My Hyperacusis Journal — Sound Therapy and CBT with Tracy Holcomb (Treble Health)

[Michael Leigh]

Thanks. I am trying. Did you ever have bad periods after having steadily making good progress?

Yes I did, quite few in fact and occasionally still do as my tinnitus is variable. It can be silent, mild, moderate, severe and very severe. I try not to allow setbacks to stop me losing my focus, direction and positivity. Whenever they arrive I take a backward glance to reflect on how far I have come. This gives me the inspiration to carry on because I have my life to live.

Also do I have to use in-ear generators for life?

Not necessarily but remember we are all different so you have to see what works for you. For now I think you should concentrate on wearing your sound generators to treat your oversensitivity to sound and see where this takes you. Follow the advice of your audiologist, take things slowly and don't push yourself too hard.

Michael

 

[Wrfortiscue]

I see, I somewhat similar. A good day for me is still moderate tinnitus. It's still very much perceivable, but tinnitus tones are more tolerable and not as reactive. I don't have quiet days. It's not like I care for silence anyways.

Why don't you care for silence? I would be happy with just stability at this point.

 

[Eleanor89]

Hello @Wrfortiscue and @Shizune.

I have built the time with my generators up gradually, minutes at a time, two minutes, then four minutes for a few days, then six minutes and so on...

I'm now two to three hours.

However, my generators do not insert in the ear. They lie outside the ear canal. The noise is extremely soft and barely audible.

Good luck with them.

 

[Shizune]

I'm sorry to hear that. Yeah, that nerve thing reminds me when you scratch your head and feel pain in your arm or chest lol. Happens to me and it's odd.

As for protection, I try to wean off or mix it up and usually spike the next day. My spikes just mean harsher left ear tone or more reactivity. If I plug up too much, I'm really sensitive. It's going to be a slow balance I assume.

Try to do a couple of minutes of sound therapy. Maybe pull the sound generators out some so it's not so deep in the canal. Ask whoever set them up to put the lowest of lowest sound. Could be the frequency aggravating it.

Surprisingly doing the sound generators today, they weren't loud like yesterday and there were periods where my harsh cutting blade tone wasn't piercing through; it was fading back. Then my left ear pulsated some pain so I stopped (after 30 minutes).

If my ear gets a little sore, I stop. She said it's part of the process and another friend who went through this reactivity had sore ears at first and adjusted. He's better now.

As per usual YMMV.

Tomorrow I see how my ears are if I do another 30 minutes or so. If spiked, I'll just do therapy with natural sounds and no earplugs, then resume the next day.

Yeah I still have no idea how the nervous system works but the scratch your head and feel pain in a random area is a very good example. No idea how to pinpoint this at all.

I'm glad to hear you're doing well. I did 5 minutes today and my tinnitus imprint was temporary, haven't been feeling as sensitive as I thought. But then I got hit with a large beep later so I am a bit fearful of if that'll mean a setback for me.

I have 3 pairs of Peltors, all which have varying degrees of wear, so I am wearing my most worn down ones (which means least amount of protection) and am doing ok.

Also I'm considering getting some high quality speakers and testing nature sounds or pink noise videos. Have you explored that at all? I read a study about nature sounds helping a lot more than white noise.

Hi @Shizune, I read about your accident and I'm familiar with that. Did any specialists (neurology) examine peripheral nervous system (PNS) and somatic nervous system? Reflex tests to evaluate sensory signals? This is important as some fibers connect to ears. I can go into more detail, but most PNS nerves that would be associated with your situations should hopefully regenerate. Sleep, fluids, magnesium, a little B12, slow walking exercise and staying relaxed should help. When deciding to discontinue a medication, do a taper.

I've been struggling to get most doctors to take me seriously about the whole thing still, so I haven't had the work-up for any of that sadly. I did get a CT scan a few months after this all began but it was normal. I am just beginning to get back in touch with my neurologist, who sadly is in the city and always has a long wait list. I've been trying to convey the changes. I've suggested stuff like an EEG but he doesn't see it's necessary for whatever reason, but I feel like that would be at least one way to measure some nerve damage. Getting doctors to go along with anything seems so difficult. I'd love to get more advice on this if you can.

