Tinnitus Today September 1999 Vol 24, No 3

September 1999 Volume 24, Number 3
Tinnitus day
THE JOURNAL OF THE AMERICAN TINNITUS ASSOCIATION
"To promote relief, prevention, and the eventual cure of tinnitus for
the benefit of present and future generations"
Since 1971
Education -Advocacy- Research - Support
In This Issue:
Changing of the Guard
New Tinnitus Research:
TRT vs. Masking Study and
ATA's. Four New Research Grants
Letters Home
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Tinnitus T o d ~ y
Editorial and Advertising offices: American Tinnitus Associoon, P.O. Box 5, Porriond, OR 97207 503/2489985, 800/6348978 tinnitus@ato.org, http:/ jwww.ota.org
Editorial and Advertising offices: American
Tinnitus Association, P.O. Box 5, Portland, OR
97207, 503/248-9985, 800/ 634-8978,
tinnitus@ata.org, http://www.ata.org
Executive Director: Steve Laubacher, Ph.D.
Edhor: Barbara Thbachnick Sanders
Tinmtus Tbday is published quarterly in March,
June, September, and December. It is mailed
to American Tinnitus Association donors and
a selected list of tinnitus sufferers and profes-
sionals who treat tinnitus. Circulation is
rotated to 80,000 annually.
The Publisher reserves the right to reject or
edit any manuscript received for publication
The Journal of the American Tinnitus Association
Volume 24 Number 3, September 1999
Tinnitus, ringing in the ears or head noises, is experienced by as many
as 50 million Americans. Medical help is often sought by those who have
it in a severe, stressful, or life-disrupting form.
Table of Contents
and to reject any advertising deemed unsuit
9
able for T i n n i n ~ Tbdoy. Acceptance of advertis-
New Directors on Board
ing by Tinntus Tbday does not constitute
endorsement of the advertiser, its products or
services, nor does Tinmtl<s Tbday make any
claims or guarantees as to the accuracy or
validity of the advertiser's offer. The opinions
expressed by conmbutors to Tinmtus Tbday are
not necessarily those of the Publisher. editors,
staff, or advertisers. American Tinnitus
Association is a non-profit human health and
welfare agency under 26 USC 501 (c)(3).
Copyright 1999 by American Tinnitus
Association. No part of this publication may
be reproduced, stored in a retrieval system,
or transmitted in any form, or by any means,
'vithout the prior '>'ritten permission of the
Publisher. lSSN: 0897-6368
Executive Director
Steve Laubacher, Ph.D., Portland, OR
Board of Directors
Paul Meade, Tigard, OR, Chairman
Joel Alexander, Park Ridge, NJ
James 0 . Chinn is, Jr., Ph.D. , Manassas, VA
Claude H. Grizzard, Sr., Atlanta, GA
W. F. S. Hopmeier, St. Louis, MO
Gary P. Jacobson, Ph.D., Detroit, MT
Sidney Kleinman, Chicago, 1L
Stephen Nagler, M.D., Atlanta, GA
Kathy Peck, San Francisco, CA
John Nichols, Scottsdale, AZ
Dan Pmjes, New York, NY
Susan Seidel, M.A. , CCC-A, 1bwson, MD
Tim Sotos, Lenexa, KS
Jack. A. Vernon, Ph. D., Portland, OR
Megan Vidis, Chicago, IL
Honorary Directors
The Honorable Mark 0. Hatfield,
U.S. Senate, Retired
1bny Randall, New York, NY
William Shatner, Los Angeles, CA
Scientific Advisors
Ronald G. Amedee, M.D., New Orleans, LA
Robert E. Brummett, Ph.D., Portland, OR
Jack D. Clemis, M.D., Chicago, lL
Robert A. Dobie, M.D., San Antonio, TX
John R. Emmett, M.D., Memphis, TN
Barbara Goldstein, Ph.D., New York, NY
John w. House, M.D., Los Angeles, CA
Gary P. Jacobson, Ph.D., Detroit, MJ
Pawel J , Jastreboff, Ph.D., Atlanta, GA
William H. Martin, Ph.D., Portland, OR
Douglas E. Mattox, M. D., Atlanta, GA
Mary B. Meikle, Ph.D., Portland, OR
J . Gail Neely, M.D., St. Louis, MO
Robert E. Sandlin, Ph.D., E1 Cajon, CA
Alexander J. Schleuning, ll, M.D.,
Portland, OR
Michael D. Seidman, M.D.,
West Bloomfield, Ml
Abraham Shulman, M.D., Brooklyn, NY
Robert Sweetow, Ph.D., San Francisco, CA
RichardS. 'l)ller, Ph.D., Iowa City, 1A
10 Swan Song
by Robert Sandlin, Ph.D.
12 TRT vs. Masking - A Research Study
by Jim Henry, Ph.D.
14 Letters Home
by Ray Ennis
16 $131,400 for New ATA Research
18 Happy New Year
by Cathie Glennon
19 Announcements
20 Tinnitus: A Blessing in Disguise?
by Richard A. Gardner, M.D.
22 Beethoven and Me
by Julian Crandall Hollick
Regular Features
4 From the Executive Director
by Steve Laubacher, Ph.D.
5 From the Editor
by Barbara Thbachnick Sanders
6 Letters to the Editor
23 Questions and Answers
by Jack A. Vernon, Ph.D.
25 Special Donors and Tributes
Cover: 'Fall Afternoon (oil on canvas, 5'x7" miniature), by Juan Estaban 1bsoni. Inquiries to
the Indigo Gallery, 504 S. Main St., EO. Box 728, Joseph, Oregon 97846-0728, 541/432-5202.
American Tinnius Association Tinnitus 7bday/ September 1999 3
FROM THE EXECUTIVE DIRECTOR
by Steve Laubacher, Ph.D.
I feel honored to have
been selected by the
Board of Directors of the
American Tinnitus
Association to serve as
Executive Director. Gloria
Reich, my predecessor, is
to be commended for her
efforts and contributions
that she made to build and develop the ATA into
the premier health association that is committed
to assisting the estimated 50 million Americans
who have tinnitus. It will be my job to build
upon her success and to work with you and all
of our constituents to take us to even greater
heights. Accordingly, I thought I would share
with you a few of my plans that will, hopefully,
enable all of us to share first in the creation of a
new vision and then the development of steps
to achieve that vision.
Our first effort in this regard has been to
reorganize staff operations to insure that we are
doing the best we can to accomplish what has
already been assigned to us by the Board of
Directors. ATA staff met with the Board at their
June meeting and proposed a new fiscal year
2000 work plan and budget. This work plan con-
tained a new organizational chart and duties
that are all designed to make us as efficient and
effective as possible. Of particular importance is
our attempt to respond quickly to those who
need our help with information that will be use-
ful. We also want to continue to improve the
very popular and successful Tinnitus Today. We
will be reviewing the types of research projects
that, hopefully, will lead to better ways of deal-
ing with tinnitus. Finally, there will be efforts
made to become more involved in advocacy,
governmental affairs, and legislation to insure
not only that maximum research dollars are
available, but to get us involved in public policy
issues such as environmental noise - a known
cause of tinnitus.
4 Tinnitus 1bday/ September 1999 American Tinnitus Association
In addition to these questions we must also
cast an eye to the future with additional effort
paid to strategic long-range planning. 1b that
end we hope to have a new planning process
completed by the end of next spring. This plan
needs to address important issues such as
reviewing our mission and determining if there
might be better ways to achieve our goals. For
example, should we focus solely on tinnitus or
should we begin to address related problems?
Should we have chapters, a national conference,
and more publications? How active should we
be in governmental affairs'? All of these ques-
tions must be answered in order for us to be
sure that we are making the kind of contribution
that can prevent, reduce, and even eliminate
tinnitus. In order to assist with this process, our
Board has committed itself to becoming even
more involved with governance by authorizing
more committee meetings and by becoming
involved in long-range planning. We will keep
you informed of our progress through mailings
and Tinnitus Today.
I would like to invite you to become
involved by sharing your ideas with us. You
could also volunteer to help us out on a Board
Committee in the areas of fund raising, busi-
ness, human resources, or program develop-
ment. And you could help us locally with some
of our related projects such as public forums or
public education. We are all very excited about
our future prospects. And we are confident that
if we pool our collective talents, we will be able
to offer more relief and even more hope to peo-
ple who suffer with tinnitus. Gl
Dr. Laubacher received a Ph.D. in Public Policy
from the University of Houston in 1990, a Masters
degree in Public Administration from Harvard in
1994, and a Masters degree in Sociology from
Duquesne University in 1973. For additional bio-
graphical information, see nchanging of the Guard,
page 5.
From the Editor
by Barbara Tabachnick Sanders
It rained every day for Steve
Laubacher's first two weeks in
Portland. Since that time, just
a few months ago, Steve's
jokes about our beautiful
(though rainy) Northwest city
have been plentiful, spoken as
a true out-of-towner will. Just
as plentiful are his ideas to
advance the significant work
of Gloria Reich and to propel ATA and the inter-
ests of those with tinnitus into even greater
national visibility.
