Dr. Nagler, 11 dB SL Tinnitus and Niagara Falls

[Street Spirit]

Great photos, @jimH and @Kathi!

Makes me wonder if there is a statistically significant difference in the proportion of motorcycle enthusiasts in the tinnitus population of the industrialized world vs. the proportion of motorcycle enthusiasts in the non-tinnitus population of the industrialized world. In other words, does being a motorcycle or racing enthusiast predispose to tinnitus? Same can be asked, I guess, of rock concert lovers, lawn maintenance workers, jack hammer operators, etc.

Yea in motorcyle forums ALOT of riders have T....especially seasoned ones..its pretty well known that a lifetime of riding a loud machine can wreck your ears but most don't bother with plugs...

 

[Street Spirit]

Well this is depressing..but I know I most likely will never ride again. .

I hope that one day changes. Like @Kathi said if you can't still do what you love, why keep living?

Good question. I ask myself that daily.

 

[Karen]

Yes, Dr. Nagler, it's only when tinnitus is bothersome that we come to this board. Many people may have tinnitus, but if it is not intrusive, they won't seek out support.

 

[Kathi]

The point I'm trying to make here (clumsily) is that even though you might (or might not) have brought on your own tinnitus, your tinnitus is *not* the problem. The intrusivity of your tinnitus is the problem, and you did nothing at all to bring on that!

You're right--it really doesn't matter 'why' I got tinnitus--or if I brought it on--I have it and that's it. My tinnitus is not as intrusive as it was at onset-- I have habituated enough to function and still find joy in life. I decided months ago after our long threads on habituation to take back my life--it is not easy and sometimes I fall back. I will always be grateful for your advice on those threads--it made me see that I had to take charge and not give up everything--that to give up would mean that I would debilitate myself --my CBT person told me the same. I've just come to the realization that this is probably as good as it gets for me, so I'll make the best of the good days (thank you @jimH ) and I've been given so much comfort and encouragement on this board that I will keep coming back to try to help as well as seek help when I need it.

It was fun here this morning--talking about something I love with someone who has walked in our shoes. I guess we took this thread off topic, but it needed to be done.

 

[Sailboardman]

I agree with Dr. Nagler. Some are bothered by even by the slightest T and some can manage higher T, with no problem. It's your brains perception of T and how it handles it, which matters. My T was matched at 65db, which my audiologist set my hearing aid masker to. I have days where I can hear the masker, slightly over my T and days I can't. The days I can't, are dangerous days for me, because I perceive my T as much more of a threat, which causes me high anxiety.

 

[Dr. Nagler]

Yes, Dr. Nagler, it's only when tinnitus is bothersome that we come to this board. Many people may have tinnitus, but if it is not intrusive, they won't seek out support.

Precisely. But every time I try to talk about what it is that makes our tinnitus intrusive and moreover what we can actually do about it, I get all kinds of shit hurled in my direction. Which is really interesting, since in the final analysis it's the thing that should matter most to the folks who hurl the most shit. Go figure.

 

[Karen]

@Dr. Nagler, Sometimes, people may not be ready to hear what it would actually take to help their tinnitus. I know that when mine first began, I couldn't imagine how I could possibly live with it --- and I wouldn't have believed that a change of mindset would actually help.

But, as many tinnitus veterans will attest, changing your outlook is what will ultimately help you cope with this condition.

 

[Kathi]

@Dr. Nagler, Sometimes, people may not be ready to hear what it would actually take to help their tinnitus. I know that when mine first began, I couldn't imagine how I could possibly live with it --- and I wouldn't have believed that a change of mindset would actually help.

But, as many tinnitus veterans will attest, changing your outlook is what will ultimately help you cope with this condition.

Guess I'm a veteran now...I can attest that changing my outlook and getting some help with my way of thinking did help me to function again. But I would also warn against viewing habituation through rose colored glasses. It is wonderful to be able to live, don't get me wrong but I think newbies (as I once was) think that it is a cure. It is not. We can get to a place where we can live but I wouldn't turn down a real cure. I don't expect to see that in my lifetime so I'm going with the best I can do...

