Should I Do One Last Concert? NIHL + Tinnitus

[Agra57]

I am in a lot of internal conflict over performing with my band one last time in about a month - the band is breaking up after this gig. I had been pursuing music as a career for about 7 years and it meant everything to me for a long time. The last couple years have really unravelled the passion of being in a rock band for me and I now care much more about preserving my health than performing - a lot of this is due to the realization of the impact performing had on my health and hearing.

I didn't know until recently however that I have NIHL which I discovered at my last audiologist visit. It is mild loss (30db in the 3khz range), among some other loss in the higher ranges but not that much. I think I definitely notice the impact of even the mild loss; It has still been heartbreaking for me because I've been visiting the audiologist throughout my career, following his advice, and wearing custom fitted hearing protection for performances. I have valued my pristine hearing to a great degree and it was hard to discover the past year made a bigger impact in hearing loss than the earlier years in my career did, at a time where I was starting to discover I didn't want to perform loud music for the rest of my life, and was even more stringent in my ear plug use. I have become more interested in learning new languages and now care about speech intelligibility and communication with others verbally much more than music.

Lately, I have noticed after each performance it takes longer for my ears to recover, and particularly since the last time I played a month ago things still don't feel quite right. The tinnitus seemed to last a lot longer but has subsided to a point where it seems like it could be manageable. It seems like I am still getting back a bit of definition in speech ranges, although whether this is imaginative or real I cannot tell.

Anyway, the main source of the conflict is that on one hand, I feel I owe it to my band mates, friends and fans to do one final performance. They would rather not play the gig than do it without me. We improvise a lot and the inter-band relationships and dynamic is an important part of our performances. They seem to think one more gig couldn't hurt me. They may be right; I'm not sure how much of what I'm struggling with is mental.

On the other hand, in my individual being, I feel 1000% ready to let this all go. I don't want to sacrifice another hair cell of my hearing ability for anything to do with music. I am ready to sell all my gear. I am ready to not go to concerts again for a period of years. I want to study languages and live a healthy life and communicate with others using all the hearing ability I have left. I am also concerned about tinnitus continuing to increase and the effect that could have on my mental health.

I am not sure if I am making this all more significant in my head than it needs to be so I am hoping to reach out to get some perspectives on those who have dealt with similar struggles. Looking back, would I more regret playing the show or not playing it? I have considered doing the show with extra hearing protection, my bandmates seem willing to do the show at a quieter volume and reduce the length of the sets, but we will be playing with a lineup of 2 full drum kits for the first time in a while so that is a big concern of mine.

The research I have looked up on safe exposures, NRR, etc. seems rather confusing and unclear so I just can't seem to get a clear answer of whether there is a way to do the gig with no further risk of hearing loss or long term tinnitus increase. Basically, my decision comes to that: If there is a way to do it safely I will do it, if not I think I would much rather not.

Any advice, support, or perspective much appreciated. Thank you.

 

[david c]

I think you need to make the right decision for you and your health - this has to be your priority rather than worrying about how bandmates etc will feel. Once you have noise-induced tinnitus your ears will be much more sensitive to noise than research on "standard safe exposure" will indicate. For all these reasons I think you shouldn't do this concert but should instead rest your ears and pursue your other interests instead.

 

[JohnAdams]

If you're going to do it, wear some really good hearing protection, maybe even some custom molded earplugs along with over ear muffs. Look at Paul Gilbert. He still plays but with massive ear protection.
Guitar is why I'm here in the first place. I really miss playing loud electric guitar.

 

[GregCA]

Basically, my decision comes to that: If there is a way to do it safely I will do it, if not I think I would much rather not.

There is, unfortunately, no way to answer that question. You've laid out the tradeoff brilliantly as you seem well informed. Now you have to chose, and only you can decide: we can't assess the risk/reward proposition for you.

Your prose tells me you are already leaning strongly towards one option, but are looking for confirmation.

Good luck!

 

[GSC]

I wouldn't do it.

 

[RaZaH]

Not worth it , its very simple to come to that conclusion .
Think of it like this , if you do it and it makes it worse , was it worth it ?
Probably not , there is your answer.

