What Do You THINK Is Causing Your Tinnitus?

[Brianna]

Actually, I put a lot of work into the majority of my responses on this board. Some of those responses might not be particularly popular, but I put a lot of work into them just the same.

No doubt, you do put in a lot of work into all your responses. I was being myopic and focused on your response to moi. Yes, moving forward is what we're all about.

 

[Dr. Nagler]

I know you are a big proponent of TRT, but in many parts of the world that is not available either.

Well let's talk about that for a moment since you introduced the topic of TRT to this thread.

To put things into perspective I am going to quote from an off-the-board exchange I had with a fellow just yesterday ...

I am a proponent of the search for the cure. I am also a practical man, and I do not believe in waiting around for that search to bear fruit if a stopgap measure like TRT or CBT can decrease suffering in the meantime. My preference is TRT because (1) it worked for Shatner and me, (2) it has worked for thousands of others, and (3) for people with truly severe intrusive tinnitus (i.e., the 9s and 10s), I do not see a treatment like CBT (that does not use sound and that therefore cannot take advantage of neuroplasticity) being anywhere near as effective as TRT. But for 8s and below, I always suggest CBT. That's why with rare exception only 9s and 10s get appointments in my clinic.​

Now I realize that TRT is not available in many parts of the world. And moreover I also realize that many people who seek TRT regardless of where they live really do not need it. That is why I wrote my post on "Overcoming Obstacles to Habituation" and why I also wrote my "Letter to a Tinnitus Sufferer."

The piece on overcoming obstacles is here:

https://www.tinnitustalk.com/threads/overcoming-obstacles-to-habituation.6886/
​

And the letter, which is 100% about self-CBT and which has absolutely nothing to do with TRT at all, is attached to the bottom of this post.

It is said that TRT can be expensive. But in considering the cost of TRT, I think that 9s and 10s might wish to consider the cost of "not-TRT" - the cost in terms of all the pills, herbs, potions, and treatments they try that wind up being nothing more than a "wallet biopsy," the cost of lost time from work (or in some cases the cost of lost jobs), and the cost of loss of joie de vivre - of joy of life. TRT cannot take away your tinnitus, but it can absolutely give you back yourself! And to a 9 or a 10, that can make all the difference. At least it did for me.

[When I read your 'what difference does it make' it kind of angered me.

I am very sorry. It was not meant to anger you or anybody else. It was meant to make you think. And your answer did, indeed, show considerable thought. The thing of it is ... none of the very valid points you raised will help you get better. What they all do is make you feel better. And in the final analysis, how you feel is a reaction, which is what my "Letter to a Tinnitus Sufferer" (see below) is all about.

Here's to quiet days ahead for all!

stephen nagler

 

[MarioT]

And once your doctor has ruled out the (very rare) causes of tinnitus that represent a threat to health or life - like in @Ricky81's case with his increased ICP ...

Then what difference does it make what caused your tinnitus?

Dear @Dr. Nagler ,

in most related literature on which I 've stumbled upon so far (medical and non-medical) tinnitus is defined as a symptom similar to pain rather than an illness/disease. Since there are no "painkillers" for T, we, the severe t sufferers, are bound to keep on looking for the underlying cause of this symptom. Why? Because we suffer and need relief! And just because that underlying cause cannot be identified by current medical diagnostics, it does not mean that there isn't one!

In many patients (including myself) tinnitus severity flucuates strongly from sometimes "almost no problem" to "extreme and totally disabling". It is apparent to me that in presence of such kind of fluctuations the condition must be indeed treatable if the real problem can be identified.

When I read your question above, I read between the lines the implication that "there is no point in further looking...". Well, when the only diagnostics that are being conducted are reduced to some primitive audiometrical tests then most obviously the medical world is not taking the condition serious. And so in turn, we the severe T sufferers, cannot take the practitioners serious when they imply that there is nothing really that can be done.

I understand that there is a psychological component to all of this and that it is best to try to dismiss any cognitive activity that leads to being aware of one's tinnitus. When my T is not above an 8/10 I have become actually pretty good in ignoring it. But this alone does not solve the problem or the fact that it can still go up to a 10/10 on any given day... this is simply unacceptable.... so I ll keep on looking!

