My sensitivity to noise, which appeared after my severe TBI, has changed my life in many ways. I’d like to say I’ve gotten better at managing my struggles, but in truth I’ve just learned to limit my exposure in the ways that I can. I also know that if I’m fighting brain fatigue, I am already at a disadvantage and need to actively seek a calm and quiet environment.
Last Thursday I decided to stop at my local coffee shop to grab a nice cup of their nitro-brew and decided to work remotely for the morning. As I was starting to check email and evaluate my tasks for the day, I started feeling that unwelcome sensation of brain drain seeping in. It’s like that sometimes; as I try to focus I feel like that flashlight that fires right up only to start fading because it’s time to replace the batteries. I instantly became aware of all the sounds around me. The clinking of glassware and metal. The discordant conversations throughout the room combining into an overwhelming crescendo of chaos that shuts down my ability to think rationally or communicate to other humans. I closed my laptop, and an enjoyable morning at the coffee shop was forgotten as I struggled to get to my truck before my head exploded – or so it felt. That was the worst event of last week but, unfortunately, not the only one.
Handling noise sensitivity is a huge struggle for many brain injury survivors. A few key strategies have helped me in coping with this new situation. First and foremost, you need to help your friends and family to understand, as much as they can, about what you go through when you are inundated or overwhelmed by sound. Communication is always so important. Let them know that sometimes, you may just need to take a break. My friends and loved ones have come to accept that at times I just need to leave the room for a few minutes. I may go outside, I may go to a different room and close the door, and there are times I have just gone to stand somewhere out of sight and plug my ears.
It took some experimentation to gain a clear understanding of the finer points of earplugs. I’ve learned to keep various types as accessible as possible. The set I ordered after the coffee shop adventure have arrived and they immediately became my favorite set; in fact, they are stored on my keyring for immediate availability whenever I need them. This set of high-fidelity earplugs provides a 17db sound level reduction while preserving a level of sound quality transmission that allows me to still hear and participate in conversations. The sound reduction is enough to allow me to comfortably sit in a busy restaurant or handle chaotic environments that aren’t too loud. In fact, the coffee shop where I’m sitting now as I write has suddenly become quite loud… so I just put them in and now it’s within my tolerance range.
Living as a caregiver with my elderly mother means that I have daily exposure to a very loud television, and usually it’s Gunsmoke or another western show with plenty of fighting and shooting. For these situations, I bought a set of 18db reduction ear plugs without the high-fidelity feature that have made all the difference when I am cooking, cleaning, or helping with my mother’s needs. Since she talks very loud, we can still communicate when I wear them. These are also good for crowded venues like our local Farmer’s Market that has live music, and other places where moderately loud noise levels are found.
Finally, there’s my good old super cheap earplugs on a cord that are sold for working in the shop. At 25db reduction, they are good for anything from running the table saw to attending a live show. Before my recent upgrade, these were my go-to, so long as I remembered to bring them. They work great for noise reduction but made conversation and meetings more of a challenge. But if you have nothing else available, these can be a great help in most situations.
The key things that I’ve learned in these last three years are…
- Communicate with those I spend time with. Let them know that reaching the limits of my tolerance may happen quite sudden and unexpectedly, and that it really isn’t anything I have control of. If I excuse myself from a chaotic situation, please don’t ask if I’m okay, just let me escape to a quieter place for a break.
- Find tools that help. Using the right set of ear protection can allow you to reduce the noise and chaos while preserving the ability to communicate with others.
- Identify and employ strategies that work. I take breaks when they’re needed without waiting for things to escalate… when I feel the chaos breaking through my filters, I excuse myself for a few minutes. I may take a bathroom break or just go outside for a few minutes to decompress. It can help.
My noise sensitivity doesn’t seem to have diminished over these last three years, but my ability to handle noisy environments and situations has improved. Whether it’s through removing myself from the situation or by reducing the noise I have to endure, having coping strategies has allowed me to be in situations that would otherwise be completely overwhelming.
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Your insights are invaluable, thank you.
Thanks for reading, and thanks for your comments. I’m only 3 years into this experience, but I’m trying to share as much as I can here with the brain injury community I’ve become part of. Please let me know if you have any specific questions or topics that you think would be valuable.
