Had Tinnitus for 3 Years — Spike at Club Last Night. Should I See ENT for Prednisone?

[Please Help]

I wore good quality earplugs (Alpine PartyPlug Pro) when I went out but I was at the club for a good 4-5 hours and noise level was around 110-115 dB. Combined w drinking alcohol, I had a significant spike last night into the morning that has finally calmed down.

Although my spike is gone and I appear to be back to my baseline lev, I am concerned that being exposed to loud noise that long even earplug protection may have caused permanent hearing damage. Normally I use NAC before going out and after, but this Time didn't have NAC before hand and only took NAC the day after. I supplemented with vitamin E and magnesium to try and limit the damage.

Question is - should I go to an ENT tomorrow and try to get a prescription to prednisone or should I just stick with my NAC / Magnesium / Vitamjne E over the counter plan? Please let me know, again my spike calmed down and it's back to baseline, and I've had tinnitus for 3 years and have mostly gotten used to it but just want to know whether I need a prednisone prescription to make sure permanent damage is kept in check.

 

[fishbone]

If I was worried that my hearing was damaged, i'd go see an audiologist and see if it was damaged or not. You are free to do what you want to do....

 

[Jcb]

Personally I would just keep up with the magnesium and vitamins, if you are worried about your hearing maybe get a hearing test just to put your mind at rest. The fact the spike went down is a good sign, maybe ease off the clubs for a while and give your ears a rest. I miss clubs man but doubt I would step foot in one ever again due to the noise levels, for me it's not worth the risk.

 

[Bill Bauer]

If I was worried that my hearing was damaged, i'd go see an audiologist and see if it was damaged or not.

Audiologists can't test for hidden hearing loss. Also, most people on this forum don't have any hearing loss (and yet have tinnitus and get tinnitus spikes).

try to get a prescription to prednisone

Prednisone carries risks. Not doing anything is also risky. Your guess about what to do is as good as anyone's (on this forum, or a an ENT guessing).

At least your spike is gone - that's probably a very good sign. If you ignore the fact that earplugs can provide a false sense of security, eventually you might run out of luck.

 

[Jack Straw]

@Please Help you are very lucky that your spike went back to baseline. You seemed to have gotten very lucky. Please be careful in the future and make sure you know your ear plugs NRR when going to a venue. Being at a loud venue for too long even with ear plugs can still be unsafe.

If you ignore the fact that earplugs can provide a false sense of security, eventually you might run out of luck.

The plugs he used were 20 dB protection. Lets assume it was 115 dB in the club and at best he got was 15 dB protection. This would mean that he was exposing himself to 100 dB. The exposure time on 100 dB from NIOSH standards (stricter than OSHA) is 15 min. If he was in the club for 4-5 hours he well exceeded the safety limit. This doesn't mean ear plugs don't work. It means that ear plugs when used improperly don't work.

If you are saying, "When ear plugs are used improperly they don't provide adequate protections and can also provide a false sense of security", than I agree with you. People need to be educated that NRR, dB levels and time limits need to be taken into account when exposing themselves to loud noises. They work if the proper dB level and time limit exposure are within safe levels (subjective).

 

[Bill Bauer]

The exposure time on 100 dB from NIOSH standards (stricter than OSHA) is 15 min. If he was in the club for 4-5 hours he well exceeded the safety limit. This doesn't mean ear plugs don't work. It means that ear plugs when used improperly don't work.

There are plenty of examples on this forum of people being exposed to the kinds of sounds that are WELL below those guidelines (that were designed for the healthy people) and ending up with permanent spikes.

For example

I developed a permanent new tone last year from something that should be safe for the average human ear.

He was talking about:

With regards to noise exposure that isn't dangerous to most people, I developed a new tone in my right ear after a noise exposure at work back in October. I spent about half an hour in an area that I would estimate was at most 90db, but it was probably less than that. I had deeply inserted large foam earplugs at the time, but apparently that was not enough protection. That tone has not gone away, and it's not some psychosomatic spike. Spikes in volume are somewhat relative in my opinion, they can be attributed to stress, lack of sleep, noise exposure, diet, etc., but completely new tones that do not go away are something different.

What is safe for you may not be safe for me. And the fact is there has been no good study done assessing the vulnerability of already damaged auditory systems. The gold standard for dangerous noise levels is based on old data from OSHA where they looked for permanent threshold shifts of 10db or more at 2000, 3000, or 4000 Hz. As we know now, you can have fairly significant auditory damage without having a permanent threshold shift in those three ranges. There is also a lot of industry push-back when OSHA tries to make safety guidelines more strict (I haven't seen this with noise levels, but I have seen it with chemical safety guidelines). Moreover, it's very likely that some people are more genetically predisposed to hearing damage than others.

If you are saying, "When ear plugs are used improperly they don't provide adequate protections and can also provide a false sense of security", than I agree with you.

No, I am saying that when you use properly inserted earplugs and are something like 10-20 dB below those guidelines, there is still a non-negligible risk that you will develop a permanent T spike (in volume) or a permanent new T tone.

 

[Please Help]

@Jack Straw thank you for the insight - I will be far more careful moving forward.

As for earplugs, do you know where you get the 20 dB reduction number for alpine partyplug pro? I haven't been able to find this number on the internet. Are there earplugs that provide even larger decibel protection? Where can I find those and how much additional dB protection do they provide? I will make sure not to visit nightclubs in the near future, but if I'm in a situation where there are loud sounds it would be nice to know I have earplugs with additional hearing protection.

 

[Contrast]

I am concerned that being exposed to loud noise that long even earplug protection may have caused permanent hearing damage

.

 

[Ed209]

I wore good quality earplugs (Alpine PartyPlug Pro) when I went out but I was at the club for a good 4-5 hours and noise level was around 110-115 dB. Combined w drinking alcohol, I had a significant spike last night into the morning that has finally calmed down.

Although my spike is gone and I appear to be back to my baseline lev, I am concerned that being exposed to loud noise that long even earplug protection may have caused permanent hearing damage. Normally I use NAC before going out and after, but this Time didn't have NAC before hand and only took NAC the day after. I supplemented with vitamin E and magnesium to try and limit the damage.

Question is - should I go to an ENT tomorrow and try to get a prescription to prednisone or should I just stick with my NAC / Magnesium / Vitamjne E over the counter plan? Please let me know, again my spike calmed down and it's back to baseline, and I've had tinnitus for 3 years and have mostly gotten used to it but just want to know whether I need a prednisone prescription to make sure permanent damage is kept in check.

You took a big risk going to a club for 4 - 5 hours with just the protection of Alpine party plugs. 110 dB - 115 dB seems incredibly loud for a nightclub, and I have no idea if your measurement was accurate or not, but assuming it was, that puts you at circa 95 dB for 5 hours which is not good for your ears at all.

I'm really glad to hear that your spike subsided but you're playing with fire at those levels with such little protection.

Nightclubs are usually between 90 dB - 95 dB on average, so wherever you were, it was louder than a typical rock concert.