

A tonic tensor tympani spams appears to be the inner ear equivalent of blinking, but even more anticipatory. For ASD one need to somehow get over their anxiety issue before they can heal. I'm not suggesting its the only factor but a prerequisite to healing. I also think exposure to loud noises can prolong the issue as well as silence. its a difficult task to not be hypervigilance yet avoid certain sound levels.

I wish there were more studying in this area. I wonder if alot of soldiers returning from combat may have this. I think a combination of treatments needs to be considered. Like anxiety / anti-depressants , Mindfulness-Based Cognitive Therapy, Yoga or Qigong, and a TMJ night guard. I'd also like to see a study on the use of Prazosin and other PSTD treatments.

 

[whale]

Reading about the symptoms I could have ASD.
My NIHL incident was seriously traumatic.
This ASD could exasperate my symptoms. But at the end of the day it is the inner ear damage that is the reason for my hearing problems. That is how I see it. Perhaps too simple?
What puzzles me is how they distinct between ASD and plain and simple inner ear damage because of the exposure to loud noise.
I will start reading more about this ASD. I think it is interesting.

I think if different because the noise doesn't have to be loud enough to cause ear damage, just perceived as damaging or annoying, and the amount of stress they are under.

 

[Candy]

Interesting, a couple of days ago the GP mentioned AS to me, it was the first time anyone had. Was about to write on forum earlier. Often after loud noises I get a feeling of the ears being blocked, believe it's my tensor timpani so always asked kids not to shout. My physiological symptoms weren't as bad, but this diagnosis seems to fit with what happened rather than my tmj.

 

[whale]

Interesting, a couple of days ago the GP mentioned AS to me, it was the first time anyone had. Was about to write on forum earlier. Often after loud noises I get a feeling of the ears being blocked, believe it's my tensor timpani so always asked kids not to shout. My physiological symptoms weren't as bad, but this diagnosis seems to fit with what happened rather than my tmj.

me to, I do have TMJ and I did have a dental injury but I was also very stress over moving and the new noise in my house were bothering me so It could be AS, I can listent to this noise very much longer, I'm feeling suicidal

 

[Candy]

@whale let's keep on hoping, it is still early days for ur T...one day at a time. U working?

 

[whale]

@Candy Thanks, Yes, I'm working. at the moment I work form home. I used to be much more focused.

 

[Reinier]

Often after loud noises I get a feeling of the ears being blocked, believe it's my tensor timpani

Because I am a technician I tend to think in processes like feedback, input, output, etc.
This tensor timpani is part of a "loop". Input in the brain from the ears (sound). If this sound is loud enough the brain tells the tensor to react. (Is it the brain that controls the tensor timpani, or is it the inner ear directly?).
This tensioning of this muscle is what I think I feel when I hear (as an example) the water tap running. I get this "full" feeling in my ears.
This loop you can not influence. It is like the iris of your eyes part of the autonomic nervous system. At least this is what I understand. But apparently this loop also can get input from the limbic system (emotion, anxiety?).
This extra input makes things much more complicated.

Still it is possible of course that there is simply inner ear damage and this "loop" is for that reason disturbed.
Perhaps both?

 

[PaulBe]

It would surprise me if this AS would be confined to people working at call centres. Why would it not apply to incidents outside this group of people? The sound level I was exposed to was higher than any headphone could have generated and totally unecpected.

Of course. I think though, that call-centre operators are a good control group for study purposes, but such research would clearly have wider reaching application. Its a shame so few are doing this work.

 

[Candy]

@whale working from home on your own must be very hard, people offer distraction, can you go to an office? Could imagine being home all day with this looming over me...can u do some voluntary work...seriously anything to get you out of the cycle u're in. I know it is the last thing u want to do...u want this gone, life back to normal but for now we all have to think of plan B. Hold on, we all have to keep the hope. x

 

[whale]

@Candy
I've got to been on call at home, but I'll try to do some more calls today.

 

[Greenqueen]

Hi everyone, I am a newby here and I believe I have acoustic shock disorder. I work in a call centre and have done for 19 years. I have a congenital hearing loss which had remained unchanged from my pre-employment test as at last test in 2012 (I was 38). I was exposed to an acoustic incident that doesn't fit what we are traditionally trained to be aware of. In my case it was my own voice and breathing amplified to a shouting assault played back through my own headset. The call ended with me in panic/fright /trauma mode but was dealt with as a technical problem (this was the first phone call with a new phone system and the sound shield was found to be faulty and replaced immediately after). Unfortunately for me, my symptoms were not recognised by mysupervisor as possible acoustic shock and therefore no steps (medical/audio logical /alternative duties) were taken and within 10-12 days my symptoms developed to include vertigo, balance issues, hyperacusis, ttts (feels like moths) anxiety and depression and being assessed for PTSD . The incident occurred 4 months ago and I am still in the process of confirming diagnosis which has included an audiogram (I unfortunately have suffered a loss in hearing from this) , MRI (all clear) and am now on diazepam for the fluttering (not working yet) . I have been on leave for 8 weeks and am unsure if I will return to a call centre role (I can't see it being a good idea)

 

[ReyKalinic]

it seem no more far by post traumatic disorder syndrome. Something happen and the brain go into an inconscious loop because the tinnitus and pain are a phantoms. Maybe the same medications and psychoteraphy could help. Don't stay too much time on benzos. I was an overdozed by years and years of clonazepam abuse. I'm safe thanks to first tegretol and after trileptal. The tinnitus is still here but much lower. hyperacusys sometime still happen. Pain is under control with a max of 5 crisys in a month. Very good, i was always hospitalized

 

[Reinier]

@Greenqueen Could I ask, what level of hearing loss you suffered?
I wonder if I suffer from Acoustic Shock Disorder and that the ASD is "feeding" my hearing problems.
I experience tinnitus, hyperacusis and distorted hearing in most effected ear.
The hearing distortion is very bad for my anxiety.

