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

My family doctor told me about that rule of thumb. ER doctor prescribed 50 mg for me and gave me enough pills to last until my appointment with the ENT. When I saw my family doctor afterwards (before I saw ENT), my family doctor prescribed 10 mg pills for me, as I weigh close to 60 kg.

I read about this rule of thumb in other threads on this forum. ONE of those threads mentioned that the maximum dose should be 60 mg.

In any case, if you weigh 80 kg, try getting 50 mg a day. Then again, if a small dose worked for you, perhaps that is all you need. Remember those rules of thumb about the dosage are guesses by the doctor about what might work. You always want to take the lowest dose that is still effective.

 

Here is that post (that mentions max 60 mg daily constraint):
https://www.tinnitustalk.com/threads/im-new-here-and-trying-not-to-panic.25239/#post-290927

 

id do a prednisone taper even though you are probably outside the window of opportunity.

consider stem cells. it has helped my hyperacusis and t spikes.

hbot as others have mentioned

 

Thanks all for the recommendations. I don't even know where to start on stem cells and HBOT is not covered by insurance here and is prohibitively expensive. Prednisone is the only thing that really seemed to help without side effects, but the taper itself seems like too small a dose.

The effects over the last few days have been... interesting. I've had multiple frequency shifts, changing sounds (a constant tone on the right side, then a buzzing, then this morning woken up several hours early by a slow, lower pitched ringing). I've been woken up by my tinnitus yesterday morning and today, which means 2/4 days on these medications. I'm strongly considering aborting at this point.... I'd love to let things pan out and maybe even do a full six week course, but things are getting weird, or even worrisome. I don't want to end up with new tones that may be hard to mask (the buzzing, especially) and the constant changes are making habituation difficult for sure.

Are things improving?? Hard to say. I can say pretty easily that sleep has become less of an issue, but that's just falling asleep. My legendary ability to stay dead to the world even with a noisy house is gone, as I noted. This did happen pre-Ami-and-Gaba. I wish we had access to what those people who did clinical trials with these drugs were saying on the day to day basis. I'm worried I'll be cutting myself off too late and already have done damage, or the drugs are working and these are just normal fluctuations. Are there any considerations about tapering off? Thanks.

 

Sorry forgot to @ you two @Bill Bauer @DebInAustralia

 

Is it because T is quieter?

The fact that it is not relentlessly the same sound is probably a good sign.

 

(1) As a matter of fact it may be slightly louder. I'm having a hard time keeping track, which would strike me as funny if it wasn't so tragic. When it seemed over all less loud I was taking Prednisone; however now it seems to be less intense when trying to sleep.

(2) I'm not entirely convinced. The fact that the noises keep changing and my mind is stuck on the volume level is probably making it a lot harder to habituate.

 

I am also trying the ACRN protocol which has a noticeable lasting effect (for at least a few minutes afterwards it's very quiet) however I am trying as much as possible to avoid anything that isn't "real" (EG treatments or meds) because I want as much as possible to hear silence naturally (not with masking).

 

I doubled the dose Tuesday night as mentioned.

My sleep sucks. Try as I might I cannot stay asleep. I can fall asleep fairly easy, but just about every single night in the past few weeks I've been woken up by the ringing at one point or the other. If I can fall back asleep it'll be reduced, but the noise will get worse as the day wears on. By night time last night it was powerfully loud..
I'm really leaning towards weaning off this current medication and going back to Pred..

If only I lived near Michigan, I'd try out that noisebox thingy they're running trials on.

I've also been experiencing A LOT of dreams and nightmares in sleep. The ringing is better or worse depending on the day. I might stop only for a little bit of normalization.

 

I've decided to taper off. With quiet mornings becoming more and more rare and with more changes than ever before I decided I am done with Amitriptyline and Gabapentin.

