How To TRAIN YOUR BRAIN with Tinnitus and Hyperacusis | Dr. Tracy Peck Holcomb

Dr. Tracy Peck Holcomb is an audiologist who's been providing compassionate tinnitus care for over 15 years.

Ben Thompson, AuD.

Hello to the Treble Health community. My name is Dr. Ben Thompson. I am here with Dr. Tracy Peck Holcomb, who is the newest audiologist at Treble Health. Dr. Tracy joins us with extensive experience, and in today’s podcast, we are going to talk for a long time about the most important things, including why tinnitus success stories are so important, different causes of tinnitus and how that affects treatments, Dr. Tracy’s experience in San Francisco at a major clinic working with tinnitus patients, and what we’re seeing at the time making this video in 2022, with what our patients need to get better. Dr. Tracy Peck Holcomb is an audiologist who’s been providing compassionate tinnitus care for over 15 years. Her clinical specialty is in the area of tinnitus and hyperacusis management. She has served on several advisory boards for both clinical and academic audiology and has given numerous presentations and lectures on hearing and tinnitus throughout the state of California. Dr. Peck Holcomb received her doctor of audiology degree in New York at Buffalo and she is a fellow member of the American Tinnitus Association, as well as a past president and board member of the California Academy of Audiology. Dr. Tracy, welcome and thank you for being here.

Dr. Ben Thompson introduces Dr. Tacy Peck Holcomb, a new addition to the team of audiologists at Treble Health and they discuss tinnitus, hyperacusis, treatment, technology, and more.

Tracy Peck Holcomb, AuD.

Thanks so much for having me. It’s a pleasure to be here.

Ben Thompson, AuD.

Yeah. We want to know about your experience with tinnitus and hyperacusis, what you’ve seen over the years. Please tell us a bit about how this whole journey started becoming an audiologist, and learning about tinnitus and choosing to specialize in this field.

Tracy Peck Holcomb, AuD.

Absolutely. So I actually started in undergrad. I happened to just see in the course catalog a course on speech and hearing sciences, and it looked interesting and signed up, and pretty quickly realized that I really liked the audiology track. I liked the neuroscience of it, I liked the counseling part of it. So my undergraduate degree from the University of Buffalo is in communicative disorders and sciences, and then it just happened to be, I mean, UB has a pretty big tinnitus researchers in the field. So I kind of just serendipitously was exposed to tinnitus, There was a tinnitus support group, a lot of information and exposure to that, which I think, you know, there’s not, at least at that time, there wasn’t a lot of that at different AUD programs. So I think that piece of it, and then just also kind of having a strong interest in psychology and counseling, it was sort of the perfect blend of, you know, my interests. And so from there, I came out to San Francisco where I did my fellowship year to get my doctorate at the Hearing and Speech Center. And again, just really luckily ended up working under Dr. Malvina Levy, who is well known in the Bay Area for her work in tinnitus. And so I happened to just be lucky in getting, you know, mentored by her, having the opportunity to co-facilitate with her, the monthly support group that’s still going on at the center, and just kind of, it was the perfect fit for me of my clinical interests and just, it’s just been a really, you know, great sort of career path for me to be able to help patients who, you know, have been around and around searching for help, searching for providers, searching for answers and to be able to provide that for people is just really, really gratifying.

Ben Thompson, AuD.

Absolutely, and we’re happy you’ve chosen this specialty. If you can think back, what were those first few moments when you saw that someone with bad, loud, bothersome tinnitus could get better? Where did you first see that in San Francisco, and how did that affect your future? You know, I remember personally, moments like that, gave me the confidence to counsel patients and explain, “Hey, we can get better here, “that most people can get better.” Do you recall similar experiences when you first started working with tinnitus patients in San Francisco?

Tracy Peck Holcomb, AuD.

