Tinnitus and Hyperacusis

The University of Wisconsin Tinnitus, Hyperacusis, and Misophonia Program provides an individualized management plan to individuals age 18 and older with debilitating tinnitus, hyperacusis, and/or misophonia. While there is no cure, we can offer strategies to provide relief and control. The clinic runs on most Tuesdays during the academic year and summer term.

If you have debilitating tinnitus or misophonia and are interested in scheduling an appointment, please complete the confidential survey: https://go.wisc.edu/ktyyfo

Tinnitus

These visits are designed to provide tinnitus support to discuss your experience with tinnitus, its impact, and tools you can employ to manage your tinnitus and achieve habituation.

The first visit: A comprehensive case history designed to scale the impact of tinnitus on activities of daily living and a comprehensive assessment of hearing, tinnitus and hyperacusis. No management strategies will be provided during this visit

Subsequent visits may include: Demo hearing aids and/or sound generators, learn about your results, obtain an understanding of how hearing works, learn about theories of the mechanisms of tinnitus, advice to improve your situation, and a plan for management.

Please note that sound therapy is an integral part of tinnitus management. Many hearing aids have built in sound generators. If you have hearing aids from Oticon, Phonak, GN Resound, Widex, Signia, or Starkey they most likely have a sound generator that we can activate and program. We cannot program hearing aids purchased from Costco, Beltone, MiracleEar, or over the counter hearing aid companies that sell locked hearing aids. If you have health insurance coverage for hearing aids, we encourage you to obtain your unlocked hearing aids under your insurance coverage.

Please go to Emergency Care or Ear, Nose, and Throat (ENT) immediately if you experience the following:

• Injury to your body
• Weakness or paralysis of any muscles in your face
• Sudden unexplained hearing loss in one or both ears
• Extreme anxiety or depression
• A current plan to end your life or a way to do it

Misophonia

The University of Wisconsin Tinnitus, Hyperacusis, and Misophonia Program employs a transdisciplinary approach to misophonia management. Currently there are no evidenced-based treatments available for misophonia. However, there are coping strategies designed to support those with misophonia. During your appointment, we will conduct a survey of the impact of misophonia, discuss current scientific research, and strategies to prevent and manage symptoms. Management strategies include strategies from a variety of disciplines such as audiology, psychology, neurology, and occupational therapy. If suggested, we will evaluate your hearing and measure your tolerance to sounds. In addition, in some cases we may recommend the use of ear level sound generators.

Candidates for misophonia management are 18 or older, at least average intellectual ability, and are willing to utilize sound therapy.

Telehealth

Per licensure laws, in order to receive services via video visit, you must be located in Wisconsin. We may deliver part of this program through the use of videoconferencing software and dedicated videoconferencing hardware and secure web-based programs. This information is transmitted over a web-based connection. Network connection speed affects overall quality of video and audio clarity. Upload and download speeds should be no less than 5 MB. To determine if you meet these requirements, go to www.speedtest.net  You can also use your mobile network on your smartphone, but know that streaming video can use a good amount of data so WiFi is preferred. If videoconferencing is not an option, we can implement a plan over the telephone. It is still recommended you have access to a computer to view the visual aids.

Cost of the Program

Our facility is a teaching clinic and your management plan will be done by doctoral graduate students in Audiology under the supervision of a licensed Audiologist. By using our services you agree to permit professionals and pre-professionals to observe assessment and management sessions.

The cost of the tinnitus management program:

• $2,725: This includes two rechargeable standard level technology hearing aids with sound generators, a comprehensive evaluation, and a management plan over three visits. Additional visits are billed at $50 per 30-minute increments.
• $1,725: This includes ear level sound generators a comprehensive evaluation, and a management plan over three visits. Additional visits are billed at $50 per 30-minute increments. There is an extra charge for Bluetooth rechargeable sound generators. Please note that if you have hearing loss you will need a combination device.
• $500: If you have hearing aids with build in sound generators that you obtained from an audiologist from Oticon, Phonak, GN Resound, Starkey, Signia, or Widex. This includes a comprehensive evaluation, programming of sound generators, and a management plan over three visits. Additional visits are billed at $50 per 30-minute increments.

The cost of the misophonia management program:

• $1,525: This includes ear level sound generators a comprehensive evaluation, and a management plan over three visits. There is an extra charge for Bluetooth rechargeable sound generators. Additional visits are billed at $50 per 30-minute increments.

Insurance

This clinic is not affiliated with UW Health or UW Hospital. This is a self-pay clinic and if you wish to bill your insurance directly for Out-of-Network reimbursement you will be provided the procedure codes. The University of Wisconsin Tinnitus, Hyperacusis, and Misophonia Program does not bill insurance and is not responsible for the amount of reimbursement or the difference in the reimbursement and the cost of services. Medicare and many insurance companies do not cover audiological treatment options for tinnitus such as hearing aids, sound therapy devices, tinnitus maskers, tinnitus treatment, or counseling.

About your Audiologist

Jon Douglas, Au.D. is an expert in tinnitus management. Dr. Douglas earned his Doctor of Audiology degree at the University of Wisconsin – Madison. He’s had extensive training at Mayo Clinic and has been working with patients of all ages since 2006. He is board certified in tinnitus management, trained under Dr. Jastreboff in Tinnitus Retraining Therapy, certified in Progressive Tinnitus Management, and trained in Cognitive Behavioral Therapy for Audiologists. He also has a certificate in Mindfulness-Based Stress Reduction and training in Coping With Misophonia: Regulate Reason Reassure (RRR). He is a member of the American Tinnitus Association, Tinnitus Retraining Therapy Association, and Misophonia Provider Network. Dr. Douglas’ passion for hearing and tinnitus is life long as he has worn hearing aids since early childhood and also has tinnitus.

PLEASE READ

Please go to Emergency Care or Ear, Nose, and Throat (ENT) immediately if you experience the following:

• Injury to your body
• Weakness or paralysis of any muscles in your face
• Sudden unexplained hearing loss in one or both ears

Please go to Emergency Care or a Mental Health Clinic if you experience the following:

• Extreme anxiety or depression
• A current plan to end your life or a way to do it

Please contact your physician for a referral if any of the following apply to you:

• Symptoms of Meniere’s disease
• Tinnitus that pulsates with your heartbeat (pulsatile tinnitus)
• Ear drainage
• Ear pain
• Dizziness
• Newly onset tinnitus, hyperacusis or hearing loss
• Progressive tinnitus or hyperacusis
• Conductive hearing loss
• Hearing loss worse in one ear

Although a medical exam is always in your interest, it is reasonable to consider forgoing an ENT exam if ALL the conditions are met:

• Bothersome tinnitus or hyperacusis that is in both ears and does not pulsate
• Tinnitus or hyperacusis following a history noise exposure
• Stable and long duration (greater than 6 months)
• Sensorineural hearing loss that is the same in both ears OR typical hearing thresholds in both ears