Spike After Hairdryer (New Loud Temporary Tone) + Possible Ototoxicity. What Should I Do?

[Arseny]

I'm sorry if this is ridiculous. I'm very scared and paranoid.

Yesterday evening I went to get a haircut. Lady decided to blowdry my hair. ~1 minute of exposure. It was pretty loud (I measured it later it was around 100-105 dB). I didn't felt any discomfort although it was louder then my home unit. I don't blow dry my hair at home.
Immediately after she turned it off I felt and insanely loud hissing tone in my left ear. It was comparable to fleeting tinnitus. No ear fullness, pressure or pain. The tone started fading within 5 minutes.
When I came home I heard a hum noise inside my head with my earmuffs on. I get it when I expose myself to 60-70 dB + noise. Overall tinnitus has increased about 30% and some of the old tones came back.

One hour later I had injections done behind my ears. The needle goes in about 1 inch/2.5 cm alongside ear canal to reach the space near the eardrum. The doctor used alcohol to disinfect the skin. After an injection after holding the tissue for 30 seconds I developed irritation and pain due to dermatitis on my right ear. They switched the tissue to chlorhexidine gluconate. It's highly ototoxic (I googled it later, ENT said it was safe). By that time bleeding almost stopped, but there was some blood on the second tissue with chlorhexidine.

After that I rushed home and took 600 mg NAC.
2 hours later I developed a migraine. I had them before starting HBOT and after a recent spike due to a train ride. I feel like my head is burning and being electrocuted at the same time. Piercing pain with every wave of tinnitus. I get electrical zaps reactive to some sounds. It might be some weird form of hyperacusis, but my LDL seems to be above 100 dB, because I didn't feel any discomfort or pain during this hair blower accident.
But I feel like now I get somewhat uncomfortable watching YouTube videos and I get jumpy/uncomfortable from email notifications. It might be Acoustic Shock Disorder. Not sure. I had this before before HBOT, but it faded dramatically since then. Is this hyperacusis?

In the morning I woke up to somewhat increased tinnitus and much louder hissing on the right side. I got this white noise type of hissing after a train incident. My audiogram in my right ear is perfect up to 16000 Hz.
It has faded by 70% since then, but now it's back to previous volume or even louder.
On top of that I hear water running through the pipes in both of my ears. It happened before too after previous noise exposures.
When I put my earmuffs on I hear a vacuum cleaner going off inside my head. At best days it was pretty quiet without any humming noise.

What should I do? Steroids? I have already done 2 courses of steroids in last 2 months. I have access to Prednisone or Dexamethasone.
I'm doing HBOT now. I justs did one session after this spike and I still have 3 sessions left before clinic closes down for New Year celebration and holidays. I'm taking Betaserc to improve efficacy of HBOT treatment.

P.S. You never notice how much you get better until you get a spike. My tinnitus definitely got better in last month with HBOT.
I also I have very low pitched vibrating tinnitus in my left ear. I'm not sure if it's TTTS or ETD or just low pitch tinnitus. I have experienced 2 short episodes of vertigo in past 1.5 months with jumpy vision, everything was shaking from side to side very quickly. I'm hoping it's just my neck problems. I have c1 and c2 rotation. Anyone experienced this?

 

[Bill Bauer]

I'm sorry if this is ridiculous.
...
Lady decided to blowdry my hair. ~1 minute of exposure.

I think above you were saying that it is ridiculous to suggest that using a hair dryer might cause any problems for one of us.

Your experiences as well as the countless experiences of many others here seem to suggest that it is ridiculous for one of us to be anywhere near a hair dryer when it is on.

I really hope that you will feel better soon. However, if you don't learn from your mistakes, and take the protection of your ears seriously (for at least a year or two), there is a chance that it won't end well.

As for Prednisone, your guess is as good as our guess. There is a chance that it will help, and there is a chance that you will experience one of its side effects (e.g., bone loss leading to dental problems). Nobody really knows the probabilities (of it helping and of it causing problems) involved. You have to choose one of those options (basically at random) and then try to not second guess your decision.

 

[Arseny]

I think above you were saying that it is ridiculous to suggest that using a hair dryer might cause any problems for one of us.

Your experiences as well as the countless experiences of many others here seem to suggest that it is ridiculous for one of us to be anywhere near a hair dryer when it is on.

I really hope that you will feel better soon. However, if you don't learn from your mistakes, and take the protection of your ears seriously (for at least a year or two), there is a chance that it won't end well.

As for Prednisone, your guess is as good as our guess. There is a chance that it will help, and there is a chance that you will experience one of its side effects (e.g., bone loss leading to dental problems). Nobody really knows the probabilities (of it helping and of it causing problems) involved. You have to choose one of those options (basically at random) and then try to not second guess your decision.

I asked my friends and relatives about this situation and got ridiculed. They have mild to moderate tinnitus and live a happy life without any hearing protection. No spikes, only good days. They don't even think about their tinnutis.
When my tinnitius started at first I asked them if music, bikes and headphones maybe harmful. Got ridiculed too. I didn't know anything about tinnutis at that time. So I didn't change my lifestyle. I probably got my tinnutis from Cipro/neck and then just fried my ears even more with headphones and bikes. No wonder that my tinnutis got progressively worse during October.

