THIS Is Your Best Chance To Relieve Tinnitus | Ask Treble Health Show Ep. 5

主持人，医生。

Host, Doctor.

本·汤普森，Treble Health的创始人。

Ben Thompson, founder of Treble Health.

我是一名耳鸣专家。

I'm a tinnitus specialist.

今天，我们将回答耳鸣群体的问题。

Today, we'll be answering questions from the tinnitus community.

首先，我们有克莱顿。

First up, we have Clayton.

克莱顿，欢迎来到节目。

Clayton, welcome to the show.

你来自哪里？

Where are you calling from?

我在加拿大曼尼托巴省的温尼伯。

I'm in Winnipeg, Manitoba, Canada.

太棒了。

I love it.

真的很棒。

I love it.

我们的邻居住在北方。

Our neighbor's up north.

那你今天想问什么问题呢？

And what's your question today?

我确实有个问题。

I guess I I have one question.

我目前正在经历一种波动，就是那个大家都不愿提起的词。

I'm I'm currently going through a fluctuation or the s word that nobody likes to use.

而且

And

就直接说吧，那可不是脏话。

Use the word because it's not a swear word.

我们可以用这个词。

We can use it.

只在我的左耳出现了突发性耳鸣。

Spike in my left ear only.

而且耳朵里有种胀满感，这对我而言特别奇怪。

And it's there's, like, a fullness to it, which is very odd for me.

我平时从来不会这样。

It doesn't I don't normally get that.

至于耳鸣，我慢慢能应对了，但这种胀满感真的快把我逼疯了。

But I guess I the ringing, I'm starting to get a handle on, but the fullness is absolutely driving me insane.

我还在想，可能因为这种胀满感，我听不清某些音调了，这比耳鸣本身更让我担心。

And I'm just wondering, like and it seems like maybe I'm losing some tones due to the fullness, and I was just that worries me more than the ringing itself.

耳朵发胀、感觉堵住，这让我想到一些可能的病因。

So fullness in the ears or the ear feeling plugged, that has me wonder about certain conditions.

常见的原因包括咽鼓管功能障碍，或者鼓膜后方有压力之类的情况。

Common conditions that could be that would historically be eustachian tube dysfunction, pressure behind the eardrum, that kind of thing.

不过，对于耳鸣来说，有些比较细微的原因会导致耳朵后面有堵塞感，这可能和你的耳鸣有关。

However, for tinnitus, there's some nuanced things that can cause fullness behind the ears that could be related to your tinnitus.

其中一个可能是鼓膜张肌综合征，就是连接耳膜的一块小肌肉过度紧张，患者可能会听到噗噗声，有时还会觉得耳朵堵着。

One of them is tensor tympani syndrome, where small muscle connected to your eardrum can be very tensed, and patients can hear a fluttering sound and sometimes experience fullness.

另一个可能跟颞下颌关节的肌肉有关。

Another one could be trouble with TMJ muscles.

颞下颌关节，就是连接下颌骨和太阳穴那块骨头的关节。

So the TMJ, temporomandibular joint, which connects the mandible, the jaw, to the temple bone.

这个关节如果太紧，会把肌肉和神经信号传到耳朵后面，也可能让耳膜绷紧，产生那种堵塞感。

That joint can be tight and can send musculature and nerve signals up behind the ear, and that can also kind of tense the eardrum there and create this feeling of fullness.

你有没有排查过这两种情况？

Have you investigated either of those?

我有时候能通过打哈欠或者吞咽让耳朵‘啪’一下打开，但总觉得说不清楚。

I'm able to pop them and stuff like that, but it's always like a I don't know.

就是一种特别怪的感觉。

It's just the weird feeling.

我从18岁就开始有耳鸣了，现在都50岁了，这事儿一直跟着我。

It's been something I've been dealing with pretty much since I've had like, I've had tinnitus since I was 18, and I'm 50 now.

这条路走了很久，但耳鸣确实贯穿了我的整个人生。

So it's it's been a long road, but, like, this this has been an issue in my whole life.

所以我也没太把它当回事。

So I I'm not too worried about it.

我就是经常捏捏鼻子鼓鼓气，过一会儿就自己恢复正常了。

I just pop my ears as much as I can, and and eventually it goes back to normal.