Also, tips for Magnesium? I've used glycinate and threonate, still seeing a lot of "liquid or bust" with this.

 

[Wrfortiscue]

I'm considering getting some high quality speakers and testing nature sounds or pink noise videos. Have you explored that at all? I read a study about nature sounds helping a lot more than white noise.

Hey, I'm still struggling. I have good moments but it's very reactive. You could get high quality speakers and just try nature sounds very low. That may work for you and it's considered sound therapy.

 

[Michael Leigh]

Also I'm considering getting some high quality speakers

Whilst the quality of sound enrichment is important Shizune, keep the volume low. The idea is to have it playing in the background without being aware of it - in other words sound enrichment should not be drawing attention to itself. A person should not immerse themselves in it. Sound enrichment should always be kept below the tinnitus. This way the brain over time will be able to habituate to it and slowly push the tinnitus further into the background. This is the way white noise generators work.

When treating oversensitivity to sound or hyperacusis it is a similar thing. Sound enrichment should be set at a low level so it's not causing irritation or spikes. It is advisable to use sound enrichment at night and not sleep in a quiet room, as explained in various posts on my started threads.

A sound machine is an ideal way of delivering high quality sound enrichment. I recommend models from Sound Oasis, as they are specifically made for people with tinnitus. Alternatively, YouTube have some high quality nature sounds that can be played through speakers. The volume should always be kept low so it's not drawing attention to itself.

When used correctly sound enrichment can be immensely helpful in treating tinnitus and hyperacusis.

Michael

 

[Shizune]

Whilst the quality of sound enrichment is important Shizune, keep the volume low. The idea is to have it playing in the background without being aware of it - in other words sound enrichment should not be drawing attention to itself. A person should not immerse themselves in it. Sound enrichment should always be kept below the tinnitus. This way the brain over time will be able to habituate to it and slowly push the tinnitus further into the background. This is the way white noise generators work.

When treating oversensitivity to sound or hyperacusis it is a similar thing. Sound enrichment should be set at a low level so it's not causing irritation or spikes. It is advisable to use sound enrichment at night and not sleep in a quiet room, as explained in various posts on my started threads.

A sound machine is an ideal way of delivering high quality sound enrichment. I recommend models from Sound Oasis, as they are specifically made for people with tinnitus. Alternatively, YouTube have some high quality nature sounds that can be played through speakers. The volume should always be kept low so it's not drawing attention to itself.

When used correctly sound enrichment can be immensely helpful in treating tinnitus and hyperacusis.

Michael

I did get a sound machine at one point but even the lowest setting was too loud for me sadly (measured about 30 dB on my phone). Can't recall the brand though. It's hard for me to have things at a quiet level that recedes into the background and below my tinnitus just because my loudness hyperacusis is so severe. I'll check out Sound Oasis stuff anyway though. If you or anyone have any recommendations for good speakers let me know too.

 

[Michael Leigh]

I did get a sound machine at one point but even the lowest setting was too loud for me sadly (measured about 30 dB on my phone). Can't recall the brand though. It's hard for me to have things at a quiet level that recedes into the background and below my tinnitus just because my loudness hyperacusis is so severe. I'll check out Sound Oasis stuff anyway though. If you or anyone have any recommendations for good speakers let me know too.

Have you considered using noise reducing earplugs when using sound enrichment? The earplugs would lower sounds further. Just a suggestion.

 

[Shizune]

Have you considered using noise reducing earplugs when using sound enrichment? The earplugs would lower sounds further. Just a suggestion.

Would it be counter-intuitive? I assume foam earplugs would block too much. Something like musician's earplugs, rather?

Hey, I'm still struggling. I have good moments but it's very reactive. You could get high quality speakers and just try nature sounds very low. That may work for you and it's considered sound therapy.

Thought I replied to this. I was going to say I'm taking a break myself. Things are getting louder and I'm getting minimal sleep even with protection because I'm woken up so easily. Good to hear you're having good moments though and I hope the reactivity clears up soon enough.

 

[Michael Leigh]

Would it be counter-intuitive? I assume foam earplugs would block too much. Something like musician's earplugs, rather?

