What I Learned About Tinnitus Thus Far. If You Got Tinnitus Recently, This Info Will Be Useful.

In this thread, I would like to write about all of the important lessons about tinnitus (T) that I learned thus far. They are in no particular order. I will add to this as I learn/remember more. If you have lessons of your own that you would like to share, by all means post them here.

The target audience are people who recently started suffering from T.

1. Many people eventually get to hear silence again
https://www.tinnitustalk.com/threads/spontaneous-recovery-stats-over-70-recover-3-studies.21441/

2. After reading the posts on this forum over the past 10 months, I learned that in many cases T tends to fade: it gets quieter and its pitch gets lower (often changing to a hiss or even a soft hiss) so that it is easier to ignore. So in the worst case scenario if your T doesn't go away, what you are hearing now is likely not going to be the sound that you will get stuck with.

3. Many others, including me, found that staying away from even moderate noises (like that of a vacuum cleaner, blender, lawn mower, and hair dryer) promotes healing.

4. Our ears have been compromised. The noise that a healthy person won't even notice can cause a serious temporary spike or even a permanent spike for one of us. So just because the noise wasn't loud enough to damage hearing of a healthy person, doesn't mean that it can't change your life to a living hell. When I pressed a loud phone to my bad ear, my T changed from a hiss to a high pitch tone that was much harder to ignore. This lasted for over three months. After a glass plate fell 10 cm onto another glass plate (30 cm away from my ear), I began hearing T in my formerly good ear. I still hear T in both ears... I had major spikes as a result of doors slamming. Now I always wear ear plugs when I am outside of my home. Some people say that protecting your ears can lead to H. This might be true for some. I (and several others here) found that H began to diminish (and was eventually gone) once I began protecting my ears from moderate noises.

5. There are countless posts on this site where people describe how they found out the hard way that hearing protection like ear plugs or muffs can provide a false sense of security, and not be enough to protect you. Here is a sample:
https://www.tinnitustalk.com/thread...-religious-purposes-in-nyc.24448/#post-294691

Some people report being ok after attending loud concerts while wearing hearing protection. Keep in mind that if you begin hitting a wall with a hammer, it will take some time before you see the objects on the other side of the wall.

6. Most spikes are temporary spikes (few become permanent). Temporary spikes can last a surprisingly long time:
https://www.tinnitustalk.com/threads/head-movement-spikes-tinnitus.25179/#post-290614
https://www.tinnitustalk.com/threads/poll-how-long-do-your-tinnitus-spikes-usually-last.23110/
https://www.tinnitustalk.com/threads/poll-how-long-was-your-longest-spike.22099/

When you get a spike, it is natural to panic and assume the worst. My advice is to wait three months or so. If the spike is still there, as loud as ever, at that point you might start worrying about this spike being permanent.

7. If you get a new acoustic trauma, it might be a good idea to take prednisone. You can go to the ER, tell them that you have T and you are experiencing a spike as a result of having to stop a screaming fire alarm. There is a good chance that they will give you 5 50 mg prednisone pills. You can go to several emergency rooms (or urgent care clinics) and get several prescriptions. The rule of thumb for prednisone is to take X mg per day (where X = your weight in kilograms) for 14 days + tapering. If you experience a serious acoustic trauma (i.e., a gun goes off near your ear or in an small room, or you actually stopped a fire alarm [I recommend against doing that(!) just run away from it]), then you may want to get a full course of prednisone. Otherwise, you may want to take a 50 mg pill on the day of the accident. You know the trauma was serious if you experience a spike or ear fullness right after, or the next morning. If the spike is gone after 48 hours, I would stop taking prednisone (assuming the acoustic trauma was caused by something minor like a slamming door).

Some places and things that might be dangerous for people like us: slamming doors (do not open windows when it is windy outside, use door stoppers), falling glass plates, fire alarm (I disabled the fire alarm at my home, of course such an action is not for everyone; I carry Peltor muffs with me everywhere I go - they would be fast to slip on in case a fire alarm goes off), hand dryers at publish washrooms, busy streets where trucks and motorcycles can be loud when accelerating, watch out for police/ambulance sirens [carry Peltor muffs with you in your car - you don't want to be stuck in traffic with an emergency vehicle using its siren near you, as had happened to one poster here], bars, restaurants, and malls (where music can begin playing at any moment), fireworks, thunderstorms/showers during which you might hear thunder, do not be around any baloons - they are incredibly loud when they pop (especially in a closed space), try to stay away from kids (or wear hearing protection whenever you are around them), don't sneeze or cough when wearing ear plugs (Google "occlusion effect").

