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victor_penya

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 #1 
Hi Dr. Nagler,


I’ve had tinnitus in the two ears for more than 20 years, but it wasn't loud and in high frequencies, It did not bother me at all. I had a mild hearing loss at 4 Khz in my left ear too (typical noise trauma)

I've always liked to listen to music loudly in hedadphones (now I'm deeply regreted about this but it is too late unfortunately).


Last May I realized my hearing loss was quite higher than before, so I became very worried and anxious about it.
I went to my ENT, and she certified that my hearing loss at 4 Khz was indeed higher than before (loss 50 dB) , but nothing too important. because my right ear was OK, so I could still hear well.

My tinnitus was the same, not intrusive at all.


Two months later In July, I was promoted at my company, it was a very very  stressful event for me, and the very next morning  I noticed a horrible feeling of fullness and fluttering in my left ear,
I thought it was a subjective tinnitus at that moment, so my anxiety and stress went up in a very important manner. My old tinnitus increased a lot, very very intrusive (fluctuating now and mixing hissing and pure tones)

Later on, after reading on the Internet, I realized that the feeling of fullness in my left ear was due to TTTS. The fullness subsided but the fluttering is almost 24 hours present, in silence sometimes it becomes kind of pulsatile.

Those days I experienced an increase in volume in my hearing too  (everthing seemed to be louder than before), not sure if this happened at that night ot it developed the following days because I thought my ear was damaged because the fullness and fluttering. I felt that  some noises like children voices, carn horns, etc bothered (but not pain).


Now, six months since that onset and I feel exactly the same, the tinnitus still is very  intrusive, the TTTS fluttering and noise sensibility is the same.

During these months I've been visiting 4 ENTs, been under benzodiazepines and antidpressive drugs to be able to sleep.

Regarding to the sensibility I've been to three audiological centers in my city, all of them performed the hyperacusis test and  said I don't have hyperacusis because my LDL are 100 dB or higher in all tested frequencies.
However I do believe that I have mild or moderate hyperacusis because I feel bothered in loud sounds and some sound like children voices are  uncomfortable. I've a decibel meter in my smartphone and I feel uncomfortable in restaurants with sounds louder than 70 dB approx.


Now I'd like to ask some questions regarding my situation:

1) For the Hyperacusis tests I was listening to pure tones increasing the volume step by step up to the level it was  unbearable (not comfortable) , is this the correct way of doing H tests?, they say I don't have H but "sound sensibility", for me it is the same.  What do you think?

2) when I spend sometime in environments with moderate volume (around 60 dB) such as the gym, my office, etc I can manage OK, but I feel my ears like being tired, clogged. Could this be a symptom of H ? perhaps the TTTS is giving these feelings?

Should I continue doing these activities?

3) Up to now, I haven't done anything to treat the H, hoping it  subsides eventually (as I read in some threads in TinnitusTalk for instance), but perhaps I should look for a really expert on the matter in other city and follow a TRT treatment.. o pink noise at home... I don't know...  What do you think?

5) I feel caught in an anxiety loop, I can manage to sleep only 4 or 5 hours without drugs, I wake up suddenly and I feel the adrenaline flowing through my body and can not sleep anymore although I feel very sleepy. I think the anxiety is because the fear of not improving in the future...

Not sure how I can break this loop, I've tried mindfulness, CBT, craneosacral, etc.. I'm going to read the book "Tinnitus A self-Management guide for the ringing in your ears" to see whether it can help.

I want to think that somepoint in time I'll be able to break this loop, otherwise living is very difficult task.

Do the people habituated be happy in the way that they don't think all the time in this?   is there any hope to be happy again?,, sorry if this questions are childish but they are important to me.


I think it is clear that the stress of the promotion of my job was the trigger of all what I'm living now, in your experience, whenever I break that anxiety loop and I can sleep well everything will settle (intrusive tinnitus, H) as before? or is this a naive assumption?

