Ototoxic-A Word Every Musician Should Know

Ototoxic.  Do you know what this word means?  I didn’t.  At least not until 2024.  If you have followed my blog for any length of time and have read my “Funny as a Brain Tumor” story,  you probably already know that I have been through the mill with my medical history.  That story, that encompasses only ten years of my life, is just a bit of the drama that I have had to live through since 1995.  In that blog post, I write about some of my hearing issues and describe how at times, music would sound out of tune and very dissonant to my brain.  This has always perplexed the doctors I have gone to see but luckily, since 2005, it only happens a couple of times a year and only lasts a couple of weeks.

That was until 2024.  Last year, in April, my hearing went bonkers.  I thought I was having one of my bi-yearly hearing attacks but much worse.  The problem, was that this time, my hearing did not get better after a couple of weeks.  My hearing was messed up 95% of the time from April-November (8 months!)  It was so bad, that I was starting to think about selling my saxophones and calling it a day!

You have to understand that what I am describing is terrible for a musician. You can go back and read my “Funny as a Brain Tumor” story for more details.  Basically, the gist of it is, that music sounds horrendously out of tune and dissonant.  Even playing the saxophone by myself sounded out of tune.  I could play something as simple as “Mary had a Little Lamb” and it would sound out of tune and wrong.  Even though I was pushing all the right keys and blowing the sax as I always do, the melody would sound horrible to my ears and brain.  The notes were not in tune with each other.  Even if I played that melody on an in-tune piano, the melody would sound out of tune.  I was also feeling like I was in an airplane when the pressure in your ears is messed or when you have water in your ears.  Everything sounded far away and muffled and even the tone on my sax sounded muted and nasal sounding.   Nothing I could do would fix it and I tried everything I could think of.

I was at a loss about what was causing this extreme hearing disability and then in August, my hearing miraculously got better for about 10 days.   I had started taking allergy pills at that time and concluded that I must have an allergy to something and that was what was causing my hearing problems.  I was excited to figure it out and I thought I had a solution, take allergy pills everyday.

My hopes were quickly dashed when about ten days later, my hearing issues came back even though I was still taking the allergy pills.   I even took two a day (even though the directions said to only take one a day) in hopes that I needed the extra dose as a special case.   It did not help.  I was devastated.  It’s hard to feel hope and be confident that you have an answer and then have it all come crumbling down around you.

I went on with my life through September, October and November.  I couldn’t listen to music and even though saxophone playing was a major part of my life, I really couldn’t play the sax very much when the feedback to my ears was that it sounded horrible and out of tune.  Besides all that, I started experiencing tinnitus all the time.  It was a constant high pitch ringing that never stopped.  It’s weird, because you feel like you are hearing it in your ears but when you cover your ears as tight as you can it continues inside your head.  The worse time for me to notice the tinnitus was in the middle of the night or in the morning.  Whenever I woke up and it was dead quiet in the room,  I would hear this high pitched tone ringing in my ears.

In November,  I was browsing the internet for solutions (like I had a hundred times before) when I stumbled on the word “ototoxic”.    I had never heard this word before, what did it mean?   I looked it up.

Ototoxic substances are agents that can damage the hearing and balance systems. They can cause a range of hearing loss, from temporary to permanent, as well as dizziness, vertigo, and tinnitus (ringing in the ears).

What?!  I had never heard this before.  I read that certain medication could be “ototoxic”  and cause issues with your hearing.  I was on a few medications at the time and started doing google searches for their names + ototoxic.  I went through each medication I had been taking and when I got to Tamsulosin (Flomax) it was listed under the medications that could be “ototoxic” (although it is not on other ototoxic lists because that side effect is so rare).     I believe this is the site where I found the info among others.

Here is what AI comes up with when you do a search for “tamsulosin & ototoxicity”:

How could a medication that makes you pee better effect your hearing?   Then, while I was sitting at my desk, it hit me that when I had taken the allergy pills in August, I had also stopped taking Tamsulosin (Flomax).  It wasn’t related, but a few days before I started taking the allergy medicine, I had decided to stop my Tamsulosin because I wasn’t sure what it was doing or if it was helping me.  A couple of weeks later, I started it again.

That’s when it hit me. My hearing got better about 7-10 days after stopping Tamsulosin (Flomax) and my hearing got bad again 7-10 days after I had started taking Tamsulosin again!   I was convinced that this was the answer.

I stopped my Tamsulosin!  Sure enough, my hearing got better about a week later.  I still had the constant tinnitus but music sounded good to me and I could start listening to it again as well as play my saxophone.

Since the end of November, my hearing has been good as far as listening to music.  My tinnitus still hasn’t gone away and maybe it is permanent from taking Tamsulosin for 6 months but I can listen to music again.   I also still have hearing loss, deaf in one ear and what I am told is probably a eustachian tube dysfunction (which is not fun either and might be connected to my hearing loss) but I can play my sax again and it sounds pretty much as it should to my ears.  I am so happy to be able to share this with all of you.

I wanted to share this with everyone because although I had gone to a number of doctors during this time, none of them had even considered that it could be the Flomax.  Ototoxicity on the list of side effects for Tamsulosin was really low.  Like 1% I think,  but with my history of experiencing a range of medical issues that were in the 1% chance category, is it not a surprise that another one should be added to my list?

The other reason I wanted to share this publicly is in case there are other musicians out there experiencing hearing issues and even hearing loss.  From what I have read, sometimes these ototoxic drugs can also cause hearing loss whether it be a gradual decline as you are taking the drug or a more severe decline.  Many people write about getting off the offending drug and having their hearing restored back to normal levels while others found it was too late and their hearing was permanently damaged from the drug they were taking.

I write all this not to scare everyone to stay away from any medication that might be “ototoxic” but to inform you that that could be a possibility.  If you are taking a medication and experiencing hearing issues, then do yourself a favor and do a google search  to see if the medication is on the ototoxic medication list.   If you catch it in time, maybe you can stop the damage before it gets too bad.  I’m hoping and praying my tinnitus goes away but at this point, I am just grateful I can listen to music and play my saxophone again.  I’m posting this for all those out there on the internet who might be searching for a solution like I was.  Hopefully, you will find this and it will give you that solution.  I hope so.   Please let me know if it does.      Steve