不过这次有点不一样，已经持续三天了。

But this is just something odd that has been about three days now.

我倒不特别担心，只是这情况以前没出现过。

So I'm not super worried about it, but I it's just it's new.

通常我一有堵塞感，一两个小时就没了，完事就完事了。

It's not something that like, usually, when I get the fullness, it's gone in an hour or two, and that's it.

是的。

Yeah.

咱们先来排除一些可能的医学原因。

Let's let's try to rule out some medical reasons.

如果这些都排除了，我们就重点看看怎么控制波动，怎么保持与神经系统的连接，让自己稳住，这应该只是个短暂的小插曲。

And then if those are ruled out, let's focus on how to control fluctuation, how to stay connected to your nervous system, stay grounded, and it should just be a temporary blip of time.

谢谢你提这个问题。

So thanks for your question.

不客气。

No problem.

好的。

Alright.

接下来是《Ask Treble Health Show》的特别嘉宾。

Next up on the Ask Treble Health Show, we have our special guest.

你好。

Hi.

你叫什么名字？

What's your name?

我叫内达，明天要和你们团队的人进行第一次咨询。

My name is Neda, and I'm having the first consult tomorrow with someone from your team.

我看了很多你做的视频。

And I've been watching a lot of the videos that you have hosted.

昨天我看了你导师贾斯特博夫的那期，学到了很多关于耳鸣的知识。

I watched yesterday the one with Jasterboff, who was your mentor, and I learned a lot about the state of tinnitus.

我想问一下，你听说过Lenire设备吗？

I wanted to ask you, have you heard of the Lenire device?

当然知道。

Absolutely.

我了解这个设备已经七年了，它从2018年起就在欧洲推出了。

I've known about it for seven years now, but it was available in Europe since 2018.

嗯，是这样。

Right.

那你对这个设备怎么看？

So what are your thoughts on that?

因为我觉得，要是早点发现你们就好了。

Because I understand, I wish I had discovered you guys earlier.

我住在弗吉尼亚州的费尔法克斯，但我一直去马里兰大学医学中心的耳鸣诊所。我双耳慢性耳鸣十年了，不过我一直靠自己的声音疗法来应对。

I live in Fairfax, Virginia, but I have gone to the UMD Tinnitus Center for I had tinnitus chronic in both ears for ten years, but I've managed it with sound therapy on my own.

他们给我做了第一阶段咨询，我打算继续做第二阶段。

But they gave me the stage one consultation, and I'm going to try to go for stage two.

他们做的就是你跟医生……

And they do what you and Doctor.

Drustre 两人都推荐，就是同时进行 CBT 和 TRT，通过一些设备来实现。

Drustre both recommend, which is like concurrently doing the CBT and also the TRT through some devices.

但我没有资格做人工耳蜗植入，我也不打算做那个。

But I'm not eligible for a cochlear implant, I'm not looking for that.

不过我有资格使用 Lenire 设备，但它要四千美元，你懂的？

But I am eligible for the linear device, but it's $4,000 you know?

另外马里兰大学还有一种叫掩蔽器的东西，我想是因为我右耳的耳鸣加重了，他们给我配了个掩蔽器，说是能调整噪音来匹配我的耳鸣频率，或者类似的作用，帮我分散注意力。

But there is also something called a masking device that the University of Maryland does, which is I guess they put something because it has intensified in my right ear, and they put a masking device that supposedly aligns the noise to your tinnitus pitch or something to help you distract.

但我去了首都听力与平衡研究所的门诊。

But so but I went to the capital hearing of Capital Institute of Hearing and Balance.

他们就在北弗吉尼亚，正好在我住的地方。

They are here in Northern Virginia, which is where I'm at.

他们有个新应用，叫 Auto。

So they have this new app called Auto.

在我看来，对你这种情况，最系统的做法是抓住两个根本：一个是声音疗法，一个是认知干预。

So the systematic approach, in my opinion, for most people in your case, would be focus on the two fundamentals of how do we reduce tinnitus, which is a sound based component and a cognitive based component.

这两者都能促进神经可塑性，减轻耳鸣，帮助神经系统恢复常态。

Both of these are going to promote neuroplasticity, reduce the tinnitus, restore normal function to the nervous system.

