Something Positive — Please Read

Hi all, I found this extremely positive post on another Tinnitus support site and wanted to share it with you:


This is my first post here because during my dark times I just wanted to avoid talking and thinking about it so much, but boy do I have a story for you. Specifically this post is for those of you who where I was 6 short months ago, Suddenly finding yourself saddled with something you don't understand and could not make sense of.

People's reactions to T vary wildly from minor annoyance to soul crushing depression, I'm guessing by the fact that you are here means you fall a little latter on that scale like I did. I would spend countless hours googling T and every possible combination of words I could think of.(seriously you have to stop doing this) I thought for sure they had to be a cure for this, I simply couldn't imagine living the rest of my life like this. If only I could find out exactly the cause I could reverse it, but as many of us learned, such a fix rarely comes.

You may think that nobody can understand the pain you are experiencing. Believe me I did. The world kept moving around me and here I was constantly on the verge of a breakdown. To make matters worse it has very hard to get someone to understand exactly how debilitating T can be, most people thinking a little ringing in the ears couldn't possibly be that bad. Congratulations for not punching them in the face, unless you did, in which case....good job.

Before I start dolling out advice like I'm some kind of expert( I'm not). I just want you, the newcomer, to trust I know what you are going through, I know what it's like to spend hours in the shower to make the sound stop just for a while. I know what it's like to contemplate suicide. I know what it's like to look at my home surroundings that used to be so comfortable to me as a mockery of the happy life I used to have. I missed silence more than I ever imagined. My sense of loss was constant and profound

I felt terrified at just the idea of this being forever, I felt guilty about whatever I didn't do to protect myself from this, I felt anger at myself that I didn't appreciate how lucky I was before, and I was overwhelmed with a sense of regret and a deep sense of injustice. I thought I was a fairly decent person, So I didn't believe my life should basically be over at age 26.I know these perpetually negative thoughts too well. They just cycle through your head over and over again. Until ,believe me, someday they don't

I still remember the desperation, I would have done anything to stop the noise in my head. Including such brilliant methods of roughly banging my head of the wall (to jostle the brain a little), standing right in front of the loud speaker at a music show, and placing my ears directly under the high powered shower stream. Those of you with brains will recognize these methods are the opposite of helpful, but that's desperation for you.

The good news is coming. To say it gets better is an understatement. When you read about people talking about their T online it's usually because they are still in desperation mode too, those of us who have essentially moved on with our lives don't lend our voices to the crowd enough. As a result the new T sufferer may get the impression online that they are the newest member in the world's most depressing club. Please believe me, your T will become less and less of a force in your life until it's only occasionally and mildly annoying, if that.

So how did I get better? Apart from the obvious force of time. You have to get ready to really grapple with yourself and exactly what are going though. Science hasn't helped us much, the best doctors can really do is prescribe you anxiety or sleeping pills if you need them. You have to face this battle yourself, try to reason your way out of the pain as best you can, if it's still hard for you to do it's no biggie, in time you will.The human brain just is not wired to be miserable forever. We have this thing called neural plasticity, so the longer you live with T, generally speaking it will become less and less noticeable.

But how does all this effect you now? You can start with a few exorcises I found helpful. First, identify the sound correctly on a rational level and hope your subconscious follows. The odds are incredibly strong that the noise we are experience is a normal process in the brain and that normal people experience it too. When they stretch in the morning, when they spend a long time in a noisy environment, or if they are in a truly silent rooms. I personally remember these short bursts of the sound in my pre-T life. So what does this mean for you? Right now you are reading the sound as a foreign intrusion that is just messing up your hearing, when really we are just experiencing an amplification of a naturally occurring process. Does this make a real difference? On a subconscious level I think it does, the sound doesn't seem quite so alien, and that at least helps to know there's not something seriously going wrong with your hearing .
I've saved my most important recommendation for last,but honestly believe that masking (along with a good anti depressant) saved my life.

There are a million ways to alter the sound and volume to a level that suits you, but I burned a CD of just white noise and I had it constantly playing wherever I was for months. Some people will advice against it because it is only a "band aid" that does not address the real issue and help you toward habituation. Let me just tell you, that view seriously underestimates the importance of band aids. Sometimes you have to stop the bleeding before you can heal the wound. If you are feeling stressed by the T, then the masker while not perfect, will at least give you some control over it.

