Can Anybody Help ASAP? Spike After MRI (1.5 Hours Ago). Can I Take Steroids (Prednisolone)?

[Arseny]

Hello,

Sorry if I make any mistakes or sound dramatic.

I just had a brain MRI for various reasons including my tinnitus in my left year.
MRI was under 100 dB (Siemens Magnetom Avanto 1.5T) and I used 3M earplugs (model 1100) and they gave me headphones with 18 dB reduction.

Now I came home I feel a very noticeable spike in my left ear and it started spreading to my right ear! I'm in panic and I don't know what to do!

I have Prednisolone (injections) at home and Piracetam.
I saw this study https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3102156/ see 3.3 post-traumatic rescue.

Should I inject it right now? Are there any possible side effects for my ears? I've used it before my asthma attack.

Please respond ASAP it's almost nighttime here and all the clinics are closed.

 

[robHing]

Please be patient and wait for more advice here.
My personal experience of Prednisolone is that
it will spike the T after taking 1st stage of pills.

Don't be panic now. Please wait ...

 

[Jack Straw]

Hello,

Sorry if I make any mistakes or sound dramatic.

I just had a brain MRI for various reasons including my tinnitus in my left year.
MRI was under 100 dB (Siemens Magnetom Avanto 1.5T) and I used 3M earplugs (model 1100) and they gave me headphones with 18 dB reduction.

Now I came home I feel a very noticeable spike in my left ear and it started spreading to my right ear! I'm in panic and I don't know what to do!

I have Prednisolone (injections) at home and Piracetam.
I saw this study https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3102156/ see 3.3 post-traumatic rescue.

Should I inject it right now? Are there any possible side effects for my ears? I've used it before my asthma attack.

Please respond ASAP it's almost nighttime here and all the clinics are closed.

You might want to wait till morning when you can see a doctor and to see if the spike quiets down.

How long was the MRI and how do you know how loud it was?

 

[Tinniger]

I also recommend to wait until the next morning.

Usually everything is improved overnight, and if not, you can still take cortisone.

 

[Arseny]

Please be patient and wait for more advice here.
My personal experience of Prednisolone is that
it will spike the T after taking 1st stage of pills.

Don't be panic now. Please wait ...

Thank you for your answer! Within last hour or so I tried to dig up as much information about this as possible and came to conflicting conclusions. Some people say that it got better and it's very important to start early and some say that it may become worse as in your case.

You might want to wait till morning when you can see a doctor and to see if the spike quiets down.

How long was the MRI and how do you know how loud it was?

Thank you for responding!

I spoke with my asthma doctor and she told me that I can go ahead and inject myself with 60-90 mg and that I shouldn't experience any side effects from just one injection. But she's only an asthma doctor =/

MRI was going for 10 or 15 minutes. The MRI machine is supposed to have 30 db reduction and stay within 99 db. For me it was very loud. I can say that even with hearing protection it was much louder that having a ride or a train. I would say it was as loud as standing withing 10 meters of a jackhammer.

Right now after I calmed down a bit I can definitely tell that I have a spike and I'm very afraid for my future. At this point from my perspective practically almost any risk is worth it if it will help me to at least return to my baseline before the MRI. Since my tinnitus is very recent (it started a month ago) I still have hope for improvements since it's most likely connected to my neck problems.

 

[Arseny]

I also recommend to wait until the next morning.

Usually everything is improved overnight, and if not, you can still take cortisone.

Thank you for response)
I'll try to make a decision right now, I feel like the noise has started pulsating a bit and there's much more noise in my right ear that was non existent before (at least I couldn't hear it)

 

[Jack Straw]

Thank you for your answer! Within last hour or so I tried to dig up as much information about this as possible and came to conflicting conclusions. Some people say that it got better and it's very important to start early and some say that it may become worse as in your case.



Thank you for responding!

I spoke with my asthma doctor and she told me that I can go ahead and inject myself with 60-90 mg and that I shouldn't experience any side effects from just one injection. But she's only an asthma doctor =/

MRI was going for 10 or 15 minutes. The MRI machine is supposed to have 30 db reduction and stay within 99 db. For me it was very loud. I can say that even with hearing protection it was much louder that having a ride or a train. I would say it was as loud as standing withing 10 meters of a jackhammer.

Right now after I calmed down a bit I can definitely tell that I have a spike and I'm very afraid for my future. At this point from my perspective practically almost any risk is worth it if it will help me to at least return to my baseline before the MRI. Since my tinnitus is very recent (it started a month ago) I still have hope for improvements since it's most likely connected to my neck problems.

