I Work in the Fire Department and ER — Sleep, Stress, Hormone, Anxiety Issues Followed by Tinnitus

Hey guys,

Been lurking for a month or so, thought it wouldn't hurt to give an intro and post some of my story so far.

I know I've barely had it a month but, I work in the medical field and have gained a new level of insight on how to look at this after getting it myself, I'm interested in knowing more and like to help and talk to other people I meet just to give them some hope or spread some information at least.

Long story as short as I can, I'm a Medic that works in the Fire Department as well as the ER overnight. For the last two years I've had some sleep issues from shift work that they gave me Ambien for, seemed to help but still was pretty back and forth... We work 24 hours usually with little sleep, then working nights just didn't help. The stress started to creep on after COVID-19 hit, people quit, call volume through the roof, we started getting mandated for 48 hour shifts every week with no sleep sometimes driving a lot and super stressful situations and that constant fear of the tones going off.

Add in some hormone issues with medication, stress, anxiety, and a touch of health anxiety from another unrelated issue with my arm, and by the end of February I was just a wreck, not sleeping for days at a time even on Ambien. By the time the tinnitus kicked in, it just made a whole situation worst. They tried to mandate me one morning for an additional 24 hours after not sleeping all night and having the tinnitus and I just broke down crying saying I can't do it and thankfully my Captain saw I was being serious and let me go home.

The first two weeks was bad, it is a usually at a 16.7 Hz and mostly in my left ear I think, sometimes it sounds like it's just in my head but, 97% sure it's the left ear. Sometimes it sounds like my right ear is trying to play too but it usually goes away. The first two weeks it would go away randomly for almost an entire day or at least half the day. At night, strangely enough laying down it either goes away completely or lessens to the point I can't tell if it's ambient noise or not. Even stranger I am usually able to fall asleep at home without any sleep meds though sometimes my mind is too active and I take it for the hell of it.

I went through the normal routine... Though I had a nurse look at my ear at work with an otoscope and she said it was red with fluid and I need to go get it dealt with. I went to my PCP and he just sort of shrugged and threw a 4mg Medrol pack at me. Waited a week before going to an ENT and, as it usually seems, he basically laughed at me and said I have ungodly good hearing and to get out, giving me a paper about TMJ. Went to a dentist yesterday that said they deal with TMJ, he for some reason decided to do a full 3D scan without telling me and didn't really look at my joints like he said he would, charged me like $300 and said Botox or an appliance and I likely have a pretty good case of TMJ.

Tomorrow I have a chiropractor visit, so we shall see. It is true I've been super stressed for a prolonged period of time, my muscles on my left side, particularly my traps and neck and all are super tight and such. My teeth are a bit of a wreck too but noting super crazy, and I have bad cracking in my jaws when I open but no pain really. The sheer number of variables make it hard for me to narrow completely.

Right now, it's manageable it seems, I don't listen to maskers too much, usually if I'm concentrated on something else I don't notice it but, at times such as working and stressed it is like a TV Or CRT monitor on high. Showers mask it, but afterwards it is very noticeable after, same with turning on faucets or touching paper or crinkle sounds, I'm thinking hyperacusis? But it usually fades quickly afterwards. I also had sinus issues around the same time it started for a bit as well as red eyes when waking up. After starting Zyrtec and nasal spray it feels like that issue cleared up but, the red eyes after waking up remain.

It feels good to vent or at least tell my story, I know it's a bit rambling but just telling it all is a bit relaxing. It doesn't sound like I have it as bad as a lot of people and I haven't had it for long but, it still definitely sucks. I feel like some of my future job options closed up such as joining the military, as well as things such as playing, listening to the piano and other softer music. I'll keep things updated as I can, hopefully I can get something of an idea as what to do. I'll likely have to quit my Fire Department job as sleeping at the station is not a good time with the way things work, but it feels like the stress isn't worth it.

Thanks for listening,

L

 

Hello!

My story is similar to yours.

I've had a very stressful period in January and February (anxiety attacks, headaches, insomnia - even with sleeping pills).

I managed somehow to overcome these problems but only for a short period of time (about 3 weeks), and then... tinnitus struck.

Mine is also moderate but I am very anxious and I have become obsessed with it.

You are lucky for having tinnitus-free periods, I think that is a good sign.

This is not my first time I am experiencing tinnitus, it all started 9 years ago.
It took me about a year to habituate, but after that I had a normal life.

