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Erythromycin Ointment

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Hi Dr Nagler



Hope you are well. I have been prescribed an Erythromycin ointment for an eye infection. Is there any reason to be concerned it might effect my tinnitus? Thank you

Category: Questions and Answers


Tinnitus newbie or newbie again

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Dear Dr. Nagler

First of all, thank you for this page.

Last year I remember I went to the ENT when I experienced tinnitus. My hearing was good, he removed some wax, the noice was still there.

I don't even remember how or if the sound ever dissapated. But I never noticed either way.

But-

I was recently exposed to loud noise at my job, several hours for two days. I didn't think straight. If I did, I would have worn ear protection.

I started noticing a tone in my right ear the day after. It was very faint at first, and then it became more noticable.

Then it turned to a high pitched constant tone. Then when I became aware, I suddenly found several more noices, an old one and static high pitched noise.

I all became really overwhelming. I stopped eating, stayed home reading and searching for a cure. I spend my time with heafphones, because it ay least covers the static and the high pitch. The old low tone turned up in volume, and reacts to almost every sound.

I thought/think my life will never be good again with this noice in my head forever. Also I have this feeling of fullness in my ear. And ot feels like the static noise is making me deaf to some tones.

I have been really stressed out, more than the last time it hit me.

And most of the time I don't know what to do with myself.

I have read the tinnitus101 and found comfort that in most cases it will subside on it's own.

It has been 3 weeks so far. The longest 3 weeks of my life.

So I just wantes to share my thoughts, and maybe get some advice. I am hoping with all my might, that it will get better or subside all together.



Thanks again.



Kirstine from Denmark

Category: Questions and Answers

Habituation second time around

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Dear Dr Nagler

First of all can I apologise for the long email!

I first noticed tinnitus in 2004 in my left ear after attending a loud concert. I had a hearing test which indicated that my hearing was normal and I also had an MRI scan to rule out a tumour on the auditory nerve because I had unilateral tinnitus. This test was negative. I also discussed possible Eustachian Tube Dysfunction with my ENT specialist because I experienced fullness in the left ear which I could relieve to some extent by swallowing. He prescribed a nasal spray to help with this. I read extensively about TRT (mainly Jonathan Hazell's website) and the Jastroboff model and I found this very reassuring. Although I did not undertake TRT or any other form of treatment I did habituate my tinnitus over a period of 18 months. Habituation for me meant that I heard my tinnitus very rarely unless I tried to find it. When I did hear my tinnitus it was almost like an old friend come to visit. I did not see myself as a 'sufferer' of tinnitus but someone who had tinnitus which was not in the least bothersome. At this point if someone had said that they could wish my tinnitus away I would have told them not to bother because it was totally irrelevant to my everyday enjoyment of life. Then in March this year my doctor prescribed the antidepressant Sertraline because I was suffering from anxiety.  After about a week I on these tablets I developed auditory hallucinations - traffic sounded like church bells - pneumatic drills sounded like a male voice.  I believe this is known as musical ear syndrome. My doctor advised me to discontinue with the Sertraline and after a week the auditory hallucinations went away. However, I then began to notice that the tinnitus in my left ear which had not been a problem for 11 years became more noticeable again. I became anxious about this and the tinnitus became louder and invasive.  I have had this problem now in my left ear for about 6 weeks or so. I feel as if my tinnitus habituation - something so precious - has been removed. I now have all of the feelings I had when I originally noticed tinnitus back in 2004.  However, there are times when my habituation seems to return for several hours and it is almost as if the problem has gone away again. My doctor has also said that I have fluid in my middle ear possibly due to Eustachian Tube Dysfunction which is exarcebating my tinnitus although this is a problem I have had since the first onset of my tinnitus in 2004.

My questions are:

Do you think that because have achieved habituation previously and I seem to have periods when even now it seems to be temporarily habituated again that this is a good indication that permanent habituation will happen again reasonably quickly?

