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jclune

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 #1 
Dear Dr. Nagler,

Thank you for hosting such an informative and readable website. I expect I am asking one of the most popular questions you get from us with chronic tinnitus. Here's my story.

My horse left the barn six months ago last week. It may be a coincidence, but at the time I was terribly stressed out over a new teaching assignment, something I never taught before, which increased dramatically my insomnia. So, I was prescribed a combination of Rozerem, Hydroxyzine and Ibuprofin. on top of the 150 mg Wellbutrin I was taking for mild depression. After four weeks of that combination, I woke with ringing ears. My nurse, who prescribed all my meds, responded to my question with "it's tinnitus, and once it takes hold you'll never lose it." I immediately stopped the medications. 

I went to see my GP, who referred me to an ENT specialist saying, since my tinnitus isn't the result damage due to some traumatic incident (explosion, blow to the head), it should resolve itself within a year, probably six months. Then, my ENT told me I have moderate deafness in my upper ranges, and so my tinnitus is very likely permanent.

I know the best answer regarding the duration of my tinnitus is "it will do what it will do, so stop thinking about it." But I just can't help but ask. Grasping at straws, I guess. Thank you for listening.

On another topic, I spent a wonderful week with friends in Atlanta. They took me to "Fat Matt's Rib Shack" on Piedmont. Pure heaven.

Best regards,
Jim
Dr. Nagler

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 #2 
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Originally Posted by Jim
My horse left the barn six months ago last week. It may be a coincidence, but at the time I was terribly stressed out over a new teaching assignment, something I never taught before, which increased dramatically my insomnia. So, I was prescribed a combination of Rozerem, Hydroxyzine and Ibuprofin. on top of the 150 mg Wellbutrin I was taking for mild depression. After four weeks of that combination, I woke with ringing ears. My nurse, who prescribed all my meds, responded to my question with "it's tinnitus, and once it takes hold you'll never lose it." I immediately stopped the medications.

Idiot.

The nurse, not you.

Let me see if I have this right. One day you develop a rather common auditory phenomenon that generally resolves on its own (and/or that can generally be readily overcome) ... and with a few choice words your nurse turns it into "The Disease For Which There Is No Cure."

Where's my gun? Sheesh.

Quote:
I went to see my GP, who referred me to an ENT specialist saying, since my tinnitus isn't the result damage due to some traumatic incident (explosion, blow to the head), it should resolve itself within a year, probably six months. Then, my ENT told me I have moderate deafness in my upper ranges, and so my tinnitus is very likely permanent.

And what would your ENT say about all those folks with varying degrees of hearing loss who do not have tinnitus?

Seems to me your nurse helped you into the coffin, and your ENT nailed it shut. What is this? "The Alien and Godzilla vs Jim?"

Quote:
I know the best answer regarding the duration of my tinnitus is "it will do what it will do, so stop thinking about it." But I just can't help but ask. Grasping at straws, I guess.
 

Can't speak for anybody else, but I have never told anybody to "stop thinking about it." That's like saying: "Don't think about a pink elephant." What's the first thing you think about when you are told not to think about a pink elephant? Exactly.

So let's back up for just a minute. On a scale of 1 to 10 where 1 is "I have tinnitus and I'd prefer not to have tinnitus but I really don't care much one way or the other because my tinnitus does not bother me," and 10 is "I have tinnitus and my tinnitus has totally, completely, permanently, and irrevocably destroyed my life," where would you say you sit overall on that huge continuum?

Quote:
Thank you for listening.

Not a problem. And apologies to your nurse and your ENT. I'm just having a bad hair day.

Stephen M. Nagler, M.D.
Atlanta Tinnitus Consultants, LLC
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The best way to find yourself is to lose yourself in the service of others.
- Mahatma Gandhi
jclune

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 #3 

Thank you. Dr. Nagler! I am amazed and grateful for your quick and helpful response

 On your scale, I would put myself somewhere around a seven, overall. The good news is I have gotten well past the initial stage of screaming into my pillow every night, much to the relief of my long-suffering English cocker spaniel. My tinnitus is variable. I have times during some days, even whole days, when it's moderately low and manageable, silent even. Then I get a spike that can last from a day to three days, when even a shower doesn't mask the sound. During those days, I just put my head down and muddle through. I know it could be much, much worse.

