TRT: How Can I Get TRT?

Discussion in 'Dr. Stephen Nagler (MD)' started by Mark K., Jan 19, 2015.

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    1. Mark K.

      Mark K. Member Benefactor

      Honolulu, Hawaii
      Tinnitus Since:
      Cause of Tinnitus:
      Not sure. May have been from medication
      Hi Dr. Nagler:
      I live in Honolulu Hawaii and I'd like to start TRT, however I don't think its offered here in Hawaii. How can I get started if its not offered in my area? Is there an online therapy? Or do you know someone you can recommend here in Hawaii? Is there anything I can do on my own to begin some type of TRT techniques? I'm seeing a therapist who will be talking to me about "mindfulness" this week. I'm also using the Widex Zen hearing aids, and I'm actively trying to tell myself this thing is not a threat.

      Any suggestions on how I should pursue TRT here in Hawaii?

      Mark K.
    2. Dr. Nagler

      Dr. Nagler Member Clinician Benefactor

      Atlanta, Georgia USA
      Tinnitus Since:
      To the best of my knowledge, it isn't.

      You would need to travel for the initial visit; all the follow-up can be done long distance via phone or Skype.

      There is no on-line TRT.

      No. As it happens I myself have a patient from Hawaii, a surgeon who lives in Honolulu. But I know of no knowledgeable and experienced TRT clinicians practicing in Hawaii.

      Excellent question. But other than familiarizing yourself with what TRT is and is not

      (see, for instance,,

      there is little you can do in that regard. For instance, there are no "exercises" in TRT, although one website incorrectly suggests otherwise.

      Great, just be aware that mindfulness has nothing to do with TRT. Neither, for that matter, does CBT.

      Fine, but Zen tones are contraindicated in TRT.

      That strategy may work for some, but in all honesty, it never appealed to me. For a person with severe intrusive tinnitus, their tinnitus is a hungry lion in their bedroom. Telling yourself that that a hungry lion in your bedroom is not a threat really does not get you too far. In TRT counseling this phenomenon is explained in terms of the "upper loop" and "lower loop."

      If you are serious about pursuing TRT in Hawaii, I'd consider contacting Dr. Paula Schwartz in Edina, Minnesota. She is the closest TRT clinician to you whom I feel comfortable recommending unconditionally. As noted earlier, an initial in-person visit would be required anywhere you do TRT. Another possibility would be Dr. Gail Brenner in Philadelphia, or Jacqui Sheldrake in London. Or I guess if you really want to scrape the bottom of the barrel, there's me in Atlanta.

      Of course, as an alternative you might consider an approach other than TRT.

      You are most welcome. I hope this response helps more than frustrates.

      Dr. Stephen Nagler

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