8. You might hear that if your T doesn't go away in 6 months, it is permanent. That is a myth. "Six months" is just a time interval that insurance companies use to classify a condition as being chronic. It has no medical basis.

Multiple sources seem to use "2 years" as their rule of thumb. See, for example
https://www.ncrar.research.va.gov/Education/Documents/TinnitusDocuments/01_HenryPTM-HB_1-10.pdf
"A general guideline is that tinnitus of at least 12 months duration has a high likelihood of being a permanent condition (Dobie, 2004b). However, it also has been suggested that a person must have experienced tinnitus for at least two years before it should be considered permanent (Vernon, 1996)."
Link to Dobie 2004: https://books.google.ca/books?hl=en...AfBTNxz1AY#v=onepage&q=dobie tinnitus&f=false

If your T keeps fading but is still audible 2 years after onset, there is no reason to think that it will stop fading after 2 years.
It will most likely continue fading. A number of members of this forum had stated that the first time they got tinnitus, they eventually got to hear silence after 12-18 months. This is evidence contradicting the statement above from that Dobbie 2004 study.

9. Many people on this forum got their T as a result of ultrasonic dental cleaning. There is no reason to take this risk. Insist that your dental hygenist cleans your teeth manually. I never heard of a hygenist declining such a request. Manual cleaning is as good as ultrasonic cleaning, and it doesn't cost more.

10. Beginning today, commit to taking better care of your teeth. You want to minimize the number of dental procedures you undergo.
It is probably not a good idea to wear ear plugs or even ear muffs during a dental procedure because of occlusion effect. You will want to ask your dentist to drill for at most 5 seconds followed by a 10 second break. If a laser can't be used, find a dentist who uses electric-powered drills (as opposed to the traditional air-powered drills) as they are supposed to be quieter. For more details, check out
https://www.tinnitustalk.com/threads/dentist-laser-vs-ordinary.2791/#post-272983

11. Many people get their T as a result of an ear infection. Do what you can to prevent an ear infection. For more information, check out
https://www.tinnitustalk.com/thread...tus-disappear-for-a-second.23966/#post-295711

12. Many get T after doctors remove wax from their ears using microsuction or syringing. There is no reason to take that risk. Ask the doctor to remove the wax from your ears using manual tools. I think the name of one of the tools is curette. Another tool looks like a wire loop. Make sure to use special ear drops for two weeks prior to your appointment to soften the wax. Also make sure that the person cleaning your ears is a doctor who has a lot of experience (and not a nurse with little experience).

 

This thread and information in it is, indeed, useful. Thank you, Bill.

 

Bill has your tinnitus faded or do you have silence? you seem to predict it to many people, just wondering where you are at....

 

Thank You Bill...that is encouraging. I'm still in the dark about what is causing my T. I'm starting to wonder if part of it could be related to TMJ. Going to a specialist tomorrow. Any info about TMJ and Tinnitus. I have been reading the forums.

 

It had faded and changed from super loud crickets to a hiss over the first three months. However, then I had my second acoustic trauma. My T got louder and changed to a high pitched tone. Again, eventually I saw some improvement, however, eventually I experienced more acoustic traumas that resulted in more T setbacks. The moral of the story - protect your ears, especially early on after onset (first 6-12 months) when your ears are most vulnerable.

 

Sorry, I don't know much about TMJ. However, I noticed that my jaw clicks when I yawn. I am now trying to make sure that I don't open my mouth too wide when I yawn. Turns out that doing this is hard on the jaw joint...

 

I appreciate your answer, but your ears are always going to be somewhat at risk, when it comes to noise and other elements...especially when dealing with tinnitus. My point is this, some might have loud tinnitus at the beginning and then it can go to much lower tones and hiss. Some might have low tones and then they might have silence for a bit and then back to the low tones.

