Who Here Has Habituated to High Frequency Tonal Tinnitus?

[MrT]

I've mentioned it in a previous thread but I have both a high-frequency tonal T and noise(hissing) T. I could see how someone could habituate to hissing T to the point where they would not notice it unless they listened for it, but I was wondering if there is anyone who has reached this level of habituation with high-frequency tonal T.

 

[Dr. Nagler]

I was wondering if there is anyone who has reached this level of habituation with high-frequency tonal T.

I personally know dozens. Really. What you describe is not the most common form of tinnitus, but it isn't all that rare either.

I doubt that many who have habituated high-frequency tonal tinnitus post here, but there are loads on www.IveDoneGreatWithMyTinnitusAndHereIsHowIDidIt.com

Of course, that site does not exist, but if you want to find a whole bunch of folks who have truly habituated to all sorts of tinnitus and totally put their tinnitus behind them, that's where you'd need to go. I doubt you'd find very many on a tinnitus support board ... because they do not need support.

I mean no disrespect to anybody here, but a fellow who falls into a rattlesnake den and at long last claws his way to safety is not likely to hang out in the reptile house at the local zoo. Indeed, that's about the last place you'd ever expect to find him.

 

[pef]

I would characterize myself as habituated.

I have an 11.5 kHz tone in my left ear. There is a hiss in my left ear as well, but the 11.5 kHz tone is prevalent over the hiss. The tone is not exactly constant, it fades in and out quickly, as if in a beat frequency pattern. Very strange.

I don't know if you consider 11.5 kHz high frequency. The tone in my left ear was much more annoying than the 7 kHz or so square wave tones in my right ear when I first got tinnitus, and it is the one I notice the most when I am aware of my T.

I suppose some might think low frequencies would be more challenging, or hissing, etc. Might just depend on the person, yes?

 

[Dr. Nagler]

@MrT and All -

I'd like to clarify my earlier answer because it might be misleading. I am unaware of anybody whose severe intrusive tinnitus - high frequency tonal or otherwise - was ever 100% habituated. 100% habituation means that you are never ever under any circumstances aware of your tinnitus unless you purposely seek it. And people who have at one point or other truly suffered from tinnitus just do not get to that point, at least not to my knowledge. Now lots of people have habituated to the extent that they used to be aware of their tinnitus 95% of the time when not purposely seeking it and are now aware of it on the order of, say, 5% of the time when not seeking it. Some might even get down to 1% or 2%. But to the best of my knowledge 0% just does not happen. So when I say that Joe has habituated his tinnitus, the better term would be Joe has "largely habituated" his tinnitus.

Hope this clarifies more than confuses.

stephen nagler

 

[MattK]

I don't know about tonal tinnitus, but honestly, I thought I'd never habituate to mine. Not only is mine high frequency and hard to mask (due to both volume and frequency), but it changes constantly. Every second it seems to be changing, like a "wavering". I don't even know anything in the real world to really compare it to. It's almost like the fine tuning of a radio where you just can't get the signal right, but it's not exactly that. Sometimes it's like I am in the woods surrounded by cicadas, but not exactly that sound either. It's hard to describe. Also, it's mostly centralized in my head, but sometimes I perceive it more in my right ear, but strangely enough, sometimes its in my left. Anyway, due to the constantly changing nature of my tinnitus, I originally thought habituation was out of the question and I thought I wasn't going to make it.

Well, long story short, I did habituate. Although probably not to the degree @Dr. Nagler would consider habituation. See, I live my life normally and don't do anything that I wouldn't normally do with or without tinnitus. Although the thing is I am constantly aware of my tinnitus. In fact, up until the last month, I used to hear my tinnitus 100% of the time it seemed. But the thing that was the turning point was when I eventually got to a point where my tinnitus had my 100% attention, but yet the sound didn't cause me distress like it used to. Eventually I got to a point where I would be aware of my tinnitus just about 90% of the day, but it no longer had my primary attention. And I'd say I've been at this stage for most of my "habituated" time now. But in the last month, finally, I have lots of times when I am unaware of my tinnitus. I am obsessive enough to where if I realize I haven't been paying attention to it, I'll start to pay attention to it. But at the onset of my tinnitus, I never thought I'd be at the point where I am now, nor did I think I would ever make it to the point of "acceptance".

About the only time my tinnitus can really get the best of me now is when I get congested, which thankfully this year has been good to me in that I haven't gotten sick or anything (although back in Sept I had a major relapse due to allergies that made my tinnitus go through the roof, but somehow I managed to make it through that too).

So, I said all of this to say that you probably can habituate to tonal tinnitus, but it's not going to be easy. I remember originally thinking that it would be nice to have a single tone as that seemed doable. This thing I have that constantly changes seemed like it was going to be impossible. After all, how do you adapt to something that constantly changes?