Use noise reducing earplugs, these are not like foam earplugs. Noise reducing earplugs have an in-built filter. They reduce external sound but don't block it out completely like foam earplugs. They are available in different levels of attenuation. Perhaps start with 18 or 25 decibel reduction, this way you could have the sound enrichment very low. As your ears improve you could use earplugs with 15 decibel noise reduction and so on. They are not expensive.

They can be bought at Amazon and eBay:

Amazon.com : noise reducing earplugs

noise reducing earplugs: Search Result | eBay

Michael

 

[Wrfortiscue]

Yeah I agree with Michael. I switched to Earasers when driving instead of foam earplugs. Foam earplugs always increase my reactivity. I understand some folks can only use foam earplugs for now.

 

[ZFire]

Why don't you care for silence? I would be happy with just stability at this point.

It's not something I've yearned for after turning severe. As a person with severe tinnitus, I also do not want to view silence as some sort of 'intrinsic good' that should be desired because that could seriously hinder my ability to adapt. It enforces all the negative associations one has with their tinnitus IMO. My goal is to not get caught up in judgments. Accept the sounds, treat it as a normal non-threatening entity, starve it of attention, the brain will eventually relax its hold on the tinnitus and stop paying attention. Easier said than done of course and a lot of it depends on how one is wired to handle a difficult situation.

But stability as you said is much more important as that could go a long way in making a positive impact in managing their relationship to tinnitus. I'd imagine the lessening of reactivity for instance would drastically improve QoL and tinnitus distress tolerance for a lot of folks here (irrespective of the tinnitus volume).

 

[Wrfortiscue]

It's not something I've yearned for after turning severe. As a person with severe tinnitus, I also do not want to view silence as some sort of 'intrinsic good' that should be desired because that could seriously hinder my ability to adapt. It enforces all the negative associations one has with their tinnitus IMO. My goal is to not get caught up in judgments. Accept the sounds, treat it as a normal non-threatening entity, starve it of attention, the brain will eventually relax its hold on the tinnitus and stop paying attention. Easier said than done of course and a lot of it depends on how one is wired to handle a difficult situation.

But stability as you said is much more important as that could go a long way in making a positive impact in managing their relationship to tinnitus. I'd imagine the lessening of reactivity for instance would drastically improve QoL and tinnitus distress tolerance for a lot of folks here (irrespective of the tinnitus volume).

Oh I definitely agree with everything you said here. I always said I want the ability to not truly care about it one bit.

 

[Kevin4444]

@Wrfortiscue, I think I am in for quite a long journey. I overprotected for a couple of years and I recently had quite bad noise exposure. I know Dr. Nagler once said he had no success for well over a year, then it all come together within a couple of weeks.

My first goal is to manage pink noise for all woken hours. I will try to mix high quality pink noise from good speakers for half a day and then use the sound generators for the rest of the day. Then my next goal is to stop all medications. I am on a very low dose of benzo and a high dose of SSRI. I cannot risk them messing with my natural healing process.

I do not mind wearing sound generators for the rest of my life as long as I see some progress. If I have some improvement within 12 months and good improvement within 24 months, I am perfectly happy.

For me, I am not 100% sure about the sound generators this time around, even though I had good success with them last time I used them 7 years ago. As I see it, I do not have too many alternatives. At least I am doing something. The nice thing about sound generators is that you do not have to trust in them, habituation is a natural process and they will work with your subconscious.

I used to be 110% productive, living a reasonable good life with tinnitus and reactive tinnitus. Now I can socialize with my family and work 2-4 hours a day. The rest of the day I have no energy left and just need to get through the day. I take a daily 1 hour walk.

Take care,
David

David, I'm a newcomer here with hyperacusis for only a few weeks. I've been very anxious and taking alprazolam a few nights a week for sleep. I'm interested (and, yes, worried) about your comment that you don't want the risk of these drugs "messing with my natural healing process." Can you explain what you mean and what source(s) you're referring to about this risk? I'd greatly appreciate it.