It could be due to the position your neck was in at the time that is increasing the volume. The MRI machine is supposed to have a 30 dB reduction? Do you mean with hearing protection? How loud is your tinnitus at baseline vs how loud is in now?

 

[Arseny]

It could be due to the position your neck was in at the time that is increasing the volume. The MRI machine is supposed to have a 30 dB reduction? Do you mean with hearing protection? How loud is your tinnitus at baseline vs how loud is in now?

https://www.mr-tip.com/serv1.php?type=db1&gid=1315
"The AudioComfort technology enables up to a 30 dB(A) acoustic noise reduction, that means nearly all clinical routine sequences are running under 99 dB(A)."

What do you mean by position of my neck? If your meaning that by laying down somewhat uncomfortably in MRI machine I have increased my tinnitus or I was experiencing the noise differently I think that it's not the case. My neck position was perfect. I feel ok when my neck is in "normal" position, but when I turn my head to the side I get black pulsating dots in my eyes. I have done some vascular tests that confirmed that I somehow pinch some of my veins by turning my head.

My base line was already pretty horrible, I could hear it over my PC fans, over my voice, over the pretty much everything that you could find indoors. Before my vascular treatment it was awful, but has gone down a bit within last 10 days. But now it's going full blast not only in my left ear, but I can notice it in my right (unaffected) ear over my PC fan and generally within my head. Before it was that when I focused on the noise in super quiet conditions I could only hear my left ear, now it's general noise within my head + right ear.
In short I would say that my left ear has increased by 1.5-2 times than it was in the morning and I can hear high pitched ringing that was there pre treatment.

 

[Redocooking]

I'm no expert but it sounds like your nerves are shot after that "treatment:. The fact that it's even going down at all is a good sign and that it's imperative you get 8 hours of sleep each day. Make sure to try and sleep on your back as well.

 

[Jack Straw]

https://www.mr-tip.com/serv1.php?type=db1&gid=1315
"The AudioComfort technology enables up to a 30 dB(A) acoustic noise reduction, that means nearly all clinical routine sequences are running under 99 dB(A)."

What do you mean by position of my neck? If your meaning that by laying down somewhat uncomfortably in MRI machine I have increased my tinnitus or I was experiencing the noise differently I think that it's not the case. My neck position was perfect. I feel ok when my neck is in "normal" position, but when I turn my head to the side I get black pulsating dots in my eyes. I have done some vascular tests that confirmed that I somehow pinch some of my veins by turning my head.

My base line was already pretty horrible, I could hear it over my PC fans, over my voice, over the pretty much everything that you could find indoors. Before my vascular treatment it was awful, but has gone down a bit within last 10 days. But now it's going full blast not only in my left ear, but I can notice it in my right (unaffected) ear over my PC fan and generally within my head. Before it was that when I focused on the noise in super quiet conditions I could only hear my left ear, now it's general noise within my head + right ear.
In short I would say that my left ear has increased by 1.5-2 times than it was in the morning and I can hear high pitched ringing that was there pre treatment.

I know there isn't that much science behind it, but have you looked into taking some supplements right now? Things like NAC, magnesium citrate, vitamin e, etc?

 

[Eric N]

Siemens Magnetom Avanto 1.5T is supposed to be quieter than other MRIs
I had a brain scan with this machine 5 years ago with no issues.

Unfortunately I can't not say the same about last years MRI which was very loud GE 2013 model and nearly 1.5x my T level.

In both cases I used foam and muffs

 

[Jack Straw]

Siemens Magnetom Avanto 1.5T is supposed to be quieter than other MRIs
I had a brain scan with this machine 5 years ago with no issues.

Unfortunately I can't not say the same about last years MRI which was very loud GE 2013 model and nearly 1.5x my T level.

In both cases I used foam and muffs

Was this the "silent" MRI machine?

 

[Eric N]

Was this the "silent" MRI machine?

I think so its is supposed to be 97% quieter than other machines I read in the specs, it was still noisy tough I would rate it at 75db if I had to take a guess while wearing hearing protection.

 

[Jack Straw]

I think so its is supposed to be 97% quieter than other machines I read in the specs, it was still noisy tough I would rate it at 75db if I had to take a guess while wearing hearing protection.

