TRT, As I See It

TRT, As I See It.

I think some people misunderstand TRT and the way it can help tinnitus. Whilst a person is entitled to an opinion, if they haven’t been on the programme and only read reports on it, I don’t believe they are getting the full picture. A number of people have asked me about its effectiveness and when should it be administered. I covered this in my post: What is TRT and when should it be started: https://www.tinnitustalk.com/threads/what-is-trt-and-when-should-it-be-started.19024/

TRT has quite a following and has caused much debate in this forum and elsewhere on the Internet. Unfortunately, a lot of these comments haven’t been favourable, although those that have had the treatment or elements of it have said they found it helpful. This treatment is expensive and I will be candid and say, only those that can afford it are able to try it.

Where I live the treatment is free but it is only available at selected hospitals. Even then, some don’t follow the TRT protocol and adapt the treatment to their requirements but good results have still been possible. In some parts of the UK it’s just not available nor is CBT. Therefore, anyone wanting TRT will have to pay privately at clinic. Other forum members have told me the treatment is free in their country and like the UK, it has been adapted to include some elements of the therapy. This may be wearing one or two white noise generators and not always having tinnitus counselling with a Hearing Therapist, so a person may be left to just get along with it.

I have learned in some countries medical insurance won’t touch TRT, so a person will have to pay for it out of their own pocket, which I think this is unfortunate.

So what is TRT and if one is able to pay for it should they, taking into account some of the negative comments that it has received? Having had TRT twice over 20 years following the TRT protocol, I will try to shed some more light on this treatment and hopefully give the individual a little more clarity to make up their own mind on whether the financial outlay is worth it, but more importantly; is it effective as a treatment for someone that has tinnitus and hyperacusis and enable them to have a better quality of life?

I first want to say the following is based on my own opinion and therefore is not professional medical advice. The onset of tinnitus can be quite an emotional roller coaster for a lot of people, and I believe a person needs time for this to settle. Many people habituate within the first six months to one year of the onset of tinnitus without any treatment. If a person just has tinnitus without any additional symptoms, such as dizziness, deafness or balance problems. I think a period of at least six months should elapse before starting a long-term treatment such as TRT. Anyone paying privately needs to know they are getting the proper treatment. Any clinic not giving you this service then I advise you to go elsewhere because it is not TRT. You should be given two white noise generators to wear and also having regular counselling sessions with a Hearing Therapist or Audiologist. More is explained in the above link.

TRT is not a complete cure so anyone seeking this might be disappointed. However, the sound therapy, which involves wearing white noise generators, I believe can cure hyperacusis as in my case. It should be noted, whilst this treatment may not cure tinnitus, many people find its perception reduces to such a low level they can comfortably live with it. Habituate. In some instances a person might be unaware of their tinnitus for long periods. Each person will respond to it differently.

If you have ever lost someone that is close to you, such as a parent, partner or even a pet then you will know what it is to grieve. Most people will go through this process at some point in their life. It is not often talked about but we all know it’s something that’s inevitable and will come to us sooner or later perhaps even more than once in our lifetime. It requires a period of time for a person to accept that their life has changed, and time is needed to adjust so they will eventually be able to move on.

Why am I saying this some of you might be wondering? A forum member recently asked what does TRT involve? I was explaining to him, the counselling part of the therapy and the relationship between patient and Hearing Therapist. At first the therapist discusses with the patient how the tinnitus makes them feel and how it has impacted on their life. Often people say they have lost interest in the things they once liked doing, which is perfectly understandable. The main goal is to gradually help them to look at life differently and with a more positive outlook. Over time the negative thinking that is often associated with tinnitus and hyperacusis is gradually dispelled and demystified. The Hearing Therapist does this in a controlled and precise manner so that the patient feels relaxed and not pressured.

The forum member then said it sounds like a form of grief counselling. After we had spoken I thought about it and have to say I believe it to be a good description, because that’s what the therapy part of TRT is akin to. Thanks Paul @PaulBe. The amount of times people have told me over the phone or read posts in this forum: “If I could only get my life back”. “My life used to be perfect”. “I keep looking at peoples ears and wondering what my life used to be like”. “If I could only hear silence again”. And so on.

When someone gets loud intrusive tinnitus with or without hyperacusis, in an instant their world has been turned upside down. Some go through periods of stress, anxiety even depression and yearn for the way life was before the onset. They need time to adjust and to accept this new anomaly in their life. Some have an easier time than others at habituating, so may not need the help of a tinnitus counselling. For some that find the tinnitus and hyperacusis severely intrusive TRT and CBT can prove to be helpful. It all depends on the individual, their emotional makeup and the severity of the condition because we are all different. It is for this reason; the treatment can take up to 2 years for a person to adjust to a different way of life and often with a positive outcome.

I was fortunate to have TRT twice and found it to be helpful on both occasions. I only wish that it were more readily available to others.

Michael

 

Hello Michael,

Here in Cumbria I have been fortunate to not only see a consultant at ENT but also an audiologist who has organised my appointment for my maskers.

After my referral I have only had to wait six weeks for my appointments.

She also deals with patients and tinnitus.

I feel that I am extremely lucky being able to access this service in my area.

It’s a pity it is not available to others.

 

Hi Eleanore89,

I wish you all the best with your treatment. I would like to make a few suggestions and think it is best to keep them to yourself and not divulge anything I say to your Audiologist or ENT consultant, as it may not be taken too well. Just listen to what they have to say and follow their advice. That way you won't come across as a know it all or telling them their job. Some people do this and it's not a good idea.

I see that you have had tinnitus since 1995 and the cause is not known. Something usually causes tinnitus and the most common is exposure to loud noise. Typically, it is listening to music through headphones. I have written articles on tinnitus that you might find helpful so please click on the links below.

If you currently use any type of headphones my advice is to stop using them even at low volume. This includes earbuds, AirPods and headsets. Your Audiologist might advise you to gradually increase the volume of your maskers. In fact, the correct name for these devices are: white noise generators. I advise caution here because a lot of people notice their tinnitus is irritated when the white noise is increased.

In my opinion it is better to set the white noise slightly below the tinnitus at all times. This was the way I was taught by my Hearing Therapist and I had much success. People have contacted me over the years that have had problems when increasing the volume of white noise generators, as advised by their Audiologist. When they have tried my suggestion their tinnitus no longer becomes irritated or spikes and the hyperacusis is still treated.

Ideally, you should be having regular counselling with your Audiologist. However, if not, just go with the flow with whatever treatment is offered to you.

Once you start treatment, my advice is not to discuss it in tinnitus forums or on social media platforms. Some people believe no form of tinnitus treatment works. Reading such comments and corresponding with these people can hinder or completely halt your success with treatment.

Please go to my started threads where there are other articles on TRT. They explain what's involved in tinnitus counselling and how to use white noise generators correctly. Please introduce them to your auditory system slowly and don't wear them straight off or for 6 to 8 hours as this often irritates the tinnitus. Just keep this to yourself.

I advise that you use low level sound enrichment at night using a sound machine. More is explained in the posts below.

Take care and wish you all the best.

Michael

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