Ear troubles and recovery with violin still singing in the air

Edited: April 4, 2021, 8:53 AM · Please explain what you mean by "ears in overdrive." Too sensitive to sound? Pain? I have multiple ear problems and wear bilateral hearing aids. I think the ENT should be able to give good advice if they are knowledgeable about the effects of covid.

By "singing in the air" did you mean to write "ringing in the ear?"

There are several kinds of tinnitus which and an EMT would be able to maybe diagnose the root cause by the type. A visit to an experienced audiologist might help too.

April 4, 2021, 9:44 AM · Thank you for your reply. I've been sensitive to sound for a long time, I think. But pain and pulsatile tinnitus is new. By "ears in overdrive", I meant that even a refrigerator hum or a very distant birdsong increased my pulsatile tinnitus and pressure in my ears that day.

Oh yes, thank you. I will visit an audiologist through my ENT.

I did mean "violin singing in the air" as in still being to play violin while recovering from this acute phase. :)

Edited: April 4, 2021, 9:54 AM · I see, forgive my misunderstanding, my reading lacks poetic understanding!

An ENT should be able to diagnose the cause, particularly if other things are present such as headaches or dizziness. Pulsatile tinnitus is relatively rare and has causes that are more readily diagnosed.

I have two of the other kinds of tinnitus which are simply due to the brain generating a signal to replace the signal loss from the auditory nerve. There are hearing aids now which have programmable masking tones but I don't use them.

After the diagnosis by the ENT the audiologist should be able to offer means to deal with the problems if they can't be cured. We all have things that go wrong with our bodies and we must adapt. And playing music is one of the most valuable things we can do and is well worth fighting for.

I would add that the audiologist should preferably be at a general hearing clinic and not necessarily at a company that specializes in hearing aid dispensing, though I had an excellent AuD audiologist at HearUSA which is associated with Siemens (Siemens now has another name). He was deaf in one ear himself and tested out all the new equipment on himself and was a good resource for information.

Edited: April 5, 2021, 7:25 AM · This is not related to your tinnitus, but there is an on-line hearing test that I have used and that gave me the same result (using over-the-ear headphones) as professional audiographs:

https://hearingtest.online/

It can also be used with hearing aids to measure and plot the frequency vs. gain or attenuation curve of (hearing aids or (ear plugs). This allows one to self-generate more than one is likely to get from an audiologist visit.

Edited: April 4, 2021, 11:25 AM · The online test doesn't test many things that the audiologist will such as speech discrimination and how well the tympanum responds to sound pressure. The audiologist testing takes about 2 hours. The settings of the hearing aids are more complex too, as they allow for compression, aiming of the microphones and other adjustments as well. There is more to it than matching the audiogram.

I have Phonak Audeo 50M-RTs. R for rechargeable, T for telecoil. The Phonak app also allows for the audiologist to adjust the settings remotely besides allowing the user to make adjustments. One example is that when I am streaming music to my aids I like to turn the external microphones off. I also like the microphones aimed fairly tightly forward so I don't have to adjust them when entering a noisy environment. The 70 and 90 level aids have more automatic noise reduction than mine do. There are also built in presets for restaurants, outdoor music, etc. I have my own preset that I turn on when I start up the aids in the morning.

The settings of the aids are in the audiologist's computer and I have a printout of all of them, which is a report about 12 pages long.

Edited: April 4, 2021, 10:15 PM · I have tinnitus and my ears get "over-driven" at times. Seeing your doctor is key. I take certain snake-oil supplements, but I got fitted earplugs made that I use whenever I play, aside from lessons and performing (when I get back to performing).

I have hopes for upcoming medical advances, like the FX-322 drug candidate being tested by Frequency Therapeutics to regrow inner ear hairs, even though one of their trial results just disappointed (could either be a sign of the drug not working, or just indicating an incorrect dosing regime), as I expect, based on my family history, to go deaf earlier in life than most.

If you can't practice yet with the ear plugs, I would recommend just holding off for now - Good sleep and stress reduction may really help. I'm sure that there are people that can practice regularly at high decibels and keep their hearing until the end of their lives, but I think those people are outliers, and as a precaution, I recommend practicing with earplugs whenever possible. Until the miracle cures come through, we only have this one set of ears.

April 4, 2021, 12:39 PM · Ann, that sounds impressive. I never got that much of an exam from the Kaiser-Permanente audiologist (30 min at most). I think for more complex problems than mine more testing would have been required (based on the audiologist text book I have).

