Getting Slightly Louder Every Day

[Kiwi1050]

Hey all, I'm about two months in and hoping some forum veterans could provide some useful guidance.

When my tinnitus first started it was just a slight annoyance, I could barely hear it over the air vent in my office. I have been a nervous wreck ever since it started; there's only been a handful of times where I have slept through the night. In the past couple weeks, however, the tinnitus has begun to gradually get louder every day (or at least my perception of it?)

In addition, the level of ringing has really started to get louder throughout the day. I wake up in the morning and barely notice it, but by the time evening rolls around it is loud enough to really bother me. Every night it seems to be getting a little bit louder than it was the night before. At the moment I need to sleep with a fan on and white noise (actually violet noise) which I find most hopeful to tune out the ringing. I also listen to violet noise at some points throughout the day, either through my phone speaker or on earbuds.

I've also been taking 2x 0.5 mg Ativan every day (one around noon, one before bedtime) because I have been extremely panicky. I am almost literally terrified to the point of panic attack without taking the Ativan. The Ativan also really quiets the ringing for 5-6 hours which helps to calm me down as well.

In the last couple weeks, I have also started to really notice some level of hyperacusis - high-pitched sounds close to the frequency of the ringing in my ears are extra noticeable and bothersome.

We went back to the ENT doctor to discuss this, and again he said that the ringing has just been getting worse because my anxiety has been getting worse and because I have been focusing on the ringing. He is certainly right that I have still been extremely anxious, and my issues are basically on my mind all day.

I am seeing a therapist once a week, reducing my work hours to limit stress there, and have been dosing up on an SSRI (Zoloft). But I am very worried how the ringing seems to be getting worse day by day. Every morning I wake up and within like 15 minutes I start to feel panicky.

I have been reading through the forums for advice but every case seems to be so different. I feel like maybe I could adjust if the tinnitus stayed at constant volume, but since it seems to be getting louder every day this honestly terrifies me and it is all I can think about.

Is it most likely just from my continually heightened anxiety and/or focusing/thinking about the tinnitus or is there something else I am doing wrong? Any advice you could give would be very appreciated!

EDIT: More details in my introductory post here.

 

[Bill Bauer]

Any advice you could give would be very appreciated!

Ativan is on the list of ototoxic medications
http://hlaa-sbc.org/wp-content/uploads/2013/11/Ototoxic_Brochure.pdf

Now, normally I wouldn't worry Too much about it. Most people take those drugs and are ok. But in your case (your T got worse), there is a chance that your T is getting worse as a result of taking Ativan.

Have you been exposed to moderate noises?

You got T as a result of sinusitis. Are you sure that your sinusitis got cured?

 

[Contrast]

Do you have a history of loud music, loud cars, loud factory work, loud headphones? You get the idea anything loud.

 

[Strife_84]

I don't belive that anxiety makes it louder. I don't believe any of it. I feel like they treat us that we imagine this noise. "just calm down and it will go away" . No saying being calm and etc. Wouldn't help to tolerate the noise better, but it won't make it go away.

This is not imaginary. This is not because of depression or hallucination. To us this is real.

I swear to go next time doctor belittles me I'm gonna pull out my phone, put a 12khz tone from it, leave it on doctors desk and say "listen that to 24/7 day and night."

I would stay away of antidepressants. They can make tinnitus worse.

 

[Kiwi1050]

Ativan is on the list of ototoxic medications
http://hlaa-sbc.org/wp-content/uploads/2013/11/Ototoxic_Brochure.pdf

Now, normally I wouldn't worry Too much about it. Most people take those drugs and are ok. But in your case (your T got worse), there is a chance that your T is getting worse as a result of taking Ativan.

Have you been exposed to moderate noises?

You got T as a result of sinusitis. Are you sure that your sinusitis got cured?

Thanks for your thoughts. I really feel like I do need a benzo right now to keep me calm, but I'll ask my doctor about switching to a different benzo. Klonopin is not on that list of ototoxic medications so I'll ask him about that.

I wouldn't say I've been exposed to any noises louder than sitting in a restaurant with background conversations and music playing. I wear ear protection when vacuuming or using power tools or anything like that.

Regarding the sinusitis, the doctor has checked my ears several times and seen no sign of infection. An audiologist also checked the pressure in my eardrums and said everything looked OK- no signs of swelling, earwax blockage, etc.

 

[Kiwi1050]

Do you have a history of loud music, loud cars, loud factory work, loud headphones? You get the idea anything loud.

Not really, I work a white collar desk job. There was a loud air pump in our parking garage that I was using to fill up the tires in my car a couple times per week. But the onset of the tinnitus definitely was concurrent with when I had the fluid blockage in my ears.

 

[Kiwi1050]

I don't belive that anxiety makes it louder. I don't believe any of it. I feel like they treat us that we imagine this noise. "just calm down and it will go away" . No saying being calm and etc. Wouldn't help to tolerate the noise better, but it won't make it go away.

This is not imaginary. This is not because of depression or hallucination. To us this is real.

I swear to go next time doctor belittles me I'm gonna pull out my phone, put a 12khz tone from it, leave it on doctors desk and say "listen that to 24/7 day and night."

I would stay away of antidepressants. They can make tinnitus worse.

Well either way, I definitely have an anxiety issue that also needs to be resolved. Regarding the antidepressants, the psychiatrist said that worsening tinnitus is an extremely rare side effect for Zoloft, so I'm not too worried about that. It's not even listed on that list of potentially ototoxic medications that Bill linked to.

