Rough Experience with an Audiologist Who Insisted on Giving Me an Audiogram and LDL Test

[SaraK18]

Hey friends,

I had a little spike in my hyperacusis and tinnitus after a loud motorcycle drove past me last weekend so I decided to make an appointment with a hyperacusis specialist.

To make a long story short, the doctor was fairly condescending and insisted on giving me a hearing test and LDL test, both of which I said I would not be having when I made the appointment.

He finally convinced me to go in the sound booth and I got so panicked at having to put the headphones on I burst into tears and he was very rude to me. My hyperacusis has been painful all week and I'm scared. He told me I needed to go see a psychiatrist and get medicated and then I could come back to him.

He did not understand that I am traumatized, and not needing psychiatric medication. I don't understand how a hyperacusis specialist doesn't comprehend PTSD and trauma from an injury.

I reluctantly agreed to the hearing test which showed exactly what it did after my acoustic trauma, slight dip around the 4000 Hz range, He also tested my tinnitus but we did not do the LDL. He said that he could give me TRT and sound therapy & in about 4 months I would be better. But first he would have to do the LDL.

Any experience or opinions on this? To me it seems risky to do a loudness test on a person with activated hyperacusis. I don't know why he can't just give me the sound therapy without traumatizing me first. Is it really necessary? Doesn't seem like there's a lot of hyperacusis specialists around so he might be my only option if I wanted to do this.

I was also telling him that laser therapy brings down my hyperacusis and he started telling me that lasers don't work. Yes, they do.

Reminded me of why I avoid Western medicine unless it's an emergency. It's humiliating opening up to someone about a serious issue and being treated with such a lack of dignity.

 

[Rockman]

That's terrible! No one understands the battle to get through every day with this. Trying to stay positive without making things worse.

 

[Michael Leigh]

Hi @SaraK18.

I am sorry to hear about the difficulty you have been having with hyperacusis and the lack of empathy from the audiologist you saw.

Twenty six years ago I had a similar experience to yours and reported the audiologist to the Head of Audiology. Fortunately I didn't have to see the person again but later learned, she was dismissed by the hospital because other tinnitus patients made complaints about her lack of empathy and condescending behaviour. This person had never experienced tinnitus.

My new audiologist was born with tinnitus and was like a breath of fresh air, because she completely understood the things I had been going through. Having TRT and regular counselling with her for two years went smoothly from day one. At the end of treatment the tinnitus reduced to very low levels that most of the times I was unaware of it. The hyperacusis was completely cured.

Even though I agree with some of the things your audiologist has said, clearly his bedside manner leaves a lot to be desired. Therefore, if I were in your position, I would try to find another tinnitus and hyperacusis specialist for treatment. Preferably one that has tinnitus and many do. I believe this is the only way one can have a good grasp of tinnitus and to give high quality counselling because tinnitus cannot be learnt from a book.

Please click on the links below and read my posts.

All the best,
Michael

What Is TRT and When Should It Be Started? | Tinnitus Talk Support Forum
Hyperacusis, As I See It | Tinnitus Talk Support Forum

 

[DaveFromChicago]

To SaraK18:

The (without exaggeration) barbaric nature of these Audiology / Hearing tests is reminiscent of numerous 19th Century medical procedures that in retrospect we regard with horror and astonishment that anyone could believe were beneficial.

When I was subjected to a hearing test, those orange rubber stoppers that were crammed into me created such a white noise blizzard that I could hardly hear the faint high pitched sounds from the actual test.

Afterwards, I was so disoriented that I felt like I had gone 10 rounds with Floyd Mayweather, and my tinnitus was raging for the better part of the day.

I could not believe that these "professionals" so completely lost site of the fact that the purpose of my visit (and the expenditure of $350.00) was for the reduction, not the maniacal aggravation, of tinnitus.

What country do you reside in?

In the USA, no Health Insurance Carrier will cover TRT, and your out-of-pocket costs could exceed $6,000.00.

Besides, my carefully considered opinion is that TRT is outright placebo junk that should be classified in the same category as those abovementioned 19th Century Quackeries.

