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Tinnitus scare last night makes me rethink this hobby. - Page 8

post #211 of 253
Quote:
Originally Posted by Torqdog View Post

I actually most nights need the TV on set to some channel like NatGeo or HGTV, movies are too stimulating. I've been doing this for as long as I can remember. I set the sleep timer for 40 minutes and rarely am awake that long. If I don't have my "visual valium", I toss and turn allot.

My wife snagged the sleep machine the moment it showed up and it sits on her side of the bed. It does help make for a full night of shut eye. Very soothing. I think some folks actually use the sleep machine to help drown out their tinnitus and are thus able to sleep better.
I use a sleep machine but not so much for the tinnitus but because like you said it is soothing. I think for most people a tv on or noise machine is soothing regardless whether the tinnitus is mild or severe.
post #212 of 253
Quote:
Originally Posted by asere View Post

How come some people need a fan or machine to go to sleep? Is it because the tinnitus is too loud? If you need a fan or machine to sleep is the tinnitus considered moderate or severe?
I listen to music, and use Spotify streaming. It's not to drown out the tinnitus, because that can't be done (in my case anyways), but it lets me focus on something else so I can relax.
post #213 of 253
Anecdotal information on a serious subject like this is great. But any hearing anomalies other than late age related are not normal. So reading about your problem here is not enough. SEE A PROFESSIONAL.
I've seen a few pros about my tinnitus. I'll never forget the first question from one of them; "Have you ever considered suicide?". Yikes!!!
After having a technical job in construction for 25 years, I took that skill to manufacturing for 20 years. It was there that I became aware of the harmful effects of noise in your work environment. They were serious about protecting your hearing. I then realized the little I wore hearing protection in my past career was woefully insufficient. I do remember one time showing up on the 18th floor of a new build once with my Audiosource handheld spectrum analyzer. I was seeing some average SPLs of 90db and higher. But there were many short bursts over a hundred db. Traffic sounds and sirens bouncing off the other high rises were pretty bad. But electricians dropping their hundred foot bundles of EMT conduit on the metal deck were the loudest at 122 db. Ouch.
Despite the hearing protection (I wish now that I ALWAYS wore it), I developed tinnitus about 15 years ago. It was low level at first but after about a year it was full blown. Prior to that at one of the annual hearing checks, I was told that at my age I still had the hearing of an 18 year old "that hadn't been to rock concerts". Say what. Yeah, there was already that category back then. They probably now include in ear buds. BTW despite the great hearing 20 years ago, I now also have age related male high frequency loss. I probably have better than average hearing for my age with the exception of the tinnitus, which from what I understand is not so much age related but more from environment.
I've never had the sharp bursts the OP had. Mine is pretty constant. For a while I thought there would be an opportunity for a device that operates on the principal of noise canceling headphones. Take the reciprocal sine wave of what's in your ear and..... it's in your ear stupid, how can any machine know what the opposite is??? OK so it's permanent.
About it being related to other hearing loss, I'll pass this on. Awhile back someone linked a site that had a hearing test on it. So we were all reporting back how we did. Well my wife has two notches up on me, sex and age. So I invited her to take the test also. Hmm, tinnitus and all, I topped out at around 15khz and she at around 14khz. Don't forget these test tones would be at a higher SPL than residual tinnitus.
OK enough of the anecdotal stuff. Ambient noise and the tricks the brain administers are enough to mask tinnitus most of the time, at least in my case. But I can tell you my wife is listening to Boz Scaggs in the other room right now and it's not louder than the ringing in my ears. This audio hobby leads me to think it's in the 8-12khz range. It's definitely high pitched only. And forever more.
SEE A PRO.
Especially if you're a 26 year old male and think hearing tapering off at 8khz is normal!!!!!

