Worsening High-Frequency Hearing After Acoustic Trauma

[Blue28]

Ok, so I sustained an acoustic trauma just over a year ago (feel free to read my Introduce Me post), and got tinnitus and hyperacusis and hearing loss in the days following the trauma. I had a hearing test and it revealed a steep notch in my hearing at 12khz in both ears (50-55db). My hearing in the lower frequencies was under 20 dbhl (it was 20dbhl in one ear and 5dbhl in other at 8khz).

I've had constant pressure in both my ears since the trauma and pain too. The hissing of my tinnitus is unreal, and it screaches all day long (and night). I'm taking NAC, magnesium, Vit B12, Ginkgo Biloba, Vit C, Zinc and a few other vitamines. I haven't exposed myself to loud noise, except the everyday unforseen noise from things where I haven't had my plugs in (daughter crying for instance), and now my recent audiogram. My new audiogram revealed a steeper notch at 12khz (now 65dbhl) and also worsening of high frequencies under 8khz (at 8khz one ear has gone from 5dbhl to 15dbhl and the other has gone from 20dbhl to 30dbhl). The other high frequencies have all decreased by around 10db too). Now, having had my hearing tested a few days ago I have more pressure and hissing, and I'm afraid that things will continue to go downhill fast. I've decided to take prednisone for several days to try to combat the effects of the hearing test.

I use ear plugs or muffs in loud environments (restaurants is as loud as it gets for me now), and when I use my vaccum cleaner etc. I'm really worried that due to the acoustic trauma my hearing will continue to deteriorate at an accelerated pace, I don't know what else I can do to stop this. The worry of the hearing loss accompanied by tinnitus, fullness, pressure and pain is taking over my life. I'm terrified.

 

[linearb]

The general consensus among audiological professionals is actually that existing damage does not predispose people to further damage. That is controversial on here, and lots of people disagree with that idea pretty violently for a number of reasons. However, the best we can really say based on the data is that in general people who suffer some loss following a single trauma, do not develop a progressively worsening problem right off the bat. On the other hand, it's inescapable that our hearing deteriorates with age, as do all of our senses and body systems.

That said -- it sounds like you're doing everything you can to protect yourself, and that your anxiety, fear of the future and resulting state of mind has as much to do with the misery you're experiencing now as the actual hearing loss you have right now.

You can't actually do anything about your hearing loss: you had the trauma, you hurt your ears, that's done.

Nerve related issues can show recovery over a timeframe where muscular issues just don't; rule of thumb is something like 7 years. I have a sibling who completely blasted their ears at a metal concert and had unilateral near-deafness for over a year. He did eventually recover a lot of the hearing he'd "lost" (and the crazy SOB still won't wear earplugs at shows, but that's another story).

I read your introduction; it's worth noting that high-frequency hearing is pretty tricky to accurately assess, and since this is generally not tested, it's also difficult to say to what extent the damage noted at those frequencies even relates to the suctioning you had done. But, again, that's water under the bridge now.

I'm not a doctor or a counselor, but pragmatically it seems like the best thing you can do is everything in your power to reduce your anxiety level and try to get yourself out of fight-or-flight mode. Is it correct to assume you're spending most of your waking time thinking about this, worrying about it and probably not sleeping very well as a result? The best thing you can do for yourself is probably to focus on good sleep, good diet, and stress reduction practices. I'm a big fan of meditation, yoga and chi kung -- but everyone has to find their own path, none of these things are magical or one-size-fits-all.

Do you have a good support network in the real world? You've probably got a bit of an uphill battle in front of you; as always the best mantra is "if you're going through hell, keep going".

 

[Tom Cnyc]

I'd doubt that ears damage more quickly after a single event. What is likely however, is that as you lose a bit of hearing when you dont have much left - its scarier and causes a harsher psychological response. A good analogy is how your dog doesn't panic when you dont give him the first bite of your food - but when you only have 3-4 bites left they're staring pretty intently at you waiting for their taste.

 

[Blue28]

Thank you @linearb for your encouraging response. You are right, I constantly think of my hearing issues, cant help it as it's all very disabling.