Be very careful in regard to accepting Michael Leigh's advice. Portions of his advice have been downright wrong and in fact dangerous at times. He is an expert about tinnitus to the extent that Dr. Pepper is a real Doctor.

Your next move should be to drop this specialist and find someone else who has received high ratings.

I have had this for over 8 years, and every day feels as if mentally I am barely holding my own against a wrestling match with an enormous anaconda.

 

[David S]

Hi @SaraK18.

My new audiologist was born with tinnitus and was like a breath of fresh air, because she completely understood the things I had been going through. Having TRT and regular counselling with her for two years went smoothly from day one. At the end of treatment the tinnitus reduced to very low levels that most of the times I was unaware of it. The hyperacusis was completely cured.

Michael, I know this was a long time ago but do you remember if the improvments was linear or did you see most benefits in the late part of the treatment?

 

[Michael Leigh]

Michael, I know this was a long time ago but do you remember if the improvments was linear or did you see most benefits in the late part of the treatment?

Indeed, this was a very long time ago David S. My improvements were slow at first, especially the hyperacusis. After six months my recovery began to increase steadily. I was able to listen to music through my HI-FI without experiencing pain in my ears. During conversation with anyone, I no longer had to explain to them, to please lower their voice because my ears hurt.

Habituation happened before I completed TRT treatment at about 17 months. I reached a stage where I no longer heard the tinnitus unless I deliberately listened for it in quiet surroundings. The hyperacusis was completely cured and has remained this way till this day, even though the tinnitus changed in 2008 to variable tinnitus.

The type of variable tinnitus I now have is completely different from the tinnitus onset in 1996.

Habituating to tinnitus with or without hyperacusis will be different for each person. This can take up to two years the first time around. However, habituating after a second noise trauma can often (but not always) be more challenging as it was in my case which took 4 years. There are no set rules and therefore a person has to try and figure out what works best for them. One thing in their favour, they are able to draw on previous years experience with tinnitus, and hyperacusis if it is present, to help work through the habituation process for the second time.

Michael

 

[David S]

Michael,

Did you use sound generators the second time around for 4 years? How long did it take before you noticed any improvement? First time around I used sound generators for one year with good success.

Thanks,
David

 

[SaraK18]

@Michael Leigh, thank you, appreciate it. It's amazing the success that you had with therapies. Very hopeful.

Do you remember if you did LDL testing, and if so, did it cause you any additional ear trouble? Was your tinnitus/hyperacusis volatile and reactive?

Also, any idea what the decibel level is for an audiogram or tinnitus pitch test? It seemed pretty quiet, but I woke up the next morning with higher pitched ringing in my left ear, which usually happens when my ears are upset from some thing. I also have burning pain deep in the ear, and today I woke up with a wet squishy feeling in my left ear. The wet feeling is never a good sign. I can't imagine that anything he did hurt me, but I'm so confused by all of this.

 

[SaraK18]

@DaveFromChicago, haha seriously it does feel medieval. My tinnitus is also worse after the appointment, with other symptoms also. I'm hoping it's from stress from the ordeal, but not sure if stress can cause fluid in the ear. Seems unlikely although I guess anything is possible. I want to email the doctor about it, but not expecting to be met with any empathy.

I am in the US also. Really sorry to hear you have been struggling with this. It is exhausting. Have you found anything that helps?

 

[SaraK18]

@Rockman, thank you

 

[twa]

@SaraK18,

I'm so sorry this happened to you. I went to an otologist and had a very similar experience. The audiologist wanted to know why I didn't want the test to assess the tympanic membrane. I said I have hyperacusis and I don't want to do it. She tried to bully me and I said no. I was about to walk out completely. No one should ever have to explain themselves to a healthcare provider. We are no longer in the days of the 20th century when we simply comply with what we are told by healthcare practitioners. We can question what happens with our health and our bodies. Through this whole ordeal with my hearing (18 months ago), I have been treated with less than gentle care. It sounds like you went through a situation with an insensitive provider who really shouldn't be working with people who have had an acoustic trauma. I would write a letter to your state's certification board and explain what happened in your visit. Most healthcare providers have a grievance process with the certification board within each state (in the US).

 

[Michael Leigh]

Did you use sound generators the second time around for 4 years? How long did it take before you noticed any improvement?

