Four Months After Firearm-Induced Acoustic Shock Tinnitus: Am I Having a Spike? Will It Get Better?

Fazdoll

Member
Author
Dec 13, 2024
30
Tinnitus Since
August 2024
Cause of Tinnitus
acoustic trauma
Hello,

I am a single woman in my mid-50s with very little history of noise exposure. Life was great, but things changed last August 6. I took a lesson at an indoor firing range while wearing earmuff hearing protection, but I did not know I should double up with earplugs. During the lesson, someone about five aisles to my right fired a pistol that cracked loudly, about 15 times. I was wincing, and even the instructor commented, saying, "Yeah, it's killing me too."

When I finished and got to my car, I felt a "force field" outside my right ear blocking sounds. I could still hear somewhat out of the ear, and this sensation began to fade the next day. (I later realized this was likely temporary threshold shift.)

The real trouble started two days after the trauma. I began hearing a faint, low buzz inside my right ear, like a buzzing fluorescent light. The next day, both ears felt like they were filled with water, though the right ear was worse. Normal sounds did not hurt, but louder noises, like trucks, did. (I later understood this was mild hyperacusis at around 85 dB or more.) Initially, I thought it was related to my sinuses.

The tinnitus buzz in my right ear persisted. It seems to be low in volume because white noise or the sound of my refrigerator at 45 dB masks it. However, mild noise exposure, especially in the car, triggered a 500 Hz flute-like tone on top of it (reactive tinnitus), which would fade after sitting quietly for about an hour. The aural fullness was worse. Both ears felt like they would not "pop," and this sensation got worse when I was driving. Speech sounded muddled on my right side, and I had to turn my head to my good ear to hear clearly. Strangely, the fullness would ease while I was asleep, and sounds would be clearer when I woke up, only to fill up again as I moved around.

I could not see an ENT until 30 days later. Two weeks of prednisone followed. An audiogram showed a 40 dB loss at 500, 750, and 1000 Hz in my right ear, with no more than a 10 dB loss at other frequencies. My left ear was completely normal. By then, the hyperacusis had improved, though I was still a little sensitive. I experienced no vertigo or dizziness. An MRI with contrast came back completely normal. The audiologist was unsure if a hearing aid would help.

Using YouTube pure-tone videos, I noticed that I sometimes experience diplacusis at 750 and 1000 Hz, though not consistently. A second ENT confirmed acoustic trauma, even at low frequencies, and told me the symptoms would "fade." I remain skeptical of that reassurance.

After reading more about this, I started wearing a foam earplug about a month ago and downloaded a decibel meter app (NIOSH). Going about my day, I do not think I have been exposed to anything louder than 85 dB unprotected since the incident, so I hope I have not caused further damage.

Now, four months in, it feels like four years. (You all know what I mean.) A couple of weeks ago, I thought I was improving. Painful hyperacusis resolved within a month, with only some lingering sensitivity, especially in crowded spaces. Aural fullness became mild and intermittent, and driving no longer triggers it. The tinnitus buzz is tolerable, and I often only notice it in quiet rooms. Noise or vibration, or even speaking, still triggers the 500 Hz flute tone, but it has occasionally not triggered or faded more quickly. I started sleeping better and thought I was on track for gradual healing or habituation within 12 to 18 months.

However, in the past few days, I have developed a new tone. It is a high-pitched ~3500 Hz sound, coming from slightly behind and to the right. This seems to be the "traditional" tinnitus tone. Strangely, I believe I have heard this tone in the past, even before the trauma, but only for a few minutes at a time. Now it is there most of the time, at about a 4 out of 10 in volume, but it gets louder when I think about it. It is also keeping me awake.

Could this new 3500 Hz tone be a spike? Is it delayed onset tinnitus from the acoustic trauma? Could it be related to a stiff neck? I did vacuum the day before this started, while wearing earplugs. The vacuum is 90 dB unprotected.

