Never saw this coming...

[JohnG]

Hi,

I was given a sleeping pill, zolpidem, 10mg, by a family doctor (who I no longer use thank God). He gave me too many and I got hooked for 4 months. When I started to titrate down to 5 mg, I noticed sounds were distorted and kinda hurt my ears but seemed like I could hear ok. Then, I got a very strong whooshing/ringing sound and what seemed like blocked hearing. The quack that gave me the pills just wanted me to keep on 5mg of the sleeping pill and put me on Celexa because he thought it was just stress and anxiety. I knew it wasn't that so I stopped the pill within two weeks of the symptoms. The emergency room was not helpful.

I paid for a head and ear canal MRI at a private MRI clinic. Nothing there. I'm in Canada so the waiting list to see an ENT is over 4 months. It has been two months now and I am going south of the border to see an ENT in Washington State in Bellingham (Seattle is two hours away). I guess I missed the window for corticosteroids (thanks to living in a crappy medical system).

The ringing is slightly better during the early morning and half of the day and gets very, very loud by the evening with noise bothering me (seems worse at higher freq). I now know it is noise that makes the T very bad. That is why it is much lower in the morning and like hell by the evening. Last night, I could not even tolerate going to a department store because the music and paging was driving me mad! It seemed like I had cotton in my ears too. This sudden hearing loss seems to come and go but I do believe I lost the higher freq especially at or near 8khz. The T seems to mask those freq too so it is hard to test myself.

My questions are:
1. Is it too late to try cortisone treatment?
2. If my hearing is in flux, is it worth paying for an audiology exam? If they find hearing loss, is this accurate if there might be a slight chance of recovery (not that I'm hopeful after two months)?

I tried white noise to block the T and if I turn off the noise, my T is actually worse!

3. Should I be avoiding as much sound as possible...even low level white noise? Seems like trying to mask T right now is not a good solution.

I feel so stupid for taking those pills ...I should have known better. Well, I'm one of you guys now.

Thanks,

John

 

[tomytl]

Hi John,

I am very sorry about your ear problems! I am in a bad condition too, have exactly like you hearing loss
and T arround 8khz, which drives me crazy at this time.

to your questions: (it's my point of view and might not reflect advices which an ENT will give)

1. Here in Europe, it's indicated to have cortison therapy withing 48 hours or within the first 2 weeks.
It's suggested, that by early start chance of positive effect is arround 30%
2.Recovery of hearing loss can happen after weeks or even monthes. In my case, the audiologist
didn't see a new notch in my hearing curve, for myself, I think I hear much less than before
my new T came in my life. It might be a processing problem in the brain.
3. your should avoid loud sound. Other sound which masks your T at low level would probably help, there
is other sound than whitenoise, but here I haven't so much experience.

Don't feel stupid about taking pills, this will just give your T more attention. I know exactly what you mean,
I also thought about "how stupid I was to...." and to....

Maybe some other people in this forum will give you some more info.

All the best
tomytl

 

[JohnG]

thanks tomytl for you help. i will see the ENT next week and I will mention the cortison therapy but like you said, it may be too late and that was only a 30% chance. I'm trying some vitamins like alpha lipoic acid and benfotiamine. That should act as an anti oxidant....maybe that will give some protection but who knows.

 

[mick]

JohnG,

I don't think it is unreasonable to still be hopeful about recovering some lost hearing after 2 months. Most ENTs say to give it at least 6 months.

At this point in time, you don't know if your T is the result of a recent loss of hearing (correct?). You may in fact not have any new hearing loss. Drugs like zolpidem can do weird things to the brain, and it is possible that you already had some hearing loss, and some latent T. Your brain just never registered it.

Its unclear to me from your intro whether or not you were/are suffering from some anxiety or not. On the assumption that you were experiencing some degree of anxiety, I'll toss out my understanding of a couple of mechanisms that can explain how tinnitus can arise from anxiety. Both are the result of brain chemistry.