David S,

I started TRT in 2008 after a second noise trauma that resulted in my tinnitus changing to variable. I wore sound generators for the entire time I was having TRT which lasted two years. I continued wearing them for a further two years. I was not experiencing any hyperacusis. Please go to my started threads and read my posts: My Experience with Tinnitus, Can I Habituate to Variable Tinnitus? Both go into more detail about variable tinnitus and how to treat it which you might find helpful.

When TRT ended in 2010 my tinnitus had improved but not like the first time I had TRT. I still experienced large fluctuations in the tinnitus. This ranged from: complete silence, mild, moderate, severe and very severe. My ENT consultant prescribed Clonazepam which helped me a lot. I still take Clonazepam approximately once or twice a month, for 1 or 2 days, if the tinnitus is very severe and won't calm down by itself.

Michael

 

[Michael Leigh]

Do you remember if you did LDL testing, and if so, did it cause you any additional ear trouble? Was your tinnitus/hyperacusis volatile and reactive?

My tinnitus and hyperacusis were very severe. I did have an LDL test.

Michael

 

[DaveFromChicago]

To SaraK18:

Good God, I have probably spent about $12,500.00 on all sorts of "therapies", supplements, etc. with no appreciable effect.

Where are you in the US?

I only ask this because TRT as Michael Leigh describes it is virtually unavailable in the entire Chicago and Outlying Suburbs.

This ought to tell you about how the Professions in general regard (or disregard) it.

And, as I mentioned before, you had better have over $6,000.00 of your own money since no Health Insurance Carrier will cover this.

As far as I am concerned, TRT is equivalent to an electrician saying, "There is nothing I can do about getting your power back on, so why don't you just learn to read until it gets too dark to see?"

All I can say is, get rid of this Current Practice and check out the Yelps, Doctor Recommendation sites, etc. for someone new. There's got to be somebody who can be more patient-oriented.

You have not had this for long enough to be in the Ultimate Freakanomics Mental Minefield Zone the way I have. This has taken up residence in my Consciousness like that Hideous Creature in the first Alien movie.

Much to my wife's dismay, to relieve the unbearable stress I have been imitating the high pitched bellows made by those Ape Humanoids that appear in the first scenes in Kubrick's "2001: A Space Odyssey." I was also reprimanded by the Police for engaging in excessive Jim-Cary-like behavior in Downtown Lake Street.

If this will help:

1) A saleslady at the Supplements Section at Whole Foods told me she had this for 5 years, and then it mysteriously went away.

2) My Muscle Massage Therapist saw a lady who had the high pitched version of this, and he said that after a few years hers suddenly and completely went away. She was so astonished that it took her a few weeks to feel comfortable with it's absence.

3) Another Massage Therapist told me that he got this from not wearing hearing protection when he learned to fly a plane. You would think that such unremitting, screeching noise would cause permanent damage to the Cilia, but he said that his went away completely after 7 years.

 

[kingsfan]

Don't go back to that sad excuse for a specialist. I applaud you for holding your ground and not doing the LDL. Keep searching and trying out audiologists if you can afford to. You'll find one that is right for you.

 

[Jack Straw]

I am really sorry this happened to you. I hope everything settles soon and you can find a new doctor who is more compassionate. I know it is hard, but keep searching!

 

[Shizune]

For TRT, my audiologist actually ran the sound generators as hearing aids while billing my insurance, which is covered, though I know for many insurances it isn't. She knows how expensive TRT can get. I am not sure if any other TRT specialists in your area are willing to do this but it may be possible.

 

[David S]

@DaveFromChicago, just curious, is it cost involved with TRT that makes you negative or is it sound enrichment and counselling in general?

 

[DaveFromChicago]

@DaveFromChicago, just curious, is it cost involved with TRT that makes you negative or is it sound enrichment and counselling in general?

Let's take the quality of the counselling I have observed.

There was a guy named Dr. Sweet who would post CBT/TRT interviews on YouTube (there were several, and I do not know if they are there anymore.) He was interviewing an Army Officer who was obviously suffering from not having worn hearing protection during shooting practice. He would ask the sorts of leading questions that I regarded as downright obtuse and very irresponsible.

