Since I decided to come out about my hearing issues, a lot of people have asked me for some insight. It seems I’m not the only one who has paid a price for playing too loud, too long and too often. You’ll have a tough time finding a musician who does not have at least some hearing issues. It’s a risk of the trade. So I thought I’d share what I’ve learned about what can go wrong with our ears and what can be done about it. There is some good news and some not so good news, but I think the most important thing is to be armed with accurate information.

First up: Tinnitus (TIN-i-tuss)
Tinnitus is any sort of a sound that you can hear that is not caused by an external source. Tinnitus can range from a short-lived ringing that lasts less than a minute never to return, to a sheet metal works living inside your head. It can be caused by a variety of things including certain diseases and drugs as well as head injuries and general hearing loss. It also seems to be linked to noise exposure.

The range of potential phantom noises is quite something. I remember once going from room to room looking for a radio someone had left on -- it was playing oldies from the late '50s -- only to discover that it was my tinnitus. Sports professionals talk about freight trains, bells and explosions, but more often it’s simply a constant ringing or hissing.

Medical professionals tend to fall back on two remedies: live with it or cover it up. One audiologist I visited early on in my venture prescribed masking devices. Similar to hearing aids, they would be tuned to my tinnitus and produce a noise that would block out the tinnitus. They would cost $1000 in today’s dollars. On the way home that day, I stopped at Canadian Tire and bought an inexpensive fan that produced enough sound to allow me to sleep.

Incidentally, that fan was a revelation. I wrote an article for a tinnitus newsletter about the fan and my take on why it worked. The sound it produced was nowhere near loud enough to block out the noise in my head, but it did give my brain something else to focus on, and that was the gist of my article. What I also got from the article was that focusing on the tinnitus was actually part of the problem.

So my solution has been to try to ignore it. Doesn’t sound like much of a solution, but it turns out to be the core of a successful tinnitus treatment. Tinnitus Retraining Therapy (TRT) addresses the condition by teaching the brain to focus on something else. The retraining helps the brain rediscover how to ignore sounds that don’t matter and to apply this skill to the tinnitus. The Tinnitus Centre in the UK reports an 80% success rate, so it may be worth looking into.

I think the main message I want to get across here is that tinnitus is likely a permanent condition, but it is not a death sentence. It also is not a degenerative disease. If you’ve had tinnitus for a few years, it’s stable, and you’re no longer mistreating your hearing, there is no reason your tinnitus should get any worse. While saying ‘live with it’ may sound facetious, it really is the only option. Most of the people I’ve talked to are bothered by their tinnitus, and often their distress is as much of a problem as the tinnitus itself. If they can find a way to not worry about it, things will improve. The one piece of advice I can give is this: Don’t hide from every day sounds. They give you something else to focus on.

Hyperacusis

When I was first diagnosed at the Musicians Clinics of Canada many years ago, one of the terms they offered was hyperacusis. It simply means a hypersensitivity to sound (or anything else). It's as if the whole world's volume control, normally set at 3 or 4, has been jacked up to 7 or 8. The cause is unknown, although people with tinnitus frequently complain of hyperacusis.

Like tinnitus, hyperacusis is mainly a benign, stable, non-life-threatening condition. That doesn't mean it can't be bothersome or even maddening. It's also a condition that can feed off itself. That leads me to two other conditions: phonophobia and misophonia.

Misophonia is a dislike of a sound. Interesting, but hardly a problem. Phonophobia is a fear of sound. Neither ailment seems like it might be relevant to a musician, but they can trigger a snowball effect.

If you are concerned about your ears -- perhaps you have a bit of tinnitus or hyperacusis, or you’re finding certain sounds uncomfortable -- you may have decided to take a proactive approach by protecting your ears from everyday sounds. It seems good in theory, but your ears are self-regulating, and they can't do that if they're detached from reality. If you habitually wear hearing protectors because you're afraid of harming your hearing, you are actually teaching your system to have hyperacusis.

The treatment for hyperacusis is to re-accustom the ears to normal sounds. Put the earplugs away and try to go without them for an hour, half a day, a full day. Work your way up to the point that you only need the plugs for extremely noisy situations. Even then they may not be necessary. I sat through half a Jeff Beck concert before I realized I didn’t have my earplugs in, at which point I figured, why not just enjoy it?

Recruitment

“Grandpa, time for dinner.” …“GRANDPA, TIME FOR DINNER.”…
“G R A N D P A, T I M E F O R D I N NE R !”

“You don’t need to yell. I’m not deaf you know.”

Well, actually grandpa is at least partly deaf. He also suffers from a condition called recruitment. And he’s not alone. Most people with hearing loss have recruitment, whether the hearing loss is from noise damage or normal wear and tear. Recruitment is both a marvel and a menace, and dreadfully difficult to understand. It can also be a challenge to live with.

When the hearing cells in a certain region of the cochlea have died off, they can no longer capture and process sound. When sounds in the damaged range hit the ear, the hearing mechanism does a wondrous thing. It ‘recruits’ other cells to help out. Trouble is, those cells are usually busy processing sounds in their own range. The result is that the recruited cells have to put out more energy. The more cells that are recruited, the more energy needed and the more the cells are overworked, hence the impression that the sound is abnormally loud. In extreme cases, the recruited cells will push the ear into pain.

Dead hearing cells stay dead. Your hearing in that range stays dead as well. And if this hearing loss is accompanied by recruitment, then the recruitment is also permanent. In my own case, I have ‘profound’ damage in the region from 2400 Hz to 3000 Hz. This is sometimes called a hi-hat hole, and for good reason. A hi-hat puts out a lot of energy in this range and is usually just inches from a drummer’s head. I have hi-hat damage in both ears and sounds in that range can easily cause pain.

So, what can we do about this?

Unfortunately, there are not many options. Recruitment is permanent and may worsen as more hearing cells die off with age. The only ‘treatment’ is to prevent sounds from reaching the affected area of the inner ear. This can be tricky. If the damage is in a critical area, such as the area responsible for hearing speech, then cutting off these sounds would be a bad idea. You may be able to live quite nicely by adopting a quiet lifestyle. I went from full-time professional drummer to computer programmer. Not my first choice, but I wasn’t in a position to argue at the time.

You can get ear molds that filter out certain frequency ranges. Ear molds can seem a bit pricey but are well worth it if they help you get through a gig without distress. At around $300, the initial cost is less than your daily hit of java.

Hearing aid technology has progressed to the point that certain hearing aids can be programmed to cut down the sound energy in the range that would trigger recruitment while leaving everything else alone. But this comes at a price; high-end hearing aids can cost $4000 to $6000 apiece.

While any one of these hearing problems is not strictly life threatening, the distress they can cause has sadly driven some sufferers to suicide. In the end, prevention is the best policy by a very wide margin.

Resources: Tinnitus.org: https://tinnitus.org

The Tinnitus Centre in the UK”- https://www.thetinnitusclinic.co.uk Musicians Clinic of Canada: https://www.musiciansclinicsofcanada.com>>

* Originally appeared as three entries on my drum blog in April of 2012.