 

[Karen]

I agree with you, @kathy. Habituation is not a cure; it's a way of coping with our tinnitus as it is. It's the best method we have right now, and I appreciate Dr. Nagler for his willingness to share that with others.

 

[Dr. Nagler]

Habituation is not a cure; it's a way of coping with our tinnitus as it is. It's the best method we have right now, and I appreciate Dr. Nagler for his willingness to share that with others.

So in my experience, people with louder tinnitus tend to have a tougher time of it than people with softer tinnitus. But that said, some people with very loud tinnitus do incredibly well, while some people with softer tinnitus are literally incapacitated. So something else is going on here. What is it? What is the primary determinant of tinnitus intrusiveness ... and what can we do about it?

 

[Street Spirit]

So in my experience, people with louder tinnitus tend to have a tougher time of it than people with softer tinnitus. But that said, some people with very loud tinnitus do incredibly well, while some people with softer tinnitus are literally incapacitated. So something else is going on here. What is it? What is the primary determinant of tinnitus intrusiveness ... and what can we do about it?

Obessive tendency traits comes to mind...maybe underlying anxiety disorders. .it all goes together. .If you have T and can ride a motorcycle and still enjoy life, I have to wonder what you are suffering from?

I have a dear, dear friend that rides his bike to drown out his T..and that is a completely different story.

 

[Kathi]

I agree with you, @kathy. Habituation is not a cure; it's a way of coping with our tinnitus as it is. It's the best method we have right now, and I appreciate Dr. Nagler for his willingness to share that with others.

I will always appreciate the help @Dr. Nagler gave me and it bothers me to see him denigrated in this forum. He truly helped me --taking the time to post about strategy and how to help myself. He participated in my threads about habituation--he pointed out my strengths and I built on them. I took his expression of driving our own buses to heart and took back my life. As you know, it is not an easy task but it can be done--one day at a time, living in the present. I only warn against viewing habituation as a cure because I viewed it that way and now have to realize that it is not. I fully expected to get to the place two of my friends are at--they don't hear their tinnitus unless one thinks about it or the other actively listen for it. I now realize that both my friends have mild tinnitus--and I'm happy that they don't suffer. I hear my tinnitus all the time--the difference is that my reaction to it has changed dramatically and I can live with it. I think that I am still going, working, riding, loving and doing all I did before is testament to Dr. Nagler's advice when I was a newbie.

 

[Kathi]

Obessive tendency traits comes to mind...maybe underlying anxiety disorders. .it all goes together. .If you have T and can ride a motorcycle and still enjoy life, I have to wonder what you are suffering from?

I have a dear, dear friend that rides his bike to drown out his T..and that is a completely different story.

You wonder what I can be suffering from? Mostly, I am not suffering. I still hear my tinnitus but my reaction to it has changed. I'm not saying that anyone should go out riding motorcycles--it's just something that I love and almost gave up. I also gave up eating for the first months and lost a lot of weight--I gave up drinking coffee. I gave up salt. I gave up chocolate. I gave up riding. I couldn't sleep and used to take my laptop to bed with me to play white noise and drown out the sound. The only thing I didn't give up was work because I had no choice. We lost my husband's business in a hurricane and I had to work for the salary and the benefits--but having to work helped me in the long term. I had my first panic attacks. I couldn't drive without anxiety. I took supplements. I tried most things suggested by my ENT. I almost gave up living and was in my house, crying about the noise in my ear/head and not letting those that love me comfort me. I used to sit in my truck and cry at lunchtime at work. Then I went to professionals other than an ENT. I went to my primary care physician and for CBT. I went to an anxiety workshop to learn how to deal with panic.

It took a lot of work to get to the place I'm in now--and it took a strategy --just as Dr. Nagler counsels. I still have bad days, but I had bad days before tinnitus too.

 

[jimH]

.If you have T and can ride a motorcycle and still enjoy life, I have to wonder what you are suffering from?