For example, he would ask, "When you are overwhelmed by this, what do you think of as a recourse?"

How many posters on here would have replied, "I am so afraid that I may actually commit suicide."

He showed an inexcusable lack of understanding regarding the extreme states we can be in. He should never have forced the client's hand into boldfacing his suicidal ideation.

Instead, he should have asked, "When you have felt yourself to be on the very brink of suicide, what thoughts typically have held you back until the urge dissolved?"

Too many of these "counsellors" have a very dangerously cavalier attitude that could act as a catalyst for disaster.

I have grave reservations that even though 2 (and more) years of counselling are recommended, given the extreme state of severe tinnitus for many even this length of time would not really serve to neutralize a continuous traumatic reaction. The chief criticism of TRT is that all this talking therapy will not have a long half-life; various participants in clinical trials said that under the duress of tinnitus it was too easy to forget why this should not be bothersome, no matter how much counselling reinforcement they had received. Let's face it, how many of us can really talk our way out of not being undermined by severe, continuous pain? When in such a state, TRT advice feels superficial and inadequate.

However, it has occurred to me that everyone here has of necessity had to develop his / her own personal TRT-like methodology just to get out of the front door in the morning (or engage in any other elementary activity).

Perhaps the "Be-Your-Own-Best-Doctor" approach takes into consideration the unique, particular aspects of each individual's tinnitus experience better than an Institutional, Standardized Approach such as TRT ever could.

 

[David S]

@DaveFromChicago, that might be the weakest point of TRT. The counseling is given by an audiologist: They are simply not a trained professional in counseling like a psychiatrist. To me the strongest part of TRT has always been the sound generators and how to use and set them. They are doing their job from early morning to late night in the subconscious.

This is how I would rank different treatments:

1. Sound generators / sound enrichment
2. Proper medication
3. Relaxation exercises
4. Counseling by a trained professional

I think that a lot of people could benefit a lot from sound generators and it is sad that more people do not give it a fair chance!

 

[SaraK18]

@David S, the doctor I saw last week said he could get me better in 4 months. That my brain stem was acting like a hearing aid not filtering sound properly. Is the goal of these therapies to heal the brain? Do you know the mechanism of healing/adaptation that takes place? My hyperacusis was not caused from over protecting, but from the injury itself.

 

[SaraK18]

@twa, thank you, and I'm sorry you have received suboptimal care also. Good for you for refusing that test. I am a healthcare provider as well (holistic) and I would NEVER treat a patient like that. The assumption that all patients will fall into certain parameters does an incredible disservice to those of us that don't.

 

[DaveFromChicago]

@DaveFromChicago, that might be the weakest point of TRT. The counseling is given by an audiologist: They are simply not a trained professional in counseling like a psychiatrist. To me the strongest part of TRT has always been the sound generators and how to use and set them. They are doing their job from early morning to late night in the subconscious.

This is how I would rank different treatments:

1. Sound generators / sound enrichment
2. Proper medication
3. Relaxation exercises
4. Counseling by a trained professional

I think that a lot of people could benefit a lot from sound generators and it is sad that more people do not give it a fair chance!

My Widex Zen has a white noise generator, and when I now have a spike I find it insufferable that what is actually an artificial tinnitus sound (the white noise) is layered on top of the natural volume of the tinnitus spike.

The combination of both is so pitilessly loud that often I cannot hear external sounds from my left ear.

My subconscious has responded by creating a recurrent dream that characterizes tinnitus as a huge, hideous black insect that is determined to corner and sting me.

However, I am fully aware that others may not have such cripplingly baroque outcomes.

 

[Nemoriri]

Some people should not be allowed to work in health care, that was incredibly awfully done of him. I hope you find another, better doctor. Shame on him.

 

[Shizune]

Just had my LDL and second audiogram done today myself. Because I need this for my disability lawyer, I could not fight back on any of it. The beeps have imprinted onto my tinnitus and after about 3 hours of driving both ways I'm miserable. Going through all this turmoil and then just being told that I need to form a better relationship with sound and get over my fear is insult to injury.