It was definately the suction that caused the damage, tinnitus came on within 24 hours but I had a fullness in my ears straight after the procedure (wish I'd know then what I know now). The procedure was seriously loud, I just didn't expect that a ENT procedure could cause damage. I've since read a study on the internet that states the suction can reach 147db at peak level! I know it was over 120db as I had physical pain during the procedure, but I didn't realise what it was. The hearing loss was abrupt, within several days I could no longer hear birds tweeting in the early hours of the morning, and the cars going past my house sounded like they were miles away. They used to sound like they were driving through my room. Also my HD TV stopped sounding good, it was like turning the radio from FM to MW :-( I have to concentrate now to hear quiet sounds in my home, that were so obvious before the trauma. So I know it was definately the microsuction that did the damage. I cannot stress enough that people should be careful when chosing this method of wax removal. Or maybe I was just really unlucky with the ENT?

On a positive note, the sun was shining today so I took my 2 year old daughter out on the bike this afternoon. A nice cycle ride in the country helped take my mind off things for an hour or so.

 

[Blue28]

Things just keep going from bad to worse, I don't know what to do anymore.

After being submitted to the hearing test, my tinnitus seemed louder and my hearing worse. Now earlier this evening I was playing with my toddler when she squealed loudly, not near my ear but in the same room, and the noise went right through me. After this I had a high pitched fleeting tinnitus noise in my ear and now, a few hours after, I have another high pitched whine to cope with. There's also pain in my ear. I've taken some steroids, as I'm afraid that this new tone will be permanent. I will take them for the next few days. I only have enough to do 3-4 days though, I hope this will be enough.

I now feel like my hearing is so damaged that any loud noise is going to make matters worse. I can't even live a semi-normal life (as normal as it gets with T, H &HL), even playing with my child is almost impossible. I feel like I have to wear plugs at all times, just in case.

How do I cope?

 

[TuneOut]

[...]
Nerve related issues can show recovery over a timeframe where muscular issues just don't; rule of thumb is something like 7 years. I have a sibling who completely blasted their ears at a metal concert and had unilateral near-deafness for over a year. He did eventually recover a lot of the hearing he'd "lost" (and the crazy SOB still won't wear earplugs at shows, but that's another story).

I hope that you can somehow get through to your brother, someway that you can make him understand the risks.

 

[Alue]

The general consensus among audiological professionals is actually that existing damage does not predispose people to further damage.

I have not heard that, and I've asked a handful of audiologists and neurotologists. The answer I most often get is "I don't know, there haven't been any studies on that." I'm just wondering where this general consensus is coming from.

 

[Bill Bauer]

I feel like I have to wear plugs at all times, just in case.

I would do that, if I were you. It is not a big deal. You can hear people talk when you were earplugs. You will get used to it. At the same time, make sure you don't wear them 24/7. I tried that, and I got an irritation on my eardrum.

 

[Bill Bauer]

I use ear plugs or muffs ... when I use my vaccum cleaner etc.

Consider asking your husband to vacuum. I find my vacuum still sounds loud, even when I wear my Peltor muffs.

 

[Greg Sacramento]

Blue, I had a loud syringing / ear cleaning with a high level of noise being placed in my ears and all the other stuff happening to you. My hearing was comparable to yours as well. This was the first time that I get T & H. The H went away after 1.5 years and the T did settle down to a buzz at 3 -3.5 years where I was able to move on with my life. I placed my mind on other things. If you are young, nerve recovery may happen quicker. Besides trying to focus away from my tinnitus, vitamin water squeezed lemonade that I started to drink at year 3 - with no additional salt and sugar seemed to help a lot.

Yes - Protecting your ears from now on is important. A couple of months ago, I let my guard down and attained more noise damage. Now, I'm in a worse place compared to the first time. Plus I'm in my 60's now.

 

[Blue28]

Thank you for your replies/support @Bill Bauer, @Greg Sacramento, I've not had a good sleep...worry and 60mg of prednisone before bed probably haven't helped at all but needs must. I'm not sure whether to take another 60mg this morning, or maybe space it throughout the day as I only took the first dose around 8 hours ago?