You shouldn't be worried about your future plans. Worst case scenario, it will take some months for you to habituate and then all you should be thinking about is proper ear protection and avoiding loud sounds.

Good luck and keep posting!

 

Good heavens. What crappy providers. It’s really hard when you can’t get any answers. But many people on this site have to guess as to what caused their tinnitus because they don’t have any answers. Very frustrating. I have hearing loss in my left ear and that accounts for one tone I have. I also have a similar noise to what you describe primarily in my right ear, in which I have perfect hearing, although sometimes I hear it in my left. I think it may be allergy related as there are certain times a year it’s worse than others and then it goes away.

Have you considered allergies in addition to TMJ? I have a friend who had the same noise and they finally discovered it was TMJ.

I do hope it improves.

 

I believe I read somewhere that a job in Fire Department and getting tinnitus makes you eligible for disability?

 

You will be fine. Just avoid noise and stop taking Ambien. You have screwed hard with your inhibition receptors.

You would KNOW if you had hyperacusis so I doubt it's that (sounds would be painful, eardrums would at the least be flinching).
Just sounds like mine before I got wayyyy worse. I would've gotten better (was waking up to silence) had I not messed with it.
So stop messing with it, and you'll be fine.

NO! steroids. NO! GABA drugs.

If you really want to "try" something low risk, if it is muscular, Cyclobenzaprine might make it go poof.

When mine was your level I thought it was the end of all things too... but even like that the military would've said yes. If you pass a hearing test that's all they care about, and you'll likely have fading in your tinnitus anyways over the year.

 

Hey guys, thanks for the positivity and suggestions.

A few updates of note, after the chiropractor and a few adjustments, there has not been too much of a change, though it was relaxing. No definitive idea if I have TMJ or not, not that I was expecting any information.

I had a doctor at the ER I work at look at my ears again, and she told me that, much like the first time almost 3 weeks ago, my ears had fluid behind it. My right ear had a lot of pressure with a lot of fluid, and my left had ear wax with a little fluid, but no infection in either.

A little hydrogen peroxide and saline in my left ear cleared up the tinnitus for a little bit, but it seems to still be unbearable in stressful situations (i.e. work) but when I'm playing games or out doing something else it sometimes fades to the point I can't tell.

I stopped taking Ambien for now as horrible as that can be, just doing Flexeril and Melatonin. I'm afraid of going to any more doctors right now seeing how useless it has been so far. Not sure if I'm still over reacting since it's only been just a month but I'm trying to hit out as many possibilities as I can while I got the insurance.

Thanks for listening once again.

 

Hi there. When my tinnitus started a few weeks ago, I started taking Gabapentin mixed with Buspar.

I want to stay away from benzos as they have wrecked my life before.

Why no GABA drugs? I have side effects like slight face and neck numbness but the tinnitus has slightly decreased and nerve pain in my foot Is lower. Truth be told I could just be imagining all these side effects.

 

ENTs are the worst, especially the ones with no compassion that tell you to just deal with it. I feel for you.

The Flexeril is for what?

I, like you, have hormone, stress and major anxiety issues. I noticed when my anxiety is under control I'm less tried, my neck and shoulder muscles are less sore and and I can deal with the anxiety better. I know, trust me, it's easy to say deal with the anxiety and stress and then the tinnitus. I actually hate it when people say that and I am by no means dealing with my anxiety in a proper manner but there is truth to is.

My anxiety is about 10% less with Buspar and my tinnitus went down a little too.

It could be the Gabapentin but I'm on a very low dose 200 mg in am and 200 mg at night. It's been known as an off brand for anxiety.

 

Because you want to give the inhibitory pathways and receptors a chance to re-potentiate/upregulate. Forcing everything to fire less will make them adapt, leaving you in a worse state once tolerance occurs.

The drugs you are taking are in my opinion far more complicated than benzos and are probably helping to potentiate an inhibitory path. They are also likely safer.

I have heard of Gabapentin induced tinnitus though, so just don't go crazy with it.

Even though it's in the name, Gabapentin does NOTHING with GABA or its receptors, it acts on calcium channels to inhibit nerve firing, hence its use as an anti-epileptic with less side effects than benzos and less risk of tolerance/dependence. Gabapentin has been around for a long time and is probably safer to take than benzos.

 

Do you find the Cyclobenzaprine helps?

If it doesn't, you should probably just taper off. It relaxes muscles pretty quick. It should be a night and day difference. Best to not be on something longer term if it's really doing nothing after a few days. Keep calm and I'm sure you'll experience a reduction over time... Some people have said earplugs at night helps too to give the best chance of rebounding if your tinnitus is due to noise impact.

