When to Run for the Hills in Noisy Environments?

My ear fullness took close to a year to resolve.

 

I read on TT that fullness is associated with hearing loss and that the prednisone is supposed to reduce swelling and thus prevent hearing loss. Do I have this wrong?

 

BTW, @Bill Bauer, props to you for sounding the warning message to all about being extra careful around sound. I've been vigilant for 2 years with no major spikes or incidents and now this happened. Some of your advice may be extreme to some but makes for a good balance of opinions on TT.

 

I think this is what I've read too. Nevertheless, ears take forever to heal, so this fullness doesn's just turn off.

 

Ear fullness can be caused by anything from compacted wax to a blocked Eustachian tube to anxiety and/or acoustic trauma. However, in your case, acoustic trauma is incredibly unlikely so I’d look at other possibilities. Taking prednisone was a bit reckless in my opinion as it’s a strong drug with potentially nasty side effects and it should only be taken for actual acoustic traumas (exposure to an explosion for example). It is also ototoxic and ironically, probably more damaging than exposure to 55 dB. Also, the evidence that it has an effect is not the greatest. The reason for this is that people with SSHL have a bounce back in their hearing without taking anything, so it’s hard to determine how much of an effect prednisone is having.

It’s far more likely that you have fluid behind your eardrum or a blocked Eustachian tube or something. I get ear fullness quite regularly (in one ear, or the other, or both sides together) because I have allergies and I have to take Dymista. If you have been using earplugs a lot, there’s also a good chance that you have pushed earwax up against your eardrum on the one side.

 

I have to agree with everything @Ed209 have posted so far.

I haven't been on this site more than a handful times the past year. Why? Because I stopped worry so much about my tinnitus. I used to be here often and worry and freak out about all the smallest things (check my posts if you don't believe it) and it would range from "had pink noise on my phone" or if a car honking in front of me would damage my ears. Thinking back on how much my tinnitus actually cripped me socially and emotionally. I would rather sit home and never do anything with my life because everything could possibly hurt my ears. Not actually anything that would be dangerous for me, but the fact that there might be something unforeseen was scary enough.

But that is no way of living. You need to take precautions when you need to, but you don't need to lock yourself in a room for the rest of your life either. I know how tough it can be to deal with spikes or ear problems, we all do here - that's why we are here. I have had really strange things going on with my ear, wax on the eardrum where they had to use microsuction to get rid of it because removing it manually was riskier. Had ears being full or have my tubes making weird cracking noises when I had colds etc.

Now I use earplugs when it is loud around me, but I still go to the cinemas (with earplugs) because I have deemed the volume to be low enough (I live in Europe so the cinemas can't be too loud anyway), I travel on long flights (only use my NC headphones) and I explore new places without being anxious to step through the door in case it would be loud. Not having that anxiety each time is so liberating, and nothing I have done so far has increased my tinnitus. You just need to use common sense with the loudness. Like Ed mentioned, we know to not go to a concert with no plugs, to not have the volume on the speaker all the way up etc, and sometimes we have scares but we don't need to sit on a bus and worry about someone sneezing next to us. It doesn't benefit anyone, least to ourselves.

If you want to live like that, that's your choice. We don't need to use this mantra for everyone here, or shame them if they went one night without earplugs because "they should have known better".

 

Seriously, stop it dude. I know when my ears have been acoustically assaulted. I have never heard that prednisone is ototoxic. Do you have any links?

 

Glucocorticosteroids

• prednisone (Deltasone)
• prednisolone (Prelone)
• ACTH (adrenocorticotrophic hormone) (Acthar)

https://makemehear.com/adults/ototoxicmedicationlist

Stop what? The last thing I want to see is people taking prednisone like they are smarties. I know who reads these threads and they are seriously vulnerable. I’m just trying to protect them.

 

So do you still go clubbing? I don't and never will again. I still go to movies, etc. But I will never go and listen to a band for two hours straight even with plugs!! It's not worth risking my tinnitus becoming any louder than it already is. Been there, done that. It didn't work out.

 

Stop telling me that my ears weren't adversely affected by the sound exposure I had over the weekend. I've had tinnitus for two years now. I'm very familiar with my ears.

As for prednisone, why is it prescribed for acoustic trauma if it is ototoxic?

 

I said it was incredibly unlikely, and any expert would tell you exactly the same. Have you had your ears assessed? It was very irresponsible of the Dr to give you prednisone for something that isn’t an acoustic trauma.