 

[Bill Bauer]

I found amitriptyline (10 mg) to be helpful when it comes to sleep. It is non-addictive, and didn't make me feel drowsy the next morning.

My doctor also prescribed 60 mg prednisone per day. He didn't say anything about spreading it out throughout the day, and it didn't occur for me to do that when I was still taking it. It sounds like this way more will get absorbed, and there might be less shock to your body. The downside is that taking it closer to your bedtime may interfere with your sleep. I wouldn't worry about taking the second dose significantly less than 24 hours after the first dose.

 

[Michael Leigh]

Thank you for your replies/support @Bill Bauer, @Greg Sacramento, I've not had a good sleep...worry and 60mg of prednisone before bed probably haven't helped at all but needs must. I'm not sure whether to take another 60mg this morning, or maybe space it throughout the day as I only took the first dose around 8 hours ago?

Very sorry to hear that you're going through such a difficult time @Blue28. I can only suggest if you haven't tried it already is clonazepam. I have it on prescription and haven't taken it in months. However, my tinnitus was very loud and intrusive over the weekend and had to take it and it calmed down considerably. Please see your GP or ENT doctor and maybe they can prescrible something to help you even if it's a temporary relief that gives you some time to get yourself together.
Best of luck
Michael

 

[Greg Sacramento]

Are you taking the Prednisone because of your sound increase from just having a new audiogram? Some do take prednisone just after a noise trauma.

 

[Blue28]

Thanks @Bill Bauer, I think I'll take 20mg this morning and then the rest later today.

Isn't Amitriptyline ototoxic? I suppose that LOTS of drugs on the market are ototoxic. I take gabapentin before bed, could I take both?

 

[Blue28]

Are you taking the Prednisone because of your sound increase from just having a new audiogram? Some do take prednisone just after a noise trauma.

I took 40mg of prednisone after my audiogram for 3 days, just to be safe. That was a week ago. But since my daughter squealed last night I'm terrified so took 60mg straight after. I'm considering taking it for 3-4 days.

When I had my acoustic trauma, I could get an appt to see the ENT for a week...so started the steroids 8 days in. If I'd had them earlier they may have helped more. Who knows? I wasn't aware of the urgency when I called for an appt, and neither it seems was the receptionist...

 

[Bill Bauer]

Thanks @Bill Bauer, I think I'll take 20mg this morning and then the rest later today.

Isn't Amitriptyline ototoxic? I suppose that LOTS of drugs on the market are ototoxic. I take gabapentin before bed, could I take both?

Damn! You are right, I see that it is in
http://hlaa-sbc.org/wp-content/uploads/2013/11/Ototoxic_Brochure.pdf

I believe the reason I took it is because of the study I learned about from
https://www.tinnitustalk.com/threads/amitriptyline.19191/#post-221876
and from
https://www.tinnitustalk.com/thread...in-the-treatment-of-subjective-tinnitus.5170/

Some comments in those threads are not very positive.

I got lucky and it didn't lead to any spikes.

 

[Blue28]

Damn! You are right, I see that it is in
http://hlaa-sbc.org/wp-content/uploads/2013/11/Ototoxic_Brochure.pdf

Thanks for the brochure, makes for an interesting read.

Does anyone have any info on nerve repair following acoustic trauma etc... I'm desperate to find something positive to hold on to.

My HL drops from -20db @ 8khz to -65db @12khz, it was fairly sudden after the trauma

 

[Greg Sacramento]

Everyone is different, but it seem that both you and I had joining seats in the same stadium. Your history matches mine. If you had loud syringing directly to the ears, nerve damage is there. So you need to be careful on what meds or drugs that you take. Oxygen should not be cut off to your ears. Good circulation is needed. If you are young or middle aged, then much of your nerve damage should heal. From my prior research the healing can take years. I was told 2- 3 years for some healing for me.