I was one of those people. It was 1997 and i was driving around with my ex- fiance and I think for 45 seconds after 9 years of hell, I had silence and then it went back to the loud tea kettle (Although today my tinnitus is much louder).
It was very emotional for me and I was on cloud nine for those 45 seconds and then I got devastated.

So the point I am making is this. Tinnitus can fluctuate and it is never predictable, people can go from low tones to loud tones, to no tones and then back. We cannot predict it and I rely on my experience, when it comes to this matter. Sure some might say that they were cured at one point, but how do we know if they have re-lapsed or not ...back into their loud or mild or low tone/hiss tinnitus. Those people are not accounted for today, we don't know how they really turned out.

You cannot make promises to members bill that their tinnitus will disappear. I wish your words would hold up and this noise/tinnitus would simply go away and all would be cured. These promises simply give someone hope and that they might get cured...but if they don't have silence again...It can really bother people and emotionally get them.

Again, no two people are the same and some might have silence again (I wish that for all people, on this forum (including myself)). Some might get cured, and some might have to live with the tinnitus.

Protecting your ears is a must and I agree with you. Tinnitus bring on new ways of living and I hope all take care of their ears.

Simple as that, I think you mean well, but we cannot predict how tinnitus will turn out.....

My post to you is not a negative one, I just look at it from my point of view..from someone that had very intrusive tinnitus and then I was relieved for 45 seconds and then back to the depths of hell again.

Be well

 

I exchanged private messages with a number of people (and also noticed posts of a number of people who said that they eventually got better), and there seems to be a pattern. This pattern is only true for those whose T seems to be fading (over a period of many months) [and that {based on what I see on this forum and based on the studies in that Stats thread} seems to be a considerable fraction of people]. The pattern is that unless one experiences acoustic traumas, it continues to fade. Once T goes away, many people relax, get exposed to noise (that healthy people around them don't even notice), and are then back to square one. Unfortunately, that is part of the pattern too...

I didn't promise anything. I wrote

The word "many" is supported by the data we see in those studies in that "stats" thread.

 

Part 2

13. If sleep is a problem for you, there are several things you can try.
Amitriptyline (10 mg) is non-addictive and it didn't make me drowsy in the morning.

You can also try taking melatonin, but make sure not to take too much of it.
https://vanwinkles.com/the-dark-side-downsides-side-effects-of-melatonin
"In 2001, researchers at MIT concluded that the correct dosage for melatonin falls between .3 and 1 mg."

Make sure you use some sort of sound enrichment. It is very helpful. The idea is not to drown out T, it is to give you something else to listen to, besides your T.
Check out
http://mynoise.net/
Or buy a device like the ones below
https://www.amazon.com/Sound-Oasis-S-5000-Deluxe-Therapy/dp/B018KUVEOM/
https://www.amazon.com/Cherry-Koala-Concentration-Relaxation-Sufferers/dp/B01FRW2WBA/

14. Airplanes. If you search this site, you will see that a large number of people report that they fly regularly, and that it hasn't had an impact on their T. Having said this, there are a handful of people saying their T got worse after a flight. I believe they haven't been wearing ear protection like muffs or noise cancelling headphones.

You will want to have both Peltor X5A muffs and noise cancelling headphones like Bose Q25. A flight attendant might ask you to remove the headphones during takeoff, I believe wearing headphones during takeoff is against regulations. You could then explain that you are wearing earmuffs and not headphones. Make sure to make it obvious to the flight attendant that you can hear him or her easily when you are wearing those muffs. Chances are the flight attendant would then leave you alone.

Once the plane reaches the cruising altitute, you can insert earplugs, and switch from earmuffs to headphones (headphones are a lot more comfortable, and in an airplane headphones seem to be more effective than muffs. Don't forget to take out the earplugs before the plane begins its descent.

The seats towards the front of the plane and the isle seats are quieter, so it makes sense to pay to choose one of those seats.

Turboprop planes (the ones that have a propeller) are popular on short flights under 90 minutes. They are a lot louder. If you have H, or if you feel vulnerable, you might want to not fly those planes until you get better.

15. Look into taking supplements. There is a lot of information about supplements on this forum. Some supplements you might want to investigate (those are the ones I have been taking) are: NAC, Magnesium bis glycinate, Vinpocetine, ALCAR (N-Acetyl-L-Carnitine), Vitamin B complex, Ginkgo Gold, and Zinc. For more details on each supplement - use this forum's "search" function.

