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Tinnitus Worse After Loudness Discomfort Level (LDL) Test

cubsfan-398

Member
Author
Sep 23, 2024
2
Tinnitus Since
2010
Cause of Tinnitus
Loud noise exposure
Hello,

I am 64 years old and have had bilateral tinnitus for 14 years. I developed hyperacusis 12 years ago. My baseline tinnitus was usually at a level I would describe as "off." However, in 2018, while wearing earbuds, I experienced an instantaneous burst of sound in my left ear, which caused my baseline tinnitus to change from "off" to a more noticeable level. At that time, the ENT told me that if the new sound level lasted more than a year, it would be considered permanent.

A few weeks ago, I had a regular hearing test and was also given a "sound sensitivity test," known as the Loudness Discomfort Level (LDL) test. This was the first time I had ever taken this test. During the test, I experienced an earache, which stopped shortly afterward, but I also developed vertigo that lasted about a week. Two days after the test, my tinnitus became much louder, though not louder than it had been at its worst in the past. I don't think I experienced any new sounds, but the increased volume was very distressing.

I informed the ENT physician's assistant about my experience. She consulted with the audiologist who performed the test, and they both assured me that the LDL test should not have worsened my condition. They explained that the test is commonly used to diagnose hyperacusis in patients like me. I also saw my general practitioner a week later, who agreed that the test should not have made anything worse. I have scheduled an appointment with an ENT specialist, but it won't be for a few months.

Recently, I have been reading posts about the LDL test, which have only increased my anxiety and fear. People on the forums say that the LDL test should be avoided, but I was unaware of this at the time. I have OCD, and this entire situation has significantly worsened my worry, anxiety, and heart arrhythmia. My tinnitus baseline is now more noticeable, and I fear this change might be permanent.

I feel horrible, crushed, and deeply upset with myself for what feels like a further injury. I have recently started cognitive behavioral therapy (CBT), but I am uncertain if it will help. Any insight, advice, or support would be greatly appreciated.

Thank you,
James
 
What were the results of your LDL test?

Audiology tests are somewhat like twisting a broken arm to see if it's broken. While they might be useful to audiologists—though this is debatable—they are often detrimental to the patient.
 
I have refused to take any more hearing tests because they make my tinnitus worse. During my last test, the technician instructed me to press the button whenever I heard a sound. I was already in the booth, and my ears were ringing loudly—BBBBBRRRGGGHHHH! I started pressing the button repeatedly. Suddenly, the door opened, and the technician asked me what I was doing. I explained that I was pressing the button whenever I heard a sound. She responded, "I HAVEN'T STARTED YET!"

I can't hear the beeps over my tinnitus, and trying to hear them only makes my tinnitus worse!

To top it off, can you believe the nurse yelled at me for pressing the button when I heard ringing, even though my ears ring 100% of the time?
 
What were the results of your LDL test?

Audiology tests are somewhat like twisting a broken arm to see if it's broken. While they might be useful to audiologists—though this is debatable—they are often detrimental to the patient.
Thank you for your reply. Although I wasn't given the specific results, I have been diagnosed with hyperacusis. I forgot to mention in my original post that my doctor advised me to "give it time," for whatever that's worth. I've read that tinnitus can worsen with age, so if it wasn't the test that triggered it, it likely would have been something else. Hopefully, cognitive behavioral therapy will be beneficial.
I have refused to take any more hearing tests because they make my tinnitus worse. During my last test, the technician instructed me to press the button whenever I heard a sound. I was already in the booth, and my ears were ringing loudly—BBBBBRRRGGGHHHH! I started pressing the button repeatedly. Suddenly, the door opened, and the technician asked me what I was doing. I explained that I was pressing the button whenever I heard a sound. She responded, "I HAVEN'T STARTED YET!"

I can't hear the beeps over my tinnitus, and trying to hear them only makes my tinnitus worse!

To top it off, can you believe the nurse yelled at me for pressing the button when I heard ringing, even though my ears ring 100% of the time?
I'm sorry to hear about your difficulties, and in your case, it's wise to avoid further tests. I wish I could turn back time, but unfortunately, it's too late for that.
 
Thank you for your reply. Although I wasn't given the specific results, I have been diagnosed with hyperacusis. I forgot to mention in my original post that my doctor advised me to "give it time," for whatever that's worth. I've read that tinnitus can worsen with age, so if it wasn't the test that triggered it, it likely would have been something else. Hopefully, cognitive behavioral therapy will be beneficial.
I think you should get a printout of your LDLs from that test. At least your sacrifice won't be in vain, knowing your current tolerance levels.
 
Audiology tests are somewhat like twisting a broken arm to see if it's broken. While they might be useful to audiologists—though this is debatable—they are often detrimental to the patient.
This is an excellent analogy that effectively highlights the profound lack of understanding among health professionals regarding severe tinnitus.

Audiologists and ENT specialists should receive training on how to identify suspected severe cases, possibly through the use of a questionnaire. If a patient is identified as a potential severe case, they should be required to sign a consent form stating:

"I have been identified as a possible severe tinnitus case and understand that any audiological testing involving sound directed into my ears may worsen my condition."
 

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