Is TRT Effective Against Cochlear Hyperacusis?

[Pawel]

I've developed cochlear hyperacusis after acoustic shock 5 years ago as in such cases I've been very close to loudspeakers turned almost full power, one of the symptoms is ear pain when exposed to too loud sound (too loud for my ears but not others).

Is TRT effective against this symptom? I mean after completing TRT this sound-inducted ear pain would disappear? I have no hearing loss.

 

[Michael Leigh]

@Pawel
I have had TRT treatment twice in 20 years with good results. The first time it completely cured my severe hyperacusis and has remained that way till this day. It helped reduce my tinnitus to a very low level that I rarely heard it. I suffered a 2nd noise trauma some years later and my tinnitus returned with a vengeance. I won't go into all the details here. Click on my Avatar and choose "Started threads" Read my post: My experience with tinnitus and other posts and articles are there that you might find helpful.

No treatment is guaranteed to work and this includes TRT. It is an expensive treatment. Some clinics that practice it say it is TRT when it is not. Click on the links below to read my article: Tinnitus, A Personal View. It explains about tinnitus and treatments and coping methods. TRT is covered. The link: Hypercacusis, As I see it. Gives my opinion on treatment for it if one isn't able to get TRT.
Hope this helps
All the best
Michael

https://www.tinnitustalk.com/threads/tinnitus-a-personal-view.18668/

https://www.tinnitustalk.com/threads/hyperacusis-as-i-see-it.19174/

 

[Pawel]

I've read the articles and there's one more question Why TRT is expensive? Is that about cost of white noise generators?

 

[Michael Leigh]

Anything that takes time is going to be expensive. Proper TRT treatment takes upto 2 years. It involves couselling sessions that typically last upto 1hr or more. The white noise generators are expensive too.

 

[GregCA]

I've read the articles and there's one more question Why TRT is expensive?

How much are you being quoted?

 

[Pawel]

Excuse me I don't understand

 

[GregCA]

Excuse me I don't understand

Why do you say it's expensive? How much is it?

 

[Pawel]

Here in Poland consulations and examinations are free.Consultation takes about 20minutes and cost of white noise sound generators is 1500PLN(~350eur) each.In my case also commuting and accomodation is a cost.I've been consulted in Kajetany ( http://whc.ifps.org.pl/en/ ) this is renomed clinic.Local physicians told me that I am suffering psychiatric disorder and wanted to put me on neuroleptics,but in this hearing clinic I've been tested and they found out that I have cochlear damage.Currently my hyperacousis worsened because of inflammation I hope this will return to previous level itself

 

[GregCA]

Here in Poland consulations and examinations are free.Consultation takes about 20minutes and cost of white noise sound generators is 1500PLN(~350eur) each.

That seems actually quite reasonable.

 

[maltese]

That seems actually quite reasonable.

That's a monthly salary (junior position) in Poland. Per noise generator (you need two).

Polska taka piękna

 

[Pawel]

@maltese Even more beautiful when you are told that you are psychiatric patient because of physician's ignorance.As I've mentioned I had to go to Kajetany where passive examination has been performed and showed cochlear damage

 

[Pawel]

@Michael Leigh For me it's hard to believe that this noise-inducted ear pain can finally cease to appear

 

[Michael Leigh]

@Michael Leigh For me it's hard to believe that this noise-inducted ear pain can finally cease to appear

With that sort of thinking @Pawel you are convincing yourself that no form of treatment is going to help you. Any sort of treatment for tinnitus especially TRT and CBT requires a person to have a positive outlook. This doesn't mean to be cured but to haven an open mind and a willingness to try. When I had my 2nd noise trauma in 2008, it took me 4 years to habituate and two of those years was having TRT for the 2nd time. Although I had downtimes I never once looked for a cure or think that I would not improve and allow negativity to take a hold.
Click on my Avatar and choose "started Threads" Read my Articles: Tinnitus, A Personal View, again and this time read it in full and don't skip through it like I suspect you done the first time. Pay attention to the document within it called: Positivity and tinnitus. If you have a printer I suggest you PRINT it and refer to it often.

Michael

 

[GregCA]

I'm always leery of treatments that require positive attitude or positive thinking in order to work: they have a ready made excuse when it doesn't work, and also a ready made scapegoat they can blame for the failure.

 

[Mithrandir]

@GregCA When my computer doesn't work, it's not because virus or bad use, it's just because my mac book has negative thinkings

 

[maltese]

I'm always leery of treatments that require positive attitude or positive thinking in order to work: they have a ready made excuse when it doesn't work, and also a ready made scapegoat they can blame for the failure.