Many thanks for your time helping people like me with their souls broken because these horribles things.

Dr. Nagler

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 #2 
Hello victor_penya ... and thank you for your interesting post. I am sorry to hear that you are having a difficult time of it.

I am going to give some thought to your many very good questions before responding - so please bear with me.

In the meantime, let me answer just one of your questions and ask one of my own.

You asked whether there is "any hope to be happy again." And the answer is absolutely yes. In fact your life can be better in the future than it ever was before this all started. I can tell you for a fact that mine is!

Now, while I am considering the rest of your post, please tell me this:

In the last line of your post you referred to people like you whose souls are broken. To my way of thinking there can be nothing worse in the world than having a broken soul. Is your soul truly broken, or is it more like you are using that particular phrase to convey how unhappy and frustrated you are? In other words, how exactly is your soul broken? Please be specific. What precisely is broken? Thank you.

Stephen M. Nagler, M.D.

__________________

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

No bird ever soared in a calm. Adversity is what lifts us.
-
David McCullough quoting Wilbur Wright
victor_penya

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Posts: 5
 #3 
Dear Dr Nagler,

Thank you very much for your prompt respose, your words about happines gives me relief and hope in the future, althought I try hard to change my way of thinking, most of the time my mind is thinking and foreseeing the worst scenario, which is I'll be always anxious because the tinnitus and the hyperacusis (or sound sensitivity) won't dissapear and having a huge impact in my life.

That is what I mean when I say broken soul, it is the lack of hope and despair in the future.  I know I have to put effort into  changing my mindset and be more optimistic,  it is the only way to improve, but I find it very hard most of the time.


Thank you again for your help



Dr. Nagler

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 #4 
So just to be very clear. Your soul is not broken in any way. Rather, the problem is that you are very unhappy and you are very frustrated. Is that correct?

Stephen M. Nagler, M.D.

__________________

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

No bird ever soared in a calm. Adversity is what lifts us.
-
David McCullough quoting Wilbur Wright
victor_penya

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Posts: 5
 #5 
yes, you are right, sometimes I'm not sure how to express my feelings.
Dr. Nagler

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Posts: 1,759
 #6 
Thank you. I have one other question. Then I will make an observation and answer all of your questions. So please be patient with me.

You wrote that when you said you had a broken soul, you were referring [in part] to your lack of hope. What I would like to know is if you actually lack hope or is it that you are so upset and exasperated that it feels like there is no hope.

Stephen M. Nagler, M.D.

__________________

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

No bird ever soared in a calm. Adversity is what lifts us.
-
David McCullough quoting Wilbur Wright
victor_penya

Member
Registered:
Posts: 5
 #7 

As the times goes by I feel I'm not improving and I'm upset and exasperated, feeling there is no hope. My family says "give it time" and inside of me there is a little part that tells me that everything will be ok again, perhaps it is a defense mechanism of the brain. I don't know why, but there are days I feel optimistic and there are days I feel very very upset and anxious with the situation.

 
Thanks

Dr. Nagler

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 #8 
Quote:
As the times goes by I feel I'm not improving and I'm upset and exasperated, feeling there is no hope. My family says "give it time" and inside of me there is a little part that tells me that everything will be ok again, perhaps it is a defense mechanism of the brain. I don't know why, but there are days I feel optimistic and there are days I feel very very upset and anxious with the situation.

Got it.

You are very very upset and anxious. That is the reality. But saying that your soul is broken or that you lack hope is not the reality at all; rather it is catastrophic black-and-white emotion-based thinking. And however bad you might feel about things, that sort of thinking serves only to make you feel worse!!!!! Please take a look at my Letter to a Tinnitus Sufferer to see what I am talking about. CLICK HERE

OK. Now to your questions ...

Quote:
1) For the Hyperacusis tests I was listening to pure tones increasing the volume step by step up to the level it was  unbearable (not comfortable) , is this the correct way of doing H tests?, they say I don't have H but "sound sensibility", for me it is the same.  What do you think?

