Developed Acute Tinnitus Six Weeks Ago — Wondering What My Options Are. Thank You.

Hello everyone, pleased to meet you all.

Brand new member of the club. Six weeks ago (16 October, 2017) I developed acute tinnitus after an accident with a firearm. Being in an enclosed space with no ear protection, I was in a lot of pain, and the first night was torture trying to sleep. I noticed soon afterwards that I had developed an extreme sensitivity to noise- even watching Youtube videos with guns, I would flinch and feel those exact same sensations that night- a rushing wind, with the almost tangible feeling of the hair cells in my ears flattening. In addition, I've lost a deal of hearing in my right ear and have only recently grown somewhat accustomed to the feeling of fullness and imbalance.

My quality of life has degraded.... SEVERELY. I will not claim to be the most socially active person on the board, but in recent weeks what I did have has simply fallen off. I cannot enjoy Mass anymore; the loud music played during service and the people singing next to me has become a painful experience. Several have commented on my use of ear plugs during the last party I attended (leading to a painful spike the following morning anyway). Music and headphones are no longer options- my tinnitus becomes intolerably loud when I don headphones and turning up the music to drown it out doesn't work- I have to turn it up to damaging levels to really hear it properly. Studying has become difficult; reading, impossible. I used to love being alone, riding my bike or sitting in bed. That's all out the window. Don't even ask me about the gun hobby- I've legitimately considered selling off my collection a few times now in anger.

How loud is my tinnitus? To put it in perspective: I can hear it over the sound of my truck engine, with music playing, the windows rolled down, and driving at 30 miles per hour. I cannot put a decibel rating on it; it is noticeable at all times. The only time this is not true is late at night when I am outside and the cicadas are chirping; apparently their frequency actually masks my tinnitus. But of course they cannot be in my truck, at home, or with me during the day.

I am ashamed to say that I have cried at least twice for hours since this has started. My ENT, though very polite and understanding, could only offer me a few bottles of lipo-flavanoids and a pair of $500 Widex noise makers. No medical professional I have met with has been any help offering even the slightest hope in medication or possible medical trials for me to enroll in. I do not wish to be dramatic, but to say I have felt despair is truly an understatement.

My situation is simple: in four day's time I am finishing an Associate's Program at University (I live in Florida). After this, I am free to do whatever; I am not regularly employed. I am greatly interested in any clinical trials for acute tinnitus anywhere in the United States (and possibly even abroad). I have been made aware that some programs have asked for patients who have become afflicted in the last 90 days- I figure 45 is plenty to spare, yes?

Thank you all so very much for your help. Even if nothing is available I want to say what you have been doing on this site for one another is great. God Bless you all. Thank you again.

 

You can try using sound masking
http://mynoise.net/
https://www.amazon.com/Sound-Oasis-S-5000-Deluxe-Therapy/dp/B018KUVEOM
https://www.amazon.com/Cherry-Koala-Concentration-Relaxation-Sufferers/dp/B01FRW2WBA

I had never cried as an adult, until I got T. For the first month or two I cried uncontrollably every day, multiple times a day. So don't be too hard on yourself.

I recommend that you try to protect your ears from even mild noises like that of a vacuum cleaner. There is a good chance that your T will fade (so that you will stop hearing it everywhere), and possibly even go away. Check out the studies listed on all of the pages in the thread below:
https://www.tinnitustalk.com/threads/spontaneous-recovery-stats-over-70-recover-3-studies.21441/

 

@Bill Bauer Thank you very much. I have been using the ACRN protocol for the absolute worst of times. Normal masking does not do much for me. Several youtube tracks which used to do something cannot cover it anymore. I believe my T is about 10k hz- and quite loud.

Before T, in the past twenty years of my life I could say that I could count the number of times I had cried on one hand, and as a man I was proud of this. Since this incident I have broken that number, many many times over.

The link you provided has given me additional hope, but without treatment I fear my tinnitus will not leave. It is severe in the deepest meaning of the word. I am absolutely desperate for any sort of help. Thank you again.

 

Many people on this forum believe that the goal is not to cover the sound, but to give you something else to listen to, besides T. Makes it easier to bear. If your T is a high pitched tone, try listening to crickets/cicada sounds.

If you don't find any good clinical trials, you may want to look into rTMS treatments. Search this site for more information about rTMS.

 

@Bill Bauer cicadas are a huge help naturally. T cannot be heard over it at night, unless I am indoors. That and about 10 minutes or so of quiet rumbling after a decent sleep instead of ringing are the only times of real relief I get.

The oxygen therapy sounds interesting. Isnt rTMS for depression?

 

You are fortunate to be living in an area where you can hear cicadas at night year round. In many other areas of the country this is no longer the case...

