My Tinnitus Has Changed ...

[attheedgeofscience]

how do you know he has hearing loss?

Because he wears hearing aids...

www.tinnitustalk.com/threads/low-level-laser-therapy-lllt-for-tinnitus-%E2%80%94-efficacy-debate.7650/page-12#post-89174

 

[Stink]

Because he wears hearing aids...

www.tinnitustalk.com/threads/low-level-laser-therapy-lllt-for-tinnitus-%E2%80%94-efficacy-debate.7650/page-12#post-89174

ok so he really can't have 91 db sl tinnitus

@Dr. Nagler why did you lie? if you did not lie... can you show us a report from your audiologist?!

or did you mean to say 41 db sl? or else

 

[Cor]

I dont think @Dr. Nagler lied. He probably meant something different. Let him just answer. On forums it's easy to point out mistakes and then run away with them. Often they're innocent mistakes.

I just first hand experience the use of sound therapy by being on a tropical island for 2 months. So im thinking there must be something to TRT.

Dr Nagler, do you think using sound generators like you do would be helpful without following the full TRT process? I did follow some CBT sessions which were somewhat helpful. I weaned myself off of Xanax as well and seem to be able to cope ok with the noise for now. But i think actual habituation is not happening because my house is in a very quiet neighbourhood of amsterdam, and I may have to wear a sound generator for a while.

 

[Dr. Nagler]

ok so he really can't have 91 db sl tinnitus
Dr. Nagler why did you lie? if you did not lie... can you show us a report from your audiologist?!
or did you mean to say 41 db sl? or else

I did not lie.

Here is the original question verbatim:

"May I ask when you got your T matched, at what loudness (dB) was it?"​

And here is my response verbatim:

"In dB? 91"​

If the question were "May I ask when you got your T matched, at what loudness (dB SL) was it?" I would have answered "In dB SL? 11"

Since the person asking the question specified that he was looking for dB, I responded in dB.

This is a support board. I initiated this thread because for the first time in some twenty years I myself was looking for support, and I greatly appreciate the overwhelming support I was given. But it seems that some here feel compelled to turn this into some sort of "gotcha" campaign.

For those who care, I have been doing quite well - especially over the past four or five days. I had hoped to return to this thread today to explain exactly what I did to get from where I was in mid-February (miserable and tearful due to the overwhelming screaming noise in my head) to where I am now (doing quite well). But right now I'm trying to figure out if I should even bother, when there are a handful of misguided individuals just waiting to dissect everything I post so they can play gotcha. They know who they are, and they need to take a good hard look at themselves.

stephen nagler

 

[dan]

For the record I never said Dr.Nagler lied about anything....but may have mislead some people to believe that there exists a 91db Tinnitus.

 

[Stink]

I did not lie.

Here is the original question verbatim:

"May I ask when you got your T matched, at what loudness (dB) was it?"​

And here is my response verbatim:

"In dB? 91"​

If the question were "May I ask when you got your T matched, at what loudness (dB SL) was it?" I would have answered "In dB SL? 11"

Since the person asking the question specified that he was looking for dB, I responded in dB.

This is a support board. I initiated this thread because for the first time in some twenty years I myself was looking for support, and I greatly appreciate the overwhelming support I was given. But it seems that some here feel compelled to turn this into some sort of "gotcha" campaign.

For those who care, I have been doing quite well - especially over the past four or five days. I had hoped to return to this thread today to explain exactly what I did to get from where I was in mid-February (miserable and tearful due to the overwhelming screaming noise in my head) to where I am now (doing quite well). But right now I'm trying to figure out if I should even bother, when there are a handful of misguided individuals just waiting to dissect everything I post so they can play gotcha. They know who they are, and they need to take a good hard look at themselves.

stephen nagler

so what is your tinnitus in db sl?

you are a DOCTOR, you should NOT MISLEAD people

 

[Dr. Nagler]

For the record I never said Dr.Nagler lied about anything....but may have mislead some people to believe that there exists a 91db Tinnitus.