The sound masking devices work in quite environments. I have one on my iPod Touch called Sleep Machine.
Patrick
post #214 of 253
Quote:
Originally Posted by Patrick Collins View Post

Anecdotal information on a serious subject like this is great. But any hearing anomalies other than late age related are not normal. So reading about your problem here is not enough. SEE A PROFESSIONAL.
I've seen a few pros about my tinnitus. I'll never forget the first question from one of them; "Have you ever considered suicide?". Yikes!!!
After having a technical job in construction for 25 years, I took that skill to manufacturing for 20 years. It was there that I became aware of the harmful effects of noise in your work environment. They were serious about protecting your hearing. I then realized the little I wore hearing protection in my past career was woefully insufficient. I do remember one time showing up on the 18th floor of a new build once with my Audiosource handheld spectrum analyzer. I was seeing some average SPLs of 90db and higher. But there were many short bursts over a hundred db. Traffic sounds and sirens bouncing off the other high rises were pretty bad. But electricians dropping their hundred foot bundles of EMT conduit on the metal deck were the loudest at 122 db. Ouch.
Despite the hearing protection (I wish now that I ALWAYS wore it), I developed tinnitus about 15 years ago. It was low level at first but after about a year it was full blown. Prior to that at one of the annual hearing checks, I was told that at my age I still had the hearing of an 18 year old "that hadn't been to rock concerts". Say what. Yeah, there was already that category back then. They probably now include in ear buds. BTW despite the great hearing 20 years ago, I now also have age related male high frequency loss. I probably have better than average hearing for my age with the exception of the tinnitus, which from what I understand is not so much age related but more from environment.
I've never had the sharp bursts the OP had. Mine is pretty constant. For a while I thought there would be an opportunity for a device that operates on the principal of noise canceling headphones. Take the reciprocal sine wave of what's in your ear and..... it's in your ear stupid, how can any machine know what the opposite is??? OK so it's permanent.
About it being related to other hearing loss, I'll pass this on. Awhile back someone linked a site that had a hearing test on it. So we were all reporting back how we did. Well my wife has two notches up on me, sex and age. So I invited her to take the test also. Hmm, tinnitus and all, I topped out at around 15khz and she at around 14khz. Don't forget these test tones would be at a higher SPL than residual tinnitus.
OK enough of the anecdotal stuff. Ambient noise and the tricks the brain administers are enough to mask tinnitus most of the time, at least in my case. But I can tell you my wife is listening to Boz Scaggs in the other room right now and it's not louder than the ringing in my ears. This audio hobby leads me to think it's in the 8-12khz range. It's definitely high pitched only. And forever more.
SEE A PRO.
Especially if you're a 26 year old male and think hearing tapering off at 8khz is normal!!!!!

The sound masking devices work in quite environments. I have one on my iPod Touch called Sleep Machine.
Patrick

How does this audio hobby lead you to think it's in the 8-12khz range? Anyone can get tinnitus with or without hearing loss and the pitch and sounds can vary regardless or the frequency or loss/no loss in hearing. Tinnitus can be from a multitude of things.
post #215 of 253
Quote:
Originally Posted by asere View Post

How does this audio hobby lead you to think it's in the 8-12khz range? Anyone can get tinnitus with or without hearing loss and the pitch and sounds can vary regardless or the frequency or loss/no loss in hearing. Tinnitus can be from a multitude of things.

He clearly stated he had consulted a professional ..
post #216 of 253
Quote:
Originally Posted by mgkdragn View Post

He clearly stated he had consulted a professional ..

I know he saw a pro. I guess I was trying to figure out if he thought he damaged his hearing from this hobby besides his work.
post #217 of 253
Quote:
Originally Posted by asere View Post

I know he saw a pro. I guess I was trying to figure out if he thought he damaged his hearing from this hobby besides his work.

In many cases, the cause cannot be definitely traced to anything .. even common aspirin can cause tinnitus .. smoking, hereditary, earwax blockage, head injury, etc .. exposure to loud noise is not always a factor ..

http://www.mayoclinic.com/health/tinnitus/DS00365/DSECTION=causes
post #218 of 253
Quote:
Originally Posted by mgkdragn View Post

In many cases, the cause cannot be definitely traced to anything .. even common aspirin can cause tinnitus .. smoking, hereditary, earwax blockage, head injury, etc .. exposure to loud noise is not always a factor ..

http://www.mayoclinic.com/health/tinnitus/DS00365/DSECTION=causes

I hear you. I still wonder what the heck caused mine. I just turned 40 with normal to mild loss.
post #219 of 253
Quote:
Originally Posted by asere View Post

I hear you. I still wonder what the heck caused mine. I just turned 40 with normal to mild loss.

