Tinnitus Retraining Therapy

[Dr. Nagler]

@Dr. Nagler I completely agree with you. Unfortunately the person I saw actually claims to have trained with Jasterbroff. She is an AuD, and has been working with tinnitus patients since 1997 or so. She also claimed to have a high success rate, and came highly recommended. She also seemed very burned out and slovenly, but I was so desperate that I went against my intuition and decided to work with her.

Yea. And I bet that the sixth letter in her last name is an "o." I really hate that that happened to you, SV, but it's no surprise to me. The real problem is that even if there were credentialing and standardization, that particular individual would qualify - because you simply cannot credential integrity, which I am very pleased to see is part of your nick.

Tell ya what, my friend. Since you already dumped a truckload of money into TRT ... if you can ever make your way to Atlanta once, I'll treat you at no charge. And all the follow-up can be handled by phone. No need for repeated back-and-forth trips. Think about it - and if the idea appeals to you, contact me off the board.

All the best -

stephen nagler

 

[Carm]

Tell ya what, my friend. Since you already dumped a truckload of money into TRT ... if you can ever make your way once to Atlanta, I'll treat you at no charge. And all the follow-up can be handled by phone. No need for repeated back-and-forth trips. Think about it - and if the idea appeals to you, contact me off the board.

What happened, @Dr. Nagler? Now offering free TRT to members? Can you treat more of us free of charge?

https://www.tinnitustalk.com/threads/tinnitus-retraining-therapy.43/page-6#post-102016

 

[Dr. Nagler]

What happened, @Dr. Nagler? Now offering free TRT to members? Can you treat more of us free of charge?
https://www.tinnitustalk.com/threads/tinnitus-retraining-therapy.43/page-6#post-102016

Carm, ever since I first went into practice as a surgeon back in 1982, I have treated 18% of my patients at no charge. I personally think that's what all healthcare professionals in all disciplines should do. Even though I am now semi-retired, my 18% policy still holds true today in my tinnitus clinic, but how I choose those individuals is really my concern. In this case, SV really got screwed by a colleague of mine - so I made the offer. But in the main, the people I treat for free these days are out of work because of their tinnitus, and they have virtually no financial resources.

 

[svintegrity]

@Dr. Nagler you are absolutely spot on! The sixth letter of her last name is an "o." I found it very validating that you knew right away who this person was. Even more so, it did my heart good to hear that you weren't surprised.

As you would agree, she would pass any credentialing standards, but still lack integrity. She is listed on the website of TRT practitioners, so I posted on this thread to warn people to still be careful. Even if someone is listed and has the credentials, it doesn't mean she will do a good job. Perhaps a question should be added to the your list that would cover whether or not the practitioner will act in good faith and care about the welfare of the client? I don't know how that question could be worded though. It's a bad situation.

For me, my desperation overrode my intuition. My thinking was that, given her credentials, it should work out fine. You are correct, I definitely got cheated. It gives the profession a bad name.

I am touched by your offer. I will contact you off the board to explain my situation.
Best, SV

 

[Dr. Nagler]

She is listed on the website of TRT practitioners ...

Well, unfortunately not only is that website not a guarantee of integrity, it is not even a guarantee of knowledge and experience. In order to get listed all a clinician has to do is take a short course, claim to have understood the material (i.e., there are no tests), and claim to be doing TRT right. And since there are no tests, they don't even have to know what "right" is - they just have to claim that they are doing it. Here is what Dr. Jastreboff himself says:

"The list is based on the statements of members and is not further verified. Consequently, it is not equivalent to certification and should not be treated as a referral list. We are not taking any responsibility for quality of services and the adherence to the original TRT protocol by the individual members."
​

I am touched by your offer. I will contact you off the board to explain my situation.

Excellent. I'll look forward to hearing from you.

 

[svintegrity]

@Dr. Nagler The lack of knowledge, experience, exams, and integrity is exactly the reason your list of questions is so important. However, even if the clinician answers all questions in the affirmative, it still does not guarantee she will do a good job. I do like Dr. Jastreboff's disclaimer about the website. However, I did not find the clinician I worked with on the website. It was from a referral. A very misguided referral indeed.

 

[Dr. Nagler]

Dr. NaglerThe lack of knowledge, experience, exams, and integrity is exactly the reason your list of questions is so important. However, even if the clinician answers all questions in the affirmative, it still does not guarantee she will do a good job.

Right. But even a highly trained and experienced Board-Certified surgeon can damage the common bile duct during a routine cholecystectomy. It happens. All of medicine is - in some way or other - a crap shoot. In fact all of life is in some way or other a crap shoot. Our job - through due diligence - is to shift the odds in our favor. But guarantees? As they say, the only guarantees in life are death and taxes.

 

[svintegrity]

@Dr. Nagler Touché. Agreed 100%. The exact procedure you speak about happened to a good friend of mine, even though he has been a skilled Board-Certified surgeon for 30 years. As an academician and researcher, I just try to focus on reliability and validity, even though it is truly all a crap shoot. Right. Shifting the odds in our favor is definitely what it is all about. As for fairness? Fare is what you pay on a bus. Best wishes.

