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Multiple Hearing Problems from Gunshot
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txtinnitus posted:
the day before Haloween 10/30/10, I shot roughly a dozen rounds out of a .45 pistol without (extremely foolishly) any ear protection whatsoever. My ears rang and had a sense of pressure and muffled hearing like coming back from a rock concert all day and the next morning. Lound sounds are distorted and restaurant level noise sounds is sort of unintelligible. i also seem more sensitive to loud noises.
the next evening, while outside with my family, the muffled sounds eased somewhat. At work the next monday, in a loud office environment, the pressure and muffledness returned. I went to an ENT tuesday 11/2. He told me I had lost some hearing at high frequencies but I was ok in conversation range. I asked him if I could expect any recovery. By this time I was also had noticed tinnitus, esp in left ear. He said if symptoms were still there in three weeks, they were probably permanent.
the next Monday, 11/8, not seeing any noticeable improvement, I went to another ENT who prescribed methylprednisolone pack (4mg, six the first day and decreasing each day). He gave me a hearing test, and comparing the results of the first, there has been some improvement at higher frequencies. conversation range is normal.
Hearing, esp fullness, seemed to improve with steroids thru the fourth day, and then fullness returned. i had a follow up appt Monday 11/15. he prescribed another steroid pack, but told me to cut the dosage in half and use it for two weeks.
At this point fullness has either left or I have habituated. Loud sounds still sound distorted, sort of like a blown speaker. Restaurants still difficult, but seem to have improved. Still sensitivity to loud sounds, but i think that may be psyhcological. The tinnitus is there, esp in left ear. At this point, I am mainly worried about hearing, the tinnitus I will deal with at a later time if it persists. My main question is, At this point can I expect any more recovery, or should it have sort of stabilized by now? I am taking multivitamin, mg, ginko bilbo, and b12. two glasses of red wine at night seems to decrease distortion and sensitivity. i have been wearing ear plugs when possible. At what point should i consider damage permanent and start worrying more about tinnitus treatments? i am 29 year old male. All comments are greatly appreciated. Thank you,
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deach777 responded:
hi tx, speaking form experience,,you should recover pretty well after a while, you are young. As long as you don;t keep doing these things without hearing protection. I constantly would shoot my .44 without prot. also I worked at two jobs, one as a metal lathe oper. and also worked at the dragstrip around highper. cars, That, when i went home i didn't hear for days. Now i'm paying for that, with very loud Tinnitis and perm. hearing loss. So take care of your ears as well as your entire body. God gave you only one, don't abuse it !!! By the way Ginkgo usually increases the tinnitis. As well as some other herbs and vitamins. Let you ears heal by themselves without putting anything in them.
Have a good evening, ~Deach~
 
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Rod Moser, PA, PhD responded:
The body has a remarkable ability to heal itself, even after some of the stupid things we do to it. I don't really agree with the ENTs "three weeks and it will be permanent" comment, but of course, the longer you continue to have symptoms, the more likely that some (not all) of those symptoms will be with you for quite a while.

Using the gun as an example: If you were shot, the damage occurs when the bullet hits you. You cannot un-shot yourself, nor can you reverse all damage done to the body. The inner ear can be permanently damaged by just ONE incident like this, and you do have to deal with the possibility that the inner ear is, indeed, irreversibly damaged. Personally, I tend to be more optimistic. I have seen full-recovery MONTHS after an incident. The fact that you are improving...even a little bit...should be considered a positive thing.

I don't think that your vitamins, wine, or earplugs are going to change your prognosis, but it is okay to use them. What will happen....will happen, but I think you should be both patient and optimistic. Give your body TIME to heal.
 
