As you may or may not know, there Coronavirus SBA Loans available, and the money goes to those who have Small or Large Businesses. This complicated issue can be more troublesome in the midst of the uncertain state of the world.

Big Ear has over 250 providers worldwide, and for most, this is a part-time gig, but it is still a small business and just can’t afford too much disruption from an unexpected factor-like Coronavirus.

My accountant has put together a helpful Coronavirus survival guide. If you take just a few minutes to comprehend, you will come away with ideas of how to keep things going as smoothly as possible.

We are all in this together and only time will tell the actual results of this disaster.

Remembering back when times were tough in 1972-1973, my grandfather and dad built a substantial addition to our nursing home business in Ohio.

The week that we opened, Carter caused interest rates to soar past 21%. In turn, this called all the previous loans that were at a much lower rate. There was no way to pay someone to take care of the elderly in those moments. Take them home and let them keep their money instead of putting them in a nursing home?

I walked up to the front door with my dad. There was a chain on the front door and a notice of failure to pay sales tax. I turned to him in doubt. All the people were still inside, and the business was running. He said we would figure this out. My dad did some creative financing, and the chain was removed within a few hours, and I asked my grandpa what to do.

His advice has stuck with me over the years and throughout all the businesses I have created and operated. He said, “We need to focus on today and keep the doors open one day at a time.”

We are in a time of great uncertainty once again, the day-to-day must be our focus. Don’t have fear, but keeping the lives and systems running in the present, and staying open to every idea.

Rash decisions for the future happen when you stay calm and don’t allow fear to take its hold on you. When you stay strong, you can see how much opportunity lies within this crisis.

This is from our Financial Advisor Debby Miller; enjoy these tips. You can get through this!

(719) 548-1646

FAX: (719) 5–18 –1936



Coronavirus Survival Guide

Coronavirus SBA Loans Made Simple

Coronavirus SBA Loans Made Simple


Coronavirus can either make or break your business. Each business will be affected to differing degrees, but everyone will have to deal with challenges during this time.

This article is designed to guide you through a step by step simple process to give your business the best possible chance of survival with clear action steps and no secret sales pitch.

This can be your opportunity to really drive growth in your business and make significant progress as you respond well to the challenge life has set.

Key Subjects

The main benefit of reading this article is gaining a strategy you can implement today to get more clarity on how you will survive this pandemic. The knowledge in this will help you:

  • Cut costs in your business
  • Get financial clarity
  • Make remote working work for your business
  • Access government financial support
  • Lead your team and innovate new revenue streams
  • Improve cashflow

Step 1 Get Lean!

Reduce overhead. Get your business to a position where it is only paying for critical overhead and, if possible, pause expenses.

This doesn’t mean stop working with your key advisors. If you have a coach, you need them more than ever to create a strategy to get through this. If you have an accountant, they should be supporting you to get access to funding quickly, if needed, and map out your likely future cash flow.

This means going through all your outgoings and canceling things that you don‘t use, such as software subscriptions.

Then go through and pause any costs that are nice to have but you don’t need right now such as staff training CPD portals. You’ll be surprised that if you just contact these suppliers and ask them for a payment holiday that lots of the bigger ones will still give you access to the software!

The point here is we are trying to reduce the fixed costs that a business has and therefore reduce the amount of gross profit needed (reduce direct costs such as FB ad spending or staff costs to deliver the service) so there is less pressure to maintain current sales revenue levels.

If your sales drop but you also successfully reduce your overhead, you will still be able to make a profit and have positive cash flow.

1. – Critically affected by COVID-19 (e.g restaurant, gym)

  1. – Negatively affected by COVID-19 (e.g marketing agency)

I understand that if you are in category 1 then this exercise will not remove the need to get additional funding, however, we can ask for less (as we need less) and we are much more likely to get it as we can put forward a business case that shows the lender we have tried our best to lean our business.

For category 2 there is a real chance you could get through this with innovation and become lean and agile.

Step 2 – Make remote effective!

Remote working has been imposed on us across the globe, so it isn’t a choice anymore. For those that didn’t work remotely before it’s important to set it up, so there is no loss of productivity.

Have an effective setup:

We could be at home for 6 months, so it’s critical that you have appropriate desk height, a proper chair, ideally two screens, and an option to stand. If you have to buy equipment to make this happen, I would do it. It’s an investment in making this time as effective as it can be. Additionally, when you return to the office, you will already have a home setup you can use where it will be possible to spend more time with family or just have some more time to yourself without commuting.

Equip your team with the best tools:

Use texting and email for communication, and use Zoom meetings. Make your setup somewhere that is free from distraction:

This is hard sometimes, I have an office, but the kids constantly come and give me updates on their homeschooling. Also, it can be seen from the front door, so the Amazon delivery driver will knock on the door when I’m on a conference call. At least it’s a separate room where mentally I feel ‘in the work zone’. I can put on my headphones, put a sign on the door for the kids, and shut my blinds so the driver can’t see me :).

Have a clear plan for the day mapped out:

It’s easier to lose track when you are on your own at home. Map out the top 3/5 things you need to achieve that day in priority order and allocate time to them in your day. Make sure to plan breaks, exercise, and mindfulness.