Do you think it would be beneficial for me to undertake TRT to speed the habituation process up or would you reccommend that I wait for a few months to see whether it happens without any intervention?

Could you reccommend someone in the UK who is a TRT expert?

I really appreciate your time in answering my questions.

Best Regards

Dr Kevin Ions

Category: Questions and Answers

Noise Cancelling Headphones

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Hello Dr. Nagler,

I know on your site you had recommended headphones (Bose brand I believe) but I was unable to find the specifics in previous posts.  I'll be flying in the near future and would like to purchase a set.  Could you please let me know which ones you recommend.

I find that the evening and mornings are when the tinnitus is most noticeable. My next question relates to a morning routine.

I find in the evening when going to bed, the tinnitus is much more noticeable but have developed a routine that helps me. I use the Oasis sound system, going to bed at the same time, do 10 minutes or so of a relaxation exercise and 5 months ago stopped taking 2.5 mg of Zoplicone (I now take 3 mg of melatonin).  My sleeping pattern has improved. 

I do find that in the mornings I still wake up to a head full of noise and was wondering if you had any techniques or suggestions as to how to reduce awareness of tinnitus in this situation. 

Thank you,

Theresa

Category: Questions and Answers

Severe reactive tinnitus and hyperacusis

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Hi Dr. Nagler,

My tinnitus is very reactive to sounds especially the white noise and pink noise. I want to get the TRT but I cannot tolerate any gentle white noise/pink noise. The T affected my life in every way. I have been on anxiety pill (benzo) for months already. I heard that benzo affects the neuroneuroplasticity. I feel I'm stuck. 

By any chance, the white noise generator from TRT is different from the white noise I can get through internet and white noise machines. So that, I can tolerate it. Also, have you had patients completed the TRT successfully when they were on benzo pills?

Category: Questions and Answers

Azithromycin - tinnitus

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Dear Dr. Nagler,

I have been suffering from tinnitus from January 2014. My tinnitus started after a physiotherapy - I had a stiff neck and after one of the sessions the tinnitus started. I have undergone series of different medical examinations and nothing has been found. The conclusion was that my tinnitus is probably connected to neck stiffness and stress.

My tinnitus sponateously (or maybe as a result of physiotherapy and acupuncture) lowered in the volume so I have been able to coexist with it for most of the time.

Three weeks ago I got a cold and horrible dry cough. My tinnitus started to get worse (I also had a lot of work so I cannot really tell what the cause is). My doctor prescribed me Azithromycin 500 mg for 3 days (1 tablet a day) for the cough. I finished the last dose last Thursday (5/25) and since Monday (5/29) I have experienced a horrible spike which is lasting up till now - my tinnitus is very loud, I can hear it even on a busy crossroad. I have beein experiencing an increase in the volume for some time and altough I cannot tell that the spike is connected to azithromycin, I did some googling and it seems a lot of people experienced the same.

So my question is - in your experience can azithromycin cause a spike? Is the effect reversible considering I took only 3 tablets 500 mg? How long might it take before Tinnitus drops to the previous level? Is there anything I can do to support it?

Obviously, I am very distressed by the spike. I still have a dry cough so azithromycin did not really help. I have been prescribed Alprazolam for the anxiety and I am afraid to take it not to worsen the condition. Can Alprazolam worsen Tinnitus?

Thank you very much for your answer!

Category: Questions and Answers

Not a patient of yours; but thanks!

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Hi Dr Nagler,

Since 3 years I have the T & H thing. From day one I was reading your stories, replies etc on the internet. 

During my first T year I became very depressed; I was not able to bring your valuable tips into practice. However I understood them very well.

After my AD meds kicked in I brought your tips into my daily routine. And was able to accept my T and most of the time I don't even care about it anymore.

