Sudden "qualitative" hearing loss compounding bilateral SNHL

[FlyingLoafOfToast]

Hello, Forumgoers,

I wanted to reach out to the brain trust with a recent development to my hearing loss.

A smidgen of background: I am 40, with bilateral sensorineural hearing loss which effectively began in 2003, when I was 21. Until mid-2020, my cookie-bite loss progressed quite slowly, often remaining stable for years. The rate of decline seemed to increase perceptibly but not terribly two summers ago. However, until this summer (Northern Hemisphere, #dork), I would describe my loss as quantitative - that is, the world simply got quieter over time, while sound quality remained quite good. All that I required to remain functional in a variety of demanding work environments (I am a merchant mariner - sailing ship officer, for one) was occasionally cranking up the gain in one frequency or another.

This appears to have changed. I had an audiogram in March, then went off to my vessel a few months later. During that most recent posting, my hearing took a solid hit and I began to struggle in every situation. After getting off of the boat, I had another audiogram which reflected the pure tone threshold degradation I expected.

Compounding that loss, however, is the much less pleasant “qualitative” damage I seem to have experienced, to use my audiologist’s word. What sound my left ear still picks up is quite corrupted in a number of ways. Long story short (too late), for examples: a piano key often has its proper pitch (I am a musician) in my right ear, but the wrong pitch (or worse) in my left. Voices have lost much of their tone and timbre; unable to reconcile the sound input I received with my knowledge of my best friend’s voice, I instead answered to a person I knew was not even present, because that seemed more credible than that I was hearing my friend’s very familiar voice. And scores more of such observations.

Additionally, I picked up what appears to be my first incessant tinnitus, a mid-high pitched whine in the afflicted left ear. In retrospect, an ocean-going tugboat may have been a poor choice for me. Oh, well, experience is what you get just after you need it.

I have had similar symptoms in the past (for example, when my left ear was suddenly registering tones more than two full octaves sharp of their actual pitches), but those episodes never lasted more than a few days. I am currently two and a half months into this experience and, for all intents and purposes, there has been no mitigation of any of my left ear symptoms.

For the time being, I have given up using my left hearing aid altogether. I’m actually significantly worse off in speech comprehension with the aid than without; . Speech comes sounding like so much static, buzzing. (I figure - at the risk of ‘figuring’ - that this puts it somewhere on the “needs to really be re-tuned” to “ear is shot, aid won’t help anymore” spectrum. As long as I’m making a fool of myself by figuring, I imagine it’s possible that my hearing has some dramatically different abilities within the mid-range, rather than the clean, linear line suggested by the audiogram with its…nine…tested frequencies.) I digress.

My problem now is to figure out how to, if it is at all possible, restore my functionality. I am aware that this may not be possible.

I’m wondering first off if anyone else out there has had similar experiences, and if so, how they have addressed them. Second, I’d like to see if my hearing aid can be recalibrated to help me out. It’s another story (happy to explain), but this time, it may fall to me to learn to use my NoahLink myself. (I am a meticulous individual and have no illusions about how serious an undertaking that probably is, but: reasons.)

If I can make it that far, I will come back for the challenge of optimizing my aids for music - that was my intent behind joining the forum months ago, however this latest injury has altered my priorities.

(I have ReSound Linx Squared aids which have been my primaries for six years now, and recently got ReSound Quattros - all of these are microphone-in-helix models.)

Welp, this has gotten a lot longer than intended. For that, I apologize. But to any and all who have taken the time to read these paragraphs, my deep appreciation.

Regards,
FLoT

[kevels55]

Welcome to the forum FLot… Quite a first post. Since you are a musician, I don’t think you will have much problem self programming… There is plenty DIYers on here, whom can help. Good Luck in your quest for better hearing. Thinking about what you have written, perhaps once you are ashore, as a precaution, it might be pertinent to consult an ENT hospital department to check if there any other underlying health issues causing this progressive hearing loss, just to err on the side of caution… Cheers Kev

[FlyingLoafOfToast]

Hi Kev,

Thanks for the welcome and the reply! I have located the DIY School Link and will start diving into it. I’m sure I’ll have questions for more experienced minds, but I’ll try to read what’s there first. With two pairs of aids, each with four programs, I have some leeway for experimentation. I have so far gotten by with only ever using a single program. Perhaps that will change.

