Hi Dr. Nagler, I was here earlier complaining of anxiety and noise sensitivity. I saw a specialist at the Cleveland Clinic and he suggested I see a TMJ specialist because of occasional jaw pain. I finally went earlier this month and have been diagnosed with it and even saw a second opinion. I am seeing a physical therapist for it because I can't afford the huge bill for splint therapy.
When you saw people at your clinic complaining of noise sensitivity and they have TMJ, did TMJ therapy helps noise sensitivity sometimes and/or did sound therapy help? Is there a difference between TMJ-related noise sensitivity and non-tmj noise sensitivity?
I also have bad toothaches that need to be fixed, but I am afraid because of my jaw and the noise involved. Can a noise sensitive person get dental work done without fear of worsening of the symtoms?
I have been seeing a CBT guy and he helped me greatly, but I had to stop seeing him because I live in Michigan and can no longer afford insurance. Any help is appreciated.
Are you using any type of sound enrichment? One thing that really struck me when I started listening to a cd filled with some soothing sounds of nature, (well over a year ago) - was that my mind kind of calmed down - I put that cd on the stereo, on very low volume, (because I was so sensitive to sounds) and sat in another room,and felt my mind relax- and back then even though so many sounds were bothersome to me- I found that nature cd calming, and relaxing- (it probably helps that I like nature) But it also makes me think - that when we are anxious,or stressed about something- maybe what we listen to, can have a calming effect on us? (If we find something that is pleasing, to us and easy on our ears?) Weather someone has tinnitus, or hyperacusis or not - The world is stressful enough these days, To find some things that are calming, and pleasing to listen to- that sound good to me, really has been, and is, music to my ears. And to find they can create a calming atmosphere, is welcome as well. (Of course it depends what I listen to, but I find some things are really calming and inspiring-and beautiful- and for me - that helps. In more ways than one.)
i purchased one of those noise generators, has settings like waterfalls, rain, evening, morning, waves etc.. and thats been a life saver for me
Can you please let us know which one you have? And does the volume go down fairly low (really low?) on it? I have heard that with some of them the volume does not go low eneough for people that are extremely sensitive to sound- so that is why I ask. Thank You.
i've tried quite a few, and the ones that i'm satisfied with are the i-spa's by
Homedics. The best one i've used is http://www.homedics.com/products/sensory/soundspa-with-ipod-dock.html, It's got alot of volume degree's and can go quite low. The sounds are (ocean, rain, night, waterfall, brook, and sunrise) and my favorite thing about this model is that you don't hear the electronic current nearly as much as other models. (that could just be me though, anything electronic peirces my ears with my hyperaucus) This one is my least favorite, http://www.homedics.com/products/sensory/soundspas/soundspa.html each volume notch goes up quite a bit, so even the lowest setting could be too much. When i used this one i kept it quite aways from my bedside table, so its not good incase you want to turn it off or switch the sounds to trick your ears during bad spikes because its so far away. (once again thats just me) The one i currently have in my bedroom at home is http://www.homedics.com/products/sensory/soundspas/soundspa-fusion-new-ipod-nano-colors.html This one is similar to the first, its got FM radio, the same sounds (ocean, rain, night, waterfall, brook, and sunrise), and had alot of volume options. The only poor thing with this one in my opinion, is that if you are super sensitive and have the volume on 1, you'll hear the electronic static. Lately my T is very loud and extremely sharp, so i have it on a vol. that the electronic static doesnt even matter anymore lol I hope this helps. For me, if it werent for these i'd never sleep. So they've helped a great deal
Hello Randolph -
I went down the TMJ avenue to the tune of thousands of dollars for a custom splint and all sorts of sophisticated scans and tests. Didn't help. The guy came highly recommended. I don't know if my particular issue isn't due to TMJ or what, but I would be cautious about spending big dollars in that area. Perry
Thanks for information :-) and your descriptions! How do the nature sounds on those sound to you? Are they pleasing? Or do you listen your ipod through it somehow? You mention hyperacusis- Have you been able to recover your tolerance to sounds as time goes by?
the nature sounds are actually pretty good on the 2 models i recommended. They don't sound static-y or ridiculously fake. The rain, ocean wave and waterfall are recorded fairly well so that you can't hear where it "loops", like with other cheap machines.. because if you know where it loops, you'll just start focusing on that and it becomes annoying.
