What Is TRT and When Should It Be Started?

Discussion in 'Support' started by Michael Leigh, Dec 14, 2016.

    1. Michael Leigh

      Michael Leigh Member Benefactor Hall of Fame

      Brighton, UK
      Tinnitus Since:
      Cause of Tinnitus:
      Noise induced
      What is TRT and when should it be started?

      I have talked about TRT in many of my posts. One tinnitus talk member recently told me that I have mentioned it no less than twenty five times. He went on to ask, am I an Audiologist promoting my practice in this forum purely for business purposes? Another member was quite disgruntled and told me to stop mentioning it because where he lives the treatment is expensive and can’t afford it. It just goes to show one never knows what is going on behind the scenes when you think no one is watching.

      I understand and empathise with people that are unable to afford this treatment or any other to help one’s health but don’t feel this is a good enough reason for me to stop mention it when I believe it can help, having had TRT twice in the 20 years that I’ve had tinnitus. I am not an Audiologist. I just consider myself like many others at tinnitus talk, who want to help people that are having a difficult time coping with this condition, as I was once helped many years go when I first got tinnitus.

      Some people have been sending me private messages asking if TRT cures tinnitus? A member mentioned having two sessions with their Audiologist and was shown some slides, and told that anxiety can make tinnitus louder. Understandably this person wasn’t sure if this was TRT, and then asked if it’s something they could do on their own? As I have mentioned I have had TRT twice and I also have the Tinnitus Retraining Therapy book, written by Professor Pawel Jasterboff and Jonathon Hazell. It is available at Amazon should anyone wish to purchase it.

      It is the reference book that Hearing Therapists and Audiologists follow when practicing TRT with their tinnitus patients. There are two parts to the treatment. Counselling and sound therapy. Sound therapy is supplied by wearing two white noise generators and then using a “sound machine “ at night by the bedside for sound enrichment. If hyperacusis is present the sound therapy will also treat it. Throughout the TRT book there is no mention that this treatment cures tinnitus. TRT or Tinnitus Retraining Therapy, is what it implies: Through regular counselling sessions there is a gradual retraining of the way a person thinks about tinnitus and to treat it as non life threatening.

      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 here is to gradually help them 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. In many instances the tinnitus is gradually pushed further into the background making it less prominent. Therefore, it must be stressed and understood, this treatment takes time. To complete a course of TRT takes approximately twelve to twenty four months and in some cases longer. The duration of each counselling session is left to the discretion of the Hearing Therapist. Typically, these can last up to one hour or more. The amount of appointments required will be different for each patient, but it is quality rather than the quantity of the counselling that really matters.

      There are a few misconceptions about this treatment and the way it is administered that some people misunderstand which I want to address. If a patient is given one white noise generator to wear this is not TRT. When two wngs are issued and no tinnitus counselling is offered on a regular basis, it is not TRT. I am not saying that a patient will not gain any benefit from the above treatments; I only want to state they do not follow the proper Tinnitus retraining therapy protocol.

      When should TRT be implemented or started?

      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 6 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 problelems. I think a period of six months should elapse before starting a long-term treatment such as TRT.

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