I no longer remember which hormones and neurotransmitters do what, but one of the intended functions of anxiety in animals is to trigger awareness and strong memory formation so that the animal learns from an anxiety producing event and can therefore avoid such episodes in the future. The chemicals released by your body and brain during stressful situations cause it elevate all sensations related to that event to a higher level of awareness. There is, I'm sure, a better explanation of this than I'm giving, but the bottom line that it is possible that you had all the elements of T in place (most likely hearing loss) before you ever experienced it, but your brain was not aware of it. Anxiety caused the various brain components that gate whether the latent T sound gets through to the more cognitive levels in your brain (one of them as I remember is called the reticular activating device). Once your brain began scanning all of its inputs in this hyper aware state it then began registering the latent T as something it needed to worry about - and voila - you began to experience T.

The other theory of how anxiety can trigger T is something called excitotoxity. In short, excessive anxiety causes your body to release a combination of chemicals for a duration that is in fact toxic to brain cells, nerve cells, and hearing hair cells. Once the chemicals are released and present for a long enough time, they do their damage and cause tinnitus. Any drug that impacts brain chemistry can exacerbate this toxic state and in fact be the straw that breaks the camel's back so to speak.

You mentioned about two things that are very common during the onset of tinnitus and that are very likely to diminish in time. You talked about your sensitivity to sounds like in a departments store. This is a form of hypercusis that is very common at T onset and is almost certain to diminish after a few months. You also mentioned your hearing seeming to be in flux or the feeling of cotton in your ears. Again, very common with T onset, and likely to subside soon for you. I experienced both of these things and both went away in far less time than it takes to habituate. One thing that might sustain their existence is protecting your ears too much. You should certainly protect your ears from sounds above 80 decibels, but you probably should not protect against everyday normal volumes. I understand how annoying it can be to be in a noisy department store or restaurant when you first get T. My advice is to go ahead and avoid such places or wear hearing protection in these areas for a short time while you are really sensitive, but then gradually expose your ears to more over time. Doing so may get you past the hypercusis and stuffed ear feeling quicker. To be clear, I am by no means saying to not wear hearing protection when you are exposed to sounds at hearing damaging levels (usually 80 db and above but could be a little lower for you) - I'd advise wearing them when using a gasoline powered lawn mower or other things in that sound volume range for instance, but protecting your ears too much can extend the early adjustment period.

I think it is worth getting an audiology exam. When you see an ENT he will almost certainly want you to. It may not shed very much light on things because it most likely will come back close to normal if not entirely normal. Note that normal does not equal zero hearing loss in an ENT's or audiologist's eyes. You most likely have some hearing loss, and it may be above the normal testing range which only goes up to 8000 hz. If you don't have any loss with a regular hearing test you can ask for a high frequency hearing test than typically goes up to 15 or 16 kHz. They may not have the equipment to do that however. The only reason to do it is to see if you really do have a loss that explains your T. You might want to determine the frequency of your T before your audiolgy exam since it is most likely to coincide with the frequency of your greatest loss. You can this fairly well with the tinnitus tuner at AudioNotch.com.

Hope things get better for you soon. Tinnitus is not fun, but it usually gets better with time.

 

[JohnG]

Hi Mick, I really appreciated that response. I did an online "audiogram" and it appears that I'm dropping off before 8k. Looks like moderate hearing loss in that range. When I was in my early 20s I had some high freq loss so you may be right that now in my 40s...and just on the 8k threshold...the brain was all set for my new awakening.

As I was titrating off that poison 10mg zolpidem pill, I had severe withdrawal symptoms ...like coming off a benzodiazepine (so i've read). Since zolpidem binds to the same receptors as benzos (GABA)... I remember during the withdrawal I was depressed, felt like I wanted to put my hand through the wall...violent thoughts....man that was a bad withdrawal...never again I tell you...never again...that is a drug from hell. I guess that was the trigger you mentioned.

It was reassuring to read that you started the same way...sensitive to sound (especially high freq and load sounds)....hearing that seems to have cotton in the ears if the T gets too much....I can deal with some hearing loss...but distorted sounds. I can't even listen to the piano without feeling like someone running their fingernails down the chalk board. That scared me me more than T (not that that doesn't scare me too) since I can't enjoy music.

