Tinnitus Spike and New Pulsing Tone After Contrast MRI

Hi Everyone,

Long time lurker, but first time poster, I have lived with tinnitus for probably fifteen years give or take (now 40), undoubtedly caused by too much loud noise from the car stereo, iPod and concerts. I'd coped pretty well until about 34-35 and noticed a sudden deterioration in my hearing accompanied by prolonged episodes of horrible aural fullness. Long story short, I was referred to an ENT and to my sadness I had hearing loss in both ears - the usual notches down to 25-30 dB at 4000 & 8000 Hz and a strange cookie bite loss at 1000 Hz in one ear all the way down to 40 dB. The ENT consultant suggested a possible diagnosis of endolymphatic hydrops due to loss of hearing and ear fullness but I wasn't convinced.

The following five years were an up and down affair, feeling depressed about struggling with hearing (I work in education so not very conducive) and during periods of prolonged fullness, my tinnitus would get extremely bad.

Fast forward to age 39-40, I'd learned to manage it pretty well, fullness had subsided and was only brought on by loud sounds, and my tinnitus was probably in one of the best places it had been for years.

All of this was completely undone by an MRI (for another health issues) three weeks ago, it was an MRI with contrast, I've had many MRIs over the years without issue and previously I had taken my own custom earplugs to go under the earmuffs. On this occasion, probably through complacency, I just didn't think to take them.

Anyway, long story short, it was awful, 5-10 minutes in I became really anxious with the loudness of the sound and in hindsight should have asked to stop. I felt the earmuffs provided weren't blocking the sound adequately enough and I had thrown away hygienic cloths over each muff that to me didn't allow the ear to be sealed in the muff itself. Through sheer anxiety I tried pressing my head into one side of the muff more to try to at least get a bit more protection to one ear, in hindsight this may have been a bad move.

I came away feeling very upset as no one had said it was with contrast and that added to the loud noise was a double whammy. I felt rough for a couple of days and had several days of ear fullness in my left ear. My tinnitus in general has spiked but the worst part is how significantly it has spiked in my left ear, not just spiked but I seem to have now acquired an 'on/off' higher pitched tone that keeps blasting on top of my normal tone every other second, this is the most insufferable part and really making me severely anxious, on edge and depressed.

I know from reading many a post like this it is a wait and see approach but just looking for maybe a little support and what many of the experienced forum members would do in this position.

• I did take a few days of mixed anti-oxidants to try and allay any damage as per studies but this clearly hasn't worked
• I booked an appointment with my GP and asked him to take a look down the ear canal to see if there was any fluid causing it, he said it looked fine apart from maybe a little bit of inward pressure on the eardrum
• He said a hearing aid may help and I have been sent to an audiologist for an updated hearing test regarding this and the idea of a hearing aid was the last thing I expected
• I've tried play notched sounds off Tinnitus HQ app which I have used on and off in the past of a bed time - isn't really helping although I know it needs to be done for months

• I don't feel like I have lost any hearing further to what I have already
• I don't feel like I am sensitive to loud sounds from this experience
• I have attached my audiogram from 2019 for those interested

If anyone could offer advice what best to do, how likely this will revert to baseline given it's almost four weeks since the incident and just any words of reassurance or support, I would be immensely grateful.

 

Hi @Cmspgran.

I am sorry to hear about the increase in your tinnitus. It is possible for it to return to baseline with time, so try not to worry too much. I suggest that you don't listen to audio through any type of headphones even at low volume. This includes earbuds, AirPods, headsets, bone conduction and noise-cancelling headphones, as you risk making the tinnitus worse. I advise you not to listen to your tinnitus app through any of the devices I have mentioned. You can listen to music through speakers but keep the volume low.