Acoustic trauma from syringing is a whole different ballgame from other acoustic traumas. Just having audio testing, or sounds placed at the ear will often give one a spike for those that had syringing as their cause of T and H. Your spike should disappear. A few days ago, I provided a medical professional link where researchers advised not having sounds or ear testing for those that had acoustic trauma from direct contact to hears until the nerves heal.

 

[Bill Bauer]

Does anyone have any info on nerve repair following acoustic trauma etc... I'm desperate to find something positive to hold on to.

Have you seen the studies on pages 1 and 2 of
https://www.tinnitustalk.com/threads/spontaneous-recovery-stats-over-70-recover-3-studies.21441/

 

[Blue28]

Everyone is different, but it seem that both you and I had joining seats in the same stadium. Your history matches mine. If you had loud syringing directly to the ears, nerve damage is there. So you need to be careful on what meds or drugs that you take. Oxygen should not be cut off to your ears. Good circulation is needed. If you are young or middle aged, then much of your nerve damage should heal. From my prior research the healing can take years. I was told 2- 3 years for some healing for me.

Acoustic trauma from syringing is a whole different ballgame from other acoustic traumas.

Sorry you had this happen to you too @Greg Sacramento, mine was through microsuction and of course the doctors don't believe me. It's ruining my life (I have a 3 yr old...this happened when she was 20 months old). Thank you for the information about the nerve repair, I'll still cling on to a glimmer of hope that things might get a little better.

 

[Greg Sacramento]

http://www.hyperacusis.net/other-factors/acoustic-shock-disorder/

Read the part on ASD assessment.

Micro suction is very similar to syringing.

Send me a conversation using Greg Sacramento from top of the page - INBOX anytime. This way I will see any correspondence from you.

 

[Blue28]

Have you seen the studies on pages 1 and 2 of
https://www.tinnitustalk.com/threads/spontaneous-recovery-stats-over-70-recover-3-studies.21441/

I have seen this but haven't read all if it...I'm going to. Thank you @Bill Bauer.

http://www.hyperacusis.net/other-factors/acoustic-shock-disorder/

Read the part on ASD assessment.

Thanks @Greg Sacramento, I read this in the early days, and am sure I suffered ASD, unfortunately I also got extensive hearing loss in the ultra high frequencies too (plus some high frequency loss). How have you recovered/coped since your trauma?

 

[Greg Sacramento]

I recovered somewhat from the syringing ASD, but a few weeks ago, I was exposed to drill noise at the dentist. I now have a loud high pitch in both ears.

 

[Blue28]

http://www.hyperacusis.net/other-factors/acoustic-shock-disorder/

Read the part on ASD assessment.

Micro suction is very similar to syringing.

Send me a conversation using Greg Sacramento from top of the page - INBOX anytime. This way I will see any correspondence from you.

Oh and they did the acoustic reflex test on me, despite me telling them I had tinnitus and hyperacusis. I refused to do the loudness discomfort level test!

 

[Bill Bauer]

Oh and they did the acoustic reflex test on me, despite me telling them I had tinnitus and hyperacusis. I refused to do the loudness discomfort level test!

It is shocking that they offered to do these tests despite your history. It shows that there was no thinking involved on their part...

 

[Greg Sacramento]

Most likely you just have a spike. You should return to baseline. That was good to refuse the loudness discomfort level test.

I'm signing out for tonight, give your 3 year old a hug from me. Send me a private conversation anytime.

 

[Blue28]

Most likely you just have a spike. You should return to baseline. That was good to refuse the loudness discomfort level test.

I'm signing out for tonight, give your 3 year old a hug from me. Send me a private conversation anytime.

Thanks

 

[MJv]

I got Clonazepam/rivotril. I am taking this for two weeks, no effects unfortunately.
Maybe you can try something for the day, low dosage. Goodluck, I know how hard it is.

 

[Blue28]

I got Clonazepam/rivotril. I am taking this for two weeks, no effects unfortunately.
Maybe you can try something for the day, low dosage. Goodluck, I know how hard it is.

Unfortunately most docs won't prescribe rivotril here, only neurologists will prescribe it and only for epilepsy. So I can't even try it, but I doubt it'd help anyway.