Was it this machine?
https://www3.gehealthcareturkiye.co.../silent scan/gehc-brochure-mr-silent-scan.pdf

They claim this to be 77 dB scan. With hearing protection you would be around 50 dB. Was this the machine the caused your permanent spike? Were you wearing hearing protection?

 

[Bart]

If you had proper hearing protection , usually they give you foam plugs and a noise canceling headset , I think the spike is most likely anxiety related and should settle back down after a good nights sleep , or at least within a couple of days.

Personally I would wait with the steroids, at least untill the next morning and it would still be well within the window of opportunity .

 

[Eric N]

Was it this machine?
https://www3.gehealthcareturkiye.co.../silent scan/gehc-brochure-mr-silent-scan.pdf

They claim this to be 77 dB scan. With hearing protection you would be around 50 dB. Was this the machine the caused your permanent spike? Were you wearing hearing protection?

No it was not a new GE the one i did probably was 110 db

 

[Jack Straw]

No it was not a new GE the one i did probably was 110 db

Oh okay. I was terrified that even a low decibel one like this was also giving people spikes.

 

[Arseny]

I'm no expert but it sounds like your nerves are shot after that "treatment:. The fact that it's even going down at all is a good sign and that it's imperative you get 8 hours of sleep each day. Make sure to try and sleep on your back as well.

By my "nerves" do you mean my hearing nerves or like "stress" nerves that people usually mean by that?

My official diagnosis is auditory neuritis + mild hearing loss in my left ear. I don't know how accurate this diagnosis is, because I also had a lot of general stress and noise exposure from my headphones which I measured are 80-85db at max volume (I used them 4-5 times a week for 1-2 hours per day to play video games (PUBG)) which I used for solid 5-6 years before with no issues. But considering my history of vascular problems doctors think that I might have damaged my hearing nerve due to brain hypoxia.

I have received treatment for stroke patients, so it's pretty powerful. I have recieved similar medicine 2 years ago with great results for my other symptoms (vertigo, problems with vision). After most recent treatment there was definitely an improvement, but after an MRI it got to pre treatment levels or worse.

Thank you I'm trying to recuperate as much as possible. I'm definitely getting enough sleep.

I know there isn't that much science behind it, but have you looked into taking some supplements right now? Things like NAC, magnesium citrate, vitamin e, etc?

Thank you for your suggestion! I will start everything you've mentioned within a couple of days. I will do a blood work first. The only thing I though of is taking B12 since I almost never eat meat and vegetarians are susceptible to B12 deficiency which I heard can cause tinnitus too.

If you had proper hearing protection , usually they give you foam plugs and a noise canceling headset , I think the spike is most likely anxiety related and should settle back down after a good nights sleep , or at least within a couple of days.

Personally I would wait with the steroids, at least untill the next morning and it would still be well within the window of opportunity .

Thank you for your answer. Yes they gave me a headset that was labeled at 18db and my 3M earplugs are tested at about ~21 db if I remember correctly. I'm still new to all of this so I'm not so sure if in inserted my earplugs correctly. They were sticking out a bit, but I could definitely feel the noise reduction, it blocked out all ambient noise and quiet music that was in the hall area of the clinic. My voice sounded hollow and other voices were quieter. I'm not really sure how sufficient protection was.

 

[Jack Straw]

By my "nerves" do you mean my hearing nerves or like "stress" nerves that people usually mean by that?

My official diagnosis is auditory neuritis + mild hearing loss in my left ear. I don't know how accurate this diagnosis is, because I also had a lot of general stress and noise exposure from my headphones which I measured are 80-85db at max volume (I used them 4-5 times a week for 1-2 hours per day to play video games (PUBG)) which I used for solid 5-6 years before with no issues. But considering my history of vascular problems doctors think that I might have damaged my hearing nerve due to brain hypoxia.

I have received treatment for stroke patients, so it's pretty powerful. I have recieved similar medicine 2 years ago with great results for my other symptoms (vertigo, problems with vision). After most recent treatment there was definitely an improvement, but after an MRI it got to pre treatment levels or worse.

Thank you I'm trying to recuperate as much as possible. I'm definitely getting enough sleep.



Thank you for your suggestion! I will start everything you've mentioned within a couple of days. I will do a blood work first. The only thing I though of is taking B12 since I almost never eat meat and vegetarians are susceptible to B12 deficiency which I heard can cause tinnitus too.