If your audiologist advises that you need hearing aids, then I think you should wear them. Hearing loss can make a person that already has tinnitus worse, or bring on the onset of tinnitus in a person that develops hearing loss. The reason being, the brain has to increase its internal gain (rather like a volume control) to hear sounds in the outside environment. Unfortunately, in the process the brain will increase the tinnitus. Once hearing aid(s) are worn, they will restore the hearing to optimum. This results in the brain no longer having to struggle to hear outside sounds and therefore, will lower its internal gain and thus the tinnitus will reduce too.

Please go to my started threads and read the following posts: The Habituation Process, How to Habituate to Tinnitus, Can I Habituate to Variable Tinnitus? New to Tinnitus, What to Do?

Start using low level sound enrichment during the day and especially at night, using a sound machine by your bedside. Keep the volume low. The idea is not to try and mask the tinnitus. More information about sound enrichment are in my posts.

All the best,
Michael

 

Thank you so much for taking the time to reply to me Michael, I really appreciate it. Thanks for the advice, I've read many a post of yours and as per your advice, I've started printing you many topics to read through for habituation and many other useful things.

Is there any 'scientific' reason you're aware of for the additional pulsing tone I seem to have acquired in the left ear? Is it just further damage or shock to the auditory system after the 30 minutes of loud noise after basically being away from loud noise for almost two years plus.

Unfortunately I have been continuing to use my AirPods which I'd used previously with no negative affects at all, in fact as I'd mentioned my tinnitus was in the best place it had been in years prior to this incident. However, I will absolutely follow your advice in the weeks and months to come to see if I can get this pulsing effect tone to go away. Single tone tinnitus I've been used to a long time and even during spikes I could cope, it's this unbearable on/off additional tone that is impossible to deal with.

 

You are welcome @Cmspgran.

I am pleased that you have decided to print my posts as they are a form of counselling. By taking your time to read them, you will absorb and retain the information, especially if you refer to them often. This will start to have a positive impact on your mental and emotional wellbeing, as your thought process about tinnitus starts to become more positive and you will no longer see it as a threat. I cannot express enough how important this is, because habituating to tinnitus starts in the mind.

I don't know of a scientific reason for the pulsing tone that you are experiencing in your ear at present. Taking into account that you have had noise-induced tinnitus for quite a while, if you notice any changes in the tinnitus or get new tones, then I advise that you are seen by an ENT doctor. If an underlying medical condition within your auditory system is not found to be the cause of the changes you are experiencing, the usual cause is related to exposure to further loud noise that you may not have been aware of, or listening to audio through headphones, earbuds, headsets, noise-cancelling and bone conduction headphones.

You have mentioned that you have been listening to audio through AirPods with no negative effects. Indeed, this is can happen but please keep in mind, each time when a person with noise-induced tinnitus listens to audio through any type of headphones, even at low volume, they run the risk of making their tinnitus worse. If a person with this type of tinnitus uses headphones for up to 10 years without any ill effects, the risk of making their tinnitus worse is still always there. I have explained this in my thread: Can I Habituate to Variable Tinnitus?

Hopefully with time your tinnitus will return to baseline. I advise that you see your GP and ask to be referred to ENT for tests, then you are likely to be referred to Audiology. I think you will find benefit using sound enrichment, ideally in the form of wearing white noise generators. If you are referred to Audiology, I advise that you don't mention white noise generators to your audiologist, just accept whatever help the NHS can provide for you. Read my thread: Keeping Things Simple With Tinnitus.

All the best,
Michael

 

Thank you, @Michael Leigh, I shall always be grateful for you taking the time to reply.

I had a little bit of a better day yesterday and thought the pulsing tone had gone to a volume not near as noticeable. Typically it had returned today with a vengeance, I realise what’s done is done and need to move away from the self-blame of not taking my earplugs to the MRI scan to use as well as the earmuffs.

I am going to follow your advice and stay away from all headphones for now, continue to use notched sound enrichment and play it slightly below my tinnitus volume and even though I’m no longer religious, pray.

It’s remarkable what I’d give to return to my previous level of tinnitus and the fact that level would freak most non tinnitus sufferers out.

