Hearing Loss

Hearing loss is a worry to all gigging musicians, after many years of playing gigs I have a constant ringing in my ears, on investigation I realise I have tinnitus.  See below for an article on tinnitus and here's a link to a website that I have found most useful http://www.tinnitus.org.uk/ .  The best thing to do is to be aware of the dangers and make changes to the way you work before this happens to you, Here's a link to a quite comprehensive tinnitus E-book that I've found and currently working through (a review of this e-book "Tinnitus Miracle" can be found at the bottom of the page).
 
I've recently started using earplugs at rehearsals after I started to get sharp stabbing pains in my ears, the difference it has made is amazing, and has probably saved my hearing from further damage.

Here's a link to the ones I'm now using, they may not be the cheapest on the market, but I prefer them to any others I've tried. there are three sets of filters included so you can vary what you use according to noise levels
 
Be Well, Play Safe

Best Wishes
Nick

Tinnitus

Tinnitus Miracle E-book Link (see bottom of this page for a review)

The word 'tinnitus' comes from the Latin word for 'ringing' and is the perception of sound in the absence of any corresponding external sound. This noise may be heard in one ear, in both ears or in the middle of the head or it may be difficult to pinpoint its exact location. The noise may be low, medium or high‑pitched. There may be a single noise or two or more components. The noise may be continuous or it may come and go.
What causes tinnitus?
Tinnitus is not a disease or an illness, it is a symptom generated within a person's own auditory pathways. Although it is often assumed that tinnitus occurs as a result of disease of the ears, this is often not the case. The precise cause of tinnitus is still not fully understood.

Who gets tinnitus?
Experiences of tinnitus are very common in all age groups, especially following exposure to loud noise; however, it is unusual for it to be a major problem. There is a widely held misconception that tinnitus is confined to the elderly, but various studies have shown that it can occur at any age, even in quite young children. Mild tinnitus is common ‑ about 10 per cent of the population have it all the time and, in up to one per cent of adults, this may affect the quality of their life.

What to do if you think you have tinnitus?
Tinnitus is rarely an indication of a serious disorder, but it is wise to see your doctor if you think you might have it. Should something treatable be causing it, you may be referred to a specialist.

Try not to worry

The noises may seem worse if you are anxious or stressed. When tinnitus starts, particularly if it's sudden, you may naturally be frightened and your concentration or your sleep may be disturbed. You may get angry and frustrated because no‑one else understands, or you may live alone and not have anyone to talk to about it ‑ that's where the BTA can help. You can contact the BTA office in Sheffield and speak to one of the helpline advisers who have years of experience talking to people with tinnitus, we can also put you in touch with a support group or contact if there is one in your area. Groups are run by people who are living with tinnitus ‑ personal contact and shared experience are very useful for many people with tinnitus.

Many people say they notice tinnitus less when they are doing something. Keeping your mind occupied helps (but don't overdo things). If the noises seem louder at quiet times, particularly during the night, it may help to have soothing music or some other environmental or natural sound quietly on in the background.

Practising relaxation and taking time out for yourself can also be a great help.

Join the British Tinnitus Association
The Association was founded 30 years ago by people with tinnitus. When you join you will receive free information leaflets and our quarterly magazine, Quiet.

Your membership will strengthen the voice of people with tinnitus. You will be helping us to work for better medical services, more research and to raise awareness about the risks from exposure to loud noise.

Source: http://www.tinnitus.org.uk/what-is-tinnitus accessed 1st March 2014



 

Ear Plugs

Here's an article I found from June 2005, most of the things mentioned here are still relevant today.