Start laying out process documents and checklists:

Everything you do remotely needs to be consistent, so if you have a team and are going to do the set task more than once, document it at the time you do it. This will make it easier to delegate as you can’t sit with someone anymore and have them pop back for questions (although you can do this virtually, it’s not going to contribute to you being effective)

Step 3 – Master your finances

This is an important time to ensure you have the visibility you need to make key strategic decisions. The importance of a financial plan:

In my opinion, a business’ strategy and tactics should be driven by the financial map (planned route to destination) and actual performance review. For example, if you have a financial plan that says you would like to maintain sales revenue levels over the Coronavirus period, you can then put numbers against the likely lost revenue to get a target for newly acquired customers.

Next to this target, you can note what the strategy is to achieve it, and what tactical actions each day, week, a month will be completed.

Then, you can track each day, week, month, your actual progress towards that goal, and adjust the tactics to settle on something that works.

Success in business isn’t about doing the same thing repeatedly; it’s about trying new things constantly until you find what works. You won’t know what works unless you are measuring progress.

You must have the right financial systems to achieve this:

It’s going to be much harder and more time consuming to achieve this with an offline accounting system (but not impossible). If you have online accounting, you can construct a financial plan, add on a reporting tool, and set up automatic reports to track progress. You can also link up an online cash flow forecasting tool to see with ultimate clarity what the likely in and outflows of cash are over the next days, weeks, and months.

If you have this system, you are unlikely to fail due to a lack of cash. We can spot the gaps ahead of time, apply for funding with the right information ready in hand to provide to lenders, and know exactly how much we need, for how long, and for what purpose.

Recommended systems:

We have a free APP called MyAdvisor. This has a receipt manager and mileage tracker. No charge and no strings attached.

Step 4 – Improve your cash flow & set up a cash flow forecast

Mapping out your likely cash flow is critical both for access to funding and to understand the impact of COVID-19.

In order to set up an online cash flow forecast you need to follow these steps:

  1. Get your books up to date (bookkeeping)
  2. Set up a financial plan
  3. Import that plans to your accounting system
  4. Setup an online cash flow forecasting tool
  5. Be able to view your future cash flow!

Note that we have shortened and simplified the process. Setting this up quickly is a learned skill. If you need help with this, let me know.

Improve cash flow by reviewing the forecast:

  • Collect funds earlier
  • Delay payment where possible
  • Offer a new product or service with a fast action discount
  • Advance bill for new client or customer work
  • Liquidate any assets you don’t need
  • Get cash in by discounting, offering payment plans or offers
  • Reduce overheads (as Step 1)


Step 5 – Be the leader your team needs

Leadership is vital during this worrying time for your team. Your role is to lean into your potential as a leader.

Give your team a clear plan:

Work on this as a leadership team (or just yourself) and brainstorm your key strategy and tactics for the next 90 days. Write this up by understanding your goals and what you can do to achieve them.

Share your plan with the rest of the team and get their ideas and input:

You’ll be amazed as the creative solutions your team can provide if you give them the chance. The idea is to develop new products or services that will help others and generate sales revenue for your business.

Get together daily when working remotely:

We always have a 15 minute all team huddle meeting on zoom every morning. It’s invaluable and brings us together as a team.

Make sure your team feels secure and valued:

You need everyone to understand that their jobs are secure, and you need them at this time more than ever. Talk to them to explain this. Now is the time for openness and authenticity.

Finalize your plan, discuss it daily with your team, and let them know how they can help:

If someone now has a role that they aren’t able to complete (ie. outside salesperson) then have them help you in a different capacity. Remember you have a great team, and you want to do everything you can to keep them.

Connect 121 with each team member:

See if they need any further support, and check in on how they are doing emotionally, mentally, and in the business.

On top of your daily huddle, have a weekly meeting, and a monthly strategy day. All can be done on zoom. Step 6- Access Government Relief

There is relief available.

  1. Economic Stimulus Package signed on Friday, March 27, 2020
    1. Individuals will be due $1200 and couples $2400 plus $500 per child.
    2. Payments start to phase out for individuals with an adjusted gross income of more than

$75000. The amount would be reduced by $5 for every additional $100 of adjusted gross income. Those singles making more than $99000 would receive nothing.

    1. The income levels are double for couples.

d.Income is based on the 2019 or 2018 return. If you made too much to qualify in those years, but expect your income to be lower in 2020, you would receive a tax credit when you file your 2020 income taxes.