I spent years running sound for large concerts .. played in a rock band .. all way before hearing protection was common .. I'm 65 and have had it for 35 years .. but I'm pretty sure I know what caused mine .. eek.gif
post #220 of 253
This thread make my tinnitus worse eek.gif Plus I have some hearing loss at age 39. Yes, and have run heavy equipment, gone to concerts, and have been in this hobby for 25 years. BUT, my other two brothers have tinnitus, including my mother. Maybe it's the aliens trying to block out their communications to the secret government biggrin.gif
post #221 of 253
I have been using hearing adds since the Viet Nam war and without them there is a little hi pitched sound that to me sounds like standing in a hallway with the wind blowing down it. That's what it sounds like to me. Years ago in the 60's I called it the sound of silence. Back then the term rock and roll had nothing to do with music.
post #222 of 253
Quote:
Originally Posted by KBMAN View Post

This thread make my tinnitus worse eek.gif Plus I have some hearing loss at age 39. Yes, and have run heavy equipment, gone to concerts, and have been in this hobby for 25 years. BUT, my other two brothers have tinnitus, including my mother. Maybe it's the aliens trying to block out their communications to the secret government biggrin.gif

LOL! Have you seen the movie Dark Skies? They mention that one sign that the aliens are coming for you is that your ear hisses. My wife and I watched that film and with that line we looked at each other and laughed.
post #223 of 253
Quote:
Originally Posted by KBMAN View Post

This thread make my tinnitus worse eek.gif Plus I have some hearing loss at age 39. Yes, and have run heavy equipment, gone to concerts, and have been in this hobby for 25 years. BUT, my other two brothers have tinnitus, including my mother. Maybe it's the aliens trying to block out their communications to the secret government biggrin.gif
You mention your 2 brothers and mother have tinnitus. I wonder if this pattern is hereditary.
post #224 of 253
Quote:
Originally Posted by asere View Post

How come some people need a fan or machine to go to sleep? Is it because the tinnitus is too loud? If you need a fan or machine to sleep is the tinnitus considered moderate or severe?
For me, it's not for drowning out the tinnitus. As other folks have mentioned, I find it soothing. I guess I've gotten accustomed to white noise (fan or a/c) while sleeping. The white noise is mostly to drown out other sounds that would wake me.

Somehow, somewhere between graduating high school and my first year of college, I transitioned from being a very heavy sleeper who could (and did) routinely sleep through 3 separate alarm clocks (including the old school type with 2 bells that sounded like a fire alarm) AND a car crash outside my window, to becoming a super light sleeper who is awakened by every soft noise.

I've tried using NRR 33db earplugs and while they help muffle soft noises, the increased quietness means ANY sound that gets through will wake me up. I've found the Ecotones rain storm setting at max level helps because the random sounds (thunder, rumbling, increasing wind etc.) trains my brain to expect random sounds and thus ignore them more effectively.

As we all know, tinnitus is comparatively loudest when ambient noise is lowest, but I'm so accustomed to tuning it out, sleeping with earplugs is no problem. I just find that I get awakened by random noises less often with the rainstorm setting than with the earplugs.


Max
post #225 of 253
Quote:
Originally Posted by djbluemax1 View Post

For me, it's not for drowning out the tinnitus. As other folks have mentioned, I find it soothing. I guess I've gotten accustomed to white noise (fan or a/c) while sleeping. The white noise is mostly to drown out other sounds that would wake me.

Somehow, somewhere between graduating high school and my first year of college, I transitioned from being a very heavy sleeper who could (and did) routinely sleep through 3 separate alarm clocks (including the old school type with 2 bells that sounded like a fire alarm) AND a car crash outside my window, to becoming a super light sleeper who is awakened by every soft noise.

I've tried using NRR 33db earplugs and while they help muffle soft noises, the increased quietness means ANY sound that gets through will wake me up. I've found the Ecotones rain storm setting at max level helps because the random sounds (thunder, rumbling, increasing wind etc.) trains my brain to expect random sounds and thus ignore them more effectively.

As we all know, tinnitus is comparatively loudest when ambient noise is lowest, but I'm so accustomed to tuning it out, sleeping with earplugs is no problem. I just find that I get awakened by random noises less often with the rainstorm setting than with the earplugs.


