My Tinnitus Has Changed ...

Sure, but what do you do when you say 10/10 today, and tomorrow it doubles in loudness?

As a beta brain, this does not compute

 

Sure of course I did not want nor did i expect it to blow it up, i was just making an honest observation, but im glad we got it straightened out....

 

Cor, this issue almost borders on the metaphysical - and it goes to one of the reasons researchers have such a tough time coming up with a true universal cure for tinnitus.

The problem is that tinnitus is a totally subjective entity. It is most definitely real, but it is subjective. Your tinnitus is exactly as loud as you perceive it to be at any given point in time - no more, no less. So to answer your question ... if on Monday you rate your tinnitus as a 10/10, which is as loud as it can possibly be in your opinion, and then on Tuesday you perceive that it has doubled in volume, I suspect you'd say something like, "Holy shit, I never thought that could happen!" And you'd rate Tuesday's tinnitus as a 10/10. What, then, would you say about Monday's tinnitus? I suspect that re-rating Monday's tinnitus would be the farthest thing from your mind.

The important thing to remember, in my opinion, is that chasing tinnitus loudness is pretty much a lost cause - at least it is in 2015. Which is why reaction is so crucial. Because if you do not react to your tinnitus (i.e., if it doesn't make you feel bad in some way or other), then what does it matter how loud it might be??!!

stephen nagler

 

LOUDNESS DOES NOT MATTER?

quiet tinnitus (hear only in quiet) >>> MUCH easier to habituate to (MUCH easier to learn not to have any reaction to it!)

LOUD tinnitus (hear everywhere, cannot be masked) >>> MUCH harder to habituate to (nearly IMPOSSIBLE to NOT have a REACTION to it)

anybody who says otherwise is a fool (no offense)... you shouldn't make statements like that... because... for most people... LOUDNESS does matter.

not reacting to loud tinnitus is impossible (or nearly impossible)... fact

search on google, there are studies that have found loudness equals T distress!

 

@Dr. Nagler I figured as much, but it's good to read it so well explained.

Im not sure I entirely agree with you that tinnitus is just perception. I have highly variable tinnitus. It can change from day to day, or even from hour to hour from 10/10, to 3/10. Lately the variable periods seem to lengthen a bit, where 10/10 would stay for a few days, and then im back to 3/10 for a while. Something external sets it off, I just dont see another way. Some function in my brain is causing the perception to change.

Unless with 'perception' you mean the same way all sound really is perception, in the sense that your brain just interprets soundwaves. But then using the word perception is kind of meaningless.

 

Not it you don't react to it, it doesn't.

Look, every person I know who has loud tinnitus would prefer it to be less loud. I know I would.

And I agree with you that in general, the louder the tinnitus the more difficult it is to habituate. But that principle does not hold true in TRT, which is one of the things that appeals to me about that particular approach.

stephen nagler

 

Well I guess if you have rated your T to 10 (even though it was more like 8) in the first place, you have to readjust your scale a bit.

Or if you want to track your T a bit more accurately you could name your T to different stages like acute/post-acute/chronic. But this is just a thought and after all - you shouldn't track your T in loudness ratings to let the habituation take place.

On the other hand, I've been keeping Tinnitus diary for last 8 months because it helps to sort my thoughts.To be exact, I don't keep listening my T. I just write down my obervations when T changes if that makes sense to you. When I get a spike after a noise exposure, I can just check my diary that how long my "this type if spike/t sound" lasted last time. It makes me feel calm when I can read that "ok, I was in the same situation with my xyz frequency hissing T 3 months ago and It took 1,5 weeks to calm down".

In the beginning diary also helped me to get familiar with my T. I've recognized about 4-5 different type/frequency T on myself and now when I'm familiar with them, I don't panic if one of them gets stronger. I just check my diary and notice that "oh, it's you again Mr. EEEEEE 14300Hz. Well, stay awhile but you may *uck off again if you like". And then I carry on

It's kind of suprising to notice that you forget your "old types of T" in 2-3 months and if they get back again (or you notice them for some reason), you have to remind yourself with a help of diary if you have gotten it before...

 

Right. In your case your tinnitus loudness rating varies. But I bet that your tinnitus loudness match is constant. I know you won't agree - few do, until they undergo a tinnitus loudness match on a "good ear day" and a tinnitus loudness match on a "bad ear day" only to discover that they are identical.

stephen nagler

 

Yup, that does seem unlikely to me, but knowing how eye perceptions are sometimes totally unbelievable, i'll say maybe

On a good ear day i may go most of the day without noticing it. Even when I consciously look for it. I can faintly hear it then. On a bad ear day, I dont have to look for it. It roars over every sound around me. Im very sceptical that the loudness is actually the same on these days.