They are pretty pleasing and not annoying to others, i chose this device because my gf even finds it soothing, whereas some cheaper models actually annoyed her and kept her up. I took this on a vacation and even my family found it a soothing sound to sleep too... so if you sleep with someone, its good to know your not inconviening them. The sounds are options through the actual machine, and if you like you can connect your ipod to the top and play your playlists through it. So if you like to listen to music while you fall asleep you can, and if you want you can hit a timer so that it shuts off after 15,30,45 and 60 minutes. As for my h/a, i've become increasingly more sensitive as time goes by. From when i first noticed my t and developed h/a, to now.. is completely exacerbated by certain external noises. I just avoid bars, concerts and listening to loud music. Even if i were to listen to my ipod, i listen to it on the lowest setting and even then sometimes i just shut it off because its too much. But its important to keep your chin up, i try not to dwell on it and just focus on living a happy life w/ t, not around it. i hope that helps
Nothing to do with TMJ here, but Thatch brings up an interesting point.
QB asks if he has recovered his tolerances over time.
His reply is no -- in fact his tolerance has dropped.
So what's the diff? Under what circumstances does hyperacusis get better and under what does it get worse? If Thatch is doing sound enrichment, why is his hyperacusis getting worse and not resolving? Where's the line between noise that builds one's tolerance and noise that sets one back?
Of course, we don't have complete information here, so there must be more about Thatch's individual situation that we don't know.
My own view is that sound that is "too much" (meaning too loud, too high-pitched, too long in duration) for the individual makes it worse.
Peach posted [in part]:
Under what circumstances does hyperacusis get better and under what does it get worse? .............. I have thought a lot about this particular question over the years. And I have come to the conclusion that hyperacusis always improves with desensitization unless the hyperacusis is due to a neurological lesion like in Lyme disease, which is relatively rare. In my opinion if a person's hyperacusis is not improving with "sound enrichment," then either the sound enrichment is not being used as effective desensitization ... or that person's sound sensitivity is due to hyperacusis AND another problem that has not been properly diagnosed (like misophonia, for instance) - and the lack of improvement is due to the undiagnosed (and therefore untreated) component. smn
You wrote- My own view is that sound that is "too much" (meaning too loud, too high-pitched, too long in duration) for the individual makes it worse. I have gotten setbacks from sounds that others would think would not "harm" the ears, or hearing- And have come to think that the terminology may make a lot of difference. Maybe it did not really "harm" my ears- but it sure as heck caused my hearing to get more sensitive. (and at times for quite awhile) As time goes by and my sensitivity levels change, (Thankfully for the better) I have learned that I need to - for myself- let more sound in- some sounds that used to be a problem for me- no longer are- even though I may not enjoy the sound- it may no longer cause a setback- FOR ME. Like the sound of a distant lawnmower. But it is a balancing act at times to figure out what I can tolerate, and what I can not- and it can vary from day to day. And like you mention- I think the amount of time the sound continues, or that I am exposed to some sounds - can also make a difference - FOR ME. I am not a doctor,and am not in the medical field - all I have is my own experience to go by- and am I am just thankful, and grateful, that I have found some things that are helping, for me. And For Me - that includes, allowing in some sounds that I would not have been able to, to start with. And also being careful. (It does not mean I throw caution to the wind- I take small steps- and started out with some very small ones - and with each small step, that I see I am OK- it gives me more confidence.) And lets me know that some things that used to be a problem for me soundwise- are not so much of a problem for me these days. It has taken a long time for me, to go from "hiding" from noise - like an airplane flying over- to allowing SOME of the sound in- depending on how loud, and how near the plane is. If I am outdoors, filling the birdbath - I may still seek shelter- in my garage when a loud plane goes over, but I MAY also allow some of the sound in, before I do that- it just depends - also