 

[Dr. Nagler]

As for fairness? Fare is what you pay on a bus.

Well I'm a cynic - but perhaps not quite as cynical as that! In my experience most people go into healthcare for the right reasons and in the main try very hard to be fair. You had a particularly bad experience in that regard, but it is the exception rather than the rule - or else I would not have immediately known who you saw for TRT.

 

[svintegrity]

@Dr. Nagler I meant no ill will by the fairness phrase. I guess it is just a way of saying that life just isn't always fair.

As a former chair of a health sciences department, I also agree that most people go into healthcare for the right reasons. It is a delight to see my former students as up and coming oncologists, surgeons, nurses, physical therapists, etc. Interesting, we had no audiologists. Bioethics was a required course for the major; fairness a given as part of the profession(s).

I remain impressed that you immediately knew which clinician I had seen. It is not missed on me that neither one of us have mentioned her name. I repeat myself, but it was validating and did my heart good that you weren't surprised by my experience. In fact the clinician of whom we are speaking transmitted false and damaging health information electronically about me to people uninvolved in my care, without my written permission. Those electronic communications can now be forwarded on to anyone. Breech of HIPPA?

I guess what our conversation has boiled down to is that life isn't always fair and there are no guarantees. Oh, except death and taxes, of course.

 

[Dr. Nagler]

I remain impressed that you immediately knew which clinician I had seen. It is not missed on me that neither one of us have mentioned her name. I repeat myself, but it was validating and did my heart good that you weren't surprised by my experience. In fact the clinician of whom we are speaking transmitted false and damaging health information electronically about me to people uninvolved in my care, without my written permission. Those electronic communications can now be forwarded on to anyone. Breech of HIPPA?

Breach of HIPAA? Absolutely!

As long as you have documentation, contact an attorney and threaten to report what she did to the US Department of Health and Human Services unless she returns all of the money you paid her plus attorneys fees. The potential civil and criminal penalties for what she did are considerable. From what you describe, she would fall under Tier 3 or Tier 4.

 

[linearb]

I am not a litigious person and in general I dislike that aspect of (mostly American) culture, but this is a case where I would absolutely be assessing and pursing my legal options.

Good luck.

 

[svintegrity]

@Dr. Nagler and @linearb Thank you for your take on the possible HIPPA violation mentioned above. I do have the documentation in my file. I had thought about speaking with an attorney, because the person who is in violation has already contacted hers. When I told her in an email not to send any more health information about me to anyone else without my written permission, she immediately shut up. I have not heard from her since.

I agree with linearb, I am not a litigious person. I just expect, and hope for, people to do the right thing. I dislike the litigious aspect of the American culture too. However, when someone crosses a line, I guess it is good to take a stand in some cases. I really appreciate your feedback. It helps me make a decision to take further action. I have already filed a formal complaint with her State Board of Audiologists, but I am not sure what good that does. Does anyone know?

 

[Dr. Nagler]

@Dr. Nagler and @linearb Thank you for your take on the possible HIPPA violation from the audiologist from the tinnitus clinic. I do have the documentation in my file. I had thought about speaking with an attorney, because the person who is in violation has already contacted hers. When I told her in an email not to send any health information about me to anyone else without my written permission, she immediately shut up. I have not heard from her since.

SV, perhaps I was not clear in what I said earlier. I do not think anything much would actually come from reporting a single HIPAA violation to the US Department of Health and Human Services or to the State Board of Audiologists unless it is part of a trend involving a number of complaints about the same individual. But the threat of reporting what is obviously a HIPAA violation - if worded properly by an attorney - might well be enough to get her to return what you paid for her "services" in addition to your attorney's fees. For your part in the "settlement," you would agree not to report her. And who knows how many others have done just that? There may, indeed, already be a trend.

The fact that you told her not to reveal your records to anybody else without your express permission and that she has to the best of your knowledge complied with that demand to date is really irrelevant in the above regard. She's already done it once, and once is more than enough. I do not know how much you paid her for whatever she did or did not do for you, but if you want it back, that is the strategy I would consider.

None of the above has anything to do with the fact that you got a raw deal in the hands of a "colleague" of mine ... and if you are interested, I am willing to do whatever I can do to make it right for you.

 

[linearb]

I do not know, @svintegrity, but I would cautiously point out that if you are pursuing legal options, it might be best to not discuss this any further on a public forum.

 

[Dr. Nagler]

I do not know, @svintegrity, but I would cautiously point out that if you are pursuing legal options, it might be best to not discuss this any further on a public forum.

Agreed.

 

[svintegrity]

@Dr. Nagler and @linearb I agree. Thanks for the information. I will leave it at this, that I was just looking for advice on the situation. Nothing further. Thank you.

 

[RCP1]

As I am on the board I may aswell give a quick update.

Be under no illusions the Jastrebroff Neurophysiological Model of Tinnitus held true with me. As soon as I stopped giving T my attention and stopped fearing it the mind pretty much pushed it down the chain of importance and I am now living normally again - Practically completely as I had been doing.

This happened pretty much straight away aswell. It wasn't something which took months.

