Solsaem Clinic (Dr. Minbo Shim) Experience

[JohnAdams]

Dexamethasone at Paparella in the Twin Cities. Dr. there just used some numbing agent I believe and then a needle syringe (hurt like hell) Shea Ear Clinic in Memphis TN used a laser to make the holes (very little pain) Not exactly sure what they injected at Shea (probably dexamethasone, lidocaine etc.) but it was injected into left ear only at both places. I had a high pitched whine in my left ear.

I would suppose Shea would be close to where you live but I don't think they do IT injections for tinnitus anymore. This was in July 2011.

How long did you have tinnitus before you got the dexamethasone treatment?

 

[just1morething]

How long did you have tinnitus before you got the dexamethasone treatment?

Well I had a airplane barotrauma from Chicago to MSP on a return flight from San Juan, PR. I had never gotten fluid in my ear before on any flights, but the 2 stage ones were always worse for me. I had several times when my ear was plugged for 2-3 days after a flight though. I usually take decongestants 1 hour before descents.

1) 3-2008, Airplane barotrauma with left ear 2/3 thirds full of fluid. I was put on an antibiotic and fluid drained in about 1 month.

2) 7-2008, Woke up with very loud noise in ears/head after an extremely loud wedding reception for my niece.

3) 2008-2009 noise wasn't too bad and then in 2010 it got really bad in left ear. 2010 Paparella injections, 2011 Shea injections.. I was around a really noisy high shrill grain vacuvator during those years. I kept a diary and thought the noise could be a side effect of lamictal 100mg at the time.

4) At present I have a loud hiss in right ear/head. Everything is hindsight with the airplane and noise exposure so that does no good to beat myself up (I'm still mad though) Usually it's worse in my barotrauma ear. Maybe it's mainly brain noise now? I have HF hearing loss and most ENT's will point that out as the cause of my tinnitus.

5) Tried hearing aid aids/maskers. Also Gabapentin plus Klonopin combo as recomended by Dr. Abraham Shulman and many supplements. I'm having difficulty getting Klonopin prescribed lately. I am hoping you have good results with your PRP etc. IT injections.

 

[JohnAdams]

I'm having difficulty getting Klonopin prescribed lately

Why? If you feel like you need it isn't that why they even make it in the first place?

 

[just1morething]

Why? If you feel like you need it isn't that why they even make it in the first place?

With the supposed opioid crisis the Dr.'s I have seen seem to be leary about prescribing benzos too. They worry about dependence and liability I suppose.

 

[Ervin64]

Exposure to noise above 80 dB has been proven to cause hearing loss. Depending on the volume, it doesn't matter even if it was brief exposure within a 24hr period. If you don't give your ears rest, and allow them to get out of the temporary threshold shift stage caused by loud noise, you are basically rebooting the temporary threshold shift time length and leading yourself into permanent hearing loss because of the loud noise exposure. Temporary threshold shifts can last days, weeks, and even a month or two in some cases. Hearing aids are not an exception to that rule.

In addition, we found out that there is less such thing as temporary hearing loss than we thought because of the synaptic ribbons degrading over time. Partial regenerative can only go so far.

It is a logical thing to say that hearing aids can cause hearing loss, because they are amplifying the sound, and too much exposure to loud noise will always cause hearing loss.

Hi Artemis2k,

I share your opinion about exposure to unhealty loud sounds.

Regarding hearing aids, I am not expert and maybe different hearing aids are built quite differently, but when I bought my first hearing aid many years back they already had possibility to set them up according to my audiogram. That means my hearing aids are increasing (with different) volume according to my loss at corresponding frequency. If someone for example has normal hearing at certain frequency and only has loss at other frequencies, than hearing aid will actualy not increase sounds at that specific non-problematic frequencies. At perfect tehnology people with hearaing aid should hear exactly as healthy person without hearing problems. Unfortunatly hearing organ is so complicated that person with currently available hearing aid never has perfect hearing (as might be the case with eye organ problems - and glasses/lenses).

 

[just1morething]

Whoa you had a hole burned into your eardrum? What did they put in there?

The laser hole in my right ear was for ventilation only....only perfusion in left problem ear.

 

[Stu1983]

Hi @JohnAdams
Any new updates on your treatment?
You've given me some hope man. Exciting times.

 

[JohnAdams]

Hi @JohnAdams
Any new updates on your treatment?
You've given me some hope man. Exciting times.

