Reactive Tinnitus Is Real

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#32
To @Street Spirit -

I truly feel your pain and frustration. Please do not think for one moment that because I look at this problem a bit differently than you do that I lack compassion and understanding. I sincerely hope you find the peace and silence you seek.

All the best -

Dr. Stephen Nagler
 
#33
@dan posted:

"So just to make things clear, the experienced TRT clinician will make the decision about the reactivity of your tinnitus.
Dr.Nagler says clearly, that if the tinnitus return to baseline within 24 hours, then chances are in your favor. I would however say much less than 24 hours (that's pushing it, imo)
If the tinnitus does not return to baseline after 24hrs, then white noise gens are contraindicated.
Feel free to correct me @Dr.Nagler."

If a person's tinnitus is significantly exacerbated by noise and does not return to baseline within 24 hours, the chances of success in TRT are less than if the person's tinnitus does return to baseline within 24 hours. The chances for success in TRT are still good, but just not as good. Some of the counseling strategies and sound therapy strategies differ in the greater than 24 hour group, but broadband sound generators ("white noise gens") are still the vehicle of choice for delivery of the sound therapy.

Dr. Stephen Nagler
 
#34
Dr Nagler, I started this thread to point out that there is a different type of tinnitus that I myself have and many others with H have that is different than regular or standard T.

I also stated in my opening post that mine went away when my H got better. So IMO I believe that " reactive T" as we have come to call it or " sound sensitive T" is a form or part of hyperacusis.

I also get spikes from food and don't care much about those, they are temporary.

I think the major issue with Reactive T is the complications it creates by having sound worsen it..how does one habituate or even mask when sound makes it worse. It makes me hesitant to use Gens or have sound enrichment going 24/7

Anyways good to know you have treated those with " sound sensitive t " through TRT. That is all that matters is that people can get better....and I did....but now it's back right alongside my severe H and it's no fun.

I appreciate your support and thank you.
 
#35
Street Spirit said:
I think the major issue with Reactive T is the complications it creates by having sound worsen it..how does one habituate or even mask when sound makes it worse. It makes me hesitant to use Gens or have sound enrichment going 24/7
Click to expand...

I would not recommend the use of broadband sound generators for what you are calling "Reactive T' unless you were under treatment by a clinician who is extremely experienced with the protocols for using them under such circumstances. Fully 25% of the patients I see in my own clinic fall under the umbrella of what you are calling Reactive T, and we use them all the time with great success. In fact, I would be pretty much at a loss as to how to treat it without them! (Note: I do not believe that 25% of the tinnitus population at large has what you are calling Reactive T; that's just how things fall out in my own clinic.)

I appreciate your support and thank you.
Click to expand...

You are welcome. Sometimes with all the back-and-forth here, it helps to remember that we are all on the same side. I wish you nothing but the best.

Dr. Stephen Nagler
 
#36
I wish you the same...and thank you for that info, that has been my gut instinct all along..I strongly consider travelling to Jastreboff because there is no one in Canada I trust.
 
#37
Street Spirit said:
I wish you the same...and thank you for that info, that has been my gut instinct all along..I strongly consider travelling to Jastreboff because there is no one in Canada I trust.
Click to expand...

Not sure what part of Canada you live in, but I really like Glynnis Tidball and Carol Lau in Vancouver.

Dr. Stephen Nagler
 
#39
Street Spirit said:
I've heard good things about clinicians in the West, sadly I am in Ontario...but thanks!
Click to expand...

Well, @Street Spirit, let me ask you this:

On a scale of 1 to 10, where 1 is "I have reactive tinnitus, but it is not a factor in my life whatsoever" and 10 is "I have reactive tinnitus, and it has totally ruined my life," where do you fall on average?

Dr. Stephen Nagler
 
#40
@Dr. Nagler

I have 14000 Htz Reactive T. I didn't realise until last couple of days that my category is practically untreatable. I have been looking at TRT with J Sheldrake in London and have been in contact to arrange an appointment.

My T is outside the range of white noise and would react to the sound of the generators.