I had a fan at my sleeping room to fade out my T whilst I wanted to get to sleep. According to one of the psychs (who has T himself) within a year I shouldn't needed the fan anymore.. I didn't believe him.. However within 8 weeks the fan wasn't needed anymore. T became a friend. I can still have my arguments with my T friend; but we always end up as friends again ;).

So I was never a patient of you, but your stories and answers on the internet helped me a lot! Thnx for that!

Ps, 

Your wife's letter to family helped my spouse as well. Altough she didn't wanted to the headphone thing.. Just a example T sound from youtube was enough. ;)

Category: Questions and Answers

Tinnitus and hearing damage

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Hi Dr. Nagler,
Hope you're well and enjoying the summer. I've got another question to which I cannot find a consistent answer.

I have mild/moderate high-frequency hearing loss and tinnitus. Left ear is a bit worse than my right ear. Is some level of high-frequency hearing loss considered "normal" as we get older? (I just turned 50 in January.)

Oh, and does the fact that I have a bit of high-frequency hearing loss already make my ears more susceptible to future damage than someone without hearing loss. In essence, do I need to be more cautious around loud noises than the general public?


Okay, I guess that's two questions. Have a great day.

 

Category: Questions and Answers


One time noise exposure jan 2017

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Hi
New to Tinnitus & H. I have T both ears and H in my right ear. Was getting a little better but had a set back on sunday when a customer poped a titr in the bicycle shop it was rather loud and I think my h is worse now. Had two days off work so I worked in the house that we have bought and I had a couple of good days used ear protection when needed anything above 80 DB.
My other challange is when I go to work I used the Bose NC headphones with masking on the train very low volume. regardless my t ramps up after the hour trip so my ears are both ringing at the end of the trip. By the time I get to work both ears are ringing and sometimes they calm down and other days they don't, making it hard to concentrate at work. I can loose the job otherwise I could loose the house that we just bought I am in a catch 22. been on the Tinnitus Talk forms found some good info & not so good I don't want to think I have other peoples problems. The doctors say it could go away but I have had little improvement in the last 2 months. Was getting better with the H but I have had a few setbacks and it seems like it was in Feb now my T has improved so it is not as loud. Seeing mental heath today in the Bronx as this is a workers comp case as I am using wine to help me sleep at night, my family is very concerned about this, I know I have to stop drinking but it is the only thing that helps me sleep. I also use Magnesium which calms me down. Just need a little advice been nearly 5 months now, this was one time exposure to a bicycle tire exploding which sounded like a gun shot it was that loud. My hearing test came in with no hearing loss for my age 60 & the ear drums were not damaged no holes or bursting. The right era drum was a little red after 2 weeks but I used Colloidal Silver for the first two months and at the 4 week mark my ear drum was clear seeing a doctor. So hearing is good too senitive. What should I ask the doctor today which meds might help me sleep I have tried natural ones but they don't work... Best DCM sorry for the spelling. I live in the bronx NYC

Category: Questions and Answers

Histamine and tinnitus

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Doctor,

I read everything I can and know most on the internet is just laymen's opinion but every once in a while something strikes a chord with me.

I recently started reading accounts of allergies, histamine and tinnitus. I've always suffered the usual pollen allergies and years before my tinnitus I suffered chronic idiopathic urticaria for about 10 years, awful, and took enough antihistamines to sink a small boat. Never found the cause and it just went away.

So, is there something to people with histamine issues that might make them to be predisposed to acquire tinnitus, or could years of antihistamine use have some effect of the onset of tinnitus? 

I'm becoming a little reluctant to use the occasional zyrtec or claritin out of concern it could exaserbate my tinnitus. Meanwhile there are reports that antihistamines might reduce tinnitus.

I'm concerned because after 4.5 months I am able to finally peacefully co-exist with my tinnitus and it's only a minor irritant when I first wake up in the morning, getting up solves that problem.

As always, thanks in advance.