 

[Cor]

What I get from you when I read your posts, and now your 'letter to a tinnitus sufferer' (which reminds me a lot about some CBT sessions I did) is that you want people to stop looking for a cure that doesn't come, and instead focus on acceptance.

For me it was important to go through a journey of trying everything I could to see if it would help. Did you go through such a phase 20 years ago? If so, maybe we're meant to before we can accept it. This is why im hesitant to tell people outright to just accept it, like most ENTs do. I think they should try whatever they feel they should try.

My tinnitus started about a year ago. The first 6 months were hell. I dont need to explain that hell, most have been through it or are going through it. Then I decided, for about 6 months I was going to try whatever seemed relatively possible, with anecdotal evidence of people feeling better. Did any of it help? Not really. But it actually did make me feel better to have tried and failed, than to have surrendered without a fight. So here I dont agree with you, the act of looking for an answer did make a difference. Maybe different personality types need a different approach.

Now, im not there yet, but my reaction to tinnitus is much less. I dont think I'll ever stop looking for a cause or a cure, but like you, im practical and am trying to CBT my way through it all the same. I dont feel they are mutually exclusive.

 

[Dr. Nagler]

What I get from you when I read your posts, and now your 'letter to a tinnitus sufferer' (which reminds me a lot about some CBT sessions I did) is that you want people to stop looking for a cure that doesn't come, and instead focus on acceptance.

I understand what you are saying - but speaking for myself, I will never "accept" my tinnitus. It is true that I have gotten to the point where I largely don't care about my tinnitus, but given the opportunity to take a pill that would cure it or even lastingly diminish it with a high degree of certainty and a low adverse reaction rate, well where do I sign up? And rather than "looking for a cure that doesn't come," I would rather say "looking for a cure that is not yet here."

For me it was important to go through a journey of trying everything I could to see if it would help. Did you go through such a phase 20 years ago?

Absolutely. I have attached my story to the bottom of this post.

I dont think I'll ever stop looking for a cause or a cure, but like you, im practical and am trying to CBT my way through it all the same. I dont feel they are mutually exclusive.

Neither do I.

stephen nagler

 

[Dr. Nagler]

But this alone does not solve the problem or the fact that it can still go up to a 10/10 on any given day... this is simply unacceptable.... so I ll keep on looking!

And I sincerely wish you well with it.

Here's to silent days ahead for all!

 

[Jbeans]

I wish I knew the reason for my tinnitus so I can make sure I don't make matters worse! Right now I'm afraid to do anything for fear it may worsen my T!

 

[AmndaLeigh]

I have a question for anyone who cares to answer:

Once your doctor has ruled out the causes of tinnitus that can be fixed and in so doing fix the tinnitus - like, say, a severe middle ear effusion ...

And once your doctor has ruled out the (very rare) causes of tinnitus that represent a threat to health or life - like in @Ricky81's case with his increased ICP ...

Then what difference does it make what caused your tinnitus?

I think people want to get to know people who have similar beginnings - or at the very least in a post like this, just know that there are people out there who have similar beginnings. It might not mean anything to professionals but once I experienced my T I immediately wanted to know about other people who might have been triggered in the same way. It's interesting to compare and contrast experience, and although I know every person is different, I would like to know about people like me who have had it go away and people like me who live with it and manage it.

 

[Angel G]

Mine was caused by combination of several factors: Probably got a kind of persistent virus/bacteria from my friend who had T for 4 years + swimming in sea waters in the same time helped it + a temporal ear nerve inflammation.
The T didn't come the same day or week, I didn't even knew I was doomed. My middle ear was with light inflammation for 1 month, but I could hear very well, just the Eustachian tube was a bit of stuck. The T arrived when I started to take prescribed to me anti-histamine to drain the tube...
Now I have it every morning and I can get relief after a hot shower over my head. If I don't take a hot shower it will torment me all the day. It returns when I'm lying for longer than 15 minutes.
It's not related to blood pressure, i think that the nerves are kept irritated by kind of a life form my immune system can't cope with.

 

[Poyraz]

Benzodiazepines, stress, loud music, ETD, jaw problems, candida.. Aahhh I got all of them!