Max
Yes, I find the sound of the rain and thunder to be the best setting and I use it every night except for the last two nights when it broke on me. I would turn it on and it would turn off in seconds. I called the company and they are the best. They are sending me a free sound card that most likely is faulty. Once I get it bring on the rain again.
I may only be speaking for myself and others might agree/disagree but sometimes just sometimes it is interesting listening to the tinnitus. Think about this we have no choice but listen to it (yes we ignore it but it is always there) and in listening to it sometimes the sound I hear which goes from a hiss, to a hum, to many sounds like a florescent light circuit.
For me as long as I stay busy it is easier to ignore but when it is semi quiet or totally quiet since I cannot ignore it as much I either think about other things or just sit and listen to it and see it as a nice medley.
post #226 of 253
I notice there is not that much tinnitus awareness. For example in the US alone there is about 50 million people with it but you don't hear much or anything about tinnitus.
post #227 of 253
Quote:
Originally Posted by asere View Post

I notice there is not that much tinnitus awareness. For example in the US alone there is about 50 million people with it but you don't hear much or anything about tinnitus.
That's because the ringing is making it difficult to hear anything else LOL smile.gif

I think folks are aware of tinnitus, but most don't take the steps to learn enough about it to prevent it, and I think that figure might even be a little low. There are a LOT of folks with tinnitus who a) haven't spoken to a doctor about it because they've just accepted it, or b) don't have any medical insurance so they've never spoken to a doctor about it.


Max
post #228 of 253
Quote:
Originally Posted by djbluemax1 View Post

That's because the ringing is making it difficult to hear anything else LOL smile.gif

I think folks are aware of tinnitus, but most don't take the steps to learn enough about it to prevent it, and I think that figure might even be a little low. There are a LOT of folks with tinnitus who a) haven't spoken to a doctor about it because they've just accepted it, or b) don't have any medical insurance so they've never spoken to a doctor about it.


Max
I know but even on tv you don't see commercials for treatment like for hearing aids for white noise or trt or anything for at least the slightest improvement.
post #229 of 253
Thread Starter 
Quote:
Originally Posted by asere View Post

I know but even on tv you don't see commercials for treatment like for hearing aids for white noise or trt or anything for at least the slightest improvement.


That's a good point, you think there would be all kinds of commercials for treatments whether they work or not.
post #230 of 253
Quote:
Originally Posted by djbluemax1 View Post

That's because the ringing is making it difficult to hear anything else LOL smile.gif

I think folks are aware of tinnitus, but most don't take the steps to learn enough about it to prevent it, and I think that figure might even be a little low. There are a LOT of folks with tinnitus who a) haven't spoken to a doctor about it because they've just accepted it, or b) don't have any medical insurance so they've never spoken to a doctor about it.


Max

I can tell you for sure that I had no idea it even existed. Had I known, I would have done things much differently. I didn't hear about it until it was too late. I've had it for a few months now, and at first I thought it would drive me insane, but thankfully, it seems to "come and go" in it's intensity and most of the time I'm not conscious of it. Thank God.., cuz when it first happened I was VERY disturbed by it. I felt like the biggest idiot on the planet ... I WISH to God someone had warned me this could happen. One reason I participate in threads like these. To raise awareness.
post #231 of 253
Quote:
Originally Posted by carp View Post

Quote:
Originally Posted by asere View Post

I know but even on tv you don't see commercials for treatment like for hearing aids for white noise or trt or anything for at least the slightest improvement.


That's a good point, you think there would be all kinds of commercials for treatments whether they work or not.
There are 2 issues here, the first being that 1) there are many possible causes for tinnitus, both temporary and permanent, and 2) there really isn't much out there that can actually do anything about permanent tinnitus.

As far as TV commercials about treatments for tinnitus, due to it being a medical condition, any device/treatment for tinnitus that wants to make any claims about medical effectiveness needs to be FDA approved, otherwise they can be sued. Sure there are things out there that claim effectiveness in treating tinnitus, but most of them don't have FDA approval. You can bet that anyone who would spend the amounts it takes to advertise on national TV is going to end up getting sued for not living up to their claims due to issue #2 above.


Max
post #232 of 253
Quote:
Originally Posted by djbluemax1 View Post

There are 2 issues here, the first being that 1) there are many possible causes for tinnitus, both temporary and permanent, and 2) there really isn't much out there that can actually do anything about permanent tinnitus.