Thank you for your support, Bill. You seem to be very a good and genuine person.
I'm protecting my ears with earmuffs when I'm outside. However I still struggle with anticipating dangerous noises since I'm very new to tinnutis and I still think that most of the noises are safe.
Are you protecting your ears inside the car?

I'm going to ENT now to talk about my situation. The tone has subsided, but still present. Typically these spikes go away within a day, but it's been 2 days already and I got a migraine on top of that. I'm sitting in the lobby of the clinic and I feel that my ears are burning. The feeling resonates to other parts of my head. This happened several times before when my tinnitius was very loud. I don't know if it's hyperacusis, acoustic shock disorder or something else.

 

[Bill Bauer]

They have mild to moderate tinnitus and live a happy life without any hearing protection.

It might be possible for you to be like that. Only time will tell. Meanwhile, you need to actually heal. Once that happens, perhaps you will discover that fewer loud sounds bother you, and perhaps it will end up being safe (although it is a risk).

No spikes, only good days. They don't even think about their tinnutis.

Another thing to keep in mind is that when people relax like that, they might be one incident away from making their body uninhabitable (due to debilitating T). So just because you have some cool friends who drive at double the speed limit on the highway and seem to be doing just fine, doesn't mean that it is a good idea to be like them, as their lifestyle just might catch up to them. So even if you beat T, it might make sense to keep T in mind when deciding whether to take some medications (don't forget to check whether they are ototoxic), or whether to expose yourself to some noises. Some exposures provide so little benefit, and other exposures seem to have such a high probability of backfiring, that it makes sense to say "no" to those exposures. But you won't realize it, if you get back to your normal life and try to forget the time when you were tormented by T.

I'm protecting my ears with earmuffs when I'm outside.

If you are on busy streets where motorcycles and trucks accelerate (and not in a seemingly quiet park), then it sounds like a good thing to do.

Are you protecting your ears inside the car?

I still do. In the past, my ears were a mess, and I believe that this policy had contributed to my healing. This summer, I tried not wearing any protection for several hours, and I actually got a spike. However, normally my drives are short, and I am not really sure whether I still need to wear earplugs when I drive. I do it because there is an upside (protection in case the airbag goes off, or an emergency vehicle with a siren drives by, etc), and not much of a downside that I am aware of. Another think about is car doors being slammed. My earplugs help when I close the door of my car. Whenever I have passengers in my car, I either wait for them to get in and close their car door before getting in myself, or I ask them to be as gentle as possible when closing their car door.

However I still struggle with anticipating dangerous noises since I'm very new to tinnutis and I still think that most of the noises are safe.

Anything as loud as a vacuum cleaner might not be safe. No matter how hard one tries to protect oneself, one is bound to get exposed multiple times, by accident (slamming metal doors, fire alarms, sirens, etc.) This is why it is so important to make the right choice when it is up to you whether to get exposed to noise.

Typically these spikes go away within a day, but it's been 2 days already

Temporary spikes can last for over three months.

I don't know if it's hyperacusis, acoustic shock disorder or something else.

Sounds like hyperacusis. It reminds me of what has happened to @Lex
https://www.tinnitustalk.com/thread...ce-onset-almost-a-year-ago.22718/#post-261301
Please read all of her posts in that thread. She has improved, but it took a very long time, and she is still not completely over it...

 

[Red]

What were the injections for?

 

[GregCA]

One hour later I had injections done behind my ears. The needle goes in about 1 inch/2.5 cm alongside ear canal to reach the space near the eardrum. The doctor used alcohol to disinfect the skin. After an injection after holding the tissue for 30 seconds I developed irritation and pain due to dermatitis on my right ear. They switched the tissue to chlorhexidine gluconate. It's highly ototoxic (I googled it later, ENT said it was safe). By that time bleeding almost stopped, but there was some blood on the second tissue with chlorhexidine.

I'm not clear about the location where the compound is injected: where does the tip of the needle end up? You say "space near the ear drum", but that could be on the outside (which would not make sense because it could be deposited directly without poking) or on the inside, which is the middle ear, where compounds are generally injected via "intratympanic injections" (ie poking the ear drum)... or perhaps somewhere else?

So where is that compound supposed to end up when it's injected?

 

[Arseny]

I'm not clear about the location where the compound is injected: where does the tip of the needle end up? You say "space near the ear drum", but that could be on the outside (which would not make sense because it could be deposited directly without poking) or on the inside, which is the middle ear, where compounds are generally injected via "intratympanic injections" (ie poking the ear drum)... or perhaps somewhere else?

So where is that compound supposed to end up when it's injected?

https://www.tinnitustalk.com/thread...damage-sensorineural-hearing-loss-snhl.32545/
Basically they inject a long needle behind your ear and guide it along the ear canal to the point where it reaches the tissues near the eardrum. The idea is to inject the medicine as close as possible to the hearing nerve.
I'm doing Ipidacrine 7.5 mg in each ear with 2 ml of 0.5% solution of Lidocaine. One of my tones changed after the second injection. From SHHHH to SSSSS or more like a soda bubbles. Not sure if it's an improvement or just lidocaine affecting my tinnitus. I tried 2 times without lidocaine and didn't notice any changes although my tinnitus was definitely quieter. I don't think that lidocaine is affecting the volume of my tinnitus, because I had a 3 day break and the volume only went down gradually during this days. I can't pinpoint the exact reason for that yet. I'm doing HBOT now too.
After the third injection I had to take a break, because of allergies. Now I just did 3 in a row hard to tell if there's any changes yet. I'm also in contact with a lady from another city who did the same injections. She has hearing loss in lower frequencies (suspected otosclerosis) and a sharp drop at 8 kHz. She just did 10 injections and her audiogram actually improved! I'll share her results if I get her permission.

