Tinnitus from Single Exposure to Nightclub

So, yeah... it's been three weeks and I'm suspecting the worst, so I've gotta get this off my chest.

About me: 23 years old, have had tinnitus in my right ear once in the past (12 months ago) due to the cold which lasted 2 weeks. Always careful with noise exposure. Super healthy and fit lifestyle (10 miles walking / week + 30 miles cycling + shop at wholefoods), no drugs.

On May 30th 2021, I went out to a nightclub with some friends. The state I'm in had just reopened, so with all of us being vaccinated we figured we would go out and celebrate. It was the first venue I had been to in many years (since college really), and none of us had brought earplugs. The exposure time was ~2 to 3 hours with breaks outside occasionally. The venue was smaller and louder than I expected. My ears definitely hurt 3/4ths of the way through the night, but I was drunk and having a good time so I decided to ignore it. Big mistake.

When we left the venue, all of our ears where ringing. My two friends, fortunately, were able to recover fully within the 48 hour window. I, unfortunately, got the works -- tinnitus, reactive tinnitus, and hyperacusis. My left ear healed completely after 1 week from the exposure -- no tinnitus or any other problems whatsoever in my left ear, which I'm thankful for. For my right ear, the reactive tinnitus and hyperacusis mostly subsided (95%) over the course of the first week. The constant and annoying ringing noise at around 2 kHz did not, and it has not changed since. My perception of it is no different 3 weeks after the exposure as it was 1 week after exposure. I suspect this is hearing loss related, so I'm preparing for the worst. I have a hearing test in two weeks, so I'll know for sure then if I'm going to have to live with this for the rest of my life or not.

Lifestyle changes I've made after the exposure to minimize future hearing loss:

• Bought an apple watch, which comes with a decibel monitor and alerting for when the decibel level reaches unsafe levels. I currently have it set to alert me at 80 dB, and have conditioned myself to excuse myself if this threshold is ever breached.
• Bought earplugs that go on my chainring. They're cheap $30 earplugs, but I'm going to get my ear molds when I go to the Audiologist so I replace them with professional grade molded earplugs
• No more concerts / nightclubs / loud bars. Not the kind of lifestyle I want. No more work stress, either. I'm going to live a modest life now with the goal of getting a wife, a suburban house, 2 kids, and pass on the burden of pursing ones dreams to my children.

I am so sad about the loss of silence. Listening to silence was one of my favorite things in the world to do. I'm one of those smart on-the-spectrum people who would eliminate any and every form of white noise when going to sleep -- unplugging electronics, paying an extra $X over market rate to rent new construction for the extra sound insulation, the works.

Neuroplasticity-wise, I think I'll be able to habituate. But for now, I'm fking sad. I'm about to quit my job at this stressful tech startup because I think the stress is aggravating my tinnitus. After that I plan to take 2 months off, spend the entirety focused on habituating, and resume working once I'm habituated.

Please offer support and assurance to me. I really need it.

 

I've been where you are right now. You're taking the right steps, making appropriate lifestyle changes, and are going in the right direction. You also have time to heal, mine (tinnitus and hyperacusis) never went away but got much more manageable over the course of about 6 - 9 months. I would say that it "stabilized."

Take some more time to really consider the decision to leave your job. In the first 3 months of my tinnitus/hyperacusis being really bothersome I was ready to quit because the stress and distraction just felt like "too much to bare." I stuck it out, modified my work routines a little, and made my life more disciplined so that I could get through a work day. That was almost 3 years ago. It turns out that staying engaged with work actually helped the habituation process, it kept my mind off the health issues, and gave me a sense of satisfaction. I think that if I had left, I would probably still be unemployed and really depressed, because I would have let the tinnitus "win" a big part of my life. So, try to keep the normal as normal as possible, and see the living with tinnitus as something to "hack" for a while until you get the hang of it.

You'll get through it, it's early.

 

You are still within the time frame for steroids. Consult an ENT ASAP. Do your own research, if you decide you want to take a course of prednisone, push for it. Make you own decision, don't let an ENT tell you what is good for you.

 

It's been a little over 7 weeks so I figure I should give an update.

I went to the audiologist, and got my hearing tested. The results were that I had better than average hearing (no dips, and better than average hearing in some ranges) on the extended hearing test (up to 16 kHz). My hyperacusis is gone for normal levels of noise. I still cover my ears for things like sirens, but hyperacusis is not present in everyday situations.

As for the tinnitus and ear fullness in my right ear: AFAICT, it's still at exactly the same level as it was at the 2 week mark. I don't notice it as much, but I don't believe it's changed in intensity. The way I would describe it is a CRT static that I can only hear it when I'm in a quiet environment and when I am standing, sitting, or laying completely still. I would rate it at a 1 or 2 / 10. I also get ear crackling in my right ear whenever I talk too much or put pressure on my ear (i.e. resting my ear against a pillow). Possibly ETD? Left ear is as it has been, completely fine.

Mentally, I feel habituated. I'm hoping it gets better, but only time will tell. I'm thankful that tinnitus is mild, but I wish it were completely gone. Tinnitus ruins slow classical music for me (something I used to enjoy a lot) because I can no long appreciate the silent moments that are used to build suspense. I can still enjoy silence in the woods when hiking as long as I'm moving or if there's some wind.

I'm very relieved that I have no hearing loss. One of my most cherished past times in life has been appreciating Hi-Fi music. I played the latest Jacob Collier the other night and I could still make out every note and the peaks and troughs of every vibration. I've been listening to music since about the start of this week through my open ear headphones at the minimum value, and it hasn't affected my tinnitus at all, so I'm glad to have this part of my old life back.

I still believe there's a significant chance I completely recover. For one, my Audiologist told me so, and also because I feel the issue is with the muscles in my ears rather than with my cochlea. I did not end up pursuing Prednisone. What I am doing is the following:

• Magnesium 400mg per day -- maybe a placebo, but in theory should help with my ear muscles / bones.
• Multivitamin gummies -- I swear these don't do anything but they taste like candy.
• Chiropractor + standing desk -- did nothing, but my posture feels better.
• Time off of work -- took 2 weeks off. This definitely helped.
• Earplugs everywhere -- not in my ears, but on my keychain. And in my ears when necessary. I'll carry these forever.

Apple Watch

I wanted to give the Apple Watch its own section in this post because I've found it to be the most important tinnitus related purchase. To anyone reading this with noise induced hearing loss, you absolutely need get an Apple Watch if you're serious about avoiding future exposure to dangerously loud noises. The Apple Watch monitors decibel levels at all times and will alert you if the decibel level crosses a dangerous threshold. You cannot trust your ears to be able to distinguish loud noise levels from dangerously loud noise levels.

I've read stories about people who recover from tinnitus completely and then relapse because they sit in front of a speaker at a wedding and don't realize just how loud the sound is. This will in theory never happen to me because when ever the noise level passes the decibel threshold I set, my watch will flash red and tell me to GTFO, which I have trained myself to do. Get an Apple Watch, or at least a watch with a decibel meter, and do not trust your ears. Trusting my ears is what got me into this mess in the first place.

With time, hopefully I'll be one of the lucky folks who can write a complete recovery post on the #SuccessStories category. Only time will tell.

TL;DR:
Hyperacusis: gone.
Tinnitus: unchanged (1-2/10).
Hearing loss: none. I agree with the results.
Habituated: yep. Still sux though.

 

Sounds great! Hopeful that your right ear will follow your left one.