  • Those who make more in 2020 than in 2019 would not have to pay back any stimulus money they receive if they end up exceeding the thresholds.
  • The payments are not taxed and those who owe back taxes would still get a check if they qualify.
  • The IRS states they will begin issuing checks within 3 weeks of the signing of the legislation.
  • The money will likely be deposited directly into individuals’ bank accountsas long as they’ve already authorized the IRS to send their tax refund that way over the past two years. If not, the IRS would send out checks in the mail.
  • For those that haven’t filed a 2019 or 2018 tax return, the IRS would rely on information on file at the Social Security Administration, which keeps records on all Americans who have paid payroll taxes.
  • It’s still possible that some people may fall through the cracks. On its website, the IRS says no sign-up would be needed to receive the money, but it’s possible the agency ends up offering further guidance.
  1. Income tax filing and payments
    1. The IRS and Colorado have extended your time to file and pay 2019 income taxes and your first estimated 2020 income tax payment until July 15, 2020.
    2. You do not need to file for this extension; it is granted automatically.
    3. If you do not think you can have everything filed by July 15th, then you MUST file an appropriate extension by the April 15th deadline.
    1. There is currently NO ability to defer payroll taxes, sales taxes, property taxes or excise taxes.
  1. Use a Federal tax credit to pay for the cost of providing leave to your employee
    1. You can apply for these tax credits when you run payroll.
    1. You’ll be able to immediately apply 100 percent of the qualified leave wages to reduce and/or receive a refund of your Federal Payroll Tax liability amount due. This includes any health care premiums you pay on behalf of your employees.
  1. Unemployment benefits
    1. Jobless workers are poised to get an extra $600 a week on top of their state benefits for up to four months. It would significantly boost everyone’s regular state benefits, which range from about $200 to $550 a week, on average, depending on where you live.
    2. Lawmakers also want to add up to 13 weeks of extended benefits, on top of state programs, which vary between up to 12 and 28 weeks.
    3. Plus, more newly jobless Americans would receive checks. A new pandemic unemployment assistance program would expand eligibility to those who are unemployed, partially unemployed or unable to work because of the virus and don’t qualify for traditional benefits. This would include independent contractors, the self-employed and gig economy workers. The pandemic program benefits would mirror what’s available in one’s state.
    4. The timing would vary based on where you live, but likely several weeks at least.
  1. Small business loans
    1. The biggest provision for small business owners in the economic aid package is roughly

$350 billion in new loans, at least a portion of which will be forgiven so long as the business continues to employ and pay its workers.

    1. Paycheck Protection Program is equal to 2.5 times your average monthly payroll.

c.Business owners need to apply for the loans at a lender approved by the Small Business Administration.

  • The forgiven amount would be equal to 8 weeks’ worth of payroll obligations (e.g., wages and benefits), plus rent or mortgage bills and utilities. And, the forgiven debt would not be treated as taxable income to the owner.
  • Phases can help with the preparation of this loan package. For $300 we will pull all documents you need to apply for the loan, and for $1000 we will do everything, including the loan application and the forgiveness application.
  • Coronavirus SBA Loans Made Simple
  1. SBA Economic Injury Disaster Loans COVID-19
    1. Borrowers have to apply directly, not through banks, funds can be available in 3 weeks (up to $2,000,000) @ 3.75% up to a 30-year amortization. Everything is done directly online via the following link
    1. We can prepare your entire loan package for you for $1500.


  • Applicants must meet the SBA requirements of a small business (500 employees or fewer).
  • Businesses directly affected by COVID-19
  • Businesses that offer services directly related to the businesses in the declaration
  • Other businesses indirectly related the industry that are likely to be harmed


  • Agricultural Enterprises
  • Religious Organizations
  • Charitable Organizations
  • Gambling Concerns
  • Casinos & Racetracks
  • Cannabis Industry


  • Applicants must have a credit history acceptable to SBA.
  • SBA must determine that the applicant’s business has the ability to repay.
  • Applicant business must be physically located in a declared county and suffered working capital losses due to the declared disaster, not due to a downturn in the economy or other reasons.


These working capital loans may be used to pay fixed debts, payroll, accounts payable, and other bills that could have been paid had the disaster not occurred. The loans are not intended to replace lost sales or profits or for expansion. Funds cannot be used to pay down long-term debt.

Next steps

It’s important that you understand this pandemic isn’t a reason for you to fail. There is a lot of support out there and ways to adjust your business strategy quickly to ensure you get through this. For a no-cost personal consultation with a principle at Phases Accounting, Tax and Business Management, Inc. (a $500 value) to get help with your personal situation give us a call at 719-548-1646.

By Zee Maq

Why Are Dentists At An Increased Risk Of Hearing Loss And Tinnitus?

A study was conducted on a group of dentists to assess the health impacts of the sound emitted by their medical equipment. The study focused on qualifying how many practicing dentists are at risk of medical conditions like NIHL (noise infused hearing loss) and tinnitus. Dentists At An Increased Risk Of Hearing Loss And Tinnitus and we will show you why.

The Main Focus

For decades now, audiologists have been carefully studying dentists as they can develop medical conditions like tinnitus and NIHL while working with their professional equipment. The noise emitted from their equipment, namely their handpieces and suction apparatus, puts them at risk.

While several smaller studies conducted in the past found and presented mixed results, they encouraged more research on the topic. The OSHA (occupational safety and health administration) quantifies the level of sound which should not be exceeded within the workplace. While some studies have noted that the OSHA standards are followed in a number of dental clinics, most clinics exceed these limits because of their equipment.

For reference, here are some studies on hearing loss.