And the CostCo exam 6 years ago was just a brief - and that's where I got my $1,000 each behind-the-ear Kirkland aids. But I later used the on-line test to learn what the gain settings were doing and to instruct the audiologist on what frequencies I wanted further enhanced or reduced. There are three environmentally "designed" presets, but I only ever use the basic one (although maybe I should turn off the rear-facing mic when I'm playing in the viola section in front of the flutes one oboes).

I recently learned that my current health insurance will buy me hearing aids up to once every 5 years so I've also been using a "free" pair of EARGO aids for the past 3 months. This service does everything remotely and adjusts my aids using WiFi while they are in their charger. I used the same approach with the on-line test with these aids in and out (and playing violin and cello with the aids in) to get my gain vs. frequency curve reset from their initial setting that had been based on the Audiograph I sent them with my order. It seemed to work, although I'm only on my 3rd day with the new settings. Time will tell.

Edited: April 4, 2021, 2:09 PM · Andrew, Sounds like you're good to go. I always enjoy your intelligent and knowledgeable posts. You are like me, you like to study things to get the most out of them. I was lucky in that my insurance paid the full ticket. The insurance company said they wouldn't but they did. I wish I had known or I'd have gotten the 90 level instruments. But what I have is good enough for the likes of me. Come June I'll be on Medicare and my new plan won't pay for them unless I use their vendor, which I won't.

Don't put your microphones too far forward or you might have to turn your head to hear your stand partner speak. Though I would anyway because I'm a lip reader. Once you're a lip reader you never stop it.

My audiologist boosted the 4k band (my aids have 12 channels) by 3 dB and that made me hear squeaks and rattles that weren't really there. She was trying to make sure I had the best speech discrimination but even with them down to the "musician" level I still hear fine. I'm lucky, my speech discrimination is 100% both sides. My mom had "normal" hearing with her aids but still had only 8% hearing discrimination so we had "interesting" conversations. I always urge people with tinnitus to get aids before their hearing discrimination gets bad because it will get worse faster without having that clean signal from the aids if it's nerve deafness.

Streaming music is a joy with a custom equalizer in each ear.

Edited: April 4, 2021, 11:09 PM · Ann, that is very interesting - I will ponder some of those things because my speech discrimination is not that good - for sure and I do depend somewhat on seeing lips move. And I have some troubles with aids that enhance 4KHz in a noticeable way.
Sorry to have broken away from the conversation for so many hours but we had a nice family celebration closer to the coast with cake, tea and the mishaps of a couple of dogs - and to close the day my granddaughter played a couple of Greek tunes on her Cretan lyra (I wonder if she still plays her violins at all any more) - And I got a chance to test my new EARGO aids "against" 7 other voices.

April 4, 2021, 8:53 PM · How did your aids work in noise (that's what a bunch of voices are called)? I haven't really tested mine since I got the app. The important thing is that you are wearing hearing aids and that will slow down the progression of the deafness if it is due to nerve deafness.

I don't know what you mean "I have some troubles aids that enhance 4KHz in a noticeable way." Feel free to email me from my contact thingie on my profile.

April 4, 2021, 10:02 PM · Wishing you all well with your solutions.

I've had tinnitus since childhood due to an incident at the beach (waves crashed on me-my young head hit the sandy shore), but never have had pain, and has never used earplugs. Perhaps it may be easier to have tinnitus as a child, as one gets used to it.

I love high frequencies-they never bother me. I think I can only listen up to 15k and a bit more right now. Wondering if my mild lack of hearing since childhood has helped me be insensitive to sounds that would otherwise bother many other people. For instance, I am never bothered with headphones that some people would deem overly sibilant (say, a DT-990 for example), and appreciate the detail, as long as the relative sound is balanced and not overly brittle.

Hope you are able to enjoy your violin soon, Paree VK.

April 5, 2021, 1:07 AM · After a life-time of violin, plus being down-wind from trumpets and piccolos, and doing snare drum in a drum corp line, and doing black powder rifle and artillery in a civil war re-enactor club, I lost the top octave and half of the next octave. My convincing clue was when I did not understand the jokes at a play, but the people next to me did. And I got into trouble at work for miss-understanding things. I have very expensive hearing aids from an audiologist. The tinnitus has been reduced.