And much like you, any alternatives I suggested were quickly shot down. I noticed a great shift in tone with this audiologist vs. when I first saw them 2 years ago. I think my skepticism about TRT might have caused annoyance.

 

[Athens]

Hey friends,

I had a little spike in my hyperacusis and tinnitus after a loud motorcycle drove past me last weekend so I decided to make an appointment with a hyperacusis specialist.

To make a long story short, the doctor was fairly condescending and insisted on giving me a hearing test and LDL test, both of which I said I would not be having when I made the appointment.

He finally convinced me to go in the sound booth and I got so panicked at having to put the headphones on I burst into tears and he was very rude to me. My hyperacusis has been painful all week and I'm scared. He told me I needed to go see a psychiatrist and get medicated and then I could come back to him.

He did not understand that I am traumatized, and not needing psychiatric medication. I don't understand how a hyperacusis specialist doesn't comprehend PTSD and trauma from an injury.

I reluctantly agreed to the hearing test which showed exactly what it did after my acoustic trauma, slight dip around the 4000 Hz range, He also tested my tinnitus but we did not do the LDL. He said that he could give me TRT and sound therapy & in about 4 months I would be better. But first he would have to do the LDL.

Any experience or opinions on this? To me it seems risky to do a loudness test on a person with activated hyperacusis. I don't know why he can't just give me the sound therapy without traumatizing me first. Is it really necessary? Doesn't seem like there's a lot of hyperacusis specialists around so he might be my only option if I wanted to do this.

I was also telling him that laser therapy brings down my hyperacusis and he started telling me that lasers don't work. Yes, they do.

Reminded me of why I avoid Western medicine unless it's an emergency. It's humiliating opening up to someone about a serious issue and being treated with such a lack of dignity.

I refused the LDL test, and the audiologist just noted my refusal on the report. I tried sound generators without success for approximately nine months.

... and I have been trying to expose myself to normal, everyday sounds without using earplugs, and I seem to be less distressed. I used to wear earplugs in the shower but no longer use them. I do wear them to play golf when I am taking a swing (sound can be very loud) but take them out after I hit the ball. I have noticed that certain environments do not seem as loud. I have met people for lunch or dinner at a restaurant as long as it is not slammed with people being very loud.

 

[SaraK18]

@Athens, thank you for sharing. So it sounds like you are doing your own gradual exposure. Were there ever times when you felt a setback or flare up because of unplugging?

 

[Athens]

@Athens, thank you for sharing. So it sounds like you are doing your own gradual exposure. Were there ever times when you felt a setback or flare up because of unplugging?

It is hard to tell. The hyperacusis does not seem worse, but the tinnitus seems more pronounced compared to last year. I worry about whether all of this exposure will worsen the hyperacusis and tinnitus, but I am generally not exposing my auditory system to levels of sound more than a normal level. I do not attend sporting events, live music, etc.

I went to lunch today and the restaurant was only half full. We ate outside which kind of disperses the sound. I got along fine.

One of my ENTs believes that a return to a normal sleeping pattern might give me relief from the hyperacusis. It is hard to determine whether it is a physiological or a psychological issue (perhaps a little of both).

I thought that the sound generators were kind of not a viable approach.

I am thinking that the passage of time might be important. There are apparently some people who have these issues spontaneously vanish which I find interesting.

 

[SaraK18]

@Athens, agreed, I think the passage of time is one of the key factors, and everyone seems to have their own timeline. Lately I have been interested in trying to heal my ears from within (mine is due to injury). I am regularly using a very gentle laser at home and I am noticing a difference. I have always responded when I try ear laser.

What was it about the sound generators that did not seem viable?

 

[Athens]

@Athens, agreed, I think the passage of time is one of the key factors, and everyone seems to have their own timeline. Lately I have been interested in trying to heal my ears from within (mine is due to injury). I am regularly using a very gentle laser at home and I am noticing a difference. I have always responded when I try ear laser.

What was it about the sound generators that did not seem viable?

I wore them and listened to pink noise for most of the day for ten months. I never noticed any improvement so I stopped using them. I know that some people have worn them for several years before they saw improvement, but even my TRT trained audiologist said that the counseling part of TRT is more important than the sound generators.