@Red @Bill Bauer

 

[Bill Bauer]

From SHHHH to SSSSS or more like a soda bubbles. Not sure if it's an improvement

Did it become more piercing?

 

[sakrt]

Did the ENT prescribe both HBOT to be done concurrently w/ injections (or was HBOT added on your own?)

 

[Arseny]

Did it become more piercing?

Actually opposite of that. I have a few tones, most of them in my left ear where I had conductive hearing loss (it has improved to normal levels now). Mild to moderate Morse Code with low frequency (like a subwoofer) vibrating tinnitus, 15000 hz hissing sound + some sort of pulsatile piercing wave of hissing that feels like it is drilling into my left side of my brain. Drilling feeling got a bit better, not the sound itself, but the feeling of drilling got less intense down to somewhat tolerable levels and hissing got a bit quieter and changed to this more tolerable sound of soda bubbles mixed with hissing. But at first it definitely got more intense, very loud and it felt like sand was being blasted onto a metal sheet with insane pressure. Not sure is it's related to the medicine or my previous spike.

I still don't know why I got that conductive hearing loss in the first place. I was using headphones at that time (pretty loud), but I never heard of anyone getting unilateral 35 db conductive loss at 8 kHz due to noise exposure. Bone conduction was at 5 db at all frequencies. I actually had 15 db conductive loss at 125, 250, 2000 and 4000 hz too in my left ear too. Tympanometry showed some negative pressure and ENT said my eardrums were "sucked in".

 

[Arseny]

Did the ENT prescribe both HBOT to be done concurrently w/ injections (or was HBOT added on your own?)

I started HBOT myself after seeing information about it here. I already did 21 sessions. ENT said that HBOT might improve outcome. The specialist at HBOT clinic said that it improves efficacy of medication.

 

[GregCA]

https://www.tinnitustalk.com/thread...damage-sensorineural-hearing-loss-snhl.32545/
Basically they inject a long needle behind your ear and guide it along the ear canal to the point where it reaches the tissues near the eardrum. The idea is to inject the medicine as close as possible to the hearing nerve.
I'm doing Ipidacrine 7.5 mg in each ear with 2 ml of 0.5% solution of Lidocaine.

Are there any medical studies related to this procedure? (in particular for SNHL & tinnitus)
I'd be fairly uncomfortable with poking near the hearing nerve. There better be good success statistics!

(the study quoted in the link you provided doesn't seem to show a control group, or measurements of improvements in hearing)

 

[Digital Doc]

Getting back to protection, I do not wear anything in the car, but I have a newer, quieter car, and just keep the windows rolled up, and cover my ears for the occasional siren that I can hear from farther off.

On the other hand, I dont dry my hair, and use protection when another family member has it on at the house. I also protect for the electric razor, the vacuum, and when outside near a somewhat busy road with lots of larger trucks and some motorcycles. I do not use plugs at work, nor when going to a supermarket, except for the one that I walk to, and just leave them in for the walk back home.

Over time, you kind of learn what not to do the hard way when the respites come, which is more than powerful negative reinforcement to change behavior. For the first few months, my rule of thumb is to wear my ear plugs if I am not sure of the noise exposure, but not have them in 24/7.

 

[Arseny]

Are there any medical studies related to this procedure? (in particular for SNHL & tinnitus)
I'd be fairly uncomfortable with poking near the hearing nerve. There better be good success statistics!

(the study quoted in the link you provided doesn't seem to show a control group, or measurements of improvements in hearing)

I'm trying to find such studies myself. I'm currently researching, but from my understanding this type of treatment is prescribed fairly often in cases with hearing loss. I will update you and the original thread when I get more results.
I found this patent http://www.findpatent.ru/patent/255/2554813.html (use Google Chrome right click "Translate to English") The use Ipidacrine (intramuscular) along with 2 other drugs and some sort of physiotherapy in cases with noise induced hearing loss. They have results there too.
But Ipidacrine is a go to drug for any kind of neuropathy. It seems to be very effective especially within 10 days after onset. So

So far I found this interesting study https://www.ncbi.nlm.nih.gov/pubmed/23721928
Carbachol should be somewhat similar to Ipidacrine. I'm not sure. I didn't have much time to look into it thoroughly.

 

[coffee_girl]

I never use a hair dryer without my muffs on, they are obscenely loud, I hope your spike ends soon.

 

[Arseny]

It might be possible for you to be like that. Only time will tell. Meanwhile, you need to actually heal. Once that happens, perhaps you will discover that fewer loud sounds bother you, and perhaps it will end up being safe (although it is a risk).