What do you think about the Shea Ear clinic (or intratympanic injections) and getting dex/lidocaine while I am still in the window? That is the one thing I am worried about. I have not had any course of treatment in the early stages other than my antioxidant course of vitamins.

 

[Valentin]

zolpidem has a short half life(few hours) so withdrawal symptoms can appear between two doses and it's not suitable for slow taper.

 

[tomytl]

John,
I can really understand you when you,talk about distorted hearing, I had the same back in 2003 on left ear, was hell!
All frequencies above 1khz were very distorted, made me feel pain in the ear, made me absolutely panic and adraid of every sound. I also missed the acute treatment, there were 4-5 days before I have seen the ENT. I got cortison infusions, Vitamine D, Vitamine B12, I got an oxigen mask and was 3-4 days in a clinic, after that I continued the procedere aboht 2 weeks at home, with oral cortisone.
I must say, for the hearing, nothing really had a clear effect, especialy not for distortion or Hyperacusis. After about 6 weeks full of panic I went to a 10 days Hyperbaric Oxygen Treatment.... Man was this stressful, after every therapy I had very big pressure in the ear.... for hearing loss or distortion unfortunately no effect.
I remember remeber we have been arround 12 people and just 1 woman told, that she had significant positive effect on her T.
Anyway, I went home, saw some different ENT's, even a special clinic for T sufferers, but nobody really could help my H and Distortion....
So is started listening very low level music, and worked a lot in front of the PC and tried folliing the melodies and different instruments. At this time, I didn't know if there will be ever some undistorted hearing.
The most changed it when I entered the work again... At first, I really thought it's not possible, everything sounded different.
Sometimes I also cried at the end of the day because of loss of hearing and this distorted hearing... But over time it improved and some day, after several monthes I started to defocus the problem.
I just was tired thinking about, stay at home and and.... I just can tell you, distortion and Hyperacusis imroved a lot.
My doc also said, that the,brain needs time to readjust, but it needs time.
(sounded very stupid for me, time....)

But the difficult thing is to not lose your mind and keep all the nerves. Even I write this to you, I also fight against my new aquired T &H and the feeling of a new hearing loss...I am really depressed. This time, I didn't miss some acute medical treatment, but I seem to be very resistent to any ear drug.
I got also benzos to help me sleep. After a few days I also got some nigjmare dreaming. Instead of taking them, I went to a Chinese Acupunture. It nocked me out for 3 days, got very tiered, could sleep.
It defocussed me to the tinnitus, but today, 4 day later T improved again....damn...
The only place where I can maks, my noise is under the shower....I could live there at the moment.....

I know, my story sounds really odd and maybe also dismotivating, because of the long time who passed.
But your situation could be completly different, maybe your relief much faster. If you can experience some little
improvement, it gives you good feelings, and it will improve (I have to say this to myself now).

What else could you do: I have been to Acupressure (which relaxes) or some massages. I have been swimming,
putted the head under water, listening the water. Have been in some wellness bath, listening the bubbles....
I think, relaxing and follow sounds will train your new hearing the best. The most terrible thing is and I do it right now is stay at home in the bedroom and try to relax, I know, this is like T, be in the same cycle.
That's why I will leave my room soon and sit in a cafeshop outside in the sun...

Let's go activ and positive in the day !!! (ohhh my god, how easy sentence.....)

If you have questions or something I might help, please ask.
If there is somebody who could give us some more tips, please do.

All the best
tomytl

 

[JohnG]

Hi tomytl...I'm glad acupuncture works somewhat. I've been seeing a Chinese doctor and it does work a little. I too get sanctity in the shower...in fact...for a few fleeting seconds after a long shower...I don't hear the T...but it is only a few seconds. I guess you are right...I just have to believe that improvement can come and the brain can adjust.

One thing that keeps me positive (if I can) is that stem cell treatment maybe 5 years away. There seems to be some very positive research on regrowing some new cilia in the cochlea. It is at least hope.

Your right..we better get busy living and being positive. Getting outside and active will be healthy and a good motivator.
Thanks!

