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winterbridge55

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I am going to have my LDL'S tested on Thursday. Should I be concerned about it aggravating my tinnitus and hyperacusis?

-Mark
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Rob

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Mark,

I'm glad you're going to get your LDLs tested.  It is an essential test for someone with hyperacusis to take.  It's doubtful that it will aggravate either your tinnitus or hyperacusis.  I believe that phonophobia - the fear that exposure to these beeps will hurt us in some way - can play a role with some.  But if you think about it, this is a test where you're in control of the volume.  The correct way to take the test is that your clinician will play a beep (sometimes a beep followed by a second beep) at a given frequency point at a certain volume.  The clinician will very gradually and safely increase the volume just a little bit at a time.  Your job is to identify the point where the beep is not just loud, but loud and also just verging on uncomfortable.  At that point, you tell the clinician to stop and he will move on to the next frequency point, once again starting at a low volume and slowly increasing the volume.  The way that it's administered in TRT is for the clinician to run through the different frequencies for one ear, followed by the other ear, and then to repeat the test for both ears and use the second set of readings. 


You will not damage your ears.  The beeps are very short and you will be fine.  I'm a big believer in this test.  It can tell your clinician, and you, a lot about your hyperacusis - and it can also provide some information with respect to misophonia.

Good luck on Thursday.

Rob 
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Guflu

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It didn't hurt my H or T at all. On the contrary. Knowing that my LDL's were higher than I expected, boosted my self-esteem. So there was a large part of misophonia and phonophobia going on in my case.
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winterbridge55

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Thanks Guflu.
I am hoping that my LDL's are lower than I think they are too.

Thanks Rob,

With your information I will know whether I am getting a good test. The audiologist has been in business for 35 years and is knowledgeable of tinnitus and hyperacusis. I will report my results.

-Mark
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marv

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Mark,

I agree with Rob IF the audiologist testing for your LDL's does the tresting correctly (as Rob described). In that case, there will be no problems at all. To make sure (I don't mean to scare you ~ I mean to prepare you) be sure you understand how the testing will be done so that's done the right way. It's not uncommon that practitioners who say they do TRT have either never been trained how to do it or have been trained but have devised their own methods which aren't proven to show results.

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Guflu

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Quote:
Originally Posted by winterbridge55

I am hoping that my LDL's are lower than I think they are too.


Mark, you want your LDL's to be high, not low
The higher the LDL's the louder the sounds you can handle !


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winterbridge55

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Well my LDL's were 95 to 100. One thing makes me think I might have thrown them off. He played the tones at different volumes and told me to identify them as comfortable, very loud or uncomfortable as you had mentioned Rob. It was difficult at times to distinguish between very loud and uncomfortable though. I am wondering if some of them were actually uncomfortable when I might have said very loud just to make me look better than I am???? Uncomfortable is a police siren or an explosion. I did say some of the tones were uncomfortable. I guess if I could tolerate most of these sounds and not go crazy with discomfort then I was identifying them accurately???? He did confirm the high frequency hearing loss and cochlear outer ear hair damage starting around 4k. My hearing though was within normal limits.
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Rob

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Well my LDL's were 95 to 100.
 
..........
 
Yes sir.  You are right on the cusp of what some well-respected clinicians and researchers consider normal tolerance. 
 
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One thing makes me think I might have thrown them off. He played the tones at different volumes and told me to identify them as comfortable, very loud or uncomfortable as you had mentioned Rob. It was difficult at times to distinguish between very loud and uncomfortable though.
 
.........
 
Two things:  First, it is sometimes very difficult to distinguish between very loud and uncomfortable.  And because of this, the second thing to keep in mind is that taking the LDLs can be a bit of an art in terms of making those sorts of fine distinctions.
 
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I am wondering if some of them were actually uncomfortable when I might have said very loud just to make me look better than I am????
 
..........
 
Buddy, no matter how you slice it, with LDLs at 95-100, you come out smelling like a rose with earbuds.  The goal of the LDLs, from your perspective, is to let your clinician know as soon as the tone becomes slightly uncomfortable and no longer just loud.  When you identify a tone that is both loud and slightly uncomfortable you're doing it right. 
 
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Uncomfortable is a police siren or an explosion.
 
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Sure.  And both of those things are usually louder than 100 dB in certain frequency ranges.
 
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I did say some of the tones were uncomfortable. I guess if I could tolerate most of these sounds and not go crazy with discomfort then I was identifying them accurately????
 
..........
 
You bet.  I think you did just fine.
 
Rob 
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winterbridge55

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Thank you Rob for helping me feel better today knowing I haven't completely trashed my ears.
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Guflu

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Quote:
Originally Posted by winterbridge55
He did confirm the high frequency hearing loss and cochlear outer ear hair damage starting around 4k. My hearing though was within normal limits.


I also have high frequency hearing loss (starting at 12 kHz), but that is normal for my age (37 yr male). How did they test the outer ear hair damage? And what does that mean?

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DrJ

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 Hearing loss at 12000 Hz and above falls into an interesting category, more oriented to bio-genetic inheritance patterns plus perhaps aging effects.

Noise damage due to routine wear and tear is thought to show up around 4000-6000 Hz on the audiogram (the noise notch).  Higher fq losses have been poorly categorized to date.

I have tested 30 somethings and seen poor hearing in the higher fq and much older people in their 50s or even 60s with fairly good hearing up there.

It is a bit of a puzzle.

To test outer hair cell function, we use Oto-acoustic Emissions, a simple in th ear quieter test that shows results of the loss of function of outer hair cells.

Dr. J

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Marsha Johnson
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Rob

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Guflu --
 
You may be familiar with the test Marsha is talking about by its acronym -- DPOAE.  The gold standard of hearing tests in 2009. 
 
Rob
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DrJ

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Reply with quote  #13 
Ha Rob, sounds like the Ear Olympics!

Remember though that the OAEs test ONLY the cells in the cochlea, nothing further up like nerves and brains.

There are conditions in which you can have perfect results on that test and be deaf.

Dr. J

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Marsha Johnson
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Guflu

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Quote:
Originally Posted by Rob
Guflu --   You may be familiar with the test Marsha is talking about by its acronym -- DPOAE.  The gold standard of hearing tests in 2009.    Rob


Ah the good ol' DPOAE. They didn't do that one for me. Since my audiogram showed up just normal with all frequencies around 0, and slowly dropping from -15 to -100 from 8k to 20 k.

My clinician didn't want to do the DPOAE because everything was already tested extensively many times and nothing unusual was showing up except for low LDL's at the time.

And actually I don't care anymore, because my hearing is so much better than it used to be last year. Today I am listening to music on normal volumes on my headphones again. Something I could not imagine doing so quickly again a few months ago. All the distortion seems to disappear into thin air and the hyperacusis is barely a problem anymore. Still have the popping and the tinnitus, but that's peanuts compared to the hyperacusis I had.



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