Friday Audiogram: Unmasking Tinnitus with Dr. Alexandra Tarvin

Ever wonder why your ears won't stop ringing? The answer might surprise you. 

Welcome to our brand-new Friday Audiogram series! Every week, we'll deliver a concentrated 7-10 minute dose of hearing healthcare wisdom you can enjoy anywhere—even while standing in line at the grocery store. These bite-sized episodes bring you essential insights from our extensive catalog of conversations with industry leaders.

In this inaugural Friday Audiogram, we tackle the complex relationship between tinnitus and hearing loss. Many patients mistakenly believe their tinnitus prevents them from hearing properly, but the reality often runs in the opposite direction. As Dr. Tarvin expertly explains, for many people, hearing loss comes first, with tinnitus developing as a symptom of that auditory deficit. This "chicken or egg" relationship requires careful unraveling during patient consultations.

We also explore the power of motivational interviewing in hearing healthcare. By asking open-ended questions like "Tell me your story," practitioners can uncover crucial information about patients' true concerns. This patient-centered approach helps distinguish between perceived problems and actual underlying issues, leading to more effective treatment plans.

Dr. Tarvin shares her personal journey to tinnitus specialization, which began when she recognized gaps in her knowledge while trying to help distressed patients. Her background in neuroscience provided the perfect foundation for exploring tinnitus management—where audiology intersects with cognitive health and emotional wellbeing.

The Hearing Matters podcast has grown beyond our wildest expectations, now reaching listeners in over 4,100 cities across 212 countries. We're grateful for every one of you who presses play and shares these conversations. Subscribe now to catch every Friday Audiogram and join our global community of hearing health advocates, professionals, and patients.

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Chapters

• 0:00 Introducing Friday Audiogram
• 1:10 Tinnitus vs Hearing Loss Management
• 3:32 Patient Stories Reveal True Issues
• 4:57 Dr. Tarvin's Journey to Tinnitus Specialization

Transcript

Blaise M. Delfino, M.S. - HIS: 0:00

Happy Friday everyone. This is Blaise Delfino and I'm really excited to share with you something new that we're trying. Welcome to the very first Friday Audiogram. Every Friday, we'll be bringing you a 7-10 minute highlight, sometimes from the latest episode, sometimes from an older one that deserves a second listen. Now, why is this? Because hearing healthcare is not a one-and-done conversation and before we head into the weekend I want you, our community, to know. One, you made it through the week. Two, you made a difference, whether you work in hearing health care, advocate for it or live with it daily. And three, you're not alone. The Hearing Matters podcast has grown into something bigger than we ever imagined 200 plus episodes, listeners in 4,100 plus cities across 212 countries. It's all because of you pressing play and sharing these stories. So here's to starting a new tradition together, one that's short, meaningful and worth listening to, even in line at the grocery store.

Blaise M. Delfino, M.S. - HIS: 1:06

This is the Friday Audiogram. Let's go Now. Let me ask you about tinnitus masking because, being a hearing care professional myself, being a former private practice owner, the technology today has brilliant tinnitus masking. But let me ask you. Let's say you just had a patient walk in and they say I have tinnitus and I. But let me ask you let's say you just had a patient walk in and they say I have tinnitus and I believe I have hearing loss, and they do in fact, present with hearing loss and also tinnitus, what are you managing first and what does that look like? Because I feel like we can help a lot of patients here with this question.

Dr. Alexandra Tarvin: 1:43

I really like to ask tell me your story, what brought you here, what prompted us to meet? What's been going on? I learned so much from that question because the patient will uncover and reveal to me what their main problem is. That's very, very different. We do ask the question. You know what seems to be your main issue on the questionnaires, right, hearing, tinnitus, sound sensitivity, right. So we are asking those questions on the intake. But when I ask the patient to really give me information on their story, that can uncover some really helpful information.