 

[tomytl]

Hi JohnG,

thanks for your post,
very good to read that you also could get some relief in the shower. I will get more charged for water this month ;-)
In my case, acute tinnitus also showed to be something like influenced by other sounds... so if I stoped the shower, T went with similar sound... with time, masking was longer and longer... at the moment, it's like just 5 seconds.

Yes, outside activity can be good, today I helped my GF in the garden, the first time in my life ;-) Usually I don't like to snip arround in the green, today I enjoyed and I listened to the little distorted birds and a little to the muffled sounds of paperpacks... All sounds will be analizing with the "new hearing"... as time goes, this will improve too... ofcourse, I had a lot pressure in the ear after doing some physical work, but the more you do, the less will presure be...

About Stem Cells... I follow this research since 2003, and there was a huge finding from Prof. Yehoash Raphael,
he could trigger hair cell regeneration for the first time via gene therapy. I raised a lot of hope and also wrote to him.
It was a very basic experiment, not what would restore hearing to normal, just a proof of concept.
The media titled: "Researcher cured sensineural hearing loss".... very boulevard...
But it was an interesting finding I guess, this technique is used by genvec, so there is really advance.
It gives me also hope, even I know, it will take a long time, because it's totally new field of medicine and
it has to be tested and tested and controlled. One of the most concern is always sideeffects, because nobody knows
how long such a treatment would last in the inner ear, or if it would change to cancer... or what ever...
But also it could be much more easy as they think, maybe just an eardrop... (said once Stefan Heller)...
Maybe they can take some knowhow from other branches of medicine, like the eyes or brain.
So in fact we don't know... but I find it very encouraging to see, that there are organisations and institution
give them a timeline... I mean, this are seriouse people, and if it's really that impossible, I don't think
they would call 10 years or foreseeable future.

All the best
tomytl

 

[JohnG]

Hi Valentin...the problem is not the half life of the drug in the bloodstream. It is the lasting effect on the GABA receptors which is long lasting. I took two weeks to taper off the drug. The protocol is a 1% decrease every 3 days.

Any drug that down regulates neurorecptors (in this case GABA) has long lasting consequences. I shouldn't have taken that drug for more than a few nights but my GP gave me one month and never warned me. I didn't read the drug info before I took it. So really, it is my fault but the GP was suppose to protect me...he didn't. Anyway, that is water under the bridge now...the ototoxicity has worked its handiwork. Never take a drug that alters the brain chemistry and expect no withdrawals...the pharmaceutical industry can be monstrous at times.

 

[JohnG]

Hi Tomytl,

This may need to go into the thread about treatments but since this is the future and is just a note of hope:

"In the Jan. 10 issue of Neuron, Massachusetts Eye and Ear and Harvard Medical School researchers demonstrate for the first time that hair cells can be regenerated in an adult mammalian ear by using a drug to stimulate resident cells to become new hair cells, resulting in partial recovery of hearing in mouse ears damaged by noise trauma. This finding holds great potential for future therapeutic application that may someday reverse deafness in humans."

http://www.sciencedaily.com/releases/2013/01/130109124201.htm
http://www.cell.com/neuron/abstract/S0896-6273(12)00953-1

"The drug, codenamed LY411575, triggers the regeneration of sensory hair cells."

http://www.dailymail.co.uk/health/a...afness-regenerating-hair-cells-inner-ear.html

I know the catch here is "someday" but you are right, serious scientists at renowned universities like Harvard (not quackery) seem to think either a drug or direct implantation of stem cells are a viable option in the near future.

Thanks!
John

 

[katriina]

I just have to comment here that reading all research and possible upcoming treatment news is the best therapy I can think of Does that make me desperate, lol...

 

[JohnG]

It just talks one big breakthrough :=) Look at the Japanese scientist,Yamanaka, that found we could create stem cells from our own cells by inducing them to pluripotent stem cells. We no longer need embryonic stem cells. That was a huge step forward that won him a Nobel peace price. It just takes one big discovery like that!

 

[JohnG]

Sorry...I've got typos everywhere. It just takes one big breakthrough :=)

 

[katriina]

Let's play with a wild idea: Think if the cure will be the most simple and ridiculous thing that we can imagine! Like we have to eat three carrots and then drink a glass of milk and sing ABC song and then we would be cured. Have anybody tested that??

