Dan's Corner, aka Ask Danik

[dan]

@dan

What about avoiding forums like this one I guess Jastreboff is practically insistent about it. Does or can it impede habituation? Seems to me TRT is the bandaid of Tinnitus.

The reason Jastreboff insists avoidance of T forums, is simple - it makes you think of your tinnitus! It can also make you anxious seeing people suffering.
But the flipside of the coin is coming to a tinnitus forum makes you feel you aren't alone. Its a tough question. I'd say that if you invested your time and money in a habituation based therapy, you owe it to yourself to try to maximize your chances of success - even if it means limiting the amount of time you spend on a tinnitus forum.

 

[dan]

My opinion, It can be deadly for some people. I would never classify it as a harmless sound. Sorry I chimed in Dan.

hey I hear ya! but in order to be successful in TRT, you have to reclassify it from deadly to harmless. That is the goal. That is the premise of TRT.

 

[Martin69]

No I don't believe TRT is a scam outright. It is a habituation facilitation method. Habituation is REAL, I don't doubt it.
I do have certain beef with TRT proponents.
Like for example the way they market their product. Or the way they present it to the world like there is really no need to rush for a cure, or the way they group all tinnitus in one bunch, like we all have the same tinnitus and if a patient isn't successful then it must be the barriers to habituation that the patient has in place - legal disability etc, visiting T forums, etc

Absolutely agree. When I was in the Tinnitus clinic (where they did TRT) they said: Every T has the same loudness.
They even did not care about the frequency. They made you an idiot because you suffer so badly.
So at the end, when you fail, it is your fault, it is your depression or your negative thinking.
And regarding the forums, I can only say that it saved my life in the beginning and still.
I met many supportive people. Of course if you post here something about suicide, it is the other way around. But this is the risk of open forums.

 

[dan]

@Martin69 -totally agree.

 

[dan]

 

[MichaelM]

When I was in the Tinnitus clinic (where they did TRT) they said: Every T has the same loudness.

What the...? Really?

 

[dan]

@Martin69 , this is according to Jastreboff, the range optimal range you need to set your sound generators in order to maximize habituation.

 

[Martin69]

@Martin69 , can you tell me what loudnesses did you try with the wng's ?

Up until it became too loud.
But I have white, pink and brown noise on my mobile.
Nevertheless I prefer cricket sounds.
So I see nothing against using crickets instead of white noise.
It is sound enrichment, which kind should not matter.

 

[dan]

TRT involves wearing - around the ear noise generators all waking hours, desktop sound enrichment is for night-time use only.

 

[Martin69]

What the...? Really?

Yes, but they had no clue.
And I am very sure that real TRT clinicians really know how bad a T can be.

 

[Martin69]

@Martin69 , this is according to Jastreboff, the range optimal range you need to set your sound generators in order to maximize habituation.

I don't understand this.
Ah, you mean the graphic.

 

[MichaelM]

Yes, but they had no clue.
And I am very sure that real TRT clinicians really know how bad a T can be.

Wondering also how much people pay for that kind of "information"...

 

[dan]

You see the diagram. The bottom scale is your hearing level (with taking into account any hearing loss). So for example, if you have 20dB hearing loss, then you set the sound generator at 20db+30db = 50db SL (sensation level) - according to Jastreboff the optimal sound level is around 30dbSL. Anything much less and you get into "Stochastic Resonance" and anything much more you begin to mask the tinnitus.

 

[Martin69]

View attachment 3466

Isn't dbSl the loudness above your hearing threshold?
So if my T is at 14 kHz and I am deaf up to 50 db on this frequency, would that mean that I need to set it to 80 db?
But this would be too loud.
Because most Ts are between 5 and 15 dbsl, aren't they?

 

[cullenbohannon]

View attachment 3466

Hey dan. Is there a link to the graph you posted. I'd like to read more of it if you get the chance.

 

[dan]

Isn't dbSl the loudness above your hearing threshold?
So if my T is at 14 kHz and I am deaf up to 50 db on this frequency, would that mean that I need to set it to 80 db?
But this would be too loud.
Because most Ts are between 5 and 15 dbsl, aren't they?

No, it does not matter the frequency of tinnitus. it matters the minimum sound level at which you can hear the sound generator- then add 30dB.

 

[Martin69]

No, it does not matter the frequency of tinnitus. it matters the minimum sound level at which you can hear the sound generator- then add 30dB.

I don't know where I read this and I was also told: T is always between 5 and 20 DB above hearing threshold.
So 30 dbsl doesn't make sense to me. Because then I would mask.
In addition I don't know where my hearing threshold at 14 kHz is. Because no one could make an audiogram there.

 

[dan]

Martin. Yes, it is true what they tell you. I was told the exact same thing - actually I was told between 3 and 15 DB above hearing t.h.
Now, Stochastic Resonance covers a range of -5dB to 15-20dB. So if a patient notices an increase in their tinnitus, it can mean that Stochastic Resonance is taking effect and sound generators need to be adjusted, if possible.
Keep in mind they didn't know about Stochastic Resonance when TRT was founded back in the 90's. And some TRT clinicians aren't aware of this phenomenon.

You don't need to take into account the frequency of your tinnitus - 14khz means nothing in TRT.

 

[dan]

Keep in mind that sound generators are not considered the important aspect in TRT.
It is the understanding of the neurophysiological model and the directive counceling which is the most important. The "demystification" of tinnitus and "reclassification" of the tinnitus signal from a threat to harmless.

