TRT Sound Management vs. Hearing Aids With Tones

[TMLB]

Hello Dr. Nagler,

Firstly, let me thank you for sharing your expertise in an open environment.

I have two questions and I'll try and be brief:

I have had tinnitus for approximately two years along with hearing loss.

Question 1:
Upon the onset of the tinnitus to which I had a significant negative reaction, I saw an audiologist and have been wearing Widex 'Dream' hearing aids since that time. (Only take them out when going to bed)

These aids have various fractal tones and what I call a white noise. When I asked the audiologist how to use the sounds -- ie. under what circumstances and for how long -- the response has always been, everyone is different; do what you feels right.

-- Are the hearing aid tones the same and/or as effective the sound used in TRT? (It's my understanding that with TRT the sound is customized to the individual)

--In respect to the hearing aid tones, do you have a recommendation on their use?
I've often wondered if I'm using the tones to my best advantage, or if I should investigate other options.

Question 2:
I have not experienced a significant reduction in my awareness of the tinnitus and wondered if I should consider TRT. I posed that question to my audiologist but she did not recommend it. There are professionals certified in TRT on the west coast of British Columbia (about 5 1/2 hours from my home). My main guidance is now from literature and I'm about to start the ATA workbook. Your thoughts?

Your advice will be greatly appreciated,

Theresa

 

[Dr. Nagler]

Hello Dr. Nagler,
Firstly, let me thank you for sharing your expertise in an open environment.

Glad to help.

I have two questions and I'll try and be brief:
I have had tinnitus for approximately two years along with hearing loss.
Question 1:
Upon the onset of the tinnitus to which I had a significant negative reaction, I saw an audiologist and have been wearing Widex 'Dream' hearing aids since that time. (Only take them out when going to bed)

I am familiar with those units.

These aids have various fractal tones and what I call a white noise. When I asked the audiologist how to use the sounds -- ie. under what circumstances and for how long -- the response has always been, everyone is different; do what you feels right

Well that would depend on what it is you want to achieve. If your desire were to achieve some degree of immediate relief through masking, partial masking, or distraction, then I would absolutely agree with your audiologist - do what you feel is right. But if you were using your Widex Dream hearing aids for the purpose of facilitation habituation of your tinnitus through TRT, then you would set them as your TRT clinician would instruct you to set them using the Category 2 TRT protocol.

-- Are the hearing aid tones the same and/or as effective the sound used in TRT?

Fractal tones are totally worthless in TRT.

(It's my understanding that with TRT the sound is customized to the individual)

That may be your understanding, but it is incorrect. I suspect you got that idea from what you read on the Internet boards. Not a particularly good source for information about TRT in my opinion.

--In respect to the hearing aid tones, do you have a recommendation on their use?

You mean fractal tones? Since you are not doing TRT, I would say use them or don't use them - whatever feels right. Just like your audiologist told you.

I've often wondered if I'm using the tones to my best advantage, or if I should investigate other options.

Again, that depends on what you are trying to achieve.

Question 2:
I have not experienced a significant reduction in my awareness of the tinnitus and wondered if I should consider TRT.

Well, that would be a personal decision. In general, I do not recommend TRT unless tinnitus is markedly affecting one's life, and he or she has already explored simpler options, like self-CBT.

I posed that question to my audiologist but she did not recommend it.

Well, since you appear to be open-minded, as I see it there would be only two reasons your audiologist would not recommend TRT in your case (i.e., at two years since onset). One would be if your tinnitus, indeed, did not markedly affect your life. And the other would be if she lacked an understanding of what TRT is and what it can accomplish in knowledgeable and experienced hands.

There are professionals certified in TRT on the west coast of British Columbia (about 5 1/2 hours from my home).

I have known Glynnis for years and years. And although I have never met Carol, I have heard very good things about her. I suspect that you would be in good hands with either.

My main guidance is now from literature and I'm about to start the ATA workbook. Your thoughts?

I am unfamiliar with the ATA workbook.

Your advice will be greatly appreciated,

Well, now you have it! I hope it was helpful, and I wish you well.

Dr. Stephen Nagler