Thank you for reading this far. The past four months have been hell. My mental state is improving, but I am in a constant state of low-level despair. I was feeling hopeful as things seemed to be improving, even the hearing loss, but now I do not know if I can handle a new high-pitched tone on top of everything else.
 
Welcome to the forum! It sounds like you are experiencing symptoms of acoustic trauma. In addition to tinnitus, this often includes other symptoms such as reactive tinnitus, hyperacusis, multiple tones, or aural fullness.

It typically takes 6 to 18 months for the ears to settle down, so it's important to be cautious and protect your ears from further loud noise exposure. Consider using musician's earplugs for added protection. During this period, patience and positivity are key.

You should see improvement over time, so keep hope alive. Take care, and God bless your recovery.
 
Welcome to the forum! It sounds like you are experiencing symptoms of acoustic trauma. In addition to tinnitus, this often includes other symptoms such as reactive tinnitus, hyperacusis, multiple tones, or aural fullness.

It typically takes 6 to 18 months for the ears to settle down, so it's important to be cautious and protect your ears from further loud noise exposure. Consider using musician's earplugs for added protection. During this period, patience and positivity are key.

You should see improvement over time, so keep hope alive. Take care, and God bless your recovery.

Hi Billie,

I got tinnitus in my right ear after a loud festival, I did not think of earplugs since I never go to these things. This is the first time experiencing tinnitus and it is driving my insane. The first 2 days were awful, it was a 10/10 but the days after it got less and on day 5-6-7 it went almost completely away 1.5/10. It was gone 1,5 week and now all of a sudden it's back bur I did not listen to any loud noise or music, I did not expect this at all. I hear it only in quite rooms but still with sleeping it drives me crazy. What are the chances this will heal and go away since it was gone and came back? It has been 3 total weeks now, where 1,5 week it was gone. I am stressed one festival made life changing changes and I will become depressed of it…. I am an 25 year old boy btw, and fully healthy normally…
 
It typically takes 6 to 18 months for the ears to settle down, so it's important to be cautious and protect your ears from further loud noise exposure. Consider using musician's earplugs for added protection. During this period, patience and positivity are key.
You should see improvement over time, so keep hope alive. Take care, and God bless your recovery.
Thank you so much for giving me a little hope. At one point, I told my boss, who is also a good friend, that it might almost be easier to have breast cancer because at least there is a definitive recovery process for that. Are you sure about recovery? All I see online are stories of people who never recover, whose symptoms get worse, or who feel suicidal. If I knew with certainty that this would improve over time, I would be far less stressed. Even some level of habituation, however incomplete, might be enough to help me cope.

I am fairly sure my hearing is better than it was. Over the past few days, I have taken three types of online hearing tests multiple times. About 80 percent of the time, they show normal hearing. I realize those tests are not entirely accurate, but they should at least be precise enough to indicate improvement. Previously, my hearing tested at 45 dB, and now it seems to be closer to 20 dB. I suspect the aural fullness I was experiencing interfered with the earlier tests. I have another official hearing test scheduled in January, followed by an ENT appointment a week later. Maybe they will provide some answers.

Thankfully, the volume of my tinnitus seems relatively mild to moderate. The buzzing is about 1 to 3 out of 10, the flute tone is 3 to 4 out of 10, and the two new tones are 4 to 5 out of 10. These tones fluctuate with stress, masking, and even the sound of the heater.

Is there a specific decibel level I should protect against? For the past six weeks, I have been wearing a foam earplug when I go out, and that seems to provide enough protection. However, there have been a few occasions where I forgot to use it and was likely exposed to 75 to 80 dB. For example, the inside of a crowded Walmart is typically around 70 to 75 dB.

Should I consider TRT, which is Tinnitus Retraining Therapy, or other treatments? I tried online notch therapy, but it only seemed to trigger the reactive 500 Hz flute tone.
 
Six-Month Update

I'm writing this down just to keep track. Six months have passed since the day my life was nearly ruined in 30 seconds. Has there been any improvement? Overall, the non-tinnitus symptoms have improved since the trauma, but the tinnitus itself has gotten worse.