Dr. Alexandra Tarvin: 2:20

Here's why there is so much misunderstanding out there on a lot of health conditions, hearing and tinnitus being included. A lot of people have a misconception that if the ringing or the buzzing would just get out of the way, they would be able to hear X, y or Z. That is the number one misunderstanding with tinnitus. The tinnitus is there because of the hearing loss for many people not everybody, but for many people. The hearinginnitus is there because of the hearing loss for many people not everybody, but for many people the hearing loss was there first. That is the chicken or the egg, depending on how you think about it. So the tinnitus is just also there. It's there as a symptom of that auditory deficit, and so a lot of people will say I have a major, major hearing problem, but it's all because of my tinnitus.

Dr. Alexandra Tarvin: 3:07

And so then, if somebody did not ask any additional follow-up questions, you would say, okay, well, we need to address of tinnitus for all of these communication issues. The communication issues is actually their presenting problem, and so now we know that we need to handle their hearing loss right. But the flip of that happens all the time too, and so it's really about having the knowledge and having the experience to ask these questions and uncover and follow the journey that the patient will take you on to figure out. Okay, but what is the actual issue? Not what they think the issue is, but what is the actual issue.

Blaise M. Delfino, M.S. - HIS: 3:49

And early in my career. You have your patients and you just want to help, yeah.

Dr. Alexandra Tarvin: 3:54

Yeah.

Blaise M. Delfino, M.S. - HIS: 3:57

To learn you have two ears and one mouth. For a reason, listen twice as much as we speak. And to learn that motivational interviewing is in the best interest of your patient number one, but also you, and just listen to what they're saying and asking the correct follow-up questions. And because this patient could say well, I worked at the steel mill for 35, 40 years back in the day and you're like well, you definitely did not wear any hearing protection, so that's could is probably the cause of your hearing loss and now tinnitus. And thank you for bringing us through that, because some clinicians of course have their own philosophy with that.

Blaise M. Delfino, M.S. - HIS: 4:36

But as it relates going back to best practices, if you are implementing those best practices, as every hearing care professional should, the patient should, with that proper care and management, walk out of the clinic with a smile on their face because they know that they've come to the right place. And I believe that's a great segue here, dr Tarvin, to really talk about your why. We've dove into a couple of the complexities of tinnitus, but I want our listeners to know your journey. What initially drew you to begin specializing in tinnitus management? Because not every hearing care professional specializes in this.

Dr. Alexandra Tarvin: 5:15

Absolutely yeah.

Dr. Alexandra Tarvin: 5:16

So I don't handle things well when I don't understand them well, and so I was a newer audiologist.

Dr. Alexandra Tarvin: 5:24

I had graduated and was working in private practice and started coming across a lot of patients that were experiencing tinnitus, and some of which didn't care, and some of them really did care, and for those that were really more disturbed or bothered by it, I found that I was lacking the skills, the knowledge and the tools to be able to walk through that journey with them, and so I no longer felt like I was doing them the greatest service, and that really did not sit well with me.

Dr. Alexandra Tarvin: 5:51

Then I thought it was a bit confusing, and then I thought, gosh, this is the brain, and I started taking some online courses and classes and reading articles that were being put out within our professional space and reading journals and figuring out like there's so much more to learn, but I want to do it in a more structured way, and so I ended up going up to Boston and doing a more advanced course with the Tinnitus Practitioners Association at the time and meeting a lot of other professionals that were also committed to either having worked with tinnitus care for a very long time or were newer to it like me, and it just started assuaging all that curiosity because I came into audiology through neuroscience and so I was very interested in how the brain worked and centers of the brain and the emotional response system, and I was already really kind of more heightened to caring about that, and so this seemed to really check my boxes on further incorporating cognitive health, mental health and neuroscience into the profession of audiology, which has a lot of full circle moments.

Dr. Alexandra Tarvin: 6:54

I won't get into all the stories there, but it really felt like, okay, this is another check here that makes this feel like I'm well suited for this because I care about what it is about.