对于只有耳鸣、没有听力损失的患者，理想的做法是使用外观像助听器的声音治疗设备，专门播放治疗音，这一点很重要。

So for a patient who only has tinnitus, no hearing loss, then the devices, the sound component, ideally, it would be sound therapy devices on the ears that look like hearing aids, but they're just providing sound therapy, which is important.

如果有人同时有听力损失，那就用经过编程的助听器，既能助听，又能提供耳鸣治疗音。

Or if someone has a hearing loss, then the devices would be hearing aids programmed for tinnitus with tinnitus sound therapy plus hearing aid treatment.

所有这些设计，都是为了让你的耳鸣状况好转。

That is all designed to get your tinnitus better.

另一方面，是认知层面的核心部分。

On the other side of it, the cognitive pillar fundamental.

认知行为疗法经过大量严谨研究证实。

CBT is, through rigorous research.

它是研究最多、证据最充分的方法。

It's the most researched and evidence based.

在一对一的治疗形式下，它在缓解耳鸣方面拥有最坚实的临床证据。

It has the largest base of evidence for something that can help tinnitus when it's done in a one on one capacity.

学会让大脑对声音做出不同的反应，这一点至关重要。

So learning ways that your brain can respond and react differently to the sound, that makes a huge difference.

但大多数患者，还有我接触的几乎所有人，都忽略了这一点。

And that's very overlooked by most patients and nearly everyone I speak to.

所以，对你这种情况，大多数人最该做的是什么？

So really, should most people do in your case?

他们应该问问自己：我到底执行了多少声音疗法的方案？

They should ask, okay, How much of the sound protocol am I following?

我有在多大程度上遵循这套认知或神经系统干预方案呢？

How much of this cognitive or nervous system protocol am I following?

如果还有改进的空间，通常都是有办法的。

And if there's opportunities to improve those, usually, those are available.

这些方法都很经济实惠。

Those are cost effective.

有些事情你马上就能开始做。

There's things you can do pretty immediately.

但有没有一种系统的方法来同时进行这两项呢？

But is there like a structured way to do them both?

你们团队会不会告诉患者，比如，你得做多少声音疗法，多少认知训练？

Like, does your team or do you guys tell the patient, okay, this is how much I want you to do sound therapy versus cognitive?

还是说这两者是同时进行的？

Or do they happen simultaneously?

你提到如果我没有听力损失，那掩蔽器该怎么和我的耳鸣匹配呢？

And you mentioned if I don't have any hearing loss, the mask, how would the masker then be aligned with my tinnitus?

还是说，我直接在iPad上放点白噪音就行？

Or it's just, or can I just put sound on my iPad and white noise?

你问得真好。

I love your questions.

很多听的人其实也有同样的疑问。

So many people listening are having the same questions.

认知训练和声音疗法，这两者都是核心方法。

So the cognitive, the sound, those are both pillars.

它们不是两种不同的路径。

They're not different approaches.

我们会建议你同时进行这两项。

And they would be recommended in unison simultaneously.

两件事一起做。

Do both at the same time.

它们完全不冲突。

They're not contradicting in any way.

是的，有一套标准流程要遵循。

Yes, there is a protocol to follow.

你刚才提到了贾苏博夫医生。

You mentioned Dr.

他开发了一套方法，叫耳鸣再训练疗法。

Jasuboff, so he created a protocol, tinnitus retraining.

这是过去二十年里最成熟、最被广泛验证的方法。

That's been the most tried and true method in the last twenty years.

我们也在用这套方法，只是做了一些调整。

That's a protocol that we use and modify a bit.

同时，我们还会结合认知行为疗法中的具体技巧，帮助人摆脱对耳鸣的过度反应，让神经系统平静下来，让大脑和情绪中枢对耳鸣产生不同的反应。

Simultaneously, there's specific techniques from a CBT, cognitive behavioral therapy, approach that are really helpful to get the mind out of reactiveness, to settle the nervous system, and for the brain and the emotional center of the brain to respond and react differently to the tinnitus.

一旦做到这一点，耳鸣的症状就会随着时间慢慢减轻。

When that happens, the tinnitus goes down over time.

所以我们在Treble Health提供这套治疗方案。

So we offer a treatment at Treble Health.