  • One study which focused on the handpieces used by the dentists found that the high-speed handpieces can produce noise of up to 87 dBA, which is over the standard limit suggested by OSHA guidelines.
  • Another study found that the handpiece produces over 102dB SPL sound, which is a hazardous sound pressure level.

Usually, newer electrically operated equipment and ones that do not operate at their full potential don’t emit dangerously high levels of noise. Some studies have also focused on the number of times dentists are exposed to sound while they’re working.

While newer handpieces are quieter due to technological advancements, the level of sound they produce is still concerning for the health of the dentists and healthcare professionals using them regularly for elongated periods.

In addition to evaluating the noise emitted by dentists’ equipment, studies have also tested the hearing threshold of dentists compared to physicians. In these tests, physicians were usually found to have a better hearing threshold compared to the practicing dentists. Even a study conducted on dental students suggested that students typically suffer from TTS (Temporary Threshold Shift) after using handpieces in the laboratory. Unfortunately, repeated TTS can lead to a permanent threshold shift.

Tests comparing the hearing health of different types of dentists have also been conducted. For example, researchers found that dentists who use high-speed handpieces usually have a poorer hearing threshold compared to dentists who never used those handpieces. This suggests that the use of noisy equipment leads to a permanent decline in hearing ability.

Tinnitus in Dentists

Although more studies should be conducted to explore dentists’ hearing health, there are some studies that show specific results. A survey conducted in South Africa found that over 31% of all practicing dentists in South Africa had tinnitus. A study in the UAE found that over 21% suffered from hearing loss, and 37% accepted that they suffer from tinnitus. However, there are no such reports regarding this issue in the US; there is almost no progress being made to ensure the hearing health and safety of American dentists.

These alarming results suggest that there is a need to increase the NIHL and tinnitus testing of dentists, especially given the new and improved equipment. Also, all the medical equipment that they use in their clinics needs to be tested and compared against each other in order to reach some conclusive results. The study, which is described below, worked to address these questions by measuring the noise levels of standard equipment being used in dental clinics. This is in combination with a survey that accessed the extension of NIHL and tinnitus exposure of dentists. Real practicing dentists were involved in the study to reach reliable results.

Equipment Used

Individual Handpieces

Individual handpieces’ noise levels were tested when a licensed dental professional used them. A mannequin was used to make the setup like a dental office. The sound level was recorded whenever the handpiece was used on the teeth of the mannequin. The teeth used were the same as the ones used to train dental students in medical colleges. 8 different usage scenarios were set up in order to measure the sound levels coming out of the handpieces.

Similarly, a high sound producing suction apparatus was also assessed for sound level. This apparatus was also used in different settings to collect valuable research data and to see how it creates varying levels of sound under different usage scenarios.

All of the measurements were made and compiled according to the common usage scenario of the dental equipment. 20 second sound samples were collected and were compared against each other for reference.

Sound Level Measurements In Dental Operatory

Dental device sound measurements were also made during dental student training in the laboratory. During the laboratory exam, over 60 headpieces were running in full capacity under the same operatory. They were simulating the environment inside a busy dental practice.

In this examination, the operatory was sampled from 12 different locations to get the average amount of sound being produced by 60 handpieces running simultaneously. These samples also included recordings from near the level of the students when they had a running handpiece in their hands.

A Survey Was Run on the Oklahoma Dentists

In this study, a questionnaire containing two main parts was emailed to the members of the Oklahoma Dental Association (ODA). The survey asked them to fill the questionnaire with information from their personal experiences. The questionnaire was specifically designed to do the following two things:

  • Assess the exposure of those dentists to different sound ranges (mostly the ranges being produced by the equipment mentioned above).
  • Assess their exposure to NIHL and tinnitus.

The first part of the survey asked the dentists for their age, gender, and the number of years they’ve been practicing in the dental field. The second part of the survey asked them if they’ve ever been diagnosed with hearing loss or tinnitus.

Since more information was needed regarding tinnitus, the survey also asks a few more questions to the people who reported suffering from tinnitus. These questions were asked to assess the severity and frequency of tinnitus they experienced. The survey also asked them how long they were exposed to noisy dental equipment and if they used some sort of protective gear to keep themselves safe from this noise.

Dentists At An Increased Risk Of Hearing Loss And Tinnitus.

The Results

Measurements made in the operatory when suction apparatus was used alone or with a handpiece suggested that a dangerous level of noise was being made by the equipment. The data collected from the ODA dentists suggested that they suffered from hearing loss according to the national average. Also, more dentists reported their exposure to tinnitus than was expected.

In Individual Handpieces

When single working handpieces were tested for sound levels, they usually made sounds of up to 70 to 83 dBA, which is below the maximum limit suggested by NIOSH (the recommended maximum 8-hour limit is 85 dBA). However, when the handpiece was used in combination with obstructed and unobstructed suction, the noise emitted exceeded the 85 dBA limit. This might be the reason for the loss of hearing in the dentists with more exposure to this apparatus.

In the Training Operatory

The data and sound samples collected from various simultaneously running handpieces in a single operatory did not exceed the NIOSH suggested maximum limit. And, since training mannequins were being used by the trainees, in this case, no suction apparatus was used along with the handpieces in the large operatory.