I’ll continue to read the forums and give my word that I’ll come back here and report on progress updates from time to time, reading such threads on this very forum have offered me a little comfort during this awful time.

 

Once again @Cmspgran, you are welcome. Please talk to your GP and ask to be referred to an ENT for tests. Hopefully, the ENT will refer you to Audiology as this is what I think you need.

Please print and read my posts. I suggest using an Oasis sound machine by your bedside that plays nature sounds. Keep the volume below the tinnitus and set to play throughout the night until morning.

Best of luck,
Michael

 

Hi again @Michael Leigh and anyone else willing to chime in. Just thought I'd post an update. Sadly it's not the update I wanted to post as the additional higher pitched on/off/pulsing tone I've acquired in my left ear is still very much with me.

However, I've made a unique observation that never applied to the standard tone tinnitus I've dealt with for many years: if I lie on the bed with head propped up by a pillow and lie still, the pulsing tone goes right down, almost borderline disappears. This may take 5-10 minutes of lying in a quiet room and staying as still as possible. I've noticed this is the case if I lie on my back or turn to the right, less so if I turn to the left.

As soon as I get up and start wandering around and talking, or I just start talking to someone in the room, shortly after the pulsing tinnitus returns. Same happens if I put the TV on at a regular volume, it's almost like movement and/or louder sounds trigger it off.

Is this suggestive of anything? My regular tinnitus never behaved like this and was always there, just some days louder, some days quieter.

Is this suggestive of hyperacusis/reactive tinnitus or something else?

Best wishes,
Paul

 

Hi @Cmspgran.

Noise-induced tinnitus can react in the ways you have described, when in bed and the head and neck are propped up against a pillow. The 8th cranial nerve (auditory nerve) is located at the base of the brain and neck. Moving in different positions can alter the perception of tinnitus for some people; I have experienced this, although it has improved over time.

Try not to keep analysing your tinnitus as this can cause worry and stress, which can lead to making the tinnitus more intense. This is the reason I have advised you to use low-level sound enrichment and avoid staying in a quiet room and surroundings.

Noise-induced tinnitus can react in this way, because your auditory system is hypersensitive at the moment. It needs to be desensitized so it becomes less reactive to sound. I do not believe there is a condition called reactive tinnitus, although some people do. From what you describe and in your previous posts, I believe you have hyperacusis. It can be treated in various ways, one of the best is using white noise generators for sound enrichment and if needed, having counselling with an audiologist as I mentioned in my previous post.

Please try to keep things simple with tinnitus and suggest that read my post: Keeping Things Simple With Tinnitus, again. I know I talk about this a lot and for good reason: The more one focuses on tinnitus by analysing every little change in it's perception, the more difficult they make it for themselves to habituate.

You may have significant hearing loss which will require you to wear hearing aid(s), your ENT and audiologist should be able to advise you on this. Coupled with the fact that you have noise-induced tinnitus, which I believe treatment with an audiologist will help. You have enough on your plate, so try not to add more stress by monitoring your tinnitus too much although I know it's not easy. This is the reason I advised you to print my posts and refer to them often, as they can help to reinforce positive thinking.

See your GP and ask to be referred to ENT and Audiology.

All the best,
Michael

 

Thank you @Michael Leigh, I have been following your advice. I have ditched the headphones and AirPods completely and I'm using sound enrichment as much as possible at a level that doesn't set off the reactive tinnitus/reactive hyperacusis.

I have gone for enriched sound that isn't notched as reading through previous posts of yours on Tinnitus Talk I'm sure I recall you recommending using non-notched sound for enrichment and throughout the habituation process.

Dare I say there has been a little improvement in the new sound and it is seemingly been a little less reactive on some days, I don't however, wish to tempt fate. I know it may be a long road back to baseline if I do eventually get there. I dream of posting a success story on this thread.