April 5, 2021, 4:53 AM · joel, I had a friend who made explosives when he was a child, blowing up stumps and beaver dams for the neighboring farmers. He had a notch in his hearing response. The audiologist asked him if he had been in the artillery.

I've learned to accept my tinnitus. If I'm hearing tinnitus it means I'm conscious.

April 5, 2021, 7:03 AM · Paree : have you tried an orchestral mute (sometimes called a concert mute) on the bridge ? This will reduce the volume without totally killing the sound like a practice mute would do. I play with one all the time now that I am working through the day and only have time to practise at night.

There is even some 'volume adjustment' available by altering how much you push it down on the bridge.

April 5, 2021, 9:23 AM · Brian, I have wondered about those, that's nice to know.

April 5, 2021, 10:14 PM · Thank you all for your kind wishes, thoughtful suggestions and for sharing your experiences.

@Ann Morrill, I hadn't practiced the previous day and that's probably why my words were making up for it. :) Very rarely do I realize that people don't talk that way. Re - ear troubles, I have been experiencing constant pressure in my ears for a few mins, pulsatile pressure and occasional sharp pain in my ears (probably my eardrums) and my outer ears feel tender at times. I have been using headphones too like there's no tomorrow since Covid19 pandemic began. It's time now to ration my hearing and save it for violin playing and listening to classical music. I'll know the state of my hearing when I've had my consult this week. And may I say, it's truly remarkable the way you've adapted and that gives my hope. :)

@Andrew Victor, thank you. I did try out an online hearing test last week before posting here. I suppose a visit to the ENT is essential in my case.

@Christian Lesniak, that would be something if we could regrow inner ear hair and function like normal. Violin playing is the only thing that has kept my sanity since the pandemic. In fact, my first violin lesson was on the very day the lockdown began although it wasn't intended that way. Prioritising long term ear health is something I should do now.

@Adalberto, thank you for sharing your experience. A lot of the music pieces that are dear to me hit the high frequency notes often. And I've been learning shifting and intonation in high positions on the fly. I want to learn to play those and still be able to hear a birdsong and children playing outside. That was hurting as well.

@Joel, that's quite an experience. I'm glad to know those hearing aids are working out.

@Brian, I have a regular practice mute which I only used in the first week of my violin practice. I've been using etymotic er20 earplugs since 3-4 days now and I finally got the hang of inserting it properly. It reduces the sound as well as any distortions I make, so it's hard to know if my intonation is right or if my bowing is as I want it to be. I suppose it'll take getting used to and maybe recording my practice might help. I'll look into those concert mutes. Thanks for sharing. I would love to be able to practice at night or in the twilight hours.

April 6, 2021, 7:00 AM · The practice mutes kill the whole sound ; it no longer sounds, acts or feels like a violin when one of those is fitted. Please try the concert/orchestral mute.

April 6, 2021, 1:10 PM · Which concert/orchestral mute would you recommend?

Edited: April 6, 2021, 5:42 PM · I have found that leather mutes give me the most tone control. That is, with a leather mute I can place it in certain ways to change the frequency balance (due to overtones) that gets to my ear. This is not the kind of mute I use when playing in an orchestra. For orchestra and all other ensemble playing I use a mute that slides on and off fastest and otherwise resides on the middle string afterlengths - but not a "wire mute."

April 6, 2021, 5:17 PM · Practice mutes have a role - for practicing. And if it's a question of harm from loud sound such as hearing loss vs using a practice mute, it's no contest IMO. Even professionals who might be able to afford elaborate isolation rooms use practice mutes at times.

They vary of course and also with respect to sound and bridge impact. Some like the expensive "WMutes" for their form and sound. You can probably make your own if you like. There are numerous alternatives from the traditional rubber mute to metal mute to rubber coated metal mute. The latter type - Artino for example, are also sometimes favoured. One can't really judge them without trying them, but most are inexpensive.

With any mute, but especially tight / metal ones, you should be careful about bridge impact / motion when attaching or removing, as that can affect the sound afterwards.

April 7, 2021, 12:48 PM · @Andrew, I hadn't heard about leather mute. Thank you. From the videos I saw about mutes comparison, this one sounded nice.

@J Ray, you're right about prioritising ear health. These days, the only true violin sound I'm able to listen to is when I pluck the strings after cleaning them at the end of my practice after I take my earplugs off. Just those 2 seconds sounds glorious. Thank you for your suggestions. I'll try out different mutes to figure out which one I like the most.