Another thing to keep in mind is that when people relax like that, they might be one incident away from making their body uninhabitable (due to debilitating T). So just because you have some cool friends who drive at double the speed limit on the highway and seem to be doing just fine, doesn't mean that it is a good idea to be like them, as their lifestyle just might catch up to them. So even if you beat T, it might make sense to keep T in mind when deciding whether to take some medications (don't forget to check whether they are ototoxic), or whether to expose yourself to some noises. Some exposures provide so little benefit, and other exposures seem to have such a high probability of backfiring, that it makes sense to say "no" to those exposures. But you won't realize it, if you get back to your normal life and try to forget the time when you were tormented by T.

If you are on busy streets where motorcycles and trucks accelerate (and not in a seemingly quiet park), then it sounds like a good thing to do.

I still do. In the past, my ears were a mess, and I believe that this policy had contributed to my healing. This summer, I tried not wearing any protection for several hours, and I actually got a spike. However, normally my drives are short, and I am not really sure whether I still need to wear earplugs when I drive. I do it because there is an upside (protection in case the airbag goes off, or an emergency vehicle with a siren drives by, etc), and not much of a downside that I am aware of. Another think about is car doors being slammed. My earplugs help when I close the door of my car. Whenever I have passengers in my car, I either wait for them to get in and close their car door before getting in myself, or I ask them to be as gentle as possible when closing their car door.

Anything as loud as a vacuum cleaner might not be safe. No matter how hard one tries to protect oneself, one is bound to get exposed multiple times, by accident (slamming metal doors, fire alarms, sirens, etc.) This is why it is so important to make the right choice when it is up to you whether to get exposed to noise.

Temporary spikes can last for over three months.

Sounds like hyperacusis. It reminds me of what has happened to @Lex
https://www.tinnitustalk.com/thread...ce-onset-almost-a-year-ago.22718/#post-261301
Please read all of her posts in that thread. She has improved, but it took a very long time, and she is still not completely over it...

Thank you very much for such an informative reply, Bill. I'm going to follow your advice. I'm going to try to give myself a month of silence after I finish HBOT this week. Not going to leave my apartment unless it's absolutely necessary.
I've read through the thread you've mentioned. I also read these studies before.
Yes it seems that I have hyperacusis. In fact it seems that I had it pretty bad after my MRI spike I just didn't know what it was. It faded down to zero last week. And it seems that my hyperacusis manifests itself in some kind of neuropathic pain/burning sensation that goes from my ear to various parts of my head. I also have a headache. Very similar to @Lex
Now I'm reactive even to quiet noises like someone turning on the water behind the wall. SMS notification causes burning/pain near my temples. I had this before in November. Just didn't know what it was.
ENT said that if my spike doesn't go down by tomorrow I should start steroids. Going to bed now we'll see how it goes.

A message to @Red and @Contrast
From my experience I can definitely tell the "reactive tinnitus" and hyperacusis are linked together.
When my tinnitus spiked dramatically after an MRI I had "reactive tinnitus to sounds louder that 60-65 db. It manifested itself in ~450 hz loud tone. It was rarely audible unless I put on my earmuffs, because it masks very easily with natural sounds. Early after an MRI this tone it was loud, very reactive and I was getting piercing electrical feeling in my head even when I was laying in my bed in total silence and some behind the wall would turn on the water (less than 35-40 db).
It gradually got better (steroids+HBOT+time), even after a setback (15 min of unprotected train ride 85-88 db) it still got better. A week after that train ride I was still reactive to some sounds. A tone in my phone (when you dial somebody) on the speaker would give me immediate electrocution to my head not far from the ears. It also might be related to Acoustic Shock Syndrome. It seems that I've got it after this 15 minute MRI.

2 days ago I was feeling much better and I tested 70 db music for 2 minutes and then immediately put my earmuffs on and I got no tone. I also didn't feel any hyperacusis symptoms.

Today after this new 100 db exposure I was at the clinic lobby (50-55 db) and I got this burning ear sensation again. When I put on my earmuffs I got I immediately heard a 554 hz loud tone. It was extremely loud to the point it completely covered my severe 15000 hz hissing tinnitus. I just didn't hear it without earmuffs, because there were a lot of low frequency sound around me.

So at least for me there's an undeniable link between "reactive tinnitus" and hyperacusis.

 

[Arseny]

Getting back to protection, I do not wear anything in the car, but I have a newer, quieter car, and just keep the windows rolled up, and cover my ears for the occasional siren that I can hear from farther off.

On the other hand, I dont dry my hair, and use protection when another family member has it on at the house. I also protect for the electric razor, the vacuum, and when outside near a somewhat busy road with lots of larger trucks and some motorcycles. I do not use plugs at work, nor when going to a supermarket, except for the one that I walk to, and just leave them in for the walk back home.

Over time, you kind of learn what not to do the hard way when the respites come, which is more than powerful negative reinforcement to change behavior. For the first few months, my rule of thumb is to wear my ear plugs if I am not sure of the noise exposure, but not have them in 24/7.

If you don't mind me asking how loud is your tinnitus? Mild/moderate/severe? What's your MML (minimum masking level)? How did you get your tinnitus? Any improvements? Do you have "reactive tinnitus"?

 

[Digital Doc]

If you don't mind me asking how loud is your tinnitus? Mild/moderate/severe? What's your MML (minimum masking level)? How did you get your tinnitus? Any improvements? Do you have "reactive tinnitus"?

I would say my tinnitus is mild by the other associated symptoms, and am guessing it is lower pitched at about 4k or so, and around 65 db. I also have some hyperacusis on bad days, and yes to reactive tinnitus as I respike pretty easily, like last week when my alarm clock went off right in my ear. I was much worse originally with TTS, and unable to sleep for days due to the constant noise.