The reason they prescribe it to genuine acoustic traumas is based on risk-reward. All medicine is. If someone is exposed to an explosion and has instantly dulled hearing, ringing/worse ringing, then prednisone and HBOT may help, so in this instance, it would be the protocol because the potential reward outweighs the risk. An audiogram would likely reveal a notch at 4 kHz for an acoustic trauma as well, because this is the most resonant frequency and often the first to show signs of noise induced damage.

I’m trying to be rational. You are convincing yourself that it’s noise damage and don’t know that.

 

I haven't been clubbing for maybe 7 years now. I stopped going years before my T started, at most I go to a bar now and then, but not the loud ones

 

That's where I disagree, it’s not a choice for everyone, especially if severe pain hyperacusis plays into the situation. Keeping fear-mongering to a minimum is important and we can do this without ignoring cases outside of the tinnitus-norm.

Unfortunately, this isn't everyone's experience. I developed about five new tones during the first four years.

 

Not everyone here has severe hyperacusis, I can understand in those cases. But if you have mild or medium T but chose to live a life where you are scared of anything that is outside your own room, then that's an issue.

I developed worsened T after my initial onset, but that had nothing to do with exposure, rather because my hair cells died along the way. I was really scared to even go to work (where everything is pretty much under 50db) and used earplugs for everything. People here are told that sitting on a plane, going outside where there is some traffic (not highways) are dangerous and what not, that's not true. Planes can be loud, I agree with that, but there are things to migrate that noise level, but you shouldn't stop traveling because of it.

 

Occupational safety standards and recommended levels for noise differ from country to another. I think it´s a sign that we just don´t know all the factors that that are involved causing hearing loss and tinnitus.

 

"Incredibly unlikely" (as an event) or "incredibly unlikely" (as a cause)? In the case of a known acoustic trauma, ear fullness is an expected outcome. Why? [Hint: the process involved starts with an "o" and involves the cochlea – what is it?]. Bottom-line: why look for the least likely causes of aural fullness, when the most likely is right at hand?

Ototoxicity can take several forms such as: reversible, irreversible, or dose-dependent. Some drugs – such as Lidocaine – can even be both anti-tinnitus and pro-tinnitus at the same time! Lidocaine – when administered intravenously – is perhaps the only known tinnitus reducing drug that is proven to work. So... why isn't it used more? Well, because the long-term side effects would outweigh the benefits: Lidocaine is neurotoxic and one of the symptoms of its use is actually tinnitus...

Repeat for the above for Prednisolone and consider why Otonomy would employ Dexamethasone for their OTIVIDEX drug if corticosteroids were ototoxic...

 

This is something a lot of people don’t consider. They feel that “I tried to live a normal lifestyle and it got worse”, yet don’t understand that it may have gotten worse regardless. When did you notice it getting worse after onset?

@Ed209 this is a good point, when people say how their tinnitus got worse over time. It doesn’t mean that this is what happened. But can give an alternative explanation.

 

Incredibly unlikely as an event. As I stated earlier, aural fullness is a sign of acoustic trauma, but it’s also a sign of compacted wax, ETD, ear infection, etc, etc. I asked flamingo twice what tests they did but got no answer, so it seems bizarre to give a person prednisone without checking for other issues first. Especially for exposure to sounds around 55 dB - 60 dB (for 2 hours).

Do you agree with the decision to give her prednisone for that kind of exposure?

Also, what’s with all the sarcasm? It was a little over the top.

 

Here's exactly what happened:

For the past two years, my weekends have been quiet as I actively avoided going to clubs and concerts, though I did go to a Cher concert, I go to the cinema ~ once a month, and went to a rocket launch (does that sound like an anxious person to you??) This past weekend was different.

I was at a social event where a live band was playing. I sat approximately 40 feet from the speakers. I was wearing 25 dB musician's ear plugs during the performance. My phone app registered an average sound level of ~ 78 dB. I was eating while the band was playing. While I was chewing, the earplug fit went out of position and sound went into my ear. I could tell because the music would suddenly became louder. The band played for two hours straight with no break!! If I were an anxious person, I would have left right away. But I didn't.

After the dinner I left my ear plugs in and went to the city where bands were playing in the street. This was an additional hour of higher than normal sound exposure. My ears were ringing when I got home that night.

The next day I went into a department store and in the women's section there was incredibly loud music playing. I was exposed to bad, loud music for approximately 5 minutes. The music was so loud that the sales clerk complained that she couldn't hear her customers. It is a general rule that if you cannot hear the person next to you, the environment you are in is TOO LOUD. I did not have my ear plugs in while I was in the store.