Thanks as well for your recommendation. I feel that my ENT and general practitioner have this fairly well covered at the moment - and there’s an added benefit to routine physicals for my US Coast Guard-issued papers. But you’re right; one ought to always be open to questioning even what one accepts as incontrovertible - just in case. A hematologist mentioned the MYH-9 disorder to me a few months ago. You never know, and it’s good to be aware of even the chance for an increased chance of certain developments. And then, perhaps, having jotted it down in the appropriate logbook, to have a wee dram and a good laugh.

Regards to you and to those wondrous Highlands I’ve only once visited,
FLoT

[Johnmurphy]

Hi there,

I feel we share very close similarities. Age, level of loss, sudden drop in short periods etc. I’ve had a very hard time but really only in places with background noise. I have recently tried the Baha but the custom molds with my Oticon 1 aids seem to get me close to what I consider do-able……The Baha definitely gave me more clarity but with the whole surgery part I feel
I will continue with the aids for the near future……Have you tried molds? After wearing aids this long I couldn’t imagine wearing only one!!!

[FlyingLoafOfToast]

Hi John,

Thanks for your reply! We are definitely similar in struggling with background noise. I may be mistaken, but I suppose your loss is (primarily) conductive as you were able to try the BAHA? I’m glad to hear you at least got clarity with this device; I remember one otolaryngologist from my past testing me with a bone-conducting headset. The beauty of the sound clarity was enough to make me tear up. (That was about a decade ago, when my loss was far milder.) I’m glad it’s an option at least and hope it may continue to be for you, if and when the time is ever correct!

By molds, do you mean when the hearing aid shell is molded to the ear canal? If so, then yes, I have used molds all along. I got twelve years (!!) out of my first pair of Phonaks before they finally gave up the ghost. I’ve been with ReSound since then, purely because their microphone-in-helix patented design has been a tremendous success for my active lifestyle and work at sea.

My problem now though is how corrupted sound is. A few months ago, my audiogram was not dissimilar to what it is now: 60-65ish dB loss in the mid ranges of the left ear, now 5-10 more. However, what I do hear in that ear now is just all messed up. When I put my left hearing aid in, the volume is just fine. But instead of hearing fairly clear voices (as I used to), I hear a confused jumble of sound which is very hard to describe. It’s kind of a tinny, or buzzing, or staticy quality to whatever sound I hear. (I’m sure it is not the aid; I also have the problem with my backup aid, which is brand-new.) Is your struggle with clarity different? Has it always been part of your hearing loss?

And yes, I ordinarily couldn’t imagine wearing only one (except when it’s in the shop or I’m otherwise forced to). But it’s funny how quickly I’ve had to pivot out of sheer necessity: I’ve even used the phone on my right ear for the first time since before the onset of my loss (my left has always been preferable). It’s the only way now, unless I use a headset. I’m retraining my friends to walk on my right side, which confuses the heck out of them after two decades of the opposite. Kind of humorous.

Regards,
FLoT

[Neville]

What’s the word recognition like in that left ear now? Would it be valuable for you to undergo cochlear implant candidacy assessment? Seems like there is a strong chance that you would not be a candidate yet, but they could provide you information about what would make you a candidate and considerations for aiding that ear in the meantime if there’s a chance that you might become a candidate down the road. I would be wary of not using a hearing aid in that ear as, generally, auditory deprivation is not the solution if you ever want an ear to be useable. If someone can tell you that you will never be an implant candidate, it makes the choice to just give up on the ear and try a CROS a bit easier.

If the clarity in that ear is poor you may be able to improve things with a more linear fit, or you may just need to turn the left down a bit to make it wearable for the time being until you get some improvement or some more guidance. Turn it off when engaged in music listening. Start considering assistive device options (multimic, roger system) if you haven’t looked at them in the past.

[Johnmurphy]

Originally mine was a SNHL loss but now is actually a mixed loss. The air bone gap is between 15-20decibels across the board. The surgeon recommends I wait a bit longer before getting the implant unless I felt a huge difference. For me the volume is better with both aids but the clarity is better with the headband and one aid.