Okay I'm too tired for this forum right now as you can see from my idea, but wouldn't that be awesome We have researched brain so hard and then eventually cure would be something like that, lol...

 

[JohnG]

Yeah...sometimes we overcomplicate things when the simple answer was there all along :=) But simplicity can still be hard to find!

 

[mick]

What do you think about the Shea Ear clinic (or intratympanic injections) and getting dex/lidocaine while I am still in the window? That is the one thing I am worried about. I have not had any course of treatment in the early stages other than my antioxidant course of vitamins.

I'm a little bit wary of the Shea Clinic treatment, but only for a simple reason: Its been around forever, and few doctors ever mention it. If it were a reliably successful treatment, I'd think doctors would mention it to their patients often. There are some posts on this forum from someone who had the treatment and was happy with it. I've also seen posts about people who were not happy or ended up with vertigo (not first party posts, however).

It certainly would not hurt to call Shea and see what they have to say. If they tell a convincing story, and the risks are within your tolerance, then go for it. At this point in time I personally have chosen to just rely on habituation, but if I ever hear of a treatment where the success rate is overwhelming, I'll go for that. My risk tolerance is pretty low when it comes to medical treatments since I've been burned a couple of times (for things not related to tinnitus).

mick

 

[JohnG]

Yeah...the vertigo risk is enough to give one pause. Then there is infection...and deafness. That's a valid point about the clinic...if that treatment worked, then Harvard or Stanford would be doing it.

I went to the park for a harmless walk..thought it would be the right medicine. But park noise..kids playing and screaming..skateboards on the pavement....All the sudden...I feel like I went up in a plane...or maybe the time I went diving..and my Eustachians started to hurt. I now have a headache...tinnitus probably is not too bad...it is very high, high pitch..kinda icky like scratching the chalkboard. But sort of hurts and maybe a bit of pressure. I guess this is the big H. I'll see the ENT tomorrow...this is debilitating.

 

[tomytl]

Hi JohnG,

my day was not bad at all, working in the garden, takling with some girls. But tonight it's going
to be bad aswell, pressure, increasing T level... Now I have like emotional-less hearing,
everything seem to be at the same level...... I'm very depressed, but unfortunately not tired....
I would just love to sleep and go tomorrow to the Acupuncture....

Hope your ENT will have some therapy for you!!!

tomytl

 

[JohnG]

Hey tomytl...glad you could enjoy some girls..focus on that..Acupuncture does work...for lowering stress. I've started it and will do it once a week. This Chinese doctor seems pretty good. Then take plenty of antioxidants. Alpha lipoic acid (R) was recommended by a neurologist when my mother had T for awhile.

 

[JohnG]

I'm a little bit wary of the Shea Clinic treatment, but only for a simple reason: Its been around forever, and few doctors ever mention it. If it were a reliably successful treatment, I'd think doctors would mention it to their patients often. There are some posts on this forum from someone who had the treatment and was happy with it. I've also seen posts about people who were not happy or ended up with vertigo (not first party posts, however).

It certainly would not hurt to call Shea and see what they have to say. If they tell a convincing story, and the risks are within your tolerance, then go for it. At this point in time I personally have chosen to just rely on habituation, but if I ever hear of a treatment where the success rate is overwhelming, I'll go for that. My risk tolerance is pretty low when it comes to medical treatments since I've been burned a couple of times (for things not related to tinnitus).

mick

JohnG,

I don't think it is unreasonable to still be hopeful about recovering some lost hearing after 2 months. Most ENTs say to give it at least 6 months.

At this point in time, you don't know if your T is the result of a recent loss of hearing (correct?). You may in fact not have any new hearing loss. Drugs like zolpidem can do weird things to the brain, and it is possible that you already had some hearing loss, and some latent T. Your brain just never registered it.

Its unclear to me from your intro whether or not you were/are suffering from some anxiety or not. On the assumption that you were experiencing some degree of anxiety, I'll toss out my understanding of a couple of mechanisms that can explain how tinnitus can arise from anxiety. Both are the result of brain chemistry.

