Two Nights Out and Tinnitus Spike/Ear Fullness

Hi Dr. Nagler,

First, I want to extend my sincere thanks to you for taking the time to offer your help. It’s so incredibly appreciated!

I’m experiencing a lot of anxiety and fear over a recent tinnitus spike and feeling of fullness in my left ear following two nights out that occurred a little over a week ago. I want to provide you with the details but I’ll try to be succinct.

The Friday before last I went to a wine bar with a new friend. We were seated underneath the music speaker in the high ceiling. This automatically made me panic a bit, as this was the only open seat in the place. I discreetly pulled out the decibel meter on my phone and it read about 76 dB, which made me relax a bit. We were there about one hour. Next, we went to a restaurant, which was mostly empty (it was fairly late at night), but they were playing music in the bar area, which is where we were seated. It felt like it was a bit loud, almost like I could feel the beat in my ears a bit, but again measured the levels and it was about 75 dB range again. Regardless I put in an earplug in my right ear, but not my left as it was not covered by my hair and I was a bit embarrassed for my new friend to see it. The music seemed to get much quieter after about 15-20 minutes though, and we were only there for about one hour. After that we went to one final place, a pizza place/bar, and they were playing music but it didn’t feel overly loud. Interestingly the sound measurement there was about 84 dB, but it was pretty busy with people. I put my earplugs in after a few minutes and we were only there about 45 minutes. I didn’t have any increase in tinnitus volume that night, but my left ear did feel a bit stuffy (which made me concerned as that’s the ear I didn’t put the earplug in at the second location). It was very cold outside that night, and we walked around quite a bit out in the elements. The ENT has told me I have on/off Eustachian tube inflammation and sinus inflammation, and I’ve previously seen him for the stuffy ear feeling (which was in my left ear at that time, too. It isn’t also the ear I sleep on), and his response was that it had to do with my tubes and sinuses. It has always resolved in the past.

The next night I met another friend for dinner in the same part of town, and after eating we walked up and down the sidewalks for about two hours. It was again very, very cold outside. When our Uber showed up to take us home, when I got in I quickly realized the radio in this person’s car was up quite loud, and I immediately felt a bit of panic. A few of the notes I could feel in my chest, and I don’t know why I didn’t ask for the stereo to be turned down; embarrassment I guess. I put my filtered musician’s plugs in (rating of -28-29 dB, the same ones I wore the previous night). I could hear my friend talking in a normal voice beside of me, although the driver was talking a bit loud when speaking to us, but it may just be her normal speaking voice. The ride to apartment is only 5 minutes from that part of town, and only one and a half songs played, with a break for ads, so it wasn’t continuous music. My tinnitus was immediately louder and when I got into bed that night I had a wicked headache and intense sinus pressure. My tinnitus has remained at this louder level since that night, one and a half weeks ago.

I am distressed because since my tinnitus onset, a bit over two years ago, I’ve been extremely cautious with my ears (too cautious according to some). I was afraid to even go out to certain restaurants and bars for a long time, but lately I noticed my hyperacusis had almost completely resolved and I had a much better outlook. This situation has made me so upset, thinking that I’ve caused something irreversible. To make matters worse, a few days ago I was coming out of the grocery store and a large SUV entered the parking lot (very far off, I should note) and the bass coming from their music was so intense it felt like it was moving the air. I didn’t have earplugs in my pocket to put in, and so I tried to hurry and get my groceries in my car. As the SUV circled the lot, the bass got louder - I could even feel it in my chest bones. I plugged my ears with my fingers for a while; the whole ordeal was probably a few minutes. My ears felt more sensitive and irritated after, whereas they’d felt as if they had maybe been starting to settle down from the previous week before that happened.

My ultimate question, Dr. Nagler, is, have I put myself in situations here that have caused auditory damage? Are my sinuses and Eustachian tubes playing a large role here, given I was out walking in the snow and cold for an extended period of time? Is there any action I need to take?

Again, thank you for your time, and I appreciate any feedback you can provide.

Ash

 

Hello @AshD -

Nothing you have written above makes me think that you have put yourself in a situation that can cause auditory damage. Noise-induced auditory damage is a function of loudness and duration. The Occupational Safety and Health Administration has estimated that workers can be exposed to noise as loud as 90dB for 8hrs a day without concern, and as best I can tell your noise exposure is nowhere near that level in loudness and duration.

Hope this helps -

Stephen M. Nagler, M.D.