Am I hearing things (you don't) ????

As usual Geoff interjects meaningless snide remarks that are neither helpful, insightful, asked for or original. All pretty much to let us know that he knows more about this (and everything else) than anyone else. And yet........still fails to make sense about half the time. And even with his superior knowledge (I will not say intellect) typically fails to help anyone in any meaningful way. And I know I shouldn’t have said any of this because 1. He seems to have no insight. 2. Doesn’t understand why most everyone thinks (knows) he is an @$$. 3. Even worse....like most trolls....he loves the attention and this was what he was after to begin with.

And prof....please don’t encourage him to get a puppy. What do you have against puppies? ;-)

I am a physician and can tell you that prof is pretty much right on the mark. I have minor hearing loss (left worse than right), chronic 24/7/365 bilateral tinnitus and hyperacusis on occasion. At a recent concert there was a very high pitched sustained guitar cord that actually triggered a very brief dizziness and slight nausea even through ear plugs.

The truth is there is very very little that can be done about tinnitus. And the origin of tinnitus is still unknown but there are theories as listed above. There are some rare anatomical problems with the otic bones that can be corrected surgically but I’ve only seen that once in close to 30 years in medicine. That is why the ENT usually tells you to learn to live with it. And audiologist can test your hearing, many ENTs have them in house.

Most other remedies for tinnitus, as seen on the internet, as snake oil. I personally believe that TRT and CBT can help people deal with tinnitus, particularly those who get stressed out about it. Most of us who have it become aware at times when we are not ’hearing’ it when in fact our brain just isn’t paying attention to it. That tells me that ’brain training’ can be useful and studies support this. I kind of do my own version of it and it helps sometimes.

I do recommend a visit to the ENT if you have new onset or worsening tinnitus but don’t be upset when they tell you there isn’t anything they can do. Its just a fact. Also see the audiologist is a good idea to find out exactly what your hearing loss is like.

There is an experimental treatment called repetitive transcranial magnetic stimulation that showed some promise in a small study but that’s been a few years ago and no new progress has been made that I’m aware of.

And above all, even if you are already suffering with tinnitus and/or hearing loss, get ear molds made and buy some SPL attenuators from Westone or Etymotic, and wear them at all music (and perhaps movie) shows. They are little discs that attach to the outside end of the molds, available in 5dB SPL attenuation incremental values. The discs can be swapped out for different applications/environments. I didn't get mine until my late-30's, but better late than never.

n80, (and others) thanks for your contribution!

As a Natural Born Skeptic, I've been wary of many of the claims for Tinnitus treatment (including ginkgo biloba and all sorts of other claims).

TRT doesn't have nearly the level of study and documentation I'd like to see for a treatment, but of all the available therapies, it at least has some in it's favour.  And there does seem at least an inherent plausibility to it, even from the experience of what it's like to have tinnitus.  The idea of habitation via tuning out the attention to it.

Even a few nights ago my tinnitus was, I noticed when going to sleep, screamingly loud.  Yet, as my mind drifted on to some other thoughts after a while I thought about my tinnitus again and...it was gone.  It had just completely receded from perception once my mind was on something else.  Even momentarily concentrating on it left it almost silent.  But as I thought about the tinnitus, listened for it, it slowly drifted back again until it was loud.  Then....drifted on to other thoughts and to sleep.   It's really amazing how much of an "attention-based" phenomenon it is.  And it also explains the variety of experience people can have with Tinnitus in terms of how much it affects their life or mood.  Some can have relatively minor T and be driven nuts, other quite loud T and just shrug their shoulders and go on with life.

I habituated quite well to pretty loud Tinnitus myself, though go through bouts of mild alarm when it seems triggered or louder.

I never used any masking sounds, just habituated and slept through it.

@ron17

I’ve read a little about Desyncra before. Though it hasn’t had nearly the amount of discussion (that I’ve seen) as TRT-like treatments.

It seems based on a similar idea, though I’ve seen a bit of skepticism cast it’s way by some TRT experts. (But then, there are often disagreements in these fields).

The main difference may be put down to the type of effort each demands. If I understand Desyncra, it would involve a more "dedicated" section of time to listen to the tailored noise. 4 to 6 hours. And the sound generators (look like tiny hearing aids) are physically attached to a device that looks like a smart phone.

In TRT, you just wear the little sound generators (essentially the same as you’d see in the Desyncra videos), which have been programmed with the tailored white noise. They are wireless and you just wear them the full day (or you can use them less...depends on comfort and advice in the personal treatment).

My main concern was my current hyperacusis, so I’m being treated for that first. I can tell you about my experience thus far if it helps.