Tinnitus is noise induced from unprotected use of lawn equipment- lawn mower, weed whacker and leaf blower. Funny thing is I used the same equipment for many years, and then all of a sudden it got me into this mess at the end of summer when I bought a new weed whacker that was just a little louder than the one it replaced, ironically with exact same size engine of 23 cc. Not for nothing, but manufacturers should be required to put a db rating sticker on their equipment to give consumers a clue of how dangerous their devices are!

I am just frustrated as every time starts to get better, there is a setback that starts the whole cycle again I have realized that I am just one loud noise away from total misery again, and the incident with the clock last week proved that to me once again, not that I was trying to experiment at all.

 

[Arseny]

Consulted with ENT and decided to go for a course of Dexamethasone after ~48 hours of exposure. Doctor doesn't think that I've done any damage, but said that's it's reasonable considering my situation.
Injected 8 mg today, didn't risk with 12 mg, because my bp was 130/80.
Got my ear injections today. They are actually injecting 40 mg of Lidocaine into each ear. I don't think it lowers tinnitus at all. Maybe one of the tones got a bit milder, but it might be from Ipidacrine or HBOT.

Started experiencing some aural fullness in my right ear this afternoon. I had this after my train incident 2 weeks ago. It went away a week later with HBOT.
The Morse code like tone in my right ear reappeared. (I got it initially after this train ride)
In silence it feels like my right ear has louder tinnitus. And my audiogram on my right ear is perfect at 5 db bone conduction and 10 db air conduction up to 16000 hz. I suspect this hissing might be coming from cochlear synaptopathy.

@Bill Bauer

 

[Bill Bauer]

In silence it feels like my right ear has louder tinnitus.

I don't know much about any of those treatments (except HBOT). There is a lot of natural fluctuation. It is difficult to tell whether some change is due to the treatment you are having or due to this random fluctuation. I learned to ignore these day-to-day fluctuations. However, if it keeps getting worse after every one of those treatments, then I would consider pausing the treatment...

 

[Digital Doc]

Quite brave to let them inject you ear. Can't say I would sign up for that one! Hope it helps.

 

[Michael Leigh]

I'm sorry if this is ridiculous. I'm very scared and paranoid.

The clue to why you are feeling this way is in the first line of your post above. I know it isn't easy when new to tinnitus, but if you try to stop worrying over tinnitus and hyperacusis. Stop using sound level meters because this reinforces the belief that you have a problem with your auditory system and induces more stress and paranoia and will make tinnitus and hyperacusis more intrusive - you will begin to feel a lot better.

Reactive tinnitus and hyperacusis are the exact same thing: Hyperacusis. Try diverting your attention to other things and stop focusing on tinnitus, spikes and hyperacusis and you will improve believe me.

Michael

 

[Bill Bauer]

this reinforces the belief that you have a problem with your auditory system

??? He HAS a problem with his auditory system!

Stop using sound level meters ... - you will begin to feel a lot better.

"You can ignore reality, but you won't be able to ignore the consequences of you ignoring reality." Ayn Rand

 

[Michael Leigh]

??? He HAS a problem with his auditory system!

Indeed, he does at this moment but I am confident in time his situation will improve. It will not be helped by constantly worrying as this will only exacerbate the problem. Stress makes tinnitus worse and tinnitus make stress worse, especially when a person is new to the condition. By following my advice improvement is assured as it does in so many cases with tinnitus and hyperacusis. Tinnitus is 90% mental. If negative thinking is allowed to take hold it can seriously hinder or completely halt the habituation process.

That is my reality, based on many years experience with tinnitus and hyperacusis - corresponding and counselling people with these conditions.

I will not be commenting further on this topic.

Michael

 

[Digital Doc]

Indeed, he does at this moment but I am confident in time his situation will improve. It will not be helped by constantly worrying as this will only exacerbate the problem. Stress makes tinnitus worse and tinnitus make stress worse, especially when a person is new to the condition. By following my advice improvement is assured as it does in so many cases with tinnitus and hyperacusis. Tinnitus is 90% mental. If negative thinking is allowed to take hold it can seriously hinder or completely halt the habituation process.

That is my reality, based on many years experience with tinnitus and hyperacusis - corresponding and counselling people with these conditions.

I will not be commenting further on this topic.

Michael

Tinnitus is a symptom, not a disease. The mistake is to lump all the causes together, and then make such overall statements.

For stress induced tinnitus, then it will indeed be all mental, and counseling should be of great benefit.

On the other hand, if it is drug induced tinnitus from ototoxicity, then the effort should be directed to finding the offending agent, and eliminating it. If this is not done, then no amount of counseling will get this better.

Similarly, for noise induced tinnitus, the emphasis needs to be on protection from noise triggers that make it worse, and potentate it.

I infer from your post that you are a counselor, and respect your experience with counseling those with the stress that inevitably develops with such a life altering symptom that T and H can be.

However, before you decide that it is mostly a mental problem, let's not lump all the causes of T together, and focus on identifying the underlying cause, and then applying a directed fix the problem, and avoid painting with such broad strokes.

Not everyone with T needs counseling, but they do need some honest answers and advice, which the medical profession is sorely lacking IMHO.