 

[RaZaH]

I did a few live gigs after I got T , was it worth it for a night out , playing to drunk people ?
Not really.

 

[Lane]

Lately, I have noticed after each performance it takes longer for my ears to recover

@Agra57 -- My take on your above words is that your ears are literally screaming at you for relief. The trajectory you describe seems clear; your ears, brain, and auditory cortexes are increasingly unable to handle this.

I have valued my pristine hearing to a great degree,,.

If those are your true sentiments, then it seems your decision should be a relatively easy one.

They seem to think one more gig couldn't hurt me.

However, they don't have to live the the possible consequences for the rest of their lives--which could be dire. If there was a worst case scenario, not only would you lose the pristine hearing you value so much, but you may well be jeopardizing your friendships with your band members, who you may come to resent for allowing them to talk you into one last gig.

On the other hand, in my individual being, I feel 1000% ready to let this all go.

Again, there's your answer. Is one infinitesimally brief moment in time really worth the possiblity that you could live with disastrous consequences for the next 50 years of your life? What is your nature? Are you a gambler? Or not?

I don't want to sacrifice another hair cell of my hearing ability for anything to do with music.

I would be surprised if you could do another gig without sacrificing another hair cell. -- You may not realize it, but ear traumas have some similarities to brain concussions. If a person experiences another concussion before a first one has healed, the consequences can be many times greater than if a person had not experienced a concussion to begin with. In other words, injured brains are far more susceptible to further injury than a healthy, uninjured brain. From everything I know about ear trauma, it's the same situation. From everything you describe, your ears are injured, and extremely vulnerable, the same way a brain would be.

I want to study languages and live a healthy life and communicate with others using all the hearing ability I have left. I am also concerned about tinnitus continuing to increase and the effect that could have on my mental health.

I hope I'm not coming on too strongly, but you clearly seem to have deep aspirations to improve the quality of your life in a number of ways. I would recommend against jeopardizing that.

Here's a final thought. I know you're concerned about letting down your friends in the band. But perhaps this whole situation can become a valuable "teaching moment" (for all of you). That is, it's forcing you to look really hard at what the most important things are for you, and what your priorities should be. If you see yourself moving toward a calmer, quieter, more fulfilling--and perhaps more introspective life--one in which you can enjoy the sounds and beauty of nature unimpeded by ear injury, then I would recommend you base your decision on those desired outcomes.

 

[Agra57]

Thank you all for your thoughtful input. I appreciate everything you have all shared. I feel great relief at the thought of not playing this show and hearing a community that understands and reminds me of how serious of a health concern this really is. I am continuing to give it some thought and am looking into options to have another guitarist sub for me. Some part of me is still seriously having trouble 100% deciding on the possibility of not being there and letting it go; I think it is a reflection of how much the band has meant to me. But I am grateful to have more information and input to consider and am feeling a bit less stuck. I am feeling I am moving towards a place where I can make the right decision and knowing that I still have the power to make a decision. Thank you for your help.

 

[Kratos]

What is the noise level on that gigs? I don't think you will get more damage wearing a pair of Peltors X5A.

 

[Agra57]

Thanks for the suggestion. Are these the ones? https://www.amazon.com/3M-Peltor-Over-Earmuffs-X5A/dp/B00CPCHBCQ

My gigs are 105-110 dB average with spikes up to 117 dB with recent measurements. The desired show length would be two 1-hour long sets with a 20 minute break and a 15 minute encore with a short break before hand.

According to my understanding (anyone please correct me if I have any misunderstandings present in my math), something like this with a 31 NRR would have an effective noise reduction of 31-7=24/2=12 dB. With combined protection of the ear plugs also I can subtract an additional 4-8db to get a net combined reduction of 16-20 dB, putting me at about 90-95 dB's of effective exposure with spikes up to 100 dB or just above.