Steve's resume
is impressive. He
was the Executive
Director of the
National Dyslexia
Association in
Maryland, the Spina
Bifida Association
Research and will be the liaison to our Scientific
Advisory Committee. Her goal is to help the
committee establish clear and forward-thinking
research guidelines. Cathie Glennon is our new
Resource Development Director and gives ATA
the benefit of her many years of experience in
the field. Robin Jennings is now the Executive
Assistant because there isn't much she can't do
to make ATA run smoothly. Debbie Nisely is our
new Business Manager who is moving our books
effortlessly (so it seems) into the 21st century.
Janice Tagliareni is our Development Assistant,
Cathie's right-hand person and ultra-diligent staff
member. Dan May is our new Fulfillment and
Mailing Specialist
who handily directs
everything that
comes into
or goes out of
these offices.
Adam Kramer,
of America in
Washington, D.C.,
and local and state
chapters of the
Association for
Retarded Citizens,
and was a consultant
for a variety of other
groups. His broad
experience with
these health organi-
zations gives us a
fresh and compre-
hensive view of the
A'D1's Staff L to R: Adam Kramer, Debbie Nisely, Cathie Glennon,
Robin Jennings, Pat Daggett, Janice Thgliareni, Dan May,
Barbara Thbachnick Sanders, Steve Laubacher
our Computer
Consultant, makes
certain that our com-
puters are Internet-
connected, okay for
Y2K, and up and
running 365 days a
year. In the next
year, more staff will
likely be added to
help us reach the
heights that Steve is
confident we can.
Although Gloria
Reich has resigned
her office as A T ~ s
world of non-profits. As one could expect with
any changing of the guard, we are pointed - and
now moving - in a new direction.
These are exciting times. I've assumed the
role of editor of Tinnitus 7bday, as well as addi-
tional duties in managing our educational pro-
grams. (Some of you might have noticed that I've
also assumed a new last name. Yes, I've recently
married!) Pat Daggett is the new Director of
Executive Director, she has chosen to stay active
in the organization. She is now a member of ATA's
Scientific Advisory Committee and will continue
to help ATA with special proj ects. Her 25 years of
devotion and labors t o an organization that grew
under her leadership - from a membership of
250 to 20,000- are remembered by all of us with
gratitude. e
American Tinnitus Association Tinnitus Thday/ September 1999 5
Letters to the Editor
Prom time to time, we include letters
from our members about their experi-
ences with ((non- traditional" treatments.
We do so in the hope that the informa-
tion offered might be helpful. Please read
these anecdotal reports carefully, consult
with your physician or medical advisor,
and decide for yourself if a given treat-
ment might be right for you. As always,
the opinions expressed are strictly those
of the letter writers and do not reflect an
opinion or endorsement by ATA.
O
ne morning in April 1998, I woke up with
very loud tinnitus in my left ear. During the
next several months I saw four specialists. I
soon discovered that my tinnitus was significantly
diminished when I exercised vigorously or took a
very hot bath, so I mentioned to the physicians
that I thought the cause of my tinnitus was related
to poor circulation. None of them pursued this line
of reasoning. The fifth otologist almost immediate-
ly suggested that my problem was likely related to
circulation and prescribed Trental (400 mg, three
times per day) . In two weeks, my debilitating tin-
nitus was gone. The tinnitus did return briefly
when I had an infected tooth on the left side of
my mouth. As soon as the tooth was pulled, the
tinnitus disappeared again.
Janice Holmberg, Oceanside, CA, 760/945-3214
D
r. Emmett is to be thanked for his very clear
and much needed article in the June 1999
Tinnitus Tbday detailing the relatively new
inner ear perfusion approaches to Meniere's dis-
ease. There has been at least one controlled study
(Silverstein et al., 1998) of inner ear perfusion by
dexamethasone. However, this found no beneficial
effect. Silverstein used only late-stage Meniere's
patients and treated them with intratympanic but
6 Tinnitu$ 'Thday/ September 1999 American Tinnitus Association
not intravenous dexamethasone. Another retro-
spective study (Arriaga and Goldman, 1998)
found less than striking effects on hearing with
intratympanic administration alone.
Despite these negative results, it may well be
that effective Meniere's and tinnitus treatment
approaches v.rill come from this general approach.
We look forward to a better determination of what
might make the approach effective.
Jim Chinnis, Warrenton, VA,
jchinnis@alum. mit. edu
A
ft.er a recent hand fracture, my doctor pre-
scribed 'JYlox for the pain. Though it takes
up to 45 minutes to start working, it worked
wonders on the pain - AND my tinnitus. With
every dose (two capsules every 4-6 hours), I've
experienced complete relief from the ringing.
After an unfortunate requirement for 'JYlox
yesterday, I promised myself I'd let someone
know today.
Bob Marquis, Hampton, 333 Harris Ave.,
Hampton, VA 23665, 7571766-0549
(Editor's Note: 'I]jlox is a prescription drug made up
of oxycodone and acetaminophen. As a narcotic, it
carries a warning that it can be habit-forming.)
T
he us with absolutely mind-
boggling opportumt1es - from ordering flow-
ers to trading stock options. We have access
to more information than we probably know what
to do with. I admit that I am like millions of peo-
ple who can' t wait to log onto the Internet. But I
know that it's important to not get too caught up
in the excitement and become confused or, more
pointedly, misinformed.
Many individuals with tinnitus venture down
the "information superhighway" because their
healthcare providers offer them no viable solu-
tions. Yet it is nearly impossible for us to get an
accurate diagnosis and treatment recommenda-
tion from someone over the Internet - health
care professional or not - who doesn't know us.
'TWo things must be considered when we
collect information on the Internet: everyone has
equal access and everyone has an opinion. The
Internet is a great source of unregulated
and unmonitored material - some good, some
bad. I feel we should all be cautious of opinions
Letters to the Editor (continued)
expressed so freely on the Internet. Free yet poor
advice cannot only be misleading, it can truly
wound.
Norma Rivera Mraz, M.A., CCC-A, Associate
Director, Southeastern Comprehensive Tinnitus
Clinic, 980 Johnson Ferry Rd. NE, #760,
Atlanta, Georgia 30342, 404/531-3979,
www. tinn. com
NJ
y tinnitus had progressed to the point
where my quality of life was being
affected. I had difficulty understanding
conversation and I became irritable. The addi-
tional energy used to function with the burden of
this irritant sometimes left me willing to forego
activities that I might otherwise have undertaken.
A coworker, new to the Internet, showed me
a printout of typical on-line "rumor-mail" that
associated the use of the artificial sweetener
"aspartame" with numerous ailments including
tinnitus. I almost discounted it, but my problem
was such a nuisance and the cost of testing this
was low (simply switching from my exclusive use
of diet drinks to non-diet drinks and from artifi-
cial sweeteners to sugar) that I tried it. Do you
know that within two days my tinnitus problem
reduced to perhaps 15% ofwhat it had been? It
has now been two months since I excluded artifi-
cial sweeteners from my diet and the amount of
improvement has been stable. I rarely think
about my tinnitus anymore. I encourage your
organization to suggest this to those who can
safely remove artificial sweeteners from their
diets. The improvement could be remarkable.
Jim French, College Park, MD, AV810@aol.com
I
n Ed Edward's letter to the editor in the June
1999 issue of Tinnitus Thday, he testified about
his remarkable results with a 600 mg daily
dose of magnesium. Because of that, I purchased
and started taking magnesium and enjoyed iden-
tical results. In fact for the first week, the tinnitus
was almost completely gone. Now, two months
later, the tinnitus has gradually returned, but
only to about half of what it was. I'm still
amazed, and surprised that this has not been
known before.
Roy C. Koeppe, PO. Box 43, Ro1fe, Iowa, 50581,
712/848-3253
I
n 1985, after the death of my father, I devel-
oped tinnitus in both ears. Like innumerable
tinnitus sufferers, I found I couldn't sleep and
had difficulty concentrating. I consulted an ear,
nose, and throat specialist who found no physical
cause for the tinnitus. I researched possible caus-
es and tried several different approaches in an
attempt to reduce the tinnitus - cutting out caf-
feine and alcohol, reducing salt intake - all to
no avail. I learned about the .ATA and started
receiving Tinnitus Thday, which is a tremendous
source of information. There was an article in the
December 1998 issue on the use of Ginkgo biloba
to treat tinnitus. I decided to try ginkgo and
began taking 40 mg per day. After two-and-a-half
months, I experienced almost complete relief
from the tinnitus. There were a few days when
it recurred, but those were days of high stress.
I hope you can pass this on to others who might
be considering ginkgo. I only wish I had tried it
sooner.
Donald Scoville, 1708 Culpepper Ct.,
Severn, MD 21144
Editor's Note: Many people have reported a reduction
in their tinnitus as a result of taking daily doses of
ginkgo, and with no adverse side effects. Ginkgo bilo-
ba is widely used in Europe to increase blood circula-
tion, to improve memory, and for tinnitus relief It is
suggested, however, that ginkgo not be taken along
with blood-thinning medications, and that patients
have a simple 1Jleeding timep test performed prior to
taking ginkgo to be sure they will not be overly sensi-
tive to ginkgo's blood thinning properties.