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txtinnitus replied to Rod Moser, PA, PhD's response:
I neglected to mention the second ENT told me to give it 3-6 months. Yesterday was getting close to the three week anniversary and I was a little frustrated and nervous. Thank you Deach and Dr. Moser for your comments. I'm not going to lie and say I have always worn ear protection in the past, but this was an unexpected event and there were no plugs around.
I know everybody is different, but over the course of the next few months, can I expect any stabilization? It seems every day I run the gamut from extremely bothersome to almost normal. It esp seems worse in the mornings, but gets better as the day wears on.
Like I said about the tinnitus, I plan on worrying about that at a later time. Would a year be too soon to consider treatment such as Neuromonics? Also, has anyone here had any experience with this?
Thank you all again,
 
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Rod Moser, PA, PhD replied to txtinnitus's response:
At three weeks, I think it is too soon for most aggressive medical interventions, but that will be up to you and your ENT. No matter how we try, we rarely have the ability speed up the recovery time....or even anticipate if recovery is possible. Damage to the inner ear occurs at the microscopic level -- far beyond the ability to see it on exam. There are no specific treatments for inner ear damage....only Tincture of Time.
 
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txtinnitus replied to Rod Moser, PA, PhD's response:
Dr. Moser,

Thank you for your reply. What are some of the "aggressive medical interventions," and at what time would they be applicable? I am prepared that there might have been some irreversible damage, I just want to make sure I'm doing all I can not to aggravate the problem/help myself heal. I have posed these questions to my ENT, but unfortunately with the busy schedules everyone keeps these days, I seem to think of more questions in hindsight. I really appreciate your time and insight. BTW, I like the Tincture of Time turn of phrase. Thanks again,
 
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salonasahj responded:
txtinnitus,

I have just had a similar experience. On 11/13/10 I went target shooting with my dad, outside. We had no hearing protection. Big mistake -- as I learned the hard way.

Between the two of us, we shot off 13 rounds of a .45 caliber automatic pistol (Glock 30). Again, I used no hearing protection for the 6 shots I fired -- figuring it was "only a few shots." I fire a gun maybe once every three years on average, so I'm NOT frequently exposed to gunfire & have NOT been exposed to it (or other very loud noises, like concerts) consistently throughout my life. And I covered my ears for the 5 shots my dad fired, for whatever that's worth (surprisingly, my ENT said it helped a lot).

So: I heard 6 shots of a .45 ACP w/o protection, 9 days ago. I'm a 38-year-old male in good health and with a good diet, including daily magnesium and vitamin E supplements.

Immediately after the first shot, my left ear started ringing. Several minutes later I noticed my hearing was distorted. Nine days later, I still have the ringing; the hearing in my left ear is still distorted -- especially high frequencies; lower frequencies sound a bit muffled; and I feel pressure in that ear.

Three days after the incident, I took 5,000 mg of magnesium and have maintained lower doses since then. I have also added more vitamin E to my supplements, as well as calcium & gingko biloba.

Four days after the incident, I went to the ENT. While I have no trouble distinguishing speech, I suffer "moderate hearing loss" in my left ear. I've lost 50%-60% of my ability to hear high frequencies in that ear, which the ENT estimated represents 5%-10% of my overall hearing. (I pressed him for these percentages, to help me interpret the audiogram.)

He prescribed a 9-day course of prednisone: 30 mg/day for 3 days, 20 mg for 3 days, then 10 mg for 3 days. He scheduled me for a follow-up appointment at two weeks.

He said there is a chance I will have a full recovery, a better chance I will have a partial recovery, and that the first month would be a good indicator of my progress toward recovery. (But not some kind of cut-off point.)

It's now nine days from the incident, and I'm trying to keep an optimistic attitude. Like you, I'm more concerned with the hearing loss than the tinnitus right now. I'm also concerned about my hypersensitivity to sound. It's not going to be much fun watching my niece open Christmas presents this year if I don't experience a major improvement there.

I obviously regret not having used hearing protection, which would have been so simple to do. My ears have been exposed to gunfire maybe five times in my life, and I simply had no idea that such infrequent exposure could have such traumautic, potentially irreversible consequences. I was not trying to take a chance -- I just had no conception that one could go from "normal hearing" to "moderate hearing loss" by popping off a few shots outdoors. My uncles and grandfathers hunted for generations without protection. Did they have hearing loss? I don't have their audiograms handy, but none of them lost 50%-60% of their ability to hear high frequencies in a single day, and irreversibly.

