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frankie_girl
 #21 
winterbridge wrote:

some of us can become a slave to our own minds which makes fighting chronic illnesses that much more difficult, like me. 

Count myself right in there, too.

Thanks for sharing your experience, doc. Oddly enough, I mentioned 60 dB because the doctor I was seeing in Austria had the t at 60 dB. He told me for the first couple of months he played the piano a lot to try and separate the sounds coming from the outside from those on the inside. After that, he habituated and now he only hears it when focusing on it or in a completely silent room. 

Ana, it's really, really low now!  My goodness, you can't hear it over the very lowest setting in a TRT device, a device that is specifically designed to be able to be set softer than your tinntus
So I think that you might consider the fact that likely your tinnitus really isn't louder than when it first started - it only seems that way because you've been fighting this battle for three long years.  I really believe that you're going to do quite well, but maybe it might be worth a look at the strategies you've been using!
 
I'm willing to consider that option. My strategies are practically non-existent,  I'm basically hoping that TRT will help me, and in the meanwhile I don't have the courage or the energy to do anything. My brain feels washed out from all the xanax. All I can say is that I'm in awe of all you people here and right now I feel like a silly kid whining about a bruised knee  
In any case, I feel the hyperacusis is the bigger problem in my case. Couple that with an anxious/hypersensitive personality, and you get me - a prisoner in my house. I know I put myself in there. I just don't know how to get out.



DrNagler
 #22 
Ana posted [in part]:

I feel the hyperacusis is the bigger problem in my case. Couple that with an anxious/hypersensitive personality, and you get me - a prisoner in my house. I know I put myself in there. I just don't know how to get out.

............

When was the last time you left the confines of your house for any reason at all?

smn

CPW151
 #23 
Guess my post early this morning was about Winterbridge's question on optimism.  Sorry but it was very late.  Stayed up to watch a three hour movie on TV and I haven't done done that for awhile. 

CPW
frankie_girl
 #24 
When is the last time you left the confines of your house for any reason at all?

I can leave the house, but only in my car (I live in the centre, big roads all around my house).
I go to work every morning, it's a 3 min drive in my car, and I come back every day at 5. I haven't walked around the town in the last 3 months. Before my visit to the doc in Austria I used to walk to work and back (15 minutes), plugging my ears with my fingers, but I stopped doing that as I felt much more comfortable in my car.
DrNagler
 #25 
Ana posted:

I can leave the house, but only in my car (I live in the centre, big roads all around my house).
I go to work every morning, it's a 3 min drive in my car, and I come back every day at 5. I haven't walked around the town in the last 3 months. Before my visit to the doc in Austria I used to walk to work and back (15 minutes), plugging my ears with my fingers, but I stopped doing that as I felt much more comfortable in my car.


...........

I see.  Thank you for your response.

So is it fair to say that although you have found it necessary to make some compromises because of your auditory challenges, you leave your house most every day?

smn

frankie_girl
 #26 
I see.  Thank you for your response.

So is it fair to say that although you have found it necessary to make some compromises because of your auditory challenges, you leave your house most every day?


Thank you, doc, for your attention. I've been needing to talk about this for ages. My statement that I am a prisoner in my house was partially a figure of speech, but partially true. I leave my house if I have to, on workdays. On weekends I usually stay in to "recover" from any excessive stress during the week.
DrNagler
 #27 
Ana, please try to give a "yes or no" answer to my question.  (Trust me, it's important.)

Here's the question again ...

So is it fair to say that although you have found it necessary to make some compromises because of your auditory challenges, you leave your house most every day?

smn
frankie_girl
 #28 
Yes, your honor

So is it fair to say that although you have found it necessary to make some compromises because of your auditory challenges, you leave your house most every day?

Yes.

DrNagler
 #29 
OK.  Now this isn't the third degree - so please do not take offense by my questioning.  But as I see it this problem of yours is multi-dimensional ... and it may take a bit of time to get you to the point where you will get maximum benefit from your next visit with the TRT clinician.

Here's my question ...

Everything else being equal, would you personally feel better (1) having a condition that has made you a prisoner in your own home or (2) having a condition that has required you to make some compromises in order for you to leave your home most days?

I'll give you a break and answer that question for you. 

Obviously the answer is #2, an answer that acknowledges that you have a significant challenge but also recognizes the strength, resource, and determination that you display daily in order to continue working full time out of the house.

So the obvious next question is ...

I know you feel bad, but why do you choose to view your condition in a matter that makes you feel worse than you really need to feel?

smn

frankie_girl
 #30 
No offense taken. I was just being silly, sorry about that.

