Checking in from the Netherlands: Got Tinnitus from Using a Hammer Drill

[Falchion]

Dexamethasone from what I hear is better than Prednisone.

Except, it hasn't worked yet.

 

[WillBeNimble]

Except, it hasn't worked yet.

I wish it did, man. Steroids are our first line of defense, but they're not very well understood as to why they help when they do.

 

[Christiaan]

@Christiaan Pento clinic just informed me they have a 6-9 month waiting list.

Ey @Falchion. That's way an extreme long wait. I had to wait approx. 2 months for extended audiogram. Have you also tried other Pento clinics? There's also one in Amersfoort.

 

[Falchion]

Ey @Falchion. That's way an extreme long wait. I had to wait approx. 2 months for extended audiogram. Have you also tried other Pento clinics? There's also one in Amersfoort.

I think the site is a general one, but I'll check.

In any case, it doesn't really matter in terms of treatment.

 

[Juan]

Dexamethasone from what I hear is better than Prednisone.

It's a more powerful corticoid.

 

[BBakkers]

I have been to Amersfoort as well. The waiting list was about 1 month and they still have one machine for an extended audiogram. So you should call them up. Best of luck!

Cheers, Fellow Dutch Sufferer.

 

[Falchion]

Alright, for those of you following along, second ENT visit today (we're just over 4 weeks in now, total).

First of all, to any Dutch readers, this is a Van Linschoten Kliniek ENT and so far I'm happy to recommend them. I haven't walked out without next steps so far. At the very least, this guy here (in Driebergen) is taking me seriously, which in and by itself is already a huge relief (considering some of the stonewalling ENT stories I've read about here).

I walked in there again with a big list of options, based on calling another ENT in Amsterdam, a guy who helps people get appointments with doctors in Germany (Germany has a different system and throws you on prednisone within the first week) and my doctor friend, who is not an ENT now but used to be one in the army.

Going down the list:

• Both my ENT, the Amsterdam ENT and my doctor friend vehemently recommend against the Germany route, despite some of the positive stories out there. The Amsterdam doc has personal experience with the intravenous treatment and had seen zero lasting effects (only effects that lasted during the treatment and a little while after, only for the symptoms to return later!). My ENT and my friend both explained how the German system is different and, according to them, is not as reliant on empirical science as the Dutch system. Simply put, while there is anecdotal evidence, there is absolutely zero actual evidence for intravenous treatment to help tinnitus when there is no substantial hearing damage. Apparently also even the German health system dropped coverage for this treatment, because (again) of lack of evidence. As my friend put it: dude, we take this stuff seriously as health professionals. If it really worked, you would be sitting there with a needle in your arm right now. You can spend a thousand bucks and hours of your time and it won't change a thing.
  
  
• In cases where there is measurable, and substantial damage, they do recommend prednisone be administered, but even then they prefer oral treatment (and a lot of German doctors do, too). Despite a slight dip in my 8khz range (between 20 and 30 dB) both my ENT and audiologist did not consider this even close to what's normally (and effectively) treated with prednisone.
  
  
• Now having said that, both the Amsterdam ENT and my own ENT considered a short prednisone prescription a "it won't hurt, so let's do it" approach, and so I walked out of the consult with a 7-day prednisone pack (60 mg/day). The Amsterdam doc recommended 1mg per kg of body weight, putting me at about 80 mg. My ENT disagreed, so I'll see what the Amsterdam doc says. If it's not dangerous, I say throw in the big guns.
  
  
• The guy I spoke to about Germany mentioned that he thought it was interesting that my tinnitus was so inconsistent. He said hearing damage from noise is usually a consistent tone that doesn't change. Indeed, I have such a tone, which is really soft and high and I can only hear when I lay in my bed and kind of concentrate. But my louder noise, what I call the "tweeter", comes and goes during the day and incredibly inconsistent in loudness, frequency and even the type of noise it generates.
  
  
• With that in mind the ENT is also making me go to a physical therapist to have my neck checked. Since I also have a bit of a crackling sound in my jar when I swallow (I read this the other day and thought to myself... jeez, I have that too, never really registered that) he also prescribed me a nasal spray (Dymista).
  
  
• The extended audiogram. He said yes, you could do that, and it might show damage in the higher frequencies. Totally possible, but it wouldn't change what we can do for you, which is to give you steroids and bloodflow meds and speed up the healing process for the hairs. So he was like, knock yourself out, but I'm going to give you the pills right now anyway.

My ENT's generally approach was: there's a metric ton of things that could be causing this thing. Yes, the hearing damage might be a factor, but there's stress, there's your body posture that seems to be a factor (it is, but inconsistently). He said, let's hit it from multiple angles and see how well we can get you.

I ain't even mad, ya know.

 

[ASilverLight]

My ENT's generally approach was: there's a metric ton of things that could be causing this thing. Yes, the hearing damage might be a factor, but there's stress, there's your body posture that seems to be a factor (it is, but inconsistently). He said, let's hit it from multiple angles and see how well we can get you.

I feel like this may be true for a lot of people. I too had a lot going on when my tinnitus surfaced and so far, many of those things aren't much better due to lack of care (hesitant GP and wait lists).