Thank you for your answer. Yes they gave me a headset that was labeled at 18db and my 3M earplugs are tested at about ~21 db if I remember correctly. I'm still new to all of this so I'm not so sure if in inserted my earplugs correctly. They were sticking out a bit, but I could definitely feel the noise reduction, it blocked out all ambient noise and quiet music that was in the hall area of the clinic. My voice sounded hollow and other voices were quieter. I'm not really sure how sufficient protection was.

https://www.tinnitustalk.com/thread...noise-induced-hearing-loss-ototoxicity.31941/

Check this thread out.

 

[Bart]

@Arseny I think you will be fine , try not to worry about it too much as that will only feed your tinnitus .

Easier said than done off course but from my experience worrying about things is often much worse than the actual noise exposure

 

[Bill Bauer]

If I were you, I would take a course of Prednisone. That way you will know that you did everything you could.

 

[Arseny]

Hello everybody, here's an update.

Today I went to a specialized doctor to the same clinic. There was a much experienced audiologist/ENT today.
She looked at my previous tests and said that the other doctor was wrong about my results.
She said that my hearing nerve is just fine, but I have some sort of trouble with "hearing by air"? I don't know how to translate it, but basically I have good hearing trough the bone, but issues with hearing through my ear.
She also noticed signs of scarring on my ear membrane which are supposedly from previous cases of otitis (I had it 1 or 2 times in my childhood).
She also interpreted my typmanogram much differently than the previous younger doctor and said that I have bad response in both ears, especially in my left ear. I'm not very educated on this, but basically the spike on the typmanogram is not that high as it's supposed to be and I have more like a wave (it looks like a hill instead of a spike) in my left ear. She said it's bad and not supposed to be this way. She prescribed some treatment, I didn't research it yet. I'll post it a bit later here.
Also she looked at my vascular tests and said that I have serious spasms in my neck and she typically sees similar results in 40+ years olds, but not in a young guy.

I did an new audiometry and it's much improved, almost perfect.

My cardiologist also prescribed me some intravenous nootropics and anti ischemic drugs. I'm starting them tomorrow. I didn't research them yet, but I know I used one of them in my childhood.

After my walk to the clinic I felt the the spike has somewhat subsided, but didn't go away completely and I could still hear my right ear ringing. I decided to inject 90 mg Prednisolone anyway after ~23 hours after exposure to MRI. All of the doctors said that I could try it without any expectations, more like a "Hail Mary" move. And that at least it will help with my dermatitis.

After 1.5- 2 hours after injection I'm having a spike in my tinnitus levels. It's definitely much louder that it was before the injection and at this point I have some sort of general noise in my head that's either is very overpowering or masking out my PC fan in a way that I can barely hear it. Other sounds seem to be fine though. I'm not sure. I feel like my ears are somewhat dull. It feels like I can hear without problems, but this hissing noise is kinda dulling general sense of background noises and making my ears somewhat full. I never had a bad reaction to Prednisolone before and injected it multiple times before in my life. But it seems to affect my tinnitus, so I don't know what to do. I will probably stop using it and will not continue steroid treatment.

Right now I'm going to call my therapist and ask for suggestions. If any of you have something to say about my situation, please do I will really appreciate it, because I'm really freaking out right now.

P.S. Although I had serious reasons to have an MRI scan due to my vascular symptoms I do regret it.
Because yesterday morning I woke up with a hiss and thought to myself "Oh, it's not that bad like before, maybe I have a chance", but in the evening after the MRI I had alarms going off inside my head.
I feel like I start to regret taking steroids too. I really hope I can get better and get rid of the noise.

 

[Telis]

Sounds like you wore the proper protection, I wore foam earplugs, not inserted correctly, 45 min of imaging done, not sure of the machine but way louder than 100db. You sound like you were pretty diligent at least. You wouldn't think that that should do any damage.

I've used power tools that are around 100db with double protection for hours, never had a issue. Maybe it's just stress, you are overthinking it.

I could barely hear the tech after I got out of the machine. My tinnitus was bad before, now, it's not livable.

I opted out of steroids this time around, as it seemed to make my situation worse the first time.

 

[robHing]

@Arseny
Thanks for update. Please hang in there.
Please give it sometime and protect your ears (no further noise aggravation),
it may calm down gradually.
As I mentioned in this thread earlier, I took stage 1 prednisolone
and stop immediately due to strong spike.
It took about 48 hours to lower down the tinnitus
(the steroid is completely out of the body).

 

[Gman]

Nearly 2 years ago I had a 23min MRI in a Siemens Magnetom Aera 1.5t. Max output is either 103db or 106db depending on which sub model. They didn't give me double protection, only some muffs which I wasn't told the NRR.

