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IceWarrior

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Reply with quote  #1 
Hello, I am just looking for some help in identifying my symptoms as doctors haven’t been much help. I am a police officer and on the SWAT team so I am exposed to loud sounds often and shoot guns often. I was recently exposed to a blast from a breaching shotgun into a car tire. All of my symptoms are only in my left ear. I now I have tinnitus which I am pretty much used to and some high frequency hearing loss but nothing that shows on the standard audiogram. Why I don’t understand is the distortion I have in my left ear. When I talk at slightly louder than normal volumes it sort of sounds like a high pitched broken speaker or a vibration. I also get this from other people’s voices and higher pitched sounds. Phone speakers tend to be the worst. I have also recently started getting some ear pain and mostly jaw pain but I can’t tell if they are coming from sounds or maybe I have TMJD. I noticed my jaw clicking and grinding which I did not notice before. When I hear sounds I do not notice any pain, even with the distortion. I guess my main question is, with Hyperacusis symptoms do you notice the pain at the same time as the sound or does it come after the sound? I’m just trying to figure out where my jaw pain and such is coming from.
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trying

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Reply with quote  #2 
Hello, for what it is worth, sometimes my hyperacusis ear pain is immediately at the time and other times it is delayed.  Sometimes the beginning of a delayed noise exposure is a fullness in the ear and then the pain comes later, or if I cease noise, the fullness feeling in the ear is more of a warning--I have had enough noise.
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trying

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Reply with quote  #3 
PS the noise exposures can be accumulative I find.
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IceWarrior

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Reply with quote  #4 
Thank you for the replies. I’m just trying to figure out what is causing my ear and jaw pain. I can go about my daily life without issue, really, but get random jaw and ear pains that seem to come for no reason. I have only been having these pains for about a week. I’m just not sure if tmj is causing the pain or hyperacusis.
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trying

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Reply with quote  #5 
I would think TMJ and hyperacusis are not mutually exclusive.  I have  TMJ on the left side and one ear is also worse than the other. But both actually have hyperacusis. It sounds like you have a lot of noise exposures to contend with.
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IceWarrior

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Reply with quote  #6 
I certainly do, and try to protect as best I can but it’s not always possible, sirens are the biggest exposure. I’m still not even sure I have hyperacusis, but maybe that’s what the distortion is. I still shoot guns with ear pro and maybe this worsens everything. I can’t say sounds hurt my ear, but for some reason my ear hurts sometimes. I will be going back to the ENT soon but I’m not sure they’re going to be able to tell me anything.
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mj

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Reply with quote  #7 
I have TMJ and Hyperacusis. My jaw pain came first and then I had ear issues. I don't want to frighten you but you will find on the board here and other sites that Hyperacusis can get bad pretty fast. The set backs can take long to recover from if ever. If you are at the point of still enjoying your life, like spending time at family Christmas parties, going to church or the mall or a restaurant, you are very fortunate. My ability to do that over the course of ten years has to the point where I am close to homebound. Not to scare you, but you should very seriously consider a role within the police force or a career somewhere else where you can safe guard your hearing as much as possible. This is a sad thing to write and a tough thing to read but believe me, you need to protect your hearing now like it is more than diamonds.

Take care!!!

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IceWarrior

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Reply with quote  #8 
Did you notice anything else besides pain, like did things sound differently? Did you know right away that sound was causing the pain? I just seem to get this pain at random times and can’t say what from. Right now I’m just trying to figure out if I have hyperacusis, obviously I have hearing issues but I don’t know if hyperacusis is one of them.
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trying

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Reply with quote  #9 
The challenge with an ENT is if they have a minor knowledge base on hyperacusis they are not that helpful. If they only test to see if one can hear rather than the noise threshold, it is not that much help.

For me the first thing I found was things just seemed louder. A normal voice tone, TV was all louder than before, one ear was impacted more by high noises life a siren and the other more by lower base sound. It is a puzzle to figure out. But I agree protect your hearing.
There are some good info on the home page, which Dan has included to help us all out. It is well worth time to review.
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mj

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Reply with quote  #10 

Hi there,

I did notice at the beginning that things sounded differently. Sounds out of my left ear sounded "tinny" or like an AM Radio. I also felt that my voice sounded different. That left after a while only to be replaced with much more sensitivity and pain.  Sometimes the pain is immediate and other times it takes a little while to set in. Sometimes the set back is mild and might just last a couple of hours and sometimes the pain is long standing to the point where I have gone to a doctor twice to see if I have an ear infection.

I have a jaw problem anyway and wear a dental splint at night and during the day. Sometimes after a hearing exposure, I might have ear and pain in the jaw area as well. I have found the gentle touch of an osteopath very helpful for my jaw but a neutral as far as I know for my ears.

