Repeated Modified Nerve Blocks and Auditory and Non-Auditory Nerve Stimulation

I don't think it will be permanent. This is complicated biology and more so when having tinnitus, but I don't think it will be permanent.

A finger is always placed at the level of the infraorbital foramen to avoid further cephalad advancement of the needle, and gentle pressure is used to prevent a hematoma formation.

Otherwise, there would be persistent paresthesia of the upper lip and prolonged numbness of the upper lip.

I would say that it's apparent that no difficult penetration of the foramen was made, which can result in nerve damage by compression in the narrow infraorbital canal, or needle penetration of the orbital floor and damage to the orbital contents - spike hopefully will resolve within days to three weeks.

The face on each side, has one area where there is a cluster of nerves - a larger goup of nerves and they are sensory. This group only interacts with the trigeminal and facial nerve when there's pain. If salivary glands in mouth are not dry or producing more saliva, then this would be another reason for spike to resolve. Over using of radiation can be a concern.

Needles are no longer being used in the secondary procedures that you had done. A nose tube is used, but use of a needle should be OK.

 

@Chinmoku, how are you doing? Thoughts are with you my friend.

 

Not well, not well at all. Don't want to trigger anyone, will post when I feel a little better hopefully.

 

Thank you Greg, God, I need something to hang on because the worsening has been catastrophic.

I can confirm that needles insertion has always been done carefully and skilfully, I never had paresthesia, numbness or any other symptom of nerve contact. Also, they told me these are particularly thin needles, among the thinnest injection needles ever.

There was no hematoma.

Radiation was only used at the first session and at the triple block. X-rays.

Lidocaine is at very low concentrations, 0.5% with volumes of 0.7 mg typically, except in the triple block where they used more.

They did use needles for the triple block. I had read that most clinics don't use needles anymore for some of those blocks, but they did. They have their patented needles and I think they wish to use those as much as possible. However, again, I felt no pain or nerve-damage related side effects.

The clinic recommends continuing more intensely when the symptoms get bad, a kind of doubling strategy. But I'm at the limit of what I can tolerate to stay alive and I don't know if it's wise to risk any more worsening, I'm really at my limit, and I may have already exceeded it.

I'm not a medical doctor but tried to use some logic. Could stopping the treatment halfway, against the recommendations, make the worsening permanent?

a) The needles didn't hit my hair cells, so there is no hair cell damage, as pointed out earlier.
b) If the needles did cause some minor nerve damage, more needles is not going to help anyway. Damage seems unlikely though, I would think more about sensitization through needles in innervated tissue.
c) If the lidocaine is causing problems, then more lidocaine will not help, but again this seems unlikely at the concentrations and volumes that have been administered.
d) Stopping the treatment early could stop the plastic changes the treatment is trying to achieve.

Point d) is the only reason I would see to continue the treatment, but it is a little vague, I need to discuss more in depth, but we know neuroplasticity is not that well understood. The approach of this clinic is mostly empirical, so I don't think there are clear answers to d). I am still discussing with the doctors, who remain very approachable and available to answer questions. I hope to survive this and post a much more detailed analysis later on, for people who wish to try the treatment.

Overall, I have two choices: keep going with the treatment, but this is impossible without something that brings down the tinnitus at least temporarily, or stop and hope for a reversion to pre-treatment levels, which were already pretty severe-catastrophic but not like this. I will have to decide shortly.

One more thing:

Can you tell me more about this, @Jerad? I wonder if the lidocaine is spiking me too. How did you get a permanent worsening? Was it injected near the ears or elsewhere? May I ask this? This seems unlikely in general but if it can happen I would like to know. I hope the effect is not permanent, how long ago has your lidocaine spike started?

 

Well, the question remains: Could this work for neurological tinnitus e.g., visual snow syndrome induced?

It doesn't have to do anything with the cochlear, instead primary with the brain e.g., thalamus, cortex.

 

Sorry to hear it, @Chinmoku. Don't worry about us - we are all here for you.

Did you notice progressive worsening that was maintained after each session?