Are you considering therapy ? I started therapy.
Could you explain what your panic/fright/trauma mode was?
When I was exposed to the very loud explosion that did the damage I believe I was traumatised too. It was a visceral feeling. Hard to describe.

 

[Candy]

The fluttering sounds like a physical ear issue rather than t. In ur shoes I would stay away from the call centre, there will be other options out there. Keep us updated...look after yourself.

 

[Greenqueen]

@Reinier . My existing hearing loss sloped from around 20db at low frequency down to around 50db. My tests were consistent and regular since 1997 when I commenced in the call centre. Since the AS incident it has dropped about 20db across the frequencies. My shock incident as mentioned before was a little different. It was my voice and breathing amplified to abusive assault level played back into my headset. Myriam Westcott explains it was the unexpectedness that was the key. No treatment yet. While I have been off work 8 weeks so far and it has been over 4 months since the incident, my symptoms were not recognised as anything other than being upset due to my equipment not working as expected with our new phone system (I had a good headset for 3 weeks after 18 years of struggling to get something that worked for me and suddenly there I was losing my newfound relief so to speak) my trauma was fear, uncontrollable crying, and shakiness. The secondary - numbness, vertigo (Which has mostly settled, hyperacusis and PTSD/anxiety/depression has developed in the weeks since. @Candy - the fluttering is tempo tensor tympani syndrome. I have always had very very mild tinnitus (never bothered me - just felt I had to mention I occasionally hear a low whistle (like an audio metric test tone) maybe once or twice a year if that). I am booking in with an acoustic shock specialist referred to me by Myriam Wescott so hope to be getting proper help soon. Having seen ENT and Clinical Psychologist I am under no doubts that ASD which has progressed to PTSD due to not being addressed at the time of the incident. I agree that it is not likely I will return to call centre. I have a long fight - both health and legal ahead of me

 

[Reinier]

I have a long fight - both health and legal ahead of me

Thanks.
The problem is that this legal stuff and not getting recognition increases your anxiety.
I can speak from experience )-; An ongoing battle that could last years. Delaying tactics etc..
I hope you get relief from this acoustic shock specialist.
I would be interested to hear how you rate this therapy.

 

[Greenqueen]

So just an update. Audiologist report confirms I present with ASD symptoms. MRI and CT scan rule out other causes. I was sent for Fitness for Duty assessment and IME states I don't meet several key clinical criteria for ASD diagnosis! Have just spent a few hours correcting the facts on the report (including the claim I was asymptomatic for 3 weeks when I ended the call in panic and tears, claiming a history of depression (Again I don't at all) and that I had not had a CT scan when I have plus an MRI). It's very frustrating when those in the diagnostic/decision making roles get the facts on which they base their decisions wrong. I have now been directed to attend a psychiatrist for a second Assessment and been told it's likely my symptoms are all psychological and that both my ASD symptoms and psychological symptoms are not work related. Crazy that this has been decided without background info and without checking medical reports/history.

 

[Mithrandir]

Good luck Greenqueen, I have the same shit, with complicated legal issues...
What do you think about cutting the tensor tympani ? Westcott talks about that in one of this paper.

 

[whale]

So just an update. Audiologist report confirms I present with ASD symptoms. MRI and CT scan rule out other causes. I was sent for Fitness for Duty assessment and IME states I don't meet several key clinical criteria for ASD diagnosis! Have just spent a few hours correcting the facts on the report (including the claim I was asymptomatic for 3 weeks when I ended the call in panic and tears, claiming a history of depression (Again I don't at all) and that I had not had a CT scan when I have plus an MRI). It's very frustrating when those in the diagnostic/decision making roles get the facts on which they base their decisions wrong. I have now been directed to attend a psychiatrist for a second Assessment and been told it's likely my symptoms are all psychological and that both my ASD symptoms and psychological symptoms are not work related. Crazy that this has been decided without background info and without checking medical reports/history.

The issue with people labeling this psychological is that sound like we have control, or therapy might help. the mind controls everything, Its a catch all for when Doctors have reached their limits of knowledge and give up. The truth is doctors and science knows very little about what is going on behind the ear drum. its a complicated neurological disorder and its cuase and treatment are not known. if I cut off my finger it will hurt, where is that pain registered, in my brain so does that mean its a psychological problem that is hurts to cut off my finger. No, ASD is real and it not understood. Doctors egos don't want to except they are cluesless in this area so they just say we are crazy and go about feeling like Gods.