Neenie...here's an indirect answer and question for a couple of the things you have brought up in this thread.
1. Plasticity...Yeah, I think I can pretty much say that anyone who thinks it ends at 6 months is in the "Flat Earth Society". I can't quite see how so many obvious "brain adaptions" could be explained otherwise. Ummmm...After 56 years of tinnitus and four 'increase levels" within that span, something has switched around in the 'ol brain or I would be worm food a long time ago. (Or perhaps I don't understand the exact meaning of "plasticity" - possible).
2. OK, this is something I have not heard anyone else say in any place or any time...yet. Maybe it's on this board, and I just don't know it. For me it's a biggie, and so super obvious I am stunned that it is kind of a "black hole"in relation to audiology/damage/drugs-meds. Neenie...YOU ARE IN THE IDEAL SITUATION TO CHECK IT OUT!
Simply speaking this is my "hypothesis":
- Obvious...Sound exposure at 'dangerous levels' can and does cause hearing loss and/or tinnitus. OK
- Obvious...Different people get hearing damage or tinnitus at different levels of exposure to sound. OK
- Obvious...Some/many people blast themselves with mega decibels, often for years, with seemingly no ill effect and certainly no tinnitus. Maybe as they age they just go... "Huh??? Sorry I'm a bit deaf mate!" OK
- Obvious...Some people get exposed to one loud sound, once, and they get hearing damage or tinnitus. OK
- Obvious...Some people get exposed to averagely loud sound over long exposure time and get damage or T. OK
- Obvious...Some people get hearing damage and/or tinnitus from ototoxic drugs. Medical, experiential fact. OK
- Obvious...Some people don't get hearing damage and/or T. from ototoxic drugs. Medical, experiential fact. OK
- Etc...
* NOT OBVIOUS - What the hell makes for the differences above??? Genetics? Big ears? Small ears? Brain make-up? "Personality" - like highly strung versus laid back? And so on... Not sure anyone knows. OK
OK, here's ONE thing I think is being seriously overlooked, and I have personal experience with, and I especially tell people about who are on IV Vancomycin or Gentamycin, etc.!
Could there just be a hidden, unconnected, unknown, un-warned about link between "Meds" and sound exposure while plasma rates are still positive for the med??? In other words, does any doctor ever say to a patient on one of the zillion meds with a "hearing signature" (and there are a helluva lot when you look in the professional sections of side effects): "Oh, by the way, until this med has cleared your bloodstream, avoid being around any loud sounds or long exposure time to elevated sound levels."...."Ummm, like what doctor?"...."Oh you know, don't go right back to your construction job without using earplugs, or an international flight for 10 hours in a noisy jet, or a rock concert, or a movie, or your screaming baby, etc."...."Ahhhhhh, why is that doctor?"...."Well, it's just possible that some people, can get let's say 'aggravated' or 'sensitive' in the hearing department. You know, sort of like having an open wound perhaps, and it's best to keep it protected and not full of muck and dirt. So sort of like that. If the hearing area is ahhhh, a bit 'on edge', let's say, it may be good to not 'over stimulate' it with a lot of 'dirt or muck'...Ha, ha...that would be, you know, the equivalent of loud sounds and so forth, that could be like hitting the tenderness with a baseball bat while it's a little 'raw' or 'susceptible'...Just a thought my dear chap. Just to keep in mind OK?!"
Has anyone ever heard this advice from a medical professional??? I sure haven't, and that was even when being given a four week course of Neomycin, one of the most ototoxic drugs on the planet AND by one of the best docs in N. California!
Now consider...Even plain old over-the-counter NSAIDs (Non Steroidal Anti-Inflammatories) like Ibuprofen have a "hearing signature", let alone the more heavy duty meds that are prescribed willy-nilly by the million every day.
Then consider that typical plasma clearing rates can vary from hours to weeks!!! The recreational drugs are well know...like plain pot varies from 1 to 7 days before you are clean on a tox test. Benzos are 1 to 4 days. Tricyclic antidepressants run 2 to 7 days. And so on. Plus this gets to be a highly complex subject because we don't even want to think about combinations of drugs/meds! (Just look at the clearance equations!)
Then consider that, quote: "Renal plasma clearance will vary with such factors as age, weight, and sex of subject, the state of cardiovascular and renal function, the nature of the material being excreted, species, etc."
WUNDERBAR!!! Just fantastic...Basically, like I said it's a "black hole" of ignorance on a functional, practical basis for the average Jane or Joe on the street (currently happy as clams without tinnitus), who goes and gets some meds from the Chemist's/Pharmacy or a doctor...Then carries on with life as usual (movies, bar, machine shop, etc.)...and then "somehow" ends up with tinnitus or hearing damage...Hello 'plasticity' - or whatever other coping mechanisms are required if it is severe! WUNDERBAR!!!
Get the idea???!!!
And just to cap it off, here's a number...38% of all (US) combat war vets from the Iraq war have tinnitus...Oh, and how many of those combat troops do you think live on Ibuprofen or the like on a daily basis and eat them like candy? (You know, those heavy guns, packs, grunt equipment, etc. - up to 80 pounds (40 kgs) or more....can get to cause a few aches and pains). And you know, war is not exactly a "quite zone".
I think I have made my point...
Neenie, here's a master's thesis idea for you if you don't have a big list of ideas already!
Go for it gal! Take care... Zimichael
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Meant to be humorous not offensive.