American Tinnjtus Association Tinnitus 70day/ September 1999 7
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8 Tinnitus Thday/ September 1999 American Tinnitus Association
NEW DIRECTORS
ON BOARD
The American Tinnitus Association
welcomes three new members to its
Board of Directors: John Nichols, of
Scottsdale, Arizona; Kathy Peck, of San
Francisco, California; and Joel
Alexander; of Park Ridge, New Jersey.
John Nichols is an attorney
as well as the facilitator of
the Phoenix Tinnitus Support
Group, the third longest-run-
ning ATA tinnitus support
group in the U.S. His back-
ground in non-profit advoca-
cy as well as his personal
experience with tinnitus led
him to join ATA's Board of
John Nichols Directors. "I have tinnitus,"
says Nichols, "and I under-
stand the debilitating effect of it. I'm passionately
dedicated to helping others overcome the limita-
tions of tinnitus and to live successful, productive
lives. I also understand how Congress works, and
why it listens to politically powerful organiza-
tions like AARP. It's because that organization has
millions of members which means millions of
voters. ATA also has to grow to have millions of
members to become politically effective. When
we do, legislators will have to listen to us because
we'll be affecting their political futures!"
Kathy Peck is the Executive
Director and Co-Founder of
H.E.A.R., (Hearing Education
and Awareness for Rockers).
The goal of her organization
is to teach teens and young
adults that overexposure to
loud noise and music can
cause permanent hearing
loss and tinnitus. Kathy's
Kathy Peck own hearing loss and tinni-
tus followed immediately
after her performance in a rock band.
Peck says, "The tinnitus problem with musi-
cians is a BIG problem. Working with ATA can
only help me do a better job and bring the mes-
sage to the people in the music industry." As for
ATA, Kathy's feelings run strong: "ATA is such a
good organization, so people-oriented, sort of
'advocacy by nature.' It knows the people that it's
serving. If you go to ATA, you know you're going
to be helped."
Joel Alexander is a CPA,
and was Jacom Computer
Services' chief financial offi-
cer for many years. After
Alexander's air bag-induced
tinnitus began two years ago,
he decided to devote his time
to ATA and to the search for
a solution for others who
struggle with tinnitus. Says
Joel Alexander Alexander, "Over the last
two years, I consulted with
numerous doctors, audiologists, and hearing pro-
fessionals who assured me that I would get used
to hearing these sounds. But I did not get used to
it. My motto has always been: 'God helps those
who help themselves.' Therefore I intend to help
others and myselfby getting actively involved
in ATA. My fervent dream is to help the distin-
guished members of ATA's Board of Directors
achieve the ultimate goal of helping the millions
of Americans who are afflicted with tinnitus."
Phil Morton of Portland, Oregon, former
Chairman of the Board, and Aaron Osherow of
St. Louis, Missouri, have retired from the Board
of Directors after many years of service to 1\TA. 1B1
Next Issue: Interviews with our new Scientific
Advisory Committee members: Douglas E. Mattox, M.D.,
Mary B. Meikle, PJ1.D., Gloria E. Reich, Ph.D.,
Michael D. Seidman, M.D., and Richard S. 7JJler, Ph.D.
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American Tinnius Association Tinnitus Thday/September 1999 9
Swan
Song
by Robert Sandlin, Ph.D.
Swan song n: the last work, act, achievement of a
person (The Random House Dictionary)
At seventy-three years of age it seems wise, if
not imperative, to entertain thoughts of undertak-
ing challenges completely unrelated to the clinical
management of the tinnitus patient. Such things
as enrolling in a magic class for the sole purpose
of entertaining my grandchildren. Th play the
electronic organ with more than just the right
hand. 1b finish three novels which have been
started but now gather dust on my bookshelf.
Th get up early in the morning just for the sole
purpose of watching the sunrise.
In essence, this brief article represents reflec-
tions over the last two decades or so about tinni-
tus, those who suffer from it, and those who offer
some form of therapeutic intervention for it. Th
that extent, then, this is my swan song.
I have experienced the joys and frustrations
of treating individuals with unrelenting, subjec-
tive tinnitus. Joys are best defined as the profes-
sional and personal satisfaction of contributing
to an individual's quality of life by eliminating
or reducing the negative emotional and
behavior changes often accompanying tinnitus.
Frustrations are best defined as not knowing what
to do when what you have done results in mini-
mal improvement - or no improvement at all -
in the person's ability to cope more effectively
with the ongoing tinnitus.
Equally as high on the list
of frustrations is the nagging
reality of not knowing what
you did that resulted in an
improvement of patient
coping strategies.
During the past twenty years,
I have had the opportunity to
experiment with a number
of therapeutic approaches
in the treatment of the tin-
nitus patient. Admittedly, I
have not investigated all conceivable treatment
modalities. Th do so would have been a Herculean
task that may have resulted in knowing only a
little bit about a lot of things, but not enough to
thoroughly understand the rationale of each. Even
a cursory examination of the literature provides a
seemingly endless list of treatment modalities.
Consider the following litany: masker therapy,
tinnitus retraining therapy, selected use ofbenzo-
diazepines and tricyclic drugs, psychological
intervention, psychiatric intervention, cognitive
therapy, TMJ modification, electrical stimulation,
biofeedback, anticonvulsing drugs such as Tegretol
and Misoline, surgical sectioning of the auditory
branch of the eighth nerve, microvascular surgery,
selective use of diuretics, acupuncture, acupres-
sure, vitamin therapy, hypnosis, and homeopathic
intervention. Add to this the management of
hyperacusis, which often accompanies subjective
tinnitus, and one begins to appreciate the magni-
tude of the problem relating to selecting a thera-
peutic approach best suited to meet the patients'
needs.
It is difficult, if not impossible, in my view,
for anyone to vigorously defend a single thera-
peutic approach as the only one to be used in the
treatment process. I say this because each of the
therapies listed has proven ofbenefit to some,
but none has proven beneficial to all persons
having tinnitus. This is certainly not to indict any
method of treatment but rather to realize that our
primary, clinical responsibility is to the person
suffering from tinnitus. It makes little difference
what the method of intervention is, if the patient
benefits and is not negatively compromised.
Patients seek help, not based on their understand-
ing of the mechanisms of tinnitus, the rationale of
a treatment method, or theoretical constructs of
site of lesion, but rather on the degree of hurt. It
is not the tinnitus itself, but the patient's reaction
to it that generates the emotional unrest and sub-
sequent negative behaviors. That is, patients are
seeking relief from the incessant, acoustic-like
sensations that are with them every hour of every
day. They are not concerned about theories or
scientific assumptions but whether or not a partic-
ular therapeutic approach offers demonstrable,
ongoing beneficial results.
E
ach patient presents with a unique set
of problems arising from tinnitus onset.
Some of these problems are generated by
fear of what the tinnitus portends. Patients draw
conclusions based on these fears, which dictate
a variety of behaviors. Many such fears are not
reality-based in terms of scientific knowledge
or objective evidence. However, this is of little
consequence if the patient's negative behavior
is perpetuated because of these fears. It is these
10 Tinnitus 'lbclay/ September 1999 American Tinnitus Association
maladaptive behaviors to which the clinician
must give attention. It is these behaviors which
need to be modified in a more positive direction.
I have observed on a number of occasions
that patients with similar histories related to their
tinnitus have almost diametrically opposed reac-
tions to its presence. Some patients accept their
tinnitus as a consequence of that which caused it.
Others experience marked changes in emotional
stability leading to overt behaviors that perpetu-
ate the debilitating effects of their tinnitus.
Regardless of the possible mechanisms involved
or the theoretical constructs of tinnitus origin,
the patient's maladaptive behaviors are deter-
mined by emotional and psychological factors
unrelated to the neurological status. As such,
the clinician's primary task is that of altering
attitudes and modifying behaviors through one
or more therapeutic approaches.
F
urther, I have observed that there is very
little, if any, predictable outcome in the
several therapeutic approaches. This
means that one cannot predict with any degree of
certainty what will happen over a given period of
time for a given patient as a result of therapeutic
intervention. One can, however, predict the prob-
ability of success by retrospective analysis. By
assessing the success rate of a given treatment
modality for a number of patients, one can pre-
dict that a certain percentage will be successful.
The trouble is that patients have little interest in
probability. They are more concerned with what
can be done at the moment to reduce their anxi-
ety and psychological and emotional distresses.
I feel that patients must be managed in a manner
that contributes not only to their understanding
of the therapeutic process but the significant part
they play in achieving positive results. Effective
treatment is not a one-way street. The patient
must play an active role in whatever treatment
plan is used.