My left ear ached and started to feel full. I have had aural fullness in my left ear ever since I woke up on Sunday morning. My left ear is the ear that has hearing loss at 4 kHz of ~ 50 dB plus tinnitus. I have slightly better hearing in my right ear and no tinnitus. All of the symptoms regarding my ears in are in my left ear only. If this were psychosomatic, wouldn't I be feeling these symptoms in both ears? I had ear plugs in both ears, wouldn't the wax buildup be the same? Wouldn't TTTS affect both ears if it was all in my head?

You implored me to be rational. The logical response is that there is a physical state that is affecting one ear only. It happens to be the ear that is already damaged.

 

I tried not to be condescending, I was just trying to help you.

What app did you use and what phone have you got (I’ve got experience with all this stuff). Also, what was it weighted at (A, C, or Z).

How old were the plugs that you used?

There’s a lot more detail now but you’re still missing key bits of information. The fact that you have a notch at 4 kHz shows that you have previous damage from noise, as this is one of the most resonant frequency’s and usually gets damaged first. However, for most of the exposure you had good protection and it didn't seem to be too loud, so the only anomaly is the department store. The most important question now is have you had your ears checked? With the use of earplugs, compacted wax would be the first thing I’d look for. I had problems with wax in my right ear because of earplug use and it made that ear go deaf. I (controversially) had it micro suctioned and then I was back to normal.

Did the Dr who gave you the prednisone check your ear/s for wax? And has a tymponometry been done to rule out fluid behind your eardrum? Have your sinuses been investigated?

If all of those things are clear then an acoustic trauma starts to become more likely, but it still doesn’t mean that’s what it is. Have you seen an ENT and had an audiogram?

There’s a lot of questions that need answering and tests that need to be done.

 

@Ed209 The doctor looked on my ears with a flashlight and checked my throat, breathing, blood pressure, etc. before giving me the prednisone. My ear plugs are Westones and they are 2 years old. I probably need to get some new ones.

I want to believe you, really I do, that it was not acoustic trauma but unfortunately I just can't.

 

Anxious people don't go to events like that. The anxiety begins After they feel the consequences of their behaviour, so the anxiety couldn't have been the cause of the new symptoms/consequences. Most people who post those stories testify the same thing (no anxiety during the event, followed by new symptoms, followed by anxiety), but of course this contradicts Ed's ideas about what is safe and what isn't, so he chooses to ignore all of those cases and to live in some fantasy world where anxiety can cause new symptoms that last for months or a lifetime.

Not sure why you chose not to leave, while plugging your ears with your fingers (which seems to provide almost as much protection as earplugs or muffs).

 

Does aural fullness indicate permanent damage? I'm hoping that whatever happened can heal.

 

I’m trying to be objective in helping her but it’s on very limited information. Based on her initial story it seemed really far fetched that any acoustic trauma could have occurred, and it’s not my idea of what’s safe and what isn’t, but medical science’s. However, if the shopping mall was as loud as she says it was, maybe it was that? Or maybe it was the rocket launch as they are genuinely loud? There’s no way of knowing without any basic tests being done, and trying to find a cause is very tricky when there’s no obvious traumatic event involved. We have no idea how loud the mall was either. It could literally be anything. The problem on this site is that everyone seems to jump to the conclusion that everything is an acoustic trauma without ruling out basic stuff.

Trying to be helpful gets you nowhere on here anymore, so if you’re convinced it’s an acoustic trauma, Flamingo, then go with that diagnosis. If I were you, though, I’d go and see an ENT consultant and get some tests done.

I’ll happily leave you all to it.

 

The sufferer is the one who has the most information, so the best guess as to the cause is what the sufferer believes is the cause.

 

Especially since I know the state I was is in before and after the weekend incidents. I was okay after the rocket launch which was more than 3 weeks ago. I was only exposed to loud music in the store for 5 minutes. I honestly no longer trust musician's ear plugs to give me good protection, though I agree it's better than nothing. Next time I'll go with foam ones.

 

There is a small chance that the rocket launch had weakened your ears, and that as a result you became vulnerable to more minor shocks.

 

And some people like @Ed209 question constant vigilance when it comes to tinnitus triggers. It's literally like having to walk on egg shells around noise.

 

Hey! I am doing fine, haven't been back for a while but popped in here since I got a DM
It was a very slow worsening, I just noticed that it was louder in quiet places (I used to have to struggle a bit to hear it, while it was easy to hear it now) but it was a subtle change. I was also very emotional and struggled to adjust to accept it and how to deal with it. So not sure how much that affected it since I have noticed that when I get upset or emotional, the tinnitus ramps up a lot.

 

Aren't your ears suppose to be rebuild resilience after a year. Why are those sounds still hurting her. ((