I may cover my ears with my hands, easier for me as it is only one ear that is really sensitive - Or I may raise my arm, curving my arm around around my head - in a way that I can protect that ear with my shoulder - before the plane gets too close, because when it gets closer it is louder Like I said- for me it is a balance. And it can depend, on how my hearing is doing on a given day, and some other factors. But allowing some of those sounds in-- did not come easy-- I started out with a second or two at a time. As I keep saying we are all different, and I can't really say what is right for anyone else- all I know is what I have found helps for me. And for me I think it is not just one thing, but many. And I think if I had kept on hiding from ALL the sounds that used to cause me problems- they still might. Because along with the other things I am doing- I think FOR ME - allowing those sounds in, a bit at a time is also is helping me to build tolerance to those particular sounds. Of course I really LOVE what I am doing in some other ways, that are helping my tolerances as well- listening to music - certainly is A LOT more pleasurable than tolerating the sound of a distant lawnmower! I never heard a lawnmower, that can sound as pretty as Simon and Garfunkel can- when they sing Scarborough Fair (which I had been unable to listen to - for a long time. Even after I started listening to music again - like other sounds, some selections were more tolerable than others - and it is only VERY recently, that the song I mention, actually sounded beautiful to me again.) (edited by aQuieterBreeze)
Thanks again for your informative reply about the sound machines! It is very much appreciated :-) you also mentioned- As for my h/a, i've become increasingly more sensitive as time goes by. From when i first noticed my t and developed h/a, to now.. is completely exacerbated by certain external noises. I just avoid bars, concerts and listening to loud music. Even if i were to listen to my ipod, i listen to it on the lowest setting and even then sometimes i just shut it off because its too much. Do you use earplugs, or other hearing protection, alot? I have heard that some people tend to over-rely on hearing protection, and use it at times it is not really needed, and I have read that doing that, can make us even more sensitive to sound. I feel lucky I never really over relied on hearing protection. Though when I need it I will use it.) As far as the ipod, I don't have one of those- but some have mentioned that SOME of the formats used for some of the music people are listening to these days, may not sound as good to sensitive ears as if other formats are used. I don't know how much of a difference it makes for some people - but there is a thread on this board you may find interesting- as some of the articles explain a bit about those formats, and also some other things that have been happening with the way music is recorded these days. (Please be sure to turn your sound down or off before clicking on links from the articles in the following thread) http://www.websitetoolbox.com/tool/post/stringplayer/vpost?id=3009655 What have they done to the music? Also with the ipod- are you listening to it over your sound machine? Or using it by itself? With earbuds? I am still not ready to try headphones, and I do not know if I will ever try earbuds- I have read they sit closer to the eardrum- and for me - I would prefer to have at least a "little" more distance from the sound, so I would be more likely to try headphones one of these days- but we are all different- and many do like their portable music players. (And probably don't mind the earbuds) When I started listening to music again, after not doing so for a very long time, (due to my hearing being really sensitive)- some things I thought would sound fine to me - and be easy to listen to- were not. And what I could listen to - really surprised me. I am only now beginning to be able to listen to (and enjoy!)some of the things that I had tried and not been able to tolerate - last Dec. and you say- But its important to keep your chin up, i try not to dwell on it and just focus on living a happy life w/ t, not around it. That is a really nice thought- Enjoying what we can, and being happy for what we are able to do, instead of focusing on things we can not do - (or can not do yet)- can make a huge difference.
while i sleep i dont use my ipod, i just use the sounds from the machine. But i do use earbuds to listen to music while i rollerblade in the summer. With all the other external sounds around me (cars, wind, the pavement) they dont bother me at all and my mind can actually relax and not focus on the t, its very relaxing.