I'll give you a break and answer that question for you.  Obviously the answer is #2, an answer that acknowledges that you have a significant challenge but also confirms that you have the strength, resources, and determination to continue working full time out of the house.


Ah! Precisely what I lack. My panicky mind takes away all my strength, focuses the determination on negative things, and shuns any options available, always fearing an increase in volume. It has been doing that for the past 10 months.
Why do I choose to view my condition like this?
I don't know. My mind tells me to. Perhaps I'm not motivated enough to leave my house at all. Perhaps I don't have the support, the love, the goals, the faith. Perhaps I'm still blaming myself for ever have boarded the plane to NY. There are many wrong turns inside my head, doc. I know that. I'm just trying to sort out which ones are wrong, and which are actual, useful ways to protect myself from harm.
DrNagler
 #31 
Ana posted [in part]:

Ah! Precisely what I lack [strength, resource, determination]. My panicky mind takes away all my strength, focuses the determination on negative things, and shuns any options available, always fearing an increase in volume. It has been doing that for the past 10 months.

............

I'm sorry, Ana, but now you have me very confused.  Please be patient and help me out here ...

Given the severity of your auditory challenge, of which I have no doubt, how in the world can you be lacking the strength, resource, and determination that are absolutely required to do precisely what you do - go to work every day?

smn


frankie_girl
 #32 
Given the severity of your auditory challenge, of which I have no doubt, how in the world can you be lacking the strength, resource, and determination that are required to do precisely what you do - go to work every day?

I have to go to work, so I do it. I do it, and afterwards I don't have any energy left, and by 5 PM my ears are already full (literally speaking). Everything else I don't have to - I choose not to because it feels safer that way. I don't have the strength and determination for that. Choosing to go somewhere on a Sunday would mean to accept responsibility for any increase in volume. Going to work means I had to do it - so if the volume increases, I find the reason and try to cope with it - but at least I'm not the one to blame if it does happen. 
DrNagler
 #33 
Ana posted:

I have to go to work, so I do it.

...........

Right.  And THAT requires considerable strength, resource, and determination.

...........

I do it, and afterwards I don't have any energy left, and by 5 PM my ears are already full (literally speaking). Everything else I don't have to - I choose not to because it feels safer that way. I don't have the strength and determination for that.
 
............
 
Oh.  Now I see.  You do have strength, resource, and determination.  That's how you get to work each day.  But earlier you said that strength, resource, and determination were "Precisely what I lack."

So is it fair to say that you have considerable strength, resource, and determination - but you wish you had more ... so you could do more?

I'll help you out again and answer "Yes, that's a fair way to put it."

Which brings me to my last question of the day, one to which I'd really like you to give some deep thought:

I know that you find yourself in very difficult straits, but why do you insist on discounting the positive - because this is the second time you have done it in the past few posts!!

[We'll move on to another area tomorrow.]

smn
frankie_girl
 #34 
Looking forward to that! I just wanted to say thanks for everything you did today and yesterday. You know how much it means. 

Ana



DrNagler
 #35 
You are very welcome.  Glad to be of some help.

Ana, I really believe that with just a bit of insight and direction, you will do quite well.  Not overnight, of course.  But very definitely over time.  As far as I can tell, you have all the tools!

But I'm not gonna let you get off without answering my last question of the day.

To repeat ...

"I know that you find yourself in very difficult straits, but why do you insist on discounting the positive?"

smn




frankie_girl
 #36 
A good morning to you and everybody reading.

Sorry if I kept you waiting yesterday. I logged off and sat in my room thinking things over for quite some time.
Here goes. I'll give you the whole "stream of thought" here, perhaps someone else reading this will benefit from my babbling

"I know that you find yourself in very difficult straits, but why do you insist on discounting the positive?"

I wasn't aware I was insisting on anything. For the sake of being argumentative, you're the one who was insisting. Ok, strike that out. I'm willing to consider that I'm being negative here. Why do I do it? Well, I take it you are a very sensible and intelligent person. So I wouldn't expect you to request me to reflect upon my own thoughts using the only tools I have - the very same thoughs. Presuming the thoughts themselves are negative, they're only bound to come up with a negative explanation (see previous posts on blame, lack of love etc.) You don't really want to hear why I'm being negative (neither should I, as it's not very productive).
Therefore, "why do you insist" can only be understood as "why don't you try to stop insisting". So, we're heading somewhere along the lines, our thoughts create our feelings/reality. I came here asking for help, and here I was doing my best not to help myself at all.
I have to give you one last inkling of resistance: have you ever tried asking a person having a panic attack why he/she insists on panicking?