Also the pitch is too high for neuromodulation.

I want to habituate and use TRT. Its the only logical way forward right now. I fully believe in it.

Thanks

R
 
#41
RCP1 said:
@Dr. Nagler

I have 14000 Htz Reactive T. I didn't realise until last couple of days that my category is practically untreatable.
Click to expand...

That is neither my understanding not my experience.

I have been looking at TRT with J Sheldrake in London and have been in contact to arrange an appointment.
Click to expand...

Excellent.

My T is outside the range of white noise
Click to expand...

Irrelevant in TRT.

and would react to the sound of the generators.
Click to expand...

Not in knowledgeable and experienced hands. That's why you are going to see Jacqui Sheldrake. All the best with it.

Dr. Stephen Nagler
 
#42
@Dr. Nagler

Thank you Doctor. I will move full steam ahead on this. It is the only course of action. Things have progressed from Panic, to calm and hope that it would recede to being involved in a battle to simply survive. I cant continue with the way things are now and as you say its a question of priority. How much is my life worth.. Genuine TRT is all there is and it works and is a short swim away.

R
 
#43
RCP1 said:
@Dr. Nagler

Thank you Doctor. I will move full steam ahead on this. It is the only course of action. Things have progressed from Panic, to calm and hope that it would recede to being involved in a battle to simply survive. I cant continue with the way things are now and as you say its a question of priority. How much is my life worth.. Genuine TRT is all there is and it works and is a short swim away.
Click to expand...

Just so we're on the same page here.

"Genuine TRT" is the only TRT. If it's not Genuine TRT, then whatever it is ... it isn't TRT.

But that said, TRT is not "all there is." There are other paths to achieving meaningful tinnitus relief. I happen to believe that TRT is the most efficient and most effective, but there are other legitimate ways to get there.

Dr. Stephen Nagler
 
#45
tinnitussufferer said:
How do you know whether the tinnitus is reacting to the food or noise or whether it is simply fluctuating ? Its hard to tell.
Click to expand...

If your tinnitus is constantly fluctuating, then it's hard to tell. Otherwise it's fairly easy.

The point I'm trying to make is the from a TRT standpoint, all that stuff is irrelevant.

Dr. Stephen Nagler
 
#46
Dr. Nagler said:
Well, @Street Spirit, let me ask you this:

On a scale of 1 to 10, where 1 is "I have reactive tinnitus, but it is not a factor in my life whatsoever" and 10 is "I have reactive tinnitus, and it has totally ruined my life," where do you fall on average?

Dr. Stephen Nagler
Click to expand...

To be honest Dr. Nagler, at this moment, my T doesn't really bother me. I mean it certainly causes me fear and the spikes are damn annoying but it's my H, that would be a 10.

But if I had to put my reactive T on a scale..a 3..when it was worse, a 7. It scared me alot to hear this weird feedback to even the most gentlest of sounds- a ticking clock. Anyways, my T has worsened within a year, and that scares me but it fluctuates alot as well. I would say I go through a good part of my day not even thinking of my T, of.course right now I am in a controlled environment because my H is so bad and I don't work...if I were in a noisy environment maybe it be alot different. ..basically I am not living...

Bottom line is I need help. I am not getting better on my own..I thought I was. This latest setback brought back phonophobia or what have you(misophonia) right back to the forefront and for all I know that could be causing me further decreased sound tolerance. Come to think of it, it all started going downhill when my T worsened and my focus went right back to my ears..panic set in. .I had a few noise incidents (.nothing major) got very sick and wham, a major league setback. .

anyways I am rambling..something we tend to do trying to figure out this funny ear business...except it isn't funny, it sucks.

and for the record @dan I know quite a few people who have recovered using TRT ;)
 
#48
H...and helped them habituate to their T :)

these people are from various groups..just not this one :)..except Dr..Nagler. .oh and Captain Kirk! lol..what the heck is his name. .oh yea William Shatner haha
 
#49
Dr. Nagler said:
I do not wish to be argumentative here, but the only difference I can see is that your tinnitus reacts to noise while mine reacts to food. However, they are both reactive.