The Oklahoma Dentists’ Survey

Three hundred ninety-five dentists of ODA were contacted and were sent the emails, including questionnaires. Of those, 144 surveys were completed and returned. All of the further analysis was conducted using these filled questionnaires.

Demographics of the Research

The mean age of the ODA dentists that responded was 57.5 years, and the range was between 76 and 35 years old. They had an average of 27.2 years of experience in the field. A majority of the participants were males which are in line with the overall percentage of males and females in the dentistry industry in the US.

Hearing Loss

1 in every 4 respondents reported a loss of hearing ability. However, keep in mind that around half of them were over 60 years of age. The hearing loss was found to be equal, or even slightly lower than, the national average when the studies were compared to the suggested national average of hearing loss per decade of life.

Over 31% of the dentists believed that their dentistry career had caused a decrease in their hearing threshold.


Some tinnitus was reported by 1 in every 3 respondents. Additionally, 1 in every 3 of the dentists reporting tinnitus mentioned that their tinnitus problem is very bothersome.

In contrast to the hearing loss measurements, which coincided with the national average, tinnitus measurements exceeded the national average. Some dentists even suggested that they find their tinnitus to be worsened by the end of their workday. One quarter believed that their tinnitus problem was because of their dental profession, while over half of them weren’t sure about this.

Dentists At An Increased Risk Of Hearing Loss And Tinnitus

Ototoxic Medications to avoid

Understanding Hearing protection

  • Setcos JC, Mahyuddin A. Noise levels encountered in dental clinical and laboratory practice. Int J Prosthodont. 1998;11:150–7.
  • Brusis T, Hilger R, Niggeloh R, Huedepohl J, Thiesen KW. Are professional dental health care workers (dentists, dental technicians, assistants) in danger of noise-induced hearing loss? Laryngorhinootologie. 2008;87:335–40. 

Medications Hearing Loss, Ototoxic Hearing Loss, Drug Hearing Loss, Medications that cause hearing loss and Tinnitus

Medications that cause hearing loss and Tinnitus

Medications Hearing Loss, Ototoxic Hearing Loss, Drug Hearing Loss, Medications that cause hearing loss, and Tinnitus.

You may not know that connections between hearing loss and medications exist. You definitely would never expect that a simple pill your doctor prescribed you would cause anything from partial to sudden complete hearing loss.

So you found a professional, and they made their best guess on a pill to give you to change the state of your condition.

The problem occurs because you are not sitting in his office as you should. You are ignorant and intimidated because you don’t know medicine, and you have not realized that the sign above his door says practicing medicine. Practicing is just guessing on how others have reacted before you; mistakes can happen.

When you receive an antibiotic like Floxin, be careful. It can cause death. Or if you live through the treatment, it can still cause Ototoxic Hearing Loss, Ototoxic Tinnitus, or heaven forbid as I experienced, both.

My recommendation is to follow my lead.

Go to the doctors with your Google app open and ready to go. Doctors don’t usually like this as you challenge their authority.

I recently did this at the dentist, and when he went to describe a simple pain management medication, I Googled it and found the side effects and told him that I could not live with this risk, what other drugs are available, and he prescribed Tramadol. I went from the most addictive opioid with massive side effects to the least addictive painkiller and learned the precautions and limits with a reduced chance of addiction.

Here is a pamphlet that I found on the side effects. It’s about medications that cause hearing loss and Tinnitus and how to avoid them at all costs.

The Pamphlet

This pamphlet indicates which most commonly used medications could potentially cause damage to your hearing or aggravate an already existing problem. It is vital that you, the patient, take responsibility for knowing which drugs you should try to avoid.

Usually, any hearing problem will only be caused by exceeding the recommended dosage of the medications. Often these problems are reversible upon discontinuation of the drug. Occasionally there are times when this change in hearing can be permanent. If you are experiencing a hearing problem, or if there is a hearing disorder in your family, ensure that your treating physician and pharmacist know.

Medications Hearing Loss, Ototoxic Hearing Loss, Drug Hearing Loss, Medications that cause hearing loss and Tinnitus

Medications Hearing Loss, Ototoxic Hearing Loss, Drug Hearing Loss, Medications that cause hearing loss and Tinnitus

If you’re prescribed one of the medications found on this list, you should immediately speak to your physician to see if another, potentially less toxic drug, could be used in its place. (This is why you need to have Google ready to search).

If the drug is over-the-counter, you should ask the pharmacist for a recommendation of a less toxic drug.

In the lists that follow, the generic name of the drug is given first. The trade name, if available, follows capitalized and in parentheses.

Many times a particular generic drug is manufactured under several trade names.

This list was compiled by:

Orin S. Kaufman, D.O.

Here is a list of Medications that cause hearing loss and Tinnitus, ototoxic hearing loss, Drug Hearing Loss, and is not an exhaustive list.

This is a list of Medications that cause hearing loss and Tinnitus, ototoxic hearing loss, Drug Hearing Loss and is not an exhaustive list.

