About Me, Symptoms, Possible Causes, and Questions — 1 Month After Tinnitus Onset

[apple core]

About me:

35-year-old male living in the upper mid-west region of the U.S. Married with a 5-month-old baby boy. Since college I have worked behind a computer in office environments.

Symptoms:

Daily and mostly left-ear hissing or buzzing that comes in and out like an electric current of poorly wired lighting. Sometimes it sounds like either a whistle is being played in my ear or a faint vacuum suction effect. Also chirping or creaking like effect that travels through the back of my head around the big ball joint. That part is not daily but comes and goes. Right ear has long periods of feeling normal and when there are noticeable symptoms I find it hard to discern if it is my anxiety intensifying the noises.

Possible Cause #1:

I have daily use of headphones or earbuds while working and it has been this way since college. I'd like to think I've been careful not to pulverize my eardrums with loud music for extended periods, and for the past five years I'd say the time breakdown is 75% podcasts-25% music. Perhaps that's irrelevant information. I bought Sony WF-1000XM3 earbuds in July. I haven't used them since December 8th, 2020 which is an important date I'll come back to. I've also been to my share of concerts, but nothing since December of 2019, pre-COVID-19. I'm ok cutting concerts out of my life and if someday I do go back I'll wear foam plugs and stand near the back. More challenging is if I can get back to listening to music at even low levels on my home stereo.

Possible Cause #2:

When I was 21 and in college I began experiencing symptoms of an undiagnosed cervical vertebrae issue that causes the back of my head, where the big ball joint is, and neck to have weird muscle twitching and spasms that shoot down my limbs as a tingling feeling. For the first 3-5 years it felt like my spine was in a near constant state of vibration. I saw a neurologist and had all sorts of tests done to rule out serious spinal disorders but was never given a diagnosis. I never had loss of balance or coordination. The condition came with periodical pain and soreness in my neck and shoulder region. The best they could offer was to tell me it was muscular-skeletal related and send me to physical therapy. Every doctor or physical therapist has told me about my poor posture and tension of my neck/shoulder region. The physical therapy never did a whole lot to help, but life went on and you could say I habituated to an ailment that was very stressful for those first 3-5 years. Due to the recent tinnitus issues I began to have weekly appointments with an acupuncturist who also works as a physical therapist and our goal is to relieve tension in my neck.

Possible Cause #3:

Owing in some part to the condition discussed above by age 23 I started taking anti-anxiety medication. I was on Lexapro from ages 23-28, then Sertraline from 28-present. Consider though that I never noticed prolonged tinnitus while taking either medication until this recent episode. Any tinnitus I've experienced before 2020 was fleeting lasting no longer than 5 minutes or the next morning following concerts.

Tinnitus Onset:

Sometime in Summer of 2020, and only in quiet situations such as when I was reading a book or my phone, could I start to notice this odd "chirp" or "squeak" pulsing like a current through the back of my head, around the big ball joint. It was extremely faint, not noticeable all the time, and while I didn't stress it too much there was part of me that thought it could be related to my spinal issue. I didn't necessarily think it was tinnitus in the traditional ear-ringing sense so I didn't think much of using earbuds. If anything, maybe the earbuds made me unable to notice it while at my work desk.

Now forward to Tuesday, December 8th. I take my earbuds out to go home and can notice this high pitch ring coming from my left ear. It's something that I recall noticing in short, faint, and infrequent periods the prior couple days. I was able to sleep fine and there was no hearing loss, like a clogged ear, but it didn't go away Wednesday or Thursday. I read online that one reason for tinnitus could be earwax build up against the eardrum. The recommendation was to syringe the ear. There was a time in college when I went to the student health clinic with a clogged ear, they syringed, and I returned home happy with clear ears and zero tinnitus. So seeing as I came across none of the warnings about ear syringing I put a couple ear wax drops in each ear, and irrigated my ears with warm water at decent pressure, about five times on each ear.

I came to regret not doing more research or waiting to talk to a doctor. Really not any luck with the ringing. I even repeated the syringing on Friday night. Now through Saturday and Sunday I noticed how sensitive my ears were, almost in pain, and a WHOOSHING noise in the back of my head. The whooshing reminded me immediately of the chirping I noticed during the summer but at an intense, loud level.

For the next two weeks I thought I did serious damage with the syringing. Now that the whooshing has subsided and my most frequent symptom is the same ear hissing/buzzing I had pre-syringe I feel that while I temporarily made my condition worse and it didn't help my anxiety, I don't think the syringing has any serious long-term impact. Basically, I think I would've had my present condition regardless of the syringing. I still wouldn't do it ever again.