16. When you get a full ear sensation it is a sign that you hurt your ears. Do not use Valsalva maneuver - it will not improve your full ear sensation, and it can do more damage to your ears (as evidenced by multiple reports on this forum).

17. Many people get T as a result of taking ototoxic medication. From now on, you will want to ask your doctor to prescribe medication that is the least ototoxic of all medications he or she can use to treat you.

You can also use the brochure below to check whether the drug you have been prescribed is ototoxic:
http://hlaa-sbc.org/wp-content/uploads/2013/11/Ototoxic_Brochure.pdf

If you live outside of U.S., and your drug is not listed, make sure you use the U.S. brand name for your drug when you search this brochure. Some drugs are listed in this brochure but they cause tinnitus in very few people. You can learn this information by going to
https://www.ehealthme.com/ds/XXXXX/tinnitus/ (replace XXXXX with the brand name of the drug, for example

https://www.ehealthme.com/ds/prednisone/tinnitus/ )

The way to interpret these is: for Prednisone, since 1998, only 720 reported getting T as a side effect. This is low - imagine how many people took prednisone in the U.S. since 1998. We also see that over 65% of the patients developed T after taking Prednisone for over a month. So this means that if you take prednisone for less than a month (as will be the case if you take it for acoustic trauma), your risk is pretty low.

18. Be careful when it comes to the tests done by your audiologist. If you search this site, you will see many stories involving Tympanometry test. For example
https://www.tinnitustalk.com/threads/beware-of-the-tympanometry-test.23097/
https://www.tinnitustalk.com/threads/is-tympanometry-safe.18558/

It is possible that you might run into trouble if Acoustic Reflex Test is done (or that they do a Tympanometry test as part of acoustic reflex test), see
https://www.tinnitustalk.com/threads/warning-acoustic-reflex-test.25645/

19. Turns out that it is natural to relax and begin taking unnecessary risks once one's T goes away. As a result, many people eventually have their T return. It is a very traumatic experience. We are given only a limited number of second chances. If you are fortunate enough to get a second chance - don't throw it away.

And that concludes my description of everything I learned about T during the past 11 months. If anyone can think of any other lessons we could share with people who are new to this, please contribute to this thread.

 

Some of us just don't have the option to avoid all noise. Most of my loud noise exposure comes from work, but I can't not work.

As for chronic tinnitus going away, I don't think it's that common, but most people do habituate in time providing it doesn't get worse.

 

I don't think the above contradicts my post. I wrote

If you know you are in an environment where you can be exposed to noise, you can wear hearing protection (assuming you are allowed to do that as part of your job).

I know one person on this forum has a job where he uses power tools to trim shrubs, cut tree branches, etc. He uses hearing protection, but says that his T gets louder and louder. People like him might want to consider changing careers.

 

Here is a link to illustrate Lesson #19 above
https://www.tinnitustalk.com/threads/i-ruined-my-recovery.25514/
Check out the first post and post #10 in that thread.

 

This is just a general observation based on all your posts but thought i’d put it here. So just to clarify then... What you are saying to people is.. Where earplugs in places like the supermarket, around a kettle or a microwave but for the genuine loud noises.. Stay away from them altogether, as earplugs are unrealiable?

 

If you are experiencing H, and you find the sound of a microwave oven (or a shower) to be disturbing, then it is probably a good idea to listen to your body and to protect your ears when the microwave is on (and to begin taking baths instead of showers). If you are not that sensitive, than of course you should be able to not wear any ear protection when you are at home. Wear earplugs to work for a week. If no incidents occur when you feel good about wearing your earplugs (e.g., no co-worker slams the door of their office), then you might consider not wearing earplugs to work.

Some places have a high chance of a noisy event happening. Walking along a busy road where a truck or a motorcycle might accelerate, or an emergency vehicle might turn on their siren is a good example. I would wear ear protection when I am in such an environment. If you choose not to wear ear protection, at least have Peltor muffs with you so that you can slip them on in case, say, you hear an emergency vehicle approaching (or loud music gets turned on in a quiet shopping mall [an event that actually hurt Lex's ears 6 months ago - she got better, but I believe her spike is still not over]
Here is a link to the post where Lex described her accident
https://www.tinnitustalk.com/threads/first-major-setback-since-onset-almost-a-year-ago.22718/ ).