The patient must be assured, or at least feel it
to be true, that the clinician is interested in his or
her well-being and is empathetic to his or her
needs. The patient needs to feel that the clinician
is not bound to a specific treatment modality
when it becomes evident that the therapeutic
approach is not working. The patient has the
right to assume there will be changes in the
treatment modality of choice, if such changes
are deemed appropriate and offer an increased
probability of tinnitus relief. The caveat, of
course, is that a change in treatment must be
based on a defensible assessment that what is
currently being used is not working. The decision
to alter the course of treatment should be based
on consensus between the clinician and the
patient. Th permit the patient to dictate when
change should occur is an abdication of clinical
responsibility and not a true test of the treatment
plan. A change in the therapeutic approach does
not imply, necessarily, that one discontinues a
given treatment plan, but rather that other treat-
ment methods might be introduced to assess
their value in providing tinnitus relief. I am con-
vinced that more attention needs to be given to
appropriate counseling and patient management,
regardless of the therapy of choice.
If there is a common need to be resolved for
the tinnitus patient it is the reinstatement of
quiet. Dr. Stephen Nagler first suggested this idea
to me a number of months ago. In essence, the
purpose of any therapy is to eliminate or reduce
the tinnitus loudness to a point that permits the
patient to lead a more normal and harmonious
existence unfettered by the ever present, unre-
lenting tinnitus.
None of us who has worked with tinnitus
patients has all the answers to this perplexing
problem. Clinicians search for answers by evalu-
ating the treatment modalities available. They
take from them those features that seem to
improve the patients ability to obtain relief and
to cope more effectively in daily life.
I think that some day we will find answers
which have eluded us thus far. Perhaps the solu-
tion will come through greater awareness of
those neurophysiologic mechanisms causing tin-
nitus. Perhaps the solution lies with the adminis-
tration of specific drugs or surgical intervention.
However, until such time these hopes and
dreams become reality, clinicians must continue
to assist the patient in dealing more effectively
with his or her tinnitus so that an acceptable
quality of life is maintained.
I
would be remiss if I failed to mention those
individuals who have been so instrumental
in helping me understand the human
dynamics of tinnitus. Dr. Jack Vernon has served
as my mentor for many years. The late Robert
Johnson contributed so much to my understand-
ing and treatment of tinnitus. Dr. Mary Meikle
has always been gracious in sharing with me that
vast amount of know ledge she has regarding tin-
nitus. Dr. Gloria Reich is to be admired for her
administration and the positive, proactive direc-
tion taken by the American Tinnitus Association.
Of course there are my tinnitus patients and oth-
ers too numerous to mention in this brief article.
Th all, my sincerest thanks. B
Dr. Sandlin is on ATA's Scientific Advisory
Committee and is the past Director of the California
Tinnitus Assessment Center in San Diego,
California.
America11 Tinnius Association Tinnitus 7bday/ September 1999 11
TRT vs. Masking A Researcl
by Jim Henry, Ph.D.
The Veterans Affairs (VA) Medical Care system pro-
vides health care for U.S. veterans and also funds
basic and clinical medical research. One branch of
VA Research is Rehabilitation, Research, and
Development (RR&'D). The RR&'D service supports
many research centers, one of which - the National
Center for Rehabilitative Auditory Research
(NCRAR) - is in Portland, Oregon. The NCRAR is
directed by Stephen Fausti, Ph.D., and is a consor-
tium of researchers, clinicians, and educators who
specialize in hearing disorders, including tinnitus.
Although there are many
causes for tinnitus, the most
common is noise-induced
hearing loss. Tinnitus is
thus a common complaint
among veterans, of whon1
over 115,000 reported ser-
vice-connected tinnitus as
of September 30, 1998.
Tinnitus disability compen-
sation for these individuals
amounts to over $110 mil-
lion per year. In spite of this major health prob-
lem for veterans, it has not been feasible for the
Department of Veterans Affairs (VA) medical sys-
tem to establish a systematic protocol for tinnitus
rehabilitation.
A proposal was recently approved by the
VNs Rehabilitation, Research, and Development
branch to conduct a three-year study at the
Portland VA Medical Center under the auspices of
the NCRAR evaluating two different forms of tin-
nitus treatment: Masking Therapy and Tinnitus
Retraining Therapy. Mary Meikle, Ph.D., and I
are the principle investigators for this study
which will begin October 1, 1999.
Despite many attempts to develop effective
treatments for tinnitus, in general these are the
only two that have achieved widespread use. The
method of Tinnitus Masking employs wearable
ear-level devices that deliver selectable bands of
relatively low-level noise to the ear in order to
totally or partial1y obscure the tinnitus sound.
Introduced in 1976, this method has been used in
many thousands of cases, with reported success
rates in the range 65-68%. The second method,
Tinnitus Retraining Therapy, attempts to produce
"habituation" of tinnitus through a specific proto-
col of education, directive counseling, and "sound
therapy" through the use of low-level broad-band
noise. Clinicians using this approach report suc-
cess rates of 80-85% although published data are
relatively few.
Controlled studies have not been done to
compare the relative effectiveness ofthese two
treatments. Consequently, there is, as yet, no
scientific basis for choosing between the two.
Because of the prevailing need for tinnitus
treatment efforts within the VA medical system,
it is important to determine which of these two
techniques offers the better rehabilitation
methodology for U.S. veterans.
We will study 200 veterans with clinically
significant tinnitus (that is, tinnitus that has
adversely affected an individual's life to the
extent that clinical treatment is sought). We will
recruit subjects from the patient populations of
the Otolaryngology and Audiology clinics at the
Portland VA Medical Center. Inclusion will be
based on a demonstrated need for tinnitus treat-
ment and the individual's willingness to comply
with the requirements of the proposed study.
After giving informed consent, subjects will be
randomly assigned so as to obtain 100 subjects in
each of two treatment groups (1) Tinnitus
Masking, and (2) Tinnitus Retraining Therapy.
Baseline observations (including audiometric and
tinnitus test results) will be obtained, with the
principal focus on measures of tinnitus severity.
Treatment will then begin.
The Tinnitus Masking program will be
conducted by an experienced audiologist skilled
in the masking treatment method, who will
apply standardized tinnitus masking techniques
according to published protocols. The Tinnitus
Retraining Therapy program will be conducted by
a different experienced audiologist skilled in the
retraining treatment method, who will apply
standardized tinnitus retraining techniques
according to published protocols. Throughout
the study, expert consultation and advice will
be provided by the developers of the Masking
and the Tinnitus Retraining Therapy treatment
metl1ods (Jack Vernon, Ph.D., Professor Emeritus
of Otolaryngology, Oregon Health Sciences
University; and Pawel Jastreboff, Ph.D., Sc.D.,
12 Tinnitus Thday/ September 1999 American Tinnims Association
Study
Professor of Otolaryngology, Emory University
School of Medicine, respectively) .
All subjects will be assessed at 3, 6, 12, and 18
months by an evaluator who is unconnected with
the treatment program and who will be blind to
the treatment being administered. Two hundred
subjects will provide adequate statistical power
for evaluating the significance of the results.
Because of the well-controlled nature of this
study, and the careful attention to quantitative
outcomes measures built into it, we anticipate
that this research will yield important informa-
tion that will help guide the VA medical system
to provide rehabilitation for veterans with tinni-
tus. Inevitably this research will be relevant to
the millions of tinnitus sufferers worldwide -
veterans and non-veterans alike. Ia
Dr. Henry can be contacted at the VA Medical
Center, 3710 SW US Veterans Hospital Rd., Portland,
OR 97207, 503/ 220-8262 x.57466,
henryj@ohsu. edu
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HELP FOR TINNITUS AND HYPERACUSIS
CAROL LEE BROOK suffered from a debilitating case of
both of these afflictions. She was hearing twelve different
sounds. Her own footsteps were unbearable to listen to, and
the shower sounded like Niagara Fal ls. She was unable to
quiet the TINNITUS noises with outside sounds because of
pain from the HYPERACUSIS. She was unable to block out
the HYPERACUSIS with earplugs and muffs because this
intensified the TINNITUS.
Because Carol refused to accept her ENTs' statements,
"There is nothing you can do about it. You'll just have to get
used to it," she tried everything she could think of to get
relief, but to no avail. She couldn't eat or sleep, and al lowed
herself to be a guinea pig for anyone who offered a possible
cure. Just as she was about to give up, she heard about a
treatment called TINNITUS RETRAINING THERAPY (TAl) that
had been developed by a neuroscientist, and out of desper-
ation decided to try it.
As a form of her own therapy, Carol wrote about
her many experiences before and during her use of TRT.
She followed her doctor's orders to the letter and the
HYPERACUSIS gradually went away. She also found that the
longer she stayed on the program, the lower the volume
of her TINNITUS sounds appeared. Her doctor has helped
William Shatner and many others, and is currently
instructing audiologists as to his TRT methods all over
the U.S. and in foreign countries.
Carol believes that she has achieved about 90%
recovery to date, and shares with you her experiences and
the effects on her family and friends in her new book,
TORTURED BY SOUND - BEYOND HUMAN ENDURANCE.
She hopes it will both entertain and help you to overcome
the effects of these sometimes debili tating afflictions.
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For credit card orders, send full name as it appears
on card, address, card type, card#, and expiration date.
e-mail: fsbrook@aol.com
American Tinnius Association Tinnitus 7bday/ September 1999 13
by Ray Ennis
After suffering with tinnitus for nine years,
seeing many different doctors, and trying their
drug therapies, cranial sacral work, hearing
devices, acupuncture, and massage, there was one
thing that stood out in my mind as much as the
ringing in my ears. It was the words I'd heard
from all of the doctors: IT'S NOT CURABLE.
