Setback in Tinnitus and Hyperacusis After Blow-Off Valve Popped and Dumped Air Quickly

[CB7x]

I'm pretty new at this, 11 months since the trauma that took my mild and intermittent tinnitus up to loud and constant, then developed hyperacusis later (overprotecting may have contributed).

I normally work in a fairly quiet environment but occasionally have to go into noisy parts of the plant. I had to go into a compressor room yesterday and today, not for long, and the compressors we have are relatively quiet as compressors go (rather than obscenely loud consumer oil-less or high RPM oiled type).

Yesterday I was in there, not directly next to any equipment. I had earplugs on me but since I've been doing so well tolerating louder (but safe) sound I chose not to put them in unless it was too loud for me since nobody else uses protection or finds it too loud to work in that area for far longer periods than I did. I got a minor tinnitus spike that went away.

Today I had to briefly go in that room again. I did what I had to do, stepped outside around a corner and started talking with someone, then a blow-off valve popped and dumped a large amount of air quickly... Loud and high pitched while only a second or less in duration (I couldn't plug ears fast enough), exactly what sets off my tinnitus and hyperacusis. Granted I'm familiar with that type of noise and before my trauma it never caused any problems... but now I'm suffering, having a couple of drinks, listening to quiet notched music, waiting for tinnitus to subside and it seems to be getting there but my ears feel full. Hoping I'll be back to baseline tomorrow, or soon.

I can deal with tinnitus, but hyperacusis sucks. I hope it's only a temporary spike or setback. Everything seemed louder and a bit uncomfortable while driving home. I've been trying not to use protection around sounds I know are under 85 dB if they are not uncomfortable. It has seemed to increase my tolerance until now when the sudden noise got me by surprise. I got too confident and didn't consider the unexpected.

 

[CB7x]

This morning my tinnitus was a bit louder than normal. I could hear it in my good ear, which I usually cannot first thing in the morning but do hear it later in the day. Less sensitivity to volume than yesterday and my ears don't feel so full. A hot shower felt good, the water didn't sound any louder than normal and didn't bother me.

I worked remotely today, to take it easy on my ears. Tinnitus was bothering me enough that I used background noise which I haven't used in months except when I sleep. My tinnitus frequency sometimes changes briefly after what feels like an ear spasm, to a higher pitch then near silence for a moment. I experienced this pitch change to a higher pitch three times today for a longer time than usual, with no ear spasm prior and no near silence after. This is new.

My ears feel a bit achy or tired now after a full day of quiet background noise while working and only one phone call. Tinnitus is not back to baseline, I didn't go anywhere today so hard to say about noise sensitivity driving or around normal sounds. I am sitting listening to music at 50-55 dB which is typical volume for me, and can hear tinnitus over the music whereas prior to yesterday I wouldn't notice it unless I focused on it.

I wonder if I should try Prednisone. If this brief loud noise exposure yesterday caused damage rather than a spike, I don't know that I should exhaust my window of opportunity waiting to see what happens. I wonder if a second of 95-105 dB (guessing) could cause damage that I should try to mitigate?

Does anyone with hyperacusis have experience with Prednisone? Most studies I've read are focused on mitigating hearing loss of course because that is easily measurable, and mention tinnitus, but nothing on hyperacusis. I understand it can spike tinnitus and hyperacusis while on or tapering off, but I'm hesitant to try if it may permanently make either worse.

 

[MindOverMatter]

@CB7x, I actually experienced a sudden "acoustic trauma" for about 1 minute two days ago. I had some Prednisone left from last year, so I started a 7 day course with 40 mg every morning just to be on the safe side really - since I had the opportunity. I had a massive spike (both hyperacusis + tinnitus), and acute anxiety for worsening condition yesterday, way calmer/better today after 2nd day with Prednisone. Feeling warm in my body, and a lot of energy. Typical when on Prednisone.

I don't think I will taper this time as it's not a massive dosage, and only for a few days.

If you are worried about this newly experienced trauma, and you have a massive spike, I'd say go for it.

 

[CB7x]

@MindOverMatter, how are you doing now farther into the Prednisone regimen? It makes me nervous that you mention a massive spike. Was it just the first day and has since subsided to your normal level? Has the hyperacusis returned to normal?

I should be able to get some Prednisone this week. You mentioned 40 mg dose. I've read anywhere from 40-60 mg/day for 5-10 days with a taper afterward. Military studies I've read suggest 60 mg for 10 days then a taper, but no mention of the taper dose or how long. I'm unsure of appropriate dose and taper.