 

[David S]

David, I'm a newcomer here with hyperacusis for only a few weeks. I've been very anxious and taking alprazolam a few nights a week for sleep. I'm interested (and, yes, worried) about your comment that you don't want the risk of these drugs "messing with my natural healing process." Can you explain what you mean and what source(s) you're referring to about this risk? I'd greatly appreciate it.

@Kevin4444, I don't think this is too much of a problem but long term it is not a good idea. Having said that, I have been using Zopiclone and Oxazepam daily for 6 months. I am about to taper. So far it does not seem to be too much of a problem. I would prefer Zopiclone over Alprazolam because most likely it is not as dependent. I also take an SSRI. Long term I want to see if my body can heal better without any meds.

 

[Cory_]

Why don't you care for silence? I would be happy with just stability at this point.

Yeah, I don't even care about rebuilding my sound tolerance anymore. My only goal is to not go catastrophic.

 

[Kevin4444]

@Kevin4444, I don't think this is too much of a problem but long term it is not a good idea. Having said that, I have been using Zopiclone and Oxazepam daily for 6 months. I am about to taper. So far it does not seem to be too much of a problem. I would prefer Zopiclone over Alprazolam because most likely it is not as dependent. I also take an SSRI. Long term I want to see if my body can heal better without any meds.

Thanks, David. Yes, I only took it for about three nights (only two consecutive) because I was in a pretty overwhelmed place -- and the lowest dose (.25 mg) each time.

 

[Wrfortiscue]

Update: I was stabilizing a couple weeks ago and sound tolerance was going up. COVID-19 brought that back down and now I'm even more squealy and buzzsaw lol. Got to dust myself off and get back to it with small increments.

 

[ZFire]

Update: I was stabilizing a couple weeks ago and sound tolerance was going up. COVID-19 brought that back down and now I'm even more squealy and buzzsaw lol. Got to dust myself off and get back to it with small increments.

How are you doing now? Has the COVID-19 spike settled down yet?

 

[Wrfortiscue]

How are you doing now? Has the COVID-19 spike settled down yet?

Yeah it settled down. I am managing ok with these random spikes and squealing going on. I was having actual quiet periods months ago but my quiet periods now are just softer haywire tinnitus tones lol.

 

[DebInAustralia]

Mostly hiss that seems to come from the center of my head but also can be all over.

At times I can actually feel the tinnitus.

Any improvements?

 

[Wrfortiscue]

Update: I was stabilizing a couple weeks ago and sound tolerance was going up. COVID-19 brought that back down and now I'm even more squealy and buzzsaw lol. Got to dust myself off and get back to it with small increments.

Can't tolerate sound therapy for now it seems. Getting bad delayed spikes.

Will back off from sound therapy for a bit to see if I stabilize or not.

Been positive, protecting only when needing to but still worsening. Very hard to adjust to loud screeching piercing oscillating brakes but here we are lol.

Also my esophagus is closing up so bad I'm suffocating sometimes just lying down. Waiting for that miracle

I've had a good life though, no regrets <3

 

[Wrfortiscue]

Having really good days, then bad ones.

 

[Marshall]

Having really good days, then bad ones.

Still continuing with sound therapy?

 

[Wrfortiscue]

Still continuing with sound therapy?

Not consistently no. I find most noises just aggravate my tinnitus or my tinnitus just rides on top. I kept pushing through it and it was just aggravating my tinnitus more, so I find a quieter approach with sound therapy here and there works better for me. Acceptance, sun and exercise have been helping way more.

 

[Marshall]

exercise have been helping way more.

Exercise was huge for me bro.

 

[Wrfortiscue]

Exercise was huge for me bro.

Yeah I'm starting to see that. I think everyone should explore any natural route if they can.

 

[SmallRonnie]

Yeah I'm starting to see that. I think everyone should explore any natural route if they can.

Totally agree that exercise and eating healthy will help a lot. They just help with so many general bodily functions too which will be an aid.

 

[Wrfortiscue]

So now what?

 

[SmallRonnie]

So now what?

I'm in a similar spot to you where I was gradually bringing sound back in but went too far, then got even worse and now I can't tolerate almost any sound at all.

I am going to just wait until it gets a little better again and then bring sound back in super slow again.

How are you doing now?