I couldn't ride the first half of last year because my T & H were at an extremely severe level. I think it's the level where sadly some people do sometimes kill themselves. I never experienced anything nearly as bad before. There were times I was actually unable to remain seated. I had to pace back and forth in my home until I became exhausted to the point where I would finally pass out/sleep. I'm just thankful that none of my family were here to see me that bad. Anyway, I WAS suffering during that time but I am not now.

Since then my T & H are back to my previous base where it cycles between moderate and loud (but not severe). I have been able to ride this way for many years with earplugs.

 

[Karen]

So in my experience, people with louder tinnitus tend to have a tougher time of it than people with softer tinnitus. But that said, some people with very loud tinnitus do incredibly well, while some people with softer tinnitus are literally incapacitated. So something else is going on here. What is it? What is the primary determinant of tinnitus intrusiveness ... and what can we do about it?

Dr. Nagler, I think it all goes back to the brain and the nervous system. Some people are simply more sensitive to intrusive sounds than others. They are more sensitive in that they notice changes to their bodies more, and it affects them deeply. We're all wired differently, and some of us (myself included) are simply more attuned to when something in the body is out of sync. It creates fear in us, whether we intend for it to or not. At least, that's my theory.

 

[Dr. Nagler]

All theories appreciated, @Karen and all. Thanks for contributing your thoughts. Thanks, too, @Kathi, for your kind words earlier. I appreciate it.

 

[Street Spirit]

You wonder what I can be suffering from? Mostly, I am not suffering. I still hear my tinnitus but my reaction to it has changed. I'm not saying that anyone should go out riding motorcycles--it's just something that I love and almost gave up. I also gave up eating for the first months and lost a lot of weight--I gave up drinking coffee. I gave up salt. I gave up chocolate. I gave up riding. I couldn't sleep and used to take my laptop to bed with me to play white noise and drown out the sound. The only thing I didn't give up was work because I had no choice. We lost my husband's business in a hurricane and I had to work for the salary and the benefits--but having to work helped me in the long term. I had my first panic attacks. I couldn't drive without anxiety. I took supplements. I tried most things suggested by my ENT. I almost gave up living and was in my house, crying about the noise in my ear/head and not letting those that love me comfort me. I used to sit in my truck and cry at lunchtime at work. Then I went to professionals other than an ENT. I went to my primary care physician and for CBT. I went to an anxiety workshop to learn how to deal with panic.

It took a lot of work to get to the place I'm in now--and it took a strategy --just as Dr. Nagler counsels. I still have bad days, but I had bad days before tinnitus too.

My point exactly..you are not suffering, that is great.

I have tried many strategies as well..but I still suffer. I will not blame myself for my suffering too. I already blame myself for enough already.

and from one rider to another. .a little compassion be nice Kathi.. sorry if I don't quite understand why if you enjoy your life, and do what you love, why you are here? Id be out enjoying my life and doing what i love. .

but I don't just have t.

 

[Street Spirit]

I couldn't ride the first half of last year because my T & H were at an extremely severe level. I think it's the level where sadly some people do sometimes kill themselves. I never experienced anything nearly as bad before. There were times I was actually unable to remain seated. I had to pace back and forth in my home until I became exhausted to the point where I would finally pass out/sleep. I'm just thankful that none of my family were here to see me that bad. Anyway, I WAS suffering during that time but I am not now.

Since then my T & H are back to my previous base where it cycles between moderate and loud (but not severe). I have been able to ride this way for many years with earplugs.

Yes..that level...add chronic pain on top of it..

sorry guys guess I am feeling sorry for.myself (is that wrong too ?) seeing all the bike posts..I will retreat from this thread.

 

[Dr. Nagler]

and from one rider to another. .a little compassion be nice Kathi.. sorry if I don't quite understand why if you enjoy your life, and do what you love, why you are here?

Maybe she's here because she finds joy in helping others. In my book that's isn't just a little compassion; it's a whole lot of compassion.

Id be out enjoying my life and doing what i love. .
but I don't just have t.

Nobody just has T.

 

[dboy]

I get all kinds of shit hurled in my direction.

