Good Times and Bad Times — Tinnitus Affected by Sildenafil and Painkillers / Anesthetics?

So, here's my tinnitus story. My apologies, it ended up a bit long...

The first time I experienced an acoustic trauma was back in 2007 or something. I went to a rock/metal club to see a few bands. I didn't have earplugs with me which I normally do. I sat in front of a monitor even though it was so loud that it felt quite uncomfortable. After the show I knew something was wrong because other people's speech sounded muddy and distant. I figured that giving my ears some 'silent treatment' for a week or two would help them recover, which it did and assumed I dodged the bullet of more severe consequences. More weeks passed and the left channel of my Korg headphones went dead - the same day I came to realize that I had developed tinnitus. It did creep me out and decided that I would never again use headphones. I still don't, for the most part.

The second acoustic trauma was probably late 2012. A bad one. Basically just ended up being with the wrong people in the wrong place at the wrong time. There were rather big studio monitors in a room, the host put his sound system on with a mic attached and gain set to 11. The feedback signal swept wide spectrum of higher frequencies and it felt like hammering a nail through the skull, I would guess. This happened in a city I had never visited before and all I could do was to count the hours to get back home the next day with my aching and ringing ears.

When I got home I tried to find some ENTs. I went to see one ASAP and I was hugely disappointed how the doctor bypassed my concerns and prescribed Betaserc and some lotion to moisturize my dry ear canals. Since Betaserc is not really a solution for an acute acoustic trauma this visit to the ENT ended up being the most expensive moisturizer ever. I made another appointment for the next morning with another ENT/audiologist who was a bit older and had more experience. I had read about hyperbaric oxygen therapy and discussed about it with him. To my amazement I ended up going through HBOT treatments. There happens to be those in my home town and if this wasn't the case it wouldn't have been an option.

Several days had passed and HBOT should be accessed ASAP. I was so desperate that I was willing to do anything and everything to make things better even just a tiny little bit. I can't really tell how much HBOT actually helped with my ears, but in the end I think some improvement did occur. But HBOT was not a solution to the problem. It was time to try some alternatives.

A family member of mine happens to have a device that allegedly stimulates blood circulation, improving oxygen and nutrition on a cellular level via pulsed magnetic field (PEMF). I thought maybe it's worth a shot. At least it can't do any harm, can it? I had purchased a load of all kind of supplements so maybe PEMF could help body to make the the most of them. If I had to pay for it I probably wouldn't have bothered with it. For a two to three month period I did PEMF on both ears approximately two to three times a week. I couldn't and still can't tell how much of a benefit it had on my ear related problems, if at all, but at least I felt good about the fact that I had tried my best. I also ended up trying acupuncture that was performed by a Chinese doctor. It was an interesting experience and I thought it gave me some help after several sessions.

Anyway, months passed and overall anxiety and tinnitus settled down to a level that didn't bother me too much and I could cope with them. Later on there have been some difficult and not so difficult times but that's just how it goes with tinnitus as most of you who read this know. Being a music lover and playing in a band involves an element of danger for a person with ear related problems, but I've done my best to protect my hearing and have managed with it.

But, that's not the end of this personal tragedy. Or shitshow. Or whatever. I had a prescription for some Sildenafil, better known as Viagra (I don't really have an ED, but I'm not going to go too much into the details on this one). I've found out that Viagra and other similar drugs have ototoxic properties. I have tried it a few times, maybe 10-12 in a timespan of several years, so no frequent use. On those occasions that I've tried it I've kept the dose minimum, around 12 to 15mg which is quite low considering 50mg is supposed to be the starting dose. There is no consensus on how or why these drugs induce ototoxic effects but it is suspected to increase blood flow in the inner ear too much. Like a cochlear hard-on. This is my suspicion too, since I've felt some excessive blood flow/pressure to the inner ear a few times but not much other adverse effects so I had thought that if I don't overdo it, everything should be okay. Last time I took it was early December. Being in a hurry I ended up taking something like 30-35mg which is considerably more than the usual doses, but not that much on a scale of 25-50-100mg strength that these pills are sold. During the next weeks I've felt some ache in both ears, fullness and overall discomfort and there were moments I experienced some SSNHL but tried not to think too much of it. Going to a doctor wouldn't be much of value, I thought.

I had a surgery mid-December where they removed an osteophyte from my right foot. Not a big deal, it was a smooth operation. Pre-op they gave some painkillers like paracetamol, maybe some Ibuprofen and during the op sedatives (Fentanyl and when I asked for more the nurse gave something else too that I don't know of, I was not allowed more Fentanyl) and anaesthetic injected to the spine. I got home the same day and for the pain doctor prescribed a shitload of 600mg Ibuprofen, some panacod (paracetamol+codeine) and a few spare mild oxycodone pills if needed. I didn't go overboard with the painkillers. I stopped taking any after a week or so and the amounts were within daily limits.

Good news is that the foot is doing great. Bad news is that ears are not. I still feel some occasional small pain in both ears but not that much as in December. It seems to get pronounced if I listen to some white noise for example so not doing that. It's like there's a 'sonal silhouette' or a tonal morse code kind of a thing going on that jumps out to ruin the soundscape that white noise is specially good to bring to attention, like shadows on a wall. Not listening to anything at the moment because it seems that I've developed/resurrected reactive tinnitus. Both ears react to some sounds creating an overtone to it, like sound of a computer fan. Or sounds of a fridge. Or cars passing by - and there are plenty, living in the center of a city.

I actually went to an ENT a week ago who is also an audiologist and had a nice looking resume. They had separately mentioned tinnitus as one of their special interests. I tried to describe my symptoms, history of ear traumas and all but didn't really listen to what I had to say and basically just told me to 'suck it up'. They checked my ear canals and decided that I needed some microsuction. If my sleep-deprived brain had been even remotely working I would have denied that but I was at a loss. It felt quite uncomfortable and LOUD, but can't really say for sure if it worsened the state of my ears or not. Never again.