YOU'LL JUST HAVE TO LEARN TO LIVE WITH IT
My quality of life had deteriorated so much
that I was depressed, anxious, closed down.
I couldn't focus and was angry most of the time.
I took sleeping pills and drank alcohol in order to
sleep, and was ready to give up. I had even gotten
to the point where I didn't want to read Tinnitus
7bday when it arrived because it all seemed so
hopeless. Fortunately, when the March 1999 issue
arrived, I opened it and saw a small article written
by Mike Cohen about a Dr. Zacharya Shemesh in
Israel who reports a 90% success rate for treating
tinnitus. I immediately contacted the Hadassah
Hospital in Israel, spoke with Dr. Shemesh, and
realized there was hope for me.
When T arrived in Israel and met Dr. Shemesh,
I instantly knew that I had made the right deci-
sion to come this far for treatment. Dr. Shemesh
has devoted his life to working with tinnitus, and
believes that in most cases tinnitus is a curable
disorder. God Bless Him!
I began treatment and
felt inspired to send e-mail
home to my wife and fam-
ily about my experiences
and feelings while being
treated. Here are some
excerpts from my
letters home.
14 TinnituS 'TOday/ September J 999 American Tinnitus Association
May 1
I arrived in Jerusalem last night around 8 p.m.,
which is the start of Sabbath. A big mistake!
Everything is closed and it is all so new to me.
I walked for hours and couldn't find a place to eat.
Sabbath starts at sundown on Friday night and
goes till sundown on Saturday and the whole city
shuts down. All the busses stop running and all
the businesses are closed. I've never seen any-
thing like it.
May 3
Coming to Jerusalem was the right move for me.
I've finally found a doctor who knows about tinni-
tus. It really takes a lot off my mind to know I
don't have to suffer with this "devil's symphony"
for the rest of my life. I finally understand the
"whys" of some of my behavior patterns during
the last few years: I wasn't just crazy. T was sick.
I found out that tinnitus is not simply a ringing in
the ears. It's a central nervous system ailment.
My depression and all the debilitating symptoms
were caused by the tinnitus. It all makes so much
sense to me now.
May 4
I spent six hours with Dr. Shemesh today. This is
so different from any experience I've ever had
with a doctor. His way of working is to find out all
about you; he treats the whole person, not just the
symptoms. Sensing his compassion and wisdom, I
held back nothing.
MayS
Today I got back some of the blood test results.
This will help Dr. Shemesh know what type of
treatment to start with. Other than a very high
vitamin B-12 count, the tests show all my levels
are normal.
May 10
Today I received information on the medication.
The pharmacy at Hadassah hospital will prepare
the medication according to instructions from
Dr. Shemesh after he considers all the medical
aspects of my condition, like my complaints,
medical history, imaging, audiometer reading,
blood test results, and his personal evaluation of
my particular health and living situation. This is
essentially "conventional" treatment, but it
reminds me of when I worked with the homeo-
pathic doctors back home. His approach is very
thorough and individualized. Shemesh says this
program is based on the same proven (but still
censored) protocol he uses in his long-standing
work with Israeli Defense Forces tinnitus patients.
I am impressed with this man's experience and
continue to build my trust in him. Dr. Shemesh
says he will continue to supervise my case over
the next 12-18 months.
May 11
I've spent the 1ast three days with Dr. Shemesh
for four, five, or six hours each day. Yesterday, I
took the first two medications and when I awoke
today, the ringing in my head had lowered 50 to
60 percent. It's hard for me to gauge. Since I've
had tinnitus for so long, I'm not sure what is nor-
mal. I can't tell you how happy I am without so
much noise in my head! I can hardly believe it.
I'm still a little afraid to become too excited, but
that, too, will pass.
May 13
I have had a slight relapse. I awoke this morning
really angry. The ringing has returned although
the volume is lower than it was previously. Dr.
Shemesh says this is a good sign. It means my
body is accepting the medication and this will
possibly happen for a short time in the beginning
of the treatment while everything is trying to
come into balance. Although I understand this, it
is still difficult to deal with my emotions when
the ringing returns. Dr. Shemesh will be teaching
me techniques to handle these times better.
May 17
I now seem to be going through major adjust-
ments. I have days when the tinnitus is mostly
just a background sound and the volume has
decreased anywhere from 40 to 80 percent and
then two days later it's back. I notice that each
time it comes back, it is a little different. Either
the volume is different or the pitch has changed
or the whole sound itself has changed from ring-
ing to buzzing to whistling. I also recall the activi-
ties of the previous day and can see factors that
might have contributed to its return. Dr. Shemesh
says the frequency of the recurrences will lessen
when I'm finally back home in my own environ-
ment and settle into a somewhat stable routine
again.
After a rendezvous with my wife who flew
from Hawaii to London to meet me for a very
special "second honeymoon," I'm now back home
in Hawaii. The tinnitus has decreased to a light
background noise, which I can manage with self-
hypnosis, and the relaxation techniques I learned
from Dr. Shemesh. I do have some "down days"
due to stress, but I'm learning to manage the
stressful times better since I know it is a major
factor in aggravating tinnitus.
I speak with Dr. Shemesh once a week, or
more often if something comes up. He is only a
phone call away if I need him. I feel like a whole
new person now, with a whole new life in front
ofme. a
A (lon g) Edit or's Note:
I called Dr. Shemesh in Israel to learn some
specifics about the treatment he offers, and to find
out why the treatment protocol is, according to Ray
Ennis,
11
Censored." Shemesh received my call warmly
and was frank about the limitations that have been
placed upon him by the Israeli Army. (Many of
Shemesh's patients are military personnel whose
hearing was damaged by military noise exposure,
like bomb and grenade blasts.) He is uneasy that his
clinical work might go unnoticed because of the
restrictions. ':As you know, he said, "in the world of
science, it is 'publish or perish.' I have not been able
publish any papers about my work with tinnitus
patients over the years. So recently we officially
applied to the Israeli Army for permission to publish
the details of these 19 years ofresearch. And we
were told 'officially' that we could not do it.
Shemesh is optimistic that the hold wiU be lifted
soon. He explains: "We are a country that is used to
secrecy. And because of that, I know that it is easier
for [the Israeli Army} to handle non-secret informa-
tion than that which is secret. He believes that the
Israeli Army will, sooner than later, get weary of its
hold on his work.
From my conversation with Dr. Shemesh, I was
able to glean two clear things about his treatment
of tinnitus patients: He offers them an absolute
understanding of their condition, and a better inves-
tigation of their problem and overall health than
most of his patients say they've had before. Shemesh
adds, "Some physicians create crisis by saying to the
patient, 'You have to learn to live with it.' If someone
calls me, they don't have to come to Israel to feel
better. Sometimes they feel better just knowing that
there is help somewhere." He feels strongly that ATI'lt
conveys the same important message to people with
tinnitus. "You let people know that there is help for
their condition. And by doing that, your organiza-
tion is doing one of the most important jobs in the
field of tinnitus in the world."
Mr. Ennis can be contacted via e-mail at:
stelablu@m.aui. net
Mike Cohen can be contacted via e-mail at:
nu@netvision. net. il
Dr. Shemesh can be contacted by
Mail: Hadassah Ein Kerem, Tinnitus Clinic,
PO. Box 12000, Jerusalem 91120, Israel
e-mail: pr@hadassah. org. il
Web site: www.hadassah.org.il/hmoltinn.html
'Ielephone: on Sunday, Wednesday, and Friday,
7-8 a.m. Israel time (7 hours later than Eastern time)
011-972-9-899-7992, Fax: 011-972-2-677-6768
American Tinnius Association Tinnitus Thday/ September 1999 15
$131,400 FOR
NEwATA
RESEARCH
The ATA Board of Directors recently approved
funding for the following four tinnitus research
studies. The grants total $131,400. The first three
studies are referred to as "basic" (in the lab,
under the microscope) research. The last one
is a clinical study, one in which tinnitus patients
are evaluated.
In their own words, the researchers explain
the goals of their work.
Title: Are mechanisms lor transient and
long-standing tinnitus different?
Principal Investigator:
Jos J. Eggermont, Ph.D.,
University of Calgary
Grant Award: $35,000
The mechanisms that underlay
transient and long-standing tinni-
tus may be different. Consider
the action of loud music provid-
ed by a rock group. This may induce in most lis-
teners a temporary threshold shift accompanied
by transient tinnitus or, in more sensitive per-
sons, a permanent high-frequency hearing loss
and also permanent tinnitus. In the latter case, a
complete reorganization of the auditory cortex
will slowly occur so that the long-lasting tinnitus
effects may be related to an over-representation
of the audiometric edge-frequencies. In the case
of long-standing tinnitus, the reorganization of
the tonotopic map in the auditory cortex may
result in increased synchronization of the sponta-
neous neural activity in that region. This has also
been proposed as a basis for tinnitus. The propos-
al will compare effects of transient and long-
standing pure tone trauma, induced at an early
age, on the spontaneous firing rate and syn-
chrony in the damaged regions of three auditory
cortical areas.
