I've never been able to play with earplugs. Can't tell how loud or soft I'm playing. I never sprung for really good ones, just used those foam things.
Now after years and years of playing in big bands, usually sitting next to the drummer and in front of the trumpets, I have some pretty good tinnitus going. I have to sleep with some kind of droning noise in the room, like a fan, otherwise I have to listen to "oooooooooooooooooooooooooooooooo..."