If you felt a huge difference with a conductive piece can you not go and trial one?

[FlyingLoafOfToast]

Hi, Neville, and thanks for writing back!

To answer your questions: my word recognition in the left ear on 23 August (a month after my symptoms began) was 80%, at an intensity (I presume but do not actually know that this corresponds to the decibel level of the test…) of 75. On 9 September, I scored only 60, at a higher intensity of 80. If I remember correctly, I have never scored below 80 on any such test, although the intensities were probably no higher than 65 or 70 in the past. (I’m overseas right now and most of my audiograms are on the other side of the Pond.)

From my otolaryngologist, I’m not yet a candidate for a cochlear implant, though she expects that’s probably a matter of time, and she says when I start really struggling with speech comprehension, she’d like to move to get me onto the list.

Thank you for your point about being wary of auditory deprivation - this is something I have seen in my browsings on this forum, which is generally new to me. I have used hearing aids pretty much every waking hour all along my journey so far. I have occasionally taken breaks of several consecutive days, or perhaps even a week straight, when I have felt that I simply need a rest, or that I’m perhaps starting to reflexively turn the volume higher and higher (which so far seems to have been symptomatic of overstimulation rather than further degradation of my ears). You’re right, though - now I have avoided my aid since the end of July, and perhaps it’s time indeed to experiment with novel programs, like the ones you mentioned.

I have a Multimic, but do not know the roger system. I shall start exploring. Thank you again for your time and insights!

Warm regards,
FLoT

[FlyingLoafOfToast]

That’s really fascinating, John! I’d never heard of such a mix before. I can see how different technologies would yield results with different strengths for you. I can also imagine how you have the preference for both aids for the time being.

(Sentiment on the side: I’m glad I’ve reached out here. On the one hand, credit where it is due, and I am aware I have learned a lot about hearing loss and corrective efforts through my own experience. On the other, I suppose one must always be aware of one’s own limitations. I’m learning a lot already just from the replies you and others have made here. So, thanks again!)

Your question about trying a conductive piece is really interesting. I suppose I never considered such a thing seriously as my loss is entirely sensorineural, and only a single doctor’s bone microphone ever truly astounded me. So I figured it was a high end, very expensive piece of equipment; moreover, this was at the end of 2012 or start of 2013, and my hearing was much less damaged almost ten years ago. But again, from the angle of always remaining open to reconsidering your options and your understanding of a question… I will put this onto my list of homeworks to do. Worst case, it simply doesn’t do anything for me.

Well actually, worst case, it ends my life as part of a freak accident involving a spilled bottle, a waffle iron, and a jacuzzi or some similar codswallop, but…yeah, you get the idea…

Regards,
FLoT

[1Bluejay]

@FlyingLoafOfToast

MYH-9 disorder

LOL! FlyingLoafOfToast begs a bigger question than hearing loss! How’d you get that unique handle?!?! Was it ON board or off?

Well, you got a lot of great tips and directions above, but I also had to ponder how your situation was a bit similar to mine. I have congenital sensorineural hearing loss, but often, when the barometric pressure changes, one (or both) ears goes a bit bonkers!

If a low pressure system is coming, I can almost lose hearing in one ear completely. It lasts for several hours. It may or may not be combined with an incessant TONE sound (granted, I also have 24x7 tinnitus!). But speech sounds very metallic, thin and almost clipped in that ear, as if the nerves are just not registering the frequencies all that well.

If a high pressure system is coming, I get a really energetic “BONG! BONG! BONG-BONG-BONG-BONG!” kind of thing going on in one ear. So I can almost always predict big changes in weather about 48-36 hours out.

You don’t mention any issues with balance or feeling dizzy, so perhaps it’s just the nerve issues going on. Have you considered taking flushing niacin to get your blood vessels pumping? Or even massaging the ears to warm them up? I find that helps a bit with my barometric pressure sessions.

I will be curious to see how your situation develops, is diagnosed and treated going forward, so please share the progress with us! Best of luck to you getting this under control as best you can.