不过，像我这样在某些诊所或世界特定地区的人，也是耳鸣方面的专家。

However, other people like me who are in certain clinics or certain places in the world, they're also specialists in tinnitus.

这一点你应该很清楚。

And, yes, it it should be very clear to you.

第一周，做这个。

Week one, do this.

第二周，做这个。

Week two, do this.

第三周，做那个。

Week three, do that.

第四周，做那个。

Week four, do that.

通常来说，像你这种情况，至少要遵循这个方案四个月，有时甚至更久。

Usually, in your case, would be following a protocol for at least four months, sometimes longer.

你刚才提到双模刺激，美国确实有一种设备。

Now you mentioned bimodal stimulation, and there's a device in The United States.

它叫线性疗法。

It's called linear.

通过舌头刺激，再配合耳机播放声音。

It goes through the tongue and then headphones over the ears.

有些患者一上来就把它当作首选治疗。

For some patients, they are using that right away as their first treatment.

另一些患者则是试过很多方法之后才用它。

Other patients are using that after they've tried many approaches.

目前还没完全定下来，到底该在什么时候启用这种疗法。

It's still forming of what is exactly the protocol of when to use that.

不过根据我读过的研究和FDA的指南，以及他们为获得批准所设计的实验，最新研究的做法是：先让患者做声音疗法，如果没效果，再尝试线性疗法。

But from my understanding of reading the research, the FDA guidelines, how they set up their research to get FDA approved, The most recent research they ran had people do sound therapy, and then if it didn't work for them, try linear.

也就是尝试双模刺激。

Try the bimodal simulation.

所以我一般建议大多数人：先试试这样。

So that's how I advise most people is, hey.

先把基础打好。

Get the fundamentals done well.

如果三到六个月后效果不明显，就换掉或停下这个方法，改用双模刺激。

And then if that's not working for you over a period of between three to six months, then transition or stop that approach and do the bimodal stimulation.

不是每个人都适用，因为情况各有不同，但总体来说这是个不错的指导方向。

That is not for every single person because there are nuances, but that's a general general way to describe what to do.

非常感谢。

Thank you so much.

你说先做声音疗法和认知训练，具体指的是哪种声音疗法？

And when you say start out with the sound therapy and the cognitive, what do you exactly mean by sound therapy?

是指掩蔽器，还是任何类型的声音疗法都可以？

Is it the maskers, or could it be any sound therapy?

这是个好问题。

It's a good question.

我这么跟你说吧。

I'll say it like this.

如果你来找我，说我想在夏天跑五英里，再减掉二十磅，我会告诉你，最好的办法是吃这样的饮食，做这样的运动。

If you were coming to me and say, Hey, I want to run five miles in the summer, and I want to lose 20 pounds, I would say, Okay, the best thing to do would be eat this kind of diet and do these kinds of exercises.

这就是最佳实践。

So best practices.

对于耳鸣治疗，最佳实践就是尽可能减轻症状。

For tinnitus treatment, best practices means I want to reduce this as much as possible.

这让我很痛苦。

This is a pain for me.

这真的很烦人。

This is annoying.

我不喜欢这种感觉。

I don't like this.

我希望它能完全消失，而最佳实践能帮我们尽可能接近这个目标。

I want it as much gone as Best practices will get us as close to that as we can.

所以耳鸣的最佳实践，就是从耳朵层面进行声音疗法。

So best practices for tinnitus would be sound therapy at the ear level.

它比通过应用或智能手机播放的声音疗法更有效，也和普通耳机或AirPods完全不同。

It's superior to sound therapy through an app or a smartphone or and it's very different than headphones or AirPods.

我可以详细说说这方面的区别。

I can go into some of the details of that.

但如果你问，能不能就用一些基础的方法？

But so if you were to say, well, can I just use some basic things?

可以。

Yes.

如果你的目标是像夏天那样减掉二十磅，那可能需要一个比较激进的方案。

If you're trying to go for that, you know, summer result and lose 20 pounds, we'll probably need a pretty aggressive approach for that.

但如果你只是开始散步、吃点沙拉，身体就会慢慢感觉好起来。

But if you were to just start walking and eat some salad, you'd start to feel a little better.