Great post. I’ll have to check out those earplugs. I myself have such a strange and conflicted relationship with sound since my severe TBI so I was very happy to see this post. So do you mainly have a sensitivity, like you said? It doesn’t present as a hearing loss and/hearing distortion? From what I can tell my situation is relatively unique. I have a hearing loss, sensitivity to sound, and extreme distortion (all voices, especially lower pitches), and my brain doesn’t process music. It just registers as something like metal on metal noise. I was completely deaf for the first 3-4 months following my accident. I’m trying to research and find out if there are others like me. My doctors and audiologists mainly say it’s a waiting game to see if my brain will heal or I’ll always be like this. While I “wait” and “heal” I’m looking into things online!!
Hi Laura, thanks for reading and thanks for your reply. My own sensitivity seems to be just with sound that is too loud or too chaotic. I struggle when I’m at a family gather or other venue where there are multiple conversations happening at the same time. My filter doesn’t work so I can’t just focus on one conversation and let the rest go without paying attention – I hear them all and they all jumble into a huge mess of broken sentences that my brain continues to try to process. In a restaurant, I’ll hear every conversation within ear shot. It can be maddeningly frustrating.
I am very sorry to learn about your loss of music. Every brain injury is completely unique, as are our outcomes. With my injury, I lost the ability to enjoy upbeat music and any music with vocals. For some reason too much going on and especially words make it tax my brain, but I can still enjoy simple and quiet instrumental music.
My doctors also prescribed the “wait and see what heals” approach. The problem I had with this was that some of my cognitive deficiencies would have benefited from earlier therapies, but I was made to wait. It wasn’t until I found an article on BBC.com about brain injury that my own search for information started, and that’s when I started pushing for therapies and revising my own lifestyle to better support my healing.
Do you also have problems with balance? Cranial nerve injuries are a common outcome of brain injuries, and cranial nerve VIII is responsible for delivering signals from the ear for hearing and our position in space. Here’s a short article talking about the cranial nerves: https://www.verywellhealth.com/cranial-nerve-damage-from-head-trauma-1720018
I also found this on BrainLine.org: https://www.brainline.org/author/janet-brown/qa/hearing-loss-after-tbi
I encourage you to continue your research, and informed patient is able ask the correct questions to get the most relevant answers from their medical professionals.
Rod, thank you so much for all the information. I am hyper sensitive to noises after my severe tbi. It even bothers me when someone pulls a pop tab off a can of soda or a beer. My husband coughs and clears his throat a lot and even that bothers me. Will I ever get over this? It’s been three months since my injury.
Linda
I wish I could tell you that it all gets better soon, but that hasn’t been my experience. Here I am over 5 years in, and just two days ago at the Home Depot store I was at, every noise seemed amplified and given sharp edges. The carts that squeaked when they rolled, people pulling shopping carts free from the stack, the voices and every little noise seemed all aimed at me and with terrible precision.
I’d have never made it though my shopping requirements, so I immediately put in my ear plugs, they are always my go-to solution when I’m suffering. I have a ear plug case that clips to my keyring, so I never leave home without them. This is my strongest recommendation, find a set of ear plugs that helps – nothing will completely erase the noise except for the silent moments we can occasionally find – but if they help, that’s a start.
Spot on. I always carry ear plugs with me, and when coffee shops are loud, I’ll bring in my old iPod to try and drown out the din. It helps me.
I also wear ear plugs at various public events, including movie theaters. Plus, I am super sensitive to low frequency sounds (often distant diesel motors, trucks, tractors, idling motors).
When I watch TV, surprisingly, I have to have the volume at HALF what everyone else wants it to be. So I wear ear plugs.
Like you, my elderly Mom (who passed away six years ago at 93) developed hearing problems and played her TV increasingly loud, so loud that I had to wear earplugs when visiting her.
With family get togethers, where everyone is seemingly talking at once, I’ve learned that I need exit when the headache begins.