My computer is not making it any easier. I've found that my tinnitus is all but certainly mimicking the computer fan noise or whatever it is, the high pitched noise emanating from the desktop. Instead of ringing on the left and a tone in both ears I hear a high pitched laser almost exclusively in both ears. I will be staying off of the desktop for the next week if I can, see if it helps matters.

 

I'm still fighting to try to get a full course of Prednisone. The doctor who was supposed to see me earlier this week mysteriously became sick a few hours prior to my appointment. In the meantime, I've had some rough times, rougher even than when I first started dealing with this.

I think I had something approaching a breakdown two nights ago as we crawl towards the third month of this. Almost as soon as I tapered off of Amitriptyline and Gabapentin I immediately noticed that the noise was no longer changing constantly and that I was stuck with a simple choice of noises- a ringing on my left, a tone in both ears and a buzzing typically on the right side (this buzzing was mimicking the noise in my computer). However this noise has seemed especially intense at times and always there- never even taking a break in the mornings as it used to under Prednisone.

Nights are tougher, and I did not fall asleep until almost six am two nights ago due to the sheer intrusiveness of the noise.

I suppose I am still coming to grips with the level of damage I have caused. Firing a gun in a car; yes, very stupid. But even one of my closest friends who was blown up in a similar vehicle says he has no such symptoms. I feel isolated, and I'm low on hope. Sorry @Bill Bauer but I'm in need of some encouragement or ideas.

 

I must add that the family are considering an MRI, not sure what they're looking for.

 

Drinking myself to sleep tonight.

Either things are getting a bit quieter with alcohol in the blood, or its harder to care when under the effects. Either way it makes things a bit more tolerable. Not enough maybe.

 

Little update for @Bill Bauer and the other concerned folks on here.

Insisted on another doctor's appointment. They said they will hook me up with a new ENT as we are past the 3 month mark and I still have severe tinnitus. They also promised me a chat about an MRI. Before I left they gave me a shot in the ass (similar to prednisone) and sent me on my way with an eight day taper of Prednisone (this was after much argument on oral 14 day course vs a shot).

I think I can safely say that the shot did nothing, as we're coming up on two days since it happened. The 40mg of Prednisone was far less effective than the 20mg on the taper pack taken back in December, 45 days after the incident. Right now I am furious. Everyone I knew said that Prednisone would not be helpful, the doctors, family etc, and now only after all this time are they willing to help and it seems I am far past the useful date for such a drug. I guess it has 'centralized' after all this time.'

My recommendation to anyone reading this who sees another person with suddenly induced tinnitus- immediately go and get a full prednisone course as soon as possible. Cancel plans if you must, which is what I would have done if I was smart.

Damn it. I feel abandoned...

 

Somehow up until just now I managed not to see your message. I am sorry!

First of all, why did you decide to stop taking amitriptyline? It is not addictive, and it helps one to fall asleep. Could it be that gabapentin was the drug that made your mornings louder?

Have you tried protecting your ears from moderate noises (e.g., vacuum cleaner)?

Have you tried taking supplements like NAC, Magnesium bis glycinate, Vinpocetine, ALCAR (N-Acetyl-L-Carnitine), Vitamin B complex, Ginkgo Gold, and Zinc?

You could try to get a quieter computer fan or a new computer (some systems have a computer in another room, and cables can then run to your office where the keyboard, mouse, and the monitor are located.

It is still possible that you will get better. This is the lesson that I learned during the past year - you can't assume that how you feel in the short run is how you will end up feeling in the long run. It changes at a glacial pace, but it changes. I hope that you will experience some fading by August...

What did you mean above?

 

@Bill Bauer. I weened off the amitriptyline not only because I was running out but because I was having weird fluctuations- noises and frequency changes, was starting to scare me. I am taking 300 mg of Gabapentin still however.
My mornings haven't been much good since I stopped taking that first dose of Pred. Wake up with noise, go to bed with noise, so it is worse overall than in December. I did also have a few quiet mornings under Ami but they were rare, and of course I can't remember the last time I had a quiet morning.