所以关键在于，你是想要低成本的缓解，还是追求最好的治疗效果？

So the question is, are you looking for just some relief at a low cost, or are you trying to get the best treatment possible?

所以答案要看具体情况。

And that's why the answer depends.

对于那些想要获得最佳治疗效果的人，耳部设备——你去问一百个医生，九十五个都会说，没错，这就是该用的方法。

For people who are trying to get the best treatment possible, devices on the ears are, ask 100 doctors, 95 of them will say, Yeah, that's how you would get it.

非常感谢你的提问。

Thank you so much for your questions.

好的，接下来是约翰。

All right, next up we have John.

约翰到了。

We've got John.

约翰，你有什么问题？你来自哪里？

John, what's your question, and where are calling from?

我来自佛罗里达州北棕榈滩。

Well, I'm calling from North Palm Beach, Florida.

我的问题是，我大概十年前开始有耳鸣，声音挺响的，但还没到特别夸张的地步。

And I guess my question is I I got some tinnitus for, like, last ten years, and my, it's, you know, pretty loud, but not extremely loud.

最近，他开始用助听器了。

And he, recently, started doing the hearing aids.

它们有个遮蔽器，会时不时地发出声音，据说这样能更好地缓解耳鸣，其实就是一种声音疗法，那个遮蔽音是忽隐忽现的。

They they has a mask, and it has a thing where it it'll, like, come and go, and they they're saying that that might be a better way to kinda stop the tinnitus and, you know, like, it's a sound therapy that and it sounds like the blocker is, coming and going on it.

你明白吗？

You know?

但我的听力其实还不错。

And but my hearing isn't bad.

我听得挺清楚的。

I hear pretty good.

只是有些高频声音有点听不太清，而这些助听器正好能弥补这一点。

But some of the higher frequencies, I'm a little bit shy on, and these hearing aids correct correct that too.

那你的目标是希望达到什么效果呢？

So what's your goal for your

我是想尽量减轻甚至彻底消除耳鸣。

I wanted to, well, I guess kind of reduce it or get rid of it as much as possible.

这是长远的目标。

That's over the long haul.

我还记得，你是不是在韦斯顿有个办公室？

And and I think I did I even came down to your you have an office down in Weston?

我现在就在这儿。

I'm here right now.

明白了。

Okay.

我以前去过一次韦斯顿，跟一个人聊过，后来他们建议我来找这边的听力专家。

Well, I went to Weston once, and I talked to somebody and then they said I should see an audiologist up here.

所以我通过保险找到了这边的听力专家，现在正在跟他合作。

That's why I went through my insurance and I'm working with an audiologist up here.

那你现在在尝试什么？

So what are you trying?

你具体在做些什么？

What what are you actually doing?

你说你用了助听器。

You said hearing aids.

还有别的吗？

What else?

没有。

No.

刚配了助听器，但这款助听器内置了耳鸣缓解程序。

Just got the hearing aid, but their hearing aids has a program in it for tinnitus.

你是什么时候开始用助听器的？

When did you start those hearing aids?

大概一个月前吧。

Maybe a month ago.

我很欣赏你现在的状态，也很高兴能和你聊，因为我觉得有些事特别重要，得跟你说清楚。

I love the position you're in, and I'm so glad to speak with you because I think it's really important that I communicate a few things.

耳鸣都十年了，怎么现在才开始治疗？

Why did you start tinnitus treatment now if you've had this for ten years?

为什么偏偏是2025年？

Why in 2025?

嗯，它慢慢变大声了。

Well, it's slowly getting louder.

所以我一直在想，这情况好像越来越糟了。

So so I'm I'm, like, you know, thinking that it's getting worse.

说不定再过五年，那声音会变得特别特别响。

So, you know, maybe in five years from now, it'd be really, really loud.

所以我现在就想趁早把它控制住。

So I'm trying to, you know, nip it in the bud kinda.

明白了。

Okay.

太好了。

I love it.

治疗听力损失，或者用这些设备来应对耳鸣，确实是非常推荐的做法，你做得很好。

Treating hearing loss or using these devices as part of tinnitus treatment is definitely recommended, so nice job with that.

设备的设置方式非常重要。

How they're set up is quite important.

声音疗法是其中一部分。

Sound therapy is part of this.