Because Hyperacusis is so rare, Audiologists quite typically don't know what they are talking about and have given me lots of dangerous advice, like "Don't over protect your ears." While to some degree that might be true, many of us on this board and others have not overprotected our ears only to have gotten ourselves in way more trouble with setbacks than if we would have gone with our instincts and protected ourselves. 

Imagine a concussion and Sydney Crosby, it wasn't his first concussion that caused all the problems, it was the second one. His brain was vulnerable and healing and then, boom, he got a second concussion, (now third I believe) that really caused all of his problems.

Can I be so bold as to suggest that you start investigating quiet jobs within the Police Force? You don't need to respond to that. Also, many people have tried TRT to help their Hyperacusis.  While it has worked for some, it caused way more problems for me and some others. I do suggest "putting a cast your ears" and always carry ear plugs and please don't shoot any more guns!!!! I got this problem from a jaw issue and acousitic trauma, a concert and a gun shot in a play. 


Take dear care of yourself!!!!

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IceWarrior

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Reply with quote  #11 
Thanks, I’m not even sure if I have hyperacusis, that’s what I’m trying to figure out. Nothing sounds different since the initial injury, just the high pitched distortion with certain or louder sounds. The distortion is about the same pitch as my tinnitus. I have also noticed other things make my ears ring, like if I accidentally let the door handle of the car snap shut my ear will ring. But I can go to restaurants, watch tv, listen to music, and everything else just fine.

It’s hard for me to think about having to do something quiet in the police force as we have to shoot at least a couple times a year. Being on the swat team I shoot a couple hundred rounds about once a month. I had this ear issue last year and have been shooting which hasn’t seemed to impact me at all. At least this happened on duty, so I would be able to get a medical pension if it were to come to the point where I no longer can do my job. But, I would have to get a doctor on my side for that. It’s just been a challenge for me to figure out what is going on with me.

It took a lot for me to post anything on any site. I really appreciate all the replies and help.
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Rob

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Reply with quote  #12 

IceWarrior, 

I’m glad you decided to post.  Finding a knowledgeable doctor to identify our symptoms and help us address them is common for the sorts of challenges you are describing, so just know you are not alone.  I was examined by five doctors before I was diagnosed with hyperacusis.

A Loudness Discomfort Level (LDL) test can help your doctor determine if you have hyperacusis.  The test is administered by an audiologist  A frequency-specific LDL test will provide very useful information about your sound tolerance.  Consider calling your ENT’s office before your next appointment to see if they can administer this test to you.

Some folks with hyperacusis also experience the kind of ear pain you describe, where the pain seems to be unrelated to any immediate sound you are hearing and instead seems to occur randomly.  I experienced two types of pain.  When I was exposed to sound that was too loud for my auditory system, it either hurt or was uncomfortable to hear.  I also experienced ear pain that could occur long after (or unrelated to) the presentation of sound, which sounds similar to what you describe (although I didn’t experience jaw pain).

Symptoms of Tensor Tympani Syndrome (TTS) have been reported by individuals exposed to an unexpected loud sound, typically with a short rise time (such as an explosion or a gunshot).  Symptoms of TTS include ear pain, tinnitus and distortion.  Some of your symptoms have also been reported by patients with temporomandibular disorders.

Your high frequency hearing loss might show up on a Distortion Product Otoacoustic Emissions (DPOAE) test rather than a standard hearing test.  A DPOAE is sort of the gold standard of hearing tests.

Given your symptoms, and your frequent exposure to loud and sudden sound, I think it is extremely important for you to use hearing protection at work.  What ear protection products do you use when you shoot and how much do these products attenuate sound?  

Rob

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Rivers

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Reply with quote  #13 
Ice Warrior--

The event that caused your problems--a gun blast/tire explosion--is very similar to mine, and our symptoms are very similar. It makes me wonder if such explosions impart a specific set of symptoms that differ from many others who suffer from hyperacusis.

In my case I was several feet from a tire that exploded unexpectedly, and the impact was immediate: sounds were distorted (I have used a similar analogy to the one you used, which is the sound coming from an over-amped radio speaker), and my ears felt pressurized like someone had pumped air into them. I walked around with a sense of woooziness. And a fluttering feeling in the ears.   I MAY have suffered some hearing loss. A TRT-trained audiologist performed a hearing test which showed I did have a moderate level of hyperacusis.

I wish I could tell you I have found a way out of this awfulness, but I haven't. Thus far I have tried Tinnitus Retraining Therapy for about six months with little to show for it. I am going to continue but slowly I have come to believe that explosion-related hearing problems may have more to do with TTTS rather than straightforward hyperacusis. TTTS stands for Tonic Tensor Tympani Syndrome. I would suggest you do some reading about that. My ear fluttering, aural pressure, occasional ear pain and distortion are all symptoms of TTTS.

