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elizo

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A question for those of you who have done (or are doing) TRT.

As far as I know, you increase the volume of the noise generators a bit every month or so. But what do you do when you've reached a certain volume level and unfortunately have a setback? Do you remain with the same level no matter how sensitive you ears are, or you decrease it to be able to tolerate the noise level after the setback? What specific steps, if any, do you follow when you have a setback?
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Rob

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Reply with quote  #2 
I would decrease the volume so you are comfortable.  I would also discuss your setback with you TRT clinician. 

Rob
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Ann

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Reply with quote  #3 
Elizo, set the volume to where you don't worry about it. I'm sure you will feel better soon.
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elizo

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Reply with quote  #4 
Thank you for your responses.

I was already decresing the volume whenever I have a setback because otherwise my hyperacusis would get worse; at least it's what works for me. I was just curious about what TRT protocol says on that subject.
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migrainegirl

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Reply with quote  #5 
I was told to keep it just barely audible. The key to TRT isn't volume, but exposure to the various bands of sound. That made it much more tolerable for me than thinking I needed to make it louder.
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DrNagler

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Reply with quote  #6 
Quote:
Originally Posted by elizo
A question for those of you who have done (or are doing) TRT.
As far as I know, you increase the volume of the noise generators a bit every month or so.

That is not my understanding. I think you should review your protocol with your TRT clinician.

stephen nagler

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DrNagler

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Reply with quote  #7 
Quote:
Originally Posted by migrainegirl
I was told to keep it just barely audible.

Bad idea, in my opinion. If you set your devices at "just barely audible," you run the risk of inducing stochastic resonance.

stephen nagler 

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bellsareriging

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Reply with quote  #8 
 
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bellsareriging

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Reply with quote  #9 
 Bad idea, in my opinion. If you set your devices at "just barely audible," you run the risk of inducing stochastic resonance.

stephen nagler


Hello Dr Nagler,

Can we please have this  sentence in " layman's  terms"   so  that all the Lay  people  on the  board  have some idea  what is being said, many of us are NOT  adopting  the  clinicians, and the TRT  training, but  are  still willing  to learn and participate on the  board, then with enough informed knowledgeable  information, ditching  all ENT  surgeons  we  can make an informed  decision  about the  best path forward for  us.

 thank you Bell
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DrNagler

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Quote:
Originally Posted by bellsareriging
Bad idea, in my opinion. If you set your devices at "just barely audible," you run the risk of inducing stochastic resonance.

stephen nagler


Hello Dr Nagler,

Can we please have this  sentence in " layman's  terms"   so  that all the Lay  people  on the  board  have some idea  what is being said, many of us are NOT  adopting  the  clinicians, and the TRT  training, but  are  still willing  to learn and participate on the  board, then with enough informed knowledgeable  information, ditching  all ENT  surgeons  we  can make an informed  decision  about the  best path forward for  us.

thank you Bell

Hi Bell. Thank you for rephrasing your question. I was going to ignore it first time around.

I think the best (admittedly simplistic) way to understand stochastic resonance as it relates to the auditory system would be to consider the brain's reaction to a foreign sound that it can just barely perceive. In such a case the brain sort of has to work overtime in an effort to try to figure out what it is. Compare that to a sound that is readily audible, where the brain doesn't have to figure out anything at all. It is this "working overtime" that can defeat the purpose of sound therapy and moreover compound the problem.

That's how I have come to view it anyway. So regardless of what you are trying to accomplish with sound therapy and how you are planning to accomplish it, the softest I would ever recommend setting devices at would be "readily audible yet not annoying or distracting" rather than "just barely audible."

Hope this clarifies more than frustrates or confuses.

Let me add one thing about how to "make an informed decision," to use your phrase. I may be naive, but I honestly do not know how anybody can make an informed healthcare decision without a proper evaluation. Trying to make an informed healthcare decision based solely on what you read on the Internet is a shot in the dark, which is just about the antithesis of the concept of "informed." There is too much individual variation that must be taken into account when making a diagnosis and designing a protocol. Moreover, there is too much bad information on the Internet that sounds like good information just because it happens to make sense!

stephen nagler

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elizo

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Reply with quote  #11 
Quote:
Originally Posted by DrNagler
That is not my understanding. I think you should review your protocol with your TRT clinician.


I can't afford a TRT clinician. If I had a TRT clinician to whom I may ask, I wouldn't have started this thread.

So, may I ask you what your understanding is then? How much and how often do people who is doing TRT increase the volume?
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DrNagler

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Reply with quote  #12 

Quote:
Originally Posted by elizo


I can't afford a TRT clinician. If I had a TRT clinician to whom I may ask, I wouldn't have started this thread.

So, may I ask you what your understanding is then? How much and how often do people who is doing TRT increase the volume?

Sorry, there is too much individual variation to responsibly make a blanket statement about how to set devices. But one thing you do not do in TRT is "increase the volume of the noise generators a bit every month or so." It may work out just fine to do things that way, but your question referred specifically to TRT.

stephen nagler


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No bird ever soared in a calm. Adversity is what lifts us.

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elizo

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Reply with quote  #13 
Ten months ago my sound tolerance was limited to around 35 dB. At that time I already knew what stochastic resonance was. It is a fact that my recovering from extreme hyperacusis started the day I decide to ignore what some people warn about stochastic resonance, though that wasn't the only reason. For instance, I also took some advice from this board. To sum up, I did what some would describe as "folly at best".

Nevertheless, now I can easily tolerate my hairdryer, which gives a sound level between 90 and 100 dB depending on how close to me ears I put it, for several minutes. I can also listen to short 100 dB sounds, which used to guarantee a big setback back then. Listening to pink noise at a barely audible volume worked for me very well. So it did for other people. The volume was so low that I often had to check if I was actually hearing something. I still listen to pink noise at an almost unaudible volume when my ears ask for it, though it rarely happens now. And I won't need to do that anymore soon.

I set a barely audible volume not because I was excited to put my miserable health at risk, but just because my ears didn't like a "readily audible" volume, I had already tried many other approaches without success, and all clinicians I visited weren't able to help me out (in fact, they made my hearing condition worse).

Everyone of us certainly should try to find a customized sound therapy protocol. Thank God I did.
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DrNagler

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Reply with quote  #14 
I am very happy that you are doing well, elizo.

All the best -

stephen nagler

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No bird ever soared in a calm. Adversity is what lifts us.

- David McCullough quoting Wilbur Wright
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elizo

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Reply with quote  #15 
Quote:
Originally Posted by DrNagler
I am very happy that you are doing well, elizo.

All the best


Thank you for your good wishes.

I also appreciate that you deleted your last post because it seemed like it revealed a certain lack of empathy as well as pride.
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DrNagler

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Reply with quote  #16 
Quote:
Originally Posted by elizo


Thank you for your good wishes.

I also appreciate that you deleted your last post because it seemed like it revealed a certain lack of empathy as well as pride.

Any reason you didn't stop after the first sentence? Or even after the word "post?"

stephen nagler

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No bird ever soared in a calm. Adversity is what lifts us.

- David McCullough quoting Wilbur Wright
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janeygirl

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Reply with quote  #17 
with TRT or anything for that matter, the clinician asks patients to increase the generators a tiny bit, also the second component of TRT is listening to non verbal music but again, increase it only a tiny bit. Along with cognitive behavioral therapy and working with a GOOD, EXPERIENCED clinician (emphasis on EXPERIENCED, i.e. someone who does TRT frequently and knows hyperacusis well too and not just tinnitus), the likelihood of it being successful is increased in my view. 
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