Title: Mechanisms ol hyperexcitability in the
inferior co/lieu/us
Richard E. Harlan, Ph.D.,
Thlane University School of
Medicine
We propose that tinnitus and
hyperacusis may result from
hyperexcitability of certain neu-
rons which relay auditory information in the
brain. Further, we propose that this hyperex-
citability is due to a loss of inhibitory inputs onto
these neurons, leaving them with unopposed exci-
tatory input. The hyperexcitability results in
excess activation of relay neurons in response to
normal sounds of low intensity (hyperacusis) and
in the absence of audible sound (tinnitus.) The
hyperexcitability of these neurons leads to expres-
sion of a particular gene called c-Fos. We will test
the hypothesis that neurons expressing the c-Fos
gene in response to intense sound also contain
particular receptors for excitatory and inhibitory
neurotransmitters. We also propose that the
hyperexcitability of these neurons could be coun-
teracted by increasing the amount of the inhibito-
ry neurotransmitter gamma aminobutyric acid
(GABA) . The ability of these drugs to decrease the
expression of the c-Fos gene in response to loud
sounds would suggest that these drugs may be
useful in treating tinnitus and hyperacusis.
Title: The role of the trigeminal ganglion and
cochlear nucleus in the modulation of
tinnitus
Susan E. Shore, Ph.D.,
Medical College of Ohio
Recently, patients have been
described who can modulate
their tinnitus by clenching the
jaw or touching the skin on the
face. In addition, there are patients whose onset
of tinnitus can be attributed to some somatic
(relating to, or affecting the body) insult in the
head and neck region, called "somatic tinnitus."
These observations have led to the hypothesis
that somatosensory input to the cochlear nucleus
(CN) modulates the spontaneous rate of its output
neurons. Somatosensory input to the CN may
therefore play a role in the generation and modu-
lation of somatic tinnitus. We have recently dis-
covered a pathway from the trigeminal ganglion
to neurons in the cochlear nucleus, which may be
16 Tinnitus 'Tbday! September 1999 American Tinnitus Association
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involved in the generation and/or modulation of
"somatic tinnitus." This hypothesis will be tested
by electrically stimulating the trigeminal gan-
glion while recording spontaneous activity in the
CN. If this pathway plays a role in somatic tinni-
tus, changes in spontaneous activity should
occur.
Title: Using auditory reorganization to minimize
perception and facilitate habituation of tinnitus
Robert W. Sweetow, Ph.D.,
U. of California, San Francisco
Although tinnitus can result
from a wide range of disorders in
the ears, recent studies suggest
that it is the brain that is ulti-
mately responsible for the problem. An abun-
dance of research indicates that certain
procedures can be utilized to actually modify the
function of portions of the brain used in hearing.
In this investigation, we will be testing the theory
that tinnitus can be eliminated or minimized by
altering the way sound is perceived (organized)
in certain regions of the brain, specifically, the
auditory cortex. We will be using computer-
controlled auditory tasks that focus on temporal
(tin1ing) and spectral (pitch and loudness) charac-
teristics to direct the reorganization ofbrain func-
tions. The tasks being used have been previously
tested and shown to produce these changes. The
specific exercises will consist of reconstruction
and recognition of specific sounds and sound
sequences. B
Applieation deadlines for ATA research
grants: June 30 and December 31.
'lb obtain an application, visit our Web site
(WJvw.ata.org) or contact Pat Daggett at
ATA, P.O. Box 5
1
Portland OR 97207,
e-mail: research@ata.org
American Tinnius Association Tinnitus 7bday/September 1999 17
HAPPY NEW YEAR
by Cathie Glennon, Director of Resource Development
Despite what the calendar says, I've always
thought of autumn as the beginning of the new
y e a 1 ~ Instead of celebrating the transition by
tossing confetti, sipping champagne, and listen-
ing to strains of Auld Lange Syne, I feel like I'm
embarking on a new year when I listen to the
school buses on the streets and feel the cooler
weather. This feeling returns right after Labor
Day every year. Each year in the fall I regroup
for new challenges and in anticipation of some-
thing exciting in the future.
The anticipation of starting the new year is
especially strong here at the American Tinnitus
Association. The first of July was the beginning
of our fiscal year and, as Barbara Thbachnick
Sanders mentions in her article, the year brings
staff changes to ATA. Our Board of Directors has
changed as well . Several new members have
joined our dedicated and enthusiastic Board. We
have the leadership, we have the vision, and we
definitely have the enthusiasm to kick off this
year. Just as importantly- maybe more impor-
tantly - we have thousands of supporters like
you who will help to make ATA's future some-
thing to cheer about.
Since July 1st, we've been working out the
details of our fund raising activities for the new
year and I'm very excited to tell you about them.
+ We'll be staging an Annual Campaign this fall .
This is the one special time of the year when
supporters can step forward decisively and
support the important ATA programs that
they care about. Watch for details in your
mailbox and please give generously when
you're asked.
+ We'll be contacting some of the hundreds of
thousands of people who over the years we've
helped with tinnitus information and support
to invite them to become ATA donors.
+ We'll be writing grants to private foundations,
telling them about our good work, and getting
them more closely involved in our work.
+ We'll be participating in more national and
local workplace giving campaigns. If you
donate at work through the Community
Health Charities or other workplace giving
campaigns, don't forget to check with your
campaign chairperson to see how you can
have your donation benefit the American
Tinnitus Association. ATA's national designa-
tion number is 0514.
18 Tinnitus Thday/ September 1999 American Tinnitus Association
+ We're hoping to make allies with service
clubs, interest groups (the local tuba society?
- Portland's got one!), and professional
groups that might have an interest in what
ATA is doing. If you know of a group or are a
member of a group that might have a special
affinity for tinnitus and would like to have
fun learning about ATA and raising money for
us, please contact me at 800/ 634-8978 ext.l8.
We can follow up on your ideas.
We'll be analyzing all elements of our fund
raising to make sure it is effective and efficient.
Just like you, we want to be sure that the largest
possible percentage of the gift you give to ATA
goes directly to important programs and not to
overhead.
I hope you are as excited about this new year
as I am. Being an ATA donor is something that
can give you a deep sense of pride. You can be
proud, too, of ATA at this point of transition. You
can be extremely proud of your past support for
the American Tinnitus Association, and you can
be proud of the work that ATA has done with
your help. It is only because of caring, generous
people like you that we can hope to provide the
extensive Education, Advocacy, Research, and
Support (E.A.R.S.) programs. This is something
you can really feel good about.
You might have noticed that a few of the
leaves on the trees have a tinge of yellow, and
that school supplies are going on sale. Together,
all of us - supporters, Board of Directors, and
staff - face the challenges of a new and exciting
year. e
WHERE THERE'S A WILL,
THERE'S A WAY
Please consider including a bequest to the
American Tinnitus Association in your will.
With a will, you can assure that the work that
is important to you, such as our efforts to
eliminate tinnitus, will continue into the
future. Your legacy can make a real difference.
Please contact Cathie Glennon, Director of
Resource Development, at (800) 634-8978
ext.l8, for more information.
COMMUNITY
HEALTH
CHARITIES
CAMPAIGN
ANNOUNCEMENTS
American Academy of Otolaryngology Meeting
Date: September 26- 30, 1999, New Orleans, LA
'Ibpics: Annual national meeting for ear, nose, and
throat physicians. This year, three courses are
devoted entirely to tinnitus.
Tinnitus Speakers: Aristides Sismanis, M.D.;
Gordon Hughes, M.D; Abraham Shulman, M.D.;
Michael J. LaRouere, M.D.; John J. Zappia, M.D.
Contact: AAO, One Prince St., Alexandria, VA
22314-3357, 703/ 836-4444.
Tinnitus Public Forum
Date: September 27, 1999, 7-9 p.m.
New Orleans Hilton Riverside, Oak Alley Room,
Poydras at the Mississippi River, New Orleans, LA,
504/ 556-3700 (call for directions)
'Ibpics: There will be no charge for this open-to-
the-public lecture and Question & Answer session.
Meet ATA's Executive Director, ATA Board mem-
bers, and members of ATA's Scientific Advisory
Committee. The Q & A session follows the panel
lecture. See back cover for more details.
Seventh Annual Conference on the Management
of the Tinnitus Patient
Date: September 30-0ctober 1, 1999
The University of Iowa, Iowa City, Iowa
'Ibpics: For professionals and tinnitus patients.
Guest of Honor: Jack Vernon, Ph.D.
Speakers include: Michael Block, Ph.D.; Gloria
Reich, Ph.D.; Meredith Eldridge, M.A.; Soly
Erlandsson, Ph.D., psychiatrist; Anne Mette-Mohr,
clinical psychologist; Paul Abbas, Ph.D.; Bruce
Gantz, M.D.; Brian McCabe, M.D.; Rich 'JYler,
Ph.D.; David Young, M.A.; and Richard Smith, M.D.