Can't really blame a mental-health-treatment for requiring positive thinking.

What TRT is supposed to do is to help you habituate = get rid of your anxiety and negativ feeling about tinnitus.

It's a little hard to achieve with a negative mindset, if you ask me.

 

[Michael Leigh]

Can't really blame a mental-health-treatment for requiring positive thinking. What TRT is supposed to do is to help you habituate = get rid of your anxiety and negativ feeling about tinnitus. It's a little hard to achieve with a negative mindset, if you ask me.

Well said @maltese If I may say so and without sounding condescending: You haven't had tinnitus long but have a maturity and positive outlook towards the condition that it's unfortunate others don't follow your example. This is precisely the reason I advise a person who is having tinnitus treatment, to stay away from people that only have a negative mindset and see no hope for the future.
Michael

 

[GregCA]

Can't really blame a mental-health-treatment for requiring positive thinking.

What TRT is supposed to do is to help you habituate = get rid of your anxiety and negativ feeling about tinnitus.

It's a little hard to achieve with a negative mindset, if you ask me.

Certainly, but banning a negative mindset is not the opposite of requiring a positive mindset.

I think it's reasonable to discourage negative thinking for any treatment (due to the nocebo effect), but for the exact same reason I don't think it's reasonable to require positive thinking for them. Nothing wrong with encouraging it, but making it a requirement is what enables the "blame the patient" excuse when results aren't achieved.

 

[maltese]

I think it's reasonable to discourage negative thinking for any treatment (due to the nocebo effect), but for the exact same reason I don't think it's reasonable to require positive thinking for them. Nothing wrong with encouraging it, but making it a requirement is what enables the "blame the patient" excuse when results aren't achieved.

You made an interesting point.

TRT doesn't cure tinnitus, it makes no attempts to reduce it's volume. All it does it "fixes" your relationship with the sound. It helps get rid of fear and negative emotions surrounding tinnitus. That's all. Nothing more or less (let's disregard "curing" H bit for the moment for simplicity).

As such TRT doesn't require positivity, but yeah, it'd be helpful if the patient believed the treatment might help him. There is no such "initial requirement", good counselling sessions should convince you that's the case.

You can't help someone who don't want to be helped.


PS I've never received TRT treatment, I've only had one counselling session with hearing therapist that helped me a lot.

 

[Pawel]

@maltese What is the price of White noise sound generators in The UK?

 

[GregCA]

As such TRT doesn't require positivity, but yeah, it'd be helpful if the patient believed the treatment might help him. There is no such "initial requirement", good counselling sessions should convince you that's the case.

If it doesn't require positive thinking, then we should never have to read anyone blaming the failure of the treatment on the basis of lack of positive thinking.

 

[Michael Leigh]

@maltese What is the price of White noise sound generators in The UK?

White noise generators are free on the NHS Pawel. As well as all
other treatment. I was recently fitted with two new digital white noise generators, in your currency around 2000 euros
Michael

 

[Michael Leigh]

@Pawel
If you start TRT treatment or any other with a Hearing Therapist or Audiologist, I advise you not to discuss it in this forum or any other. If you must visit tinnitus forums while having treatment try not to make it too often.
Michael

 

[japongus]

@Pawel
If you start TRT treatment or any other with a Hearing Therapist or Audiologist, I advise you not to discuss it in this forum or any other. If you must visit tinnitus forums while having treatment try not to make it too often.
Michael

This is a relatively free forum that thank god doesn't have TRT loonies in the admin positions. For unicorns people are free to go to chat-hyperacusis.

The debate is out on what hyperacusis is because it's defined as discomfort on an LDL test and the audiologists giving those tests out are under TRT monopoly. As such, asking the patients to be more precise in describing their discomfort would be against their own logic as it would give credence that this is a mechanical condition, so we have the crap statistics we have these days.

Many things can cause discomfort with sound. Reactive tinnitus, damaged muscles in the middle ear, recruitment or cochlear damage, a stapes that's too loose (like Silverstein recently found out), a floppy basilar membrane inside the inner ear, hearing loss either conductive or sensorineural can cause tinnitus that can be reactive to sound due to recruitment or fake recruitment, middle ear muscles can jam the ossicles too tight and cause hearing loss this causes a tinnitus that just happens to be loud enough and of a specific frequency that it can be felt instead of heard and that's the ''hyperacusis'' as it imitates external sound, or the middle ear muscles can just be too tense tonically or they can be spasming. In all these scenarios and many more, sound enters the limbic system already magnified. There are trillions of years of evolution that wired our brains up to be what they are today and it is defenseless and incapable of doing the tabula rasa gymnastics you keep projecting at it.

