Dan's Corner, aka Ask Danik

Another thread has inspired me to open a thread where sufferers can actually discuss "do-it-yourself" TRT. Or any other tinnitus related questions I can answer.
I know a lot about TRT and the theory behind it. I've talked to TRT clinicians, I've been there done that. Seeing as this has never been done before on a tinnitus forum ever before, I am here to offer my knowledge in the subject.
I am open to answer any questions about Tinnitus Retraining Therapy.
I understand that TRT is not going to help me or some others, but it can certainly help many people, so i'm here to offer what I know -which believe me is a lot.



So Roll in the questions!

(some examples would be - how loud should I set my sound generators, which sound generators should I buy, what is tinnitus reclassification, is TRT for me, etc, etc)

 

I have mild T for 3 months and sensitivity to sounds that make broken speaker effect where do I start?
I want get rid of T or at least train my brain not to hear it.

 

ok first of all, just so you know, TRT isn't designed to get rid of your tinnitus.
If your tinnitus becomes lower during TRT (its been known to happen) then according to true TRT, it wasn't because of TRT, but because your brain replasticized itself due to some yet unknown mechanism. I think TRT can trigger some positive brain plasticity in some patients.

Now you should start by reading about the "Neurophysiological Model of Tinnitus".
It sounds like you have some hyperacusis and therefore you need to address that issue first.

 

ANY QUESTION ADDRESSED TO ME PLEASE USE

@dan

So that I get a notification.

 

Not a trt question but.
My T as been high when I wake up. Then it slows down a bit as I carry on with morning routine. Recently having lot of days with spikes and quite moments (just bearable levels if T or day to day noise can cover it)
Very rarely I had days mornings are quite..
I do have stiff jaws and ETD issues.
I am addressing those issues stiffness has reduced a lot. ETD is fluctuating..
Trying NAC ..
Can give ur comments @dan anything I can give a try..
I am habituated .. Use melatonin for sleeping issues.

 

Try Ginko Biloba.

 

@dan
I heard that tinnitus is just a harmless sound.
But I also heard that for some people it can be quite harmful.
I'm confused

 

That's an excellent question Valeri.
Tinnitus sound, or "ringing in the ears" is harmless. It's your reaction to the sound that's detrimental. Reaction to tinnitus manifests itself as:

• Insomnia
• Anxiety
• Irritability
• Inability to concentrate
• Loss of appetite
• Social isolation
• Depression
• Suicidal ideation
• Obsessive compulsive behavior

 

Thank you for your detailed answer.
I would like to know why is there a reaction to tinnitus in the first place if it is just a harmless sound?
Why don't we react in the same way when we get a flu or headache?

 

We react to tinnitus ,because our auditory cortex has a feedback loop to an area in the brain called the Insula - it is responsible for our emotional and cognitive control.
People who suffer from tinnitus have hyperexcited Insular areas, as opposed to people who are habituated and don't suffer from tinnitus.
Our auditory pathways are built to alert us to danger. In tinnitus patients, the Insula is constantly on high alert from this intrusive sound. In habituated people, tinnitus no longer registers as anything important.

When you get a headache, you know it will go away, so you don't get the anxiety that comes along with a chronic condition. I would say people with chronic migraines can also get depressed.

 

@dan
Thanks for the offer. I was in a tinnitus clinic where they did TRT with me.
Dr. Nagler is correct in a way that TRT is not done within some weeks, but could take 18 to 24 months. So maybe it was no real TRT. Nevertheless I also went through all the Jastreboff papers, read all on www.tinnitus.org, read the H&W book about CBT and so on. I tried white noise, hearing aids, combined devices.

The thing is, I have at least two tones above 10 kHz. If for example the 14 kHz tone is switched on (which is 99 % of the time), my blood pressure increases immediately, I get high tension, anxiety etc. I can only stand the noise by mixing with high-pitched cricket sounds. For example if I am chewing, my head is buzzing.

Afte one year, I thought I will habituate to this. I thought that others made it, so will I. I fought against depression, but now I have one. I also have the other things stated above. Only insomnia is no problem for me. I sleep 9-10 hours.

I believed in brain plasticity, but my brain has NOT hardened to the sound yet. I must admit that if the high tone is not there, I could handle it in some way. I could even stay in quiet rooms without a problem. But the 14 kHz tone is just awful.

Dr. Nagler says, my reaction is normal. This is how the brain works.
The people around me think, it cannot be just the noise in my head, but it is a normal depression.

So her comes my question: How to cope with such a high tone and not react to it?