你之前提到，你脑子里会有一些噪音，或者说是遮蔽声。

So you said that you have some noises or some masking, some blocking inside.

你具体听到的是什么？

What exactly do you hear?

是白噪音吗？

Is it white noise?

是海浪声吗？

Is it ocean waves?

那到底是什么？

Or what is it?

有点像白噪音。

It's like white noise.

听起来像是耳鸣，但频率更低一些。

It kind of sounds like a it sounds like tinnitus, but at a lower frequency.

好的。

Okay.

如果你是我的病人，按我们通常遇到的情况，我会建议你每天佩戴助听设备六到八小时，坚持六个月到八个月。

If you're my patient, and assuming you're the average kind of patient that we see, what I would recommend is that you have those hearing devices in your ears for between six and eight hours per day, and commit to that for a period of six to eight months.

好的。

Okay.

我发现这对大多数人都是适用的。

I've found that that applies to most people.

有些人可能需要戴得久一点，有些人则短一些。

Some people will need to use the devices longer, other people shorter.

这样你就完成了耳鸣治疗的一个关键环节：用对了医疗设备，并且能坚持正确使用。

Then you have one of the pillars of tinnitus treatment covered, which is you have the right medical devices, and you'd be compliant with how to use them.

白噪音是个不错的选择。

White noise is a good sound.

我还会确保白噪音的音量比你的耳鸣声更轻柔。

I would also want to make sure that the white noise is softer than your tinnitus.

我们不希望白噪音比耳鸣声还大。

We don't want the white noise to be louder than your tinnitus.

你是这么设置的吗？

Is that how you have it?

是的。

Yeah.

我觉得它比耳鸣声稍微轻一点，但就像我说的，它有个程序。

I think it's a little bit less loud than the tinnitus, but it's like I said, it it has, like, a program.

我没怎么用过，但有一种模式，白噪音会时有时无。

I haven't used it, but there's one where kinda the white noise kinda comes and goes.

它会慢慢出现，再慢慢消失，他们说很多人会用这种疗法来缓解耳鸣之类的。

It fades in and fades out, and and then, you know, then they were saying that that maybe a lot of people kinda do that type of therapy to kinda stop it or something like that.

你听说过这种做法吗？

Have you ever heard of that kinda?

你的白噪音听起来确实是响一阵，然后又安静下来。

Your white noise actually sounds like it makes noise, then it gets quiet.

没有。

No.

我觉得可以就这样设置。

I say I can have it like that.

好的。

Okay.

明白了。

Got it.

我目前就用这种普通的掩蔽模式。

I just have it on regular masking like this.

好的。

Okay.

明白了。

Got it.

是的。

Yeah.

我建议用持续稳定的背景噪音。

My recommendation would be steady state noise.

就是那种持续的白噪音。

So steady state white noise.

确保噪音是中性的，或者让你感觉舒服的。

Make sure the noise is neutral or positive.

如果听起来让你烦，那我们就得换种声音。

If it's if it's annoying to you, then we need to change the sound.

不过没错，持续稳定的噪音比那种忽大忽小的声音要好得多。

But, yes, steady state noise is better than very fluctuating waves or something like that.

好的。

Okay.

你已经把持续稳定的噪音设置好了，我觉得。

Steady state noise, you have it set up properly, I believe.

现在就剩下坚持使用了。

So now it's just about compliance and using it.

不过，这也引出了另一个问题：我们还能为你的耳鸣做些什么呢？

However, it opens the door of, Well, what else should we do for your tinnitus?

因为这可不是简单地说一句‘你听到声音了，一年后再来’就完事的。

Because it's not as simple as just, Hey, you're hearing it with sounds and come back to me in a year.

你说你住在棕榈滩。

You said you're in Palm Beach.

我给大家讲个小故事。

A little story for everyone.

我叔叔丹尼最近去世了，是个特别好的人。

My uncle, Uncle Danny, recently passed away, great guy.

他娶了当地一家开餐厅的人，那是一家位于西棕榈滩的意大利餐厅。

He married into a family that they owned a restaurant, an Italian restaurant in West Palm Beach.

Testa餐厅很有名，位置就在棕榈滩的水边，环境特别好。

Testa's Restaurant was a well known, great spa, right in the water in Palm Beach.

