Hi Dr Nagler, I was wondering if you could potentially help shed some light on what might be going on with my tinnitus as of late, or provide a few potential answers. I first noticed my tinnitus the day after my 20th Birthday, from going out to a uni nightclub. It wasn't the first time I went clubbing and neither was it the last. It shook me up for that day but I soon basically forgot about it, it was so quiet and I guess I habituated to it. It barely crossed my mind for 4 years. I continued going out to the occasional rave etc and listening to my mp3 player loads, but not as loud as I used to (back in High School one of my science teachers would always joke that I'd get tinnitus because I used to listen to my headphones so loud! Yikes!). In April last year I remember lying on a hotel bed in St Petersburg and noticing it, thinking 'Hmm my tinnitus has gotten a little louder'. I proceeded to turn down the level that I listened to music even more. However, I soon forgot about it and went out to a big London nightclub with some mates on Easter, I must have been on the dancefloor for around 8 hours. When we left the club that's when I noticed my ears were ringing a lot more aggressively than they sometimes did after a night out. After a while they settled down but my tinnitus was a lot louder than before, I'd notice it in bed etc, but still, everyday sounds would easily mask it (the fan on my laptop, the water pipes in my flat etc). I went days when I didn't hear it and/or it didn't cross my mind. I went to a club night wearing these http://www.amazon.co.uk/3M-E-A-R-Cl...RG/ref=zg_bs_1939564031_9/277-0941836-0953039. I went on holiday to Italy and I can't remember thinking about it at all, though that may just be because my memory's a bit crap. However, I got caught out by a loud household smoke alarm in August, and I remember noticing straight away after that that the things that masked it before weren't covering it up now. Still, it wasn't THAT loud really. However since then it has gotten louder and louder, despite being more cautious. I wear Etymotic ER-20s when I go to a relatively noisy pub or restaurant. I wear the previously mentioned 3M E.A.R earplugs on the 15 minute commute each way on the tube to work, and since getting them for Christmas I wear Bose QC25's over the top of them as well. My tinnitus has kept increasing though, and it seems to be snowballing. I now have headaches often. Each time it goes up it is rather unpleasant, but I reckon that if it just stayed at that level for a while I could habituate eventually. The puzzle is why it is increasing so relentlessly. I've had an MRI and an all clear on that front. I have been having a bit of trouble with pins and needles and aching/burning pain in my arms and hands, and maybe my legs, and my neck has been aching on and off but I don't know if they're related or two separate issues. I'm booked in for a separate MRI and nerve test for those soon. My jaw sometimes hurts and aches, as do my teeth and other parts of my face, but I don't know if that's just the stress/anxiety from the rapidly worsening tinnitus or not. Hell it's possible it might have been happening before all of this and it's just that I'm only noticing it and trying to figure out connections now. I'm quite worried about my future, last night I woke up in the middle of the night with very loud and horrendous frequency ringing (what I imagine people would call severe, though it can always be worse, unfortunately). It totally caught me off guard and I thought I would have to get an emergency hospital appointment and try and get some anti-depressants ASAP and therapy or whatever to be able to function at all and I'm overjoyed that I was able to get to sleep again and wake up with my tinnitus at the usual level that it has been these last few days. However, I'm worried that that new level could come on again permanently at any time now - after bed tonight for instance. All my previous spikes under similar circumstances have eventually stuck around and built to the level of tinnitus that I have now. I'd be ever so grateful if you could take time out of your day if possible to give me any advice or ideas of what is going on and what I could do, I apologise for basically writing down my entire life story! I also apologise for any bad grammar or odd phrasing and if there's any thing else you'd like to know I'd be happy to give it to you. I have a second appointment with a tinnitus specialist at Addenbrooke's next Friday but I'm worried that it's going to get noticeably worse again before then. I'd deeply love for it all to be just stress and anxiety and for it to go down to how it used to be if I just relaxed more but somehow that just doesn't seem likely. It's a bit of a chicken and egg thing with stress and tinnitus I guess.