 

[Bill Bauer]

Klonopin is not on that list of ototoxic medications so I'll ask him about that.

@josh77 People that take klonopin and have tinnitus on this board advise strongly to not create dependency. Take it short term and in small doses, otherwise you mind end up with permanent tinnitus increase when you will go to withdrawal and thats something you want to avoid.

I wouldn't say I've been exposed to any noises louder than sitting in a restaurant with background conversations and music playing. I wear ear protection when vacuuming or using power tools or anything like that.

Please see the posts that I quoted in the first post in the thread below
https://www.tinnitustalk.com/threads/learn-from-others-mistakes.29437/
Specifically, search for the three quotes of posts made by "eatmotacos". He says he got a T spike that had lasted for at least three months (with no sign of fading) as a result of being in a restaurant with no loud music and many people talking.

If you read the other posts there, you will see that hearing protection can provide a false sense of security - people think they are safe when they wear hearing protection, only to find out the hard way that they are not.

Now, many (the majority?) people expose themselves to noises while wearing hearing protection and are ok. But in your case, T Has been getting louder. It is certainly possible (likely even?) that you are one of the people whose T gets worse after being exposed to moderate noise.

You might consider staying away from moderate noises (e.g., ask someone else to vacuum/use the power tools, and go only to quiet restaurants) for 3-6 months.

Also check out
https://www.buzzfeed.com/joycecohen/noise-kills-when-everyday-sound-becomes-torture

Recognition of the dangers of noise — which are often mischaracterized and more far-reaching than previously assumed — is "dawning a little bit but doesn't go beyond the research community so far," says Jos Eggermont, a professor at the University of Calgary in Alberta, Canada. He was stunned when his research showed that exposure to low-level noise, in amounts not generally considered harmful, caused extensive damage in the auditory cortex.

My not-yet husband emailed me because I was getting better and he was getting worse. He wanted to know my strategy. Time and silence, I told him.

and

I didn't read all the above comments, but did peruse a fair amount of it, and ran across many good points on both sides of the argument. What strikes me is there seems to be an underlying assumption (of course I may be wrong on this) that all brains and neurological systems are created equal. The way I see it, that's simply not the case, so everybody's way of dealing with tinnitus and/or hyperacusis is going to have to be highly individualized.

I read a book many years ago called "Adrenal Syndrome". A lot of the book touched on the residual resiliency of people's adrenal glands as they respond to life's stresses. Very low resiliency often resulted in months/years of chronic debilitating exhaustion following a stressful event(s) in their lives. Very high resiliency indicated essentially the opposite. The author broke this down into some rough numbers:

25% of people have low resiliency, meaning normal life stressors will often send them into some degree of a tailspin.
25% of people have high resiliency, meaning that no matter how severe a stressor comes into their lives, they will be able to cope without becoming debilitated to any degree.
50% of people fall somewhere inbetween.

I believe there are some kind of corresponding numbers for a person's brain and neurological resiliency as well, which can greatly affect the ability to cope with tinnitus. (I believe adrenal resiliency also plays a major role in our ability to cope). -- Based on these assumptions, it's pretty easy for me to conclude that what may be overprotection for one person will be underprotection for another, and vice versa.

I think the main point to understand for someone new to tinnitus is that their path forward is going to be a lot of "testing the waters". Generally, IMHO, it's going to take a few weeks or months to get important insights that will help us achieve a healthy balance. In all likelihood, most people are going to learn from experience when their over-protecting or under-protecting.

I've come to believe however, that in those early months, if one is going to err in either direction, it should be toward overprotection. It just seems to me the consequences of underprotection (which could result in permanent injury) in those early times are much more dire than the consequences of overprotection--which as I understand, generally results in temporary setbacks.

Doing a number of things to better support the brain and neurological system and the body's stress response (adrenal glands) is quite high on my list of recommendations I would make to anybody with tinnitus. Doing so might even prevent phonophobia or OCD, etc., as we go through our learning curves -- Just my 2 cents worth.

Relative newbies to tinnitus are likely to find all the information/opinions above quite confusing. So here are a few common-sense rules to follow:

1. The best protection of all is avoidance. Even the best earplugs can't guarantee complete hearing protection so those relatively new to tinnitus are best advised to avoid prolonged loud noise exposure - especially amplified sound at for example live concerts and sports events. This may involve lifestyle changes.

2. When in doubt, use hearing protection. In the many tasks we all do through the week, some will inevitably involve exposure to noise - which may be at higher levels than we at first realise - so using hearing protection for many of these is only sensible.

3. Build quiet into your day. It's not a good idea to be wearing hearing protection all the time - so you need to give your ears a break by ensuring that there will be quieter times during your day when hearing protection isn't necessary.This may involve changing your routine. Use soft masking noise and light music (not using headphones) to avoid "silence" where tinnitus is most noticeable.

4. Don't stress about stress. Tinnitus newbies are forever being told that the thing which makes tinnitus worse is stress. But while it's true that how you are feeling at a particular moment can make tinnitus temporarily louder, it won't have a lasting effect. But prolonged loud noise exposure can make tinnitus permanently louder. So don't stress about stress - but do be concerned about noise.

Oh go you'll be fine they said. Wear earplugs they said.

So I went to the event with ear plugs. Was there for only a few minutes. Big mistake. Gave me low drone/hum that's worst than the high pitch hiss/eeeee, tea kettle sounds. Never went away. sigh
3 1/2 years ago.

Everyone is different. Every situation is different.
You have to make a decision and live with it.