But after reading some of the stories here, I consider myself getting off easy because I just have tinnitus. Those who have hyperacusis... I don't even know what to say about that, because H sounds like it would be hell on earth. So when I am talking about habituation, I'm only talking about T, not T + H or any other combination of auditory problems.

 

[Dr. Nagler]

I live my life normally and don't do anything that I wouldn't normally do with or without tinnitus.

In the final analysis that's all that matters.

I mean even if someday there's a true cure, the very best anybody will be able to do will be to live your life normally and not do anything you wouldn't do with or without tinnitus.

Well stated, @MattK.

stephen nagler

 

[LifesABeach]

@MrT and All -

I'd like to clarify my earlier answer because it might be misleading. I am unaware of anybody whose severe intrusive tinnitus - high frequency tonal or otherwise - was ever 100% habituated. 100% habituation means that you are never ever under any circumstances aware of your tinnitus unless you purposely seek it. And people who have at one point or other truly suffered from tinnitus just do not get to that point, at least not to my knowledge. Now lots of people have habituated to the extent that they used to be aware of their tinnitus 95% of the time when not purposely seeking it and are now aware of it on the order of, say, 5% of the time when not seeking it. Some might even get down to 1% or 2%. But to the best of my knowledge 0% just does not happen. So when I say that Joe has habituated his tinnitus, the better term would be Joe has "largely habituated" his tinnitus.

Hope this clarifies more than confuses.

stephen nagler

I never heard it phrased quite that way, but it certainly makes sense.

Prior to things going to hell in a handbasket for me around 4 months ago, I had been "living with" my tinnitus pretty well for several years. During that time, I had plenty of 1, 2, 3 and 4 (on a scale of 10 ... 10 being the worst case) tinnitus days. And even an occasional terrible day. I always thought of myself as habituated during those years b/c I was mostly able to live my life without taking orders from a screeching tyrant. Nor did I spent any time looking for tinnitus cures during those years.

I guess I should have thought of myself more as a "functionally habituated." And you know what? I'd give almost anything just to get back to that point right now.

 

[Dr. Nagler]

I guess I should have thought of myself more as a "functionally habituated." And you know what? I'd give almost anything just to get back to that point right now.

So what specifically are you doing to make that dream a reality?

stephen nagler

 

[LifesABeach]

So what specifically are you doing to make that dream a reality?

stephen nagler

1. Investigating TRT, per our previous exchanges.
2. Testing out Phonak Audeo hearing aids with pink noise (and then perhaps Widex with Zen). It has only been a few weeks and so I'm not jumping to any conclusion yet, but I'm guessing this might not turn out well. On the one hand, I need the amplification b/c of my degree of hearing loss in both ears. On the other hand, the tinnitus just seems to go crazy on me after hearing what I know is only moderately loud sounds (I'm just wearing the aids at home now to control a bit for excessive environmental noise.) I've never been diagnosed with "reactive" tinnitus, but I'm guessing I have it.
3. My current audiologist is just a wonderful person and knows many aspects of her profession well, but she's admitted that she doesn't have much experience "treating" people who are really suffering from it. I'm going to continue with her for a while if only to get more hearing aid experience for free (can demo without plunking down any $), but at the same time I'm looking elsewhere for another audiologist who might be more suited to helping me. I've read good things about Malvina Levy at Speech and Hearing of Northern California in this regard and so I might try her.
4. That's about it for now (my health situation is complicated with the headache problems we've discussed in other threads and so I'm working on that as well - trying to reduce intensity/duration/frequency without aggravating the tinnitus.)

 

[Dr. Nagler]

Sounds like a plan.

By the way, I wear Phonak Audeo hearing aids (Q90) and have been very pleased.

 

[LifesABeach]

Sounds like a plan.

By the way, I wear Phonak Audeo hearing aids (Q90) and have been very pleased.

Dr. Nagler, can you explain in layman's terms how loud the pink or white noise should be set on these aids for purposes of helping those with tinnitus?

Thanks.

 

[Dr. Nagler]

Dr. Nagler, can you explain in layman's terms how loud the pink or white noise should be set on these aids for purposes of helping those with tinnitus?

Sure. It depends on what you are trying to achieve. If you want to achieve immediate relief through total masking, then set them to totally mask your tinnitus - assuming your tinnitus can be totally masked - and see where that gets you. (You should know within a few minutes.) If you want to achieve immediate relief by just "taking the edge" off, then set them to where they are most comfortable. In either case, experiment with both pink noise and white noise to see which gives you greater immediate relief. If you are doing TRT (where the primary purpose is facilitation of habituation rather than the achievement of immediate relief), then set them according to TRT Category 2 protocol as explained by the TRT clinician who is doing your TRT counseling.

stephen nagler

 

[LifesABeach]

Sure. It depends on what you are trying to achieve. If you want to achieve immediate relief through total masking, then set them to totally mask your tinnitus - assuming your tinnitus can be totally masked - and see where that gets you. (You should know within a few minutes.) If you want to achieve immediate relief by just "taking the edge" off, then set them to where they are most comfortable. In either case, experiment with both pink noise and white noise to see which gives you greater immediate relief. If you are doing TRT (where the primary purpose is facilitation of habituation rather than the achievement of immediate relief), then set them according to TRT Category 2 protocol as explained by the TRT clinician who is doing your TRT counseling.

stephen nagler

Thanks, Doc.