Is this because of Sildenafil or the combination of other potentially ototoxic painkillers/anaesthetics in conjunction with it? I guess no-one can tell. These are pretty much the same symptoms that I experienced back in the day (sounds/frequencies distorting with increased tinnitus) rubbed into my face again with a few new tricks.

Since 2012 music was never the same again but I had habituated so well that didn't really pay attention to sounds/frequencies distorting that much even though I could tell how my ears made me hear things and tones that should not be there. But here I am - suffering the consequences of my poor decisions once again. I hope I can reach the same level things were a few months ago.

Thanks for reading!

 

Habituate and pray for better treatments or a cure. PROTECT YOUR EARS! Better yet, stay away from loud noises!

 

Thanks for sharing. I am also a victim of some bad decisions and naïve thinking and bad doctors telling me to "suck it up" or "what do I expect from them". So I think we have many things in common. So, welcome to Tinnitus Talk.

My story can be found in the other thread (or threads), but just to make a little spoiler... I had my chance to actually be more careful about my hearing when I had first temporary onset when I was around 22-23 (don't remember exactly), but the doctors I have asked for help were treating me like a weirdo with an imaginary squealing in the head. So yeah, it went away after 2 months, and I forgot about it until I got it back permanently at age of 33 when I accidentally blasted my headphones at full volume. Without going into detail what it did with myself, instead of protecting my hearing, doing HBOT (which nobody has suggested to me), I followed doctors' advice and went to loud MRI and did many loud hearing tests.

Back then I was naïve thinking that one cannot ruin one's hearing with a few seconds' blast - wrong! You can, when seeking medical advice one can get a treatment for very common conditions - wrong! there's no treatment for tinnitus, and doctors don't give a damn. I could name many other things... Ignorance is bliss. My pre-tinnitus naïve ignorant world was much nicer.

Still even with all the recent experience, January 2020 I got myself tinnitus worsening from such a trivial thing as a big bus braking next to me for a couple of seconds while trying to get through crowded pedestrian crossing in center of San Francisco. The bus was braking on and on... the coming sound was horrible, piercing, distorted, and I was petrified. I should have run to some nearby shop or something, hide somewhere, but I was standing there like an ass thinking that that damn bus must and finally will get through and drive away and nothing bad can happen. But that moment was taking forever. And in the evening I had a return flight to Europe, so I had no time to recover from that ooopsie. So yeah, I guess we all have some "sleep-deprived" brain malfunction moments. I guess we are just unlucky that these things have such a life-altering consequences, instead of just some scratches or broken bone that will heal relatively fast.

Yeah, if only the the habituation could work when someone wants it and if only there was someone who hears your prayers and has a will and means to help.

 

That is my hope!

 

Thanks for the reply! I've been lurking on this forum for a while and have read some of your posts too.

I'm mostly interested in finding good supplements that could potentially be helpful when things are going south. Anatomy of hearing is unfortunately so complex that finding the right ones that could be of use is a wild guess at best. I'm having the PEMF treatments again a few times a week.

The supplements I'm taking at the moment include:

ALCAR with ALA
Astaxanthin
Magnesium
NAC
Vitamin D3
Vitamin B-complex
Vitamin C
Fish oil with EPA/DHA
Zinc
Ginkgo Biloba

If they do nothing for my ears, then maybe they help with overall wellbeing and that never hurt anybody. Having some control over the stress that tinnitus causes plays a huge role regarding healing process. Ordered some Lion's Mane yesterday to boost NGF. But a bunch of good supplements hurts the wallet a bunch, so some will eventually drop out in the long run.

When it comes to my ears I avoid ENTs like the plague in the future. Of course there are some good ones, but the chances of finding one are next to none. Too often tinnitus patients face gaslighting from doctors and nobody wants to take responsibility (I kind of understand this because there really are no official effective treatments). I found it a bit baffling that the last ENT/audiologist I went to didn't know anything about the terms that are being used on this forum all the time, like hyperacusis, reactive tinnitus etc. Being an audiologist and having an interest in treating tinnitus it would seem that these phenomenons should be familiar but that is not the case. Most of the time it seems they don't know shit.

Yeah, I feel you. Those bus brakes can be really loud and disturbing. Public transport is solely based around bus traffic where I live and there's always several of them around. I feel anxious having to go outside because of them and that's why I wear earplugs when walking around the city.

 

Blood patch for the treatment of post-dural puncture tinnitus

"Audiometric disturbances are recognised as potential complications after spinal or epidural anaesthesia; however, incidences of tinnitus occur less frequently."

"In summary, an epidural blood patch is an effective treatment for post-lumbar puncture tinnitus."​

I would never have guessed that post-lumbar puncture tinnitus was a thing. And I would guess my orthopedic surgeon doesn't know either. Can't say for sure if this is the cause for my ears getting worse or if it is a contributing factor or not. All I can say is that I'm confused.

 

What I never get are the Sildenafil references in relation to tinnitus.

Ginkgo Biloba sort of has the same effect, no?

"Ginkgo biloba extract (GBE) facilitates blood flow, influences nitric oxide systems, and has a relaxant effect on smooth muscle tissue"​

Why then is GBE prescribed to treat tinnitus? Even my pharmacist made me buy a box when I told her of my tinnitus.

 

I'm not a pharmacologist but I would say Sildenafil is a more potent inhibitor of the PDE5 enzyme than GBE, which regulates cGMP that is increased by nitric oxide and when there are no regulative enzymes doing their job risk there is a greater risk of experiencing excessive blood flow. Medicines can turn to poison when intensity or quantity increases.