I had no spike after but did get full on vertigo the next day and also H that gradually worsened, TTTS, ear fullness and noticeably worse and unpredictable T. I still suffer to this day with all, but my T can go very low sometimes. My conditions were compounded by other subsequent noise exposures.
I wish I knew what I know today. If I had have had pred back then I would have taken it. But if your double protection was on properly, it is probably just your nerves causing the spike.

 

[Eric N]

@Arseny how is your spike doing?

 

[Arseny]

@Arseny how is your spike doing?

Hello,
Thank you for reaching out.
It has yet to come down completely. I'm having fluctuations and sometimes it's a bit better in the morning, but in addition to previous sounds I hear an electrical hiss in my right side of the brain all the time and a quiet tone in my right ear, but it's quiet.
I feel like the overall volume is fluctuating during the day, but the volume on the right side has got progressively worse since the MRI and almost caught up the the volume on the left. Beforehand it was noticeable only in very quiet conditions before, but now the hiss apparent on both sides in every environment under 60-65 db.
I feel like I'm walking on the edge of the knife. If it gets a bit quieter is tolerable, but if it gets any louder I'm breaking in tears within 5 minutes. Both from panic, and from realization how loud it is.

I have started a course of Dexamethasone injections today. For now it's 4 mg - skip a day - 8 mg - skip - 8 mg - skip - 8 mg - skip - 4 mg. My doctor says we can bump it up to 12 mg (3 ampules) if I'm feeling ok.
Do you think the dosage is adequate? It supposed to be equal to 30/60/90 mg of Predinisolone.
I have read a study where they gave 40 mg of Dexamethasone for 3 days and than 10 mg for a few days with very good results, but it's 10 times more of what I'm getting now and my cardiologist said that it's very risky with my underlying vascular conditions. She's afraid that it can spike my blood pressure and potentially cause increase in my intracranial pressure which is on of the possible reasons for at least some parts of my tinnitus.

 

[Eric N]

Hello,
Thank you for reaching out.
It has yet to come down completely. I'm having fluctuations and sometimes it's a bit better in the morning, but in addition to previous sounds I hear an electrical hiss in my right side of the brain all the time and a quiet tone in my right ear, but it's quiet.
I feel like the overall volume is fluctuating during the day, but the volume on the right side has got progressively worse since the MRI and almost caught up the the volume on the left. Beforehand it was noticeable only in very quiet conditions before, but now the hiss apparent on both sides in every environment under 60-65 db.
I feel like I'm walking on the edge of the knife. If it gets a bit quieter is tolerable, but if it gets any louder I'm breaking in tears within 5 minutes. Both from panic, and from realization how loud it is.

I have started a course of Dexamethasone injections today. For now it's 4 mg - skip a day - 8 mg - skip - 8 mg - skip - 8 mg - skip - 4 mg. My doctor says we can bump it up to 12 mg (3 ampules) if I'm feeling ok.
Do you think the dosage is adequate? It supposed to be equal to 30/60/90 mg of Predinisolone.
I have read a study where they gave 40 mg of Dexamethasone for 3 days and than 10 mg for a few days with very good results, but it's 10 times more of what I'm getting now and my cardiologist said that it's very risky with my underlying vascular conditions. She's afraid that it can spike my blood pressure and potentially cause increase in my intracranial pressure which is on of the possible reasons for at least some parts of my tinnitus.

sorry I can't comment on the steroids, but did you actually get more hearing loss do you have a before and after audiogram?

 

[Arseny]

sorry I can't comment on the steroids, but did you actually get more hearing loss do you have a before and after audiogram?

To my surprise the audiogram after the MRI was very good in comparison to what I've had before.
To be honest I don't think I have any noticeable hearing loss. I'm trying to find a clinic where they can do a test for "hidden hearing loss" with speech and noise masking. But I've never experienced any problems with deciphering speech even in very loud conditions before or after.

 

[Alue]

I saw this study https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3102156/ see 3.3 post-traumatic rescue.

From the text:

A larger number of patients recovered (69%) when treatment was begun within the first hour after the acute trauma, rather than after a delay of > 1 to 16 h (24% recovery) or more than 24 h (13% recovery). Furthermore, final threshold shifts were significantly lower in the group treated immediately.

It seems like if you wait till the next day it's already too late. The thing is, if you take it in the evening after an acoustic trauma you probably aren't going to sleep much at all that night...