他们经营了很多年，整整几十年啊，可惜啊。

They operated for many years, unfortunately, dozens and dozens and dozens of years.

可惜后来关门了。

Unfortunately it closed down.

我小时候常去西棕榈滩，那边后院种着葡萄柚树，气候热带，我特别喜欢那里。

I used to grow up as a kid going to West Palm Beach and the areas down there, grapefruit trees in the backyard, tropical weather, so I love it.

这才是生活。

It's the life.

我特别喜欢。

I love it.

我特别喜欢。

I love it.

好吧，现在问题是，除了助听器之外，还有哪些办法。

All right, so now it's the question of what else other than hearing aids, basically.

第一步是，你的助听器调得合适吗？

First step is, are your hearing aids set up properly?

你的调得挺好，给你听力师点赞。

Which yours are, so kudos to your audiologist.

既然你的目标是尽可能减轻甚至消除它，那我们就需要引入认知技巧和安抚神经系统的方法。

Now, based on your goal of reduce it as much as possible, or make it go away or reduce it, that then opens us up into cognitive techniques and settling the nervous system.

具体来说，我会教你一些针对耳鸣的认知行为疗法技巧。

So specifically, things that I would be working on with you would be CBT techniques, cognitive behavioral therapy techniques for tinnitus.

我会让你重点练习针对睡眠和失眠、由耳鸣或其他生活压力引发的焦虑和紧张，同时配合一些有引导的呼吸练习来平复你的神经系统。

I would have you do those focused on sleep and insomnia, anxiety or stress that's in your life because of the tinnitus or other parts of your life, and some guided breathing techniques to settle your nervous system.

这些练习你要在整个六到八个月的助听器声音疗法期间持续进行。

I would have you be doing that during the six to eight month period that you're using the sound therapy through the hearing aids.

明白吗？

Right?

好的。

Okay.

如果这套方法执行到位，耳鸣显著缓解的成功率能达到百分之八十到八十五。

That approach, when it's done well, has between an eighty percent and eighty five percent success rate at significantly reducing tinnitus.

等这段疗程结束，你就可以把助听器的设置调回只用于更清晰地听清别人说话。

Then at the end of that, you can change the settings in the hearing aids so that they're just for hearing people more clearly.

你可以直接关闭声音疗法功能，让助听器只作为听力辅助设备使用。

You can basically turn off the sound therapy so that they're just hearing aids, and you can use them just for your hearing.

这就是治疗耳鸣的完整计划。

So that's the roadmap for tinnitus.

我喜欢在这个阶段和你聊天，约翰，因为有些人用了助听器一个月后，会跟我这么说。

I like talking to you at this stage because, John, some people, when they're a month into this with the hearing aids, they'll say things to me.

他们会觉得，我也没觉得有什么明显改善。

They'll be like, I'm not really seeing much improvement.

我不确定。

I don't know.

有点帮助，但我觉得自己其实没那么需要助听器。

It helps a little bit, but I don't really think I needed hearing aids too much.

我需要的只是减轻耳鸣。

I just needed to reduce tinnitus.

我打算不戴了。

I'm going to stop using them.

我要把它们退了。

I'm going to return them.

我想试试别的办法。

I'm going to try something else.

但事实是，耳鸣治疗需要时间，得有耐心，让大脑在几个月里慢慢适应和重新调整，而不是几周内就指望见效。

But the reality is tinnitus treatment takes time, so we have to be patient and let the brain learn and retrain itself over many months, not over just a few weeks.

你提到的认知行为疗法，具体是怎么做的？是做认知分析吗？

Now, the CBT you're talking about, what do you do for a CBT, cognitive analysis?

你会被安排一些具体的练习、技巧和训练，目的是改变大脑对耳鸣的情绪和心理反应，同时让神经系统平静下来。

What you do would be, you would be assigned specific practices, techniques, exercises that would be changing your brain's emotional and psychological response to the tinnitus, as well as settling the nervous system.

有时候感觉像是健康指导。

Sometimes it can feel like health coaching.

有时候又像心理治疗，但我们用的就是这些方法。

Sometimes it can feel like therapy, but we're using those techniques.