Q What kind of ear plugs should I get for wearing at gigs?
Published in SOS June 2005

 I've been coming home from gigs recently with my ears ringing and I'm worried about damaging my hearing. I think it's definitely time to invest in some kind of (preferably unobtrusive) ear protection, but what kind of ear plugs should I be looking at? I still want to be able to hear what's going on but keep my ears out of danger at the same time. I guess I can't wear earplugs when I'm actually performing, but at least I can reduce the chances of permanent damage when I'm watching the other bands. What's your advice?
Patrick Bailey

Technical Editor Hugh Robjohns replies: You are very wise to be concerned and to want to do something about it. A set of ear plugs needn't cost a lot and, if you play or go to loud gigs regularly, should be considered a necessity.

Hearing damage is directly related to both sound level and length of exposure. So, even if you don't want to wear ear plugs when you're performing, consider wearing them when you're rehearsing, as well as at gigs — it has been suggested that musicians often do more damage to their ears during the many hours of rehearsal than in the comparatively short time they spend on stage.

I would recommend investigating the options for good-quality ear plugs that reduce the overall level of sound but maintain an even spectral balance so that you can still hear everything clearly, although the overall level is reduced. Disposable solid-foam ear plugs won't give you this even balance and will adversely affect your enjoyment of the music. You can often find suitable generic ear plugs in the good musical instrument and equipment retailers, sold as 'musicians' earplugs', and available in different strengths (amounts of attenuation). Obviously, the greater the number of dBs of attenuation, the better overall protection they offer.

However, for a really comfortable and long-lasting solution, I would recommend making an appointment with a good audiologist who will be able to take ear moulds and make earplugs to your precise specifications that will be comfortable to wear for long periods and easy to clean and look after. Custom-made earplugs will cost more, but considering that hearing damage is irreversible, if you value your ears the cost should be irrelevant!

More information and advice is available from the RNID (www.rnid.org.uk). The web site of their ongoing 'Don't Lose The Music' campaign (www.dontlosethemusic.com) is aimed specifically at musicians, DJs, clubbers and concert-goers and is linked with two hearing protection specialists — Advanced Communication Solutions, or ACS for short (www.hearingprotection.co.uk), and Sensorcom (www.sensorcom.com) — who can produce custom-fitted ear plugs

Source: http://www.soundonsound.com/sos/jun05/articles/qa0605_2.htm accessed 17th May 2013

Action Hearing Loss

Why does loud music damage hearing?

Listening to music at a loud volume for long periods of time, or on a regular basis will damage your hearing.

Ringing in your ears can be an early warning sign of damage. Continuing to listen to music at high levels could result in permanent hearing loss or tinnitus.

Worried you might be doing damage? Find out 5 ways to protect your hearing right now.

What’s a dangerous level for loud music?

Loudness of a sound is measured in decibels (dB). Experts agree that exposure to noise at or above 85 dB can damage hearing over time.

•An average nightclub has a noise level of 110dB.
•The maximum volume of some MP3 players is the same noise level as a pneumatic drill (90dB)
. Wow, that’s intense!
Sound intensity doubles with every 3dB. Sounds at 88dB are twice as intense as sounds at 85dB, although this won’t be obvious to the listener.

That means that for every 3dB increase in volume, damage can occur in half the time.

Respect the experts

“Hearing loss caused by noise is completely avoidable,” says Abby Davies, our Senior Audiologist

“Once your hearing is damaged by noise it can’t be repaired. The best thing to do is to protect your hearing now, so the damage doesn’t occur in the first place. This will reduce your chances of noise induced hearing loss in the future.”

How do you know you have hearing loss?

Your hearing loss won’t seem obvious right away. But over time, you may notice that it’s harder to hear things like a friend talking to you when the TV is on in the background, or find you have to put your mobile on speaker just to hear someone who talks quietly.

Need more info or worried you may already have hearing loss?

•Visit our Noise induced hearing loss section
•Read our Noise exposure factsheet
•Take our quick and free online hearing check
•Contact our Information Line on telephone: 0808 808 0123
•Speak to your GP
.