 

[Michael Leigh]

@Digital Doc

I have had tinnitus it since 1996, and like you it was caused by noise exposure. Whilst I am not a qualified counsellor as such, I believe my experience with tinnitus and hyperacusis, spanning over 20 years more than qualifies me to have sufficient knowledge of "noise induced tinnitus" Thus, this has enabled me to counsel and advise people by telephone, email and at Tinnitus forums.

To counsel someone with tinnitus and be of help to them, I believe one has to have the condition otherwise they cannot know anything about it. Many things can cause this condition and for this reason, I mostly advise people that acquired it by "exposure to loud noise" .

I have written many articles on tinnitus that are available to read on my "started threads". Some people have found Tinnitus, A Personal View, of interest: https://www.tinnitustalk.com/threads/tinnitus-a-personal-view.18668/

Whether the tinnitus is a result of noise trauma, an underlying medical problem within the auditory system, TMJ or drug induced, the tinnitus signal is generated and lives in the part of the brain known as the limbic system. It s this part of the brain that controls our emotions: love, hate, fear etc. They are intrinsically linked to the tinnitus and therefore affected by it. Stress makes tinnitus worse and tinnitus makes stress worse, so it can become a vicious circle if stressed is not managed. There are various ways this can be addressed. Please see the post below.

I agree that the underlying problem causing the tinnitus must be addressed but in the case of "noise induced" tinnitus, particularly when someone is having difficulty with habituation, counselling with a Hearing Therapist or Audiologist trained in the treatment and management of tinnitus can be quite effective. Coupled with sound therapy in the form of white noise generators to treat hyperacusis for example and medication where necessary: Anti-depressant and other types of drugs can help a person having difficulty with tinnitus management immensely.

Can tinnitus counselling help?

There are various kinds of treatments and coping methods for tinnitus that fit into four main categories: Sound therapy, medication, counselling and relaxation techniques. Most people are familiar with sound therapy. It has proven to be helpful relatively inexpensive and can easily be implemented. Medication such as clonazepam is known to help some people and will reduce the tinnitus to a low level or suppress it completely. Not always advisable to be taken long term due to dependency and unpleasant side effects that may result when taken in large dosages. Relaxation techniques including mindfulness based cognitive therapy (MBCT) can be beneficial and is often group based.

I believe tinnitus counselling with or without sound therapy to be the best treatment in helping a person habituate. Whether they are a newbie or someone that has been seasoned to tinnitus for a while and noticed a resurgence in the condition for one reason or another. Some people are apprehensive about counselling and question its efficacy due to the fact we are all different. I have had counselling twice as part of TRT and found it helpful on both occasions. People have contacted me over the years saying they found it beneficial and helped put them on the road to habituation and were thankful having tried it.

It all depends what one expects from this kind of treatment and whether they will be able to find a suitable clinic that practices it. Perhaps more of a deciding factor and importance to some is the financial outlay. This treatment is not cheap and prices vary considerably especially when incorporated into TRT or CBT. Can it be justified when there is no guarantee of the level of success if any? That is something each person will have to decided for themselves, because it is too complex a question for me to answer.

I will say having had this condition for many years, that tinnitus is an integral part of our mental health and cannot be separate from it, because it has a direct impact on our emotions. The more stressed we become the more intrusive it will be. Anything that helps us to relax will usually have a positive impact on the tinnitus and make it more tolerable and less intrusive. Counselling with a Hearing Therapist or Audiologist trained in the management of tinnitus can be of immense help and should be considered especially if a person is having difficulty coping and is already taking an antidepressant or similar medication.

People have asked me how can counselling lower the tinnitus? Again, we are all different, but I advise anyone with this thinking to try and not be too negative. Of course be prudent and ask questions but approach it with an open mind as it can be all to easy to convince themselves that it won't work, so you could be setting yourself up for failure before you have even begun. A therapist works with a patient is a specific way. First discussing how the tinnitus makes them feel and how it has impacted on their life. Often people say they have lost interest in the things they once liked doing, which is understandable. Those they are close to particularly loved one's don't understand what they are going through which can put a lot of to strain on a relationship.

Through talk therapy a person learns to look at life differently and with a more positive outlook. Over time the negative thinking that is often associated with tinnitus is gradually dispelled and demystified. The therapist does this in a controlled and precise manner so that the patient feels relaxed and not pressured. In many instances the tinnitus is gradually pushed further into the background making it less prominent.

I believe this is best done with a Hearing Therapist or Audiologist who has been trained in the management of tinnitus. Often these people have tinnitus or experienced it at some time in their life. Therefore, they will have a depth of understanding and be able to empathize with a patient rather than someone who is just a counsellor and having no experience with this condition.

Michael

 

[Arseny]

The clue to why you are feeling this way is in the first line of your post above. I know it isn't easy when new to tinnitus, but if you try to stop worrying over tinnitus and hyperacusis. Stop using sound level meters because this reinforces the belief that you have a problem with your auditory system and induces more stress and paranoia and will make tinnitus and hyperacusis more intrusive - you will begin to feel a lot better.

Reactive tinnitus and hyperacusis are the exact same thing: Hyperacusis. Try diverting your attention to other things and stop focusing on tinnitus, spikes and hyperacusis and you will improve believe me.

