Hello, here's my Story: T started suddenly and with no apparent reason on my left ear in May 2005. It was accompanied by an intermittent feeling of aural fullness on the affected side. Sounds made with fingers stroking the ear canal were definitely muffled compared to the right side. Went through ENT and audiologist examinations, they found nothing apart from a mild conductive hearing deficit on both sides (which I assume is very common even among T-free people). T was at 6000 Hz. No treatment was offered to decrease loudness. I went through the usual and well known period of panic and depressive mood. My T was essentially a night-time problem, I could forget about it during the day. When laying in bed in the quiet room it became loud. My main trouble was falling asleep. Being a doctor (Anesthesiology and Critical Care) I had access to all sort of medications. I just went to PubMed and tried everything that had worked in at least one study (well, not exactly everything, of course but you get the picture). That's the worst part of my story, who knows if I harmed myself with all that stuff. The neuro-audiologist I consulted prescribed me dexamethasone, high-dose Vitamin C and acetazolamide (plus 2 liters of water a day). That was not in the hope of treating T but because he was concerned that my aural fullness could herald a sensorineural hearing loss and he thought this regimen could prevent it. He thought the whole thing was due to an inner ear viral infection (not otherwise specified). As far as I know I don't have today a perceptible hearing deficit. In about 6 months my T gradually reduced to being almost not more perceptible, and I considered myself T-free, although with an effort I could still hear it (I just didn't do such efforts often, of course). T has returned since: in August 2006 (again panic and medicine experimentation, I remember among others Clonazepam and Campral (which probably gave my a major Depression, fortunately self-limiting)). T gone again in 2 months time. Sometime in Fall 2008 (short period, took dexamethasone right away, who knows if that helped?) February 2010, again 3 months, took anticoagulants and melatonin (Sulodexide, there's an italian study in PubMed) Fall 2013 (melatonin, dexamethasone) Now: mid-September 2015: T again, this time it has crept up slowly, I didn't bother at first, now a month into it it's definitely loud at night. During the day I can barely hear it, but when I lay in bed it' difficult to relax. I never wanted to use sound devices in my ears, somehow I think they might not help. On the other hand, I'm totally dependent from ear plugs at night (since before I had T) because any kind of noise at night makes it difficult for me to fall asleep. I find the earplugs increase my T perception only marginally, but who knows, maybe they make thing worse 'cause they increase the subconscious T-input to the brain. I hope this time will also get better, but as always I'm stuck with the fear that "this time will be different", and that T won't go away (in the sense described above). What is different this time is that T has come in very slowly, i.e. I can't say exactly which day has it begun last month. Now about what I think causes and mechanisms for (my) T might be: - I've had acoustic traumas all my life, but in no way more than the average teen-ager and young adult that occasionally plays with bands (piano/keyboards), goes to clubs, listens to loud earphones. I remember being at a dance club shortly before my relapse in 2006, and I remember the bilateral tinnitus on coming back home, but that was gone by the next morning. So there's a lot of acoustic trauma events we go through which damage our inner ear but which by themselves do not lead to T - a lot of people have mild T and never knew that, that is if you ask them they say they can hear some sounds when they press their ears or in bed but they never tought of it as anything abnormal or to worry about So there are people with hearing loss, subclinical inner ear damage, or even mild T, who will never come to this forum and who are perfectly well. - So there's a combination of peripheral ear damage and "something else" in the brain that causes T. For me it is clear that it's not all in the head, I always had ear symptoms (fullness) before spikes or relapses. But why us? what do we have in common that makes us hearing it loud? Of course we don't know yet for sure, but if you have time read the recent article from Rauschecker et al about the common neural abnormalities found in T-sufferes and chronic pain sufferers. There's a thread in TT, under Research News. It was published in Trends in Cognitive Sciences in Sept. 2015, and the full-text is available. What at first scared me by reading it, is that they say a constant finding in both groups of patients is grey-matter loss (in the case of T in the ventromedial prefrontal cortex) in voxel-based MRI studies. That sounds bad, isn'it'? like when brain tissue is gone it's gone forever, so T forever? And indeed some authors have compared T to a neurodegenerative disorder. But the authors of this article don't agree, they say that grey matter loss in MRI studies is very often expression of neuronal plasticity, wich under certain circumstances may be reversible. As for the causes of this grey-matter loss, they cite stress as the major culprit. There is enough evidence that T patients have an abnormal stress response, as evidenced in other studies by dexamethasone suppression tests. As for possible strategies for reversibility, they mention restoring sleep patterns and putative strategies to facilitate neuronal plasticity. All my T spikes/relapses (but funnily not the onset episode) came at periods of intense stress for me, in particular in periods when I had to change jobs (and town, home, etc.). This time might be different because I'm changing job and I'm getting split from my wife and I had to find a place to live (we have been married 5 years and we have a 5/y daughter, who's the reason why I'm finally moving to the town where she lives- I've always commuted in these 5 years, 2-3- days a week at home 4-5- away) But this post is getting too long, I hope to post some positive thought/story in the next weeks or so. Cheers to all, Andrea