Source: http://www.actiononhearingloss.org.uk/loud-music/hearing-loss-from-loud-music.aspx accessed 17th May 2013

Tinnitus Treatment

Read on to learn about tinnitus treatment.
Tinnitus is a symptom rather than a disease and it has many causes. This maybe something easy to treat like an ear canal blocked with cerumen (ear wax) or tinnitus may be due to a more problematic ear condition which cannot be easily treated.

Assessment
If you have tinnitus the first step in dealing with the problem is an assessment by your family doctor or GP who may be able to cure the problem if it is simply one of an ear canal blocked by wax by syringing the ear canal and removing the wax. If the family doctor is unable to treat the ear problem causing the tinnitus he or she will refer you for an assessment by a specialist ENT surgeon or audiologist at a specialist tinnitus clinic. Full assessment includes a detailed history of the tinnitus symptoms, examination of the ear by a specialist doctor, an audiogram (hearing test) possibly an MRI scan of the ear and auditory nerve.

Tinnitus treatment
Once a diagnosis has been made then the specialist can advise on treatment of the tinnitus. If the tinnitus is the result of a particular ear condition or disease then treating the underlying problem will help to cure or reduce the severity of the tinnitus. In many cases of tinnitus there is no easy or quick remedy, but nearly all cases of tinnitus can be greatly improved or even cured with the correct management, but this can take time and perseverance. The best place to start with treatment is at the specialist clinic. The medical staff will be able to advise on a treatment plan. This initially involves treating any underlying ear disease or problem.

Deal with deafness
The first step in treating tinnitus is dealing with any deafness or hearing loss. It is important to treat hearing loss, often with hearing aids, because struggling to hear properly may even worsen the symptoms of tinnitus. It has been found that reducing even slight deafness relieves the workload of the hearing centres of the brain and the brain then takes less notice of the tinnitus. An improvement in hearing also means that sounds that were previously inaudible can now be heard and these will help to mask the tinnitus sounds.

The next step in tinnitus treatment is usually sound therapy.

Masking and Sound therapy
Tinnitus sufferers find that their symptoms are worst during silence. Filling this silence with therapeutic sounds usually helps to relieve the persistent noise of the tinnitus. There are many studies that have shown that sound therapy can help to manage or treat tinnitus. Everyone is different and it is a matter of trying diffferent therapeutic sounds. No one type of sound therapy has been shown to be better than others. It is best not to limit yourself to a single method or a particular device. Rather, try out different types of sound therapy and obtain the knowledge and develop the skills to use sound and sound devices in adaptive ways to manage any life situation disrupted by tinnitus. This can be accomplished by learning the different ways that sound can be used to manage reactions to tinnitus, and developing and implementing custom sound-based management plans that address your unique tinnitus problem and needs.

Effective therapeutic sound can be produced by environmental sound, by tapes, CDs, MP3 players and iPods, by table-top/bedside soothing sound generators, by sounds downloaded to and played by a computer, or by wearable sound generators. These are also called maskers or white noise generators. Maskers are worn in the ears, and usually produce a constant white noise or a gentle rushing sound or a processed sound designed to be pleasant to listen to and which helps relieve the tinnitus. Most resemble hearing aids, and fit behind or in the ear canal. The type of sound therapy that is suitable for you depends on your preferences and particular situation.

Audiologists and ENT specialist report that generally people get on best with a sound that is pleasant to listen to and that does not require or demand too much attention. This article covers sound therapy in more detail below.

Counselling
If you are going to manage and treat tinnitus it is vital to gain a full and detailed understanding of the condition. Effective management usually involves some form of counselling. This is usually carried out by hearing therapists, audiologists or ENT (ear nose and throat) doctors. Counselling is a talking treatment that teaches you in detail about tinnitus, how to establish ways of coping with it and how to manage it effectively. It is surprising just how effective this can be. Simply talking about your tinnitus and how it affects you on a daily basis can help you to gain a deeper understanding of the condition and lessen the effect of its symptoms on your quality of life. This article covers talking therapy in greater detail below.