 

Its not the length that makes in not TRT, but more specifically what you actually do that counts.
If you tell me the exact protocol that you followed, I could then tell you if it was indeed TRT or not TRT. Simply saying "I tried white noise" doesn't tell me anything. What exactly was the protocol? At what dBspl did they program the noise generators ? how many hours a day did you wear them? What kind are they ? This is all very important stuff.
Dr.Nagler said this and Dr.Nagler said that, but Dr.Nagler isn't here to help you is he.
Oh yeah he knows good TRT clinicians and he will refer you to his colleagues. My point is you can do all that on your own, but you still need to work with an audiologist that sold you the ear instruments. You paid for them, so that service should be included.

Lets see what you did wrong and then maybe you can give it another go.

If I don't answer right away, I might be asleep.

 

I have a very experienced audiologist which has several tinnitus patients.
We tried different noises, white, pink, brown, different loudness etc.
Of course I know that the noise should not cover my T. This was not possible at all.
My T is so high that it was clearly audible even if the WNG volume was very high.
Actually my T worked against it and became louder, or maybe only my perception.
So the best thing I found was high-pitched cricket sounds. They mix with my T and give me relief.
But I try to not mask/mix all the time, but getting used to my T.

I know about several people with a T in lower frequencies and the WNGs help them.

 

I think you should be careful. It seems some people are taking this seriously and not all newbies are going to understand much of your sarcasm in this thread. I know you believe TRT is crap and have a lot of issues with it. Personally, I think it's more of a placebo affect more than anything else, but it works for some people and that is all that matters in my mind.

I do think it would be a interesting idea to put together a DIY TRT protocol and see what we come up with. It seems the big drawback is how to replicate the directive counseling sessions with an actual person. But if we wanted to listen to one of those counseling sessions, we can look here:

http://www.tinnitus.org/counselling_session.html

-Mike

 

@dan
When do ppl normally start TRT? Is there an ideal time or does it matter?

 

Of course we know Dan.
But I thought it is seriously.
Only the Gingko recommendation was sarcasm.

 

If someone wants to offer themselves up as an expert who is going to teach people how to successfully do TRT, I would hope they would have at least done it themselves. Dan believes TRT is a scam, so I don't know how this can be seen as genuine.

 

wow what a great guy @dan must be if this is sarcasm. I mean, all other forums on the net have trolls and I'm glad to see someone noticed the void here on TT and took the initiative to fill it.

 

Love the sarcasm. Only you and Mpt have the ability to make me laugh on this forum.

Admittedly, sometimes Dr. Nagler makes me laugh - but that is for a very different reason...

 

Hello all, if this is sarcasm or a joke, let's mark it clearly as such and move it to another area other than support - just my opinion.

I am no newbie, but I remember what it was like to be new and this would have been very confusing for me in a very difficult time. I know we all know that feeling. People come here in earnest to ask serious questions when they are in a great deal of pain and confusion.

Whether this is genuine or not, purporting to be an expert on something and giving answers in that guise when it may not be the case is perhaps not the best idea, even if it comes from a good place.

 

I enjoy snarky humor as much as the next person. But I don't find sarcasm helpful or productive in this setting. Only confusing and, ultimately, disappointing. But that's just my opinion.

If people do want to indulge in sarcasm, I agree with @awbw8. It should be clearly marked as a parody.

 

@dan
I have read all docs on tinnitus.org.
So how do i start?
First get used to sounds like broken speaker?

 

I wasn't being sarcastic - Ginko Bilobo is known to promote circulation to the inner ear.
Jesus people, you guys are edgy. The guy said he was HABITUATED, what else could I offer him as advice? Probably it sounded sarcastic.

 

@Martin69 , can you tell me what loudnesses did you try with the wng's ?

 

Depends what you want to do? If you want to do DIY trt, then read about the Neurophysiological Model first - that would be a good start. There is a diagram there, study and understand the loop.

 

That's a good question.
I would say anywhere from 6-12 months of onset, depending on what your tinnitus does.
I think the first 6 months should be spent trying to find the cause of your tinnitus and trying to cure it if possible. Trying to cure tinnitus and TRT don't mix.

 

@dan I do apologize for my post then. I just assumed that others were correct about the sarcasm.

 

No I don't believe TRT is a scam outright. It is a habituation facilitation method. Habituation is REAL, I don't doubt it.
I do have certain beef with TRT proponents.
Like for example the way they market their product. Or the way they present it to the world like there is really no need to rush for a cure, or the way they group all tinnitus in one bunch, like we all have the same tinnitus and if a patient isn't successful then it must be the barriers to habituation that the patient has in place - legal disability etc, visiting T forums, etc

 

@dan

What about avoiding forums like this one I guess Jastreboff is practically insistent about it. Does or can it impede habituation?

 

My opinion, It can be deadly for some people. I would never classify it as a harmless sound. Sorry I chimed in Dan.