I met with my GP by video conference on December 16th and he prescribed a nasal spray which has given no relief to the tinnitus. On January 6th I was able to see an audiologist and ENT. They told me I had "perfect" hearing in their short screening procedure and that was basically it.

It was after this visit that I came across a thread mentioning Tinnitus Talk and threads of @Michael Leigh. So while I stopped using the earbuds on December 8th I continued to wear over-ear headphones with large cushions, making sure to take breaks and only at low volumes. My GP told me this would be OK. Well, headphone use is now cut out since January 7th.

Current regiment:

400 mg of Magnesium Glycinate, 120 mg of Ginkgo Biloba, and a multi-vitamin with B12. Will add a Zinc supplement next weekend after my body gets used to the Magnesium. I see the acupuncturist/physical therapist once per week and we've decided for the time being we should focus on relieving tension in the neck region with stretches, yoga, and core exercises to improve my posture. Shoulder and neck strengthening exercises with weights or elastic bands (which is something I had been doing on my own) might be counter productive so for the time being they are shelved. It has only been a week but I think I've gotten some relief or improvement from this regiment.

Questions for future:

Through all this time I've been able to sleep normally, 8 hours a night, without the use of masking. Reading other stories I realize how lucky I am to be in this position. My heart really goes out to those struggling with sleep. I can head to bed with bad tinnitus and by laying down with the back of my head against a pillow I am able to get some relief and drift away after reading a couple pages of a book. I also have a history of insomnia, so this is notable.

Regardless that I'm able to sleep, should I use masking sounds at night anyway? Do you think I could benefit from having my hearing exposed to this stimulus during sleeping hours? Or is there potential harm?

Is Sertraline an ototoxic medication? I can't find it on lists of anti-anxiety meds to avoid, but it is listed as a substitute to Zoloft.

I work as an engineer for a mechanical contractor and we do our own prefabrication of ductwork and piping in our shop. I'm a safe distance from MOST of the loud noises like air hammers. However, a thin wall separates me from part of the shop where they do electric sawing and pipes clank off each other like you get in this work environment. My phone's sound meter measures the decibels in the high 40 dB to 50 dB even when the saws are going. I've started to wear my foam ear plugs anytime I pass through the shop back and forth from my office to the bathroom or breakroom. Would you recommend wearing the foam plugs at ALL parts of the work day? Is there potential harm to wearing foam plugs for 8 hours a day and depriving my ears of auditory exposure? What DB range should I avoid now or be careful with?

Today I came across Michael Leigh's discussion about EMF exposure from computers. It's added another layer of anxiety as I make my living with computers and would really have to get some special treatment from my company to be able to work from home and sit in a different room from computers. How serious do other posters treat or think about this element?

I see a different ENT tomorrow. I'll try and keep my expectations low but this time I plan on going with a set of my questions and simply walk away with a better understanding of my condition, or at least a road map to figure out a root cause. The last ENT was not someone I want to see again.

Also, I will go to a Tinnitus Clinic at the hospital on February 1st. I read they specialize in TRT. Because it is a tinnitus clinic, should I expect a much more in-depth hearing screening that will give me a better picture about hearing loss? They told me I will be there for two hours. If they tell me there is no hearing loss, does that indicate Possible Causes #2 or #3 are more likely than #1?

Thank you for reading. Thank you to the builders of this website and especially @Michael Leigh for offering such strong support. I'm doing my best to focus on success stories and take small steps in a positive direction. I vow to post my own success story should I ever feel like I'm habituated and happy again.

 

[apple core]

I guess you can't edit a post but I just want to mention that I found the lengthy thread in "Support" about EMT and computers, so in the interest of not bogging this thread with unnecessary extra discussion, I wish I could omit that part. Sorry for being so exhausting and thank you.

 

[Drachen]

Hey there! Thank you for stopping by and sharing your story. I am fairly new to this all myself, but I have done an extensive bit of research over the past few weeks, and I want to provide assistance wherever I can.

Regardless that I'm able to sleep, should I use masking sounds at night anyway? Do you think I could benefit from having my hearing exposed to this stimulus during sleeping hours? Or is there potential harm?

This is a good question that I would like to see answered by others. There are some, especially those who support the general dogma of tinnitus retraining therapy, that believe masking sounds at a volume below your noise is helpful and conducive to bringing about change. For the others, the masking really does not provide much benefit besides the masking and can be used at volumes above. These two camps are often at odds, and I don't think there's enough conclusive science in one camp that will disprove the other. Again, this will boil down to what works best for you.