I went to my regular doctor to check out this thing on my neck that looks like cancer, and they checked my eardrums and said they look fine. They could see one injection site on my left eardrum and a little dried blood on my right. I can plug my right ear and hear zero tinnitus. My tinnitus in my left ear is only perceptible for maybe 1/4th of the day. When the tone in my left ears fades in I can whistle for like 2-5 seconds at the same pitch and it goes away for a long time, like sometimes for the rest of the day.

The tone has changed from a solid tone to something that sounds like the same tone but fainter like it's out of breath. I've been getting spikes of baseline tinnitus and hyperacusis but they are becoming more infrequent.
The only tone that is what I would call problematic or distracting is a HF tone that's about 13.3 Khz and it's not there all the time and when it is there it's like it's tied to a fader and just coming in and out a little bit.

I took a GABA the night before last before bed and yesterday my HF tinnitus was horrendous, but by yesterday afternoon it went back away when I was working out. For 4 of the last 5 days I have had extremely low amazing days. Today I have no hyperacusis, my right ear is silent when I plug it, and my left ear tinnitus is just barely noticeable.

I'm trying to get in with an ENT/Otolaryngologist to get my hearing checked soon.

Dr. Shim has been following up with me as well and asking about my progress.

 

[GSC]

I went to my regular doctor to check out this thing on my neck that looks like cancer, and they checked my eardrums and said they look fine. They could see one injection site on my left eardrum and a little dried blood on my right. I can plug my right ear and hear zero tinnitus. My tinnitus in my left ear is only perceptible for maybe 1/4th of the day. When the tone in my left ears fades in I can whistle for like 2-5 seconds at the same pitch and it goes away for a long time, like sometimes for the rest of the day.

The tone has changed from a solid tone to something that sounds like the same tone but fainter like it's out of breath. I've been getting spikes of baseline tinnitus and hyperacusis but they are becoming more infrequent.
The only tone that is what I would call problematic or distracting is a HF tone that's about 13.3 Khz and it's not there all the time and when it is there it's like it's tied to a fader and just coming in and out a little bit.

I took a GABA the night before last before bed and yesterday my HF tinnitus was horrendous, but by yesterday afternoon it went back away when I was working out. For 4 of the last 5 days I have had extremely low amazing days. Today I have no hyperacusis, my right ear is silent when I plug it, and my left ear tinnitus is just barely noticeable.

I'm trying to get in with an ENT/Otolaryngologist to get my hearing checked soon.

Dr. Shim has been following up with me as well and asking about my progress.

YEAAAAAAAAAAAAAAAAH. LOOK AT YOUUUUUUUUUUU POPPIN BOTTLES

 

[JohnAdams]

YEAAAAAAAAAAAAAAAAH. LOOK AT YOUUUUUUUUUUU POPPIN BOTTLES

I was just talking to a coworker about how could I possibly explain this to an ENT/otolaryngologist.

My hearing loss is within the margin of error on my audiograms so those will be weak evidence, even though I know I can hear better, and that my tinnitus has diminished, which is subjective. So some dork like me comes into your practice and says they know how to treat hearing los and tinnitus with basically the equivalent of a grainy picture of a UFO, what do you make of that? It would be highly unethical to start treating patients with this method based on just my subjective testimony and my audiograms.

What would have to happen is a research lab would have to start doing animal tests with this method, which I guess could be funded with grants. So maybe I need to just write all of this down and start e-mailing universities with otolaryngology departments.

Then correct me if I'm wrong but there's not an objective measure for tinnitus, just hearing loss, right? So they could provide data from animal testing that would show evidence for hearing improvements but not the tinnitus, therefore the tinnitus world may not be so quick to pick up on it. Also, how hard would it be to extract bone marrow from hamsters in a significant quantity and also, you have to hold your head still and not swallow while it sets up in your head, and you cannot be sedated because you swallow as a reflex even when you are sedated, right? How do tell a hamster not to swallow?

 

[JohnAdams]

 

[Stu1983]

@JohnAdams
I'm so happy to hear of your success. Lots of respect for going out there and trying this. Thank you.
I hope that the growths are not serious and you make a full recovery.
Just curious how loud was your tinnitus and did you have any hearing loss. I have moderate hearing loss and moderate to severe tinnitus that's changes through your the days. Would I be able to receive this treatment ?

Love and respect
Stu from Toronto

 

[Ray552]

Any improvement in visual snow / vision? @JohnAdams

 

[JohnAdams]

I hope that the growths are not serious and you make a full recovery.

I have an appointment with a dermatologist next week. It seems benign.

ust curious how loud was your tinnitus and did you have any hearing loss.