I am unaware of any place in the literature that defines "reactive tinnitus" as tinnitus that reacts specifically to noise.

If you want to call what you have "noise-sensitive tinnitus," "sounnd-sensitive tinnitus," or the like, I think that's fine. But if you choose to call what you have "reactive tinnitus," then I'm going to choose to call what I have "reactive tinnitus" - because both of us have tinnitus that reacts.

By the way, it's an important point with important clinical implications. Otherwise I would not have entered the thread.

Best to all -

Dr. Stephen Nagler
Click to expand...

Pfffsstttttttttttgr#3!***uNGGHppprtt=^//">&^Bvvvtttzzzggrtt!!!

YOU HAVE NO CLUE!!! Here we go again...with your unbelievable ignorance on this issue and the wonderous miracle of TRT. Actually leave out TRT as I'm sure "anything" done for the amount of time it generally takes to do TRT will help 80% of people with T just because time has gone by!

To compare reacting to spicy food to reacting to sound exposure which initiates, or can initiate PERMANENT increases in T volume (not this Mickey Mouse < 24 hours stuff) is exceedingly juvenile and argumentative. They are different galaxies!!! Eating food X or not, is a simple preference choice! Getting exposed to sound is also a choice...the choice to stay indoors and protected or to have LIFE! And do not dare give me some BS about me not choosing or attempting to have a LIFE and being ruled like a loser slave by my T/H. Nothing could be further from the truth!

You have read my replies to you three times in three different threads yet you continue to "bait" this issue. You continue to think this is some kind of game. You continue to think this "Reactive T" for want of a better term, is some kind of 'normal T thing'...well NO IT'S NOT, because I had "normal" T for FIFTY YEARS at two volume levels and had what you have, where it did not go ape in the presence of sound. Loud "Niagara Falls" volume or not, compared to Reactive T that is kid stuff to deal with!
No wonder you are so cavalier about it. You plain have no experience of it or understanding of it. Yes it is rare thank god, but your intransigent arrogance and denial about the possibility of such is just outright bizarre.

I could go on for pages about this, but you have had my attempts to explain before and have shown the absorption capacities of granite. You are not worth the time...And stress has absolutely no impact on my T, none at all. If that were the case I would have increased T every time I read one of your brick wall postulations.

Z.
 
#50
I agree...this gerneral advise is a little dangerous given that there are several different types of T. I experienced spike after permanant spike with this same advise. Now I sit here with sevre T and H.

This not care about T is great until it gets worse becasue you didn't care. Then you care.
 
#51
@Telis I am sorry for your situation :(
What do you mean you experienced" spike after permanent spike" due to what advice? to not over protect your ears? or to just ignore your T and get on with it? did you have H before as well?

See my gut (or anxiety) has always told me to protect my ears in uncontrolled environments...seeing how my T and H reacted to loud sounds and even steady frequencies like water running or driving (and food!) I am VERY reactive-much like my personality :/ anyways...but when my H got better my T no longer reacted(that I noticed)..but was always there like " normal" T..

So it's safe to say many of us here have "reactive T" also have H.

which was my point. .there is a connection..

peace to all..
 
#52
Zimichael said:
Pfffsstttttttttttgr#3!***uNGGHppprtt=^//">&^Bvvvtttzzzggrtt!!!

YOU HAVE NO CLUE!!!
Click to expand...

Actually nobody has a clue. See: https://www.tinnitustalk.com/threads/you-have-no-clue.7002/

Here we go again...with your unbelievable ignorance on this issue and the wonderous miracle of TRT. Actually leave out TRT as I'm sure "anything" done for the amount of time it generally takes to do TRT will help 80% of people with T just because time has gone by!
Click to expand...

Right. Just try telling that to the folks who suffered from severe intrusive tinnitus for 20+ years ... and then within six to twelve months of starting TRT were doing just fine.

But this post isn't about TRT. It's about your obvious inability to make your point without getting your shorts in a wad.