I don't wear earplugs at all, sound is healthy for the ear and i've never deprived it of that. I just make an effort to avoid really loud environments and if im around something loud (like a fire alarm), i just cover my ears till its over.. other then covering my ears durin brief things like that i dont protect them with plugs or covers. and pt, i do use sound enrichment, and over time i do find myself being more sensitive to sounds.. however i never said my tolerance decreased.. if anything i think its greatly greatly increased. If i think back to when i first got t, and knowing what i thought about it then ( i thought it was insane, and loud) compared to now, well if i had todays t then, i'd probably go insane and self destruct. When i look at how loud it is now, and how im actually coping with it better, i know my tollerance has increased 10-fold. Like alot of us i went through an episode of depression when coming to terms with this disorder, but as soon as i moved passed the depression, and began to be greatful for what i do have in life, i found that i tolerated this so much better. I'll tell you guys this, and you can take it for what its worth, this view and attitude is what helps me carry on: I work as a paramedic, and theres not a week that goes by where i dont get a call to a nursing home, where my patient sufferes from MS, ALS or very severe and aggressive dementia. I see these ppl suffer, trapped in shells of a body, and not just in they're 80's, lots in they're 40's and 50's. Most can't talk, others can't even control they're eye lids anymore.. living in a world of darkness for 10-20 years sometimes. Wondering, who's rolling me? who's moving me, who's wiping my bum and who's shoving that damn catheter in me so hard again. Some of they're minds still work, they are aware of whats going on, they just can't say anything, even though they'd probably sell they're very soul just to scream sometimes. My neighbor is 27 years old and has MS, and 2 years ago he was shootin hoops on his drive way, the guy could probably outrun me. Today he's in a wheelchair, he can't move his hands, feed himself, take himself to a bathroom. He's 27 and he gets hoisted up twice a day to go to the bathroom and someone has to wipe his own bum. Can you fathom that loss of control? He wont even live to see his 30's they say. And you dont go gentle into that good night, its a slow, torturous, agonizingly slow and dragged out way to go. I look at these ppl, and i think that if all i ever have to deal with, is this ringing, a noise that can compare to a leer-jet at times, that i am lucky. I can still walk, run, make my meals, watch tv, go out on the town, i can swim, play sports, have a beer with the guys, and make love to my gf. We may live in a loud, very annoying world, filled with countless sleepless nights and days that you wish you never woke up too sometimes because the noise is so loud... but we still were able to crawl into our beds by ourselves, and get out by ourselves, and be in command of our day and our bodies. Like i said, that thought may not be for everyone, and some may strongly disagree... but this is just what helps "me", a great deal. For those interested, i recommend reading a book called "Tuesdays with Morrie" by Mitich Albom, its a great book if you want to appreciate what we do have.. and its a book on how your attitude is everything, no matter what troubles you face.
I may have misunderstood you, when you said you were more sensitive to sounds- I am glad to hear that over time your tolerance to sounds has increased. you mentioned- i do use sound enrichment, and over time i do find myself being more sensitive to sounds.. however i never said my tolerance decreased.. if anything i think its greatly greatly increased. If i think back to when i first got t, and knowing what i thought about it then ( i thought it was insane, and loud) compared to now, well if i had todays t then, i'd probably go insane and self destruct. When i look at how loud it is now, and how im actually coping with it better, i know my tollerance has increased 10-fold. (Do you mean that sounds that used to sound loud, other than your T - sound less loud? Or do they sound louder?) Everyday sounds seem less loud to me these days, and though I still have a long way to go- I have wondered if being more sensitive to sound, may be part of what has allowed me to pick up and notice some of the very beautiful nuances in music- that I never noticed before, and very truly appreciate. (Or it could be that I quit listening to music for so long? Or a combination? Doesn't really matter- what matters to me is that some of it sounds so nice- to my ears.) It's curious how we can look at things in life from different angles sometimes- and it can make a world of difference, in our own worlds. What you have written reminds us- It is good to remember what we have, and count our blessings. Randolph- Sorry for the side track in this thread, are you still there?
QB wrote [in part]:
Everyday sounds seem less loud to me these days, and though I still have a long way to go- .......... To QB: May I ask ... What is your goal, what specifically are you doing to achieve it, and how will you know when you are there? smn
I was not ignoring your other recent question (to me) on the board- just trying to figure out exactly how, and the best way - to reply- as that one is a somewhat "generic question" - as I was not thinking only, or mainly - about my own situation- but others as well. So now you leave me with a few good questions to consider- please do not think I am not doing that, even if my reply takes a little while. Thank you. The short answer to part of your question in this thread- My goal is to get better and to recover as much as possible, I have already surpassed what I had once thought was possible, and that shows me- that I do not want to set limits - on how much recovery and improvement I may be able to experience. I am one of those people that actually believes, so much is possible. And I also think - how we think about things can influence so much of our lives. And I think sometimes one of our own limitations can be, what we think it is not possible, so I prefer to think about what is possible. And at this point - I don't want to set limits on it. I will be back a bit later with more of a reply, thank you for you patience.