April 7, 2021, 1:07 PM · I used ear plugs when playing violin starting about 35 years ago (before I "graduated" to hearing aids after about 15 or 20 years of that).

I first noticed my hearing problems when I started to have problems tuning my violin in orchestra. I thought there ws something wrong with the oboe giving us the pitch, but then I realized I was hearing a different pitch from each ear. I discussed it with our bass player (who was also our sometime conductor and, more importantly, had been a "tone-master" recording engineer know throughout the recording industry). He informed me that I was probably over-driving my left ear causing me to hear that pitch as too high - sure enough it is described in books about the physics of sound and music.

I solved the problem by using an inexpensive wax earplug in my left ear when playing violin. With that kind of plug, loosely fitted in the ear I could adjust the amount of sound attenuation. On the simple basis of difference in distance of my left and right ears to the violin top, I estimated I needed somewhere between 12 and 18DB attenuation at my left ear. Since those ear plugs were so inexpensive I bought a whole box and handed them out to all the violinists in our community orchestra and we to see if our mass intonation would improve. BOY, DID IT EVER!! And they could all tell!

Also tried it with the viola section at the same time, where it seemed to make no difference.

April 8, 2021, 7:25 PM · Violas are much less dangerous, unless you are at the last stand immediately in front of the trumpets. Once when I was in that spot, the conductor asked if the trumpets needed those plastic sound shields. The lead trumpet said "No, the Violas aren't bothering us."
I have also had the exhilarating experience of being immediately in front of the timpani for Rite of Spring.

April 9, 2021, 5:40 AM · "Also tried it with the viola section at the same time, where it seemed to make no difference."

We poor violists spend our time not really hearing what we are doing!
Then when we get a solo passage it's a bit of an embarrassment..

April 9, 2021, 2:33 PM · @Andrew, how do you figure out how much attenuation you need in your left ear? I play the violin with almost center position but I suppose the vibrations from the violin body directly reaching the jaw also contribute to the loudness exposure. I have been using these new earplugs in both ears as I find tinnitus coming from the right and also both my eardrums seem to twitch sharply with certain sounds these last few days.

How do you dampen the bone conduction? I tried folding a piece of cloth on my chinrest but there must be other effective tried and tested ways.

April 9, 2021, 3:02 PM · I ignored bone conduction and just assumed the attenuation of distance to each ear would be about 12-18 db more to my right ear. I fitted the left hearing aid loosely to approximate that. I position ("aim") my violin (and viola) very far to the left because I use left-mounted chinrests and have long arms.

I had read that an apparent halving of the "sound level" (as heard) required about 10DB of attenuation.

April 9, 2021, 6:57 PM · You can't stop bone conduction of loud sounds. Guys in the military (artillery mainly) have hearing loss even when using proper hearing protection. Explosive pressure shock waves can kill (!). When I played amplified violin in a very loud band, I used an ear plug in the left ear, I could hear myself through the bones in my head, and hear the sound of the rest of the band bouncing off the rear wall, in my right ear.

April 11, 2021, 9:37 PM · "I had read that an apparent halving of the "sound level" (as heard) required about 10DB of attenuation."

10dB is a huge change, although humans aren't particularly good at measuring SPLs with their ears. 3dB is actual doubling of sound energy. I agree that perceived doubling can be anything because it's subjective, but am just adding that relatively small measured differences can correspond to large physical differences.

https://pulsarinstruments.com/en/post/understanding-3db-rule

Edited: April 11, 2021, 10:24 PM · I realize that - but the ears don't. I know what DBs are!

Admittedly, It is nearly impossible to define doubling of heard sound just as it is with seen light just based on what we hear or see.

April 12, 2021, 12:15 PM · @Andrew, I have been using both earplugs because both of them hurt and I have increased tinnitus now. All this began acutely 2 weeks ago. I can't help thinking there could be an infectious/inflammatory component somewhere. A PA at primary care took a cursory look into my ear canals and found them "clean" and no signs of infection/inflammation. But I did get an ENT & audiology referral on request. It's a long wait until then. I don't know if this qualifies as an ER visit. It has been hard for me to judge the extent of attenuation I need in each of my ears with the ongoing issues.