There is no uniform standard way to instruct a patient regarding when to hit press the button during LDL (hyperacusis) testing, but it is not supposed to be a torture session by any means. Most often the audiologists I have worked with tell their patients to press the button when the sound is uncomfortable and they really do not want to go any louder. I have no problem with the instructions you were given, and even if you had pressed the button at 10dB lower than you indicated in your post, I would not diagnose you with hyperacusis. 

Quote:
2) when I spend sometime in environments with moderate volume (around 60 dB) such as the gym, my office, etc I can manage OK, but I feel my ears like being tired, clogged. Could this be a symptom of H ? perhaps the TTTS is giving these feelings?

Tired ears or a clogged feeling are not symptoms of hyperacusis. As far as TTTS goes, that diagnosis should be made by an experienced ENT or neurotologist after a careful examination. Concluding that you have TTTS based on something you read on the Internet is unwise, in my opinion.

Quote:
Should I continue doing these activities?

I would absolutely continue going to the office and participating in activities that give you pleasure. I would also resist the temptation to use earplugs unless the sound level in the environment is such that you have to raise your own voice in order to be heard by somebody standing next to you.

Quote:
3) Up to now, I haven't done anything to treat the H, hoping it  subsides eventually (as I read in some threads in TinnitusTalk for instance), but perhaps I should look for a really expert on the matter in other city and follow a TRT treatment.. o pink noise at home... I don't know...  What do you think?

I absolutely think that you should undergo a proper evaluation performed by an audiologist who is both knowledgeable and experienced in testing individuals with tinnitus and decreased sound tolerance.

Quote:
5) I feel caught in an anxiety loop, I can manage to sleep only 4 or 5 hours without drugs, I wake up suddenly and I feel the adrenaline flowing through my body and can not sleep anymore although I feel very sleepy. I think the anxiety is because the fear of not improving in the future... 

Not sure how I can break this loop, I've tried mindfulness, CBT, craneosacral, etc.. I'm going to read the book "Tinnitus A self-Management guide for the ringing in your ears" to see whether it can help.

I want to think that somepoint in time I'll be able to break this loop, otherwise living is very difficult task.

I understand exactly what you are saying. I think you should see Jacqui Sheldrake in London for the testing and management of your tinnitus and sound sensitivity issues. And I think you should see Laurence McKenna (who shares an office with Jacqui) for help with the anxiety and sleep problems. I suspect that after you see each of them once, all follow-up can be handled by phone or Skype, but you might check with them ahead of time to be sure. I know that London is a bit of a distance for you, but I do not know anybody closer to your home well enough to suggest an alternative.

Quote:
Do the people habituated be happy in the way that they don't think all the time in this?   is there any hope to be happy again?,, sorry if this questions are childish but they are important to me.

Those questions are absolutely not childish. The answers are Yes and Yes. But I do believe that you would benefit from having professional guidance to get you headed in the right direction, which is why I suggested Jacqui Sheldrake and Laurence McKenna.

Quote:
I think it is clear that the stress of the promotion of my job was the trigger of all what I'm living now, in your experience, whenever I break that anxiety loop and I can sleep well everything will settle (intrusive tinnitus, H) as before? or is this a naive assumption?

Your life can be better than before!

All the best with it -

Stephen M. Nagler, M.D.

__________________

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

No bird ever soared in a calm. Adversity is what lifts us.
-
David McCullough quoting Wilbur Wright
victor_penya

Member
Registered:
Posts: 5
 #9 
Thank you very much Dr Nagler for your time and help.  I'll follow your advices.

All the best

Victor Penya
Dr. Nagler

Owner
Registered:
Posts: 1,759
 #10 
You are most welcome.

Stephen M. Nagler, M.D.

__________________

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

No bird ever soared in a calm. Adversity is what lifts us.
-
David McCullough quoting Wilbur Wright
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