I do hope that treating some issues may eventually reduce my tinnitus.

 

[Falchion]

Oh and, to add to that, my ENT totally agreed that avoiding headphones is a good idea with tinnitus, but really they should be avoided in general.

 

[Falchion]

I feel like this may be true for a lot of people. I too had a lot going on when my tinnitus surfaced and so far, many of those things aren't much better due to lack of care (hesitant GP and wait lists).

I do hope that treating some issues may eventually reduce my tinnitus.

If it's not actual damage to your hearing, these should be issues you could tackle yourself. Why hasn't the stress been reduced?

 

[ASilverLight]

If it's not actual damage to your hearing, these should be issues you could tackle yourself. Why hasn't the stress been reduced?

Mostly because some stress factors are hard to resolve(cannot afford to move out for example). I have no measured hearing damage but haven't had an extended one, so can't rule it out.

But anyway, my health in general is a mess and I haven't had any decent care yet so far, so nothing is really getting better.

 

[Falchion]

Mostly because some stress factors are hard to resolve(cannot afford to move out for example). I have no measured hearing damage but haven't had an extended one, so can't rule it out.

But anyway, my health in general is a mess and I haven't had any decent care yet so far, so nothing is really getting better.

That sucks man. American? The one thing that made me really happy to move back to the Netherlands after living in the US: how f*cked you are in the States if you're not healthy or have money. Let alone lack both.

 

[ASilverLight]

That sucks man. American? The one thing that made me really happy to move back to the Netherlands after living in the US: how f*cked you are in the States if you're not healthy or have money. Let alone lack both.

Lol nope, Dutch too, just have a bad GP who wanted to wait because I had a lot of fluid when it started. Finally seeing an ENT next week but already had a standard hearing test which was fine.

I've not been very lucky with doctors in general though, I just seem to be getting the bad ones.

 

[TomBradyGOAT]

There is a very old article about vibratory tinnitus. It was looking at people that I believe used drills all day. Thus the vibratory component. In it they tested a Stellate Ganglion Block. They said it helped. The issue is that nobody followed up on it. Stellate Blocks are now being tested for PTSD. Also good luck finding someone who will do a Stellate Block to even test what was a theory done on a few people. The down sides are way over hyped. If guided it shouldn't have any negative issues. In the wrong hands a Stellate Block hitting the wrong area will honestly mean death. I know a pain management doctor who wouldn't do it because one of his coworkers way back nicked something in a 70 year old lady and she died. But Mariam Wescott was supposed to publish something about it helping a person with Tonic Tensor Tympani Syndrome. Sorry for the long winded response. I just found it interesting there is an old study about tinnitus from your line of work.

 

[Falchion]

Good Lord my T is all over the place. Almost silent all week late at night and morning. More active during the day. And then suddenly, still louder at night and loud in the morning... Tapering off as the morning progresses.

‍

 

[Falchion]

Alright, 5 weeks in, and halfway through my prednison treatment.

At this point, obviously, it's hard to pinpoint any specifics as to what's helping or isn't. However, I'm glad to say that my T has absolutely been more stable and better to handle the last couple of days.

Just to give you guys an overview of what I've been taking:

Supplements, from about a week into this:

1. NAC (I took two 600mg capsules between meals, after reading through the forum I switched to one at night before sleep and one in the morning on an empty stomach).
2. Gingko (2x 2 600 mg capsules, during a meal).
3. Magnesium complex (was going to take this anyway).
4. Multivitamines including zinq and whatnot.
5. Algae oil capsules.
6. And, last but not least, even though I've been very inconsistent with it: golden milk, a turmeric-based drink with oatmilk that I make myself (recipe credit to my ex-wife, who remains a good friend).

Two weeks in, at the ENT, we add in the meds:

1. Dexamethasone, 5mg in the morning, 10 days.
2. Betahistine, 16mg, in the evening with some food, 30 days.

Four weeks in, added in:

1. Prednisolon, 2x 60mg (one in the morning, one in the evening).
2. Dymista nasal spray, twice a day.

As I've mentioned before, my T seems to have two layers:

1. Base tone eeee, which is sort of a much higher version of the sound you'll hear them play in a movie when a grenade goes off near to one of the characters. I can barely hear this one during the day, I hear it at night in bed when tone #2 isn't as present. This is basically a 1/10 or 2/10 sound level.
2. A much more aggressive "tweeter" tone that is extremely irregular. It's sort of a combination of morse code, a high-pitched bird song... it's just weird. It can get loud (though for me that's a 5/10) at which point I can physically feel it resonating in my inner ear (or, at least, something is happening that makes me feel that way).

Speaking to someone in the business of tinnitus, in his experience my first tone is the one I should be hearing if I have hearing damage (which I don't have in the regular spectrum). The second one, he suggested, is much more likely due to other causes (stress in my body, psychosomatic issues).

Now, especially #2 seems to have calmed down a bunch. As I said, it's hard to tell, as things have been slowly getting a little better (even before the prednisolon), I kind of feel like it's the pred that's giving it the next kick.