What you will need to consider is that your ears need to be protected against damage. Hearing damage comes from excessive volume and duration. If you keep your masking at a low enough level, it should be fine for consistent use, and therefore you shouldn't damage yourself any further.

Is Sertraline an ototoxic medication? I can't find it on lists of anti-anxiety meds to avoid, but it is listed as a substitute to Zoloft.

The single list of ototoxic medications I tend to use when it comes to evaluating medicine, herbals, and chemicals is the one provided by the ATA. You can find it at this link. Sadly, Sertraline and Zoloft both are included on this list.

That being said, your mileage may vary. Several users have used it without their condition getting worse, and several others have potentially associated it with spikes. The same even goes for drugs like amitriptyline and Mirtazapine, both of which are generally well-regarded here yet they are still both on the list and sometimes cited as potentially problematic.

You'll have to figure out what you're comfortable taking risks with when it comes to addressing your problems with medication. I know this answer sucks and isn't helpful, but there is really no sure-fire way to tell if something will help you or hurt you.

Would you recommend wearing the foam plugs at ALL parts of the work day? Is there potential harm to wearing foam plugs for 8 hours a day and depriving my ears of auditory exposure? What DB range should I avoid now or be careful with?

I think you should wear foam plugs when you think you might be exposed to noise of high decibels. I don't think you need to do it when you're simply at your desk or congregating with workers, but if you're going outside among vehicles and such, it is probably a good idea in case there are any horns honking or sirens blaring, at least for a few months.

Some believe that "overprotecting" your ears can lead to greater sensitivity, whereas others think you should protect as much as you view necessary in order to avoid more damage. This is unfortunately another area of ambiguity where there are two sides that are often at odds with the other. I have not been able to find anything conclusive either way that states you should follow one path or the other. I do think the only bad option is not using any protection at all.

Also, I will go to a Tinnitus Clinic at the hospital on February 1st. I read they specialize in TRT. Because it is a tinnitus clinic, should I expect a much more in-depth hearing screening that will give me a better picture about hearing loss? They told me I will be there for two hours. If they tell me there is no hearing loss, does that indicate Possible Causes #2 or #3 are more likely than #1?

No hearing test currently available is robust enough to accurately judge how much hearing loss you may have and the extent to which it is present. This is even if they provide high frequency audiometry, which seems likely given how long you're anticipated to be there.

Now, considering they are a specialized clinic, they might be able to provide you with clearer guidance on what the cause of your issue may be and what sort of steps might be preferred going forward. Just understand that it is fact hearing damage is hard to determine to its full extent, and just because you come out with "perfect hearing", that doesn't mean there aren't ranges that are potentially damaged outside of what has been tested. If your clinicians are worth the titles of "specialists" in this area, then I would hope they understand and can convey to you that hidden damage can still be present and contribute to the problem. Hell, my audiologist even understood this, and she is not a specialist.

It's very possible that all of the possible causes could be contributing to the symptom to some extent. There is simply no sure-fire way to tell what might be the origin unless it is something easier to detect like blockages or infections.

 

[apple core]

@Drachen

Thank you for the thoughtful reply. Your "Introduce Yourself" post actually inspired mine. I also noticed some of your other posts and you seem intelligent and committed to understanding this predicament well.

The ENT on Monday prescribed me a blood pressure medication and told me to quit caffeine. He thought I was going to have a stroke. I decided to lay low from this message board but admit I still pop back in to the Research page. I find that I project one negative post from a random user that isn't scientific and it really affects my anxiety. The same ENT told me I have some hearing loss outside of the normal range but that this was fairly common. Maybe I will post the audiogram when it comes in the mail.

All the best to you. You have a good attitude.

 

[apple core]

Oh, I also talked with an aunt who said her son, my cousin, who is a couple years older than me had a tinnitus spike after an airplane flight. It didn't go away, he struggled, he found he had hearing loss, and it eventually became tolerable. She hasn't asked him about it in years and I still see him living a normal life. So add that to a habituation success story.

 

[Drachen]

@apple core, thank you very much for your kind words. It means a lot to hear that I had inspired you to reach out. I am glad, at the very least, that I can provide some service to other sufferers. The best thing we can do as a community is stick together and help one another out until recovery.

I wish you the best with your blood pressure. Many have reported that this is a problematic aspect that can worsen the noise, so perhaps if the medication works, you will see some extent with relief. The same goes for caffeine. I used to be a heavy tea and coffee drinker, but I'd since cut all of that out (aside from herbal teas) in fear that it'll make things worse. I hope you'll be able to find suitable alternatives on your end, and if you'd like, I could recommend some favorable teas.