Yeah, I mean, I think, you know, it’s hard when you’re a new provider, especially with a clinic population that, you know, has been struggling a lot and having a really hard time, it can be pretty intimidating. I think my mentor sort of just threw me into it, which was probably the best thing to do. And, you know, I could see, I mean, people were coming in just completely distraught, and sort of have tried, you know, tried everything, seen, like I said, seen multiple providers, feeling pretty hopeless. And even just having one appointment, one session, and sort of taking the time to validate what they’re going through, it’s a real thing to take a moment to say, like, I hear you. And yes, like there are some things, there are lots of things actually that we can, you know, work on together to get better. And even just that, I think like a lot of times, even now I hear at the end of initial sessions with patients, they’ll say, “You know, I’m leaving today with a feeling of hope. “I’m leaving today with a sense of like, “I have some power over this, “like I have things that I can do.” And that’s just, it’s huge. It’s a huge part of the beginning of that journey to getting better with your tinnitus.

Ben Thompson, AuD.

Yeah. Tell us about your approach to comprehensive tinnitus care, comprehensive tinnitus management, if someone consults you via telehealth now, or when you previously worked at a clinic in person, what is your path, what is your protocol so to speak of how you assess what is really going on and what we can do about it to help?

Tracy Peck Holcomb, AuD.

So I think my general approach is I really like to get like an extensive case history. I like to really hear what, you know, patients are, have been through, you know, how they think their tinnitus started, how it’s impacting their day to day, their sleep, their stress levels, their family interactions, like all the things that I think can make it really challenging at first to feel like you can manage around it, right? So getting a really extensive case history is really important to me. Establishing that rapport with patients and that level of trust, ’cause I think there’s an inherent, for a lot of patients, there’s this level of like, well, you know, what are you going to be able to do for me? You know, I’ve tried everything. So I think that’s really important to establish, and I think just like, again, validating, you know, this is a real thing, but it’s also something that can get better, and you know, we’re going to work together to customize a plan for you. And I think the other big piece is, that piece of it, that customization. So there are lots and lots of things you can do to help with tinnitus. I think what works for one person might not work for another. So it’s a matter of kind of, you know, fine tuning and finding what combination of different strategies, whether it be sound therapy, whether it be cognitive behavioral techniques, whether it be, you know, mindfulness and meditation, or a combination of all of those things. I think it’s figuring out what’s going to work best for that patient, meeting them where they’re at, and then guiding them through that journey to getting better.

Ben Thompson, AuD.

How long do you typically work with tinnitus patients, for example, weeks, months, over a year, what’s the different timeline that you’ve found after your, you know, over 10 years of specializing in tinnitus? What are the typical time ranges that patients need to get better, to improve to a manageable level where they might be able to manage this on their own and not need the support or the technology?

Tracy Peck Holcomb, AuD.

It varies. I mean, it definitely varies. It depends on where people are at in that journey when they find me, or when, you know, I meet with them. But I think if it’s somebody who’s coming in who, you know, tinnitus is relatively new to them, the onset is relatively new, that within, you know, within the first couple of months or so, you can start to implement some things that help to give them some relief, which as you know, too, you know, from working with patients for several years now, that initially getting that kind of sense of relief, sense of, some sense of control, a little bit of, you know, empowerment goes a long way. But yeah, I mean, I think on average, you know, within three months, if people are kind of doing the things that we know can help, there’s a significant shift. I have had patients, you know, where it takes longer, six months, nine months, but by, you know, by, I’d say on average around six months or so, like most people are doing much better, feel much better. The tinnitus is not controlling them. You know, they’ve regained some of their life back, you know? And so it’s self-fulfilling once you start to feel a little bit better, and the noise or the sound isn’t as bothersome as it was in the very beginning, that fight or flight response has sort of settled down, it progresses pretty quickly to feeling better and having a handle on it.

Ben Thompson, AuD.

Yeah.

Ben Thompson, AuD.

I want to share a story that two and a half years ago, I reached out to you to ask if I could come join your tinnitus support group in San Francisco.

Tracy Peck Holcomb, AuD.