The above is what I plan to do. The risk is not negligible, and as a result it is not acceptable to me. If you feel strongly about attending those loud events, at least read some horror stories of people who wore hearing protection to loud events and lived to regret it. If those stories don't change your mind, then perhaps your preferences are such that it makes sense for you to take that risk.

 

Part 3

20. http://hyperacusisfocus.org/research/earplug-use-2/
"While there are over 2200 posts on hyperacusis setbacks in the patient forum on chat-hyperacusis.net, no academic papers could be found using a pubmed search."

The fact that there have been no published studies regarding what causes permanent and temporary T spikes, means there is no scientific reason behind doctor advice to only protect your ears against noises that are known to damage the inner ear. They are basing this advice on studies that talk about what can damage healthy ears, whereas what can hurt us hasn't been studied (and the overwhelming number of testimonies on this site imply that sounds that can hurt us are Way quieter than the sounds that can damage healthy ears).

21. I protected my ears from even moderate noises, and wore earplugs whenever I was outside. My hyperacusis (H) got better and eventually I was free of H. It is possible that this happened becasue I would make sure to watch TV with volume set to medium. If you do that, you ensure that you are exposed to the kind of noise that will not hurt your ears, while building your tolerance to noise and healing your H.

22. Many of us believe that it is a good idea to never use headphones again, even at low volume. For more details, check out the thread below
https://www.tinnitustalk.com/threads/isnt-it-ok-to-use-headphones-even-at-low-volume.25287/

23. Early on, you might consider HBOT treatments. You can learn a lot about HBOT on this site. Below, I will just talk about what I learned based on my personal experince with HBOT.

It can get somewhat loud inside of the chamber. Ask the operator to use the lowest "air flow-through rate". Also insist on being allowed to bring ear plugs into the chamber and using them when the chamber gets pressurized.

The conscripts in the first study described on
https://www.tinnitustalk.com/threads/spontaneous-recovery-stats-over-70-recover-3-studies.21441/
all got HBOT. They had a good rate of recovery...

24. If your T doesn't change at all during the first year or two, and you are having trouble habituating, you can try rTMS treatment.
According to
https://www.tinnitustalk.com/thread...atments-rtms-tdcs-tacs.326/page-6#post-229580
rTMS helps 30-40% of T sufferers

Find a clinic that specializes in using rTMS to treat T (most clinics out there serve psychiatric patients). I believe the studies below provide a description of the treatment (i.e., where to stimulate, how many pulses, etc.) Make sure to show it to your practitioner and ensure that this is what they plan to do (ensure they don't just treat you the way they normally use rTMS to treat psychiatric patients).
https://www.researchgate.net/public...tex_for_tinnitus_suppression_Clinical_article

https://link.springer.com/chapter/10.1007/978-1-60761-145-5_90

 

@Bill Bauer how long did you have H before it fully went away and what time period after onset did you see improvement, including setbacks etc...

 

Unfortunately, I haven't been keeping a diary. My best guess is that by about 6 months my H was minor, and it was mostly gone by the time I was 9 months in.

 

@Bill Bauer But did you have many setbacks? Like major setbacks in your H besides the major setback in your T.

 

In the beginning, my H was pretty severe. I found the sound of a microwave oven to be disturbing. However, I was able to avoid noise (or wear hearing protection when the noise couldn't be avoided), so I wasn't particularly bothered by H. Also, the severity of H is even harder to evaluate than the seriousness of T. My best guess is that acoustic traumas that spiked up my T had interfered with healing as far as H was concerned. I don't remember a major spike in H following my second acoustic trauma, but that doesn't mean it didn't happen. By that time I was very disciplined about avoiding noise and using hearing protection, so I was able to avoid discomfort, but it is possible that softer noises would have caused discomfort at that time.

 

I wish I could have read this when I first got T.

