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Bart76

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 #16 
Quote:
your biggest obstacle to success can most likely be found in a full-length mirror


You are completely correct , once I can get over that hurdle and remove the so called barriers to habituation I should be on the right track . 


You have my heartfelt thanks for all the time you took in replying to my questions Dr. Nagler. , this wonderfull site is one of the best tinnitus boards I have ever found , a great help and source of support .

Kind Regards ,
Bart

Dr. Nagler

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 #17 
You are welcome, Bart.

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

No bird ever soared in a calm. Adversity is what lifts us.
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David McCullough quoting Wilbur Wright
Bart76

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 #18 
Dear Dr nagler ,

My tinnitus does not seem to improve , I even, feel like it is getting worse .

I talked to my therapist about my concerns but she seemed to minimise the , in my opinion, very legitimate question about the category 4 patients and sound generators , or simply ignore it .

I think the whole explanation of the different categories is pretty vague at best , and to my knowledge my therapist did not extensively test or ask about my history and my reaction to sound exposure , the only thing she briefly asked was of I suffered from hyperacusis .

I have light hyperacusis, and my tinnitus occasionally responds and gets louder when exposed to noise, and that exacerbation can last for several days, but that might be psychological due to focus , how exactly do you categorise this between 0 to 4 ?

I was also given some sort of sound cube with pre programmed notched sounds that I could use as sound enrichment , it has 4 different sound samples of about half an hour each, and they just play one after the other and comprise mostly of nature soothing nature sound, and the sound of waves wich sounds alot like pink noise, I played this for the entire night and when I woke up my tinnitus was really bad and it has not really recovered much for over a week.

What is considered, or do you consider 'high levels' of pink noise ? Is partially masking it at night with pink noise considered high levels ? 

My apologies for these questions but for my peace of mind I just need to know .

Thank you very much ,
Bart


Dr. Nagler

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 #19 
Bart, your situation presents a bit of a challenge for me in terms of trying to address your very specific concerns on a public site like this, a site that is not well-suited to extensive back-and-forth discourse and where I am therefore largely constrained to speaking in generalities. More than that, each answer to one of your very good questions seems to generate more very good questions. And on it goes. My suggestion at this point (Post #19 in the thread) would be for you to consider setting up a one-to-one consultation with me where we can really get into the meat of the problem and make sure you are headed in the right direction. You can read about what I am talking about by clicking HERE - and if you wish to set something up, you can click HERE.

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

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

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 #20 
Hello Bart -

Please take no offense, but I have decided not to accept your very latest post for public viewing on this board because it is a comment rather than a question - and this site is strictly for Q & A.

That said, I hope you will allow me to make a few observations. And I apologize in advance for being blunt ...

  • You state very early on in this thread that you are lucky in that your audiologist has 15 years experience as a TRT clinician. That is all well and good, but any TRT clinician who has 15 years' experience and who has personally evaluated you (which I myself have not) ought to be able to answer the questions you have raised in this thread clearly and to your satisfaction with ease. And quite frankly the fact that your tinnitus clinician apparently cannot do so really concerns me. Moreover, it ought to concern you as well!

  • However your TRT clinician with 15 years' experience with TRT has recommended that you set your devices, it is not consistent the protocol specified by Dr. Jastreboff. Which means that whatever you are doing under the assumption that it is TRT, it is not TRT. It may be totally wonderful and ultimately highly effective, but it is not TRT.

  • I do not know enough about you and your tinnitus to determine whether or not I myself would have even recommended TRT for you in the first place.

Now after some 19 back and forth exchanges, I have suggested that if you wish to pursue this discussion further, it would be best to do it via phone or Skype. You raised another couple of concerns in the post to which I referred in the first line above, and my suggestion would be for you to fill out THIS FORM completely and include those concerns in the "Your Message" section before hitting the "submit" button.

Cordially -

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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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.