Category: Questions and Answers

somatic tinnitus

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i got tinnitus from bad posture sitting with my pc on my lap from almost 2 month ago so that´s so annoying. It have decreed from 4-5 tones to 3 and so has the volume. where 2 of the tones are always present. i think am somewhat begin to experience habituation to one of thee tones because sometimes i need to search for it. is it possible to reach habitation with this kind of tinnitus it also swift from ear to ear and am a bit scared after reading that somatic tinnitus tens to be more sever then normal T so am a scared of it getting worse also i sometimes wake up 2 times at night i can easy fall asleep but stay asleep is sometimes hard. i think is from the anxiety because i dont feel is the sound that´s so much the problem but the fact i think so much about but am not so sure and perhaps also from all the horror storys i have read.

English is not my native language sry  for that I hope you will answer anyway have a grate day :D

Category: Questions and Answers

Tinnitis newbie cisplatin

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Hi Dr Nagler,

After completing a course of cisplatin, I developed continuous T. This started about a week ago. So I am experiencing the typical responses... anxiety, fear, trouble concentrating and dealing with these "inappropriate" sympathetic nervous system responses.



I have an audiology appt next week, to compare to my baseline test.



Today I started working on the CBT book I found on your site. Thanks for making that available. A couple days ago I spoke with the audiologist who did my baseline exam. She suggested the app Starkey, and I have been using the "relax" sounds most of the time when I am awake (volume set so I can still hear my T) and also a bit louder at bedtime. It seems to help some.



Although I have a benzo rx (used for chemo nausea), I have been avoiding using it for anxiety, so as not to deter habituation.



My spouse has had T for many years and is habituated, so I know that is possible.



I am simply putting one foot in front of the other as best I can and not guessing whether or not this is a permanent condition. Though it can be discouraging to wake up each morning and it's still there.



Questions: I thought I had read somewhere on your site that CBT and TRT should not be done at the same time- is sequential ok? Can you suggest a TRT provider in the Austin, TX area?



Thank you so much for your time and expertise!



Category: Questions and Answers

How To Post a Question

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Hello Friends (New and Old) -

Welcome to Dr. Nagler's Tinnitus Corner, a place where you can find direct straightforward answers to questions about tinnitus, hyperacusis, and related subjects. In other words, this site is designed to empower you to be your own best advocate in overcoming your tinnitus and hyperacusis.

To post a question, please go to Questions and Answers, and click on "New Topic." Your question will not actually appear on the board until I have reviewed it and formulated an answer, which will hopefully take no longer than forty-eight to seventy-two hours. You should get an e-mail notifying you when that happens.

The mission of Dr. Nagler's Tinnitus Corner is simple. Ask a question, and get information directly from me. Good information. Useful information. Can I absolutely guarantee 100% accuracy in 100% of my responses? No, of course not. But I will absolutely guarantee to give it my very best effort.

Here's to quieter days ahead for all!

Dr. Stephen Nagler
Atlanta Tinnitus Consultants, LLC

Category: Please Read First

Desyncra

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Hello Dr. Nagler,

In researching tinnitus therapies today, I came across a therapy I hadn't heard of previously called "Desyncra".  Do you have any feedback regarding this therapy and if it can be effective?

Best Wishes,

Duncan

Category: Questions and Answers

anti-biotic

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Hello Doctor Nagel, new to this forum. Read your articles on "newbie to tinnitus" and that is myself.
Concerned about your 5 no-no drugs, I have just started a regimen of AMOX-CLAV, does this fall into
those 5? my tinnitus started a little more than a month ago, the AMOX is for a sinus infection. Welcome any thoughts, and thank you in advance.    tim

Category: Questions and Answers


voice in the head

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Good afternoon Dr Nagler, I hope you are well.

