Next Steps?

[bodhisattva]

Dr. Nagler,

During a bout with extreme anxiety and panic attacks i awoke (3-4 weeks ago) with a ringing in my ears.
I was taking welbutrin (only a week or so), i read that it can cause T, so i stopped that immediately, the ringing persisted. Went to a walk in clinic, they gave me prednisone and anti biotics.

I went to an audiologist and and ENT. No blockages, only very minor hearing loss in upper frequencies. ENT gave me dymystia (SP? nasal steroid) didn't do much for me. ENT saw no reason for me to continue the antibiotics, and the prednisone was elevating my anxiety way too much to deal with at the time.

Two questions:
1- should i give the prednisone another shot (under a doctors supervision of course) as the anxiety is a little more manageable now
2- what sort of doc should i see next? Neurologist? Another ENT for a 2nd opinion?

I live in Nashville TN and am close to Vanderbilt, not sure if you know of any good docs in the area but any guidance is so welcome.

Thank you sir

Jay

 

[Dr. Nagler]

Two questions:
1- should i give the prednisone another shot (under a doctors supervision of course) as the anxiety is a little more manageable now
2- what sort of doc should i see next? Neurologist? Another ENT for a 2nd opinion?

I live in Nashville TN and am close to Vanderbilt, not sure if you know of any good docs in the area but any guidance is so welcome.

Hi Jay -

So reading your post it seems to me that in prescribing prednisone and antibiotics for tinnitus that emerged during a period of extreme anxiety with no identifiable underlying cause , the doc in the walk-in clinic was sort of shooting from the hip. I personally see no reason to try the prednisone again, but why don't you run that by the ENT?

Whom should you see next? Well that strictly depends on how much your tinnitus bothers you. Your ENT has presumably ruled out the (rare) fixable causes of tinnitus and the (extremely rare) dangerous causes of tinnitus - so what you are left with is, for lack of a better term, a nuisance. It can be a HUGE NUISANCE or it can be a tiny nuisance. One thing you can do is just give it a little time, since many cases just seem to settle down on their own. But if your tinnitus is a HUGE NUISANCE and you don't want to give it a little more time, then probably your next stop should be a tinnitus center where they know what they are doing. The Chairman of the Department of Audiology at Vanderbilt is a friend of mine named Dr. Gary Jacobson. He used to be very much involved in tinnitus, but I think his interests have moved more towards the vestibular side of things. Anyway, why don't you give him a call (you can mention my name if you like), and ask him whom you should see for a tinnitus evaluation and treatment.

Hope this helps -

stephen nagler