As far as TV commercials about treatments for tinnitus, due to it being a medical condition, any device/treatment for tinnitus that wants to make any claims about medical effectiveness needs to be FDA approved, otherwise they can be sued. Sure there are things out there that claim effectiveness in treating tinnitus, but most of them don't have FDA approval. You can bet that anyone who would spend the amounts it takes to advertise on national TV is going to end up getting sued for not living up to their claims due to issue #2 above.


Max
that is all true but the same time there would be devices FDA aproved if the awareness was there. They don't have to prove it works but with patient claiming it helps that is a start. How about having commercials for cognitive and tinnitus retraining therapy so people can be more aware to get treatment.
post #233 of 253
Quote:
Originally Posted by bareyb View Post

I can tell you for sure that I had no idea it even existed. Had I known, I would have done things much differently. I didn't hear about it until it was too late. I've had it for a few months now, and at first I thought it would drive me insane, but thankfully, it seems to "come and go" in it's intensity and most of the time I'm not conscious of it. Thank God.., cuz when it first happened I was VERY disturbed by it. I felt like the biggest idiot on the planet ... I WISH to God someone had warned me this could happen. One reason I participate in threads like these. To raise awareness.
Unfortunately, it's something that many, many folks tend to gloss over until they're afflicted by it. Once you HAVE it, you notice how often references are made to it, whether it's in a list of potential side effects for certain medications advertised on TV, or the mention of potential hearing damage with any headphones/earbuds iPod items etc.

My parents were aware of potential dangers back in the 80's when my brother and I first began using earbuds with Walkman portable cassette players (remember those things? LOL. Even before the Discman and way before MP3 players). They always warned us to keep the volume down. Earbuds and headphones weren't what caused my tinnitus though. If I had to try to recall, I would say it was probably 3 incidents that did the most damage: 1) firing guns (and especially a snub-nosed .357) with no hearing protection when I was ~13 that left me with ringing in my ears and muffled hearing for 2-3 days, 2) having a firecracker go off less than a foot from my ear that left me deaf in that ear for 2 days (I seriously thought that I was permanently deaf in that ear for those 2 days, and was afraid to tell my parents), 3) a nightclub that had the music blasting so loud that it left my ears ringing and hearing muffled for a couple of days.

Through all that (especially the firecracker that left me deaf in my right ear for 2 days), I'm actually amazed that I still have the hearing that I do.


Max
post #234 of 253
Quote:
Originally Posted by djbluemax1 View Post

Unfortunately, it's something that many, many folks tend to gloss over until they're afflicted by it. Once you HAVE it, you notice how often references are made to it, whether it's in a list of potential side effects for certain medications advertised on TV, or the mention of potential hearing damage with any headphones/earbuds iPod items etc.

My parents were aware of potential dangers back in the 80's when my brother and I first began using earbuds with Walkman portable cassette players (remember those things? LOL. Even before the Discman and way before MP3 players). They always warned us to keep the volume down. Earbuds and headphones weren't what caused my tinnitus though. If I had to try to recall, I would say it was probably 3 incidents that did the most damage: 1) firing guns (and especially a snub-nosed .357) with no hearing protection when I was ~13 that left me with ringing in my ears and muffled hearing for 2-3 days, 2) having a firecracker go off less than a foot from my ear that left me deaf in that ear for 2 days (I seriously thought that I was permanently deaf in that ear for those 2 days, and was afraid to tell my parents), 3) a nightclub that had the music blasting so loud that it left my ears ringing and hearing muffled for a couple of days.

Through all that (especially the firecracker that left me deaf in my right ear for 2 days), I'm actually amazed that I still have the hearing that I do.


Max
that's true and all we can do now is manage and know we are still blessed. There are many things worse out there. I work in a pediatric hospital and there are sad cases daily. I remember you once told me I would get used to the tinnitus. I'm getting there!
post #235 of 253
Quote:
Originally Posted by asere View Post

Quote:
Originally Posted by djbluemax1 View Post

There are 2 issues here, the first being that 1) there are many possible causes for tinnitus, both temporary and permanent, and 2) there really isn't much out there that can actually do anything about permanent tinnitus.

As far as TV commercials about treatments for tinnitus, due to it being a medical condition, any device/treatment for tinnitus that wants to make any claims about medical effectiveness needs to be FDA approved, otherwise they can be sued. Sure there are things out there that claim effectiveness in treating tinnitus, but most of them don't have FDA approval. You can bet that anyone who would spend the amounts it takes to advertise on national TV is going to end up getting sued for not living up to their claims due to issue #2 above.