When the tinnitus started in '06, I would trying masking for immediate relief, but it doesn't look like that's much of an option now. I tried with headphones and my smartphone before beginning with the hearing aids and I had to turn it up so far that it seemed like an unreasonable amount of noise to be feeding into my ears. Plus, when it got loud enough to really compete with the tinnitus at all, it just seemed to make the tinnitus worse instead of better. So, I guess I'll have to wait to talk to a TRT clinician to get the exact sound level. For now, I'll just go with "a hair above noticeable" while I'm experimenting with the hearing aids.

Do you happen to know anything +/- about Speech and Hearing of Northern CA relative to helping those suffering from tinnitus.

Thanks again.

 

[Stink]

it's lot more difficult to habituate to high frequency tinnitus than low frequency hissing

 

[Dr. Nagler]

So, I guess I'll have to wait to talk to a TRT clinician to get the exact sound level. For now, I'll just go with "a hair above noticeable" while I'm experimenting with the hearing aids.

Actually, that's the one setting I absolutely would not use - because due to the stochastic resonance phenomenon, it can aggravate your tinnitus and delay habituation. The simplest way to understand stochastic resonance in audiology is to think about what your brain would do if it detected just a "little bit" of broadband sound coming from your devices. Your brain would naturally try to magnify it to figure out what it was, right? And in so doing, it would also magnify your tinnitus, which is exactly what you don't want!

Do you happen to know anything +/- about Speech and Hearing of Northern CA relative to helping those suffering from tinnitus.

Yes, I think the world of Malvina Levy, who has been at that center for years. But if you are specifically interested in TRT (which according to your posting you are), I would definitely go elsewhere.

stephen nagler

 

[LifesABeach]

Actually, that's the one setting I absolutely would not use - because due to the stochastic resonance phenomenon, it can aggravate your tinnitus and delay habituation. The simplest way to understand stochastic resonance in audiology is to think about what your brain would do if it detected just a "little bit" of broadband sound coming from your devices. Your brain would naturally try to magnify it to figure out what it was, right? And in so doing, it would also magnify your tinnitus, which is exactly what you don't want!

Oh boy! I thought I'd try to do something useful while investigating TRT but I guess it was the wrong thing! Guess I'll turn it up!

[

Yes, I think the world of Malvina Levy, who has been at that center for years. But if you are specifically interested in TRT (which according to your posting you are), I would definitely go elsewhere.

stephen nagler

If she's not a TRT fan, then she'd only be good for the hearing aid aspect and/or perhaps tinnitus counseling? What is her real specialty relative to tinnitus? Hard to tell from what I've read. It's always a summary like, "She evaluates patients and provides tinnitus therapies, treatment options and phone counseling." (From an ATA bio). I just know it's all positive.

Thanks.

 

[Dr. Nagler]

It's always a summary like, "She evaluates patients and provides tinnitus therapies, treatment options and phone counseling." (From an ATA bio). I just know it's all positive.

Like I said, I think Malvina is terrific. I have known her for years and think the world of her. I just would not use her for TRT. Why? Well, she has not taken a TRT course. She has not studied TRT. And she does not know the TRT counseling and TRT sound therapy strategies category by category. Malvina Levy is bright, compassionate, experienced, ethical, knowledgeable, and - well - simply wonderful. It's just that there's a gap. (We all have 'em!) So if TRT is your specific interest, I'd go elsewhere.

 

[Dr. Nagler]

@LifesABeach, perhaps this will help. I am going to attach the instruction sheet I give my own Category 1 TRT patients. (You would be Category 2, which is considerably more complex, but at least the sheet will give you a bit of a feel for it.) Please understand, however, that the goal of TRT sound therapy is not the achievement of immediate relief, but rather the facilitation of habituation of tinnitus in association with TRT counseling. If you were not going to do the TRT counseling piece or if you were just seeking immediate relief through sound therapy, I'd tell you to ignore the instruction sheet entirely, simply set your devices at whatever sound level gave you the most comfort, and leave it at that.

