What to Avoid When Seeing an ENT or Audiologist?

I have an appointment with an ENT on Wednesday but am still on the fence as to whether I will keep the appointment. What I'm afraid of is being subjected to a test or instrument that could make my symptoms worse.

Does anyone have any advice on what to absolutely avoid? Doctors barely understand tinnitus, and frankly, practically none of them give a shit about you, so I am trying to be as cautious as I can.

 

I would avoid the ENT and audiologist.

 

I did the CVEMP/Caloric Test and I got permanent hyperacusis and loud tinnitus. I did it on Jan 15 and I got H on January 16. My T increased on January 17. It has been as you can see a long time and I didnt see any improvement. It damaged my hearing in both ears, damaged inner hair cells. I never had dips in hearing in right ear on audiogram but now I do. I also have dip on left ear as well. In addition I developed Visual Snow and Black Eye Floaters.


1) Acoustic Reflex
2) Electrocochlaography
3. cVEMP/VEMP
4. Microsuction with Air
5. Caloric Test with Water and Air
6. ABR

 

https://www.tinnitustalk.com/threads/tests-procedures-to-avoid.26681/

 

Be careful about the advice you will get in here: it is from people who have no credentials and do not know your particular case. I'd take it with a big grain of salt.

As for your appointment, make sure it is interactive: talk to the doc and ask questions about every procedure or exam s/he offers.

In general, ENT docs don't do much beyond an otoscopic examination and perhaps some fork tests.

If you suspect hearing damage, you can expect to be referred to an audiologist for a few more tests, possibly tympanometry and likely Pure Tone Audiometry.

Good luck!

 

Their experience of a test causing irreversible damage (e.g., @dpdx ) seems to be a better credential than any credential a doctor who doesn't care enough to adjust his ways when dealing with a T patient might have.

 

I was going to warn the topic starter about those tests, but I didn't think they were common. A doctor once hit a fork onto something, making it vibrate, and then proceeded to attempt to touch my forehead with it. I wouldn't let him do it. Vibration is what caused my T, my ears don't need any more vibration. In any case, the best advice is to use your common sense.

 

My tinnitus and hyperacusis have been worsened. I have permanent hyperacusis and my tinnitus right now is blasting loud 9/10. It all began after those ear tests. My audiologist told me it was a bad idea to do cVEMP and now its likely to be permanent. He said he didn't do Acoustic Reflex on me because of the fear that it will cause more damage and exacerbate tinnitus.

My audiogram was perfect last year, this year I have dips on 3 kHz and 6 kHz and mild hearing loss in noisy areas (hidden hearing loss), which was not present last year. I have tinnitus in both ears now and hyperacusis in both ears. It hasn't gotten better. It was a big mistake and I REGRET DOING THOSE TESTS EVERY DAY...

 

I have severe hyperacusis and mild/moderate tinnitus. Normal hearing between 250 Hz to 8 kHz.

Since last week I have a lot of ear pain in my right ear. It comes and goes but overall it's getting worse.

Tomorrow I am seeing an ENT. What tests might she be likely to propose, and importantly: Which should I avoid?

 

Hi all

Finally got my ENT appointment at the Freeman in Newcastle (UK) in Feb.

What tests should I avoid/refuse in case it makes tinnitus worse (than it already is)?

I'm going to have choice words if I get the 'here's a leaflet' routine.

 

I wouldn't go by any blanket rule about tests to avoid/refuse. Each person is different in their needs and medical history.

What I personally do, however, is question every procedure in terms of:

1. why is it needed (what is the rationale for doing it)?
2. what are the possible risks?

I'd only consider going forward with a procedure when I know at least these 2 things about it, and that I feel comfortable about the risk/reward proposition derived from them.

You'd be surprised at how many flows exit at the first question.

 

HI @Allan1967

My advice to you is to let your ENT doctor, Audiologist and Hearing Therapist do their Job as they are the professionals. Please do not listen to some of the fireside quacks, in this forum that tell you certain tests on your auditory system are harmful because they are not.

I had very severe tinnitus and hyperacusis many years ago when I first got tinnitus. I had all the tests and had no problems at all. Over the years I have had many tests at ENT and haven't had one problem. If you are ever advised to have microsuction or ear irrigation, apply eardrops 3 times a day for 10 days to each ear before having wax removed.

There is no need to bombard your ENT doctor with lots of questions, just calm down and relax you will be in good hands.
It is stress, worries, panic and fear that are your biggest problems, caused by listening to some of the people in this forum that don't know better.

Michael

 

I would not be on this forum had it not been for the incompetence of an ENT "specialist". Prior to seeing him I had NO hearing damage, just a bit of wax in my ear canal.

Firstly, poorly managed microsuction by this ENT doctor caused "clarinetting" in both ears giving me hearing loss, hyperacusis and chronic tinnitus. My life has been ruined by this procedure performed by a "professional".