I no longer remember which hormones and neurotransmitters do what, but one of the intended functions of anxiety in animals is to trigger awareness and strong memory formation so that the animal learns from an anxiety producing event and can therefore avoid such episodes in the future. The chemicals released by your body and brain during stressful situations cause it elevate all sensations related to that event to a higher level of awareness. There is, I'm sure, a better explanation of this than I'm giving, but the bottom line that it is possible that you had all the elements of T in place (most likely hearing loss) before you ever experienced it, but your brain was not aware of it. Anxiety caused the various brain components that gate whether the latent T sound gets through to the more cognitive levels in your brain (one of them as I remember is called the reticular activating device). Once your brain began scanning all of its inputs in this hyper aware state it then began registering the latent T as something it needed to worry about - and voila - you began to experience T.

The other theory of how anxiety can trigger T is something called excitotoxity. In short, excessive anxiety causes your body to release a combination of chemicals for a duration that is in fact toxic to brain cells, nerve cells, and hearing hair cells. Once the chemicals are released and present for a long enough time, they do their damage and cause tinnitus. Any drug that impacts brain chemistry can exacerbate this toxic state and in fact be the straw that breaks the camel's back so to speak.

You mentioned about two things that are very common during the onset of tinnitus and that are very likely to diminish in time. You talked about your sensitivity to sounds like in a departments store. This is a form of hypercusis that is very common at T onset and is almost certain to diminish after a few months. You also mentioned your hearing seeming to be in flux or the feeling of cotton in your ears. Again, very common with T onset, and likely to subside soon for you. I experienced both of these things and both went away in far less time than it takes to habituate. One thing that might sustain their existence is protecting your ears too much. You should certainly protect your ears from sounds above 80 decibels, but you probably should not protect against everyday normal volumes. I understand how annoying it can be to be in a noisy department store or restaurant when you first get T. My advice is to go ahead and avoid such places or wear hearing protection in these areas for a short time while you are really sensitive, but then gradually expose your ears to more over time. Doing so may get you past the hypercusis and stuffed ear feeling quicker. To be clear, I am by no means saying to not wear hearing protection when you are exposed to sounds at hearing damaging levels (usually 80 db and above but could be a little lower for you) - I'd advise wearing them when using a gasoline powered lawn mower or other things in that sound volume range for instance, but protecting your ears too much can extend the early adjustment period.

I think it is worth getting an audiology exam. When you see an ENT he will almost certainly want you to. It may not shed very much light on things because it most likely will come back close to normal if not entirely normal. Note that normal does not equal zero hearing loss in an ENT's or audiologist's eyes. You most likely have some hearing loss, and it may be above the normal testing range which only goes up to 8000 hz. If you don't have any loss with a regular hearing test you can ask for a high frequency hearing test than typically goes up to 15 or 16 kHz. They may not have the equipment to do that however. The only reason to do it is to see if you really do have a loss that explains your T. You might want to determine the frequency of your T before your audiolgy exam since it is most likely to coincide with the frequency of your greatest loss. You can this fairly well with the tinnitus tuner at AudioNotch.com.

Hope things get better for you soon. Tinnitus is not fun, but it usually gets better with time.

Hey Mick,

Got back from my ENT. Well, I missed the 1 week limit to get corticosteroids. And the ear pain is the big H. He said it will go down in a few months (I hope), like you said. Same with wearing hearing protection. Just use it if the noise is above 70ish db or if it is just too uncomfortable.

I did the audiology test there in the office. Appears my hearing drops off at 6k and above...and is mild to medium hearing loss with it being slightly worse in one ear. But completely normal for voices. I had no problem with the word test.

So I think your theory may be right. The stress induced by the withdrawal may have set off the ticking time bomb. I know I have had some high freq loss for a good part of 20 years so this may not be that surprising. In my early 20s, I was in the army and fired a machine gun (sometimes we couldn't wear hearing protection). I was never a big concert goer but I did go the the ones I did without protection in my early days of going out. So it may not be ototoxicity that did it but maybe like you said...a stress trigger.

So it is the course of vitamins for me and maybe a tincture of time.

Thanks