I Think I Just Gave Myself a Third Acoustic Trauma. Is This My Third Strike?

Just before I made this post.

I set the volume on my PC to 1 out of 100, and I set the volume on the site to 1 out of 100. When I tried to find my frequency, the sound felt too loud (not good when it is high-pitch). I was able to turn it off after 1 or 2 seconds. Turns out I forgot to turn down the volume on my speakers. Just in case, I took a prednisone tablet.

Today I think I am worse(!), tinnitus is even more high pitch now. I can't believe I managed to hurt myself a third time. Then again, if it is THAT easy to hurt yourself then I shouldn't be surprised. I am hoping for the best, but this is profoundly disturbing...

 

Life happens bro, take it easy and hopefully your sound/spike settles down

 

Did you immediately think your tinnitus was worse? Or did you think it was worse after taking predisone? Some people claim to have spikes while taking predisone, perhaps something to do with increased blood pressure. I know for me, I felt my tinnitus was louder and my anxiety was horrible while taking predisone.

Did you do anything today to try to keep your mind off of it?

Any foam earplug use? Again for me, they make my tinnitus seem even louder because they block safe sounds too -- leaving me stuck listening to only my tinnitus.

 

I'm sure you will be fine!
Try not to dwell on it and don't search for your sound.
Stay as calm and as relaxed as you can.
Relaxing music that you like can work wonders.
Tomorrow is a whole new day and hope a better day for you.
Love glynis

 

I don't think you are injuring yourself Bill, but I do think you are reinforcing existing anxiety which is much the same thing in practical terms.. How do I know? Its exactly what I do. Its just taken me a few years to fully realize it (which doesn't always help mind you).

 

My ear felt full immediately after.

Perhaps it Is prednisone (although the last time I took it my T didn't feel worse).

Now the question is - is it a good idea for me to take the second pill...

I tried.

In the past month, I would get for a couple of hours when I would get the loudest T of the day. Most of today was close to that. I admit that right now (early evening) it is back to yesterday's baseline.

I am not sure about taking that prednisone again. I know it is not good for me. Also it is so difficult to get it (must spend hours at the emergency).

 

There is no established evidence that prednisone works for noise induced hearing loss right? Btw it is also on the ototoxic list of medications and has tinnitus as a side effect.

 

The link below can give us some idea about how bad prednisone is as far as causing T:
http://www.ehealthme.com/ds/prednisone/tinnitus/
Looks like of those who got side effects, about 0.3% reported to having T.

Erythromycin is known to cause T. According to
http://www.ehealthme.com/ds/erythromycin/tinnitus/
about 1% of those who report side effects got T.

It is possible that Erythromycin causes side effects in larger fraction of users. Looks like the risk is less than 0.1% for prednisone. That's still significant.

The good news is that 2/3rds get T after taking prednisone for more than a month.

 

Last year I tried to self medicate with some prednisone I had left after getting a spike for using foam earplugs - not sure why that happened. I took 30mgs for one or two days but only ended up with shoulder cramps for a few weeks and pain near my gallbladder for months it was bad enough that I went to see a doctor.

 

Bill, you will eventually learn that not every "loud" sound will increase your tinnitus. Yea, sometimes sounds will make you more aware of your T or your T may spike for a few minutes hours days, but not all loud sounds = damage / increase in T.

Try taking some time off the forum. Sometimes having a support community at your finger tips isn't the best way to habituate. You will read both reassuring stories and horror stories (but guess which ones stick with you). You have to learn to trust yourself and trust that things will be okay.

Hope you're feeling better.

V

 

J Otolaryngol Head Neck Surg. 2017; 46: 41. Published online 2017 May 23

Current insights in noise-induced hearing loss: a literature review of the underlying mechanism, pathophysiology, asymmetry, and management options
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Anti-inflammatory effects of corticosteroids to reduce noise induced trauma

Different types of pharmaceutical agents have been shown to reduce the risk of hearing loss secondary to acoustic trauma. Steroids, specifically intratympanic dexamethasone, may have a therapeutic beneficial effect on NIHL when given before [162] or after [163] acoustic trauma in animals. Although an effect is shown in a wide range of dosages, higher dosages appear to be associated with better hearing preservation [162].