I cannot thank you enough for your advice, kindness and empathy that you give to strangers like me on a random board like this for free. I hope to one day offer someone with tinnitus the same reassurance and support if I can once again habituate.

 

Thank you for your kind words @Cmspgran.

I believe you will habituate but it will take time. You are doing the right thing by using low-level sound enrichment but be careful not to immerse yourself in sound, as a way of speeding up the habituation process, because you could become disappointed if expected improvements in your tinnitus and hyperacusis, are not realised in the timeframe that you want. Take things easy and try not to put pressure on yourself. If possible, start a new hobby or interest, anything to help take away your attention from focusing on the tinnitus too much.

All the best,
Michael

 

Well, a two month update to this thread and it’s not the update I wanted to make.

Getting toward the fourth month mark now and my tinnitus feels as bad as when it first started and some days are even worse. I have severe reactive tinnitus, a pulsing hiss that ramps up to voices, some days I can watch tv quiet without it ramping up, other days not.

Most the time I have to go lie on the bed in the quiet to get any relief. It is reactive in almost real time and can take minutes to take down once lying on the bed.

As a ‘standard’ tinnitus sufferer for almost 20 years, I now understand what it means to have catastrophic tinnitus as this has taken me to a pit of despair I didn’t think was possible.

Since my original posts, I have paid to see a private ENT as the wait on the NHS is so long. My hearing hasn’t changed on the audiogram at all since the one I posted earlier, tympanometry test was normal and the ENT stated the tinnitus will go away, but it may take up to 12 months. I’m not naive to realise he was probably saying that to make me feel better.

I’m working a new job which is mainly from home (thank god) and am barely clinging on.

I’m just reaching out to anyone to please comment and give some thoughts as to what can I expect, especially those who’ve had/have reactive tinnitus.

Sound enrichment through the night seems to be making the tinnitus worse, it latches onto it and wakes me up. Do I carry on with low level pink noise or not? There’s also a particular cricket sound on my sound app that blocks my tinnitus really well even at low volume, I’ve been turning to that get by.

If anyone has any thoughts whatsoever, I’d be grateful, whether it’s experience with reactive tinnitus, treatment options (i.e. sound therapy vs. quiet) or just any words of encouragement as I’m really really struggling right now...

 

I understand the difficulties that you are going through @Cmspgran but you really should have waited on the NHS instead of paying privately to see an ENT. Again, I understand your situation but the private ENT, in my opinion, will not be able to give you the treatment that you need. The reason being ENT doctors treat underlying medical conditions that cause tinnitus but they do not treat tinnitus or hyperacusis because these are not their area of expertise. Therefore, it's best to be seen under the NHS.

When you are seen by an NHS ENT, and tests are carried out on your auditory system, you will probably be referred to Audiology for treatment for your tinnitus and hyperacusis. I have covered the treatment that is necessary for tinnitus and hyperacusis in many of my threads which I believe you have read.

We are all different so please experiment using sound enrichment. I have said many times that the advice I give in my posts and threads is not absolute and, therefore, should be used as a guide. Two years ago, @Eleanor89 was having a tremendous amount of difficulty with her tinnitus and severe hyperacusis. She was unable to cope with wearing white noise generators as they made her oversensitivity to sound (hyperacusis) worse in the way you describe. @Eleanor89 followed my suggestions to start using a sound machine at night at very low level for 1 or 2 hours - the onboard timer enabled the sound machine to be switched off. Over time she gradually increased the listening time.

I advised @Eleanor89 to set the white noise generators to their lowest volume and wear them for just 5 or 10 minutes, then take them off to give the ears a rest and then wear them for another 5 to 10 minutes. Over the course of many months @Eleanor89 was able to wear the sound generators for most of the day and her hyperacusis made significant improvement to the point that she is able to get along with her life quite comfortably now.

Take care and I hope you start to feel better soon.

Michael

 

Hi @Michael Leigh, thanks for reaching out again.

