Contact Michael Leigh, he knows a lot about such things and about ear problems in general, and is very helpful.
https://www.tinnitustalk.com/members/michael-leigh.3134/
Thank you for your kind comments
@Irish and for advising
@Pawel to contact me and I will try to help. I have had TRT twice, the full treatment and not a scaled down version of it.
HI
@Pawel
I want to make you aware that TRT follows a strict protocol and needs to be administered correctly for a person/patient to gain maximum benefit from it. By the sound of things, the advice that your Audiologist has given you makes me believe you are starting out completely on the wrong footing. Firstly, if your Audiologist is going to be treating you with TRT then he/she should be able to advise where to purchase the white noise generators.
There are two parts to TRT. Counselling and the wearing of two white noise generators and using a sound machine at night by your bedside. Please note: Some people believe white noise produced through a phone or other device and played through headphones, earbuds is the same as white noise played through white noise generators. Let me assure you this is not the case. White noise played through earbuds or headphones sounds crude and abrasive compared to white noise generators, which are intended for this purpose. I have used white noise generators for many years and continue to do so. The sound is smooth and regulated and doesn't cause irritation to the auditory system which cannot always be said for white noise played through headphones or earbuds.
Please read the posts below and I hope they will be of some help. I will paste a website link at the bottom of the page, giving information where white noise generators can be purchased in the UK.
All the best
Michael
What is TRT and when should it be started?
I have talked about TRT in many of my posts. One tinnitus talk member recently told me that I have mentioned it no less than twenty five times. He went on to ask, am I an Audiologist promoting my practice in this forum purely for business purposes? Another member was quite disgruntled and told me to stop mentioning it because where he lives the treatment is expensive and can't afford it. It just goes to show one never knows what is going on behind the scenes when you think no one is watching.
I understand and empathise with people that are unable to afford this treatment or any other to help one's health but don't feel this is a good enough reason for me to stop mention it when I believe it can help, having had TRT twice in the 20 years that I've had tinnitus. I am not an Audiologist. I just consider myself like many others at tinnitus talk, who want to help people that are having a difficult time coping with this condition, as I was once helped many years go when I first got tinnitus.
Some people have been sending me private messages asking if TRT cures tinnitus? A member mentioned having two sessions with their Audiologist and was shown some slides, and told that anxiety can make tinnitus louder. Understandably this person wasn't sure if this was TRT, and then asked if it's something they could do on their own? As I have mentioned I have had TRT twice and I also have the Tinnitus Retraining Therapy book, written by Professor Pawel Jastreboff and Jonathon Hazell. It is available at Amazon should anyone wish to purchase it.
It is the reference book that Hearing Therapists and Audiologists follow when practicing TRT with their tinnitus patients. There are two parts to the treatment. Counselling and sound therapy. Sound therapy is supplied by wearing two white noise generators and then using a "sound machine " at night by the bedside for sound enrichment. If hyperacusis is present the sound therapy will also treat it. Throughout the TRT book there is no mention that this treatment cures tinnitus. TRT or Tinnitus Retraining Therapy, is what it implies: Through regular counselling sessions there is a gradual retraining of the way a person thinks about tinnitus and to treat it as non life threatening.
At first the therapist discusses with the patient how the tinnitus makes them feel and how it has impacted on their life. Often people say they have lost interest in the things they once liked doing, which is perfectly understandable. The main goal here is to gradually help them look at life differently and with a more positive outlook. Over time the negative thinking that is often associated with tinnitus and hyperacusis is gradually dispelled and demystified.
The Hearing Therapist does this in a controlled and precise manner so that the patient feels relaxed and not pressured. In many instances the tinnitus is gradually pushed further into the background making it less prominent. Therefore, it must be stressed and understood, this treatment takes time. To complete a course of TRT takes approximately twelve to twenty four months and in some cases longer. The duration of each counselling session is left to the discretion of the Hearing Therapist. Typically, these can last up to one hour or more. The amount of appointments required will be different for each patient, but it is quality rather than the quantity of the counselling that really matters.
There are a few misconceptions about this treatment and the way it is administered that some people misunderstand which I want to address. If a patient is given one white noise generator to wear this is not TRT. When two wngs are issued and no tinnitus counselling is offered on a regular basis, it is not TRT. I am not saying that a patient will not gain any benefit from the above treatments; I only want to state they do not follow the proper Tinnitus retraining therapy protocol.
When should TRT be implemented or started?
The following is based on my own opinion and therefore is not professional medical advice. The onset of tinnitus can be quite an emotional roller coaster for a lot of people, and I believe a person needs time for this to settle. Many people habituate within the first 6 months to one year of the onset of tinnitus without any treatment. If a person just has tinnitus without any additional symptoms, such as dizziness, deafness or balance problelems. I think a period of six months should elapse before starting a long-term treatment such as TRT.
Someone recently asked me: What happens in TRT sessions?
I feel this question deserves an appropriate answer but I'm unable to do that in a few sentences so please bare with me. Whenever I mention TRT and the benefits that a person with tinnitus is likely to get from it, someone says to me: The treatment cost a lot of money and many can't afford it. One person even had the effrontery to ask me not to mention TRT in any of my posts because of its cost. Then I was asked if I'm an audiologist trying to promote my TRT business through tinnitus talk. For the record, I am not an audiologist nor do I work in the medical field.