Michael

Michael, I don't want to offend you, but your advice is flat out dangerous. It might work for people who don't experience spikes at all, but for most of people with tinnitus it will just lead to worsening of their condition and will prevent natural improvement and healing.

When my tinnitus started I asked my friends and relatives about it. They also said "just don't stress about it and don't go to concerts". And I listened to them, didn't change my lifestyle, decided to just ignore it. And do you want to know where it led me? Mild tinnitus increased to severe DEBILITATING tinnitus in less than 1.5 months.
And by debilitating I mean D E B I L I T A T I N G. I couldn't sleep or eat at all, lost 11 pounds in less than a week. Couldn't function at all. And it wasn't because I'm weak or anything like that. I've lived through a lot of tough situations. Almost got killed several times, developed PTSD and panic attacks after near death experience (they are almost gone now, 80-90% cured.)
My tinnitus in November was extremely severe I was contemplating suicide every day for more than a month. I was obsessing over s*icide and had multiple s*icidal ideations each day. I wanted just to jump out of the window after each spike of tinnitus during the day. I had to be monitored 24/7 for more than a month so that I just don't k*ll myself.

I got mild tinnitus at first from ETD/problems with neck blood flow to the brain/Cipro IV/accumulated noise exposure from using headphones to play video games, no music.
Listened to people and ENTs about it, followed their advice about just "not stressing about it"
Tinnitus worsened from mild (only audible in silent rooms) to moderate in 2 weeks. I didn't stop using my motorcycle and didn't stop playing games using headphones (under 80 db). Just took some nose spray to treat suspected ETD.

Then I got really worried, started doing multiple checkups that revealed a lot of additional problems with my neck and brain blood flow, got rushed in for an MRI. This could have waited at least 1 or 2 weeks, but ENTs and cardiologists were very insistent. They told me a lot of scary stuff about tumors, high intracranial blood pressure and other scary stuff that I don't even want to remember.
Result?
15 minutes of under 99 db noise with 3M 1100 foam earplugs and 18 db earmuffs. Tinnitus raised from moderate to severe. Developed TTTS, Acoustic Shock Syndrome, some weird form of hyperacusis and constant debilitating migraines. And now it seems that I might have speech in noise issues (hidden hearing loss) despite perfect audiogram on my right ear. My left ear recovered a lot. OAE and DPOAE show that my hair cells are present and not damaged.

I had no improvements until I started steroids and HBOT. Then slowly got better.
Took a 15 minute train ride (85-88 db) after forgetting my earmuffs at the clinic. The noise was definitely not very loud and apparently safe for everybody else. Got another spike, TTTS worsened along with low pitch tinnitus, developed hissing and a new tone in my right ear (perfect audiogram up to 16000 hz)
New course of steroids and HBOT, got better.

And now this. 1 minute or less of ~100 db exposure. Another spike, migraines came back full force, ASD worsened significantly. Now I'm on steroids again along with HBOT.

Yesterday I was grocery with my sister. I lifted one of my ear muffs to hear what she was saying and guess what? Immediately got blasted with a burglar alarm.

No Michael, from now on it's going to be earplugs and earmuffs all day everyday. Not going to trust anybody how tells me to "stop worrying about my tinnitus" and any "safe" environments like that quiet hair salon.

I'm sorry, but "tinnitus is 90% mental is pure BS. I know what habituation is and I have habituated to few of my tones, however it's IMPOSSIBLE to habituate to this level of high pitch intrusive tinnitus. Like @Bam says "This is my poison. If I had to explain it someone I would say it's the sound of s*icide."

Antianxiety medication, CBT, TRT is all BS when you have this level of noise in your head. Yeah I've tried some meds. Yes I feel calm. It doesn't lower the volume and it doesn't lower my suffering. I'm way past "fight or flight".
I actually practiced mindfulness mediation way before tinnitus onset, but it barely helps now.

I got better now, even after these setbacks, but now migraines are so bad I feel like I have a high pitch drill pushing into my left side of the brain. Painkillers don't work at all. They are so bad I don't even care about tinnitus anymore. This combination of tinnitus and headaches is absolutely merciless. Non stop 24/7 severe migraine.

For anyone who reads this post, USE EARPLUGS AND EARMUFFS RELIGIOUSLY IF YOU RECENTLY GOT TINNITUS AND DON'T F*CK*NG LISTEN TO ANYBODY WHO TELLS YOU TO "JUST STOP STRESSING ABOUT IT AND LIVE A NORMAL LIFE"

@Bill Bauer @Digital Doc

 

[Michael Leigh]

Michael, I don't want to offend you, but your advice is flat out dangerous. It might work for people who don't experience spikes at all, but for most of people with tinnitus it will just lead to worsening of their condition and will prevent natural improvement and healing.

@Arseny

I am not offended that you find my advice dangerous just appalled with the way you have chosen to respond to me when I was trying to help you. You have had tinnitus for 5mins and I have had it for over 20 years and helped many people throughout this time.

I have nothing against anyone not wishing to follow my advice or disagreeing with what I have to say, because one cannot please everyone. Your clear lack of respect and use of bad language towards me, shows the type of person that you are and I have no wish to correspond with such an individual. My only regret is that I wish I had known about this sooner, then I would have given you a wide berth like some other people in this forum.