Disclosure: Regarding the attachment below. I do not sell GHI Tranquil Simplicity I OTE devices, I do not sell the Brookstone Tranquil Moments unit, and I do not sell the Sound Pillow Sleep System. Moreover, I have no direct or indirect financial relationship with the companies that manufacture those products.

stephen nagler

 

[LifesABeach]

@LifesABeach, perhaps this will help. I am going to attach the instruction sheet I give my own Category 1 TRT patients. (You would be Category 2, which is considerably more complex, but at least the sheet will give you a bit of a feel for it.) Please understand, however, that the goal of TRT sound therapy is not the achievement of immediate relief, but rather the facilitation of habituation of tinnitus in association with TRT counseling. If you were not going to do the TRT counseling piece or if you were just seeking immediate relief through sound therapy, I'd tell you to ignore the instruction sheet entirely, simply set your devices at whatever sound level gave you the most comfort, and leave it at that.

stephen nagler

Understood. Many thanks.

 

[Dr. Nagler]

Understood. Many thanks.

Glad to help.

 

[marqualler]

I mean no disrespect to anybody here, but a fellow who falls into a rattlesnake den and at long last claws his way to safety is not likely to hang out in the reptile house at the local zoo. Indeed, that's about the last place you'd ever expect to find him.

Not to take this thread off-topic, but--I am an example of a person who really struggled with the onset of tinnitus, got a lot of help from members here, and now am doing much better but continue to enjoy my time here. i.e. I have "habituated" but continue to derive energy from the friendships I have made here and the work we are doing to find a cure. In fact, I find it quite empowering. That might not be the case at other places, but it is definitely not true here.

So when you say you don't expect people to visit message boards once they are doing better, I have to propose the alternative to the rule!

 

[Dr. Nagler]

I am an example of a person who really struggled with the onset of tinnitus, got a lot of help from members here, and now am doing much better but continue to enjoy my time here. i.e. I have "habituated" ...

I am thrilled to hear that you are doing much better. In the final analysis doing much better is what it's all about!

But in terms of habituation, perhaps we are talking about two different things. Not long ago you visited a TRT clinic with the intention of starting TRT. You had asked me for the name of a TRT clinician I would recommend - but for some reason you wound up seeing a different audiologist and was turned off by the entire experience. (Knowing the fellow, I can't say I blame you - especially when he tried to sell you an expensive Neuromonics unit you did not need.) Anyway, when I talk about people who have habituated their tinnitus, I am talking about a subset of folks who have habituated to the extent that - unlike you - they would have no reason whatsoever to even remotely consider looking into TRT (or any other habituation-based protocol) ... because tinnitus is no longer a significant factor in their lives.

And given the large number of folks who were once truly suffering from severe intrusive tinnitus but who have indeed habituated to the extent I described above, you really do not find many of them on boards like this. Sure, they'd probably go for the cure if a legitimate one came along. But other than that they generally have no interest whatsoever in tinnitus - theirs or anybody else's.

 

[ruben ruiz]

I habituated then the T got worse. Im trying to re habituate but I have issues. Sleeping, I cant do it without meds.
Also my belly and digestive track are wearing out. I recently got gastritis and an ulcer. The digestive track and the t and h are playing ping pong. The anxiety is a bit much. Im a fighter this is a different sort of fight. I also have sleep apnea- too many things. The nights are plain awful. Is it possible to bring the anxiety down hence the T as well?
Thank you.

 

[jazz]

I habituated then the T got worse. Im trying to re habituate but I have issues. Sleeping, I cant do it without meds.
Also my belly and digestive track are wearing out. I recently got gastritis and an ulcer. The digestive track and the t and h are playing ping pong. The anxiety is a bit much. Im a fighter this is a different sort of fight. I also have sleep apnea- too many things. The nights are plain awful. Is it possible to bring the anxiety down hence the T as well?
Thank you.

Have you tried eating something very bland like mashed potatoes? I recently had a dental issue and had to eat mashed potatoes for two weeks and was not hungry. I also have ulcer issues, but the potatoes were kind! I even baked some sweet potatoes a few nights for variety.

Just a though!

 

[Valentina]

@MrT

I found out that the food with a high content of magnesium can help with habituation. For example, white meat such as chicken and fish, spinaches, zucchini, fennel, tomatoes contain magnesium.

 

[ThorOdinson]

Don't most people have high frequency tinnitus because high frequency hearing loss is more common? And they say most people do habituate. Wouldn't that mean this answer is "yes"?

 

[Forever hopeful]

Don't most people have high frequency tinnitus because high frequency hearing loss is more common? And they say most people do habituate. Wouldn't that mean this answer is "yes"?

I sure hope so. I have high frequency tinnitus and it fluctuates. If I am really involved in something, it is less noticeable. I can't mask it due to its frequency but I try to blend with high frequency nature sounds. I need lots of sound to sleep. Oh and sleep meds. Every time I think I am getting better, I go through another loud intrusive phase and it's like starting all over again. This makes my old tinnitus seem like a cake walk.