This is a list of Medications that cause hearing loss and Tinnitus, ototoxic hearing loss, Drug Hearing Loss, and is not an exhaustive list.

Medications that cause hearing loss


• aspirin and aspirin-containing products

• salicylates and methyl- salicylates (linaments)

(Toxic effects appear to be dose-related and are almost always reversible once medications are discontinued.)

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)

(Most NSAIDS have the potential for causing hearing loss and Tinnitus. Because new drugs are frequently approved for use, you must check with your doctor or pharmacist to determine if the medication you were prescribed can cause a problem.)

• diclofenac (Voltaren)

• etodolac (Lodine)

• fenoprofen (Nalfon)

• ibuprofen (Motrin, Advil, Nuprin, etc.)

• indomethacin (Indocin)

• naproxen (Naprosyn, Anaprox, Aleve)

• piroxicam (Feldene)

• sulindac (Clinoril)

(Toxic effects are dose-related and are

almost always reversible once medications are discontinued.)


• aminoglycosides

– amikacin (Amakin)

– gentamycin (Garamycin)

– kanamycin (Kantrex)

– neomycin (Found in many over-the-counter antibiotic ointments.)

– netilmicin (Netromycin)

– streptomycin

– tobramycin (Nebcin)

(Of particular interest: topical ear drop medications containing gentamycin or neomycin do not appear to be ototoxic in humans unless the tympanic membrane (eardrum) is perforated. When a solution of an aminoglycoside antibiotic is used on the skin and used together with an aminoglycoside antibiotic, there is a risk of an increase of the ototoxic effect. It is also the case if used intravenously; there is a risk of a rise in ototoxic effects, primarily if the solution used on a wound that is open or raw or if the patient has underlying kidney damage.

Neomycin is the most toxic drug to the structure involved in hearing, the cochlea, so it is recommended for topical use only. But even topical therapy had resulted in hearing loss when large areas were treated, and large amounts of the drug were absorbed into the body. Hearing loss caused by this class of antibiotics is usually permanent.

• erythromycin

– (EES)

– (E-mycin)

– (Ilosone)

– (Eryc)

– (Pediazole)

– (Biaxin)

– (Zithromax)

(Usually ototoxic when given in intravenous doses of 2-4 grams per

24 hours, especially if there is underlying kidney failure.)

• vancomycin (Vancocin) (Similar to aminoglycosides in that it may be ototoxic when used intravenously in life-threatening infections. The fact that aminoglycosides and vancomycin are often used together intravenously when treating life-threatening infections further exaggerates the problem.)

• minocycline (Minocin) (Similar to erythromycin)

• polymixin B & amphotericin B

(Antifungal preparations)

• capreomycin (Capestat) (Anti-tuberculosis medication)

Drugs that can cause Tinnitus


• bendroflumethiazide (Corzine)

• bumetanide (Bumex)

• chlorthalidone (Tenoretic)

• ethacrynic acid (Edecrin)

• furosemide (Lasix)

(These are usually ototoxic when given intravenously for acute kidney failure, acute hypertensive crisis, or acute pulmonary edema/congestive heart failure. Rare cases of ototoxicity have been found when these medications are taken orally in high doses by people with chronic kidney disease.)

Chemotherapeutic Agents

• bleomycin (Blenoxane)

• bromocriptine (Parlodel)

• carbo platinum (Carboplatin)

• cisplatin (Platinol)

• methotrexate (Rheumatrex)

• nitrogen mustard (Mustargen)

• vinblastin (Velban)

• vincristine (Oncovin)

(The ototoxic effects can be minimized by

carefully monitoring blood levels.)


• chloroquine phosphate (Aralen)

• quinacrine hydrochloride


• quinine sulfate (Quinam)

(The ototoxic effects are very similar to

those of aspirin.)

Mucosal Protectant

• misoprostol (Cytotec)

Narcotic Analgesics

• hydrocodone (Lorcet, Vicodin)

Vapors, Solvents

• cyclohexane

• dichloromethane

• hexane (gasoline)

• lindane (Kwell)

• methyl-chloride

• methyl-n-butyl-ketone

• perchlor-ethylene

• Styrene

• tetrachlor-ethane

• toluol

• trichloroethylene


• aminoglycosides (see the previous section)

• amphotericin B

• chloramphenicol (Chloromycetin)

• minocycline (Minocin)

• polymyxin B

• sulfonamides (Septra, Bactrim)

• vancomycin (Vancocin)


• bleomycin (Blenoxane)

• cis-platinum (Platinol)

• carbo platinum (Paraplatin)

• methotrexate (Rheumatrex)

• nitrogen mustard (Mustagen)

• vinblastin (Velban)


• acetazolamide (Diamox)

• bumetanide (Bumex)

• bendrofluazide

• clorothalidone (Hygroton, Tenoretic)

• diapamide

• ethacrynic acid (Edecrin)

• furosemide (Lasix)

• hydrochlorthiazide (Hydrodiuril)

• methylchlorthizide (Enduron)

Cardiac Medications

• celiprolol

• flecainide (Tambocar)

• lidocaine

• metoprolol (Lopressor)