Alas, there is no straightforward cure for TTTS. Basically, your ears (controlled by the auditory parts of your brain) have freaked out as result of the explosion, and they continue to freak out. A TRT approach may eventually help the ears to calm down and that's why I will continue with this therapy.

We seem to be in a small set of hyperacusis sufferers with our own set of problems. By "we" I mean people whose problems emanate from an explosion rather than a pure loudness event. A tire explosion produces a shock wave in addition to the noise itself, and I have begun to wonder if that shock wave produces some of our unusual symptoms.

Please stay in contact with this message board. I wish I had more helpful advice but maybe between us we can help find some solutions to explosion-related problems. 

     
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Rob

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Reply with quote  #14 

It makes me wonder if such explosions impart a specific set of symptoms that differ from many others who suffer from hyperacusis. 

The tensor tympani and stapedius muscles reduce the power at which sound reaches the inner ear.  In some cases, tensor tympani muscle activity may increase, and the muscle may eventually be fixed in a state of tonic contraction.  Klochoff (1979) speculated that the overactivity of the tensor tympani muscle can be associated with symptoms including episodic aural fullness; otalgia (ear pain); dysacusis consisting of murmurs, clicks, and distortion.  Symptoms of Tensor Tympani Syndrome – some researchers and clinicians have preferred using the term Tonic Tensor Tympani Syndrome – have been reported by individuals exposed to unexpected loud sound, typically with a short rise time that produces a so-called acoustic shock, as well as by patients with temporomandibular disorders. 

Symptoms of TTTS can be completely resolved.  Westcott has reported that broadband noise desensitization therapy combined with Cognitive Behavioral Therapy, or referral to a physiotherapist or pain specialist are helpful to some hyperacusic patients with ear pain and the other symptoms both of you have described.  In my case, broadband noise was not effective for managing ear pain.  A different approach was needed.  Please see my other posts on the Music Protocol I developed to help me manage and completely resolve my ear pain.  

Rob    

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Rivers

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Reply with quote  #15 
Rob and Ice Warrior--

First to Rob: That's an interesting suggestion about music therapy and I will check out your posts.Like you, continuous broadband sound has done little to alter the symptoms that I now associate with TTS. My TRT-trained audiologist says that my sound distortion likely comes from hyperacusis, the theory being that the H has turned up the gain in the auditory pathways to the point where distortion results. That could be, but my LDLs are in the 85-87 db range and basically would not be a huge problem if it were not for the sound distortion. I have begun to wonder if TTS can produce distortion on its own. As with so many of these questions, we are left to do our own research, using ourselves as guinea pigs.

Quick question: is your music protocol an outgrowth of the Tomatis method?

Then to Ice Warrior: Like Rob, I would urge you to get your hearing tested. It will reveal a lot about your particular problems. And be sure to have your LDLs tested, which many audiologists will not do automatically. They are a measure of your discomfort levels at various decibel levels and will give you an idea of where you stand with hyperacusis.

Also, I'm wondering if you could conduct a quick experiment with your hearing. Plug in a couple of ear buds and listen to music, and then to talk radio, at a low to medium level. Nothing loud. Does the sound distortion still exist when you are listening thru the ear buds? With me, the sound distortion virtually--not completely--disappears, and I have never encountered another sufferer who responds this way. So I'm wondering if this is another unusual feature of explosion-related problems, and whether it could be a clue about a solution. Let me know if you try the experiment.







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Rob

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Reply with quote  #16 

Rivers -

The music protocol I developed has nothing in common with the Tomatis method of auditory stimulation.  The fullest explanation of the protocol and my reasoning behind it can be found in a chapter I contributed to the book Hyperacusis and Disorders of Sound Intolerance, published in 2018 by Plural Publishing and edited by David Baguley and Marc Fagelson.  In an earlier post in this thread, you wrote that the ears “have freaked out” and you were hopeful that continuing with the approach you are using to help manage hyperacusis “may eventually help the ears calm down.”  I developed the protocol to help me reevaluate the emotional response to sound that accompanied my hyperacusis and to address my anxiety and stress about sound in certain settings.  The protocol helped me completely resolve the severe ear pain I felt and helped me further improve my LDLs.  (The use of broadband noise was also instrumental in helping me improve my LDLs.) 

Rob           

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Rivers

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Reply with quote  #17 
Rob--Thanks much and I will keep you posted on how the music therapy helps. I am encouraged by your experience, which has some similarities to mine in that the TTS symptoms were a major issue. In visiting the various forums on tinnitus/hyperacusis I have often felt I did not fit into the norm, and I am now learning that there may be many norms out there. So I will try the music protocol and see what happens.

Robt
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