by Neil Bauman, Ph.D.
A man asked,
In September 2011, after drinking with friends, we went to a bar and just before we left, there was a very loud song. When I came out of the building, I heard loud tinnitus in my right ear. I didn’t realize it was a big issue and went to the doctor’s three days later. The doctor said I had sudden hearing loss, and I received treatment for the next two months. The medicine the doctor used was mainly trophic nerve, anti-coagulation and vasodilation medicine. The result is not good—my hearing loss only improved from 80+ dB to 70 dB.
My questions are:
1. Is there any possibility that I can further improve my hearing?
2. Apart from the tinnitus, I have another problem that bothers me even more that the hearing loss and tinnitus. My right ear is very sensitive to certain sounds/noises, for example noisy crowds of people and the noise from plastic bags. When I hear the noise, my tinnitus will get much louder than when I am in a quiet environment. My doctor said there is no good method to cure this except to let my body heal itself. Do you have any suggestions?
There were a number of factors that set you up for your hearing loss and tinnitus. First, loud sounds, whether music or noise can damage your ears and cause your ears to ring. I doubt that this was the first time your ears ever rang after being in a noisy bar. When your ears ring, that is a sign that you are damaging your ears and you need to take protective action so it doesn’t happen again. If you don’t, the next time your ears may ring longer (and louder), and eventually they will ring forever—you will be left with permanent loud tinnitus day and night. This is not exactly a fun experience and can quickly take the joy out of your life. So the first step is prevention so you never experience this.
Other factors besides the loud noise included the alcohol you drank. Alcohol alone can cause hearing loss. So can smoking, or being in a smoky environment such as bars often are.
In addition, smoke and noise can have a synergistic effect on your hearing—causing the resulting hearing loss to be even greater if you are around loud noise in a smoky atmosphere at the same time than either of these factors by themselves. The same holds true for carbon monoxide—often found in higher concentrations in smoky environments.
You can read more about these factors in two articles I wrote back in 2008.
I doubt that your hearing loss was all the result of that one loud sound. Certainly the loud noise you have exposed your ears to over the years has taken its toll on your hearing. In addition, there are a number of factors that can cause sudden hearing loss such as a viral infection in your inner ear, a mini-stroke (blood clot in the tiny arteries leading to your inner ears), various diseases, a blow to the head, etc.
Apparently your doctor was thinking mostly that you might have had a mini-stroke—so he gave you medicine to break up blood clots, and dilate (expand) your arteries to try to get more blood to your inner ears in case you might have clogged arteries. At the same time he provided you with good nutrition for your auditory nerves.
Unfortunately, these treatments didn’t improve your hearing much—around 10 dB. This is certainly a step in the right direction, but it still leaves you with a severe hearing loss.
With sudden hearing loss, sometimes your hearing comes back without any treatment (or in spite of any treatment), sometimes it comes back because of treatment, and sometimes it never comes back no matter what treatment you receive. Whether the treatment you received helped you or not, we’ll never know.
This brings me to my two rules of thumb regarding sudden hearing loss.
1. The greater the sudden hearing loss, the less hearing typically comes back. With say a 40 dB loss, you might expect to get 30 dB back, but with an 80 or 90 dB loss, you might only get back 10 or 15 dB, such as in your case.
2. The hearing level you have at the end of 30 days after the sudden hearing loss is likely what you are going to be left with for the rest of your life. In other words, seldom does more hearing come back after 30 days (barring a miracle) unless it has been continuously coming back day by day throughout the initial 30 day period. If this is the case, more hearing may continue to come back. Since your sudden hearing loss happened several months ago, it is very unlikely that any medical treatment now will help restore your hearing. The damage has been done—the hair cells have died—and thus you now have a permanent hearing loss.
At this point, you need to turn your attention from trying to recover more hearing to learning how to successfully live with a hearing loss. This means learning all sorts of coping skills and using amplification (hearing aids and assistive listening devices) to help you hear better. My book, “Keys to Successfully Living with Your Hearing Loss” will certainly help get you well on your way down this new road you are destined to travel.
The other problem you have where certain sounds now sound much too loud and make your tinnitus worse is quite common in people who have lost hearing due to exposing their ears to loud sounds.
A lot of people think of hearing loss as, well—hearing loss. But few realize that along with hearing loss, we often also have either recruitment or hyperacusis, such as you are experiencing, where some normal sounds are now too loud.
Thus, in addition to learning successful hearing loss coping strategies, you also have to learn how to live with this extra racket. Here are a couple of guidelines.
First, you need to protect your ears from loud sounds in the future. Each time you expose your ears to truly loud sounds, you can make your tinnitus worse and your sensitivity to loud sounds even greater. This means avoiding loud venues, or wearing appropriate ear protection—ear plugs or ear muffs.
Second, you must be careful not to overprotect your ears from sounds. Thus only wear ear plugs when it is truly noisy. If you wear them in normal sound situations, you will make this condition worse and worse. The simple rule is to protect your ears when you need to, but never overprotect your ears.
Finally, do not obsess over your ears and this sound sensitivity. The more you worry about it, the worse it will become. Learn how to protect your ears, then learn to ignore these louder sounds as much as you can and let your brain slowly turn down its internal volume. You will probably always be more sensitive to sounds than you were before, but by doing the above you can learn to successfully live with them.