I am sure this isn't the norm but it worked for me.

Wishing everyone the best.

Slán

R

 

[attheedgeofscience]

Be under no illusions the Jastrebroff Neurophysiological Model of Tinnitus held true with me. As soon as I stopped giving T my attention and stopped fearing it the mind pretty much pushed it down the chain of importance and I am now living normally again - Practically completely as I had been doing.

Many thanks. For the benefit of forum members, would you mind elaborating on the content of the sessions you have had? I know you were suffering somewhat before your first session, and so, in your opinion, how did loud tinnitus suddenly become a non-issue, for instance?

Thanks - you are one of the few testimonials here.

 

[RCP1]

Hi ATEOS. My background is similar to yours. I have a masters in Financial mathematics and another in computer science and a primary degree in pure mathematics. I am highly logical and identify with your way of thinking and approach. I was highly sceptical of trt before i began but there was nothing else that could help imo. So what was done. Firstly i had a 2 hour counselling session the aim of which was to convince my subconscious that tinnitus is a sound anyone can tap into and it is the brain moving it up in the chain of importance that makes it intrusive. It also convinces you that if you stop fearing the sound completely and absolutely that the brain pushes it back down the chain of importance. I was given wng to deal with the sound sensitivity i had and was told not to use ear plugs unless in extreme sound. I had a few other counselling sessions to reinforce the fear concept and dropping the sound back down the chain of importance. the result of all this was to take me from a guy who heard his tinnitus 90% of the time to a guy who can now go 15 hours without hearing it. Its still there and if i were to focus on it it would come back full force after a while. I am back in work months now. I work in Dublin a busy Capital with loud noise. Commute on a loud bus etc. And yet my tinnitus awareness has decreased hugely. Thats my testimony. I stopped fearing the sound on a deep level and it became less of an issue. Is it a perfect solution... no. Has it allowed me to continue with my Life with Little distress... yes. Hope this helps someone. R

 

[Dr. Nagler]

Thanks for that explanations, @RCP1.

I have two questions, if I may.

First, how wouid you characterize your tinnitus with regard to loudness?

Second, has your tinnitus itself changed in any way as a result of your TRT?

Thank you.

 

[RCP1]

Hello Dr N.

Sure. My T is reactionary so it varies from day to day. I would say it varies from a 0.5 to a 7 in terms of loudness. Although as Ive Said regardless of loudness it isnt brought to my conscious awareness as often.

No it hasnt changed as a result of trt. The sound sensitivity has though.

All in all I am suffering much much less. Before Christmas I was staring at the abyss. Today i am enjoying life again.

This is my honest account.

Thanks

R

 

[amandine]

@RCP1
Thank you so much for your explanation here.
One quick question please if I may? Do you have any hearing loss? Did your WNG's include a hearing aid of some sort as well? You say that you had H as well and this is much improved but would this TRT work if you did not have H but only had T?
Think it would be great info for the community here if you dont mind answering these questions here please and thank you.........

 

[preslys]

@RCP1

It's a natural habituation, I don't think TRT did it.

 

[Dr. Nagler]

RCP1 It's a natural habituation, I don't think TRT did it.

Could be. No way to tell for sure. I mean, @RCP1 could've waited ten or fifteen years before starting TRT. And then when he habituated, he'd have been positive it was due to TRT. But he decided not to wait. He sought out a knowledgeable and experienced TRT clinician who came very highly recommended and went ahead with it without waiting ten or fifteen years. Let's ask him why, shall we?

 

[preslys]

@Dr. Nagler

I Tried TRT it didn't work on me. It was as a nightmare for me .I lost a lot of dollars to make my T louder.
Now I am plannig to do HIFU .(but I have to win a lof of money)

 

[Dr. Nagler]

Dr. Nagler I Tried TRT it didn't work on me. It was as a nightmare for me I lost a lot of dollars to make my T louder.

I am so sorry to hear that. In fact, I absolutely hate what has happened to you!

I am not saying that this is the case with you, but a lot of people say they have "tried TRT," yet because there is no standardization or credentialing in TRT, it turns out that what they tried wasn't TRT at all. Are you certain that what you are calling TRT is actually TRT?

Now I am plannig to do HIFU.

I sincerely wish you well with it.

 

[Leah]

Can that happen? Can TRT make it worse? Having a very, very bad day here.
Looking forward to my appt with Dr. Brenner at the end of the month.
So nice to have you here to "hold my hand" thanks for being available.

 

[Dr. Nagler]

Can that happen? Can TRT make it worse? Having a very, very bad day here.
Looking forward to my appt with Dr. Brenner at the end of the month.

No. TRT done properly cannot make tinnitus worse. TRT in the hands of an inexperienced clinician can sometimes (rarely) make tinnitus worse. But with Dr. Brenner, inexperience will not be an issue. You can absolutely count on that!

So nice to have you here to "hold my hand" thanks for being available.

Ahh, the extremes some guys will go to in order to hold the hand of a beautiful woman!

 

[Leah]

Thanks for the re-assurance. When this is a success, we will celebrate!!! My treat!!!