It is unfortunate that many things in this world are only obtainable if a person is able to pay for them and this is especially sad when it includes healthcare. I was fortunate to have TRT treatment twice and live in the UK where we do not pay for our healthcare. However, TRT is not available at many UK hospitals - although there are usually alternative treatments and devices such as hearing aids and white noise generators that are given free that help tinnitus patients.
I believe the reason TRT is not more readily available here is due to its cost and the duration of the treatment. Therefore, if people in the UK want to try TRT and it's unavailable at a hospital where they live and they are unable to travel the distance to a hospital were it is available; their other option is a private tinnitus clinic which again cost a lot of money and will be comparable to other countries across the world.
If a person is referred to a hearing therapist for TRT (tinnitus retraining therapy) and they also have hyperaucusis (sensitivity to sound) that often accompanies exposure to loud noise, it will also be treated. TRT or tinnitus retraining therapy is exactly what it implies. It is a retraining of the mind or the way a person thinks about their tinnitus and the impact that it has on their life. In my opinion, ninety percent of how a person is able to cope and overcome tinnitus is in the mind and this is why tinnitus counseling is so important when the condition is severe.
A person's emotions can be seriously affected and their ability to carry out everyday tasks. Things such as going to work, relaxing or to go for a leisurely walk can become very difficult. It can put immense pressure on a person's relationship with their partner and friends because one feels no one understands what they are going through. Through regular counselling sessions with a Hearing Therapist trained in TRT, the patient learns not to look at their tinnitus as non-life threatening nor to be constantly afraid of it and to be monitoring every little change in its perception.
The Hearing Therapist does this in a controlled and precise manner so that the patient feels relaxed and not pressured. Over time the negative thinking that is often associated with tinnitus and hyperacusis is gradually dispelled and demystified. Therefore, it must be stressed and understood, this treatment takes time and is something that cannot be rushed.
The second part of the treatment requires the patient to wear two white noise generators for up to ten hours a day. They are first put on in the morning and the white noise set to just below the tinnitus, and then left alone. It can be tempting to turn up the volume when out on the street as traffic noise can make it difficult to hear them. Please don't do this. Constantly adjusting the wngs volume will delay the habituation process. Over time the brain habituates to the white noise generators and pushes the tinnitus further into the background where it becomes less noticeable. This cannot be successfully achieved if the wngs is repeatedly adjusted throughout the day.
While the auditory system is being treated with white noise it is gradually being desensitised and treating the hyperacusis. White noise generators should not be used when going to sleep at night. When retiring one should use a sound machine by the bedside and the volume adjusted to a level just below the tinnitus. The sound machine should be set to play throughout the night until morning and this provides the brain and auditory system with sound enrichment.
To complete a course of TRT takes approximately twelve to twenty four months and in some cases longer. The duration of each counseling session is left to the discretion of the Hearing Therapist. Typically, these can last up to one hour or more. The amount of appointments required will be different for each patient, but it is quality rather than the quantity of the counseling that really matters.
There are a few misconceptions about TRT and the way it is administered that some people misunderstand which I want to address. If a patient is given one white noise generator to wear this is not TRT. When two wngs are issued and no tinnitus counseling is offered on a regular basis, it is not TRT. I am not saying that a patient will not gain any benefit from the above treatments; I only want to state they do not follow the proper Tinnitus retraining therapy protocol.
Post to a forum member
If you have been listening to white noise through headphones even at low volume this could be the reason your tinnitus has been getting worse. Since your tinnitus was originally caused by loud noise; providing there is no underlying medical condition making your tinnitus worse, the usual reason is "sound". Either using headphones (even at low volume) or being in an environment where sound is irritating your auditory system.
Many people think listening to white noise through headphones is just the same as using white noise generators. I assure it is not. I keep telling people this but those, that think they know better can't wait to voice their opinion saying I'm wrong. White noise played through headphones is unregulated and can irritate the auditory system even at low volume. I am not saying everyone will be adversely affected, but one takes a risk using this crude method of sound therapy.
HI Daniel R
I do not recommend you listen to white noise through any type of headphones including bone conduction headphones. I am very experienced in this area for I have had TRT twice, the full treatment and not a stripped down version of it. I have been wearing white noise generators for 22 years and have had various types. BTE (Behind The Ear) which closely resemble hearing hearing aid, and the smaller and more discrete In-ear type that fit in the entrance to the ear canal.
Despite what anyone in this forum might tell you or any Audiologist, Hearing Therapist says Daniel; playing white noise through headphones is not the same as when it is played through proper white noise generators that are designed for this specific purpose. White noise played through headphones sounds: crude, harsh and unregulated compared to white noise generators, which supply a smooth, gentle regulated sound into the ear canal and auditory system.
I know $3000 is a lot of money but the ear is a very delicate and sophisticated organ and needs to be treated with care. If you want the best from TRT, then I advise you to use the proper devices that are intended for this treatment. White noise generators have to be worn continuously for up to 10hrs a day. Headphones will look rather cumbersome in comparison and as I said, the white noise emitted from them is crude and harsh and you risk making your tinnitus spike or made worse. The white noise volume on headphones cannot be finely tuned/set like the volume on white noise generators, please trust me on this.
I wish you every success with TRT. When you start it I strongly advise you to keep away from tinnitus forums. If you do visit them I advise you not to mention to anyone that you are having this treatment. My reasons are explained in the post below, please click on the link.
Michael
http://www.puretoneretail.net/tinnitus.html
Member