Loud enough to need masking and drive me nuts. Loud enough to hear while driving on the interstate. It was always fluctuating though. Between not really loud, to really loud especially if I didn't sleep well. I tried some THC oil early in and it made it REALLY LOUD temporarily. Yea I have (had?) hearing loss and trouble discerning speech with background noise, and fluctuating hyperacusis.

Would I be able to receive this treatment ?

That is a decision that you need to thoroughly consider and consult with Dr. Shim yourself. I cannot simply say "yes, go for it". At least not yet. I can say that beforehand he told me that the worst complications he encountered was otitis media that always resolved. I can also say that I had zero complications. I will say that it is not for the faint of heart. Getting bone marrow extracted really hurts. Also, getting that many intratympanic injections is like an endurance challenge. Also, the amount of treatment and the results can vary drastically depending on how much hearing loss you have and your age. The younger you are, the better.

Any improvement in visual snow / vision?

Not yet. It took about 3 months for it to set in so I'd imagine that it would take that long or longer to resolve, if it does.

 

[JohnAdams]

I've been using this to experiment with my tinnitus.

http://www.generalfuzz.net/acrn-hifreq/

I'm in my office and my tinnitus started creeping back in a little in my left ear and I just play the single tone for a second and then my tinnitus goes away, for a while. Not just for seconds, but hours.

 

[Stu1983]

@JohnAdams

Thanks bro for the response and info.

 

[JohnAdams]

Any improvement in visual snow / vision

Sorry, I have floaters and maybe slight visual snow if I look out at something dark. I never notice visual snow unless I look really hard for it.

 

[GregCA]

Then correct me if I'm wrong but there's not an objective measure for tinnitus, just hearing loss, right?

Tinnitus measurements work the same as hearing loss measurements: a patient is subjected to sounds of various volumes & pitches and the patient needs to provide feedback about them. Neither method relies on a sampling devoid of patient feedback.

Tinnitus loudness and pitch matching follow a well known protocol that is described in some of the scientific papers related to treatments.

The loudness measurements are needed to determine if a treatment shows any improvement (example: http://www.tinnitusjournal.com/arti...ective-personalized-treatment-of-tinnitus.pdf )

 

[JohnAdams]

@GregCA yeah I did that in his clinic. But isn't that still partly a subjective measure? I'm just going on what @David said in the podcast in regards to the desire to have an objective measure for tinnitus.

 

[GregCA]

@GregCA yeah I did that in his clinic. But isn't that still partly a subjective measure?

It depends on the purpose for the measure.

For example, if we measure your tinnitus loudness and via protocol we conclude, with your "subjective assessment", that it is equivalent in loudness to a signal that is 30 dB loud, then this is what you perceive it to be.

For all practical purposes, this is what you feel it sounds like, and that's all that matters to you, whether that's due to a 1 nanoWatt signal on an auditory pathway or a 10 nanoWatt signal - it doesn't matter for this purpose (it does matter when we want to figure out a mapping between electrical power and tinnitus volume, but this is a rare endeavor: in practice, we want to help patients perceive a less loud tinnitus).

If we measure it again post treatment and you claim that it now is 20 dB, then from your perspective, which is all that matters to you, you've actually perceived a reduction of 10 dB.

So for this particular purpose, the subjective nature of the measurement is irrelevant.

However, if we wanted to tie a disability payment to a volume level, we'd have to think twice about using a patient reported measurement, as you can imagine it can easily be gamed. For those purposes, measurement techniques that don't require patient feedback make sense.

 

[Ed209]

It depends on the purpose for the measure.

For example, if we measure your tinnitus loudness and via protocol we conclude, with your "subjective assessment", that it is equivalent in loudness to a signal that is 30 dB loud, then this is what you perceive it to be.

For all practical purposes, this is what you feel it sounds like, and that's all that matters to you, whether that's due to a 1 nanoWatt signal on an auditory pathway or a 10 nanoWatt signal - it doesn't matter for this purpose (it does matter when we want to figure out a mapping between electrical power and tinnitus volume, but this is a rare endeavor: in practice, we want to help patients perceive a less loud tinnitus).

If we measure it again post treatment and you claim that it now is 20 dB, then from your perspective, which is all that matters to you, you've actually perceived a reduction of 10 dB.

So for this particular purpose, the subjective nature of the measurement is irrelevant.

However, if we wanted to tie a disability payment to a volume level, we'd have to think twice about using a patient reported measurement, as you can imagine it can easily be gamed. For those purposes, measurement techniques that don't require patient feedback make sense.