To compare reacting to spicy food to reacting to sound exposure which initiates, or can initiate PERMANENT increases in T volume (not this Mickey Mouse < 24 hours stuff) is exceedingly juvenile and argumentative. They are different galaxies!!! Eating food X or not, is a simple preference choice! Getting exposed to sound is also a choice...the choice to stay indoors and protected or to have LIFE! And do not dare give me some BS about me not choosing or attempting to have a LIFE and being ruled like a loser slave by my T/H. Nothing could be further from the truth!
Click to expand...

Since nobody has a clue, the truth in this case is rather difficult to grasp.

You have read my replies to you three times in three different threads yet ...
Click to expand...

Actually I don't read your posts at all. I used to try, but I always found myself giving up after the first sentence or two. So I no longer try at all. Not worth the time or the effort. I wonder how many feel as I do. Indeed, the only reason I read this one was because your infantile yelling ...

"Pfffsstttttttttttgr#3!***uNGGHppprtt=^//">&^Bvvvtttzzzggrtt!!!"
​
followed by

"YOU HAVE NO CLUE!!!"​

... caught my attention.

Now today is Thanksgiving. I'm going to spend the rest of the day focusing on my blessings. I suggest you take a chill pill and try to focus on yours.

stephen nagler
 
#53
Dr. Nagler said:
Actually nobody has a clue. See: https://www.tinnitustalk.com/threads/you-have-no-clue.7002/



Right. Just try telling that to the folks who suffered from severe intrusive tinnitus for 20+ years ... and then within six to twelve months of starting TRT were doing just fine.

But this post isn't about TRT. It's about your obvious inability to make your point without getting your shorts in a wad.



Since nobody has a clue, the truth in this case is rather difficult to grasp.



Actually I don't read your posts at all. I used to try, but I always found myself giving up after the first sentence or two. So I no longer try at all. Not worth the time or the effort. I wonder how many feel as I do. Indeed, the only reason I read this one was because your infantile yelling ...

"Pfffsstttttttttttgr#3!***uNGGHppprtt=^//">&^Bvvvtttzzzggrtt!!!"
​
followed by

"YOU HAVE NO CLUE!!!"​

... caught my attention.

Now today is Thanksgiving. I'm going to spend the rest of the day focusing on my blessings. I suggest you take a chill pill and try to focus on yours.

stephen nagler
Click to expand...

Well then, no wonder you don't have a clue, as if you never bothered to read my "explanations" then you will have no idea how ridiculous it is to compare the choice to have a 'spike' from Thai food to 'permanent spikes' that do not go away or down and trying to live a life in the world.
You have a long history of tirades so it's a bit 'the pot calling the kettle black' here...and you indeed are the only person that is able to bring me to such a place of frustration. My Brit background of "politeness" takes lot to rile up in such a fashion.
However, it is now clear, that if you have not bothered to read my Profile. If you have not bothered to wonder c/o the icon notification that I have had four increases of tinnitus and you don't find that professionally 'interesting' and unusual enough to wonder how. If you have not bothered to read my explanatory posts well before I got "riled at you" *[In fact my first contact with you when you were new on TT was to offer to converse as you seemed like a really qualified and interesting fellow. You declined, implying you had had some "difficulties" with people in the past. Soon after you trashed me at a time I was getting divorced. I could see why!]. If you have not read my replies these past three 'recent times' where I have clearly described this "Reactive T" (for want of a better word) and perhaps would have 'professionally' seen what that implied....then no wonder you have no useful response. Indeed, you thus admit to me that "you haven't a clue".
The mere fact that you have previously replied to posts (mine) without reading them (or pretending not to - as you often refer to comments in them later), shows exactly what I think you are. Someone so pompous and self important and so entrenched in their views, that the word "granite" is a poor metaphor.

And "chill pills" do not exist for my level of "Reactive T", neither does Thanksgiving...as how can I go to friends or family and dampen their festive enjoyment so much by having everyone walking on eggshells, trying to not cough, or laugh suddenly, or clink a plate, or shriek in delight, or....do what humans do in such occasions?! I do not force that on them. Let them enjoy themselves. After all I have had tinnitus for 58 years and four jumps up, so have lots of experience with this.