And this is an important part of it. As hard as it may be to you now to understand, the sound itself actually the problem. Objectively speaking the sound should be a small (and mostly subconscious) annoyance at most as shouldn't interfere with any of your activities. It's what the sound REPRESENTS to you that fills you with dread. It's the idea that there is nothing you can do about it, we humans like our freedom of autonomy and T violates so much of what it means to us to be a free person. This is why using a masker like white noise gives a little control back to you. You can go about your routine but always know that a few feet away is a cd player that will play a sound that will let you get your relax ion back for a while. And that's what you really need, relaxation. With most of life's challenges at least you usually get a cool off period to calm yourself down, that's what masking will do for the vast majority of you.

And I'm here to tell you, anecdotally at least, that masking has long term benefits as well .I masked constantly for months, I could never imagine not having to use this noise though, until one day I just realized I could. The white noise made me perceive my sound as coming from an outside source, which is much easier to deal with. So now that I've stopped masking, most of the time my T subconsciously registers as background noise. It really is a miracle that I hope many of you can replicate . I do still use the masking on rare occasions when I'm watching a movie or something and I'm noticing the T, but then I just flip the masker on for a few minutes and I'm good to go again.

I have to be honest, I'm only 6 months into this so I'm hardly a guru. I think I've made tremendous progress in only 6 months (that feels like 6 years), but I still occasionally get a little down about it, but these moments are getting rarer and shorter lived. I have full confidence that I'll be 100% the old me in 6 more months.

So please, know these dark early days WILL pass. I know it's painful, it's the hardest thing I've ever had to do, but you will get your life back. The simple pleasures. For me it's a warm shower in the morning and the companionship of my fiance and two wonderful little dogs. Almost ever day now I have a moment when I feel happy to be alive, and honestly I couldn't have even said that before the T.

So I hope you go to bed tonight and sleep a little better knowing that this pain, as vivid and heart wrenching as it may be, will be gone someday soon. And as an added bonus, life's little problems won't seem so important anymore. If a naturally pessimistic and frequently depressed person like me can find the joy in life post T-pain (kinda pun?) then anyone can. If you need help please reach out to the many wonderful people around the web who have gone through the same thing you are, and if you need any clarification or have any questions for me I'll hang around here for that too. Peace.

-Christopher

 

I mean no disrespect to Sybs who simply reposted this message but I feel strongly about some opinions in this being presented as facts.

First of all as someone who has examined ALL the so called evidence about Tinnitus being a natural noise I simply cannot disagree more with this and to be honest I get really irritated at the people who try to push this rather perverse view on others. I remember my life very well before I got hearing loss and Tinnitus. I would frequently sit in silence to study and where I used to live was a very quiet area. I would wake up in silence each day. Never heard any strange Tinnitus like noises in my entire life. I have also sat in sound proof rooms for hearing tests and never heard any tinnitus like noises. After I got it I heard it everywhere in the quiet places where I only heard silence before. Silence is mentioned in many ancients texts from far quieter times in human history so I doubt they were all delusional and suffering with Tinnitus noises in their heads.

My Tinnitus is at the same frequency as my hearing loss so I'm pretty sure if that was fixed the noise would disappear. So until that happens and I still have Tinnitus I will remain very skeptical at such ludicrous claims. In my opinion this is a bizarre attempt to normalize something which I believe is disturbingly abnormal. Before anyone replies and says that people with normal hearing still have tinnitus I would advise them to read the link below about that.

http://www.acoustics.org/press/159th/liberman.htm

It talks about how significant degeneration of the cochlear nerve occurs after noise exposure, even when there is no hair cell loss, and even when hearing thresholds have returned to normal.

If something works for you does not mean it's works for everyone so let's be mindfull of that. For me 'pretending' everything is fine is delusional and very bad psychologically. For some it seems to work brilliantly. Let's also not forget volume is a factor. Someone who can hear their Tinnitus standing next to a speaker at a club is not the same as someone who can only hear it in silence. There is no one size fits all philosophy. As someone who has been through TRT and was considered a textbook success I can honestly say maskers actually just irritated my ears. Once I stopped wearing them I actually felt much better. I wouldn't recommend them to people if they asked me but I would never go round telling people never to have Maskers. What works for some people does not work for all. We should never forget that when offering our 'opinions' on these matters.