 

Stink, I think you've greatly misunderstood what he's saying. He's said if you don't react to it, then it doesn't matter. Some people have loud tinnitus and it rarely brothers them.

If loud tinnitus is making you distressed, then you're reacting! But he's saying what if you didn't react as if you didn't notice it. Then in that case it wouldn't matter. This is not to say that you can habituated to loud tinnitus as easily as quiet tinnitus.

Stink, it seems that you're so eager to "get" Dr Nagler that you're not trying to understand what his point is.

 

@Dr. Nagler do you have any idea what may have casued your worsening?

Sorry if this has already been covered.

 

I really don't. All I can say is that it was a quantum change. There was nothing subtle about it. And I can also say I am tons better today than I was six or seven weeks ago, when it happened and sent me into a tailspin. My tinnitus? It is no better at all. But I am! And that's what's important, don't you think?

stephen nagler

 

This argument crops up a lot, but it is fundamentally incoherent. Dr Nagler himself says

If you would prefer it to be less loud then it matters. Saying anything else is doublethink.

 

Well I have to disagree here. Even though I haven't been tested I can say that my T is really low in the morning if I've gotten a good sleep. Humming of my fridge can cover my T in the good mornings. I can't hear it even if I try. But when I come out from work I can hear my T easily over the humming at the exact same spot every day consistently. I may be in the minority but I think my perception is as accurate as my perceptions in hearing test.

 

Like I said, most everybody disagrees. And most everybody is stunned to find out that they are wrong. So let's talk about it after you have actually done the experiment.

stephen nagler

 

Well I would have if there is a place in Finland to do that. I just don't see how different "reaction" or "perception" could prevent me hearing my T over a masking sound.

 

What experiment can we do to test this? @Zechariah said he can mask it with his fridge in the morning, but not in the evening. So either the fridge has become less loud, or the tinnitus has become less loud?

I started reading Jastreboff's book again, and if I remember correctly the ambient sound level plays a big role in perception. If thats the case, how can the actual tinnitus loudness be the same regardless of ambient sound?

im sure my inability to grasp this is because im trying to look at this mathematically while I probably shouldnt.

Ambient sound level = A
Tinnitus Loudness level = B

Perception P = B-A ?

If A doesnt change, but P is obviously different, how can B remain the same? This is why im saying some other factor must be involved.

 

On the matter of Dr Nagler's tinnitus loudness, he says in his bio on TT:

"My tinnitus is as loud as ever - like a cross between a screaming teakettle and a roaring jet turbine."

I suspect that some machismo about T loudness crops up occasionally on TT. Not accusing Dr Nagler here, but 11dB SL is one db louder than mine was measured at at its worst following an increase. It has now gone down a bit from there, but even then I would not have described it using words even close to Dr Nagler's.

 

Dr. Nagler, the best I can offer you - specifically - is to quote @here2help...

...whom you referred to as "an expert" if I recall correctly.

As @FERNANDO GIL can testify I actually did mention your worsening tinnitus in a PM to him a while back, but I also mentioned that there would be no point in even suggesting anything else to you because in "your world", all that exists is TRT. And so the options are pretty limited, I'd say.

My guess is that your shift/increase in tinnitus is linked to your worsening hearing (as a result of wearing increasingly powerful hearing aids):

Constantly bombarding an already damaged cochlea with noise (= hearing aids) is a bit like rubbing salt in a wound, if you ask me. Dr. Wilden specifically mentioned the dangers of hearing aids to me during my first consultation with him almost two years ago now. The more you rely on them, the more damaged your hearing becomes - leading to a need for even stronger hearing aids. Downward spiral.

I certainly think so. And I am glad that you, as well as anyone else, is doing better.

 

he said the same thing nagler is saying

If a person's suffering had to do with

the key word is If suffering had to do with

meaning that suffering does not have anything to do with loudness or pitch according to here2help or nagler

 

That's the theory. But does the theory work in practice? After all, human beings are just that: human beings!

There is always room for a few more members in the flat Earth society.

 

There are people with a loudness match of 2dB SL who are largely incapacitated by their tinnitus, and there are people with a loudness match of 10dB SL who are hardly affected by their tinnitus at all. Moreover, there are people with a loudness match of 10dB SL who are largely incapacitated by their tinnitus and who, over time, are hardly affected by their tinnitus at all - yet their loudness match remains at 10dB SL.