[Neville]

@FlyingLoafOfToast

To answer your questions: my word recognition in the left ear on 23 August (a month after my symptoms began) was 80%, at an intensity (I presume but do not actually know that this corresponds to the decibel level of the test…) of 75. On 9 September, I scored only 60, at a higher intensity of 80.

Hrm. Given the left ear thresholds you have posted, particularly 1 kHz, a presentation level of 80 seems like it would leave out some significant audibility. I would be interested in your WRS at higher levels if you could tolerate it. Additionally, I’m not sure 80% to 60% is even a significant difference on a 25 word list given normal test-retest variability. However, none of this really matters next to your significant change in reported day-to-day perception and function other than to say that your max tested word recognition in that ear could well still be higher than 60%.

@FlyingLoafOfToast

I have used hearing aids pretty much every waking hour all along my journey so far. I have occasionally taken breaks of several consecutive days, or perhaps even a week straight, when I have felt that I simply need a rest, or that I’m perhaps starting to reflexively turn the volume higher and higher (which so far seems to have been symptomatic of overstimulation rather than further degradation of my ears). You’re right, though - now I have avoided my aid since the end of July, and perhaps it’s time indeed to experiment with novel programs, like the ones you mentioned.

It seems your history of consistent amplification would set you up well for a future CI if ever needed. I wouldn’t worry about those occassional gaps, although I would start to worry about this gap from July.

There are a few relevant questions that we don’t actually have experimental data to answer. We know that someone who goes many years without amplification can experience poor outcomes from cochlear implantation. I think medical professionals generally assume that required experience is ear-specific, but we do not actually know. The auditory system becomes binaural very quickly upstream from the ear and it could be the case that consistent amplification in ONE ear is enough to support later re-activation of the other ear. But I don’t think we don’t know yet. Secondly, if one receives perceptually poor input from one ear but is interested in maintaining the function of that ear for potential future implantation, how MUCH amplification do we need to meet this goal if the experience of it is negative? Right now I think we default to “as much as possible”, but again this is not necessarily the case. I’ve said elsewhere that we have evidence that the visual cortex will maintain normal organization if a small ratio of binocular input is given next to a larger amount of monocular vision–off the top of my head I think about 1:8. The brain “prefers” normal input and so a smaller amount of normal input can successully counterbalance a larger amount of abnormal input. Is this true of the auditory system? Who knows. What is the ratio? Defaulting to “as much as possible” is all well and good, but one has to live one’s life and if the degraded input fromt he bad ear is actually impairing function, or even just teerribly aversive, it’s not really reasonable to ask someone to persist indefinitely.

Possible future implant aside, the auditory system is flexible and it’s also not unreasonable to think that consistent amplification in that ear might support some recovery. There is currently some minor evidence to suggest, for example, that early amplification after a sudden sensorineural hearing loss leads to better recovery of clarity than waiting (sudden loss is often accompanied by a whole host of unpleasant perceptual phenomena including loudness tolerance issues and distortion).

Were I in your position, I might consider the following path forward, but ones mileage may vary: Have your hearing aids re-adjusted to full prescriptive targets given the change in your thresholds, if you haven’t already. If your thresholds really have dropped significantly, this could require new hearing aids. See if you can live with them at target volume for a few months just to see if there some sign of functional recovery in the left. If you really can’t, don’t just ditch this level of amplifcation, move it over to a secondary program that you can access if necessary or tolerable, and then start adjusting the main program to preference.

I was going to put some other thoughts in here, but I’ve been called to dinner. Hopefully I’ll think them again later.

[FlyingLoafOfToast]

Hey there, Bluejay!

Glad you appreciate the handle. Oh, once upon a storm-tossed North Atlantic off of the Spanish coastline, under stays’ls and a double-reefed main, a heavy swell from the quarter added to the ship’s normal roll made the gimbled tables down in the mess exceed their limits, whereupon lunch took to the skies (off of the high side of the table, because in such a situation, the high side of the table is the low side of the ship), which is really hilarious (especially if you’re on the low side of the table), and - by means of a detailed side story which I won’t relate - in this almighty kerfuffle (and the most appropriate time for the mess to be called the mess), my handle was born…

maybe…

DANG! If I might for a moment set aside the obvious tribulation your experience must be, holy mackerel, as a sailor, I deeply appreciate your neurological barometric abilities. I feel like you’d be such an asset on the crew, more reliable and more fun than the barometers in the wheelhouse - and maybe I could finally get the deckhands to stop rapping the glass to make the needle jump every time they take a reading. A barometer that communicates with you (and hits back) would solve so many problems.