I am not here to mislead anybody. The man specified that he wanted the response in dB, and I gave him the response in dB. What the hell do you want from me, Dan? If he asked for my loudness match in dB SL, or if he simply asked for my loudness match without specifying the unit, I'd have said 11dB SL. But since he made it clear that he wanted the response in dB, I responded in dB. And I even specified it was in dB to avoid any confusion.

stephen nagler

 

[MattK]

No Dan, it's not misleading at least not intentionally. It'd be like if someone asked me for my height in meters so I gave it to him. And then someone else comes along and says, "That makes no sense because going by centimeters, the number would be different."

When someone specifies a unit of measure then that's how an answer is reported. Do you really expect otherwise?

 

[Dr. Nagler]

so what is your tinnitus in db sl?

11, just like I wrote in my response to your last question (#185).

you are a DOCTOR, you should NOT MISLEAD people

There is a whole lot of misleading on this board, but none of it comes from me.

stephen nagler

 

[Cor]

Can we stop this silly nonsense. @Dr. Nagler gave his reasoning which is pretty clear, so lets drop it.

 

[MattK]

so what is your tinnitus in db sl?

you are a DOCTOR, you should NOT MISLEAD people

No offense but take the time to read. He tells you in the very post you quoted. He said in dB SL it's 11.

And there is nothing misleading about answering a question in the units requested. Is that a hard concept?

If I asked, "how many gallons of gas can a 2015 Ford Focus hold" which do you think would be the appropriate unit of measure: a. Liters b. Milliliters c. Gallons d. Pints? Think hard. Apparently for some of you this is a tough one.

 

[attheedgeofscience]

But right now I'm trying to figure out if I should even bother, when there are a handful of misguided individuals just waiting to dissect everything I post so they can play gotcha.

Dr. Nagler tinnitus matching has no meaning unless it is stated in db SL. Something you yourself point out in the following thread of yours...

OK. So for the reason explained above, it really makes no sense to talk about a loudness match in anything by dB SL.

Source: http://stringplayer.websitetoolbox.com/post/show_single_post?pid=27637604&postcount=2

I indeed never said you lied, but your (original) statement is misleading. And it wouldn't be the first time, now would it? Shall I prove it to you (and the rest of the board)?

They know who they are, and they need to take a good hard look at themselves.

You don't need to consider whether you want to leave. I already decided to leave TT some three weeks ago. Because of you, that is. That's why I have been largely absent from this board (only checking in once a week). And the only reason I keep coming back sporadically is that we still have "bits and pieces" of on-going work in relation to our publication of the informal Trobalt trial. But that too will come to an end at some point.

 

[attheedgeofscience]

Apparently for some of you this is a tough one.

Apparently it is. For you...

"db SL" has nothing to do with units. It has to do with relative measurements.

To use your own concept of a fuel tank, "db SL" would be equivalent to saying: if I filled up my car with 20 litres of gas, how much would be in it afterwards? Well that would depend on how much gas is already in the tank! So the question would be impossible to answer, essentially (unless you know how much gas is in the car already).

 

[MattK]

Never really thought I'd see the day when someone answered s question point blank and then gets accused of being deceitful.

Apparently it is. For you...

"db SL" has nothing to do with units. It has to do with relative measurements.

To use your own concept of a fuel tank, "db SL" would be equivalent to saying: if I filled up my car with 20 litres of gas, how much would be in it afterwards? Well that would depend on how much gas is already in the tank! So the question would be impossible to answer, essentially (unless you know how much gas is in the car already).

You've missed the concept of the question. So you're saying that if someone asked him what the dB was that he should not have answered that way?

 

[Stink]

OK THANKS DR NAGLER FOR THE EXPLANATION

THE DB SL HAS BEEN EXPLAINED

SORRY IF I WAS TOO RUDE

DR NAGLER IS VERY HELPFUL, SHOW HIM YOUR SUPPORT AND STOP THE OFF TOPIC

 

[attheedgeofscience]

You've missed the concept of the question. So you're saying that if someone asked him what the dB was that he should not have answered that way?