P.S. I'm thinking this thread should be renamed into "cognitive therapy for ana"  
DrNagler
 #37 
Ana posted:

So, we're heading somewhere along the lines, our thoughts create our feelings/reality. I came here asking for help, and here I was doing my best not to help myself at all.

...........

Well, you weren't aware of it ... and now you are.  So now you can decide to make a purposeful effort to challenge that type of thinking.  And I think it's a very important thing to do.  Why?  Because more than it not being helpful to discount the positive ... it is actually counterproductive to your achieving your goal.

.............. 

I have to give you one last inkling of resistance: have you ever tried asking a person having a panic attack why he/she insists on panicking?

..............

No.  That would be an unfair thing to ask, because a panic attack is a physiological response.  But I might ask a person who has panic attacks to examine whether or not there is a rational basis for the thinking that led up to the attack.  Do you see the difference?

smn

frankie_girl
 #38 

No.  That would be an unfair thing to ask, because a panic attack is a physiological response.  But I might ask a person who has panic attacks to examine whether or not there is a rational basis for the thinking that led up to the attack.  Do you see the difference?
 
I do. I mentioned the PA's because I suffered from them on and off in the previous years, when I had the t but had very little information on what it is and how it will develop. I believe that's partly why I still have all the fears, as the rational basis for the thinking is still uncertain (e.g. the doc in Austria saying my inner ear cannot defend itself, getting a different opinion here).

We tackled this topic on the previous page. You said there was no logical reason for thinking the t would increase. I said there was. Then we diverged into talking about my lack of positive attitude to get on with my life and habituate. Now, having a positive attitude is one thing, and having a clear rational basis is another. 

The only thing possible for me to do here is to strongly believe the t will not increase again. That would mean to override my previous experience. Either that, or decide not to care if it ever increases again. Do you think that would work?

A


DrNagler
 #39 
Ana posted:

I do. I mentioned the PA's because I suffered from them on and off in the previous years,

.............

OK.  You have a history of panic attacks prior to the onset of your tinnitus and hyperacusis.  Although the panic attacks have nothing to do with your auditory problems, I wonder if you happen to know what is largely considered to be the single best approach to the treatment of panic attack disorder?

..............

when I had the t but had very little information on what it is and how it will develop. I believe that's partly why I still have all the fears,

.............

That makes sense.  In fact, I used to be in the same boat as you in that regard.

..............

as the rational basis for the thinking is still uncertain (e.g. the doc in Austria saying my inner ear cannot defend itself, getting a different opinion here).

................

How confident are you that the doc in Austria is correct with respect to the above?  And by the way, since you are seeing him for TRT, have you asked him about where he learned the protocol, how many patients he has treated with TRT, and what his results are?

While we're at it, what do you hope to be the result of your TRT for your tinnitus?  For your hyperacusis?

..................

We tackled this topic on the previous page. You said there was no logical reason for thinking the t would increase. I said there was. Then we diverged into talking about my lack of positive attitude to get on with my life and habituate. Now, having a positive attitude is one thing, and having a clear rational basis is another.

................

Well, what was your tinnitus loudness match in dB when your tinnitus first started, and what is it now?  I mean, you are telling me that it's louder now than it was then, which is your opinion ... and you certainly have a right to it.  But I am trying to find out from you what the rational basis is for that opinion.  All I know is that (1) in retrospect you think it's getting louder and (2) after three years of supposedly getting louder it is totally masked at the very softest volume at which a TRT device can be set.

.............

The only thing possible for me to do here is to strongly believe the t will not increase again. That would mean to override my previous experience.

..............

Right.  And I am asking you about that experience, because unless my hunch is wrong, it is little more than a continually self-reinforced assumption that has no basis in fact.

...............

Either that, or decide not to care if it ever increases again. Do you think that would work?

..............

No, I do not think that would work any more than my deciding not to care if my wife's breast cancer recurs.

I realize that I have been loading you up with a lot of questions, Ana, but I need to know where you are starting from in order to offer an opinion regarding the direction I believe you should consider taking.  So please take your time and briefly address each point I have raised in this post.

Kind regards -

smn 

frankie_girl
 #40 

Hello again.

OK.  You have a history of panic attacks prior to the onset of your tinnitus and hyperacusis.  Although the panic attacks have nothing to do with your auditory problems, I wonder if you happen to know what is largely considered to be the single best approach to the treatment of panic attack disorder?

No, I don't. Xanax? (just kidding.)

How confident are you that the doc in Austria is correct with respect to the above?  And by the way, since you are seeing him for TRT, have you asked him about where he learned the protocol, how many patients he has treated with TRT, and what his results are?