I didn’t realize this was almost certainly TBI related until a little over a year ago. I’d had over half a dozen head blows producing one skull fracture, a bunch of knockouts (with other broken bones) over the my life. Over the past year Ifinally* sought care for some of the post TBI issues that still affected me. I’m very grateful that I came through all these very well, compared to many others – I feel like the luckiest person in the world. Hard to believe, but never had anyone told me anything about TBI! Now I’m catching up!
Thanks for sharing your experience, Ed. My first reaction to reading your comment was… what the heck do you do??? I hope that your lifestyle has reached a point where you are no longer at risk for such frequent injuries.
Just catching up on your reply from 2019! 3 of my head injuries were bike crash related. Bike vs pothole->skull fracture, Bike versus road banked in wrong direction and slid into embankment (broke rib, brief knockout, broke helmet), Group bike ride sideswiped by bus (I blame the bad intersection design not the driver), thrown off side of road, broke hand, knocked out for quite some time, broke helmet. I have since been advised by two doctors to avoid bike riding, which I am adhering too. Also had a fall on ice with a blow to the back of my head and brief knockout. Plus one non-knockout blow that left me with slow speech, slow brain, etc, for 3 weeks when the fog finally lifted.
Now I strive to be very careful about engaging in activities that could lead to head injuries.
I now encourage others to be “head safe”.
I too have had TBI’s first in 2001 and the second in 2010. I have had trouble with loud noises from multiple loud sources. people do not understand that this a real thing. they get pissed and say I am just a bitch or they will be gone soon and I will be all alone. The pain is hell it hits just below my ears like I am being stabbed and radiates down my neck. then my head goes numb, and the throbbing of a vice tightening begins. How do I get people to understand? I have always been the strong caregiver and they seem to be extremely pissed that I am no longer the workhorse. I usually just excuse myself and leave but, my one adult son is so loud I hear him talking when I am shut in the house and he is in the backyard. My husband is HOH and refuses to use a hearing aid so he has the radio and TV at maximum all the time. How do I get people to understand that this is n actual medical condition? I do wear earplugs when I go to the movies and other activities. Sick of the rolling eyes and heads shaking when I ask they turn the volume down. This from my own family. I need to give them documented proof. Help.
This is an all too common situation with a brain injury, since it is essentially an invisible injury. We still look strong and healthy, why are we acting strange now? We can’t fault others for not immediately understanding, but we can hope that after we show a little outside evidence that they will better understand and try to help us in the ways that they can. Here’s another part of this situation they may not understand: the injury and initial recovery are just the tip of the iceberg for many brain injury survivors – Post-Concussion Syndrome (PCS) is the second part of this equation.
I found an easy read on BrainLine that you can share with them, talking about hearing problems and hypersensitivity to sound (also called hyperacusis):
https://www.brainline.org/article/recovering-mild-traumatic-brain-injury
The reality is that hyperacusis is only one of the areas of hypersensitivity that may arise after brain injury… here’s a link that discusses this topic:
https://www.brainline.org/article/lost-found-dealing-sensory-overload-after-brain-injury
There are so very many scientific studies to be found as well, a Google search for scholarly articles on hyperacusis after brain injury shows 571 results. Here’s a link to one study of PCS that discusses our sensitivity to noise:
https://www.ncbi.nlm.nih.gov/books/NBK185342/
The best thing I can give you here is a key to our toolbox – so that you can find the tools you need when you need them. I have learned my way around the Google search tool for finding articles to learn about brain injury and find recovery tools. If you want easier reads, use general searches… here are a couple that might be valuable:
“noise sensitivity tbi” – this returns over 2 million results, but the first page should get you some good info.
“hyperacusis after tbi” – this returns about 80k results, again, first page or two should be sufficient.
Finally, if you want scholarly articles and papers on scientific studies, just add “ncbi” to the search criteria. NCBI is the National Center for Biological Information, and connects to the National Library of Medicine archives.
My biggest point of guidance for you is to set your boundaries, and let your family know that sometimes you will need a short break to reduce the feeling of overstimulation. This is a post I did on handling overstimulation: https://www.mytbiblog.com/overstimulation/
I wish you the very best on your journey, and please feel free to reach out any time, and I’ll assist where I’m able in helping you find the information you need.