Ahhhhh, but you wouldn't know that because you have not bothered to look at or read what I have said so many times. You are not worth my time. And indeed, my future challenge on TT is to try and find ways to ignore your 'flat earth' views and hope you don't stick those views into just about every thread possible.

Zimichael
 
#54
Zimichael said:
Thanksgiving...as how can I go to friends or family and dampen their festive enjoyment so much by having everyone walking on eggshells, trying to not cough, or laugh suddenly, or clink a plate, or shriek in delight, or....do what humans do in such occasions?! I do not force that on them. Let them enjoy themselves.
Click to expand...

I feel bad for you @Zimichael.

Perhaps instead of ruining the day for your family and friends, you could spend the time making an effort to improve the life of somebody less fortunate than yourself.

stephen nagler
 
#55
Name a quiet place...The local Plowshares soup line is far from it! I can't even volunteer in the Library without putting Etymotics in and 15 minutes later my head/ringing is on fire.
I choose to be available 24/7 by speakerphone instead.
Glad you read my post! We're getting somewhere...
 
#56
Zimichael said:
I choose to be available 24/7 by speakerphone instead.
Click to expand...

Choose instead to help serve Thanksgiving dinner in a battered women's shelter. Use a ton of ear protection and put up with the auditory consequences. It won't kill you. Get off the speakerphone, and make a difference in the life of a real live person. Stop playing the role of the victim.

Just a thought.

stephen nagler
 
#57
You just don't get it!!! You see, you failed to comprehend what I said two posts up. I was at a memorial service for a young friend just two weeks ago and really, really wanted to be there. I kept the plugs in for an hour and could not handle it any more and had to leave early. The T was SOOOOOOOOO loud and it keeps getting louder. I paid a price. I was absolutely exhausted. It took me days to recover and yes T did come back down slowly THIS TIME!!!
Read my Profile!!! It has NOT always come back down. If you knew what I had done in my life you would know I am the antithesis of a "victim"...I have zero time for that, though T has softened that stance for sure.

And if you do not think people can be helped long distance by spending hours on a phone you show massive ignorance. They can be helped far more with human voice than writing endless lines and posts on a chat board like you do.

I'm done with you Nagler, you just don't get it!
 
#58
@Zimichael I know you're suffering big time. I know to say you're extremely frustrated would be a massive understatement. But I think interacting with Dr. Nagler isn't the best thing for you. You two clearly don't see eye-to-eye on how to treat tinnitus, or how severe it can be. And that's how it's been for quite a while now. I think for your own sake, it would be better if you just didn't pay attention to Dr. Nagler's posts or anyone else who might upset you.

@Dr. Nagler I'm not taking sides. But I am just telling Zimichael that I think interacting with you isn't the best thing for him. I know you don't meant to purposely upset him, but either way, that's what happens.
 
#59
Zimichael said:
And if you do not think people can be helped long distance by spending hours on a phone you show massive ignorance.
Click to expand...

Seems to me that if you can spend hours and hours on a speakerphone, your tinnitus isn't as "reactive" as you say it is.

My patients with severe sound sensitive tinnitus are often unable to speak on the phone at all. In fact I can think of two individuals offhand who were for the longest time unable to even tolerate the noise created by their own voices. They are both much much better now, one thanks to TRT and the other thanks to a different desensitization protocol

The answer to all of this lies within you, @Zimichael. I wish you well.

Dr. Stephen Nagler
 
#60
MattK said:
@Dr. Nagler I'm not taking sides. But I am just telling Zimichael that I think interacting with you isn't the best thing for him. I know you don't meant to purposely upset him, but either way, that's what happens.
Click to expand...

I appreciate your input on this issue, @MattK, but I'm not posting for Zimichael ... even though it seems that I am addressing him. Rather, I am posting for those with "reactive" tinnitus but who have an open mind about these things. Zimichael is to me just a metaphor. He stopped counting when he started YELLING.

Best to all -

Dr. Stephen Nagler
 
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