Age: 67.0
Sex: F
Vaccine: COVID19
Symptoms: Poor quality sleep, Respiratory tract congestion, Sleep disorder, Suicidal ideation, Tinnitus
Clinical narrative: 3/31/2021, the day after receiving my second Covid vaccination, I was reclining on a couch, relaxing and reading a book. I noticed that the "sound" of my tinnitus was breaking through my focus for reading. I have experienced tinnitus for many years, and it had never before broken my reading focus to this painful extent. Since this initial surprise, the tinnitus "sound" has continued as louder and more sharply penetrating than I had previously experienced - and has increased in intensity. Since April I have had difficulty sleeping (not a tinnitus effect previously), difficulty concentrating in stressful conversations, and difficulty relaxing, as I no longer have quiet available to me. Before March 31 my mild tinnitus did not interfere with the sense of quiet a quiet place afforded. I have also had fantasies of suicide, as suicide would appear to be the only avenue to enjoying quiet again. (Actually, I can enjoy quiet in my dreams - I know I've woken up when I hear the "eeeeekkkkkk" again!) The sound is highly annoying, inherently nerve-racking, and hurts my ears and head! (~8000 hz at ~20-30 db - Think fingernails on a chalkboard).   My internist referred me to an ENT for a hearing test; earliest available appointment 5/14/21. The hearing test showed some loss of hearing and tinnitus. Re the tinnitus, the ENT advised, "It's your brain, not your ears, so I can't do anything for you". In early August my cardiologist prescribed Lisinopril (.25 mg) to address heart function issues (Not treating high blood pressure - my normal blood pressure is 110 over 70, with 16 oz. of coffee in the AM!). Lisinopril reduced my blood pressure to ~ 90 over 60, with coffee). I took this medication 8/11/218/27/21 but found that it dramatically increased the feeling of fullness in my ears - and my tinnitus felt like it was intensifying - and I slept very badly during these two weeks (first fantasies of suicide) - so I discontinued taking Lisinopril. While taking Lisinopril I contacted my ENT as the tinnitus seemed to be worsening. My ENT tested my hearing for a second time on 8/24/21 and reported no changes from the 5/14/21 test. The audiologist in the practice recommended full-spectrum CBD to help me fall asleep. I tried this whenever I was having trouble falling asleep, beginning 8/25/21, but eventually found that whenever I thereafter awoke in the middle of the night I suffered a drug-addled, nightmarish struggle to fall back to sleep. (More 3 AM fantasies of suicide).  During this period, 8/25/202111/04/2021, I took approximately 45 full spectrum gummies. With increased difficulty achieving a full nights sleep, I tested Night-time Sudafed (1 tablet at ~11 PM each night for 9 nights beginning 10/27/2021) to help me fall asleep and reduce my congestion (And help tinnitus? - I am normally fairly congested and have always had a poor sense of smell!). Night-time Sudafed dropped me off to sleep, but later when I awoke I suffered chills and weird feelings of anxiety, then lethargy the next day. In desperation, on 11/05/2021 I contacted my internist and an endochronologist friend. My friend advised me to "go clean" - no Sudafed, no CBD for 4-5 days - which I did. I have not taken Sudafed or CBD since. During this period I also stopped drinking coffee and alcohol to ensure neither would interfere with my sleep. 11/06/2021 my internist prescribed Lorazepam (.5mg) to help when I cannot fall asleep. I took my first Lorazepam ~11/13/2021 and have taken ~8 since then.  I have also reduced my intake of salt and begun taking a multi-vitamin. I have not been able to identify any correlation between diet, activity... Sound therapy (cricket sounds, forest sounds) has helped offset the effects of the harshness of the tinnitus "sound",  helping me to relax enough to fall asleep. Since August I have spent at least $1,000 on various headphones, speakers, and apps to deliver soothing sounds to my brain! In early November I also identified several ENT's who advertise as addressing tinnitus in their practice. I have an appointment 12/14/2021 with one such ENT, who I hope will offer some medical insight and possible measures to pursue to lessen the "noise". In addition, I speak with a psychiatrist every 34 weeks, at a cost to me of $150 per session (no insurance involved). Since April, coping with tinnitus has become a dominant theme of our discussions.