Hyperacusis

I had some hyperacusis during the first six weeks, but I haven't really felt it since. I do occasionally experience mild discomfort or very slight pain in both ears, but it feels more like it's in the outer ear canal rather than deep inside. It seems to be more noticeable when I'm anxious rather than triggered by sound. It's random and short-lived.

Sensitivity

I don't react to single loud sounds, but I am sensitive to echoing voices around 65 dB. Possibly not as much as before. Using a foam plug in my right ear helps with this.

Hearing

A hearing test still shows a threshold of about 35 dB between 500 and 1000 Hz, while all other frequencies are at or below 10 dB. My speech recognition is fine.

Aural Fullness

For the first month, aural fullness was absolutely awful. It mostly subsided within four months, possibly due to prednisone. Now, I have a very low level of fullness most of the time, with occasional episodes of stronger fullness that last about 30 to 60 minutes, one or two times per day. It tends to worsen with stress.

Vibration

Sometimes when I speak, especially loudly or for a long time (like on the phone), I feel vibrations on my right side. A couple of times, I didn't hear as much vibration, so there might be some improvement.

Mental State

There has been some improvement, if you can call it that. I don't feel the overwhelming panic anymore. Instead, I live with a constant despair of acceptance. I can function as a person, just not very well. I can concentrate at work when I have to, but I have no ambition or drive for new hobbies, career advancement, or self-improvement.

Sleep

This has improved. I've accepted the noise enough to fall asleep with it in the background, even with new tones. White noise and music never really worked for me, but talk-heavy podcasts distract me and help me fall asleep. Benadryl and melatonin don't seem to make a difference.

Tinnitus

I'm estimating volume based on a 1-to-10 scale. Some people have tinnitus so loud that white noise would have to be damagingly loud to mask it—maybe that's a 10. I'm nowhere near that. My buzz tone can be masked at 40 dB, which I gauge as a 2/10. Other tones are too high-pitched to mask. I'd say my case falls on the mild side of moderate.
  • Original buzz tone (fluorescent light sound, in-ear): Still there. Low volume, about 2/10. It spikes with activities like driving but calms down within an hour. No real change. Somatic.

  • 500 Hz reactive flute tone (in-ear): Around 3/10. When triggered, it fades in 20 minutes instead of 45. A few times, it didn't trigger at all. This might be improving, but it's still inconsistent. Can be somatic.

  • High electronic ringing (full head): Can range from 2/10 to 6/10, worsens with stress or when I think about it. Initially thought it was 3500 Hz, but now it seems closer to 7500 Hz, possibly with harmonics. Not sure if the tone actually changed or if I misidentified the frequency before. Right now, this tone dominates everything else.

  • Morse-code tone (~1100 Hz, in-ear): Soft volume, around 1-3/10. It settles to a softer level during the day but can spike at night.

  • New tone (past two weeks): Around 1500 Hz in my unaffected ear. Yikes. It's extremely soft—I had to plug my ears to notice it—but now that I know it's there, I hear it more. Ugh. Now I'm just driving myself crazy.
Oto-Neurologist Visit

I saw an oto-neurologist last month. He has had tinnitus for over 20 years, with no known cause, and doesn't really care about it anymore (fully habituated). He said:
  1. New tones can be caused by anxiety, but he can't say for sure.

  2. Low-frequency hearing loss due to acoustic trauma is unusual but possible. The theory is that it results from inflammation rather than direct damage to the cilia.

  3. Even though I lost some hearing, I can still understand speech and get by without a hearing aid. I might try one for other symptoms, but that's my decision.

  4. He was adamant that I needed much more time and told me to come back in a year for another audiogram. He kept repeating that, for most people, this fades—not necessarily completely, but it fades. Yeah, right.
Bottom Line

After six months, the tinnitus itself is no better, but I'm getting better at dealing with it. Still not good though.
 

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