Different routes of delivery have been investigated in animals, including intratympanic, intraperitoneal and direct administration into the scala tympani, and all have demonstrated protective effects as evidenced by preserved hearing (15–20 dB lower hearing thresholds on auditory brainstem response (ABR) measurement and preserved cochlear architecture [163, 164]. Each route of delivery may protect hearing at a different level; intratympanic administration appears to be more protective for the efferent terminal outer hair cells synapses, whereas intraperitoneal injections are more protective for the organ of Corti and stria vascularis architecture [163]. Accordingly, there appears to be a synergistic benefit from the administration by both routes when treating NIHL [165]. In human studies, it has been shown that after acoustic trauma, the administration of systemic with intratympanic steroid treatment results in better hearing outcomes than with systemic steroids alone [165, 166]. Although there is some evidence for a protective effect of steroids in acute acoustic trauma, clearly it is not a long-term option for chronic occupational noise exposure considering the negative side effects of systemic long-term steroid usage.

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Eur Arch Otorhinolaryngol. 2016 Dec;273(12):4089-4101. Epub 2016 Feb 16.

Pharmacological agents used for treatment and prevention
in noise-induced hearing loss

Steroids

Interest in hormonal regulation of hearing physiology and sensitivity to noise has resulted in conservative strategies focusing on steroid hormones. The most studied steroids are dexamethasone and methylprednisolone. Administration route, timing and effective dose have all been investigated in various previous studies.

In a study performed by Wang et al., intraperitoneal injection of 1 mg/kg dexamethasone for five consecutive days in guinea pigs exposed to 115-dB SPL white band noise provided protection against NIHL, possibly by suppressing cochlear Hes1 expression via a glucocorticoid receptor-dependent mechanism [5]. In another study; 1-, 10-, 100- and 1000-ng/ml doses of dexamethasone were administered directly into the scala tympani of guinea pigs exposed to 120-dB SPL octave band noise on the fourth day of dexamethasone administration. Direct application of dexamethasone to the inner ear was reported to be effective in protecting against NIHL [6]. Arslan et al. [7] investigated the effect of dexamethasone in the treatment of NIHL in 26 rats. These were exposed to 115-dB SPL white noise for 3 h a day for 10 days. Dexamethasone was injected at 2 mg/kg for 7 days in the first hour after noise exposure. The final hearing threshold was 5 dB, a normal hearing level, in the treated group, which was significantly better than that in the non-treated group (22.5 dB nHL). The results showed that early initiation of dexamethasone therapy is effective in the treatment of NIHL.

Transtympanic administration of methylprednisolone is also effective in the treatment of NIHL. Ozdogan et al. [8] administered intratympanic methylprednisolone following noise exposure in 16 rats. They reported a decrease in the numbers of apoptotic cells in the outer and inner hair cells of the cochlea. They concluded that intratympanic methylprednisolone injection after acoustic trauma reduces outer hair cell loss. Tabuchi et al. [9] investigated the therapeutic time window of methylprednisolone in acoustic injury. Mice were exposed to 128-dB SPL for 4 h. The authors reported that when administered before or immediately after noise, methylprednisolone has a protective effect against acoustic injury. However, when administered 3 h after acoustic overexposure, no protective effect was observed. These findings suggest that the therapeutic time window of methylprednisolone is very short.

In contrast, studies have also reported that steroids have no otoprotective effect. Bas et al. [10] studied the effect of dexamethasone against NIHL in 32 rats exposed to 120-dB SPL noise for 4 h. The day before noise exposure and for a subsequent period of 14 days, the animals were administered dexamethasone. The authors reported that dexamethasone was not effective in protecting against NIHL. In another study performed by Takahashi et al. [11] guinea pigs were exposed to 110-, 115- or 120-dB SPL noise for 10 min. Methylprednisolone was given intraperitoneally for 7 days after noise exposure. The authors concluded that methylprednisolone is not effective in the treatment of acoustic trauma caused by exposure to 115- or 120-dB SPL, while it is effective in exposure to 110-dB SPL.

 

Great find. Do I take it that up to 110 there is a probably viable first-aid option, but once over that (notably from 115 on), all bets are off (if you are a Guinea pig)?

It would be incredibly hard to recruit suitable and willing candidates for a human trial.

 

The military is a good place. The US governerment spends over a billion dollars a year for disability from service-related tinnitus and hearing loss.

 

I think you'd have to enroll them at the start of the injury, at least within the first two weeks or so.