 

[Martin69]

Keep in mind that sound generators are not considered the important aspect in TRT.
It is the understanding of the neurophysiological model and the directive counceling which is the most important. The "demystification" of tinnitus and "reclassification" of the tinnitus signal from a threat to harmless.

Yes. I understand that my neurons are firing on 14 kHz which sounds like a train against rail tracks.
It is some kind of eletrical orchestra in my head. I understand it is my brain making the noise.
And that it is only my reaction causing the distress.
I find it everything, but not harmlessif I am in a swim stadium (like today) where it was crazy loud, but my T was never masked (mainly because of the frequency).

 

[dan]

I understand that. The point of sound therapy is to get your mind to say - hey I can habituate to a sound! You introduce a sound which is not intrusive and is readily habituable, then once you stop hearing that sound, your brain will learn to ignore the tinnitus as well.
That is what is "Retraining".

 

[dan]

Its like when you were a kid. Your daddy put training wheels on your bicycle.
Some people don't need training wheels, but most do.

 

[bwspot]

@dan
I have read all docs on tinnitus.org.
So how do i start?
First get used to sounds like broken speaker?

@dan

I have read it and kind of get the idea.
The first step is get rid of reaction. I dont even know If i have one.
I do have T and I live with it but I constantly wonder if I can fix it but without any stress.
I also have the broken speaker effect as reaction to some sounds.
According to tinnitus.org:
- get rid of reaction
- 10 times a day feel the reaction
- sound enrichment

thats all i can get from that page

 

[dan]

I'm not sure if TRT has anything to say about "broken speaker" effect.
Sounds to me like you have some sound distortion problem.
I can tell you that this sound distortion may improve on its own over time.
If you habituate fully to your tinnitus, then it will be as good as gone.

 

[Michael2013]

I'm not sure if TRT has anything to say about "broken speaker" effect.
Sounds to me like you have some sound distortion problem.
I can tell you that this sound distortion may improve on its own over time.
If you habituate fully to your tinnitus, then it will be as good as gone.

Have you habituated yet? Or made any progress toward it?

 

[valeri]

@dan
Do you have any first hand experience or success with TRT?

 

[bwspot]

I'm not sure if TRT has anything to say about "broken speaker" effect.
Sounds to me like you have some sound distortion problem.
I can tell you that this sound distortion may improve on its own over time.
If you habituate fully to your tinnitus, then it will be as good as gone.

@dan

Sorry, but i dont see any use of this thread so far.
So far, I did not get any practical advice.
I wonder what is the point of this Ask Dan thread for DIY TRT?

 

[Asian]

@dan- this is not related to TRT but I got T from banging my head really hard on a concrete wall which was stupid mistake. Any idea why a concussion bring on T . my hearing tests and OAE were normal. Thanks

 

[awbw8]

@Asian and @bwspot - I just want to make it clear to anyone who may be confused that this "Dan's Corner" is not part of the "Doctor's Corner" series set up by the TinnitusTalk moderators. Questions about concussions etc. should really be directed towards a medical doctor in your life, or if that is not possible, you can post a general support thread of your own which more people in the community will see, or ask a question of Dr. Nagler (a MD).

@bwspot Since this thread is about "DIY TRT," I just thought I would put my opinion out there. As a disclaimer, I did not go through much of the TRT process outside of a lot of reading on it and a long consultation with a respected and very kind therapist. It would have been my next route had I not habituated on my own with time and other methods. I am not recommending it (or not) as I do not have personal experience with it.

That said, from my impressions of it, "DIY TRT" is not really going to be TRT at all. Perhaps there are elements one could take from TRT, but then it is no longer TRT - it's something else, just a DIY treatment. DIY treatments can work (living proof right here), but it's not TRT - TRT is by its nature not DIY - it involves person to person counseling (more than a person just setting your sound generators). There are good and bad practitioners out there, and it's not fool-proof, but if you go for it, do it all the way and with a good practitioner! I cannot say it enough, a caring, compassionate caregiver/healer, no matter what you are seeking is the deal maker or breaker. Otherwise, put your time and money into a DIY that can work and is meant to be DIY.

As an example of what I feel is a good DIY, CBT was very useful to me, and you can learn and use it on your own successfully from my understanding and experience. It didn't cure me in and of itself, but in the early days it helped me not to panic. Dr. Hubbard (in the Dr's corner) is a CBT therapist - he would be a great resource, better than me! Again, I have no experience with CBT curing me, but it helped and in the end, my habituation journey was a hodge-podge of my efforts and just time.

All that said, I am not an expert outside of being someone who read a lot and habituated. The above are just my personal opinions based on those readings and experiences, but I wanted to offer them up if they could be helpful to anyone in making their own decisions. When I first got T, I was very desperate for therapies and answers, but make sure you get both from the best sources you can - shop around for the answers. Best of luck to you all : )

 

[nogood]

@dan thank for the reply .. no ginkgo biloba alone did not help me..

but one other tablet which is Gingko Biloba 60 Mg+Piracetam 800 Mg+Vinpocetine 5 tablet did help me at very early stage.. i am think of going back and take it again..

unfortunately i can only get it from india as of now., where i am not its RX only for Piracetam and Vinpocetine.

I might be slightly diverting from TRT topic but piracetam is a Nootropic its proven that it does make people smart, in away it can help brain adopt faster..? what do u think..?