Question: To Dr. XXXXXXX Kumar: Hi Doctor, I hope you remember me. I'll try to keep it short. I had SSHL (right ear) last July and was given an inadequate dosage of Prednisone (10mg/day for one week) and still suffering, in fact it's much worse. Was persuaded to have an MRI (Dec.27) Only finding was that I have cerebral small blood vessel damage. My blood pressure is 159/102. I assume I'll be going on BP medication soon. I had used an earpopper around October and feel I must have caused damage because soon after, I awoke one night with a loud hissing in my right ear. It's been there ever since. It sometimes subsides in the middle of the day but always returns when I sleep. Hasn't subsided for the last three days, though. When I burp, my ear flutters strongly, like a spasm, unless I close my ear flap with my finger. Every time I burp, with no exception. I've never been able to get anyone to pay attention to my Eustachian tube. But this is surely a mechanical problem with the Eustachian tube isn't it? My blood pressure was 137 over something before all this happened. I'm certain the anxiety and sleeplessness from the hissing noise has caused the blood pressure and damage to my brain, Don't you agree that there must be something wrong with my Eustachian tube?

Thank-you doctor. Can steroid spray be obtained over the counter or will I need a prescription? Thanks for the suggestion, but music doesn't mask the noise. In the meantime I'll try the steam. I have a prescription for Zopiclone to help me sleep but have to see my GP to renew each time. It's the only way I can sleep. I'm going to be fitted with an ambulatory blood pressure monitor today for 24 hours. Then the neurologist will prescribe blood pressure medication for me. Do you think the Earpopper could have damaged my ear? I used it several times in succession one day and then the hissing and fluttering started soon after.

Thanks Doctor. If there is such damage, would it be possible to repair it by using steroid spray or steam or some other method, and could any other part of the ear have been harmed by the Earpopper? Also, I took a night-time Benadryl (anti-histamine) four nights ago. Just one capsule and that's the only time I've taken it. The hissing has not stopped at all since then. Of course, I have had high anxiety from seeing the neurologist and learning I have the small blood vessel damage in my cerebral white matter. Could the Benadryl have permanently harmed my ear or brain function? I am currently wearing a blood pressure monitor and most of the readings have ranged from 140/90 to 125/80.

Thank-you very much Dr. XXXXXXX I have been on Doxycycline for over a month of a 2-month course. 100mg/day. When I visited a dermatologist for a minor skin issue and I mentioned the hissing in my ear, he prescribed the Doxycycline in the belief it might help. I suppose he suspected an infection. Should I stop taking it? It hasn't helped so far. I wore the BP monitor all night and took a total of 12mg of Zopiclone and 3mg melatonin so that i could sleep. The noise had become much worse, a whooshing, hissing, and a new sound: like a small motor all going at once in my right ear. Very distressing. The sounds are still there now. I have to wear the BP monitor until 2pm today. Could the electronic BP monitor I'm wearing on my waist be contributing to the noise in my ear? The device itself only seems to make a sound when it takes a reading.

Thank-you so much for everything, Doctor. You've been so patient and diligent in answering my questions. The tinnitus thankfully diminished later in the day. I'm sure that adequate sleep is imperative in order to bring about a reduction of the hissing during the day but it always returns when I sleep and I wake up in the middle of the night with it back in full force. I'm forced to take sleeping aids just so I can sleep enough so that at least I can get some relief during the day. Otherwise the hissing is incessant throughout the day. When the hissing is prominent, there is no other sound or music at any volume that will mask it, unfortunately. I learned today that I will require a prescription for the steroidal nasal spray so I will see my GP about that. I'm waiting to hear from the neurologist about what needs to be done to control my blood pressure and cholesterol to prevent further damage to my brain. I appear to have no other outward symptoms at this time. Again, thank-you very much, Doctor.

Thank you so very much, Doctor. I didn't get much sleep last night but I won't take your time rehashing things. I just hope the hissing diminishes again today. I'm still waiting to hear from the neurologist so that I can hopefully begin some kind of treatment regimen. I will certainly let you know what happens. Your help and counsel continues to be invaluable. Thanks again.

Still waiting to hear from the neurologist regarding BP monitor results. I've discovered that the key to reducing the hissing noise during the day is to stay standing as much as possible. Being in the company of loving and supportive people, combined with lots of standing, seems to be the best scenario to stop the hissing. Perhaps this indicates a circulation issue? Or is it my Eustachian tube? Also emotions are obviously a factor. Unfortunately the hissing returns when I sleep. I wish I could sleep standing up. I tried to sleep without taking Zopiclone but I couldn't. In the end I had to take one tablet. (5 mg). Still only slept 4-5 hours, sitting in a chair. So I don't feel very good today but trying to stay active anyway. Hissing is quite moderate right now. Lately my fingers get numb and tingly at night and the same thing seems to be starting in my feet. (I seem to recall that my mother, who eventually passed from dementia, also had foot numbness at night). So it seems my heart health needs to be addressed. I'm taking coQ10 in hopes that will help. Should I take aspirin? I've heard it's ototoxic but I wonder if I should take small doses of it. I've often used it in the past as a sleep aid (1/2 tablet). I notice one of the listed side effects of the steroidal nasal spray is heightened blood pressure so I hesitate to use it. I am using steam, as you suggested. My ear still flutters when I burp. Still have hearing loss and distortion in the ear. (Planning to trade my car in for one that is quieter). I regret getting the MRI, as knowing I have small blood vessel disease has heightened my anxiety and sleep difficulties which raises my BP and makes things even worse. A viscous circle. But I am hopeful that I will get treatment to stabilize my condition. My mother did not have tinnitus and the neurologist says multi-infarct dementia is not inherited and at present I don't have it, nor do I have Parkinson's (my father had it). My mother"s sister had tinnitus and passed from a heart attack in her early eighties. I have been agnostic for most of my life but the more I learn and experience, the closer I come to believing in God. So I am praying, and others, including my wonderful wife, are praying for me also. I apologize for the chaotic nature of this letter. Thank-you very much for your support, doctor, and I look forward to your further support and counsel.