 

Sorry Molan, I guess I just re-posted it as it really helped to give me some hope and I genuinely thought it might help others. Obviously, I am new to this whereas it sounds like you have tried lots of things, and remember the sound of silence. I appreciate that one size certainly does not fit all - we all have different types of sounds, different volumes, different perceptions and different tolerances to it, and different causes. Also, for some of us it will come and go, while for others it will remain constant, and for some of us it may be very shortlived and go away by itself never to return and we may never know what caused it. I must agree with you that I don't like the idea of accepting it and would rather get to the bottom of it and have it dealt with as something that is abnormal.

 

Hi Sybs no need to apologize I realize you were just re-posting something you thought would be helpful to people.

It's amazing how differently some people perceive things. If I had read that when I first heard got Tinnitus I would have been even more depressed to put it lightly! However for some people it gives them hope and that is fine too but for me we have to be careful to distinguish between fact and opinion and posts like that can unfortunately be very misleading.

 

This is my own experience. Of course, it is completely subjective, and not posted to dispute or disrespects others who has different outlook from their T, especially as T has different causation factors:

Whether I identify the T sound on a rational level or not, and whether I believe it is a normal process of the brain or the nervous system or not, the fact remains that I should not be hearing these processes on an undulating basis. This is simply unnatural, and no amount of trying to persuade me that most folks hear T can convince me that this is an unacceptable state which unfortunately I'm forced to accept out of no choice. Most folks hear T in silent rooms etc. but that normally recedes. In a T sufferer's case, the T is too prominent to recede on its own. Various expensive tools to revert it back into a background sound that one fails to hear is very much trail and error. And in friends who are T sufferers, even when they have no reaction to it, the T stays firmly entrenched and permanently so. So much for the theory that reaction plays a hugh part in whether T stays or go. The only recession that ever happen is only when the T sufferer is distracted - by work or maskers - but in actual scenario, it never left the plane where it is always on call or lying in wait. Whereas in a normal person, even when they try to on-call the T, they have to try very very hard, and often in vain. It's like a person who is not prone to panic attacks, when they try to induce it in themselves to understand what the real horror of panic atttacks is, they find it tremendously difficult to call that up.

There are many like me who hardly mask, just let it be, and live life around it because there simply is no choice. Time on its own was what played a key part in modulating the brain's initial strong reaction to it. Not everyone is so lucky to have the blunt of T taken off by time alone, many needs band-aids. Irregardless, to someone like me who enjoyed pure and blissful silence without T intrusion, this T really sucks. Whether I react or not react to T, nothing can take away the realisation that a great deal of what I used to enjoy is lost from my life. Now the only silence I enjoy is a pseudo one that happens when the T is forgotten. But when I wish to switch off noise around me and enjoy pure and simple silence like before, I am disabled now, where before, it comes on call instantly.

I get irritated whenever I hear all-too-wise audiologists - some of whom have tinnitus themselves - tell me I am negatively reacting to the T because I fear there is some growth in my head or system causing it. Ever since T appear, I've never even thought it could be due to any growth or trauma. I am not even convinced I have hearing loss or virus attack. When they heard my main grievance was the loss of silence, they told me silence is natural and that famous test has proven many hears T when put in a silent room blah blah. Irregardless, I've never heard T when put in any silent room except when I swallow etc. and that's to be expected. So that fact that others hear T in silent rooms doesn't apply to me. Silence is gone, and something I am forced to accept unwillingly. I've habituated to a good degree - without much band aids. But I still am extremely disbelieving when someone tries to convince me T is a natural state of affairs. To me, it was not, is not, will not be, and will never be. It is unnatural. Full stop. My reaction and dislike for it plays not one whit on whether I habituate or not.

Such a thinking as mine is supremely condemned by all involved in TRT etc. Nevertheless, T is not my friend. Why should I befriend something against my will? I live with it but only because I am forced to.

I'd rather that instead of placing a blanket brainwash theory on T, therapists looks beyond sound therapies and hearing aids and study deep into the nervous systems to find more ways as to how it can be defended / mended against such intrusions.

What I agree with is not to constantly dwell on T, as that may be the only chance for it to ever vanish off the conscious radar. T can't be my friend as I never like to say good bye to friends. T is an alien thing, something I wish to let go.

 

I'll fight it off to death.