You still don't get it. "db" and "db SL" are both measured in decibels. But the first is an absolute measurement, the other is a relative measurement. You don't answer a tinnitus loudness matching question in absolute terms, because it has no meaning...

 

[MattK]

You still don't get it. "db" and "db SL" are both measured in decibels. But the first is an absolute measurement, the other is a relative measurement. You don't answer a tinnitus loudness matching question in absolute terms, because it has no meaning...

No I DO get that. What I'm saying is if someone asks for a unit of measure, then he should expect in answer in that measure. I supposed Dr Nagler could've answered the question and then explain why it is meaningless. But still no reason to think of him as deceitful.

Using your car fuel anslogy if I asked, how many gallons of gas can your tank hold?" The correct answer isn't, "it depends on how full it already is".

 

[James P]

Dr Nagler, I hope you will take the time to post your recovery story. It would be comforting knowledge to have for the future if my tinnitus does get worse.

I appreciated your letter to a tinnitus sufferer it, was very helpful. I'm sorry you had to go through an experience i cant relate to, but it has helped me appreciate what i have and put life into perspective

 

[attheedgeofscience]

No I DO get that. What I'm saying is if someone asks for a unit of measure, then he should expect in answer in that measure. I supposed Dr Nagler could've answered the question and then explain why it is meaningless. But still no reason to think of him as deceitful.

Tinnitus loudness matching is "always" quoted in db SL (it has no meaning if you don't i.e. the severity of the tinnitus cannot be evaluated in anything but db SL...). Now a db SL figure of 91 db would be unfathomable. Hence misleading...

By implication, a knowledgeable/medical person would always quote their tinnitus loudness matching in db SL (even if asked what their tinnitus loudness match is in "db"). It's a protocol. Just like there is a protocol when a doctor asks a nurse to do a blood test on a patient. Even if the doctor does not specifically mention that the nurse needs to clean the site of injection beforehand, the nurse would still do it, right? Right... because that's the protocol...

 

[Stink]

@attheedgeofscience is right

http://www.tinnitusarchive.org/dataSets/1/methods/tinnitusClinicTestProtocol/#loud

db sl - sensation level - is the protocol here

dr. nagler (trt clinician) should know this !!!

 

[MattK]

Tinnitus loudness matching is "always" quoted in db SL (it has no meaning if you don't i.e. the severity of the tinnitus cannot be evaluated in anything but db SL...). Now a db SL figure of 91 db would be unfathomable. Hence misleading...

By implication, a knowledgeable/medical person would always quote their tinnitus loudness matching in db SL (even if asked what their tinnitus loudness match is in "db"). It's a protocol. Just like there is a protocol when a doctor asks a nurse to do a blood test on a patient. Even if the doctor does not specifically mention that the nurse needs to clean the site of injection beforehand, the nurse would still do it, right? Right... because that's the protocol...

Ok, now is there a chance it was merely an oversight on his part? What benefit would he gain by being intentionally deceitful when he knows there are knowledgable members who're more than willing to call him out?

 

[Dr. Nagler]

The tinnitus loudness match in dB is clinically meaningless. But so is the tinnitus loudness match in dB SL. The whole topic is utterly ridiculous from a clinical standpoint. I was asked for my loudness match in dB, and I responded with my loudness match in dB. Done. Asked and answered. Or so I thought.

But here's the thing: the loudness match is of value only for research purposes. It has absolutely no therapeutic or prognostic implications whatsoever. As I said earlier (in Post #163), "In tinnitus, perception is the only reality. Your tinnitus is exactly as loud as it sounds to you." And the tinnitus loudness "as it sounds to you" is the tinnitus loudness rating, not the tinnitus loudness match, regardless of whether the loudness match is measured in dB or in dB SL.