I do hope that that comment was not about me. I made every attempt to discuss rationally and politely with you yesterday and the day before, while you were little but patronising and arrogant in return. I do not wish to reopen any hostilities, but I cannot turn a blind eye while you posture as a completely innocent victim. There are valid reasons why people get extremely frustrated with you and having the support of these good people here that you have helped does not erase that fact.

In order to preserve the peace could I therefore suggest that you not provoke the situation yourself any further.

You are mistaken. My moderate high frequency hearing loss is nothing compared to the dB level at the foot of Niagara Falls. That 90dB threshold you referred to earlier was at 12.5K, an ultra-high frequency that is way outside the range of the sounds encountered in everyday living! Putting it in more concrete terms, the frequency of the highest note on a piano is 4186 Hz. My 90dB threshold is at 12,500 Hz! And I always wear my hearing aids anyway. So if that's where you think you got, then you got nowhere.

Now, without any "sh**" intended, could we calmly and courteously make one further attempt to illuminate the topic of the thread a little. As I said yesterday, I am not claiming there is one answer to the question. As yesterday, I am exploring one possible mechanism at work. If this offends you then you are very welcome to take your own advice and stop reading my posts (as are any other readers). This is the point at which to do so if that is your wish (although of course your engagement and input is most welcome). The rest of my post is only an attempt to illuminate a technical question posed in the original post. Nothing more or less.

Here is my hypothesis:

If Dr. Nagler wears his hearing aids in the "Maid of the Mist" then I guess that they must be capable of not amplifying any sound to a point loud enough to cause hearing damage. According to the following webpage the noise level at the loudest point of Niagara Falls is 95dB:

http://teacher.scholastic.com/activities/explorations/bats/libraryarticle.asp?ItemID=235&SubjectID=141&categoryID=3

That is the loudest point, not necessarily the point reached on the "Maid of the Mist". But lets say 95dB reaches Dr. Nagler's outer ear/hearing aid. The hearing aid would presumably not amplify this at all.

I do not know Dr. Nagler's level of hearing loss at the sound frequencies of the waterfall. If it were around 45dB (for example), then Dr. Nagler would hear the waterfall as being around 50dB. So the situation we would have is a very high frequency (12.5kHz?) 11dB SL tinnitus failing to be masked by 50dB of lower frequency noise.

This scenario seems reasonable to me, and less of a mystery. Any input or modification of the hypothesis is welcome in a spirit of open discussion (including real figures to replace my hypothetical ones). I have to be away from the internet for a while, so cannot respond immediately.

 

[Dr. Nagler]

@dboy, high quality hearing aids have a feature called "compression," which in simplest terms means that at louder and louder volumes they amplify less and less.

Your post is quite involved. I you don't mind, please restate your question. Thank you.

 

[gary]

Maybe she's here because she finds joy in helping others. In my book that's isn't just a little compassion; it's a whole lot of compassion.

That's one of the reasons why I am still here, helping others is great therapy for me..

 

[Kathi]

My point exactly..you are not suffering, that is great.

I have tried many strategies as well..but I still suffer. I will not blame myself for my suffering too. I already blame myself for enough already.

and from one rider to another. .a little compassion be nice Kathi.. sorry if I don't quite understand why if you enjoy your life, and do what you love, why you are here? Id be out enjoying my life and doing what i love. .

but I don't just have t.

I'm sorry if you think I have no compassion. I responded to your questioning about what a person who could ride a motor cycle and enjoy life could be suffering from. I wanted you to see that I'm not just someone with mild tinnitus making a big deal out of it. I wanted to get it across that I suffered but now I don't (I still have bad days but they are getting less and less). I wanted you to see that it is possible. Again, I apologize if I hurt your feelings in anyway. That was never my intention. My heart goes out to you Street Spirit. I hope you do get in the wind again, I truly do.

To respond to your question about why am I here--too many of us get their lives back and disappear.

 

[Karen]

I agree with Kathi. There are those of us who have habituated as much as we can, and we're still on this board to provide support more than asking for support ourselves. That's why Kathi is here, and I'm so glad she is!!!

 

[Dr. Nagler]

@Kathi and @Karen, do you think that the reason you were able to habituate your tinnitus is that it wasn't so bad to begin with?