 

Hi Ellen,

Your post is written beautifully and there are many points that you have made that I can empathise strongly with, especially...'My reaction and dislike for it plays not one whit on whether I habituate or not'.

I too believe that I can distract myself from it but that that my reaction to my T plays no part in whether it is loud or quiet. It's loud when it's loud and it's quiet when it's quiet - and this has nothing to do with my emotional reaction to it. I also agree with many other points you have made.

I don't believe though that T is necessarily 'firmly entrenched and permanently so'. Some people who have suffered excruciating tinnitus have recovered - recovered fully - so much so that they cannot hear their tinnitus even when listening for it in a quiet environment.

It is easy to forget this when surrounded by so many who have had tinnitus for years, when some have parents with tinnitus that never went away and when nobody is able to confirm whether your tinnitus will last forever or eventually go away.

But it is a fact. Tinnitus for some people disappears, even after years. My next door but one neighbour at my previous house had it for over 2 years. Had it badly. She can now no longer hear it even when listening for it. It is understandable that, on the internet, there are far fewer reports of it disappearing than of it continuing for years. People who are suffering are searching for help, support and cures. Those who had tinnitus that went away are less likely to be on these forums.

I still hope and believe that mine will go away eventually and I don't believe that this hope will harm my recovery in any way - even if my T turns out to be the type that stays forever. The power of positive thought?

Click

 

Although I agree with most of what Ellen says, I do believe there are external factors that might interact with tinnitus. Click says 'It's loud when it's loud and it's quiet when it's quiet', but I believe there is a reason why it's loud and why it's not loud. I haven't been able to put my finger on what my 'trigger' might be, and that's no surprise, since I don't keep a log of what i'm doing, eating, thinking etc all day long.
Tinnitus is created in the brain. The brain can be modified (take some LSD if you want instant prove of that), so the region in which tinnitus is created might just as well be subject to alteration or modification. Not necessarily by therapy, but by substances.
That's my 2 cents on the subject.

 

I believe that too LOTR. Mine fluctuates so much that, to me, it just has to be something making it go up, down, disappear...something we do or experience every day at different levels.

Many people have T that is constant and perhaps for them this isn't the same but I have times when I have no T (even if I listen), days when the T is very very low and I have to listen for it to be able to hear it, days when it's hissing at a medium volume and days when it screeches so much that I want to kill someone.

I have been keeping a very detailed log of food, sleep, exercise, weather etc. My conclusion is that, for me, although I don't believe my T was caused by food or an imbalance of vitamins/minerals, it really is affected by what I consume. I'm also not taking any drugs or supplements for the tinnitus - which means that I don't have to consider if these are reducing the volume.

I can most accurately assess what affects my tinnitus on days when it is barely there. On very loud days the food/drink doesn't make much difference - probably because my head is full of noise anyway.

My T is now very, very low on most days and I believe that it's my change of diet that has achieved this.

For me, adjusting my diet (albeit ensuring that it's still healthy & balanced) is a much easier way of reducing the volume than drugs/supplements/brain ops/ear ops etc. And I need the volume low because when it's high it drives me insane.

I also realise that I could be wrong about it all and that the food/tinnitus connection is coincidental - but I don't think so.

 

You know what. I'll do an experiment. Starting next week monday (6th of May), I will drink ONLY water, I will eat ONLY raw vegetables and fruit. For an entire week. Let's see how that goes.

And click, you can chip in too: for 1 week, starting monday 6th of May, you will eat nothing but Burgerking junk-food (sorry, I have to be specific) and drink gallons of coca-cola

 

Think I'll stick to my organic fillet steak and veg but don't let that stop you doing your bit!

I'm looking forward to the results with great anticipation

 

Oh, I will do this, for sure. And I'll post the result, whatever that is, here.

 

Interesting to hear about this. I think tinnitus is different for all of us. For some people it's pretty much an annoying constant. For others it can fluctuate a great deal in intensity from day to day - with no real reason. I don't really believe diet has much of an impact on tinnitus but having a balanced diet is always a good idea.