From the hearing loss perspective, that’s just mind-blowing. I would love to know the mechanics behind this, as I’m sure you and many others would as well. Of course, nothing removes the pain in the butt/neck/head that hearing loss often is, but, danged if I haven’t gained a new appreciation for how fascinating these fragile bodies we inhabit are.

Your suggestions are new to me and I will add them to my toolkit. I’m amazed at how much perspective I’m gaining from these replies. Thank you!

I will indeed keep posting on this thread, and I wish you, too, the very best moving forward.

Regards,
FLoT

[FlyingLoafOfToast]

Hi Neville,

Thanks again for your response. I find much of this information most intriguing.

To further shoot the statistics of my recent WRS to heck, I didn’t even have 25 words in those banks. Crazy as it may sound, I think they were ten word samples. I don’t know why. In any case, I appreciate your fundamental point on the matter, and I agree.

I’ve taken your advice about not strictly avoiding input to the left ear. Historically, as I said, I have ditched the hearing aids mainly when I feel that overstimulation is translating into dependence on abnormally high volume settings. A few days off have always resulted in the perception of comfortable functionality at lower volumes.

In this case, figuring that overexposure to sound was responsible for the damage, I pulled out all of the stops to limit exposure. For my last week or so aboard, plus every flight since then, I wore an earplug. I guess I’ve just figured that, especially if the hearing aid is making comprehension worse, then there’s no reason at all to pump sound directly into that ear. However, now I am attempting to use my aid, just at a reduced volume. So far, in optimal listening environments at least, it is “working” - by which I mean I am definitely depending on binaural input for speech comprehension.

As a general rule of thumb, my current understanding is that rehabilitation depends on both rest when and how necessary, but also activity within tolerable limits. Your suggestions dovetail with this idea, even though there is much we do not yet know.

I suspect that my audiogram would be far less linear were it tested at much more frequent intervals. Based on observational data with music for example, I think I now have some wild differences note-to-note where previously, my perception was much more streamlined, with, say, whole octaves being relatively consistent even if one were more robust than another. Perhaps, as you’ve touched on from time to time, this is both a large part of my “qualitative” issue (and if so, no doubt amplified - ba-dum-TISS - by my hearing aid, if its program is indeed inappropriate for my new thresholds, which I suspect to be the case.) All the more reason to do as you suggest.

For various reasons, it might fall to me to do this myself. I think my audiologist is used to me simply asking for what I want, and, from her perspective, there is not much difference between my current audiogram and my previous ones. Which is very fair - but again, I’ve only got eight data points per ear on that audiogram. So my gut feeling is that it may be time to experiment with something quite different than I have before, once I learn how to safely do so, that is.

I hope dinner was lovely.
Regards,
FLoT

[Neville]

@FlyingLoafOfToast

To further shoot the statistics of my recent WRS to heck, I didn’t even have 25 words in those banks.

Oh, then they were just doing that test for fun, no practical purpose.

@FlyingLoafOfToast

Historically, as I said, I have ditched the hearing aids mainly when I feel that overstimulation is translating into dependence on abnormally high volume settings. A few days off have always resulted in the perception of comfortable functionality at lower volumes.

This is interesting. I can maybe see that there could be some perception on your part that you were damaging something with too much volume? Without having you and your hearing aids in my office I can only guess, but I would probably be less worried about that and suspect, instead, that the period of deprivation results in things generally feeling louder when you put your hearing aids back in. I’ve mentioned elsewhere that adult fittings often have a fairly large overhead margin where we can still turn the hearing aids up without worrying about safety, but with the benefit of increased audibility. Said another way, we lean towards comfort for adults rather than leaning in to audibility. DSL child targets are used by individuals born with hearing loss for their entire lives without evidence of hearing-aid-related-progression-of-loss and are considerably louder than adult targets. Individuals used to child targets absolutely benefit from this increased audibility, there are just tolerance issues in setting adults to that level. If it is the case that you prefer your hearing aids to be louder, just check with your clinician whether your preferred volume (as measured with their real-ear system) is still safe (or, if you are curious, ask them about fitting to child targets) and then go ahead and wear them where you like–volume comfort is flexible, but your brain cannot use what is not audible in the first place.