Some other observations:

1. Coffee doesn't seem to make a real difference.
2. Haven't figured out any dietary influences yet, but I kind of feel like things are worse when my kids are over (I tend to eat just meat and veggies by myself, but for the kids I also cook pasta and have the occasional pizza... so carbs).
3. I spent an evening playing board games with my dudes, allowing myself to drink a bit more, just to see what would happen. In my case that's a couple of beers and a hint of Scotch. I don't know if it was less sleep or the booze, but my T was more audible the next day.
4. I work out a lot, physical activity doesn't seem to effect it at all *usually*. Sometimes I kind of feel like it does.
5. I haven't had trouble sleeping, though with the prednisolon it seems a little harder (known side effect). I tend to get my 8 hours in consistently.

As for next steps, I got an appointment with a physical therapist next week, and I've also asked an old friend (who is a chiropractor) if she has any ideas. Finally, I still have an appointment with an Amsterdam ENT, who was going to prescribe me more prednison than my own ENT was. I still have to talk to him again and see whether it's worth upping the dose at all.

I'll keep y'all posted.

 

[Falchion]

Done with the prednisolon. That at least made the overall T better, if of course that was the real reason it got less. I don't think I can hear the constant tone at all anymore, just the oscillatory "this is likely not due to the hearing damage" noises.

Next up physical therapy and a chiropractor.

I saw the latter yesterday, someone I've known for a while and trust. I read up on tinnitus treatments with chiro and acupuncture, and considering my symptoms (I can change my T with my posture, I also hear sounds during swallowing and sometimes talking or singing) and history (metric tons of stress over the last few years, chronic for much longer) this might very well help. For sure, while she wasn't making promises, the chiro confirmed my neck absolutely needs work.

Fingers crossed. T keeps being all over the place, with sometimes being very high pitched and annoying. It does seem to ramp up when I get restless or stressed. Maybe it's just a warning sign from my body.

 

[Midas]

Have you tried taking GABA?
Do you experience hyperacusis?
You probably have put your ears to the test before (ear pain standing in front of a fat speaker? Hello!)

Working inside with heavy machinery without hearing protection is like staring straight into a laser beam, your eyes will get destroyed.

I suggest you get you some good custom made musician earplugs and also buy a universal set in a key changer so you never again go home without, just in case.
If you continue to expose yourself to (extremely) loud noises this will worsen and eventually you end up with hyperacusis. You don't want that, trust me. But probably like me you'll think, nah man, my ears are fine. What kind of workout do you do?

Can you manipulate the buzz/hiss by moving your head/neck/jaw?

BTW, a stress factor is involved.

 

[Falchion]

Hey @Midas I've always been careful with my ears. This was a freak incident for me. And while I believe you're right, many people use power tools incidentally and most walk away unscathed. My ex mentioned today she's used the same hammer drill I used while drilling a hole in my bathroom - a small, empty room with plenty of echo - and walked out with no sign of anything hearing related whatsoever.

What do you mean when you refer to my workout?

I can create a consistent tone when I clench my jaw. Generally it doesn't seem to influence the t much when I move my jaw or anything.

Further update, I went to a vacation park with the kids and the ex this weekend. Involved an indoor pool which I was keen to test for influence on my T. I'd asked the ENT and he told me swimming was fine, and that I should worry about the noise.

Spend two hours inside yesterday and two today. Absolutely no negative effect on my T, which was nice. I was careful not to dive too much, but I did go under a few times.

In fact, after the pool the t seemed less. Considering how erratic mine is that might be total coincidence. However, the ex remarked that maybe body temperature was a factor.

For sure, last time it was HOT and my T was acting up. It's cooler now, we went to the pool... It's been really quiet the last few hours.

Food for thought?

 

[Falchion]

Over 9 weeks in. Finished my beshistine treatment, still on the nasal spray.

I've been seeing a chiropractor and a physical therapist, which my ENT encouraged, and while nothing has been definitive, I feel like there's slow improvement.

I tend to go asleep and wake up in virtual silence these days. T seems to be worst in the morning after getting up, but it remains extremely irregular. Fortunately it's also become very manageable, I'm getting more and more periods of silence. At the same time, when I do hear the sounds they don't bother me as much.

I'm still taking all the supplements, and play sounds at night. I might try and stop that, see if it makes a difference. I suspect not.

I still have these moments where I feel hit in the head, where the T is almost inside my head.

Oh, also had another hearing test done. 8000hz is at 20dB, according to the audiologist that's excellent.

 

[Valiant]

Hey @Falchion . I appreciate all the detail you shared about your process. Thank you for it. How are you doing of late? Hopefully, your progress continues.

 

[n_li808]

@Falchion hey how are you doing now?? Do you protect your ears when you go out, like with earplugs or anything?

 

[Samwan]

Hey @Falchion, I hope you are well. I did the same mistake last week using a hammer drill without ear protection and came across your post online. I too went through a stressful period due to relocating to Germany from the UK with kids. The symptoms that I am having is very similar to yours and I have a doctor's appointment tomorrow to get my ears checked. I am hoping that they will recommend me to a specialist. I have gone through all your posts and thank you for sharing your progress in such detail.