So if you want to suffer less, then I respectfully suggest that you look deeper than loudness for your solution - especially since there really isn't much you can predictably do about loudness anyway, at least not in 2015.

stephen nagler

 

Coming from a Computer Science background ive always approached tinnitus with that in mind. Probably not a good idea, but you go with what you know. So ive mentally pictured tinnitus as follows.

The human body is like a computer with 1 CPU, the brain. The brain has a lot of tasks it can do, but in the end, like a computer, it can only use up 100% of its resources. Some of these tasks are background tasks, which must be performed no matter what (breathing, etc). Other tasks are performed as the CPU permits.

Part of the brain does signal processing for the senses, including audio. Part of that is a pre-processing filter. That filter makes sure we hear what we need to hear so the brain can react to it but ignore the rest. This so the brain isnt overloaded with signal processing.

Tinnitus adds a permanent audio input to the audio processor. Since the pre-processor doesnt quite understand this sound, it lets it pass to the brain to react to. And so we do react, often badly, emotionally.

This processing takes up a lot of resources. Signal processing is expensive. So the brain goes into a much higher state of 'base load' as it's permanently processing this weird new signal. You may be tired quicker, dont react as fast to things, forget things, etc. There just isnt quite the same amount of brain power left.

What happens if your brain suddenly gets more occupied with a totally new task. For instance, i feel my tinnitus becomes much worse if I concentrate on a task. Concentrating takes up a primary function in my brain, leaving less power to other tasks, including the audio processor and filter. The filter gets less brain-cycles, and isnt filtering the tinnitus sound as well. Ergo, i perceive a higher volume of tinnitus.

But, in your case @Dr. Nagler what if something got introduced into your body that the brain needs to operate on? Maybe a disease, maybe your vision processor needs more cpu. Whatever it is, the audio processor gets less resources and the filter doesnt function as well anymore. Id be interested to see if in that state the brain would react the same when a real important external sound would enter (your wife's voice? as im wondering if the overal function of this audio filter is diminished.

Sorry for the long text, but thinking about it this way im wondering if tinnitus loudness isnt the result of an external task being loaded into the brain, thus leading to a less efficient audio filter.

 

...I'm just trying to keep the "bullshit levels" down.

 

Of course it would work. After all, you don't get bothered by things you have no reaction to, right? Of course, what you mean is can one get to a point where they truly never react. In that part of it, all I can say is people (some people) can get to a point where they react little enough to where it doesn't affect their lives very much.

But, ATEOS, I must also point out that the purpose of my post was to point out to stink that he misunderstood Dr. Nagler's point/position. Whether one AGREES with Dr. Nagler's theory/position is a completely different topic/argument.

 

This is completely wrong. Both dB and dB SL are relative measures in exactly the same way. The former is relative to an arbitrary standard sound that approximates the hearing threshold of a normal-hearing person. The latter is relative to a sound that matches the hearing threshold of a particular person.

 

Not only that, Jim, I find ATEOS's references to "bullshit levels" and the "flat Earth society" to be particularly offensive. He entered this wonderful support thread some 60 posts ago and purposely took it so far off base that it is unrecognizable.

Again, I sincerely thank those of you who supported me in my time of need.

stephen nagler

 

This barely makes any sense... and there is several flaws in it. I'm not going to start correcting them. Instead I try to understand your message and ask you: Aren't you going a bit far from the original point?

I have to ask though that wtf is "arbitrary standard sound"? It's like every sound can be standard...in a arbitrary way

 

Oh... I am so sorry doc that I posted 11 posts in your "wonderful" thread.



A "drop in the ocean" compared to your 155 posts in some other thread on... ahem... LLLT:



Standard Dr. Nagler tactic:

1) Attack everything except TRT...
2) If that does not work, then play the victim.

And I gotta hand it to you doc, that, you are rather skillful at playing the victim...

 

Interesting.

If I found what you posted to be pitifully irrelevant, I would likely just let it slide. And if I didn't, I surely would not refer to an opinion of yours as pitifully irrelevant. But for some reason you feel compelled to make a point of it when you disagree with my opinion. Of course, nothing you ever say is pitifully irrelevant, so it's obviously a hypothetical. But even so, one wonders why you must repeatedly pick at your sores instead of just letting them heal. And one further wonders what role your compulsive tendencies play in your overall pathology.

I'm just sayin' ...

stephen nagler