Dr. Nagler's Tinnitus Corner
Register Latest Topics
 
 
 


Reply
  Author   Comment  
Toffeecat

Member
Registered:
Posts: 3
 #1 
Hi Dr  Nagler. I thought id post some happy news and ask a few questions. My T started 10 yrs ago. After the usual panic, looking on certain forums (ouch) I found out about TRT. I wont say what my day job is but lets say I know a great deal about therapies and make up of the human body. I was fortunate and met a guy who had done TRT in London. He went through several years of therapy with the result his T just fell away to a nothing, the occasional jump but as he wasn't bothered it just went. So of I went to London and engaged in TRT. I understood the concepts and sort of linked them to what our bodies do. We hear a new noise, panic, light up our nervous system so the brain does as it does, monitors the noise and appears to amplify it. After two years, maybe less the T had become a nothing. I wasn't bothered what it did so brain had turned it down. Happy days.

Five years later my day job has become very stressfull. My brother became very ill (since passed away) and my thoughts on T slowly changed to fear again or more accurate fear of reaction.  So.......back comes T. Damm I thought, why did you do that!

So, I have re engaged with what I know of TRT and our brains. I live in a gentle noise induced environment, nice rain sounds. I always sleep great anyway. I avoid forums generally and have began to enjoy life again.

I noticed stress on my shoulders and jaws, a sign of tension which I now take as a warning im not habituating Im stressing so work on stress reduction. I realised thoughts play the central role. I cant change that Ive got T but I can change how I feel about it and so as my brain has better things to do, change my T again.

I just wondered if any of your patients had successfully completed TRT like me then at some point in the future relapsed only to re learn the skills they had learned previously. Its weird but the skills that you learn don't seem to ever go away. Yes its frustrating and yes I could kick myself but it just seems what took 5 years last time is taking much less this time.





Dr. Nagler

Owner
Registered:
Posts: 1,125
 #2 
Quote:
Originally Posted by Toffeecat
I just wondered if any of your patients had successfully completed TRT like me then at some point in the future relapsed only to re learn the skills they had learned previously.

I have been struggling with respect to how answer your question because as far as I know TRT does not involve learning any skills at all!

TRT has two components: TRT counseling and TRT sound therapy.

TRT counseling is basically a bi-directional informational process wherein the patient's tinnitus is assessed and explained in terms of the Neurophysiological Model of Tinnitus. It usually takes the form of an initial session and a couple of follow-up sessions. TRT sound therapy generally involves wearing a pair of devices set in accordance with the patient's TRT category for a period of time, usually around six months to a year. And that's pretty-much it. There are no particular skills to learn at all.

That said, after an individual has largely habituated his or her tinnitus through TRT, there is always the possibility of some sort of "relapse." I have not seen any hard data in that regard, but I would estimate it to be around 15%. In such cases the best thing to do is to check back in with your TRT clinician for a quick review of what's going on and resume using your devices as originally instructed. TRT is like learning to ride a bike. By that I mean, within a few weeks you can expect to be right back where you were before the relapse. Incidentally, that very thing happened to me. Around twenty years after successfully completing TRT, I found myself in the midst of a "rough patch." I was totally fine for twenty years and then I found myself slipping in a big way for no apparent reason at all. So even though I understand TRT as well as anybody, I checked in with my former TRT clinician and resumed the sound therapy. A couple of weeks later I was fine again.

Hope this helps.

Stephen M. Nagler, M.D.
Atlanta Tinnitus Consultants, LLC

__________________

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

Member
Registered:
Posts: 3
 #3 
Hi, thanks Dr Nagler. Perhaps I should have explained that I did complete TRT with Jaqui in London and it was a complete success. I completed the counselling and wore the ear generators for over a year until much like yourself it was more a hassle to use then rather than not. I also didn't need the noise laden environment so stopped that to. What appeared to happen was that I was under considerable stress at work and my brother was very ill and I just forgot what I had learned.Ill get in touch with Jaqui in London if things don't improve although to be fair, I'm not depressed, I sleep fine and the times I don't notice it is increasing as I loose the sense of fear. Much quicker than pre TRT. I have remembered the aversive reaction part and started to smile again. Although I have lost my ear generators. Damm!
Dr. Nagler

Owner
Registered:
Posts: 1,125
 #4 
The type of stress you describe can certainly function as a "tinnitus emerger," allowing your tinnitus that had been comfortably existing under the surface to rear its ugly head once again. When that occurred, your autonomic nervous system recognized it as "The Guest From Hell" and began to monitor it, which is precisely what you don't want to happen - but you have absolutely no control over it. And thus the vicious circle involving your ANS, your auditory cortex, and your limbic system became re-established. It's all about conditioned responses, a process that should be very readily reversed by re-instituting TRT sound therapy for a few weeks. So do get back in touch with Jacqui ... and while you're at it, please be sure to give her my very best regards.

Stephen M. Nagler, M.D.

__________________

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

Member
Registered:
Posts: 3
 #5 
Hi thanks Dr Nagler. Luckily the stress of my brothers passing is subsiding, my job when I'm back will be less "intense". Ill email Jaqui and pop down to London at the end of the month. I actually lost my ear gens many years ago but until then I'm working on my reactions which are slowly improving, the neck and shoulders don't hurt, the jaw neither and all due to my past learning. 

To end on a positive note I met a fella in Scotland five years ago who had done TRT with Jaqui and his T went from full on to a whisper after a few years of treatment. And when it did rear its head he was so habituated he like you treated it as a nothing, it disappeared to re emerge some time later as a whisper, almost like his brain was checking up on him. So TRT does work and its a powerfull tool.

Similar work on pain reduction is also ongoing by use of nothing more than changing perception of pain and its getting amazing results. Brian sure is a complex wonderfull thing.

Thanks again for the advice and ill say hi to Jaqui.

Mick
Dr. Nagler

Owner
Registered:
Posts: 1,125
 #6 
Glad to help.

Stephen M. Nagler, M.D.

__________________

The best way to find yourself is to lose yourself in the service of others.
- Mahatma Gandhi
Previous Topic | Next Topic
Print
Reply

Quick Navigation:

Easily create a Forum Website with Website Toolbox.



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.