The problem with this protocol is the subjective reliability of it. One study (Reed 1960) showed that only 25% were able to reliably find the correct pitch when matching to a pure tone. It's also been shown that matches can vary a lot from one session to another. Interestingly, some - particularly those with no musical training - often confuse loudness with pitch, which is a problem if one is trying to obtain objective accuracy. However, if people are trained to interpret sound more accurately, it's been demonstrated that accuracy usually improves.

Essentially, there are problems with the objectivity of this method which is why the questionnaires are still one of the primary measures of tinnitus severity. The way we perceive sound falls into the science of psychoacoustics and it's known that quantifying external (and internal) sounds is a difficult task. The context of what we are hearing and/or how we hear something can change the intensity of our perception. There's a lot going on in those neural pathways! Brownbear once stated on here that he had heard there may be a shift into measuring tinnitus in phons or sones.

The need for an objective measure of tinnitus is as strong as ever.

Further reading:

Dr Brian Moore: page 187

https://www.researchgate.net/profil...al-Tests-for-Tinnitus-in-Animals.pdf#page=194

Dr Deborah Hall:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4257689/

And another study:

https://scholar.google.co.uk/scholar?q=repeatability+accuracy+of+tinnitus+loudness+matching&hl=en&as_sdt=0&as_vis=1&oi=scholart#d=gs_qabs&u=#p=CIIfhEYFJI0J

 

[JohnAdams]

The problem with this protocol is the subjective reliability of it. One study (Reed 1960) showed that only 25% were able to reliably find the correct pitch when matching to a pure tone. It's also been shown that matches can vary a lot from one session to another. Interestingly, some - particularly those with no musical training - often confuse loudness with pitch, which is a problem if one is trying to obtain objective accuracy. However, if people are trained to interpret sound more accurately, it's been demonstrated that accuracy usually improves.

Essentially, there are problems with the objectivity of this method which is why the questionnaires are still one of the primary measures of tinnitus severity. The way we perceive sound falls into the science of psychoacoustics and it's known that quantifying external (and internal) sounds is a difficult task. The context of what we are hearing and/or how we hear something can change the intensity of our perception. There's a lot going on in those neural pathways! Brownbear once stated on here that he had heard there may be a shift into measuring tinnitus in phons or sones.

The need for an objective measure of tinnitus is as strong as ever.

Further reading:

Dr Brian Moore: page 187

https://www.researchgate.net/profil...al-Tests-for-Tinnitus-in-Animals.pdf#page=194

Dr Deborah Hall:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4257689/

And another study:

https://scholar.google.co.uk/scholar?q=repeatability+accuracy+of+tinnitus+loudness+matching&hl=en&as_sdt=0&as_vis=1&oi=scholart#d=gs_qabs&u=#p=CIIfhEYFJI0J

I'm all for discovering an objective measure but research funding should not hold this as a prerequisite for funding curative research. For most of us, tinnitus is a symptom of hearing loss, and that is very easy to measure. Tinnitus research should be focusing on hearing loss first, not simply tinnitus.

 

[Ed209]

I'm all for discovering an objective measure but research funding should not hold this as a prerequisite for funding curative research. For most of us, tinnitus is a symptom of hearing loss, and that is very easy to measure. Tinnitus research should be focusing on hearing loss first, not simply tinnitus.

My intention with that post wasn't to say we should be funding anything in particular - and I agree that a cure is the priority - but to highlight some of the pitfalls of tinnitus pitch and loudness matching.

However, it's possibly the closest thing we've got right now to putting a number on severity.

 

[JohnAdams]

My intention with that post wasn't to say we should be funding anything in particular

Yeah I know. I didn't mean to insinuate you did.

 

[just1morething]

Getting bone marrow extracted really hurts

Would Dr. Shim have done PRP injections only through your eardrums if you had asked? Or is the bone marrow extraction part of his protocol treatment mandatory for better results? I know it's too early to even know if you will have long term tinnitus reduction from the procedure you have had done. I certainly hope you do for your own sake as well as to give us all some hope.

You would think well known ear clinics such as Shea, Silverstein, or House Ear Clinic in the US would have tried IT injections of PRP only for tinnitus? Or companies such as Otonomy? Maybe you don't want to comment on this? Or just evaluating in a few more months would be better.

 

[JohnAdams]

Would Dr. Shim have done PRP injections only through your eardrums if you had asked? Or is the bone marrow extraction part of his protocol treatment mandatory for better results?

I wouldn't have asked. He has been doing this in a clinical setting for years so I would take his advice. I'd think he would accommodate such a request though. Seeing as how bone marrow extraction is more work for him I wouldn't think he would do that if it wasn't better, or necessary.

You would think well known ear clinics such as Shea, Silverstein, or House Ear Clinic in the US would have tried IT injections of PRP only for tinnitus?