 

[Kathi]

@Kathi and @Karen, so you think that the reason you were able to habituate your tinnitus is that it wasn't so bad to begin with?

LOL Dr. Nagler!! My tinnitus is still the same as it was at onset! It's still loud--I hear it over most anything but I do have quiet days and I'm thankful for that--many here never get a break. It still spikes and sometimes reacts to noise. It's very unpredictable. Nothing has changed but me. Most days I just get on with things--having to work really helped me because I couldn't dwell on it. As you know and helped with, I also had a plan. I went to my PCP, he got me stabilized with a low dosage of Xanax (remember how I said that the relief was worth the extra time it might take to habituate?) and he referred me for CBT. He also gave me Ambien for 10 days so I could get some sleep. After that, I just kept putting one foot in front of the other--going to therapy, attending an anxiety workshop, taking the meds and doing relaxation exercises. I also started socializing again. At six months I started to see a light at the end of the tunnel....at 18 months I was a little disappointed because I didn't feel I was habituated 'enough'. Now at 21 months, I know that I am habituated but I've realized, just in the past few days, that habituation is not a cure. I was hoping for what my friends had achieved--they only hear tinnitus if they think about it or actively listen for it. I now realize that they have mild tinnitus (and I'm happy that they don't suffer). I do all that I used to do before onset. The noise is part of me now. I do admit that I get frustrated on some days but when that happens I can see a direct line to stress/anxiety and I consciously make myself chill out.

So what is the purpose of your question?

 

[PaulBe]

Nobody just has T.

One for the reminder wall. T is merely the key to Pandora's box. Opening it the easy part. It opens itself for you. I remember Myriam Westcott telling me that, like myself, many of her clients were shocked at the intensity of their own reaction to it.

(Gary, that's the latest Zil prototype right there)

 

[Street Spirit]

Maybe she's here because she finds joy in helping others. In my book that's isn't just a little compassion; it's a whole lot of compassion.


Nobody just has T.

Hey Dr. Do you ride?
No?

Then please do refrain from responding. My compassion comment was not directed towards being a support figure here at TT but to a fellow rider who can no longer ride! at least rounds these parts we have a certain kinship. .maybe round your parts @Kathi you don't!

I agree with Kathi. There are those of us who have habituated as much as we can, and we're still on this board to provide support more than asking for support ourselves. That's why Kathi is here, and I'm so glad she is!!!

Well I suffer greatly and am here every single day supporting people-while being kind I might add! I did not find any of your responses supportive in the least..well @jimH gave a hug, thanks Jim!

@Kathi I somehow missed your post while in a blind rage towards Dr.Naglers post. I apologize and thank you!

That's one of the reasons why I am still here, helping others is great therapy for me..

as i said that is NOT what I was referring to! Tho Nag would want you to believe it.

Nobody just has T.

well some just have T and therefore can still ride!

what the hell was your point? cause that was mine!

 

[Karen]

@Street Spirit,

I'm sorry if I didn't come across as supportive to you. I certainly understand that you're suffering with both tinnitus and hyperacusis, plus other ailments, too, and can imagine you've been having a hard time. Thanks for being here to support others in their tinnitus journey.

Take care, and hugs,
Karen

 

[Dr. Nagler]

LOL Dr. Nagler!! My tinnitus is still the same as it was at onset! It's still loud--I hear it over most anything ...

So what is the purpose of your question?

I asked because some people on this board have claimed that if you can habituate your tinnitus, it couldn't have been all that bad in the first place. That certainly was not the case with me. And it seems that tinnitus was no walk in the park for you either.

well some just have T and therefore can still ride!
what the hell was your point? cause that was mine!

My point is that there are folks who couldn't ride and who now can because they worked at it. I couldn't even get out of bed some days, but I did something about it. You're not the only person who has had it rough. So I'm wondering if there's something out there for you besides the bitterness and resentment you have displayed in this thread. Because bitterness and resentment never got anybody anywhere.

So I'm wondering what the barriers you see blocking your road to progress.