Can TRT Work (Using Earphones?)

Discussion in 'Support' started by mexigrl64, May 7, 2015.

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    1. mexigrl64
      Frustrated

      mexigrl64 Member

      Tinnitus Since:
      07/30/2000
      Hi,

      I recently had an appointment with a specialist who recommended that I get Bose in ear headphones and use the Oticon Pink Noise app (after testing she decided that was a good one for me). She said that my Hyperacusis is still quite an issue (although it rarely bothers me after 15 years) and so I should wear the headphones for as much as 8 hours a day. It's pretty impractical to try to do that however (and not look like a sullen teenager ;-)

      I've been trying at home and I swear my T seems louder. I realize it's a long term solution. I've considered the in ear noise generators as a better solution but she wants me to wait for a few months.

      Has TRT worked for you? Has anyone done it with earphones rather than noise generators?

      Thanks so much!

      Barri
       
    2. Dr. Nagler

      Dr. Nagler Member

      Location:
      Atlanta, Georgia USA
      Tinnitus Since:
      04/1994
      Yes.

      No. There are a number of reasons why it can't be done with earphones, but the bottom line is No.

      That's not to say you can't find a measure of relief with earphones. You can. And it's not to say that the use of earphones can't help in some way or other with habituation. It might. But it's just not TRT. In fact, you mentioned one of the reasons yourself. It's just not practical to wear earphones all day long without looking like a sullen teenager. (That's not one of the main reasons you can't use earphones in TRT, but it's a reason nonetheless.)

      You are welcome.
       

    3. Dr. Nagler interesting you say "No" as at H network so many years ago, you said one could do TRT using pink noise cd and that the gens while convenient aren't needed..

      Could you explain further. .or correct me if I am wrong :)
       
    4. 15 years??? Was it always mild? or has it improved..clearly you feel the need to still treat it regardless..
       
    5. Dr. Nagler

      Dr. Nagler Member

      Location:
      Atlanta, Georgia USA
      Tinnitus Since:
      04/1994
      That's for hyperacusis desensitization - not for severe intrusive tinnitus. Hyperacusis desensitization is a whole lot easier to accomplish using wearable broadband sound generators, but it can be accomplished less expensively using a pink noise CD. We know that thanks to the work of the fine folks at OHSU, where they developed the Moses-Lang CD.

      But just to clarify, hyperacusis desensitization using a pink noise CD is not TRT. And if I said it was in a post on the Hyperacusis Network way back when, then I misspoke.

      Here's a piece I wrote some 16 years ago on how to use a pink noise CD for hyperacusis desensitization ...


      MOSES LANG CD

      For Hyperacusis (Pink Noise Band):

      The purpose of the pink noise band is to shift your threshold of discomfort due to sound back towards normal. To use the pink noise band, put the Moses/Lang CD in a CD player and gradually increase the loudness until it begins to be uncomfortable; immediately reduce the loudness to the maximum level at which the sound is comfortable. This treatment should never cause discomfort; you are always in control. Set the pink noise band on replay and use the CD for approximately 2 hours each day. (You may break up the time into several listening periods that total two hours rather than playing the CD for two hours all at once.) Each time you restart the CD, even if you restart it several times totaling two hours, be sure to start at 0 loudness and establish a new maximum comfort level. In this manner you will gradually improve your loudness tolerance. It is important to realize that you do not have to listen to the CD; rather just play it in the room as you go about another activity. Do not use headphones with the CD player, but please understand that if you walk around you will be varying the volume of sound from the CD player that reaches your ears. It is therefore important that any activity that you engage in be sedentary – reading a book, writing a letter, playing cards, working on a puzzle, eating a meal, etc. The process of desensitization – of shifting the discomfort threshold back towards normal – is effective, but it is slow and can take many months; do not become discouraged.
       
      • Like Like x 1
    6. Thank you Dr. Nagler :)
       
    7. Dr. Nagler

      Dr. Nagler Member

      Location:
      Atlanta, Georgia USA
      Tinnitus Since:
      04/1994
      You are welcome, Lynn. By the way, I wrote that set of Moses Lang instructions back in 1999. The very first iPod didn't even hit the market until 2001. So we are talking Stone Age here. I'd probably approach it a differently were I writing it today!
       
      • Like Like x 1
    8. mexigrl64
      Frustrated

      mexigrl64 Member

      Tinnitus Since:
      07/30/2000
      I'm hoping to get some thoughts from those who are or have used TRT therapy as well. Thank you Dr Nagler I appreciate your information. I do have hyperacusis, although it rarely bothers me and I know how to deal with it. However my concern is to treat the tinnitus. The specialist said that we have to treat both. They advised doing the earphones for as long as possible each day. I will be out of the country for 3 months and asked about getting the in ear devices. I was told that it was better to wait and keep working with the earphones. There was a concern about me being away and them not being able to work on the devices, or being able to assist me in tuning them.

      Thanks
       
    9. Dr. Nagler

      Dr. Nagler Member

      Location:
      Atlanta, Georgia USA
      Tinnitus Since:
      04/1994
      You are welcome. There is so much bad information out there; I just do my best to give good information. Now sometimes that good information is unpleasant to hear - but my goal is to be as direct as possible in the hopes that folks will have a little bit easier time as they navigate through admittedly muddy waters. And that is especially true in TRT threads like this one. So, mexigirl, if I say something below that you find to be a bit unpleasant, please take it in the above light.

      OK. I am with you so far.

      Again, so far so good.

      Oops. Why treat hyperacusis that is not a problem for you? To me that does not compute.

      To treat something that does not need treating? You lost me there again. Sorry.

      Makes perfect sense to me. That's what you do in TRT.

      You lost me yet again. Seems you've got it right, and the "specialist" has it wrong. I'm just sayin' ...

      There is no need to "tune" the devices used in TRT. In fact, 90% of my own TRT patients live out-of-state. It would be a helluva thing if they had to keep coming back to get their devices tuned.

      There is some sort of disconnect here, my friend. And I suspect that the fault is not yours.

      Not a problem. Glad to help.
       
    10. FlyFish

      FlyFish Member

      Location:
      Western US
      Tinnitus Since:
      10/2012
      What is a good wearable sound generator consistent with TRT?
       

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