OK, for those who might be interested, my tinnitus loudness rating is 10 out of 10. So when dan, ATEOS, and Stink want to stop playing gotcha and start talking about what's really important - like how can a person with a tinnitus loudness rating of 10/10 be doing well - let me know.

stephen nagler

 

[attheedgeofscience]

Ok, now is there a chance it was merely an oversight on his part?

I don't know - is there...?

www.tinnitustalk.com/threads/low-level-laser-therapy-lllt-for-tinnitus-%E2%80%94-efficacy-debate.7650/page-18#post-97400

As for the topic in question (i.e. loudness matching), I personally would have let the comment "go" as it stood...

In dB? 91

...but then another member commented on the loudness...

Wow, just wow. You are a very strong man! Like you said, if you're able to get through this and continue to thrive then anyone else can do it too.

...and it seemed pretty clear to me that he was misled (and @Dr. Nagler did not clear up the misunderstanding). Even so, I (still) did not comment on the discrepancy (because this is a support board). However when @dan legitimately decided to comment on the discrepancy, I, likewise decided to add my two cents to the discussion - which - because of members like yourself, who feel the need to lecture me on things they don't understand, turned into a number of posts. I would have gladly left this thread with just my only comment, but that was not possible.

 

[Cor]

How does one measure the loudness rating? Ive told myself over the months that 'it cant get any louder than this", and then im proven wrong. @Dr. Nagler you may have said 10/10 20 years ago, but now it went even higher. So how does that work?

 

[dan]

@Dr. Nagler I want nothing from you. I merely prevented some people from panicking believing that their tinnitus might one day reach 91dB loudness - as loud as a real life lawn mower or whatever.
Just cleared that up is all.

 

[Dr. Nagler]

How does one measure the loudness rating? Ive told myself over the months that 'it cant get any louder than this", and then im proven wrong. Dr. Nagler, you may have said 10/10 20 years ago, but now it went even higher. So how does that work?

Tinnitus is a subjective phenomenon - so for clinical purposes the loudness is most appropriately measured subjectively with the tinnitus loudness rating (like on a 1 to 10 scale). So it is conceivable you might think that your tinnitus "can't possibly get any louder" ... until it does!

The tinnitus loudness match (whether in dB or dB SL) is an attempt to use objective criteria to measure a subjective phenomenon. And while the loudness match may someday be found to have a role in research, it has absolutely no clinical (i.e., therapeutic or prognostic) implications.

stephen nagler

 

[Dr. Nagler]

@Dr. Nagler I want nothing from you. I merely prevented some people from panicking believing that their tinnitus might one day reach 91dB loudness - as loud as a real life lawn mower or whatever.
Just cleared that up is all.

Dan, I want nothing from you, either.

And I can easily hear my tinnitus over a "real life lawn mower."

stephen nagler

 

[Cor]

But does one measure it? or is it a personal subjective number? Like you just say 10/10, because thats how you feel it compared to previous experiences? And if I say 10/10 now. But tomorrow it doubles in volume, what do I say tomorrow when someone asks?

In your case, you say it's 10/10. But lets say tomorrow it gets twice as loud. What would you say tomorrow?

 

[MattK]

@Dr. Nagler I want nothing from you. I merely prevented some people from panicking believing that their tinnitus might one day reach 91dB loudness - as loud as a real life lawn mower or whatever.
Just cleared that up is all.

Dan after re-reading what you wrote, I do not believe you meant for this to blow up like it did. I think it really took off into the wrong direction when ATEOS entered the equation. Though I'm sure you agree with him, he was much more aggressive in his "correction".

 

[Zechariah]

But does one measure it? or is it a personal subjective number? Like you just say 10/10, because thats how you feel it compared to previous experiences? And if I say 10/10 now. But tomorrow it doubles in volume, what do I say tomorrow when someone asks?

In your case, you say it's 10/10. But lets say tomorrow it gets twice as loud. What would you say tomorrow?

When talking about tinnitus loudness rating, I think that the one should always match the current rating to the worst T experience he/she has experienced to date. Atleast that's how I've rated my T.