If you find benzos help / work, that's awesome to have some around in case you get a spike and it's a bit of an mental emergency to calm it down, just don't start thinking you can take it day to day. Maybe once every couple weeks tops?

I tried Scopolamine patches too. It might've helped "a little" with just the high ringing. Definitely makes you drowsy. They are OTC.

 

OK, I understand. Thank you. You seem to have a wealth of knowledge. Yea I am definitely staying away from benzos. I don't plan on taking more Gabapentin (400 mg) than I am currently.

Do you have any insight on Trileptal? My neuro and psychiatrist want to put me on a low dose (300 mg)?

Thanks.

 

I might know just enough to hurt myself more, I'm no expert. I just have a basic / mild understanding of biochemistry and attended a few lectures about the inner ear that were taking place at the university I work in.

Once a drug starts acting on several receptors I can't begin to guess what might happen... I'd assume a psychiatrist would hopefully have an idea of the pathways they want to turn on or off with various drugs.

My experience is what I base a fair amount of stuff off, from what I've tried so far.

Trileptal seems like the updated version of Carbamazepine. I doubt it will help for anything other than morse code / typewriter tinnitus (in fact it's so specific to that, it's used for diagnostics and is one of the few truly treatable types of tinnitus based on trials). You can YouTube typwriter tinnitus to see if that's what you have.

If you were to try it, ,I wouldn't stay on it for long. Ask them how long they'd want to put you on it for. Sodium channel modulators/blockers aren't the best thing to stay on long term for anything... even if they do work initially. I've heard of horror stories when you stay on them for long periods (synaptopathy, dysacusis, acoustic changes, akathisia to note some that are possible and from the stories I've read here and elsewhere, those adverse effects are not always temporary).

If your tinnitus is "just ringing," you can try it... but like I said, if it isn't morse code in nature, do not expect it to work.

 

Another bit of an update.

Since I cant take Cyclobenzaprine at work driving a rescue and all, I was off it for a a day before coming back to it.

Admittedly there is a lot of different factors, sleep, the way I sleep, etc... but coming home after working for 24 hours and taking 600 mg of Ibuprofen and 5 mg of Cyclobenzaprine as well as Cetirizine D with some sleep in a good position I had a fairly normal day and barely noticed my tinnitus. It weaved in and out, but for the most part it was probably 80% better.

The other thing I noticed when I was working was the side that seems to have the tinnitus, right at the Tragus towards the TMJ joint is very painful to the touch and seemed to be swollen, as some of my medic coworkers felt as well compared to the other side, so I'm leaning towards this was TMJ, exacerbated by allergies/sinus infection as well as stress.

Today for instance, I somehow ended on my side with the swollen joint and woke up with pain and sharp tinnitus, and now that I've taken all those meds it is fading and becoming dull. Still can't explain why my eyes are red when I wake up or my arms going numb but, I'll figure that out eventually I'm sure -_-

Done with the Ambien as well, and it can be hard to sleep but, better than being drugged up for sure.

Will keep you guys updated.

 

Hey guys,

I haven't posted in awhile, wanted to wait until I had more info to post. It's been a weird week or two, with my tinnitus more or less staying the same until this week.

I ended up with a remote otoscope so I could look at my own ears since I keep getting so many different stories from doctors and the like, they both seemed to have fluid still with earwax on one side all over the membrane. After cleaning them out and taking time to steam my nose and all, the last week was getting steadily better. Two days in a row I woke without any tinnitus and it largely stayed like that.

Then for some reason I got really sick, sore throat, ear pain and sinus pain, it's been going on about a week. Cleared from COVID-19, so started another antibiotic today as it hasn't been getting better. Strangely enough my tinnitus has gotten a little better, I usually wake up without any and last night I went to bed without any. It also seems to change, instead of my usual high pitch modulation it changes sometimes to crickets, or even a lower monotone in either ear. Sometimes I can hear the monotone without holding my ears close, sometimes not.

My ears have also begun to pop when I swallow or randomly, something I was unable to do before this week. When steaming or Neti Potting, I feel like I can open my ETD or something like it, almost like I can whistle through my ear but, as far as I can see I didn't rupture anything, it is quite odd...

Anyway, I want say I feel like it's getting better, but feeling like death plus the tinnitus makes it hard when it hits at the same time - _-

Will keep ya posted.