According to this calculator and these assumed measurements and reduction amounts, according to OSHA / MSHA I would be safe at this exposure level and duration with only a 50% dose of allowed sound. But according to NIOSH / BuzzyBeeIH I would be at a 252% daily dose. So it's hard to make anything of that.
https://www.noisemeters.com/apps/exposure-calculator/

It seems reasonable to think it might be safe but hard to make any definitive conclusions. Add into this equation the factors a couple of posters here pointed out that once hearing is damaged and tinnitus is present the safe noise standards may need to be taken with a grain of salt. This, along with the differences in opinion on safe exposure is why it seems hard to make an educated decision.

I am planning on seeing an audiologist who specializes in NIHL for musicians and seeing if they feel I can safely perform the gig. Short of that assurance, I am putting back up plans in place to either not play the gig or play only a select few songs.

At least I am doing what I can do here.

 

[Digital Doc]

The OSHA recommendations go back around 40 years, and are out of date. For example, they assume no additional noise exposure after an 8 hour workday. They only recommend protection starting at 85 db's, but most of Europe recommends starting at 80 db's.

All of the above is for normal ears. With hearing damage and T, all bets are off and all kinds of sound exposure can set things off for the worse.

The audiologist is likely to sell you custom hearing protection, but that can mitigate additional damage, compared to no protection, that is not the same as making it safe. Your calculations could be refined, as there are earplugs with a 33 NRR rating, and the ear muffs on top can take off another 5 db. However, any exposures above the 100's are ridiculously high, and should be avoided at all costs.

Especially in the early stages it is essential to give a good chance for the ears to heal, which can takes months or even years.

 

[Agra57]

Thank you, this is really helpful to me in clearing a lot of things up - Explaining why damage continued occurring with hearing protection and I am getting a more well tuned risk assessment by the hour due to this thread. Many thanks.

 

[Digital Doc]

Thank you, this is really helpful to me in clearing a lot of things up - Explaining why damage continued occurring with hearing protection and I am getting a more well tuned risk assessment by the hour due to this thread. Many thanks.

You are welcome. I know I can get a tiny mini spike for an hour or so just from vacuuming with my foam earplugs perfectly in my ears, and my vacuum is only in the mid to high 80's. Gotta be extra careful! I now use the lawn equipment with both muffs and earplugs, and this helps quite a bit. However, no matter what the protection, I know I cannot ever go to a rock concert again.

 

[Bill Bauer]

Any advice, support, or perspective much appreciated.

Oh go you'll be fine they said. Wear earplugs they said.

So I went to the event with ear plugs. Was there for only a few minutes. Big mistake. Gave me low drone/hum that's worst than the high pitch hiss/eeeee, tea kettle sounds. Never went away. sigh
3 1/2 years ago.

Everyone is different. Every situation is different.
You have to make a decision and live with it.

I have made some mistakes in my past by going to loud places with earplugs and made my progress bad, and now sometimes I think it's permanent, but I am happy that I am somewhat habituated and don't have any panic attacks.

Even if you get completely recovered don't expose yourself to any loud environment anymore even with earplugs.

@another sean is right. Played an acoustic piano for about an hour, like an amateur, went to bed a couple of hours later - tinnitus felt quite intense that night, woke up and all hell broke loose. High pitched tinnitus higher and my left war making more weird noises. It's been pandemonium since.

Relatively safe Bill. I was wearing a musicians earplug in my right ear, but not my left as I had an issue with dry skin in my ear lobe at the time, but regardless, there was no discomfort, no fullness, no pain, nothing. On reflection I think my tinnitus felt more intense later in the night, but I wasn't perturbed by that as it's not uncommon for tinnitus to feel more intense at certain points of the day, especially night.

It can get extremely bad. I went to clubs and concerts for four years after inital onset of mild T and H, and I was fine. I got some increased T before going to bed, but that was all.

Until one day, it wasn't.

https://www.tinnitustalk.com/threads/learn-from-others-mistakes.29437/

 

[Lane]

... once hearing is damaged and tinnitus is present the safe noise standards may need to be taken with a grain of salt. ------ I am planning on seeing an audiologist who specializes in NIHL for musicians and seeing if they feel I can safely perform the gig. Short of that assurance...