There is a thread here where someone wrote that back in 1990s rTMS was tested as a treatment of T and depression. It had helped around 30% of the patients (and made a small fraction of patients worse off). Unfortunately, FDA requires that a treatment helps at least 40% of the patients for it to be approved. Some clinics still use it to treat T patients.

 

The sooner after onset you have your HBOT treatments, the more effective they are supposed to be.

 

Gotcha. I must sign off for the night- finals week here and heavy work load. I will dig deeper once I have a spare hour. Appreciate it!

 

Well, I'm pretty sure my tinnitus has gotten worse. ENT gave me Widex type noisemakers and they seemed to be helping- I think I finally figured out what a 'withdrawal' looks like. Not only has the noise minus the maskers gotten far worse, the frequency has changed AND a new sound has been added- very difficult to mask. I'm very afraid of keeping the hearing aids in- I'm fearful of the possibility of dependency.

 

@Bill Bauer Spoke with a clinic up the road who said they would be willing to give me five sessions in the chamber plus a consultation for $1500 total. Does that sound ideal?

 

I was also paying around $300 per session, and I also ended up having 5 sessions. Are the sessions 90 minutes long, or 60 minutes long? Will you have a personal tank, or will it be done in a large enclosure?

Ask them to set the air flow rate to the minimum setting. Air flow doesn't influence the concentration of oxygen, but it does make the chamber noisy. Also bring good earplugs with you. Make sure they are new/clean. Once the chamber is pressurized, you can wear the ear plugs to protect your ears from the noises of the chamber.

 

@Bill Bauer I would have to call back and ask those questions. Really the major problem I have is justifying the cost over the potential benefit (or lack there of, or even worsening of symptoms if this goes wrong). Did it actually help your tinnitus? I cannot find many other options, will be looking up more on rTMS as I go.

 

I read the paper, so maybe I can help.

The paper is focused on military men that have contracted tinnitus from loud noises around explosions/firearms (that's you). 70% have gotten heavy recovery/full recovery. They also have a much longer history of noise and are older than you, so the chances are very heavy in your favor that it will help cure your tinnitus by a lot.

 

It made it louder. I am pretty sure it was because it was so noisy inside of the chamber, and I learned that they would allow me to take ear plugs to the chamber and that it is possible to make the air flow lower to reduce the noise, only during my last session. When I arrived for my sixth session, they did a medical check and noticed that my eardrum had a little inflammation on it. They refused to let me into the chamber! (I went to see a doctor that same day, and he confirmed seeing the little inflammation on my ear drum.) I was able to find another company that agreed to stay open after hours to let me have my session. I rented a hotel room and waited for my appointment. This is when I realized that my T was very loud. I got scared about making my T worse, and eventually called the other company to cancel my session. My T settled down in a couple of days. Like I said, I think it spiked as a result of some noise inside of the chamber that didn't even have to be there.

HBOT certainly hasn't helped my T right away. It is my understanding that a standard HBOT course is 10-15-25 sessions (it is better to do them every 24 hours, without breaks for the weekend). I have no idea how I would have felt had I not had HBOT, or had I had a full HBOT course of at least 10 sessions. My T eventually faded (only for me to have that second acoustic trauma at the end of month three), who knows whether those HBOT sessions had anything to do with it.

The bottom line is that it is my understanding that the probability that HBOT helps is higher than the probability that it will make things worse.

 

Some of those soldiers might have gotten better even without HBOT treatments. However, 70% of the patients hearing silence after only a year is in fact a lot higher than the corresponding fraction reported in all of the other studies in that thread, where the patients haven't received any HBOT treatments. So it seems that there might be something to HBOT.

 

Yeah of course I think HBOT is very significant to helping acute noise induced tinnitus. I try to remain bullish because results of scientific papers are often exxagerated.

 

@Bill Bauer, @threefirefour
So how many sessions do they expect me to take? I was asked to expect a minimum of five. How many are the soldiers taking?
I'm not entirely sure I can afford ten sessions or even more. My insurance would not cover such a procedure at this location. I could do five at minimum; and yet I feel trapped because as time goes on I know the treatment might be getting less effective. How long from the first acoustic shock were the Finns getting treatment? Thanks.

 

I don't believe that dissertation mentions that information. My guess is - right away.

I guess five sessions is better than nothing... I think that it is money well spent (unless you won't be able to do rTMS as a result; note rTMS is more likely to make a difference [positive AND negative, with negative being less likely than the positive]).

I might be mistaken, but I think those soldiers had more than 20 sessions - you can follow the links in that thread to be sure.

 

I could do a lot more if it wasn't so costly. Here in the Southern Florida region the local clinic charges $250 per oxygen therapy.

 

There are clinics in Canada that charge less (+ it will be cheaper for you because of the favorable exchange rate). But after you pay $70 for a hotel room + for your flight the difference might not be worth it. You may want to look into it...