I have protected my ears as best I can, no more shooting, even bought a decibel meter on my phone and turned the music way down even though I don't wear headphones. I have not taken any of the mentioned supplements but I do have some magnesium on hand, I am desperate once again for relief. Do you have any recommendations?

I really hope there is some fading too. However as I mentioned we are at the three month mark and I'm not entirely sure it hasn't gotten worse. I am down in general. Probably going to be unable to go to the clinical trial in Michigan.

What I mean by centralized is that it is probably centralized in my brain, the tinnitus. The prednisone doesn't have much of any effect anymore.

 

You would normally want to use prednisone after an acoustic trauma. If a balloon pops nearby, or a baby screams near your ear - it helps to take prednisone in those situations (and do it withing 48 hours of the event) to reduce the damage done to your inner ear.

Many people experience fading by the end of month three. However, everyone is different (and everyone's injury that had caused T in the first place was different), so I would not lose hope that it would fade, just yet. Give it another 6-9 months. If you experience any improvement during that time, then you could hope that the improvement and fading continue well into the future.

Try taking those supplements - they shouldn't hurt. Just make sure not to exceed the recommended dosage.

 

Thanks for the suggestions.

Forgive me if I don't sound like I've much hope. I was told that by the third day the noise should be gone and by month three, it's just as bad as it ever was. Unfortunately once this Prednisone runs out it's highly unlikely they will give me more.

This magnesium is some "nature made" stuff, 250 mg per tablet. Will take some now and sign off, with some 300 mg of Gaba and 40 mg of Pred in my system as well. Take care and thanks...

 

That's a good dose. It is good to take it in the evening, as it promotes sleep.

Have you been using sound enrichment when you try to fall asleep?

 

I haven't been using any sort of sound therapy. I tried ACRN for a while but it simply couldn't mask the ringing forever and eventually it stopped working. Considering looking into notched music or sound enrichment, hell maybe moving a fish tank into my room.

 

This might explain your difficulties with falling asleep!

Some people (I think I remember @Michael Leigh making a post where he said that) think it might actually help to lower T. I am not sure about that. However, having something else to listen to besides your T helps a LOT (at least it helps me). You don't want to set is so loud that you stop hearing your T. Set is so that you can hear both the nature sounds (the sound of crickets helps when you have high pitch T) and your T at the same time. Initially you will feel upset about hearing T. But after 5-15 minutes you are most likely going to begin listening to the nature sounds.

In any case, you have got to try it. Either play http://mynoise.net through your smart phone, or use a product like
https://www.amazon.com/Cherry-Koala-Concentration-Relaxation-Sufferers/dp/B01FRW2WBA/
or
https://www.amazon.com/Sound-Oasis-S-5000-Deluxe-Therapy/dp/B018KUVEOM

 

@Richard Bladykas @Bill Bauer


Anyone with tinnitus particularly if it is intrusive, should avoid silence especially at night. This is mentioned throughout the TRT (Tinnitus Retraining Therapy) book written by Professor Jastreboff. In fact silence is considered to be harmful. The brain and auditory system never switch off. When we are asleep or in quiet surroundings, the brain has the ability to increase its background activity. In doing so it will also increase the tinnitus making it louder and more intrusive. By using low level sound enrichment, it supplies the brain and auditory system with sound and thus, helps prevent the brain from increasing its own background activity. Over time the tinnitus is suppressed.

This is particularly evident in people that have tinnitus due to hearing loss. When the brain is unable to hear certain sounds/frequencies from the outside environment, it will turn up its internal gain to hear those sounds/frequencies. In doing so tinnitus can develop and over time become more intrusive. Once a person is fitted with a hearing aid/s, the brain no longer has to work so hard turns down its gain (volume control) and over time, the tinnitus is reduced too.