When I mentioned what I did about sounds sounding less loud - Everyday sounds seem less loud to me these days, and though I still have a long way to go- They do- in general- and most of the time- but not always, and I do still have a long ways to go - They used to sound incredibly Loud to me- so less loud is wonderful. It almost feels like someone is slowly turning down the volume on the rest of the world, finally- it is to a reasonable level in some cases, (most times these days I can be in the grocery store I go to and everything sounds pretty "normal" )- But on another day, if my hearing is a bit more sensitive - the coolers and the music playing, and other sounds, still sound louder. And another store may have different acoustics, and sound levels, and seem louder still as well. But more is tolerable to me than it used to be. But there are also some sounds that though they may not seem quite as incredible loud to me, as they used to be - are still very difficult (and like other sounds those can sound louder to me from one day to the next) - like some motor type sounds- such as yard care or construction equipment. And even my refrigerator which is sometimes more bothersome to me than other times- sometimes it still depends on how close i need to be to it- and for how long, while it is running, how long i can handle it. (Sometimes it is still difficult to be in the kitchen while it is running.) And there is a point still with some sounds where too much is still too much for me to handle, and that point can vary from one day to the next - and what sounds ok one day, may not the next. But there are more days where I can handle a whole lot more than I used to, and sounds seem less loud in general- but it still goes back and forth. But the "good days" are outnumbering the not so good (and the not AS good days) - these days. And some days? It seems like I can turn the music up a bit more- and/or maybe try something more energetic or challenging to listen to - and I do that on those days. And some days- seem not just like a good day - but a "better" day. That is a bit hard to describe, but maybe you could say that on those days- I could turn the volume on the tv or stereo up a bit more - and perhaps handle more than usual in the way of what ever sounds come my way. (I look forward to more of those days :-) But most of the time recently - when I do turn my stereo up a little more than I normally listen to it- I seem to notice the percussion more again, than if the volume is down a little more - (like within the range where I normally listen to the music) And that percussion usually sounds more pronounced to me than it should. (Though on one of those "better" days it may sound ok) I still listen to the music on my stereo, over external speakers- and though I no longer listen on the barely audible levels I started out with- I have not been real focused on the volume for the most part - but generally stay within a comfortable range for that. (though there are times on really good days where I have Carefully and Cautiously tried to see how loud I could listen to something, and been surprised.) The other night my hearing got more sensitive, (It was that way before I even started listening to music that night, so I opted for more gentle selections and a lower volume) and it settled down some before I went to sleep - but when I woke up it was much worse. My hearing was more sensitive and I noticed some pain- I wondered why until I opened my front door and heard the sound of what sounded like a high pitch whine of a large table saw. (the sound was coming from down the street) So I closed the door - put my cd of nature sounds on the stereo on low volume for background sound, listening to it for a bit and then went about my day, and hoped that my hearing would settle back down- I did not worry about it much - I just hoped it would settle down enough so that when I went to vote the following day, I would not risk a further setback. I listened to softer music, on a lower volume that night, and when I woke up in morning- I was happily pleased - that my hearing had settled down, even more than I had expected!- I put on that nature cd again, (though I usually start my days with music, these days) - and as the day went by my hearing settled back down more. I was even able to cope with some sounds, from someones else's car stereo in a parking lot better than I would have expected- I was on foot heading for my car and they were driving in - thankfully we were going in opposite directions. And though THANKFULLY they did NOT have the stereo cranked up that loud, they did have those "kicker speakers" - I covered my ears, and made as fast tracks away as safely possible - and hoped for the best. I had to turn my car radio down quiet a bit for my drive home. My sensitivities to sound thankfully settled back down, at least for the most part - quite awhile after I got home. And last night i was able to listen to the softer music that i choose of certain cds and was fine with that- the more energetic stuff was more difficult though. Anyway- early this morning, yard crews showed up out back- stayed for hours, and then showed up next door and stayed for a long time - and nice days bring neighbors out all doing things in their yard with very loud equipment - like leaf blowers. Thankfully it no longer stays light until after 9 like it does in the summer- and when the sun goes down the loud lawn machines must go to sleep or something :-)- I am very grateful they do not do that stuff after dark- usually-though I have had a neighbor mow using the headlights on his lawn tractor a time or too. And sometimes it all gets to be a bit much still- my ears/hearing gets more sensitive- and on a day like today- when I would love to call some people and talk to them - I know I am better off to wait. The effects on my hearing seem to be cumulative sometimes, so i am better off to let my hearing settle back down- before doing something else that may likely aggravate it more. And conversations over the phone are still one of the things that i usually have to limit - timewise- even on pretty good days. )it all depends on the day- how my hearing is doing- the phone line connection- voices of who i am talking to - it all varies -(normally - I can spend more time on the phone than i used to be able to- but in a more sensitive state- talking on the phone has been known many times to make my hearing even more sensitive - or cause a further setback, that lasts for awhile. And sometimes it can be hard to limit the time of those phone conversations. And tonight, is one of those times I don't think talking on the phone at all would be good for my hearing. I would also love to be able to go out and have dinner tonight with friends in an favorite restaurant and not have to wonder if I would get a setback from it - and not have the ambient sounds seem louder than they should. But that will have to wait. With my hearing being this sensitive- i would not enjoy it- and i would rather allow my hearing to settle down. But that is one of the things - i want to be able to do- one of these days- You asked about goals- that is one- to enjoy dinner out- with friends, any time i wish to do so. Without having to use hearing protection. And without getting a setback from it. And hopefully without having anything sound louder than it normally should. (in part because when i can do that- it will mean that many more things are also possible, and more moderate and moderately loud sounds - will sound less loud to me. ) But to have my hearing in general - settle down, quicker than it used too. and to have it, at least usually, take more in general- to make it more sensitive - is Wonderful. But I do still have a long way to go. Sorry for the delay, and this really long post - I will get to answering your questions soon.