In terms of self-fitting while maintaining safety, having the hearing aids fit to child targets using real-ear verification measures could also give you an upper limit on a safe long-term listening level and then you could adjust downwards to preference from there.

[FlyingLoafOfToast]

Hi, Neville!

My apologies for the delay. I’ve crossed the Pond and am now shipboard for a few weeks, relocating a ship from the Great Lakes down to Florida. This is my first chance to reply! I’ll be busier these next weeks, but in service range much of the time, so I should be able to keep up with any further replies.

This is also my first attempt working since two months ago, so I will be once again able to make more observations in real-world situations.

@Neville

This is interesting. I can maybe see that there could be some perception on your part that you were damaging something with too much volume?

Basically. I usually thought of it as “(prematurely) becoming dependent on higher input levels” rather than outright damage.

@Neville

but I would probably be less worried about that and suspect, instead, that the period of deprivation results in things generally feeling louder when you put your hearing aids back in.

I have learnt to quote in replies, and this is helpful. Yes. I have always considered this a break for an addled brain. Filtering sound (deciding whether to pay attention to it or not) is a necessary part of my compensation strategy - this won’t be surprising, I’m sure - and, generally, I observe a cycle of higher-than-necessary volume contributing to a “laziness” on my part. It’s as though the increased stimulation makes the work momentarily easier, with the caveat that it of course doesn’t solve all of my problems. So a few hours or days later, then I want a dose of even higher volume. That is obviously an unsustainable process, which is part of why I try to stay closer to the minimum required amplification.

I completely acknowledge and agree with your later point, however, that the brain cannot use what is not audible in the first place. There’s the rub.

@Neville

I’ve mentioned elsewhere that adult fittings often have a fairly large overhead margin where we can still turn the hearing aids up without worrying about safety, but with the benefit of increased audibility.

It’s too early to say for certain, but my impression is that some of the “qualitative” effects (such as perceiving incorrect pitch) may have moderated. In the meanwhile, I am using both hearing aids still, although with my previous settings, as I have not had a chance to either get to my audiologist nor start self-programming experiments. I am on my default program, generally with the volume increased one “degree” in each ear - sometimes two.

My eight current shipmates have a range of voices from “robustly clear” to “almost a timid mouse”. Work is generally on deck or in fairly normal enclosed compartments, or via radio when I’m driving the tender. I’m able to hear what I need to, particularly point-blank and when facing the speaker. I can comprehend more than I’d expected, but I also certainly smile and nod things off in casual settings. More to the point, there is a sharp drop off in comprehensibility with range especially, or other adverse variables such as relative position or orientation with the speaker. The remaining “qualitative” issues (the sensation of voices being “tinny” or “buzzy”, for example) moderate with increased volume and/or closer proximity to the sound source. I have observed the same with listening to very familiar pieces of music in the past week, in fairly ideal environments: at two feet, a melody might jump out, and my brain might fill in the wrong harmony because the input is incomplete. Put my ear right up to the speaker, though, and I could generally detect much more of the sound as well as correctly identify pitch. Today, in a quiet, empty compartment, the cook at three feet is loud and clear. At eight feet, his voice is quieter but fairly clear in my right ear, and louder but becoming grainy in my left. That last part is the new one.

I suppose all of this dovetails rather nicely with your points so far.

Definitely agreed that the next step should be building a new amplification curve on those aids. At some point, I’ll need to dig into comparing my Linx Squared pair with my new, still unused Linx Quattros. However, I think I shall stick with my familiar, older Linx Squared pair, seeing as I have a decent bit of functionality for the present. More variables might make things trickier.

Onwards, ever onwards. With many thanks again for your assistance and support!