Unfortunately the NHS Trust in my area offers no treatment for tinnitus, I was told this by a vestibular physio who works at the hospital I’ve been referred to. They basically tell you to go live with it and give some leaflets. I guess it just shows how bad the NHS has got since your experience.

I think I’m pretty much on my own with it. I shall try to experiment more with the sound enrichment.

 

I am sorry to hear that @Cmspgran. Treatment for tinnitus through the NHS does vary throughout the UK. If you are willing and able to travel, you have the right to be treated at any NHS hospital in the UK that is willing to accept you. If I were you, I would try and pursue this route.

I would like to pick up on your point about how bad the NHS has got. I still maintain it gives very good treatment free at point of delivery. My youngest brother recently passed away after being cared for in an NHS hospital for 7 months. The nurses and doctors were excellent in my opinion, but unfortunately my brother had too many health complications.

Take care,
Michael

 

I am sincerely sorry for the loss of your brother. The NHS medics and clinicians work incredibly hard and are amazing, they just have to work in a system that can no longer cope with the amount of people going through it.

I was originally told it would be a 6 month wait to see an ENT on the NHS and have now been told to expect 9 months or more. My case isn't seen as urgent, that's the problem.

 

Thank you for your kind words @Cmspgran. Thank you @Jupiterman.

The NHS has its problems. Unfortunately the media only talk about when things are not going right with it and seldom mention the treatment it provides to thousands of people 365 days of the year.

You said your vestibular physio told you there is no treatment for tinnitus at the NHS hospital that you have been referred to. You also say:

If I were in your situation, then I would make an appointment to see my GP. I would calmly say: Doctor, I am really struggling to cope each day with tinnitus and hyperacusis. I would mention what the vestibular physio told me and said that I am absolutely desperate for some help. Listen to what your doctor has to say. If your GP doesn't recommend referring you to another hospital that treats tinnitus, then I would progress to the next stage:

It is important to say the following words exactly as I am going to write them: "Doctor, I am willing to travel and would like to request a referral to another hospital that treats tinnitus". Listen again to your GP's reply. If your GP says that's it's not possible to get a referral to another hospital. Calmly say that you intend to write to your MP to see if it's possible something can be done for you to get some help. I don't think it will come to that, as your GP will realize that you're serious. It is very important to mention the words: "You would like to make a request to be referred to another hospital that treats tinnitus."

Best of luck,
Michael

 

Thank you @Michael Leigh. I’m going to pursue this advice. I need to do some research of best treatments for tinnitus in the North West of England.

 

You are welcome @Cmspgran.

I would like to offer you some further advice. I hope you don't mind. By all means do your research in finding a NHS Hospital that treats tinnitus patients, but do this discretely by perusing the hospital's website to see the services they provide - don't contact them directly because this is not the right thing to do. Furthermore, you must remember that you are the patient and your GP is the medical professional, your GP is the person that should make the necessary enquiries to make a referral for you to be seen at another NHS Hospital if needed.

The last thing you should do is tell your GP about other NHS Hospitals that provide tinnitus treatment, as this can come across as demanding and telling the doctor their job and consequently rubbing them up the wrong way. However, if your doctor ask your opinion if you have any hospitals in mind that you would like to be referred to, this is another matter.

Please read my thread: Keeping Things Simple with Tinnitus, where I explain this in detail. The right approach is to show some humility and more often than not, you go a lot further in getting the help that you need. This doesn't mean you should accept anyone in the medical field to belittle you or be condescending.

An audiologist tried that with me 27 years ago when I first got tinnitus and I reported her by writing a letter to the Head of Audiology. Fortunately I never saw this person again but later learned other tinnitus patients complained about her and she was dismissed by the Hospital Trust. The audiologist in question told me she never experienced tinnitus which was probably one of the reasons she had no empathy or understanding towards tinnitus patients.

Since then I have had very good treatment by my GP and the medical professionals at ENT and Audiology.

I wish you well,
Michael