 

Yes, Click, you're right. (I wrote that in a huff and rushed, a lot of typo errors.) When I speak of 'firmly entrenched and permanently so', I was referring only to those friends who still hear T despite never ever having any adverse reaction to it. In fact one of them told me she loves noises and whenever it gets too silent, she would put on the radio or open the door to let in surrounding noises! I thought at first that she was joking when she says T fits right into her life. Then again, she grew up in a family where everything was loud, voices, music and all. I was irritated by audiologists/doctors who impose a blanket conclusion that I am hearing T because I am reacting adversely to it. They insist I hear T because my reaction is negative. So I had to reference friends whose reaction was nil, and in fact positive, yet they do hear their T.

You're right because I had a friend who went syringing his ears and was hit by an array of loud sounds to the degree he was driven to extreme thoughts. It was at the height of aggravation that he awoke to a sudden return of silence. He claims the T was there one minute, and simply gone the next - just when he decided he couldn't take it anymore. Another had T from years of being a hotline operator. Years after quitting the job, she could only hear T if she strains very hard to hear it but 99% of the time, she simply don't hear it even when she is reminded of T.

Wow, Click, your organic fillet steak sounds yum yum. I may have to keep a sleep diary along with a diet diary. Insufficient sleep hours / sleeping past midnight appears to have impact on my T volume. T comes to the fore too whenever I am confronted by complex type of work that places mental strain. Since this is a clue the stress level has gone into unhealthy zone, I deal with complexity differently these days. Food culprits difficult to trace. Quite ironical that whenever I consume Vit B, I appear to hear the T more..

 

Thank you for this post. Lot of people have tinnitus, sometimes for years, and it does go away. Those people are indeed less like to be visiting the forum and posting. There are so many medical factors that could result in tinnitus. And sometimes there is a combination of factors that result in tinnitus. Fixing one factor may reduce the tinnitus to a manageable level, or send it away completely. Hope is a good thing to have.

 

Depends how loud it is,end of.If its loud you will not feel free of it,if It not too loud you will.
There endeth the lesson.

 

I think sometimes "it goes away" because of habituation. It may actually still be there, but by natural habituation people can learn to avoid that part of the brain. The brain can learn to reconcile this threat through neuroplasticity, rewiring itself.

Molan does makes a point about loudness being a big factor, though. If it's really loud, it's hard to come to grips and get into a positive mindset. To say that we can convince ourselves that the sound is no threat and not annoying is like like saying sleeping on a bed of nails is comfortable.

We really need to have a "willing suspension of disbelief" to stay positive a lot of the time. Some of us are prone to obsessive thoughts, negativity and ultra sensitiveness, which all make this thing a tougher hill to climb. I also think that some of us are more listeners by nature and are in the habit of monitoring sounds/music. Even slight tinnitus can be a major annoyance for some people.

 

I am an auditory person, and even slight tinnitus is difficult for me. When T first started, it was much louder, lower pitched and maddening. It settled into a higher pitch with lower volume. But I've also learned to control through managing factors like avoiding NSAIDs, stress, salt etc. I think mine is TMJ and neck related, but it could be due to other factors that I don't know. My point is that hope is good, for me.

When I went to my first ENT, he told me that there was no cure, and to go home and live with it. He did not say, it may get better, or coach me that there are things that sometimes decrease the ringing. He did not bother to analyze what may have caused the T. He was dismissive and basically told me the situation was hopeless.

Now, my T may not go away. But other people's do. Since T is caused by so many varied conditions, such as neck stress, dental issues, too much of a vitamin, too little of a vitamin, depression, head trauma etc. Wouldn't it be better to allow for some hope? Otherwise you have people coming on here and seeing nothing but doom and gloom.

Like Click said, "I still hope and believe that mine will go away eventually and I don't believe that this hope will harm my recovery in any way - even if my T turns out to be the type that stays forever. The power of positive thought?"

 

Well, starting my third day of only raw veggies, fruit and water. God, it's boring! God, I feel great!

 

I'm having trouble deciphering your actual feelings from possible sarcasm LOTR

Yes, it's boring.. but do you feel great?

 

I think many people here, quite rightly, try not to give false hope and they are also concerned that those who have T are already anxious enough without the additional burden of worrying about what foods to eat or not eat.

It is so true that anxiety is one of the hardest side effects of tinnitus to cope with. I still believe that most of my problems at the start were caused by the anxiety associated with having a screaming noise in my head.

But for me that anxiety was caused by the screaming - not by anything else. Many people who get tinnitus already have anxiety or depression before onset.. but I didn't. My anxiety was solely caused by my tinnitus.