Max
that is all true but the same time there would be devices FDA aproved if the awareness was there. They don't have to prove it works but with patient claiming it helps that is a start. How about having commercials for cognitive and tinnitus retraining therapy so people can be more aware to get treatment.
No, FDA approval requires testing to prove that something can do what it claims to medically do. Patient claims aren't enough, and FDA testing/approval is EXPENSIVE. As for commercials for cognitive retraining therapy, it's all about cost vs benefit. The treatment enters that do this don't see a sufficient cost-benefit ratio to pay for national advertising, and no one sees any monetary benefit to paying for ads to raise awareness about tinnitus. The only folks who have a potential to make money off increasing the awareness of potential hearing damage are the folks making hearing protection, but the simple truth is, these companies make the majority of their profit from commercial sales where OSHA and NIOSH mandate requirements and education. If a company placed an ad selling hearing protection targeted at every day consumers, talking about using hearing protection for everyday activities like mowing the lawn, using power tools at home etc., the typical average Joe who isn't already suffering from obvious hearing damage and tinnitus will simply gloss over it and the potential increase in revenue probably isn't going to justify the costs to the hearing protection manufacturer. It's like increasing your costs by 15% to try to snare a group that accounts for 2% of your sales


Max
post #236 of 253
Quote:
Originally Posted by djbluemax1 View Post

No, FDA approval requires testing to prove that something can do what it claims to medically do. Patient claims aren't enough, and FDA testing/approval is EXPENSIVE. As for commercials for cognitive retraining therapy, it's all about cost vs benefit. The treatment enters that do this don't see a sufficient cost-benefit ratio to pay for national advertising, and no one sees any monetary benefit to paying for ads to raise awareness about tinnitus. The only folks who have a potential to make money off increasing the awareness of potential hearing damage are the folks making hearing protection, but the simple truth is, these companies make the majority of their profit from commercial sales where OSHA and NIOSH mandate requirements and education. If a company placed an ad selling hearing protection targeted at every day consumers, talking about using hearing protection for everyday activities like mowing the lawn, using power tools at home etc., the typical average Joe who isn't already suffering from obvious hearing damage and tinnitus will simply gloss over it and the potential increase in revenue probably isn't going to justify the costs to the hearing protection manufacturer. It's like increasing your costs by 15% to try to snare a group that accounts for 2% of your sales


Max
you couldn't have said it better. The hearing aid company would loose too much if everyone was proactive.
post #237 of 253
Quote:
Originally Posted by asere View Post

I use a sleep machine but not so much for the tinnitus but because like you said it is soothing. I think for most people a tv on or noise machine is soothing regardless whether the tinnitus is mild or severe.
I use an iPhone customizable storm app that's hooked up wirelessly to a speaker at the the other side of the room. I can make the storm/rain/lightning/thunder just how I want, and it helps hide the tinnitus. I even take it on vacations because I can't deal without it. I wish I'd never gotten into this hobby. Never did anything else to abuse my ears.
post #238 of 253
Quote:
Originally Posted by sb1 View Post

I use an iPhone customizable storm app that's hooked up wirelessly to a speaker at the the other side of the room. I can make the storm/rain/lightning/thunder just how I want, and it helps hide the tinnitus. I even take it on vacations because I can't deal without it. I wish I'd never gotten into this hobby. Never did anything else to abuse my ears.
did you always listen loud?
post #239 of 253
Today I was watching a movie on tv and when a music bass scene came on I could only hear/feel the bass only out of one ear. Has this happened to anyone before and is it because of tinnitus?
post #240 of 253
Quote:
Originally Posted by asere View Post

Today I was watching a movie on tv and when a music bass scene came on I could only hear/feel the bass only out of one ear. Has this happened to anyone before and is it because of tinnitus?
Doesn't sound like a tinnitus related occurrence.

2 possibilities:
A) it's occasionally possible to have one ear in a null at certain frequencies. Easiest way to see if that's it is to move your head around.
B) even more common is to get one ear's pressure unequalized, which will leave it sounding 'off' till it 'pops'. I get that every once in a while, just from swallowing or occasionally while turning my head. A couple of deep yawns and I'm good.


Max
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