He was the first one to offer me any plausible explanation for what was happening. Previously, I considered noise trauma from too much clubbing, but I had no explanation as to why the condition deteriorated or why my noise sensitivity was so low. When he told me about the result of the suppression test, I felt relieved, but also more concerned, as the reason was physical! Then, when he said the brain could adapt to this, I was surprised, but he said he already had patients with the same problem which got beter with TRT. After searching the net for anything similar and finding no mention if it whatsoever, I had some doubts, but it felt so much better having someone I could trust! Now, I honestly don't know what to think.

I haven't asked him where he learned the protocol or how many patients he had, but he mentioned having success with TRT. Well, I don't expect anyone would say they didn't have success, would they? 

While we're at it, what do you hope to be the result of your TRT for your tinnitus?  For your hyperacusis?

I hope one day everyday noises won't bother me. I don't know if I will ever be able to watch tv, but it would be nice. This is by far the strangest aspect of my hyperacusis, and I'm really curious as to what causes the noise emitted by tvs and computers to be so invasive to my brain! I would like this to stop,  but I don't understand how wearing the noise generators will do that.
I would like to think that maybe someday the t volume will return to what it was when I first got it (in September 2005), a low white noise I can only hear in total silence.

Well, what was your tinnitus loudness match in dB when your tinnitus first started, and what is it now?  I mean, you are telling me that it's louder now than it was then, which is your opinion ... and you certainly have a right to it.  But I am trying to find out from you what the rational basis is for that opinion.  All I know is that (1) in retrospect you think it's getting louder and (2) after three years of supposedly getting louder it is totally masked at the very softest volume at which a TRT device can be set.

Ok, I'll try to give you the whole story with as much details as possible.

When it first started, I didn't have it measured (my country still lives in the dark ages, you know). But I suppose it might have been about 3-4 dB. It was a hiss, a white noise sound only audible in total silence. In the morning it would be almost non-existent. It remained more or less like that for two years. Perhaps it increased ever so slightly after one or two nights out, which I normally avoided but which happened "accidentally".

In December 2007, I noticed a new sound in my left ear, a grinding, inconstant noise as opposed to my usual hiss. After coming home from a New Year's (five hours in a restaurant with a jazz band next door; I wore earplugs for the last two hours), I immediately noticed the sound produced by the tv set irritated me. The next morning the t level was higher, let's say 8 dB. It stayed there over the following weeks.

On January 15 I took the trip to the states. I wore earplugs and earmuffs all the time, but the noise was still too much for me (9 hours flight). In NY, I noticed another increase in loudness (let's say 15dB), plus a strange whistle in my left ear, so if I was sleeping on the left side, my whole head would fill with the whistle and stayed like that all night. I also had to wear earplugs when walking around town, and even that didn't seem protection enough.

On returning home after a week the situation was still the same. I couldn't stand being in the same room with a tv set and any traffic noise was suddenly waaay to much for me. I could hear the hissing t during daytime. I slept on my right side to avoid having the whistle in my entire head. Then another whistle appeared in my right ear after a 3 hour bus ride (with earplugs).

By then I was already a nervous wreck and couldn't sleep at all, so a couple of weeks later I started with the Xanax. The first Xanax immediately lowered my t to the level from Sept. 2005 (barely audible).

I was at home for a week and everything seemed ok. Then I went back to work and the t was louder in the evening. That started my compulsive habit of checking the t volume when returning from work, and avoiding going anywhere on weekends.

Since then I had several more increases in volume from occurences such as trains passing by, which would, admittedly, settle back with time.

After doing TRT for a month, I noticed a new sound - a whistle/ringing in both ears (inside my head) which I initially associated with computer use, but which still hasn't subsided now, two months later, no matter if I use the computer during the day or not. Now, this may be also related to the fact that three months ago I reduced my evening dose of X from 0.5 to 0.25, but doesn't seem likely to me, as it would probably already go away by now.
My current t level, in the evening, is above 20 dB, which I can only say by comparison to a whisper being 30 dB.
When I put my earplugs on in a quiet area, the t seems unbearably loud, it almost hurts my ears. Three years ago, I would put my earplugs on and only hear a soft hissing.

Either that, or decide not to care if it ever increases again. Do you think that would work?

No, I do not think that would work any more than my deciding not to care if my wife's breast cancer recurs.

I am very sorry to hear your wife had breast cancer. But she's lucky to have you at her side.
I absolutely don't think that would work, either.

I realize that I have been loading you up with a lot of questions...

None more than I have been asking myself almost daily. It's nice to have a dialogue instead on a monologue, though

Thanks and regards

Ana
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