Explosions, Gunshots, Feedback Sounds — Tinnitus for Ten Years

Hey, my name is Tom. I've had tinnitus in both ears since 2010. The initial accident that caused the tinnitus was in 2010, when I was working on a movie in Detroit, MI (I'm a camera/SteadiCam operator for film and television). We were doing a giant explosion scene indoors on stage, and I don't think I had my earplugs seated properly... After the blast my hearing was never the same.

Flash forward to 2018, when my worst nightmare came true. I was visiting a friend who was showing me his rifle when it went off in a small bedroom. Since the accident with the rifle my tinnitus has been much worse. Not to mention I relive the accident daily and nightly and struggled greatly with PTSD.

I'm writing this today after yet another work accident last night. We were filming a scene outdoors with giant rain towers, so imagine the volume of a loud rainstorm. The assistant director needed to call out over the volume of the rain, so they used a microphone and speaker. They placed the speaker right behind me (I had no idea). The problem is the assistant director switched on the mic too close to the speaker and THE LOUDEST feedback sound came through the speaker only a few feet away from me. A sound so loud it paralyzed me instantly. I couldn't plug my ears in time. I got home that night and both ears were ringing out of control. I didn't sleep a wink last night. The ringing hasn't gone down at all. It's been 24 hours. I have had noise exposure in the past and it's spiked the tinnitus, and then it goes down with time. I'm worried this time is different because of how loud the speaker was. If anyone has any advice or thoughts I would appreciate them greatly.

I'm left with some general questions, if anyone could shed some light.

• 1. Does having tinnitus make me more susceptible to noise related damage than someone without tinnitus?
• 2. Can two people experience the same sudden noise exposure and have different reactions? For example: I was standing next to several other people when the loudspeaker produced the feedback sound (story I reference above in last paragraph). The other two people were not affected by the sound, yet my tinnitus spiked. I am hoping this severe ringing will go down in the coming weeks and return to its normal level of ringing...

Any advice would be great, thanks!

 

Hi Tom, when you have tinnitus, just like the rest of us here, your hearing has already been damaged and therefore extra vulnerable. So that's why the other people standing near the speaker were not affected by the sudden noise. They still have this natural resistance that people with tinnitus don't have anymore. You might have some sound sensitivity as well, which makes the noise even louder, because your hearing is not able anymore to attenuate the noise. A healthy hearing amplifies soft sounds and attenuates loud ones. People with tinnitus don't have that margin, that flexibility anymore. That's the case with me anyway. I don't hear soft sounds, but perceive loud sounds as extremely loud. It's one thing or the other, there's no in between anymore.

Anyway, I guess what you have right now is a big spike, which might last a couple of weeks, but it will calm down eventually. Just try not to connect any negative thoughts or feelings to the ongoing sound in your head, and you'll see it through. I've dealt with spikes many times in the past and that's how I deal with them.

 

First, go to the ENT or ER and get Prednisone immediately. You have had an acoustic trauma and it needs to be addressed as soon as possible to mitigate the damage (and by that I mean right now, not in a couple of days). Aside Prednisone, also get NAC and Magnesium. I don't wait on these, as hair cells might still be dying for up to a week. Your tinnitus might still get worse, or at least you reduce your chance of getting better again. My last setback was due to noise, I had a week of pain and only after that my tinnitus rose permanently (which I wasn't expecting).

Honestly, I would not work with any device that could cause loud noise or feedback, especially not if it is set up by other people. My last setback was entirely the fault of another person, the one before also to a large degree and in your case too it was the fault of another person. If you keep working there, it will happen again, eventually. People make mistakes. Depending how sensitive your ears are however, it might be enough if you wear hearing protection preemptively in situations where loud noise might occur. They're not a failsafe though.

 

Hey Peter61 and Sevv thanks for your replies! Wow it feels great to actually talk about this stuff and read your comments. It's my first time sharing details like this with others.

So I just got back from the audiologist/ENT. I went to see a new doctor here in LA, and she was fantastic. The audiogram showed that overall my hearing is still within a good range. There is a dip around 4 kHz from the aforementioned accidents. That dip was present on previous audiograms, and is consistent with noise induced hearing damage. Pressure test was done as well as a physical exam. Thankfully everything still checked out, and she didn't see and physical damage.