Secondly, the multitude of tests performed or requested by "professionals" (ENTs, audiologists) ie Acoustic Reflex, LDL, MRI to name but a few have exacerbated my symptoms and made things permanently worse for me.

Please be very careful as some "professionals" either don't care or don't understand the damage that can be caused by certain tests and procedures. You are the one that has to live with the damage for the rest of your life, not them.

 

The only thing that an ENT or audiologist is good for is out ruling an 8th nerve tumor
and giving a steroid and telling you to take b-12 and magnesium. Known medicines that will help hearing recover.



Problem is you don't get the steroid unless you have hearing loss with speech range and 250-8khz BS.

 

There are no professional's when it comes to tinnitus or noise induced pain, maybe researchers like Susan Shore at UoM and Professor Liberman who may one day be considered professionals/experts but right now were in a state where only TRT shill-lords make up the occupation of pseudo professionals and dogmatic mindsets persist.

 

HI @Allan1967

Since you will be reading this thread my advice to you remains the same. Go to your ENT appointment and try to be calm and relaxed as possible. You have two choices: have the tests that your doctor recommends or not. You are not a medical professional neither are some of the people in this forum that will advise you not to have certain procedures and tests that your doctor will advise. The last thing you want to be doing is to rub the doctor up the wrong way. Ask questions for sure but I advise caution by not saying which tests you refuse to have, based on advice from people that are not medically qualified. It is scaremongering that causes problems and instils a negative mindset and I’m sure you don’t want to be part of that.

I have mentioned to you before, as soon as you start any treatment keep away from tinnitus forums and certainly don’t discus the treatment that you are having there, as negative thinking people tend to believe that no treatment other than a complete cure for tinnitus is acceptable. Reading their posts will often have a detrimental effect on your habituation progress and moving on with your life, so I advise to keep away.

Some of the people at tinnitus forums have additional problems in their life that you are not aware of, and use these places and other social media platforms, to voice their frustrations with the world. They blame their government and medical professionals for the circumstances that has befallen upon them. It is sad and unfortunate but that is the way I see it.

Take care and I wish you well.

Michael

 

be it would better if we could atleast try to have a civil debate about how hyperacusis should be managed as well as the pros and cons of Jasterboff's model and TRT.

 

Thanks Michael... you are a kind soul.

FYI... I cancelled my Tiex order. I came across a few old posts elsewhere by people who said it made it worse and I know if it makes it worse, even temporarily for me, I'll bin it.

I'm going to hang on for Neuromod.

 

@Contrast

Indeed it would but I don't think a civil debate will be possible with you regarding hyperacusis or Jastreboff's TRT model, because you and others in this forum, have already made up your mind that hyperacusis cannot be successfully treated and Jastreboff TRT model is a scam. All this is based on information that you have read at websites and pasted umpteen times in this forum and you believe it to be true, having had no personal experience of TRT.

I have had TRT twice, the full treatment and not a scaled down version of it and know that it works. It is not a cure for tinnitus it is, Tinnitus Retraining Therapy. You also believe that anyone suffering from oversensitivity to sound unless pain is felt, it cannot be hyperacusis and therefore it is Reactive Tinnitus,which there is no such thing. This term was made-up in tinnitus forums. Pain is not always felt with hyperacusis contrary to what some people believe. I once had very severe hyperacusis that was completely cured in 2 years using white noise generators as part of TRT 22 years ago.

It would be nice to have a debate on the conditions that you have mentioned, but unless you have some personal experience of treatments that you've tried, instead of basing your opinions on website information, I don't think this is possible.

Michael

 

What I'm saying is that I believe there are several types of hyperacusis that have different technical causes, and Jasterboff's TRT may only help one type, where other types may go untreated and unclassified.

For example lack of fat around the Audiotory nerve, or damaged outer hair cells are both believed to contribute to "hyperacusis with pain" but since they both have separate pathologies we don't know if TRT works on both of them. What about audiotory processing disorders where some things sound too loud that seems neurological.

Once the dust has settled and hyperacusis is researched more we will know what subtype of hyperacusis is best benefited by TRT, but the ultimate goal would be regenerating damaged cochlear tissue not 6 months to 2 years of TRT.

The reason I get upset with your ideas is because you over simplify a very complex issue.

 

I just want to know, do you believe hyperacusis is a neurological issue like tinnitus, or a peripheral issue like nerve damage in the ear? I have read Jasterboff's model and he seems to subscribe to the correct view that tinnitus is in the brain, infact early on he pushed the neuro-model of tinnitus which is certainly a good thing back when people thought tinnitus was in the ear.

I am sorry for times I contradict myself on the forum with edgy post, I will have to go back and address foolish contradictions that I made.