Beyond that it has been an interesting week. Slow and steady improvement since the trauma on Tuesday, every day has been slightly less bad. Friday I had some friends over for dinner and drinks. Later that evening after everyone left my wife had the TV at a volume I thought was loud but I didn't find it uncomfortable as I normally would, but I mentioned as much to the wife and turned it down to be safe. She said I probably drank enough that I didn't notice it, whatever, I chalked it up to alcohol and enjoyed a temporary reprieve.

Today I woke up and after a minute or two in bed with quiet background sounds noticed my tinnitus didn't seem as loud. I plugged my good ear and the tinnitus was barely noticeable. Plugged my bad ear and it was definitely there but less loud than normal (or I was starting to acclimate to the spike, to play devil's advocate). This morning was more in line with my baseline.

I went about my day and I did not notice the tinnitus as much, louder sounds such as my dog barking at the mailman did not hurt, though the tinnitus got a little louder throughout the day as it usually does. The wife invited her friend over for dinner, her friend's husband is a great guy but a bit of a loud talker and can be uncomfortable or painful for me at times. I was looking forward to company but unsure of loud talking. Sure enough there was loud talking but I only found it slightly uncomfortable a few brief times, not painful.

I'm shocked by the past 24 hours. The tinnitus is still very noticeable, but the hyperacusis seems to be much less. This is like a rollercoaster, I don't know if it will last, if it's random or related to my sound exposure on Tuesday or anything since then. I guess all I can do is wait and see.

 

[MindOverMatter]

@CB7x: Day 5 with Prednisone, 40 mg. Been loose in my stomach due to Prednisone, which is normal. Hyperacusis has been very low last 5 days on Prednisone. Spike has returned to baseline. I will finish my regimen by Tuesday. No tapering off this time due to only a week's of regiment. If I did 60 mg or 80 mg, I would choose to taper down to 40 mg - 20 mg - 10 mg - 5 mg for a week.

In regards to your trauma, to me it doesn't seem like you need Prednisone. You are on track. Your spike is coming down naturally, as it often will.

 

[CB7x]

Thanks for sharing your experience on Prednisone so far. I'm curious how it will go once you're off of it for a day or few.

At this point I'm hesitant to try Prednisone since I've read about a few cases of increased tinnitus and hyperacusis afterward. I think your assessment of coming down from a spike may be accurate. I was able to ride my motorcycle to work today and yesterday with the warmer weather and it did not bother me aside from the usual temporary tinnitus spike from using plugs.

The strange thing for me is while some sounds still seem loud, hyperacusis seems less in that it seems to take a louder sound to trigger discomfort or pain. There were some sudden loud sounds in the office today (not damaging level), I doubt over 85 dB but it was a sudden change in range from low dB to a momentary loud beep. This made me flinch until I removed myself from the situation after the third time. It was uncomfortable, I think it would have hurt before while now it was only uncomfortable.

I'm almost a year post trauma and sort of figured nothing would change. I don't know if this is random or has any relation to the trauma last week from the air valve. I will enjoy a higher tolerance to sound as long as it lasts while still protecting for genuinely harmful decibel levels.

 

[CB7x]

I figured I should provide an update on this. I am less sensitive to loud sounds and have been a bit more adventurous, or perhaps gambling, the past week. As I've said before I'm new to this... but from my limited experience I believe overprotecting will make things much worse in the long term. I've found pushing my limits of discomfort expands them, though of course pushing too far or a trauma that may not be so traumatizing to a normal person will set me way back.

I've found I can drive with my radio on 10 for extended periods of time, rather than 8 pushing my limits previously. 1 - would have been unbearable for more than a few seconds a month ago. Before trauma I'd listen at 12-14 on the highway to hear it clearly over highway and wind noise.

When riding my motorcycle (a lot lately) I've been using Eargasm 16 NRR plugs more than 3M 25 NRR that I used before. The other day I started it without plugs at all, and it sounded very loud to me. I measured it with a cheap meter and it was 72-75 dB (deep low pitched tone) in the seat and 5' behind. I even went for a little ride up and down the street with no plugs, it was loud for me, but just uncomfortable and not painful. It would be too much to go for a real ride without plugs though, into the throttle and particularly at speed with wind.

I was in a room at work for a while that is 70-75 dB constant higher pitched, that normally sets off my tinnitus without protection. It did not spike my tinnitus as much and was only slightly uncomfortable. This is huge for me.

I don't understand this increase in tolerance nearly a year after trauma or if it has any correlation to my more mild trauma a few weeks ago. I have Prednisone on hand but have not taken it and do not intend to. I don't want to risk the potential negatives when I've seen an improvement in the time it took to get it.