Regards,
FLoT

[x475aws]

You must be in a perpetually noisy environment, so more concern about damage than usual.

[FlyingLoafOfToast]

Hi there, x475aws,

Actually, not so much, with the exception of my previous posting. Much of my work has been on sailing ships. Much of my existence is on deck, in open air, quite a bit quieter than driving a car down the highway. Belowdecks is not so much loud as difficult due to the various layouts of the compartments.

Engine rooms are always loud when the mains are going, but they are isolated and if I ever go in there, it is usually only for a few seconds, and in any case I load up on the ear protection.

Best,
FLoT

[FlyingLoafOfToast]

Hello to any reader, and Happy 2023,

I wanted to post an update for any who may be interested in further observations. No pressure.

I followed Neville’s advice and basically have worn both aids since mid-October. I have not yet followed his advice on having them reprogrammed, though I have every intent of it. For now, I am still on the same settings I was when this mess began.

The nutshell version: my situation is improved in various ways. I do not mean I am not having difficulties. But things in general are improved. In short, I still retain good functionality in ideal settings, and I struggle in less-than-ideal settings. What’s different compared to before my injury last summer? Some situations which were formerly ideal are now less so. What’s optimal? Close range, less background noise, cleaner sound (there are situational differences, e.g. listening to spoken language versus music) - the usual gamut, probably.

My symptoms have moderated, or in cases (e.g. tinnitus), my perception of them has moderated. The tinnitus was fairly disturbing for the first two months. Now, it rarely is. It can be (or seem) worse if I put heavier demands on my hearing, and better when I get breaks.

My speech comprehension is notably improved, both in English (native language) and German (foreign). Again, I wouldn’t say it’s good, but if I guesstimate I picked up no more than 5% of spoken German in October, I could distinguish 20-50% or better in December. (That’s not hard science, but it doesn’t need to be. Just an example of gains, consistent with other such experiences.)

The “buzzing” effect I described initially does not seem to be present in voices any longer. Although some people sound different than they used to, I am no longer confronting a world in which - for example - my father and my best friend sound really similar to each other (and robotic to boot). Tone and timbre perception are better than after the incident, if not so good as they once were.

Music provides much more interesting perceptual observations. Additionally, I can make some worthwhile comparisons: I have a large library of very familiar recordings - the exact ones I’ve listened to for decades, and I am even able to use the same environments and playback devices to make comparisons.

More complex music can be more difficult to properly comprehend. In October, a Beethoven piano concerto’s orchestral chords played forte or louder might (and did) sound horribly off-key, particularly in my left ear. I’d pick up dissonances and non-existent tones, for example, hearing A-flat, A-natural, and a bunch of stuff on both sides and between both notes when I know the entire orchestra is sounding only an A-flat chord. Such “active confusion” (as though the recording were trying to mess with my ear) has gradually abated, and now most confusion seems to be “passive” - that is, my ear simply doesn’t hear all of the sound (or enough of it) to properly identify the pitch, and I may have the sensation that a note or chord or recording is not in the key I know it is in.

It is not simply a matter of how many instruments the piece is scored for, however.

I saw a live performance of Beethoven’s Ninth for New Year’s Eve. I perceived all or next to all pitches correctly, even when it came to the full orchestra and chorus cutting loose with everything they had. Some delicacies were absent or muted in the balance, but not wrong. That was heartening.

By contrast, listening to a Hans Zimmer number from “Gladiator” or “Pirates of the Caribbean” (yes, I like plenty of other genres of music as well, let me off of the hook!) on, say, my cell phone makes a sound which is utterly incomprehensible. Listening to music through a cell phone was a hopeless endeavor for me even more than a decade ago, when my hearing was substantially better off than it now is. But the experience is still very intriguing to me, because since my further loss in July, the perception is: a bunch of noise, which might seem musical, except that it’s as though someone is rapidly oscillating the volume control knob from zero to eleven and back again. It’s particularly true when there’s a robust bass presence, it seems. This is a marked shift in how I used to perceive the same recordings on the same device.