Thanks for your detailed post, QB. What I really want to know is what
specifically you are doing in order "to be able to go out and have dinner ... with friends in an favorite restaurant and not have to wonder if [you will] get a setback from it - and not have the ambient sounds seem louder than they should." smn
Hi guys! Sorry to try to take this thread back to the original point, but I was wondering Dr. Nagler if my original questions could be answered.
It would be greatly appreciated! Randolph
Randolph, I apologize. I got into this thread a couple of days after it started and completely missed your initial post. Thanks much for pointing me to it.
You wrote: Hi Dr. Nagler, I was here earlier complaining of anxiety and noise sensitivity. I saw a specialist at the Cleveland Clinic and he suggested I see a TMJ specialist because of occasional jaw pain. I finally went earlier this month and have been diagnosed with it and even saw a second opinion. I am seeing a physical therapist for it because I can't afford the huge bill for splint therapy. When you saw people at your clinic complaining of noise sensitivity and they have TMJ, did TMJ therapy helps noise sensitivity sometimes and/or did sound therapy help? Is there a difference between TMJ-related noise sensitivity and non-tmj noise sensitivity? ............ I have seen numerous people over the years who have tinnitus (and/or hyperacusis) AND TMJ symptoms, like jaw pain. There are a number of human anatomical (i.e., cadaver) studies that have shown muscle/ligament/tendon/nerve associations between the TMJ (temporomandibular joint) and various outer, middle, and inner ear structures. I can see why an evaluation by a TMJ specialist might be recommended for jaw pain. On the other side of the coin, just because there are some anatomical correlations between the TMJ and the ear, that does not mean that if a person with an auditory symptom like tinnitus or hyperacusis also has a TMJ problem, the TMJ problem necessarily caused the auditory symptom. In fact, given that maybe 20% of the population has tinnitus to some degree or another and given that 5% of the population has TMJ symptoms, it stands to reason that when the two coexist, they might be causally-related ... but they might very well be related by coincidence only. To give you an idea where I am going with this, while I have never seen a study that looked at the incidence of auditory symptoms in the TMJ population vs the general population, if one were done I would bet that they would be equal. Put another way, in my entire clinical experience as well as through contact with numerous clinicians and patients since I first became interested in tinnitus over a dozen years ago, I am aware of only one individual whose auditory symptoms might have improved to some degree or another as the result of treatment directed towards the TMJ. (And that was an anecdotal report on a message board.) So what I generally tell folks who find themselves in situations like yours is to undergo treatment directed at correcting the TMJ problem ONLY IF they have non-auditory symptoms that are felt to be related to the TMJ and that are severe enough to warrant the TMJ treatment ... and they should consider any improvement in their auditory problem that might remotely result from TMJ treatment to be a bonus rather than a reason to have the TMJ treatment in the first place. ................ I also have bad toothaches that need to be fixed, but I am afraid because of my jaw and the noise involved. Can a noise sensitive person get dental work done without fear of worsening of the symtoms? ............. Generally, yes. And even if there is an exacerbation of symptoms (as might rarely be the case), things should settle back down within a week or two. If drilling is to be involved, be sure to follow Rob in Denver's suggestions. Again, sorry for the delay in responding. smn