 

The following thread seems to illustrate points #19 and 22
https://www.tinnitustalk.com/threads/trying-to-live.25963/

 

25. Here is a good overview of possible treatments. Use this forum to search for information about each treatment that you might be interested in
https://www.tinnitustalk.com/threads/tinnitus-—-possible-treatments-—-modern-medicine.26045/

 

The post below illustrates points #3 and #4 above. It looks like the two of us independently came up with the same strategy. The post is really good, check it out:
https://www.tinnitustalk.com/thread...s-—-have-a-protection-plan.13571/#post-164645

 

THIS! I always thought that hazardous/loud sounds can damage us and cause permanent spikes, but now I am noticing that moderate sounds can accumulate and damage us...crazy...

 

Unfortunately this is true. I got numerous spikes by being at a bar without earplugs, being at a mall without earplugs, walking next to a busy road without earplugs, standing next to a door that slammed loudly, being next to a cryinh baby, being at the library (alarm came on) without earplugs. My Tinnitus has gotten worse and my spikes are more severe now. I didnt think that moderate sounds can hurt me in the beginning, but now I am convinced that moderate sounds can hurt us. I thought if i go to the mall without eaprlugs nothing will happen it is not a club or cinema, well i got a major spike that lasted four days. I am now dealing with a massive spike which i never had before. and this is all from being at a library. Tinnitus is higher pitched now and sounds like a tea kettle. I also have developed a new sound (buzzing). I was at the library and the fire alarm came on (didnt have earplugs) but i covered my ears, two hours latter massive spike. This happened on Wed and now its Saturday. I am taking my peltor muffs everywhere outside now. I learned this the hard way.

 

Usually my spikes last four days, with each day the Tinnitus lowering but this has been high since Wed night.

 

Here is a good summary that supports point #1

http://journals.sagepub.com/doi/pdf/10.1177/0194599814545325

Thank you for providing the link to this study in another thread, @Greg Sacramento !

 

I know where you’re coming from, I really do. This is my experience with T and not advice. My advice would be to do what ever you think is necessary. My situation I think is maybe unique. My tinnitus in the early days, used to be solely reactive, meaning, that when I was in silence, it was non-existent. Only being around noise (not necessary loud noise) would the tinnitus appear. It used to range from nothing to being so loud and intense my ear drum would hurt. I wore ear plugs but I don’t think they made much difference (in terms of stopping the spikes). After a period of time, certainty no more than a year, my T changed. It ended up becoming continuous but stopped being anywhere near as reactive. Now it is there all the time but I don’t get the increases in volume that the ‘so called moderate noises’ used to cause. There are exceptions.. A vacuum cleaner, even now, usually causes me some problems (I don’t know why a vacuum cleaner is particularly troublesome!). Even with earplugs, I still normally get a horrible increase in volume (but has always been temporary). So my T is different now compared to how it used to be and I don’t know what changed. It’s generally tiredness, stress and even hunger that cause me to have spikes. Noise, generally, never does. So basically I don’t know what changed with my T. I don’t know if I started getting more used to sounds and my ear got used to them or if I caused more damage because my T is permanent and continuous but not generally reactive to noise like it was in the beginning. So even though I have a permanent continuous ringing I don’t fear noise liked I used to. Another thing, sleep always used to help my T. Now it makes it worse. T is so unpredictable.

 

26. If you can't get your mind off of memories of how you got T, don't worry - it gets better. A joke eventually stops being funny. Likewise, T and memories of how one got T eventually stop eliciting a strong emotional response...

27.
https://www.coopersafety.com/earplugs-noise-reduction

The above method is also described by other reputable sources
https://multimedia.3m.com/mws/media...how-to-use-the-noise-reduction-rating-nrr.pdf
http://www.sensear.com/blog/noise-reduction-rating-nrr-a-beginner’s-guide
https://www.earsandears.com/noise-reduction-ratings-nrr-safe-noise-levels/

 

Bill, I am suffering tinnitus and hyperacusis from a single gunshot in a small room. I went to the ER two days later and she prescribed me prednisone but I was skeptical about taking it as 2 days later I saw an ENT who did not give me prednisone. I saw another ENT 3 days after that who also did not give me prednisone. I'm seeing another ENT one week from today and I'm really regretting not taking the prednisone I was given. I still have some pills left, should I take them for now and ask the next ENT to give me more? Am I too late?
Yesterday was 2 weeks since it happened. It seems to be only in my left ear but I'm starting to notice random popping in my right ear as well, getting worried..