 

@Bill Bauer What do you think an acceptable cost for 10 sessions plus a consultation would be?

Had my worst night so far. I could not sleep last night. Body shook uncontrollably. T was extremely loud and multi-tone. Ended up taking an hour walk or more and called up a friend who is also dealing with it while letting the cicadas sooth me. Finally fell asleep around 2 and woke around 11. Interestingly enough I had my longest period of quiet this morning. It seems to be tied to when I get out of bed. 20-30 minutes of relative quiet, no ringing. But I'm not so sure I can stand another night like last night, and I'm not sure why it is happening now instead of six weeks ago.

 

I would pay a considerable fraction of my networth for a chance for it to get better...

I think it is a good sign that you get quiet periods. Do you hear complete silence when you plug your ears during those quiet periods?

Have you been protecting your ears from moderate noises like that of a vacuum cleaner?

 

I think rTMS would be more of a last resort for chronic severe tinnitus, not someone that is new to tinnitus. There were a few people whose tinnitus was made much worse by rTMS. @snow86 comes to mind.

 

My quiet periods come only if I sleep well. As an example I first woke up around 7 after five hours of sleep, then went back to bed until 11. The ringing was loud at 7, but when I woke up at 11 it did not show up until I physically climbed from the bed. The quiet periods are definitely tied to sleep and when my 'day' starts. Of course, after this, it only takes a few minutes at best before it comes back full force.

My hyperacusis has been doing a bit better, but my tinnitus reactions, if not the tinnitus itself, seem to be getting worse more and more. I will be resorting to sleeping outside at night so that the cicadas can mask the intensity. I am pleading with every doctor I know about experimental treatments, including HBOT and Ketamine... emphasis on pleading.

Are there any experimental treatments that won't have some horrible side effect? Seems like all of them have the chance to make it worse.

 

This seems to be true of every treatment and drug related to T. For example there are papers reporting that amitriptyline is an effective treatment:
https://www.researchgate.net/profil...e_Tinnitus/links/5502051c0cf24cee39fb28c8.pdf
"We investigated the effect of amitriptyline, a tricyclic antidepressant, on patients with subjective tinnitus. The study group
consisted of 37 adult patients admitted to the Ear, Nose, and Throat and Audiology Department of Hacettepe University.
The amitriptyline group consisted of 20 patients and the placebo group consisted of 17 patients. All of the patients were
evaluated using a questionnaire, audiologic evaluation, high-frequency audiometry, impedancemetric tests, auditory brain-
stem response, tinnitus frequency, and loudness matching assessed by audiometric methods at the beginning and end of the
study. The patients in the amitriptyline group received 50 mg/day amitriptyline in the first week and 100 mg/day for the fol-
lowing 5 weeks. In the placebo group, the patients received tablets consisting of lactose starch for 6 weeks, with a dosage of
1 tablet/day. The subjective complaints of the patients in the amitriptyline group decreased, and the “present” symptoms
resulted in fewer complaints. The severity of tinnitus decreased in the amitriptyline group by means of subjective and audio-
metric methods. In the placebo group, no significant change was observed. The success of treatment was 95% in the
amitriptyline group and 12% in the placebo group. Amitriptyline therapy was concluded to be effective."

and then there is this:
https://www.ncbi.nlm.nih.gov/pubmed/18308819
"An unusual case of prolonged tinnitus following low-dose amitriptyline."

Some people get T after one amitriptyline pill...

 

That same study you linked states in the abstract that none of the sufferers got their tinnitus from acute acoustic shock.

 

In this survey
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2832848/
when they discuss amitriptyline, they never state that it is not effective for those whose T is a result of an acoustic trauma.

 

Here is a study about rTMS that you might find interesting
http://journals.lww.com/headtraumar..._Transcranial_Magnetic_Stimulation_for.6.aspx

And here are more surveys of T treatments:
https://www.neurological.org.nz/sit...macological, Langguth and Elgoyhen (2012).pdf
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2898164/
http://www.tinnitusjournal.com/articles/review-of-pharmacological-therapy-for-tinnitus.pdf (an old one, but I might as well include it)

You can find more studies by using scholar.google.com

 

Interesting.
I have prednisone available (in pill form) and I can have amitriptyline prescribed. Anything else I should know about?

 

You can find the names of more drugs (e.g., gabapentin, etc.) that were reported to help some T sufferers in those surveys.

Keep prednisone in case you get another acoustic trauma. You can take amitriptyline (10 mg) to help you sleep. If you decide to try using it to treat your T, first of all note that you need a 50-100 mg daily doses for that. Second of all, make sure to read this forum for more information about this treatment. You may also want to use scholar.google.com to identify more studies involving the impact of amitrityline on T.