For people like me (there must be a few out there... hopefully!) thinking about what we eat and seeing that it does make a difference... is a total relief rather than an added anxiety.

I hate my T being loud... far, far more than I love food.

Everyone is different but I know that I can control the volume of my T by controlling what I eat. It works. If I slip up and eat something with more salt/sodium or I think 'I'm going to have a cup of tea - to hell with tinnitus controlling me' then my T screeches - sometimes for 4 days (this happened after I ate gammon/bacon joint).

I ate organic food before tinnitus & I ate healthily. Now I'm still doing this but I am eliminating certain foods that I know cause my T to scream. For me this is worthwhile but if controlling your diet in this way causes you more stress or anxiety then it's probably not a good idea.

 

I actually I do, I mean physically. Doesn't do much for my tinnitus so far, but my body seems to appreciate the rest it gets from 'toxic' substances.

 

Erik-
When I was younger, I also had bouts with anxiety. I use to listen to relaxation tapes, and self-help tapes to get rid of my anxiety. Over the years life has toughened me, blunting my sensitivity. As we age, our perspective about some things can change.

They say that certain personality types are more prone to having a problem with tinnitus by creating a viscious cycle of thoughts. I feel that I am improving, but it's like watching grass grow. Compared to how I was when I first got T, the difference in my T is like night and day. Still not completely there, but I haven't given up hope.

 

Yours really does seem to have improved Erik. I can't tell you how pleased I am for you - it certainly sounds as though you're almost 'normal' again . You and I acquired T within weeks of each other & I read all your postings on here (although I skim read the technical ones - too many tubes and electrodes frighten me). I knew that you were 'eating freely' again & doing loads of stuff that people steer clear of with T - it's amazing and I just hope that I get to that stage too.

It is a mystery and we can only do what we feel is best for ourselves. Somehow we have to cope and it does get so much easier thank goodness.

I'm moving back to Cornwall next week... the scary place where my T first started. I blamed the whole of Cornwall for my tinnitus at first - the air, the atmosphere, the gases coming from the mineral rock content or even the altitude... I didn't have T before I moved there last year & after three weeks of living there I had a head that was screaming... so of course it must have been Cornwall's fault - really logical eh!

So moving back is frightening but it's where I want to live & next week I'm taking the plunge. Hopefully not letting my T rule where I live will prove to be a good decision.

 

Well done LOTR. If you normally eat 'toxic' food then this may be the best decision you've ever made

 

I never experienced any significant unhealthy anxiety in my life until I began dealing with doctors. Their dismissive and overall attitude that patients are dumb, misguided, and unable to decipher their own senses, feelings, and basic knowledge of what has transpired is the thing that started anxiety for me. The sense that there was no hope for me to recover from my ills because the so called professionals won't even give me the time of day is what caused me anxiety. Others have told me likewise. The anxiety is what ultimately led to my T, and of course the anxiety created by the T (which for me was mostly due to the fact that I suddenly had another medical problem that doctors did not understand, nor want to figure out) caused more anxiety and T.

How does it help for a doctor to say or incinuate to the patient to just go home and live with it - no matter what "it" is. How does that help anyone? We all know there are things that can help minimize the impact of T on our lives, and things that may possible prevent it from becoming permanant (HBOT and steriod therapies are a couple that come to mind). So why not suggest those things to patients? There is always something that can be done to help. Maybe the help is just something that moves you 1 millimeter closer to a solution or relief, or even 1 mm closer to someone else who has some ideas. One millimeter is better than nothing. I can never see there being a time that I would ever say to someone in dire need of help, "Just live with it." That to me is equivalent to saying either 1) I don't believe that you are suffering, or 2) I simply don't care. I've learned the hard way - when you get that kind of response from a doctor or anyone that you are paying for help, then just walk away, and do not pay. That means also contacting you're insurance company to tell them to not pay.

 

Please tell me what foods you have eliminated?

 

That is a good idea. I think I'll do that. Visiting doctors causes a lot of stress for me too. Their dismissive demeanor, unwillingness to discuss details, and accusatory attitude is downright demoralizing. I won't even mention the wrong diagnosis.. I've learned the hard way to ask around with various doctors (my Primary Care Physician etc) to find who the good doctors are, rather than just book a random appointment with someone listed in my Healthcare.