 I am 66yrs old and about 5 yrs ago I thought I had a blocked ear where I could hear my voice in my head when I spoke. Through business commitments I did not get advise about it until months later, we lived in Austria then. I saw the GP there and he informed me I had Tinnitus. We unfortunately moved back to the UK before I saw the specialist. I have been to the local hospital here and the specialist gave me no explanation about it. I have searched relevant web sites but can never find any information on this type of tinnitus! My hearing came back good but due to hearing my own voice constantly - sometimes bad enough to stop speaking - I do miss a lot of what people say. I do hope you can enlighten me as to what has caused this. If the other ear went like it I couldn't cope.

Kind regards

Eileen 

Category: Questions and Answers

T Questions to learn

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hello dr nagler!  hope all is well with you and your family!  you are an inspiration and thank you for your time! 
1) i was wondering how loud can tinnitus get? has there been any data collected on the loudness? or does tinnitus have a certain cut-off point? very loud noise can rupture ear drums so i was wondering if T ever gets that loud?  i know loudness means nothing when it comes to T but i was just curious.
2)if tinnitus stays the same in volume then why does the brain trigger a response that makes it seem unbearable on some occasions? i think i remember reading somewhere that your T had changed in tone to a point where you thought it was louder than your already intrusive T but upon closer examination the volume never changed it was just the pitch. 
3) how common is fleeting tinnitus in people who don't have 24/7 T?
4) if you have hearing loss and can only hear T at 90db but you hear nothing for the first 80db would this sound loud to a T suffer as compared to someone hearing 90db w perfect hearing?  i would assume the perfect hearing guy would be in agony because he hears the full volume as compared to a person w hearing loss of 80db.  dont have a clear understanding of this.
5)when you started TRT how long did it take before your life changed for the better?

thank you for your time!!

Category: Questions and Answers

rTMS Cynicism

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Hi Doctor,

Firstly - thank you for your forum.  It's fantastic we have the opportunity to speak to somebody who is not only medically qualified, but who intimately understands tinnitus.  It sure beats those "google" and internet doctors! 

Anyway to my question...

On the surface, rTMS appears to be a highly studied area of treatment for tinnitus.  A search alone on clinicaltrials.gov https://clinicaltrials.gov/ct2/results?cond=Rtms+Tinnitus&term=&cntry1=&state1=&SearchAll=Search+all+studies&recrs= reveals over 14 studied (some completed and some ongoing).  There is many other articles, and clinical studies performed on the topic which I'm sure you've probably already read :) 

Now obviously all studies reliability depend on the robustness and how these were conducted (are they double blinded, randomised placebo for example?!).  And potentially many of the studies on topic may not be worth the paper they can be printed on, but there appears to be an overall pattern forming that rTMS does show efficacy over the placebo (albeit around a 50% improvement rate).  

Being acutely aware of my own confirmation bias thus attempting to be impartial and open minded on the topic as possible, I ask you based upon what you've written on these forums:

Why do you have the cynicism on rTMS as a treatment for tinnitus now and moving forward? 
 

Category: Questions and Answers

Attended wedding reception - T spike

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Hi Dr. Nagler,

I went to a wedding reception last Saturday night.  I was only there for a couple of hours or so, but it got very loud and the speakers and DJ were focused directly at our table about 30 feet away.  I ended up putting earplugs in, but it might have been too little, too late.  We ended up leaving early.  It got to the point where you had to speak loudly for people to hear, so you know levels are too high at that point.

On any rate, my T that evening after I left the reception did not thankfully go any higher. So I thought all was well as typically when loud noise creates a T spike, I always thought it happens immediately.  I was up for about 4-5 hours before going to be that night and again, no spike.

However, the last 3 days (including the day after the reception) have been "loud days".  Usually my loud T days do not go beyond 1-2 days.  I am afraid it will stay at this loud level.

That has always been my greatest fear about T is that my quieter days go away and the loud days become the norm.  I realize habituation is key, but just saying.

Just for reference sake, my quite/low T days do not really bother me.  On a scale of 0-10, it's about a 0 or 1 at most.  My loud T days, it's about an 8 or even 9 at times.  Once in a while a 7.

