TRT Incompatible?

Discussion in 'Dr. Stephen Nagler (MD)' started by MarioT, Feb 17, 2015.

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    1. MarioT
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      MarioT Member

      Tinnitus Since:
      Cause of Tinnitus:
      Stress + SSRI medication
      Hello @Dr. Nagler

      Since I did not want to hijack the previous thread on my personal experience on TRT I decided to post my question here.

      First of all some info on my particular case: I developed sudden billateral tinnitus during a period of greater anxiety and after starting antidepressant (SSRI) treatment 2 years ago. All conducted audiological tests did not show up any significant hearing loss. Audiometry results are excellent. I also do not suffer from any hyperacusis, loud noises do not cause me discomfort. My T could be characterized as "centralized" being more of a head noise, thatfor I strongly feel that my condition is more of a CNS phenomenon rather than an ENT-problem. On a "good day" my T is maskeable by external acoustic stimuli while on a bad day masking is impossible due to the fact that the prominent frequencies rise above the 14 Khz threshold. Needless to say, I feel greatly disabled by this condition and need to do something about it..

      1 year ago I consulted an ENT who prescribed me TRT treatment. Since my insurance covered the costs I acquired behind-the-ear white noise generators after consulting a TRT specialized audiologist. Although I approached this treatment full of hope and with an open mind I unfortunately had to drop out because the white noise generators seemed to actually aggravate my T instead of having a soothing effect. It actually feels like if no matter how high or low I turn the volume my T adapts to the white noise and intensifies as if it is being "provoked" by any attempt of partial masking. There have been several attempts to restart this treatment on my behalf but every time I wear those generators over 2 hours my T goes sky-rocket.

      Does that mean that I belong to the unfortunate 20% that do not benefit from this treatment? You probaly might have encountered similar cases like mine. What is your advice?

      Thank you very much in advance,

      Best regards,

    2. Dr. Nagler

      Dr. Nagler Member Clinician Benefactor

      Atlanta, Georgia USA
      Tinnitus Since:
      ... which tells me that more likely than not your "TRT specialized audiologist" was clueless at the worst or at the very least woefully inexperienced. TRT in Germany, with one or two notable exceptions, is simply awful. Indeed, most "TRT clinicians" in Germany do not do TRT at all. As I have said elsewhere:

      One of the problems with TRT is that the name is not trademarked – so with many clinicians claiming to offer TRT, what you see is not necessarily what you get. And to my way of thinking, that represents an enormous challenge for the tinnitus community. Anybody can call himself or herself a "TRT clinician." Moreover, since there is no credentialing or standardization in TRT, even if a clinician has read Dr. Jastreboff's book and taken his course, there is no assurance that he or she has retained the material or even understood it in the first place.

      And for whatever reason, nowhere in the world is that problem more apparent than in Germany.

      I understand, that can sometimes happen - especially early on. It is generally rather easy to address, depending on TRT Category, type of broadband sound, presence or absence of misophonia, etc.

      Well my advice before abandoning what you believe to be TRT would be for you to see a truly knowledgeable and experienced TRT clinician rather than merely somebody who refers to himself or herself as a "TRT specialized audiologist." Although I do not know her personally, I have heard very good things about Gabriele Lux-Wellenhof in Frankfurt am Main in that particular regard.

      You are most welcome.

      stephen nagler
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