还有些时候，它更像是有引导的呼吸练习，或者某种冥想方式。

Other times it can feel like guided breathing or some forms of meditation.

所以这是一个总称，没错。

So it's an umbrella term, but that's what Yeah.

它

It

我妻子得了阿尔茨海默病，我一直得照顾她。

It was like my wife's got Alzheimer's, so and it's been kind of fed top take care of her.

所以过去几年，我的压力一直挺大的，就是因为这个。

And so my stress level's gone up in the last, like, couple of years because of that.

我觉得可能就是这个让耳鸣变得更响了。

So so I think maybe that's what's making it louder too.

你懂的。

You know?

也许我压力一上来，耳鸣就跟着加重了。

Maybe my with my stress going up, the tinnitus goes up.

很高兴你提到这一点。

I'm so glad you brought that up.

希望你好好照顾她。

Wish you best taking care for her.

没错。

Absolutely.

这种压力正是导致耳鸣加重的隐形原因。

Something like that is the kind of stressor that is this invisible cause of why tinnitus got worse.

我不明白为什么我的耳鸣变得更严重了。

I don't know why my tinnitus is worse.

我觉得我的听力并没有进一步下降。

I don't think I lost more hearing.

我也说不清楚。

I don't know.

是我吃错了药，还是发生了别的事？完全是偶然吗？

Did I take the wrong medication or something happened, was it completely random?

很多时候，连很多医生都想不到这一层关联。

Often, even most doctors fail to connect the dots here.

但确实，耳鸣加重前那三到六个月的压力，或者如果你生活一团乱、身心失衡，绝对会让耳鸣变得更响。

But yeah, stress in the three to six months leading up to when tinnitus got louder absolutely, or if life was under a certain amount of disorder or dysregulation in your system, that can absolutely make it louder.

明白了。

Okay.

好的。

Alright.

好的，约翰。

Alright, John.

谢谢你的提问。

Thanks for your questions.

如果你还需要帮助，可以联系Treble Health。

And if you need more help, reach out to us at Treble Health.

我们在韦斯顿有办公室。

We're we're we're in Weston.

我们在韦斯顿设有一家诊所。

We have a clinic in Weston.

如果你什么时候

If you ever

想过来

need to

就告诉我们一声。

come by, just let us know.

安吉拉，欢迎来到《Ask Treble Health》第六期节目。

Angela, welcome to the Ask Treble Health Show episode six.

我能怎么帮您？

How can I help?

您有什么问题？

And what's your question?

我之前服过一些药。

I had took some medication.

这件事发生在八个月前。

This happened eight months ago.

这个问题已经彻底掌控了我的生活。

This problem has taken over my life.

我不知道该怎么处理它。

I don't know how to treat it.

我也不知道该去哪里寻求帮助。

I don't know where to get any help.

我有个小儿子。

I have my little boy.

我没有任何支持。

I don't have no support.

我孤身一人。

I don't have anybody.

我老家那儿，根本没人遇到这种情况。

Where I'm from, people don't really have this, really.

大家对这事儿一无所知，我真不知道该怎么办了。

And they know nothing about it, and I don't know what to do.

我真的快撑不住了。

I'm I'm at my wit's end here.

它已经完全占据了我整个生活。

I it's just taken over my whole life.

是啊。

And Yeah.

我还年轻。

I'm young.

我三十三岁。

I'm 33.

我不知道还能怎么办了。

I don't know what to do anymore.

我能理解你此刻有多艰难。

You're in a place where I understand how hard this can be.

你身处一个有很多人经历过或懂得你处境的群体中。

And you're in a community of people who have been there or know what you're going through.

我首先想说，我知道这真的很难，我完全理解你的感受。

So I just first want to acknowledge that this is challenging and totally hear you.

过去几个月里，你试过什么办法吗？

Have you tried anything over the months?

有没有尝试过一些简单的策略或措施？

Have you tried to put any strategies in place or tried anything simple?

没有。

No.

过去九个月，差不多一年了，我既没寻求帮助，也没接受任何治疗。

I have not gotten no help and no treatment for it over the past nine months or almost a year now.

明白了。

Okay.

我真的把生活彻底搞砸了。

And I've just completely lost my life.

我现在什么都不敢做了。

I mean, I don't do anything anymore.