• procainamide (Pronestyl)


• propranolol (Inderal)

• quinidine (Quinaglute, Quinidex)

• indomethacin (Indocin)

• isoxicam

• ketoprofen (Orudis)

Psychopharmacological Agents

• amitryptiline (Elavil)

• benzodiazepine class

– alprazolam (Xanax)

– clorazepate (Tranxene)

– chlordiazepoxide (Librium)

– diazepam (Valium)

– flurazepam (Dalmane)

– lorazepam (Ativan)

– midazolam (Versed)

– oxazepam (Serax)

– prozepam (Centrax)

– quazepam (Doral)

– temazepam (Restoril)

– triazolam (Halcion)

• bupropion (Welbutrin)

• carbamzepine (Tegretol)

• diclofensine

• doxepin (Sinequin)

• desiprimine (Norpramin)

• fluoxetin (Prozac)

• imipramine (Tofranil)

• lithium

• melitracen

• molindon (Moban)

• paroxetin

• phenelzin (Nardil)

• protriptilin (Vivactil)

• trazodon (Desyrel)

• zimeldin

Non-Steroidal Anti-inflammatory Drugs (NSAIDs)

(Please see notation for NSAIDS under “hearing loss.”)

• aspirin

• acematacine

• benorilate

• benoxaprofen

• carprofen

• diclofenac (Voltaren)

• diflunisal (Dolobid)

• fenoprofen (Nalfon)

• feprazon

• ibuprofen (Motrin, Advil, Nuprin)

• methyl salicylates (BenGay)

• naproxen (Naprosyn, Anaprox, Aleve)

• D-Penicilliamin

• phenylbutazone (Butazolidine)

• piroxicam (Feldene)

• proglumetacin

• proquazon

• rofecoxib (Vioxx)

• salicylates

• sulindac (Clinoril)

• tolmetin (Tolectin)

• zomepirac


• prednisolone (Prednisone)

• ACTH (adrenocorticotrophic hormone) (Acthar)


• bupivacain

• tetracain

• lidocaine (Novacaine)


• chloroquine (Aralen)

• hydroxychloroquine (Plaquenil)


• thalidomide (Thalomid)

Miscellaneous Toxic Substances

• alcohol

• arsenum

• caffeine

• lead

• marijuana

• nicotine

• mercury

• auronofin (gold, Ridaura)

(Ironically, several of these drugs found to cause Tinnitus, are also used to treat

tinnitus (e.g., amitryptiline, benzodiazepine class, carbamazepine, furosemide, lidocaine, prednisone).)

Medications Hearing Loss, Ototoxic Hearing Loss, Drug Hearing Loss, Medications that cause hearing loss and Tinnitus

This is a list of Medications that cause hearing loss and Tinnitus, ototoxic hearing loss, Drug Hearing Loss, and is not an exhaustive list.

About the League

A pioneer in hearing rehabilitation, human services, and hearing conservation. The League for the Hard of Hearing, founded in 1910, is a private, not-for-profit rehabilitation agency for infants, children, and adults who are hard of hearing, deaf, and deaf-blind.

The mission of the League for the Hard of Hearing is to improve the quality of life for people with all degrees of hearing loss. This is accomplished by providing hearing rehabilitation and human service programs for people who are hard of hearing and deaf, and their families, regardless of age or mode of communication.
We strive to empower consumers and professionals to achieve their potential and to provide leadership to, and be the model for, disciplines that relate to hearing rehabilitation.
We promote hearing conservation and provide public education about hearing.

Ototoxic Drugs: Bibliography

Claussen, C.F, (1996). Chemically induced or drug-induced Tinnitus. International Tinnitus Journal, 2, l-2.
Drug Facts & Comparisons. (1995) St. Louis, MO. J.B. Lippincott.
Epstein, S. (1996) What you should know about ototoxic medications. Journal of Self Help for Hard of Hearing People, 16, 29-30.
PDR Drug Interactions and Side Effects. (50th ed.). (1996). Montvale, N.J: Medical Economics Co.
Physicians Desk Reference (50th ed.). (1996). Montvale, NJ: Medical Economics Co. Suss, E. When the Hearing Gets Hard. (pp. 167-216). New York, NY: Bantam Books.
USP is dispensing Information. (1997). In Drug Information for the Health Care Professional. Vol. 1. Rockville, MD: The United States Pharmacopeial Convention, Inc.

Original Copy

Does the Coronavirus Treatment Cause Tinnitus and Hearing Loss? Sneak peek at what the headlines will read in a few months; coronavirus survivors will have other health complications.


Imagine that you live through the nightmare that is the Coronavirus, and now you have a massive ringing in your ears. Could it be a lifelong issue? Do you have sudden hearing loss in one or both ears?

This happens all the time to thousands of people around the world, whose cases don’t get reported. You must be aware of the side effects of medications you are given, and if the cure is worth it.

In November 1997, I took the antibiotic Floxin for a few issues that I was having, and not a day later, my ears started ringing like in a movie where they show a deafening explosion. The only difference is, my ears have never stopped ringing. God forbid, if you happen to get the Coronavirus, it won’t be treated by an antibiotic but you might want to stop and think about the treatment.