 

[PaulBe]

For unicorns people are free to go to chat-hyperacusis.

haha. Funny coz its true.

 

[Michael Leigh]

Many things can cause discomfort with sound. Reactive tinnitus, damaged muscles in the middle ear, recruitment or

An interesting post @japongus It was a pleasure to read it without having to see expletives and other unpleasant language which is common in your writing. Therefore, on this occasion I have decided to reply to you. Just goes to show what one is able to achieve when they put their mind to it. You actually come across as quite a pleasant person, perhaps a little sarcastic but then none of use are perfect. Please continue on this path. I would just say there is no such thing as Reactive tinnitus. You will find it is not documented in any tinnitus books or used in the medical field. It was a term made up in tinnitus forums. However, it does sound nice and can give the impression one knows what they are talking about when using it. Reactive tinnitus is actually hyperacusis (sensitivity to sound) which comes in different levels of severity and is something that often accompanies tinnitus when it was noise induced.

I wish you well.
Michael

 

[japongus]

An interesting post @japongus It was a pleasure to read it without having to see expletives and other unpleasant language which is common in your writing. Therefore, on this occasion I have decided to reply to you. Just goes to show what one is able to achieve when they put their mind to it. You actually come across as quite a pleasant person, perhaps a little sarcastic but then none of use are perfect. Please continue on this path.

Yikers, you sound like the murderer in Woody Allen's Matchpoint. Or Cosmo's flavor of the month sex advice.

I would just say there is no such thing as Reactive tinnitus. You will find it is not documented in any tinnitus books or used in the medical field. It was a term made up in tinnitus forums. However, it does sound nice and can give the impression one knows what they are talking about when using it. Reactive tinnitus is actually hyperacusis (sensitivity to sound) which comes in different levels of severity and is something that often accompanies tinnitus when it was noise induced.

I wish you well.
Michael[/QUOTE]

Recruitment can react to sounds, myoclonus can or could be reacting to sounds, it's an unfinished debate, tested out in the previous decade at chat-h between lib and astrid, not by TRT a la carte providers. The conclusion was merely that hyperacusis might be involving more direct pain and more pain after the sound, that there may really just be neuropathic pain out there and that there may be cochlear or middle ear issues when vibrations are being felt, that the middle ear can be involved for the reasons I've told you in imitating external sounds, and that when tenotomy does or doesn't work it's merely because different muscles in the ear or nearby are affected aka dystonia. Plus we have a case of nerve decompression hyperacusis over at H sufferers in facebook, and she didn't mention any echoes or vibrations in the ear.

All before sound reaches the limbic system. And Pulec- at exactly the same time Jastreboff was saying he had proof tinnitus and hyperacusis was in the brain- was saying cochlear nerve cutting eliminated tinnitus. But how would Jastreboff know, he doesn't operate on the ear. Jastreboff is just clueless about the ear and doubles down on his rhetoric. And it looks like tonic tensor tympani syndrome might be a fake condition being paraded around by Jastreboff acolytes like Westcott. But no, apparently ''hyperacusis'' is an ethereal Zeuslike entity apart from the sinner's world of otology where no one even knows what meniere's disease is.

 

[Michael Leigh]

@japongus Again, an interesting post although I became little lost whilst reading it. My fault and nothing to do with you. Since Professor Pawel Jastreboff is clueless and you clearly have a dislike for this teachings. Perhaps you would like to show him and the rest of us how it's done. I look forward to reading your book on tinnitus and treatments.
All the best
Michael

 

[japongus]

Thanks dude, I do have a megaplan. My life goal is to spend 40 years in a medical practice of orgasmic prestige, and then I hope to worsen the already pathetic questions on the hyperacusis questionnaire, the ones that don't differentiate between myoclonus and hyperacusis, and in all this time couldn't even hypothesise about the involvement of middle ear muscles or a wiggy stapes or compressed nerves and so on. My aim is by 2060 it'll consist of two questions, 1. do ducks cause you a lot of stress and 2. were rabbits the cause of your hyperacusis? Hugs and kisses

 

[pytajnick]

Here in Poland consulations and examinations are free.Consultation takes about 20minutes and cost of white noise sound generators is 1500PLN(~350eur) each.In my case also commuting and accomodation is a cost.I've been consulted in Kajetany ( http://whc.ifps.org.pl/en/ ) this is renomed clinic.Local physicians told me that I am suffering psychiatric disorder and wanted to put me on neuroleptics,but in this hearing clinic I've been tested and they found out that I have cochlear damage.Currently my hyperacousis worsened because of inflammation I hope this will return to previous level itself

What tests did they conduct to diagnose cochlear damage?