Contact: Rich 'JYler 319/356-2471,
fax: 319/ 353-6739, rich-tyler@uiowa.edu,
http:! / WV\rw.medicine. uiowa.edu/ otolaryngology I
news/ news.html
ATA is a member of the Community Health
Charities (CHC). If you participate in a CHC
workplace giving campaign, you can designate
your gift to ATA using number 0514 on your
pledge card.
If you are involved in other workplace cam-
paigns, check with your campaign chairperson
for information on designating your gift to ATA.
Last year, ATA raised over $80,000 for our
programs through Community Health Charities
and other workplace giving. This is a significant
part of our budget.
Thank you to those special donors! Your gift
means a lot to us.
Mid-Atlantic Tinnitus Conference
Date: April1, 2000, 9:30a.m.- 4 p.m.
West Jersey Hospital, Voorhees, NJ
Meeting organizers: Dhyan Cassie, M.A., CCC-A,
Gail Brenner, M.A., CCC-A, and Linda Beach
Guest Speakers (at press time): researcher
Richard Salvi, Ph.D.; tinnitus clinic director
Stephen Nagler, M.D.; and ATA's Executive
Director; Steve Laubacher, Ph.D.
Contact: Dhyan Cassie, 609/ 983-8981
ATXs Tinnitus Support Network-
With a little help from your friends
Our support network of volunteers is the
foundation of hope for thousands of people with
tinnitus across the country. If you are interested
in giving telephone, e-mail, or in-person help to
others with tinnitus, please contact us. Or, for
information about a support group or telephone
contact nearest you, call or write to us.
(800/ 634-8978, ATA, P.O.Box 5, Portland, OR
97207 -0005)
Welcome New Support Network Volunteers
'Thlephone and Letter Contact
Beryl Clark
445 Seaside Ave., Box 164, Honolulu, HI 96815
808/ 923-8716
Thlephone Contact
Susan S. Partin
336/835-3438
American Tinnius Association Tinnitus 7bday/September 1999 19
TINNITUS: A BLESSING IN DISGUISE?
by Richard A. Gordne" M.D.
My tinnitus began in
November 1978 when I was
47, and has remained with me
ever since. At that time, I
became aware of a hearing
loss, which ultimately war-
ranted my wearing hearing
aids. It is well known that
presbyacusis (the hearing loss
associated with the aging
process) predisposes individu-
als to tinnitus. This has been my situation. Most
often my tinnitus is bilateral - in both ears -
and consists of whistling and other high-pitched
sounds. Over the years I have learned that my
tinnitus, for the most part, has a life of its own
and fluctuates for reasons that are entirely
unknown to me. There are two things, however,
that will predictably intensify my tinnitus: loud
noise and certain medicines, e.g., aspirin and
nonsteroidal anti-inflammatory agents.
We are living in a time when we are exposed
to various kinds of acoustical trauma, and this
problem is ever increasing. Probably the
offenders are those who subject us to amplified
music. Unfortunately, such amplification has
become so prevalent that it is difficult to avoid it.
Rock concerts are well-known to be acoustically
traumatic. Theaters are also now amplifying their
music considerably. Nightclubs, cafes, and many
restaurants are similarly exposing their patrons to
acoustical trauma. Receptions at weddings and
similar affairs typically expose guests to traumat-
ic levels of music. Many subway lines in large
cities expose riders to an acoustically traumatic
environment.
Exposure to loud noise will increase my
tinnitus v.rith 100% predictability. In less than a
minute after such exposure, I suffer an instanta-
neous exacerbation of my tinnitus which can
last for minutes, hours, or days. Accordingly,
I absolutely refuse to subject myself to such
trauma. Much to the chagrin of some friends
and relatives, 1'11 attend the weddings and Bar
Mitzvahs but leave before the loud music starts.
I've learned that those who Jove and care for me
understand my reasons and are not offended.
Over the years I have given considerable
thought to tinnitus and have evolved a theory
that makes sense to me. To understand my theo-
20 Tinnitus 'Zbday/September 1999 American Tinnitus Association
ry better one needs to give consideration to the
body phenomenon of pain. Pain is
not a disease. Rather, it is a symptom which
alerts the patient and the physician that some-
thing in the body is going wrong. It is a signal
that directs the patient's attention to the area.
from which the pain emanates. For example, 1f
one inadvertently touches something extremely
hot, pain is felt instantaneously and the wm
reflexively jerk the hand away from the pamful
stimulus in order to protect body tissues from
damage. When the pain is the result of a n:edical
condition, the proper medical and/ or
treatment is likely to alleviate this symptom.
In the rare disease called Familial
Dysautonomia (Riley-Day a
defect causes interference w1th the transm1ss1on
of pain stimuH from the skin to the central ner-
vous system. Because of their insensitivity
pain, children with this disease do not reflexively
remove themselves from painful stimuli.
Accordingly, they may not bring dangerous situa-
tions to the attention of parents and other care-
takers. Injuries to the skin, eyes, tongue, and
gums are common.
Certain tissues do not have the capacity to
feel pain of the kind one experiences when a fin-
ger touches a hot plate. The retina of the eye is
an example. Obviously, it can still be damaged.
For example, if one were to try to look directly .at
the sun without protection, the human body w11l
provide automatic protection by reflexively clos-
ing the eyelids and jerking the head away so. that
the light will not impinge directly on the retmas.
The same principle holds with regard to the
sense of smell. A noxious odor results in immedi-
ate attempts to withdraw and protect oneself.
The sense of taste works in a similar manner.
Something that is extremely bitter or distasteful
is often reflexively spit out in order to protect the
body from the potential harm it might cause.
Although the external ear can feel pain, the
internal ear (where the hearing organs are locat-
ed) is not pain sensitive. However; like other
tissues in the body, the ear needs protectiOn from
that which will damage it: loud noise.
Now to my theory. Because tinnitus will usu-
ally increase if one subjects oneself to ongoing
exposure to loud noises, and it will usually
reduce when one removes oneself from the noisy
situation, my type of tinnitus (the kind
v.rith presbyacusis) might simply be a body s1gnal
that says "get the hell out of there!"
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TINNITUS: A BLESSING IN DISGUISE? (CONTINUED)
If this theory is correct, then the discovery of
a treatment that suppresses tinnitus might be a
mixed blessing. The same treatment that would
alleviate the grief of the tinnitus sufferer might
also deprive the individual of the mechanism that
alerts one to the danger of loud noises - and
possibly to the dangers of some disease process
that is cp.using the tinnitus.
We who have tinnitus might never enjoy the
pleasures of complete silence - walking through
quiet woods, silently enjoying a beautiful scene,
or just sitting quietly and relaxing. It is a depriva-
tion and a loss of a pleasure. But it is not a physi-
cal pain. For me, when I lead an active life,
involve myself in those things that provide me
with interest and enjoyment, I am less likely to
be bothered by my tinnitus (or other irritants, for
that matter).
It is my hope that my theory will prove use-
ful for tinnitus sufferers by helping them take a
slightly more positive attitude toward their tinni-
tus: to view it as a useful symptom (its grievous
aspects notwithstanding) that helps them avoid
acoustical trauma and protects them from further
hearing loss and further intensification of their
tinnitus.
The Hippocratic dictum to doctors is: "Nulli
nocere" - Above all, do not harm. Doctors might
not be able to help most of the tinnitus patients
who come their way, but they can warn them
about the detrimental effects of noise trauma. My
theory serves this principle, and is epitomized by
a close friend's poignant warning: "If you don't
listen to your body when it whispers, it wm start
to scream., a
Richard A. Gardner; M.D., is Clinical ProfessoY of
Child Psychiatry at Columbia University College of
Physicians and Surgeons in New York City. He is
also in the private pmctice of psychiatry in Cresskill,
New Jersey.
Ame1ican Tinnius Association Tinnitus Thday/September 1999 21
Beethoven and Me
by Julian Crandall Hollick
Julian Crandall Hollick is a well-known producer for
National Public Radio who sculpts with sound to pro-
duce highly complex and beautiful pieces. Currently,
he is traveling abroad for a new series about Islam.
In May of this year, he developed a middle ear infec-
tion that left him with tinnitus and quite literally
unable to hear.
For two weeks, Beethoven and I were members
of the same select society. I was brought up on
Beethoven's music. I adore it. But I hated every
minute he and I belonged to the same select
group.
The trouble started at the beginning of May.
I flew to Bangladesh - a long flight - and my ears
didn't immediately "pop" on landing. That was
unusual. I tried all the usual things - yawning,
turning my head from side to side, blowing my
nose. And after 24 hours my ears did clear, so all
was well.
'TWo weeks later I flew to Boston and that's
when the problem began. Normally my ears pop
once I'm back inside the terminal. This time they
didn't.
I waited. My son advised "candling" or burning
a special tapered candle to suck up the offending
wax. This made sense. I'd last had my ears cleaned
when I was six or seven. So maybe they were all
full of wax? I lay on my side with a candle burning
away a few inches above my ear. It was rather
pleasant as 1 heard the wax being sucked up into
the candle.
