White Noise Generators

Discussion in 'Dr. Stephen Nagler (MD)' started by Martin69, Apr 24, 2014.

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    1. Martin69

      Martin69 Member Benefactor

      Tinnitus Since:
      Cause of Tinnitus:
      (Health) Anxiety
      Dear Dr. Nagler.
      When you did your TRT 20 years ago, did you also use some kind of sound (partly) masking your T?
      You said that your T was unmaskable. So what kind of sound did you use?
      I am asking because I tried hearing aids, white noise generators and combi devices.
      I have the impression that white noise makes my T louder. At least it is more difficult listening to two sounds, T and white noise. Whenever I switch off the white noise, it is more a relief than I want to switch it on again.
      Bird or ciqada sounds help better for my high-pitched T. But one can also not listen the whole day to birds.
      Any recommendation from your experience for people with high-pitched T that cannot be masked, or maybe only by a shower?
      Thanks in advance and sorry for asking so many questions.
      Thank you for your valuable time.
    2. Dr. Nagler

      Dr. Nagler Member Clinician Benefactor

      Atlanta, Georgia USA
      Tinnitus Since:
      Martin, TRT is a very specific protocol. It starts with an evaluation during which a person's "TRT category" is identified by his or her TRT clinician. There are five distinct TRT categories, which are inconveniently numbered 0 through 4. The numbering does not reflect severity; rather it is based on the presence or absence of hyperacusis, hearing loss, and a number of other auditory factors. Sound therapy and TRT counseling (which used to be called "directive counseling") are the two essential elements in TRT. The particular form of sound therapy as well as the TRT counseling strategies are dictated by the TRT category. Thus, for instance, a Category 0 patient would receive completely different sound therapy and counseling recommendations from a Category 3 patient. My parameters fell into Category 1, and I was instructed by my TRT clinician in the use of broadband sound delivered through wearable devices in accordance with that category. I set them each morning as I was told, each device independent of the other. The end result of the instructions was that (1) the sound did not suppress my tinnitus in any way, (2) the sound was not annoying, (3) the sound did not interfere with communication, (4) the sound did not elicit the stochastic resonance phenomenon, and (5) within the aforementioned constraints the sound maximally facilitated habituation.

      Yes, I do have a recommendation. My recommendation would be to locate a knowledgeable and experienced tinnitus clinician, undergo a proper evaluation, and follow that clinician's suggestions based upon the evaluation. I would make the same recommendation regardless of modality - TRT, CBT, NTT, whatever. In my case I did TRT and had to travel 700 miles to the clinician's office. Moreover, I had to see him four times over the span of a year; follow-up TRT counseling is extremely important. Nowadays many TRT clinicians are set up to handle the follow-up by phone or Skype - so you only need one actual visit. I did not have that luxury when I did TRT twenty years ago, so my wife and I made the 700 mile trip four times. I am not embarrassed to admit that TRT was the single best investment of time and money in my life. I am sure that some feel otherwise, but that's how it was for me. However, I need to stress that when I did TRT, I did it right. I did not cut any corners, which is something I see so many folks doing. For me, my tinnitus was as serious as a heart attack - so I found a knowledgeable, competent, experienced clinician and did was I was told to do.

      You live in Germany, right? If I lived in Germany, I'd call Jacqui Sheldrake in London, ask her when her first available appointment was, and go! If I had to sell my car or take out a second mortgage on my home, then that's what I would do. What I would not do - and I say this with kindness and respect - is try to figure out some sort of patchwork do-it-yourself program. But that's just me.

      All the best!

      Dr. Stephen Nagler
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