So, why are my ears still ringing and why is my hearing still muffled? She explained that there are many factors that go into personalizing an audio assessment like this. Ranging from how and when your ringing started, to family history. For me, she believes that this is a combination of my ears being hypersensitive to sound, and several mental factors all playing together to heighten the appearance of the ringing. She explained that my ears will need some time to relax in order for the muffled hearing/excessive ringing to go down to its baseline. It is normal for someone with my flavor of tinnitus. Moreover she explained that I need to see a psychiatrist to help me with dealing with the ringing. She took the event with the loudspeaker and explained it like this --- First you heard the loud sound (speaker feedback) and it triggered a fight or flight response, that increased my blood pressure, and instantly triggered anxiety over the possibilities of having further damaged my hearing. The acoustic trauma of the speaker feedback was enough to make my sensitive ears ring louder (but she expects that to go down in the coming days) --- She believes that if I am able to get some of the PTSD/Anxiety under control from the previous accidents, it will help prevent these spikes from getting out of control in the future. She went on to explain that this will not be the last time something like this happens. I'm guaranteed to run into more sudden loud sounds in my lifetime, and I need to start preparing for when it does happen again so I can keep my emotions in check. She made it clear she does not want me wearing earplugs all day to prevent unforeseen damage from noise, or to live in constant fear of more damage. That's what can lead to more hearing problems like hypersensitivity and other hearing issues. She said be responsible with your hearing and wear proper protection when needed but live your life. I liked that attitude and I agree that I should not shelter myself from the possibility of another loud sound, nor live in constant fear of the next loud sound. I did that for years and it never worked out. In the end I was prescribed a high dose of a liquid vitamin N-acetyl cysteine (2mg per dose). Her recommendation was to try this twice daily mixed in juice. If in a week I'm still having issues to call for a prescription steroid.

I'll make sure to post in a week after I'm finished with the NAC vitamin treatment. Thanks again for your time reading this.

 

My take is this.

Two possible scenarios:

1. Your tinnitus rose because of anxiety (which is a possible explanation) and it will go down on its own once your emotions get normal again.
2. You have actually experienced acoustic trauma and your hair cells are currently dying off. An acoustic trauma can lead to immediate and delayed hair cell death as I've said. You can still improve the reaction to the delayed hair cell death with Prednisone. NAC and Magnesium do help (though 2mg of NAC seems really low, my package says 600mg...) but I wouldn't rely solely on those.

So, it's your choice to make. You can wait it out a week, but if it turns out by then that you have scenario 2, you worsened your chances a lot at getting your old tinnitus back. Your doctor can talk a lot, but she ain't taking the risk. Sure Prednisone is not a wonder drug and it has potential side effects but in general it improves your chances of getting better by a good amount. This chance for improvement will be a lot worse in a week.

Edit: just realized you also have muffled hearing. Muffled hearing as I see it is always a symptom of acoustic trauma. I have never read that anxiety leads to muffled hearing. Why would it? It makes no sense. Anxiety leads you to think more about your hearing and loud noise and might lead to reduced noise tolerance (heightened startle reflex) but muffled hearing makes no sense. It must be acoustic trauma. So I would really recommend getting Prednisone somewhere else if she doesn't want to give it now. @Bill Bauer, you've read this thread too, what do you think?

Also be careful about taking unnecessary risks with noise exposure. Sensitive ears can be the consequence of anxiety (heightened startle reflex, your doctor is right about this one), but also of hyperacusis. If you experience a stabbing or burning sensation after when hearing normal noise, you have hyperacusis, which doesn't respond to your "attitude". You will need to avoid sounds until it has gotten better (which it usually does, but very slowly).

 

Can you call a doctor and try to get Prednisolone ASAP?

 

If I were the OP, I would go and get the drugs. Why risk having it worse? I can promise you severe symptoms will ruin you as they have myself.

 

Yes I think so.

Yes, people have different reactions. This is like being prone to have any medical condition. Some people see better than others, some people are more prone to developing cancer etc. Hearing is the same, there are individual differences.

If I were you, I would go right now to get either prednisone (dose according to weight) or Deflazacort (generally speaking, 30 mg, one pill, per day) and would start having that medication for at least 10 days. Feedback is one of the worst sounds one can encounter and, in my personal experience, it can set you back permanently.

 

I called in and got a prescription for Prednisone. I started taking them one week after my exposure. I’m on day 3.

I will say that after the most recent noise exposure to the speaker feedback, the ringing did go down to a more manageable level. I’m not sure it went fully down to the baseline so that’s why I called in the prescription for the steroids. The steroids have definitely caused a spike in my tinnitus, which have been very difficult to deal with at night. My doctor warned me of this spike, that’s why she was hesitant to start with them to begin with.

I’ll report back after I complete the steroids to see if they made a difference.

Has anyone else experienced a big jump in volume of their tinnitus from taking Prednisone?