@Joel, I suppose so but just having a folded cloth underneath my chin seems to dampen some of those vibrations. Of course, with earplugs and cloth and what not, my violin playing experience isn't what I loved it to be. Thanks for the fair warning, if I had any hidden aspirations of playing in an orchestra just to tick it off my bucket list, I know better now. I'd rather stick to playing quietly for my own sake and listening to all the music I want. :)

April 12, 2021, 11:52 PM · Paree VK,

Do as you wish or is good for you regarding violin studying, but please follow up on this issue. It is not normal and needs to be diagnosed and fixed. Perhaps it is a temporary issue that will solve itself over time, but it is best to find the cause.

I was too young too remember but after the beach incident, my hearing was very poor and muffled for many days-I have trouble recollecting whether it was a full week or just a few days. Afterwards, only tinnitus remained and hearing was "normal" (I of course did not realize what tinnitus was until much, much later; as I type, the high frequencies "rage" on my ears, but unlike with Schumann, I just happily ignore the high pitched "white noise" in my head). I have lost a bit of hearing later on due to age, but not that much, and still have no pain. I never use earplugs for anything, but as I stated earlier, it may well be that I am used to living with subpar hearing ability, so high frequencies, while easily discernible, are still never painful or bothersome.

Do not quit on the things you love just yet, whether it is listening to a bird song, children playing, or violin playing. Be well, stay safe, and remain hopeful. Best wishes with the later diagnosis.

April 13, 2021, 3:54 AM · Here is a site dealing with many of the very varied specific needs of musicians:
{https://musicandhearingaids.org/blog/}

April 13, 2021, 8:50 AM · Paree, Pain in the ears such as you describe is definitely an emergency. The primary care doc was remiss in just looking at the outer ear. I am sorry that you have to wait to get care for something so serious.

April 13, 2021, 5:06 PM · Thank you all for being so kind. I had a virtual urgent care consult with a physician assistant yesterday and today, I walked into an urgent care center and had a family medicine physician take a look at my situation. This doesn't constitute an emergency, I was told. It isn't life threatening but I suppose it depends on which side you are on. The prospect of losing certain frequency range permanently and having to live with tinnitus and hyperacusis is frightening especially if it can be prevented and treated in a timely manner. Today, I was given nasal steroids and oral antihistamine to help relieve any congestion and perhaps improve my symptoms until the end of the month appointment with ENT. Antibiotics weren't thought necessary even though my right eardrum looked a bit dull (it's normally translucent). Middle ear infections in adults whose symptoms last this long and are this bad need to be treated with antibiotics but I can't self-prescribe. It would have been helpful to have someone who knows the different stages of infection/inflammation presentation look at my ears. And a bedside hearing test with a tuning fork would have helped too. Is this really the norm here when it comes to seeking medical care? Do you have to wait for weeks and months to get to see someone who knows about your condition?

April 13, 2021, 5:11 PM · Paree, I don't know where you are but it isn't normal where I am.

April 13, 2021, 5:47 PM · I'm in Madison, WI.

April 13, 2021, 6:00 PM · I see. It's more difficult if you don't have a regular doc that you see all the time like I do. I'm like an old car, things are always breaking.

April 18, 2021, 11:47 AM · My own experience of ear problems stopped a thirty year career as a professional orchestral musician. I have Meniere’s Disease which came with lose of low frequency (not such a problem for a violinist), loss of balance (tolerable), tinnitus (an annoying high Bb), and severe distortion of loud sounds (the game changer).
I wish you well, and hope your problems are a brief blip!

Cheers Carlo

April 18, 2021, 3:32 PM · @Ann, I admire your tenacity.

@Carlo, Thank you. I hope so too but if the original problem wasn't serious or long lasting, this long wait to get someone qualified to look at my problem is most likely going to do it. I'm sorry to know about the way your career ended. Won't hearing aids help with managing distortion of loud sounds?

April 18, 2021, 8:14 PM · In the meantime, wear an earplug for sure on the left and if you can stand it on the right, too. Hyperacusis is treatable (through less noise exposure) but you need to limit one or all three of these if possible - how loud something is, how close something is, and how long you are exposed to it. I always play with an earplug in the left. Both tinitus and hyperacusis are a reaction to sound exposure. BTW, there is new tinnitus treatment on the horizon, for the first time ever: https://www.scientificamerican.com/article/new-tinnitus-treatment-alleviates-annoying-ringing-in-the-ears1/

Good luck and take care of your ears :)