Yeah.

Ben Thompson, AuD.

And at the time I told myself that I want to specialize more and more in tinnitus. I want to learn more about the community. I was seeing patients, yes, but I wanted to create something which ended up becoming a YouTube channel. And I remember being around that table, there was about eight of us. It was one of the first times that I had been so close to a group of individuals in a support group setting. And at first I want to say thank you for letting me sit in on that session, and also gain some insights from your experience leading groups, seeing people go through these cycles of tinnitus, come to the group distraught, get help one on one, be a part of the group and then graduate, right? Leave, move on as most do. What insights do you have from your years of leading the tinnitus support group in San Francisco?

Tracy Peck Holcomb, AuD.

I mean, the beautiful thing about that group is that every, you know, it’s once a month, and you never know. You never know who’s going to show up. You never know that the sort of like combination of people who are going to join. And I think that that’s incredible, because sometimes you have people who are all very newly dealing and trying to cope with their tinnitus. And then you have sometimes people that are sort of in that boat. And then you have people who have, you know, had it for many years, but are doing pretty well, and just kind of want to check in and get that sort of moral support, that sense of peer support and group support, which I think is just so important. And you just, you see this, you know, I try in the group, I try not to, you know, I can talk a lot, but I try to sit back in those groups, and just let the kind of peer to peer mentorship, the peer to peer support come through. And people have just wonderful tips and wonderful ways that have worked for them that they’re so happy to share with people who are kind of newly in and coping, and trying to deal with their tinnitus. And it’s just, it’s so impactful for me facilitating that group to hear from everybody, and I learned just as much during those groups as the people who attend the group. So it’s just such a really cool format for people to share their stories, and to feel like, you know, they’re not alone. And again, there’s a lot you can do, you know? So I think it supports, literally supports kind of the work that you’re doing individually, you know, that people have done on their own. So it’s fantastic. The group piece is pretty phenomenal. Yeah.

Ben Thompson, AuD.

And we plan to continue our own Treble Health monthly group Zoom that’s for any active member in one of our programs. And you also plan to continue to lead the San Francisco group as well, correct?

Tracy Peck Holcomb, AuD.

Correct, yeah. And I just, I also wanted to mention just, you know, during COVID, we shifted to doing the group virtually as a lot of people shifted to doing things virtually. And it just, it’s one of the things that actually drew me to Treble is because just that format, you know, we used to have maybe eight to 10 people, you’re driving into San Francisco, you’re trying to find parking, it’s, you know, not at opportune time. So the virtual format, the virtual platform opened it up significantly. We had people joining from all over the country. So it just was like, wow, like we can really have such a bigger reach in this kind of setting. So that was one of the things actually that had me interested in Treble, so. Yeah.

Ben Thompson, AuD.

In your opinion, what are the benefits now that you’ve been doing telehealth for about two years, right, since COVID started at the time of recording this video. And for us at least, telehealth is something that started with COVID, but will persist and continue on long past it. In your opinion, for giving the best possible care to someone with tinnitus to get the best possible outcomes, that’s what we’re here for. Everything we’re doing as a company is certainly, you know, geared towards that, that’s our goal. In your opinion, what are the pros and cons of telehealth for the tinnitus patient, right? Are there any in person tests that are mandatory, necessary, that someone with tinnitus should definitely get? And then what might be the advantages or the benefits of the virtual or the Zoom format in telehealth for someone with tinnitus?

Tracy Peck Holcomb, AuD.

Yeah, I mean, you definitely want to have, you know, you want to have individuals who have had kind of a thorough diagnostic evaluation, you know, you want to make sure to rule out anything that would warrant kind of–

Ben Thompson, AuD.

Hearing test, right?

Tracy Peck Holcomb, AuD.

Yeah, having a hearing test, you know, making sure that, you know, middle ear function is okay, that there’s not sort of a mechanical issue, you know, wax is blocking the ear, eardrum, things like that. I mean,