Any thoughts or advice appreciated.  Is this loud likely to be the new norm?  It's put me in sort of a depressed mood.  I really haven't been depressed about my T in quite some time.

Thanks,

Dave

Category: Questions and Answers

Coped with tinnitus for 10 years, but new tinnitus is overwhelming.

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Hi Dr. Nagler

I live in a rural city in Australia about a 2 hour trip from Melbourne, I first got tinnitus about 10 years ago, when it started i would rate the volume at about a 5- 6, it was 24/7 and i could hear it all the time, i employed tactics like sound enrichment and guided relaxation which eventually lead to the tinnitus getting to the point where it no longer bothered me too much.
For years the tinnitus was at a point where i could go for days without noticing it and the volume seemed to have reduced from a 5-6 to about a 3-4, it could still be a minor annoyance at times.

Move to late Feb 2017 and my tinnitus got excruciatingly loud while on oral and topical antbiotics for an ear infection which it turns out was a misdiagnosis by my GP, i found out it was a misdiagnosis because i insisted on a referral to an ENT who told me i did not have an ear infection, my GP had once again that same day told me that i still had an ear infection in both ears.

My tinnitus at the start of march i rated 10/10 when seen by an audiologist who told me to give it 3 or 4 months and you'll hardly notice it, move forward 4 months to now and i realise that rating of 10 was wrong because it has gotten even louder now, it is so loud and distressing that i am having immense trouble sleeping and the tinnitus is causing a massive ammount of anxiety.
My hearing has also deteriorated and the ENT said the audiogram i recently had done showed i have nerve damage most likely caused by the antibiotics.

I have some hearing aids that i got from the audiologist that also work as tinnitus maskers, when i started using them 3 months ago they did a good job of reducing the tinnitus distress when i wore them with the level set just below the tinnitus, but now they don't work well anymore because the tinnitus has gotten louder and the pitch has increased enough that the sound they make just doesn't do anything to reduce the perception of the tinnitus, it's basicaly just adding more noise.
The maskers also make my right ear ache after about 15 minutes now, and when i remove them the right ear feels sort of dull and muffled.
The audiologist has told me that the maskers can't do any damage but i'm now scared to wear them since my hearing is still deteriorating and the tinnitus getting ever louder.
I kept telling my audiologist how loud it is and she asked if i could hear it under the shower and when i told her i could easily hear it under the shower she was shocked. 


I have seen a psychologist who said that she had experience working with tinnitus sufferers but that did not work out, i felt i was getting no benefit from her therapy which entailed her advising me to play some golf or go to a movie or go for a walk and say hello to 10 people.
She also wanted me to believe that my tinnitus was being caused by not doing enough things that i enjoy, and not the antibiotics and hearing damage, she told me if i believe the tinnitus is caused by damage to my auditory system then her CBT wont be able to help me. 

I am realy struggling to cope with this tinnitus it is so much worse than the tinnitus that i lived with for 10 years, it moves around in my ears and head somedays louder in the head and some days louder in the ears.
it is so loud, high pitched and intrusive, nothing blocks the sound out anymore, i never used to be able to hear my tinnitus in the shower but now i can clearly hear it in the shower with the exhaust fan and the radio going, i was mowing the lawn the other day and i took my ear muffs off just for a few seconds and yep i could hear it over the lawn mower too.

I would appreciate any advice, i never thought after 10 years of living with and for the most part being on top of my tinnitus that i would ever be in this constant state of distress, only sleeping 1 to 5 hours per night and waking multiple times, unable to relax or even enjoy watching a movie, i never thought my tinnitus could get this loud, after about 8 years of no change in volume or pitch i was so unprepared for such an enormous change from a 3-4 to where it is now maybe a 10, i certainly hope it can't get any louder.

Scott.

Category: Questions and Answers

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