A couple of points: 1) "may need" is not the correct wording here; the correct wording is: "absolutely needs". 2) Most people who've been on this forum for a while sooner or later learn that audiologists and ENTs--generally speaking--know relatively little about tinnitus, and often give very poor advice. So any assurance you may get from your audiologist should be taken with more than a grain of salt. -- All the Best!

P.S. -- This testimonial from the previous post is worth repeating: -- "It can get extremely bad. I went to clubs and concerts for four years after inital onset of mild T and H, and I was fine. I got some increased T before going to bed, but that was all. -- Until one day, it wasn't."

My wife has had relatively moderate tinnitus for many years, and has pretty much gotten used to and habituated to it. Never had to go out of her way to avoid loud noises, or anything like that. I was in the kitchen a few days ago, and used the blender for just a short while (with earmuffs on). My wife walked out after a few seconds, and later said she experienced a piercing sensation in her ears from the blender she'd never experienced before. And it took a couple days for her to recover.

Fortunately, it appears she did recover. But it also appears that with time and age, her damaged ears from antibiotics as a college student have become more and more vulnerable to various traumas. The bottom line: ear damage and trauma is almost always cumulative, and some of the effects won't show up for many years later. -- Something important to know for those trying to look at the long-term.

 

[another sean]

 

[Juan]

Once you have noise-induced tinnitus your ears will be much more sensitive to noise than research on "standard safe exposure" will indicate.

There you nailed it, the plain truth.

 

[Juan]

My gigs are 105-110 dB average with spikes up to 117 dB with recent measurements. The desired show length would be two 1-hour long sets with a 20 minute break and a 15 minute encore with a short break before hand.

I wouldnt do it, no way. That's unsafe even with hearing protection and your ears are already giving the last warning signs.

 

[Don Tinny]

I think it's not worth the risk. My tinnitus had almost disappeared and became severe when I wanted to "go back to rock". That last concert (with ear plugs) ruined me.

 

[PureNoise]

I think it's not worth the risk. My tinnitus had almost disappeared and became severe when I wanted to "go back to rock". That last concert (with ear plugs) ruined me.

Could it have been that ear peace plugs aren't that good and if you had better foam or custom moulded plugs that may not have happened?

Were you standing at the front or near the speakers?

Just wondering because many posters and people I know go to concerts safely with earplugs, mostly custom.

 

[Don Tinny]

Could it have been that ear peace plugs aren't that good and if you had better foam or custom moulded plugs that may not have happened?

Were you standing at the front or near the speakers?

Just wondering because many posters and people I know go to concerts safely with earplugs, mostly custom.

I was located in the back.
Yes. The plugs were not the best, but I think the risk is too high, even if you go with two bricks in the ears. Pay an hour or two of fun with years of suffering and self-blame. Just play low at home and watch some music video. It´s only my advice.

And there is a central problem. You can´t really enjoy a show if you are thinking about your plugs and tinnitus.

 

[PureNoise]

I was located in the back.
Yes. The plugs were not the best, but I think the risk is too high, even if you go with two bricks in the ears. Pay an hour or two of fun with years of suffering and self-blame. Just play low at home and watch some music video. It´s only my advice.

And there is a central problem. You can´t truly enjoy a show if you are thinking about your plugs and tinnitus.

Outdoor or indoor concert? Big difference.

Yeah I'll probably avoid concerts and loud clubs. I will probably go to bars with good earplugs and when it gets too loud I'll leave.

 

[Contrast]

.

 

[Digital Doc]

This last concert fits the definition of insanity, you know, doing the same thing over and over again, and expecting a different result.

 

[Don Tinny]

Outdoor or indoor concert? Big difference.

Yeah I'll probably avoid concerts and loud clubs. I will probably go to bars with good earplugs and when it gets too loud I'll leave.

Indoor and small place

 

[PeteJ]

I wish, in retrospect, that I avoided the few concerts I went to. I would eliminate them all if I could. I was interested in music before t. Now, I wish I wasn't or at least, only played something acoustic. Can our ears handle that?

I dunno, but I would do anything to take it all back. I don't know why concerts have to be so loud or why musicians want to risk their hearing
It's not worth it considering the potential consequences.