Well, there is an ethical barrier to just start injecting blood products into human ears. Fortunately Dr. Shim knew what he was doing and was able to bypass rigorous animal studies to verify the safety of this. But yeah, you'd think these other institutes would have looked into this.

It's not that complicated.
IGF-1 has been proven in human clinical trials to restore hearing loss.
The researchers from those trials speculated that the action was from hair cell regeneration.
There were no adverse effects from the study population.
IGF-1 as well as other growth factors that are involved in tissue healing and regeneration are in PRP and bone marrow.
I can state for a fact it's safe when administered properly because I did it.

 

[hsk]

I wouldn't have asked. He has been doing this in a clinical setting for years so I would take his advice. I'd think he would accommodate such a request though. Seeing as how bone marrow extraction is more work for him I wouldn't think he would do that if i wasn't better, or necessary.

Well, there is an ethical barrier to just start injecting blood products into human ears. Fortunately Dr. Shim knew what he was doing and was able to bypass rigorous animal studies to verify the safety of this. But yeah, you'd think these other institutes would have looked into this.

It's not that complicated.
IGF-1 has been proven in human clinical trials to restore hearing loss.
The researchers from those trials speculated that the action was from hair cell regeneration.
There were no adverse effects from the study population.
IGF-1 as well as other growth factors that are involved in tissue healing and regeneration are in PRP and bone marrow.
I can state for a fact it's safe when administered properly because I did it.

You might have posted it before, but for my edification could you post the research on human clinical trials that restore hearing loss with IGF-1?

 

[Tom Cnyc]

I don't know if you've read the original thread about Dr. Shim or not, but, there's a good amount of skepticism about this. People are actually posting some very nasty things about this man based on their own debased logic.
Plus, Neuromod doesn't purport to regenerate hair cells or restore hearing.

I'm about to have a meeting with an ENT that my friend/coworker knows and talk about potentially getting something like this going in America.

Would Dr. Shim have done PRP injections only through your eardrums if you had asked? Or is the bone marrow extraction part of his protocol treatment mandatory for better results? I know it's too early to even know if you will have long term tinnitus reduction from the procedure you have had done. I certainly hope you do for your own sake as well as to give us all some hope.

You would think well known ear clinics such as Shea, Silverstein, or House Ear Clinic in the US would have tried IT injections of PRP only for tinnitus? Or companies such as Otonomy? Maybe you don't want to comment on this? Or just evaluating in a few more months would be better.

Why would you not want the steroid alongside the PRP?

 

[JohnAdams]

Why would you not want the steroid alongside the PRP?

I got a steroid injection because while I was there I suffered an additional acoustic trauma. I went to Gyongbukgong Palace and as I was leaving some goofball parade was protesting dog and cat meat slaughter and the cheerleader of the procession pointed his megaphone right at me and it blasted my ears and when I went back into the clinic the next day I told Dr. Shim about it and he gave me a hearing test which showed a significant transient threshold shift and then gave me dexamethasone to try and alleviate any damage that may have occurred.

 

[Contrast]

I went to my regular doctor to check out this thing on my neck that looks like cancer, and they checked my eardrums and said they look fine. They could see one injection site on my left eardrum and a little dried blood on my right. I can plug my right ear and hear zero tinnitus. My tinnitus in my left ear is only perceptible for maybe 1/4th of the day. When the tone in my left ears fades in I can whistle for like 2-5 seconds at the same pitch and it goes away for a long time, like sometimes for the rest of the day.

The tone has changed from a solid tone to something that sounds like the same tone but fainter like it's out of breath. I've been getting spikes of baseline tinnitus and hyperacusis but they are becoming more infrequent.
The only tone that is what I would call problematic or distracting is a HF tone that's about 13.3 Khz and it's not there all the time and when it is there it's like it's tied to a fader and just coming in and out a little bit.

I took a GABA the night before last before bed and yesterday my HF tinnitus was horrendous, but by yesterday afternoon it went back away when I was working out. For 4 of the last 5 days I have had extremely low amazing days. Today I have no hyperacusis, my right ear is silent when I plug it, and my left ear tinnitus is just barely noticeable.

I'm trying to get in with an ENT/Otolaryngologist to get my hearing checked soon.

Dr. Shim has been following up with me as well and asking about my progress.

John may have really did it, he may have really conquered tinnitus and restored his hair cells. Something no mammal has done in probably 100 million years. Congratulations on that one!

We still need to wait, however if this works for cochlear synaptopathy and this trigeminal nerve irritability form noise. I will fly over there myself.