Carry on using earmuffs and earplugs religiously and you will get everything that is coming to you.

Michael

 

[Digital Doc]

Michael, I don't want to offend you, but your advice is flat out dangerous. It might work for people who don't experience spikes at all, but for most of people with tinnitus it will just lead to worsening of their condition and will prevent natural improvement and healing.

When my tinnitus started I asked my friends and relatives about it. They also said "just don't stress about it and don't go to concerts". And I listened to them, didn't change my lifestyle, decided to just ignore it. And do you want to know where it led me? Mild tinnitus increased to severe DEBILITATING tinnitus in less than 1.5 months.
And by debilitating I mean D E B I L I T A T I N G. I couldn't sleep or eat at all, lost 11 pounds in less than a week. Couldn't function at all. And it wasn't because I'm weak or anything like that. I've lived through a lot of tough situations. Almost got killed several times, developed PTSD and panic attacks after near death experience (they are almost gone now, 80-90% cured.)
My tinnitus in November was extremely severe I was contemplating suicide every day for more than a month. I was obsessing over s*icide and had multiple s*icidal ideations each day. I wanted just to jump out of the window after each spike of tinnitus during the day. I had to be monitored 24/7 for more than a month so that I just don't k*ll myself.

I got mild tinnitus at first from ETD/problems with neck blood flow to the brain/Cipro IV/accumulated noise exposure from using headphones to play video games, no music.
Listened to people and ENTs about it, followed their advice about just "not stressing about it"
Tinnitus worsened from mild (only audible in silent rooms) to moderate in 2 weeks. I didn't stop using my motorcycle and didn't stop playing games using headphones (under 80 db). Just took some nose spray to treat suspected ETD.

Then I got really worried, started doing multiple checkups that revealed a lot of additional problems with my neck and brain blood flow, got rushed in for an MRI. This could have waited at least 1 or 2 weeks, but ENTs and cardiologists were very insistent. They told me a lot of scary stuff about tumors, high intracranial blood pressure and other scary stuff that I don't even want to remember.
Result?
15 minutes of under 99 db noise with 3M 1100 foam earplugs and 18 db earmuffs. Tinnitus raised from moderate to severe. Developed TTTS, Acoustic Shock Syndrome, some weird form of hyperacusis and constant debilitating migraines. And now it seems that I might have speech in noise issues (hidden hearing loss) despite perfect audiogram on my right ear. My left ear recovered a lot. OAE and DPOAE show that my hair cells are present and not damaged.

I had no improvements until I started steroids and HBOT. Then slowly got better.
Took a 15 minute train ride (85-88 db) after forgetting my earmuffs at the clinic. The noise was definitely not very loud and apparently safe for everybody else. Got another spike, TTTS worsened along with low pitch tinnitus, developed hissing and a new tone in my right ear (perfect audiogram up to 16000 hz)
New course of steroids and HBOT, got better.

And now this. 1 minute or less of ~100 db exposure. Another spike, migraines came back full force, ASD worsened significantly. Now I'm on steroids again along with HBOT.

Yesterday I was grocery with my sister. I lifted one of my ear muffs to hear what she was saying and guess what? Immediately got blasted with a burglar alarm.

No Michael, from now on it's going to be earplugs and earmuffs all day everyday. Not going to trust anybody how tells me to "stop worrying about my tinnitus" and any "safe" environments like that quiet hair salon.

I'm sorry, but "tinnitus is 90% mental is pure BS. I know what habituation is and I have habituated to few of my tones, however it's IMPOSSIBLE to habituate to this level of high pitch intrusive tinnitus. Like @Bam says "This is my poison. If I had to explain it someone I would say it's the sound of s*icide."

Antianxiety medication, CBT, TRT is all BS when you have this level of noise in your head. Yeah I've tried some meds. Yes I feel calm. It doesn't lower the volume and it doesn't lower my suffering. I'm way past "fight or flight".
I actually practiced mindfulness mediation way before tinnitus onset, but it barely helps now.

I got better now, even after these setbacks, but now migraines are so bad I feel like I have a high pitch drill pushing into my left side of the brain. Painkillers don't work at all. They are so bad I don't even care about tinnitus anymore. This combination of tinnitus and headaches is absolutely merciless. Non stop 24/7 severe migraine.

For anyone who reads this post, USE EARPLUGS AND EARMUFFS RELIGIOUSLY IF YOU RECENTLY GOT TINNITUS AND DON'T F*CK*NG LISTEN TO ANYBODY WHO TELLS YOU TO "JUST STOP STRESSING ABOUT IT AND LIVE A NORMAL LIFE"

@Bill Bauer @Digital Doc

Makes sense why the hair dryer caused such a problem for you, and was cringing when I read the full story above and relized that you got stuffed into an MRI tube that was the last thing you needed at that point. I have not had one personally, but am quite familiar with the sound of them that I liken to a hyped up monkey banging a hammer.

You need to protect from any additional damage, and you can best decide when or if to back off from it. I would settle in as this could be quite a prolonged process, but if you do your best to avoid further insults, there should be improvement down the road. I really hope it comes soon for you.

 

[Bill Bauer]

Your clear lack of respect and use of bad language towards me, shows the type of person that you are

Put yourself into his shoes. He followed certain advice, and ended up with debilitating T. Then he sees you giving that same advice. Can you blame him?!