I have developed a few coping techniques, like going outside for a walk and listening to the ambient sounds, to distract me from the noise, and having a masking sound while I sleep. It's the free "Rain Rain" App., which I recommend.


Thank you, again, for your kind support. I really appreciate it!

 

Dr. Nagler

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 #4 
 
Quote:
Originally Posted by jclune
Thank you. Dr. Nagler! I am amazed and grateful for your quick and helpful response

You are welcome. Glad to help.

Quote:
On your scale, I would put myself somewhere around a seven, overall. The good news is I have gotten well past the initial stage of screaming into my pillow every night, much to the relief of my long-suffering English cocker spaniel. My tinnitus is variable. I have times during some days, even whole days, when it's moderately low and manageable, silent even. Then I get a spike that can last from a day to three days, when even a shower doesn't mask the sound. During those days, I just put my head down and muddle through. I know it could be much, much worse. I have developed a few coping techniques, like going outside for a walk and listening to the ambient sounds, to distract me from the noise, and having a masking sound while I sleep. It's the free "Rain Rain" App., which I recommend.

Jim, there are a number of different ways to go about this problem, which means that no one of those ways is perfect ... or there would be only one way! You seem to be looking at it from the standpoint of distraction and trying to cope. In other words, you are trying to "learn to live with it." I myself am rather partial to the concept of habituation, which as I see it is more akin to learning to live withOUT it. Here is part of a Q&A I wrote for the just-released Summer 2017 issue of Tinnitus Today:

  • Q. What is the difference between habituation and learning to live with tinnitus?
  • A. When I think of learning to live with tinnitus, I think of developing effective strategies for coping with it or dealing with it. I think in particular of figuring out how to get through those "bad ear days." Habituation is something entirely different. Habituation is a process whereby you react to your tinnitus less and less over time – and as a consequence become less and less aware of it. With habituation, as with learning to live with it, your tinnitus is still present every time you purposely seek it. But with habituation you just don't care. And if, as a result, you go from being aware of your tinnitus 90% of the time to being aware of your tinnitus 10% of the time, in my opinion that's not learning to live with your tinnitus. Rather, that's learning to live without your tinnitus.
If that sort of thing speaks to you more than the types of strategies you have been employing up to this point, then you might want to look into Tinnitus Retraining Therapy or other habituation-based approaches.

Stephen M. Nagler, M.D.
 

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The best way to find yourself is to lose yourself in the service of others.
- Mahatma Gandhi
jclune

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 #5 
Thank you, Dr. Nagler. I appreciate your observations and advice. I have been putting off looking into TRT and sound therapy due to the cost, not covered by my insurance, and the hope this condition would resolve itself somehow. Now, at six months I think it's time for me to be more proactive.
Dr. Nagler

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 #6 
Quote:
Thank you, Dr. Nagler. I appreciate your observations and advice.

You are welcome.

Quote:
I have been putting off looking into TRT and sound therapy due to the cost, not covered by my insurance, and the hope this condition would resolve itself somehow. Now, at six months I think it's time for me to be more proactive.

Regarding the cost of TRT, I have seen top notch TRT for less than $3000 (including evaluation, TRT counseling, wearable TRT devices, and all follow-up visits.)  And many insurance companies do indeed cover part or all of TRT, even if they say they don't when you first inquire. It's often a matter of submitting the proper codes and explanations. Finally
, when considering the cost of TRT, I guess the cost of "not-TRT" should be taken into consideration.

I am not trying to "sell" you or anybody else on TRT. Just attempting to look at both sides of the equation. For me as a TRT patient in the mid-1990s, I can honestly say that with the exception of the wedding band on my wife's ring finger, TRT was the single best investment I ever made in my entire life.

All the best -

Stephen M. Nagler, M.D.


__________________

The best way to find yourself is to lose yourself in the service of others.
- Mahatma Gandhi
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Dr. Nagler's Tinnitus Corner is provided for education and information only. It is not intended for the purpose of providing medical care and should in no way substitute for appropriate in-person consultations with qualified healthcare professionals. By using this site, participants agree to hold Dr. Nagler and Atlanta Tinnitus Consultants, LLC harmless with respect to any loss, injury, claim, liability, or damage arising from following the postings herein.