First, my hyperacusis got, at points about a month ago, REALLY bad.
In fact, the day before my appointment to begin treatment, I woke up with my hearing completely screwed up: one ear sounding "dull" and the other like someone had eq’d all the upper frequencies way up, and painfully so. Though in the "dull" ear even just running water sounded like shrill bursts of white noise. It was brutal! I’ve never had it quite that bad.

Fortunately it somewhat resolved during the day. But the thing that p#sses me off when the hyperacusis is bad is not just that sound (especially upper frequency) "hurts," but the sound, particularly in my left ear, actually sounds wrong - like a raw nerve where everything sounds brighter in that ear. That’s when I know I’m having a bought of hyperacusis (though, as I’ve said, it’s been quite rare since my first onset in 20010.

So when, after a recent really loud noise exposure, my left ear went in to that "super bright, harsh sound" mode, I knew the hyperacusis had been triggered.

So, first day of the treatment, mid day, I was fitted with the little noise generators. For treating hyperacusis, they discourage as much as possible using ear plugs, because that tends to make the brain "crank up" the volume even more to hear, and only exacerbates the noise sensitivity when you take out your earplugs. (Anyone can experience this if they just wear earplugs for a while - things will sound a bit brighter and louder for a bit, after taking them out). So the portion that goes in your ear is not meant to occlude (block) the ear like an earplug. It’s perforated with large open areas to keep direct sound going in to the ear, while allowing the tailored white noise to be pumped in.

The audiologist, using a computer program, dialed in the right tone and loudness level for my comfort, and then the earbuds were programmed for me. They have volume controls if you want to turn it up, or down due to discomfort. The combination of the choice of molded frequency...something like a very dull, steady tone almost like a steady cold wind...combined with the open nature of the earbuds, means that external sound doesn’t sound at all damped. Speech etc are all clear (I have the musician’s earplugs that are are supposed to produce flat noise reduction, and even those aren’t nearly as "invisible" sonically as these noise generators in the ears).

One of the ways the noise helps is it provides something of a base-line buffer for external sounds. So a sudden sound, like a dish suddenly put down beside you, is not as dynamic and shocking to the ear. So right off the bat, my hearing felt more calmed during the first day I wore them.

I did worry that pumping continuous noise in to my ears could exacerbate my tinnitus, which unfortunately can be "reactive tinnitus" (reacts, gets louder, with noise). I’m happy to say that hasn’t been the case. Even after the first day, in fact when I took the noise generators out, my tinnitus ringing actually seemed to be more quiet!

Part of the therapy is to also use a white noise generator they give you, to put at your bedside, set to a "calming" volume. Personally, I’m a very light sleeper and have always slept in silence, so getting used to ANY new noise was a bit of a bummer. But it seems I’ve gotten used to it and sleep pretty well. The idea is to keep the subconscious part of the auditory system constantly stimulated, even when sleeping, to keep that "re-wiring" going on.

It is daunting that one is supposed to be prepared for up to two years of treatment! However, apparently many people report substantial improvement within a few months, so I’m hoping that’s the case.

I can report that, after almost two weeks in to the treatment, my ears do indeed already feel better. It’s incremental, but distinct. So for instance, when I take out the noise generators my hearing no longer sounds "wrong." That wonky "brightness eq" in my left ear seems to be gone and sound seems much more even, smooth and normal as it was before my hyperacusis started. That doesn’t mean I’m out of the woods yet. Sounds in the certain upper frequency range of my hyperacusis still stick out and annoy me. So for instance, if I try to listen to some funky or latin music with a horn section, the horns still annoy my ears. But they don’t sound "off" as in extra brightened, as they did a few weeks ago. So that’s a very good thing!

I’m feeling optimistic. Will report back in this thread if I make good progress in a few months.

Prof, I misspoke earlier in regard to TRT. I know very little about it but often suggest to my patients that they can try it since there isn't significant risk. Most have not found it worth the trouble.

In this discussion I had confused it with a form of cognitive behavioral therapy (CBT). Sorry if I caused confusion but I was primarily referring to CBT.

In regard to your observations on the mental aspect of tinnitus, well, I agree. Mine tends to be worse when I'm stressed, tired or sick. And I'm learning to mentally 'attenuate' the perception but it is far from foolproof. 

It has never been an issue in regard to sleep. I run a small floor fan in the room and that masks it fairly well.

In the past, when I would have those sudden bursts of very loud ringing I had the luxury of having one of my partners look at my ear drum and/or perform a quick tympanometry. Always normal.

I have not had formal audiometry but informally it is clear that it is mild presbycusis (old ears) and just high frequency and primarily just on the left.