Tinnitus retraining therapy
Tinnitus retraining therapy (TRT) is a well established regimen that involves a combination of sound therapy and counselling to enable people to overcome their tinnitus. TRT involves a process called habituation. This involves retraining the way that your brain reacts and responds to the tinnitus noise. The aim is to help you start to tune out of it and become less aware of it.

In the UK, very few ENT specialists use TRT in its full form but many hearing therapists, audiologists and doctors, use the principles of TRT in a less structured way. It is important to note that TRT should only be performed by those who have been trained in using the technique. TRT is covered in more detail below.

Cognitive behavioural therapy
Cognitive behavioural therapy (CBT) is the phrase psychologists use for treatments that enable people to overcome problems such as anxiety, depression and post-traumatic stress disorder (PTSD). Our thoughts and behaviour affect the way we feel. Our thoughts affect our behaviour. CBT can help you to manage, overcome and treat your tinnitus. CBT therapy works by improving thinking, behaviour and thought processes to relieve and manage the symptoms of tinnitus and any associated symptoms of distress, anxiety or depression. If you are suffering from tinnitus and you have a limited knowledge about the condition, then you may have distressing thoughts or ideas that lead to emotional upset or anxiety. The thoughts or beliefs that you have may be incorrect and correcting them usually help to ease your emotional distress and unnecessary worry. CBT is covered in more detail below. 

Helping yourself
Self-help is used by many to manage their tinnitus, sometimes with great beneficial effect. These methods include:

•Dealing with stress and tension - stress and anxiety will often aggravate or intensify tinnitus worse so regular relaxation and exercise may help you deal with tension.
•Tinnitus interactive support groups - if you suffer from tinnitus then talking to others with the same problem can be an effective way to help you deal with the symptoms and to make friends. 
•Soothing and calming music – playing music is a good means to help you to relax and can be a great way to drift off to sleep if you have tinnitus related insomnia. 
See below for more on self-help

Pharmacotherapy and drugs
Unfortunately there is currently no specific medication which will completely cure tinnitus, but many drugs to treat tinnitus have been studied. A surprising number have been found to provide relief. See below for detailed information. Medication such as anti-depressants or in extreme cases anxiolytics (drugs for anxiety e.g. alprazolam or diazepam) may be prescribed to relieve depression or severe anxiety in combination with talking therapies and counselling. Medication is covered in more detail below.

Making changes to your lifestyle
It is possible to improve tinnitus symptoms by changing or improving your diet and lifestyle:

•Dietary changes that may help tinnitus include – reducing or giving up drinks and foods containing caffeine (coffee, tea, coca cola, pepsi, red bull and carbonated drinks with caffeine added and chocolate), quinine (found in tonic water) and alcohol. Some tinntius sufferers find that these drinks may temporarily worsen their condition.
•A diet low in salt. This is sometimes advised by ENT specialits. A low salt diet and/or diuretics are frequently suggested as a treatment for Merniere's disease. This middle ear problem includes tinnitus as a symptom, along with deafness and vertigo.
•Stop smoking – nicotine is well known to adversly affect the blood supply to the middle ear and the sensitive sensory cells.
•Take up or increase your exercise levels – start exercising or increase your physical activity levels further if you are already exercising. If you suffer from severe tinnitus and are unable to work, then it is vital to maintain an physically and mentally active lifestyle. 
•Keep your brain working - mental activity and keeping busy usually helps tinnitus. Keeping busy is an excellent distraction and keeping mentally active has been found to help relieve tinnitus.
•Do not hide away and become a hermit. Research the best ways to mask and distract yourself from your tinnitus – surround your environment with soothing and pleasant sounds; by turning on the radio or stereo system to play soft gentle music. Try listening to relaxation cds or music. Enjoy external sounds such as the noise of the rain, the ocean waves (if you are lucky enough to live by the sea) or the sounds of the birds or city life depending on where you live. It is important not to withdraw from life. 

Source: http://www.enetmd.com/content/tinnitus-treatment Accessed 3rd March 2014

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