In better environments, music can seem to have a “mono” recording quality to it where it was previously more warm and balanced. It can be difficult to not touch the volume knob during listening. I figure I’m amplifying the music far enough to hear the missing or muted parts well enough, and then some of the rest is too loud - particularly if the music itself crescendos or has a dynamic shift.

In conclusion, I don’t think any of this is ground-breaking or surprising - though one never knows what another person might find valuable, so I’ve decided to follow up. In any case, my experiences seem to all underscore what Neville earlier mentioned: my aids are surely less than ideally calibrated to my new hearing loss, and this part of it at least is manageable…so…manage it. I think I’ve been fairly lucky in the symptoms having died down and my current level of functionality being here without even having touched the aids; I have hopes that an appropriate recalibration will further improve things, at least in small measure. So, next step: either to the audiologist, and/or finally and carefully learn how to self-program.

Regards to all,
FLOT

[Neville]

Good improvements! Thanks for the follow-up.

@FlyingLoafOfToast

By contrast, listening to a Hans Zimmer number from “Gladiator” or “Pirates of the Caribbean” (yes, I like plenty of other genres of music as well, let me off of the hook!)

I have both of those themes on my playlist. I feel like movie scores and classical are definitely overlapping genres. When you say listening on your phone, are you streaming the audio through your hearing aids or just listening on the phone speaker?

The brain depends very heavily on balanced binaural input for localizing sound and hearing in noise, so it makes sense that insult to one ear would impact more complex environments more dramatically. There’s some flexibility there for the brain to learn to deal with new input, although if something is still in flux it would have to learn and learn again. I don’t know how far out one might expect retraining benefits. When people get cochlear implants, I think we expect the majority of changes to occur within the first 6 months with trailing improvements out to 12-18 months; perhaps that suggests a window.

For what its worth, if you do ever pursue cochlear implant candidacy it seems to me that with your persistence and attention to detailed listening, you have what would be required for good outcomes.

When I was first hit dramatically with tinnitus, I’d say it was awful for the first 2 months, bothersome for 6, and still intruded on my life for 2 years. At this point I’m many years out and while it is still occasionally annoying, I mostly don’t notice it.

[FlyingLoafOfToast]

Hi, Neville!

You seem to have agreeable taste in music.

For the listening, I meant just through the phone speaker. That perception of a volume knob being rapidly oscillated (sometimes coinciding with the beat, or the pulse of the bass), and from a loud level to virtually (or factually) inaudible and back, is a very curious one. It’s not just my phone speaker that does this. The car’s stereo system will present similar phenomena on the same tracks. Although not every single variable is strictly controlled in these observations, we’re still definitely talking the exact same files on the same devices in similar listening conditions. I know the speakers and the tracks are fine; other people testify that it sounds just normal to them. We clearly are not having the same listening experience.

There are other curious experiences and comparisons, even with much more lightly scored music. In short, I think it all supports the current thinking: I’ve had a significant sudden drop in the left ear’s mid ranges. By the time I crank the volume knob to the point where I’m comfortably hearing the quietest parts of the music, other parts are way too loud. This might have something to do with the entire sound of those movie tracks just cutting; maybe the bass is just completely overwhelming my devices, for example. (Doesn’t seem to be a loud volume, though.)

I suspect that the whole picture becomes even murkier because my loss is probably not as linear as my audiogram shows. That only tests, what, nine bands? I’ve been curious to find a way to plot my hearing on a much finer level: note by note on a piano would be neat to know. Of course I can’t make a hearing aid accomodate such a fine level of customization, but the knowledge would be intrinsically valuable and I could possibly employ equalizers for even better listening results in certain environments. As with many things in life, it’s all about balance.

I’m heartened by your optimism surrounding my candidacy for cochlear implants. I keep that on the radar, although I have at least one if not two major reasons to hold off on that as long as possible.

Your tinnitus experience seems quite relatable. In my case, I am not sure whether it has simply moderated, or whether my perception of it has. Perhaps both. The net result is the same, though - it doesn’t by itself threaten my ability to sleep as it did back in August and September.

I remain very appreciative of and quite curious about the scientific mechanics points you make. That particular answers elude us does not detract from either of those feelings! It’s fascinating stuff and is always more than welcome by me.

Best,
FLOT