I do completely understand your decision to keep the board at a distance. I absolutely follow what you mean with regards to focusing on the negative posts. I am and have been for some time a very anxious person who is prone to catastrophizing, so when I see those who are chronically and/or severely afflicted, my brain begins to catastrophize. I have been doing what I can to avoid the more depressing threads and posts and focus on the better, more uplifting sections like the research news or success stories. As you mentioned yourself, it's not possible to avoid them entirely without just foregoing the board. I recommend following whatever path helps lessen your stress and anxiety.

I didn't mention this in my initial post, but congratulations as well on your (relatively) new child. I'm sure he's not helping much with the loudness, but the joy from having your own son must be tremendous all the same.

The best thing most people agree that one can do is wait and fight through this mess. I know it's easier said than done, as I am still finding it difficult sometimes to manage the day-to-day, but I suppose this is another example of how life isn't meant to be a cakewalk. That being said, I certainly expect in the near future we will be looking back at this time in our lives and grateful we managed to fight through it, overcome the distress, and recover from this nuisance.

 

[twa]

Oh, I also talked with an aunt who said her son, my cousin, who is a couple years older than me had a tinnitus spike after an airplane flight. It didn't go away, he struggled, he found he had hearing loss, and it eventually became tolerable. She hasn't asked him about it in years and I still see him living a normal life. So add that to a habituation success story.

Hi apple core,

Did your cousin's tinnitus lower in volume?

twa

 

[apple core]

id your cousin's tinnitus lower in volume?

Not sure as I haven't talked to him directly about it. My aunt gave me his email address if I want to talk to him about treatment he researched. He's an anesthesiologist so a smart guy. I haven't yet because she said he asked her to not mention it and it was tolerable, i.e. he doesn't want to think about it.

However, I see him on dance floors at weddings and at 4th of July parades on Facebook. That's a tell it's tolerable to a point he isn't afraid to do these things.

 

[apple core]

I consider my case "moderate" since I am able to sleep without masking though it has drained me of all joy in life at present. While I believe I could eventually habituate to the level of tinnitus I have now, I am extremely anxious that prolonged use of the ototoxic, SSRI Sertraline has and will make my tinnitus worse. Therefore, I have anxiety about the drug that is supposed to reduce my anxiety.

• Tinnitus spike/onset was early December, 2020 (~1.75 months).
• Have been taking Sertraline for over five years with no noticeable side effects until now (if this is a side effect).
• ENT told me I have sensorineural high frequency noise induced hearing loss.
• Same ENT recommended not stopping Sertraline since I have been on it for a while with no side effects. He put me on a blood pressure medication since my BP was very high when I was at his office. GP thought I should discuss it with Psychiatrist. Psychiatrist thought it was good idea to cut back 50 mg per day every week until I am off (currently at 200 mg per day). She thought since it is not helping my anxiety now it is basically ineffectual anyway. She explained that side effects can happen even after five years. She has never had a patient with hearing loss side effect.
• Psychiatrist will prescribe Mirtazapine if I need it. I was also told about Atarax from a family member.
• Moving my desk at work to a slightly less noisy side of the office to help with anxiety about being too close to our shop with constant electric sawing (yes, I'm a wreck).

Feedback appreciated. Thank you. For now, I do plan on cutting back 50 mg per day starting today.

 

[Lukee]

Hey @apple core, pretty new here myself and have had tinnitus for only just over a week. Mine is accompanied by fullness in the ears and even pain which has been subsiding over the last couple days. Like you, joyful things are not in my mind right now but I am trying my best to make it better and look on the bright side. You have a huge advantage that your sleeping has not been affected. I basically haven't had a good night's sleep for about a week and I don't know if it's the tinnitus waking me or my anxiety about the situation or both.

In any case, in my research over the last week, I have found that an uncommon cause of tinnitus is Craniocervical instability (CCI). Given your head and neck issues, it might be something to look into. Also, you're already seeing a physical therapist but just in case, check out the McKenzie Method for tinnitus on YouTube. It's basically neck tuck exercises for tinnitus that is mechanically induced. I hope this helps you but if it doesn't, look on the bright side, you are sleeping well, you are otherwise able-bodied, you will hopefully habituate after some time and we are on the verge of many promising therapies for tinnitus and hearing loss.

All the best.
L

 

[apple core]

@Lukee thank you!