So I think like Dr. Moser and your ENT said, there is plenty of time for recovery... It doesn't all have to happen in the first two weeks, or during the course of the steroid treatment, or in the first month. It can be a slow process and still be a complete or near-complete process. That is my hope -- and I've been relieved to hear it from my ENT, your ENT, Dr. Moser, and buddies of mine who are long-time hunters and target-shooters.



Best of luck in y(our) recovery. Would be interested to hear about your progress as it occurs, especially since our situations are so very similar.

Finally -- no more loud noises for me without protection, from the lawnmower to the train platform. Would've been happy to walk around in muffs-n-plugs my whole life if I'd known it was such a big damn deal.
 
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txtinnitus replied to salonasahj's response:
Same here. I shoot maybe 2-3 times a year, sometimes not at all.
A little over three weeks in and things are improving. The ringing is still there, although it seems to have subsided in the rt ear most of the time. The left ear still sounds like a damn tea kettle, esp at night. The distortion seems to be getting better for me. Like you, it is the high frequencies that sound distorted, but again, improving somewhat. The pressure seems almost completely gone.
At this time, I would say (my subjective estimates) ny left ear is at 85% what it was, right ear at 90%. I am hopeful of a full recovery too, but am also trying to mentally prepare myself that I my hearing might not ever be the same. Like you, it seems hard to comprehend that when I pulled up to my father-in-law's house on Saturday afternoon, everthing was fine; when I left a couple of hours later, everything had changed. But I also keep focusing on what didn't change. I can still hear my seven month old daughter laugh and cry, I can see her and pick her up, I can walk up and down the stairs.
Also doing my best to try to put it out of my mind and let my body and time do the best it can, and not constantly listen for ringing or distortion. Another reason I think it is improving, I am starting to grow more frustrated with the tinnitus, it seems I'm paying more attention to that now than the hearing. My sensitivity to sound seems to have improved also; I no longer jump everytime the dog barks. I decided to quit wearing the plugs during everyday activities, I think it was sort of conditioning me to flinch at normal sounds, if that makes sense. I am still wearing them, muffs actuall, when I mow the yard, or plugs if I have to go into an industrial area at work.
Best of luck to you too, and let me know how it goes for you as well. Happy Thanksgiving everybody
 
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salonasahj replied to txtinnitus's response:
If you're 85%/90% after three weeks, that's good progress. Probably just more of the same is needed -- time and relaxation. You mentioned Neuromonics in a previous message, so I checked it out online. Was surprised to see my own ENT's office listed as a provider. I live in Manhattan and could have chosen from literally hundreds of ENT's covered by my insurance. The fact that my doctor (who I chose based on educational background, years of experience, etc.) uses Neuromonics makes me think it's worth looking into. Will ask him about it on my next visit.

I was thinking... I've had pretty bad vision all my life, like 20/100. Have worn contacts since I was 13 years old. So I'm used to it — I never think about it and it never bothers me. But if someone went from having 20/20 vision one minute, to having my lousy 20/100 vision the next minute, they'd be horrified... I think it's similar with our (temporary) hearing problems -- it's mostly the suddenness of it. The symptoms themselves are pretty manageable, they just came on so quickly that it's nerve-wracking.

In the last few days, I've noticed a decrease in my tinnitus. First, the tone decreased (becoming somewhat less annoying). Second, the volume decreased a bit. It's still there, but I think getting better. I expect you may experience something similar -- like you say, just give it time and not focus on it.

Will let you know what my doctor says about Neuromonics, if the turkey doesn't cure us first. Happy Thanksgiving.
 
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txtinnitus replied to salonasahj's response:
Went Back to the ENT this morning. I told him everything seemed to be better, but obviously not where I'd like it to be, and he reminded me to give it time. Said nerve damage could take nine months to heal in some cases.
At this point, the pressure and sensitivity seems to be gone. Distortion only occurs at loud volumes, especially when they come from me (ie, if I yell at my wife from downstairs or across the yard). Restaurants, road noise and similar situations make everything muffled.
The tinnitus is...confusing. In the morning, right after I wake up, it's almost non-existent, maybe a soft hissing. I'm learning loud noises, stress, fatigue, hunger (or eating too much) can set it off. In short, the better I feel, the less it's there or I notice it. But I do hate that I have to give it so much attention to keep it at bay, if that makes sense.
I mentioned Neuromonics to my ENT, and he didn't seem to keen on it, kind of categorized it as a glorified masker. I'm not planning on doing anything for a year, and I'm going to do my best to forget about it. I go back to ENT in four to six months, and we'll do hearing tests to see if there has been any measurable improvement.
I know what you're saying about the suddenness of it. If it had happened gradually, I don't think it would be a big deal at all. Take care all,
 