 

Hearing damage isn't the only singular cause of tinnitus/tinnitus spikes, you know... People like @DocTors_94, me and @Chinmoku spike from insignificant noises, permanently. It doesn't make it any less horrendous...

I stand firmly on my opinion that this treatment will most not likely be effective for purely hearing loss tinnitus i.e. phantom cochlea, as that has little to anything to do with cranial nerves. I also don't think it will affect visual snow at all.

 

@Chinmoku, I’m sorry to hear about the worsening and this troubling time. I feel bad for you and I am praying for you.

My issue with lidocaine was last December and resulted from a topical cream that was put on two open ulcers on my leg. I believe it was either 1% or 2%, but it was not injected at all. They put it on the ulcers to perform debridement, which is a type of surgical procedure where they use a tool to just manually loosen-up the tissue to remove dead skin and so forth. They wiped-off most of the remaining lidocaine after, but I figure it got in my bloodstream because 8 hours later, I had a very pronounced spike. Nothing else had happened — no sound exposures to attribute the spike to. I did use Silvercel pads over the wounds that day, too, but I find it highly unlikely that they caused the issue. Those pads are just to keep the wound protected and sanitary. So I was confident it was the lidocaine. Obviously, can’t be 100% sure, but I was rattled enough by it that I wouldn’t feel comfortable using it again.

In the aftermath, the tinnitus was rough for that night and started to calm in the next few days, but it seemed to permanently alter my dental drill tone, and changed its characteristics from oscillating / on and off to more persistent, like always there. In the next month or so, it calmed more and became lower / more steady.

I have ultra severe hyperacusis and my auditory system is very touchy. I seem to spike easily or worsen easily. I thought that might be why my system is so fragile and volatile to begin with. I don’t know, though. There are so many unknowns with this condition and experiences vary from person to person.

 

Thank you for letting me know, and I'm sorry this happened to you.

In my case the lidocaine was injected in trigger points near the ear. Other people I talked to got it regularly injected from dentists or other specialists, one of them near the ear, but without spiking. God, I hope it's not that but it could be one of the consistent scenarios. As I was injected 6 times, it might take a while to wear off if it is indeed what triggered this worsening. Ototoxicity is usually manifested only when the lidocaine is directly injected in the hair cells and not systemically or topically, but as you say God knows what happens with this horrid condition. There is no rhyme or reason. Thank you for letting me know.

I would also be grateful to anyone else who was spiked by a lidocaine injection to let me know their experience.

 

They never made a single statement about visual snow. I don't think it's one of their objectives.

The treatment idea is to alter brain plasticity through an alternating of stimulation and sedation, thus confusing the brain. It's a sledgehammer tactic, but it seems to have worked on some people tinnitus. However, I never heard of it doing anything for visual snow. You can ask the clinic by emailing them, the address is in the paper in the very first post of this thread.

 

One thing that has been a literal lifesaver for me is to play an exact tone of my tinnitus on my phone, which will silence it for about 10-20 seconds. This gives me a temporary bit of sanity during bad spikes. It’s not much at all but maybe it can help you in some form. Just knowing I can switch some of it off at will makes it slightly more bearable for me. Keep in mind we’re all unique and your tinnitus may react differently to this treatment than mine does... obviously don’t do anything that makes you uncomfortable.

I have about 20 tinnitus tones just to give you a perspective of where I’m coming from. Definitely not a mild case. Unfortunately this was caused by the COVID-19 vaccine as a rare side effect.

Regarding the treatment, personally I’d wait and see if this is a temporary spike and if it will calm down in a week or so. You can always do more sessions down the line.

Best of luck to you, we are all rooting for you.

 

Yes, unfortunately. There was no zig-zagging in my case, just steady, continued elevation. Not sure why.

 

Thanks for this, I will try a few sound combinations. I had residual inhibition when this started but it has almost completely gone as the tinnitus got worse and worse and the sound saturated.

 

Praying for you.

I think you must go on and push through.

Be strong my friend.

I think this is our best chance to date.