Although doctors mean well, you must remember that they are only practicing medicine. They are not scientists, and their job is to guess about what problem you have, run some tests, and then prescribe you the correct medicine. (Sometimes receiving a good bonus from the pharmaceutical rep is also their motive). Then, depending on the medication, they wait for results; including death, despite that being a terrible thought. I would almost promise you that if you were their own family member, they would take time to study the side effects of whatever medication they are promoting.

We are in a difficult, complicated place in medicine today, as there are many existing solutions. Still, those solutions are not always made public or put into practice for various reasons, and having coronavirus could bring unexpected side effects after the fact.

I am not a doctor or an attorney, If I were I would not share this with you.

However, I am an experienced researcher and I have studied the cases of many people before me who have died from the cure.

This is a new time. We don’t have fair, complete information. Prescriptions can cause massive complications.

Protect yourself. Stay healthy and stay informed!


Coronavirus Treatment Causes Tinnitus and Hearing Loss

Coronavirus Treatment Causes Tinnitus and Hearing Loss


This is a book that outlines the effect of antibiotics on your hearing health (DOWNLOAD).

“First do no harm,” is one of the major tenets of healthcare. While the Center for Disease Control (CDC) is still learning about COVID-19, current information suggests that older people and those with severe chronic health conditions such as heart disease, lung disease, and diabetes, are at a higher risk of developing more serious illnesses from COVID-19.

Through my travels, I have seen the masks and precautions, from Canada to New York, to Orlando, and San Juan. Everyone is scared. As I left for a 7-day cruise, the news in the hotel lobby read “21 on Cruise Ship tested positive for Coronavirus.” Everyone is being affected in some way.

Although “Brought to you by Big Pharma” should have accompanied this headline, it did not. This widespread scare will cause massive hearing damage from the numerous medications used to treat it. We won’t hear about it, but with a little research, you will discover a whole iceberg of information underneath.
All I really ask is, if you take treatment, know the risk.

So many days I wish I would not have taken the medications; only when I’m dead will the ringing stop.

Know the risk of what the cure (potential treatment) can do to you.

Coronavirus Treatment Causes Tinnitus and Hearing Loss – Is that what you really want?

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Does active noise canceling work to protect your hearing?

Active Noise Canceling Big Ear

The short answer is ABSOLUTELY NO. It takes a little bit to understand just what active noise canceling is and isn’t and what it can do and what its limitations are.

Let’s, first of all, understand that it would never be designed to use as a hearing protection device, but rather a background noise eliminator. The main glaring flaw is 2 fold and it is not a flaw really it is just what it is.

  1. Are you using a active noise canceling unit that is using a ear tip to be able to seal off the ear canal and be a better hearing protection device than a open speaker like the old earbuds where you can still hear all the outside noise and have to turn up the sound in the device to overcome the background noise.
  2. This is something that is very hard to find but is in the very small print. This is not meant to be a hearing protection device. The issue is it cant control any kind of sudden impulse sound or quickly changing loud bursts of sound. It is designed to listen and access the sounds coming in and creating an anti frequency to cancel this sound wave to give you the effect on reduced background noise. This takes time to do and if you try and use this active noise canceling device like a hearing protection device you will constantly get dosed and this will lead to Tinnitus and noise-induced hearing loss.

Here is an excellent article in Wiki on how active noise canceling works.

There are a few different patents and devices out there that taught that it will eliminate all the sounds and most people automatically think that would then include hearing protection.

Many people who read or sell this unit take a pretty hard opinion about their new devices, but they are not doing more than 100 events per year talking belly to belly to customers that are all confused now when they come up to our booths. So many are asking us is this active noise canceling like it is somehow some kind of hearing protection device and it just simply is not.

So the positives

The jawbone device was one of the first to really get this technology out to the consumer and they are now out of business. They were too soon and too expensive and no one knew what it was. It was too heavy and did not fit very many ears without an adapter. Once you added a custom ear adapter it became an amazing unit.

The Bose headset was one of the first to get market penetration on the over the ears noise canceling and if you had noting it was better than that, but you sweat and it was not comfortable to wear. You still could hear all the sudden pulse and impact sounds are so it is not hearing protection.

We are a hearing protection company first so are jaded on products that claim and give the false sense to be some sort of reduction product but when you look at there disclaimers and indemnification clauses they try and not be liable for the miss information or confusion that they cause.

What the best noise canceling headphone with compression

The proper device to create:

It would be expensive and overkill, but the right product that will need to be created would be a sealed active noise canceling with compression. This would allow all the background noise to be recreated and compressed to be recreated so you could control and limit the impulse and random bursts of sound.

There is no reason to get into a debate with the active noise canceling device companies because they always say that it is not a hearing protection device, some where in small print, but like drug companies they only tout the benefits and let you believe that it would be hearing would be protected because we neutralize noise.

So at the end of the day if you are in an area that is over 95dB, wear some sort of hearing protection and don’t rely on an active noise canceling device to protect your hearing from noise-induced hearing loss.

How to find the right hearing protection.