 

Your comment has made me smile and I'm sorry to have made you upset that I tend to simplify things. You seem to be a technically minded person that wants to go deep into a subject leaving no stone unturned. I have met similar people like yourself, at other forums such as classical music and HI-FI. Some people want to go deep into the way Mozart composed his 29th symphony for instance, I prefer to just listen and enjoy his music. When it comes onto HI-FI and the difference between valve/tube amplification vs solid state and whether electric mains cables powering a system, costing £1,000/$1,284 can really be justified? For some it can and they vehemently defend their decision.

You do make some interesting points about hyperacusis. I have never thought about there being different types of the condition, although I am aware it comes in different levels of severity. I have Jastreboff's TRT book which is quite technical and makes for heavy reading at times. Having tinnitus hinders me from going into too much heavy reading and just cannot handle it.

I don't believe hyperacusis is totally a neurological issue but believe it is to some extent, especially if the condition is left untreated, as I have mentioned in my post: The complexities of tinnitus and hyperacusis: https://www.tinnitustalk.com/threads/the-complexities-of-tinnitus-and-hyperacusis.25733/ in addition to this I believe other conditions can manifest from hyperacusis as mentioned in the above link.

I don't think hyperacusis is nerve damage as such, certainly the nerves have been affected but this doesn't mean they can't be treated. I am talking about ordinary hyperacusis as a result of being exposed to loud noise. I believe as Jastreboff says in his book, the gateways in or auditory pathways in the brain have become hypersensitive due to "loud noise" exposure and they need to be desensitized using white noise generators and sound enrichment to close down these gateways. Counselling with a Hearing Therapist or Audiologist is essential too if this treatment is to be successful. This was certainly the case with me as my hyperacusis was treated and I have been cured for 22 years.

Michael

 

What kind of steroid would be given? Is it for sensory hearing loss or conductive?

 

Same here for me too!!! A Microsuction procedure causedcmy extremely mild Tinnitus to become unbearable coupled with hypercausis. I’m sure it was the incompetence of the Audiologist though!!

 

Everyone is entitled to their opinion, but people who have suffered at the hands of “professional” ENTs and Audiologists shouldn’t be labelled as negative or irrelevant. They’ve suffered and are suffering because they trusted those who are meant to help. The disregard for patients, particularly vulnerable ones with T is criminal. I am one of those.

I would advise absolute caution when seeing an ENT or Audiologist. Many do not care at all. For every one that is competent, there’s many others who are hacks. Ask what each test is about and decline any that seem risky. Stop any that don’t feel right. It’s your right to say no.

I’m not sure how some people can be anti headphones yet happy to have their ears vacuumed at up to 140dbs.

 

Don't listen to the fireside quacks and those who are not medically qualified says Michael, but do listen to him .

The experiences of those worsened by medical procedures they were told would not harm them are real, and as Gman says such people should not be labelled as negative, irrelevant or lacking credibility due to probably having other problems in their lives

However, there is some sense in the view that it's easy to become paralysed with fear. I definitely agree that some procedures have risks that medical professionals will often deny - this seems to be the culture in medicine. Normally, perhaps, there is little an ENT can do about tinnitus, but sometimes tinnitus DOES have associated causes which I suppose may be difficult to diagnose or treat without the necessary tests. I agree it seems sensible to ask about tests that are offered and any risks, at least.

 

HI @Allan1967

I think you have made the right decision by cancelling Tiex. It can make tinnitus more intrusive while using it but this is temporary. You need to be in the right mindset to try something like Tiex and I don't think you should explore any other treatment while you are about to be seen by the NHS.

Allan I know what I am talking about. The last thing you want to do is start demanding and coming across as arrogant towards the people that you have gone to for help. They are likely to think to themselves. If he knows so much why come to us for help? The softly, softly approach is much better and you will get a lot further in life by being polite and listening to those in the know.

I have been 22 years under the NHS for my tinnitus and believe me when I say I have had very good treatment. It has it's problems like any large organisation but the press only highlight when things go wrong with the NHS and rarely report the good that they do. Treating thousands of people daily in hospital, walk-in clinics and at GP surgeries to say the least. You are in good hands.

Another thing I want to say. Please try and forget about Neuromod or any other treatment at the moment. The reason being, you will have the mindset that any treatment via the NHS or self-help for that matter won't work. This is the wrong approach believe me. Keep away from tinnitus forums and negative thinking people and you will do much better. You have had tinnitus a long time and with your experience you will get through this as I did. Be positive and you'll do just fine.

All the best
Michael

 

Thanks Michael... I will be professional and polite with them.

 

I am pleased to hear that Allan you will see my advice is right
Best of luck
Michael

 

I'm sorry for all that received error from a medical setting.

Agree

Agree - I worked in healthcare and had seen good and bad.

Agree. Tinnitus can have associated causes and healthcare needs to be more knowledgeable and cautious of care error.