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Rod Moser, PA, PhD replied to txtinnitus's response:
Thanks so much for the update....I certainly hope that time will be the great healer in your case.
 
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salonasahj replied to txtinnitus's response:
The 9-months-to-heal advice gives me hope -- cuz I don't mind if the road to recovery is slow, as long as there is a road and I'm on it.

If you've made progress on the pressure and distortion, my guess (based on anecdotal info I've seen/heard/collected) is that the ringing will be the next thing to improve.

That seems to be the symptom that lasts the longest... many "cases" where a person's ears rang for months or a year, and then healed. (Cases where the ringing was caused by a loud noise -- I'm not talking about viruses or Rx side effects; obviously different situations with potentially different prognoses and timelines. You and I care about time-to-heal and degree of recovery following noise-induced damage.)

I hope you update us from time to time on how it's going for you -- these boards are a good resource for people with questions and concerns; and the best info on timeline/recovery/etc., really does seem to be anecdotal (from patients and doctors).

So please keep us posted and until then, best wishes for a full and speedy recovery.
 
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txtinnitus replied to salonasahj's response:
Just a little bit of an update. The ringing seems to have diminished in volume during most times of the day. I would imagine also, I have grown more accustomed to it. About a week ago, it seems I just got tired of worrying about it. i started trying to "listen over the sound" if that makes any sense. The pitch seems to have lowered, also; it seems more like a buzz now than the searing high line hum it was. Interesting enough, I've had a hell of a cold this past week, and still, things seem to be incrementally getting better. Loud volumes are still a problem with the distortion, (I'm talking like concert level loud. At church this past Sunday, the volume was too high) but day to day stuff does not seem to bother me anymore. I imagine it has been a combination of improvement and habituation.

Sorry I've rambled a bit, hope everything is going well for everyone.
 
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pederse7 replied to txtinnitus's response:
txtinnitus - the same thing happened to me on 11/20/10. Its been almost 3 weeks now. The sensitivity to loud sounds is what I am most concerned with. I tried going into a busy restaurant tonight and there was just way too many people talking too loud. Have you noticed any improvement with the sensitivity to loud sounds after the third week? I feel I can learn to live with the tinnitus, but this sensitivity is awful.

Any positive information would make me feel great.

Thanks
Matt
 
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txtinnitus replied to pederse7's response:
Matt,

For me, it has gotten better. I think a lot of the sensitivity was me being jumpy at every noise, but it seems to have physically gotten better also. Since it is all subjective, it makes it tough to judge, but I can say I don't dread going to restaurants myself now. I'm not advocating drinking your problem away, but a drink or two while dining took the edge off for me. It took me a while to realize that everyday sounds weren't going to send my hearing over the edge. It was kind of like I had to get used to hearing again.

As another example, I work on a street where large trucks continually run up and down the road. The first few days after my hearing problems began, I would cringe or duck into the office or my truck if I was outside when one came by. I would get a lot of distortion when they came by too. Now, they still seem louder than they did before, but I don't have the feeling that they are doing any damage, if that makes sense.

All that being said, I would definitely try to protect your hearing. Any time I'm in an industrial area at work, or using lawnmower or leaf blower or even vacuum cleaner at home, and sometimes just when my earing seems particulary bad, I wear ear plugs. I have also since gone on a hunting trip with work, and when shooting, used ear muffs. I was extremely nervous, it was the first time I had shot since I damaged my hearing, but everything was fine.

Keep hanging in there, it seemed to me at a month I turned a corner. Believe me, there is still a long way to go, and i know things might not ever be the same, but for me, things seem to have improved dramatically from where I was on Halloween. Best of luck,

Jess


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