Sound Machines

I have recently been asked about the benefits of using a sound machine after someone read my post on another thread, please find it below.

Sound Oasis makes the best sound machines in my opinion and they are specifically designed for people with tinnitus although anyone will benefit using one. The quality of their digital sounds will be far superior to any homemade sounds that you compile if your intention is to use them for sound enrichment.

A sound machine can be used night and day but do their magic best when we are in deep sleep. It supplies the brain and auditory system with sound enrichment. Over time, the tinnitus is pushed further into the background making it less intrusive and will make the path to habituation easier.

I have three Oasis models. The S-650 is very popular and the one I usually recommend people buy. It comes with a variety of sounds on two sound cards. Additional cards can be purchased. The S-850 travel, is more expensive and compact. It has 18 on-board digital sounds and doesn’t use cards. Some people might be bothered by the clock’s blue backlight at night-time. It dims but cannot be turned completely off; the S650 backlight can be set to switch off automatically.

The S-5000 is the top model. Larger and more sophisticated than the others and can only be mains operated. It uses a three-speaker system, that has a subwoofer for increased depth and definition to the sound. According to Oasis, over 140 on-board sound combinations are possible. It has FM/AM radio and an external sound source can be selected via the auxiliary input. There are a host of other features.

The purpose of using a sound machine is to have it playing in the background without drawing attention to itself unlike a radio. For this reason, music mustn’t be used at night for sound enrichment, as it will draw the Brain’s attention and delay habituation.

In my opinion and the advice of Professor Jastreboff, developer of TRT. Sound enrichment particularly at night should be used by anyone that has intrusive tinnitus. I would go as far to say, it is imperative to do so if you want to help yourself. Over time you will get used to having sound around you both during the day and night. I find it strange to be in a very quiet room now having used a sound machine for so long.

Michael


PS: Many people have contacted me after they have habituated to their T and stopped using sound enrichment at night, only to find their tinnitus becoming intrusive again. The rule of thumb: avoid quiet rooms and surroundings especially at night by using a sound machine.

 

I really appreciate the advice on sound machines. How has sound enrichment helped you? It doesn't seem like a long term effect...

 

It depends what you are looking for? I know sound enrichment works and don't quite understand what you mean by saying: "it doesn't seem like a long term effect"? It certainly is for I have been using it for 22 years. You are new to tinnitus and need to give yourself time and have plently of patience....

Michael

 

I mean that you need to keep it running or else it will become intrusive once again. Apologies for the mood I might be in; it's been a difficult 3 months and I hardly slept last night.

 

We have all been there. I advise you to go to my "started threads" and read my posts on "positivity" and acquiring a positive mindset. In the early stages of tinnitus which you are in, it is not uncommon to feel the way you do. This is negative thinking and is to be expected. There are posts on my started threads that will help you to deal with that. Speak to your GP and get something to help with stress and sleep.

Sound enrichment becomes a regular routine once a person gets used to it. Some people sleep without sound enrichment and their tinnitus doesn't get worse. My posts should only be used as guidance.

Michael

 

@Richard Bladykas

Amitriptyline can cause headaches if increase them to fast but they are great to help you sleep with the sedative effect anywhere from 10-100mg...I slept well on 50mg.
Regarding changes in tinnitus,it should have settled when you got up to your dose you require after your brain adjusted to increased doses and about 6 weeks on the dose needed.
I think you needed to keep it going longer.
Coming off them to fast can cause missfiring signals causing head tinnitus and in your ears.
Love glynis

 

Thanks for the advice Micheal.

So what you're saying is go back on it, one week at 50mg and then five at 100 per day?

 

No you need to do it a lot slower under your doctors advice.
10mg a week 20mg 2 weeks 30mg 2 weeks then 50mg 2 weeks so on but your own doctors advice.
I was on it 12 years.
Taking 30-50mg in one go is way to strong and cause headaches etc

 

Has it made a notable difference for you? You said you've been on it many years.