'
1
Full. Absolutely full! Look at the amount of
wax!" my wife triumphed. "I've never seen so
much wax. When did you last clean them?" The
once-hollow candle was indeed full of wax. It
went on for three days like this. After each can-
dling there seemed some improvement to my
diminished hearing and the slight buzz I heard.
There would be a lessening of the buzz in one of
my ears when I tilted my head to one side. But
hope only lasted a few minutes as clouds moved
back in.
And then my hearing went. Thtally.
One moment I was with my family. The next
I was isolated in a padded cell with a constant
roaring sound inside my head. Anyone familiar
with recording would recognize it immediately as
22 Tinnitus ?belay/September 1999 American Tinnitus AssQciation
"white noise" - the sound a river or a waterfall
makes, a sound indistinguishable from a raging
wind. It has no recognizable character. It is just
noise. And this time it didn't let up. It didn't mat-
ter if I tilted my head sideways or forward or
upside down, or laid down on my side. 1t was
there, ever-constant.
So I went to see an ear specialist. Apart from
the usual (telling me I was overweight), she prod-
ded and listened and then solemnly informed me
I had no movement in my middle ear, and that I
had an infection. It could have been brought on
by the flight, she said, and the candling could
have aggravated things. But the fluid was now
static and it had to be loosened. It could only be
cleared up by a hefty dose of penicillin and regular
clearing of the nasal passages, head swathed in a
towel over a basin ofboiling water, with plenty of
Vicks. I didn't dare seek another opinion and
maybe more bad news. But in the back of my
mind, I wondered, "What would happen if it didn't
clear up?"
Ten days came and went. I took the penicillin
and steamed my head and nothing changed. I
started wondering what Smetana, the 19th century
Czech composer who woke up one morning stone
deaf, must have felt like. Did he feel suicidal? In a
rage? Did he have any inkling beforehand?
Or what about Beethoven, who progressively
lost his hearing and yet still"heard" his composi-
tions, his music, within his head? Would I, could I
produce radio programs in spite of, or perhaps
because I could no longer hear as others could?
If it were possible, what a challenge! I could imag-
ine strange wonderful new relationships between
sound and voice, both conceived as musical instru-
ments. But was it possible? Or was I imagining
such potential creativity? I didn't want to pity
myself. I wanted to believe.
Ten years earlier, I had had a sudden and
similar panic when I collapsed and woke up in
a hospital to discover I was a diabetic. For three
weeks, I tried injecting myselfbut I was not very
successful. I went into a sweat just thinking about
injecting myself. My skin became leathery in
anticipation. And how could I ever work abroad,
in the deserts of Rajasthan or on a hike in the
Himalayas and keep a cool supply of insulin? I dis-
covered that NPRjournalist Scott Simon had been
a diabetic since he had been sixteen, and some-
how he managed to inject himself, even in fox-
holes during "Desert Storm." So it could be done.
QUESTIONS AND ANSWERS
Jack Vernon's Personal Responses to Questions from our Readers
by Jack A. Vernon, Ph.D., Professor Emeritus,
Oregon Health Sciences University
Q
Ms. B. in New York reports that she was
aware of a study of three tinnitus patients
who were treated with Prozac, all of
whom had their tinnitus disappear. On the basis
of this report, Ms. B. also started taking Prozac
(10 mg a day) and on the fifth day her tinnitus
completely resolved. She has now been on Prozac
for nine days and her tinnitus has not returned.
She asks if others have taken Prozac and if so
with what result.
A
We have had various reports from tinni-
tus patients who were prescribed Prozac
and we conducted a rather informal open
study of Prozac. Out of 25 patients, five received
tinnitus relief, 13 reported no effect upon their
tinnitus, and seven said their tinnitus was tem-
porarily worse. These results leave us not know-
ing exactly what to recommend regarding Prozac
but I think I would make the following sugges-
tion. 'lly Prozac if you wish and if there is exac-
erbation of your tinnitus immediately stop
taking it. May I ask of those who try Prozac to
please inform us of the results.
Q
Mr. P. from Australia indicates that he
has had ear surgery whereby his ear
canal was enlarged and grommets (or
tubes) were inserted through both eardrums. As
a result of the surgery, he now has severe tinni-
tus. 1b date he has found that bilateral hearing
aids have been of no help with his tinnitus
which was measured to be 7330 Hz. He obtains
some relief from a Walkman and has been fit-
ted with bilateral tinnitus instruments (units
that contain both hearing aids and tinnitus
maskers with independent volume controls).
He asks why the hearing aids failed to provide
tinnitus relief. He also indicates that he experi-
ences rather severe depression.
A
The fact that your tinnitus is at 7330 Hz
places it well above any sounds that most
hearing aids would amplify. You need
masking sounds in the 7000 Hz region to effect
masking. The tinnitus instruments could pro-
vide the relief you seek. In addition I would sug-
gest bedside masking for sleeping, like a CD
player with Petroff Audio 'Technology's CDs.
Because of your depression, I would caution you
against the use of tri-cyclic antidepressants
(continued)
Beethoven and Me (continued)
But losing hearing seemed a far darker situa-
tion. I started to retreat into a private world and a
private language. It was frustrating for others not
to be able to talk with me. To be honest, I'm not
sure I really missed them. Yes, I was in a cocoon
and I couldn't get out. But if I wanted to be free
of unwanted conversations I had a perfect excuse.
And then it happened. Something made me
sneeze.
"I can hear! They're opening!" I screamed.
Of course, I thought I was just talking at normal
volume. And nobody knew what I was talking
about. They couldn't share in this wonderful joy.
What was open? The Pub? The stores? What?
And then, just as soon as they opened, a shaft of
sunlight streaming in, they closed again. I was
back in my own little world. In darkness. But they
had opened!
Two days later I sneezed again, and my ears
popped opened for good.
I have a lot of sympathy now for deaf people
and people with tinnitus. An awful lot. And I
thank God I can hear again and that the tinnitus
is gone. I will never take hearing for granted.
No doctor has advised me against flying again,
perhaps because I haven't asked. Indeed, not fly-
ing would make it rather difficult for me to work.
Nevertheless, I wondered if J wasn't tempting Fate
last week when I flew again, this time to Pakistan
and back.
My ears never closed. B
American Tinnius Association Tinnitus Thday/ September 1999 23
QUESTIONS AND ANSWERS (continued)
because they can exacerbate tinnitus. I assume
that your depression will leave once your tinni-
tus is relieved. If not, you might want to try the
drug Wellbutrin or the herb St. John's Wort, both
of which are effective against depression and do
not exacerbate tinnitus.
Q
Ms. S. from Pennsylvania has noticed
that her tinnitus is worse after sleeping.
She says that even a short nap in the
afternoon can cause a significant increase in
her tinnitus and she would like an explanation.
A
I wish I could give a definitive answer.
There is a group of tinnitus patients who
find that their tinnitus is greatly altered
by sleep. For these patients it can go either way.
If they are having a good day and go to sleep, or
even take a nap, they awaken with increased
ringing. Or if they are having a bad day and go
to sleep, they awaken with a significant reduc-
tion in their tinnitus. The change always occurs
during sleep. I have discussed this matter with
sleep experts who throw their hands up and say
they have no idea why tinnitus should behave
in this manner. Since we cannot explain this
phenomenon yet, let's see if we can change it.
I would suggest that you sleep with a bedside
masker as a possible way to break this unusual
cycle.
Q
Ms. H. from Connecticut indicates that
her tinnitus was exacerbated by dental
surgery involving implants in both upper
and lower gums. She describes the tinnitus as a
hissing sound which covers the entire head plus
a pulsatile tinnitus on the right side of the head.
She has tried acupuncture, masking devices,
hypnotherapy, and prayer and only the latter
seems to help. She takes a variety of drugs:
Darvocet, multi-vitamins, Nortriptyline,
Lorazepam, Prozac, Premarin, and Provera.
A
You are taking such a host of medications
that one wonders to what extent their
combination might be causing an
increased tinnitus. Perhaps you would be willing
to discuss your drug regimen with your primary
physician to see if they are all necessary. I also
wonder if you were properly fitted with the
maskers you tried. It might also be reasonable to
try CD masking sounds.
24 Tinmtus 'Jbday/September 1999 American Tinnitus Association
Q
Mr. S. in Pennsylvania sent me a
letter he had received about a "natural
formula" that had been discovered for
the relief of tinnitus. He asks:
11
Do you have
any comments to make about this so-called
'amazing' product?"
A
The letter Mr. S. received was also sent
to me and it makes tinnitus relief claims
for a product called "Tinnitabs." The stat-
ed effect of Tinnitabs is from the author's own
experience (which means the results are not
based upon any properly conducted tests). The
product contains five natural homeopathic
ingredients that are said to trigger natural
healing processes in the body. According to the
letter, a bottle of 250 tablets costs $19.95 on a
money-back guarantee. Interestingly enough,
Tinnitabs is not available in stores or health
product catalogues -just mail order from the
company. Now, having said all that, it is my
guess that Tinnitabs probably won't hurt you
if you want to try them although I doubt the
claims made for this product. If you or anyone
else tries Tinnitabs, I would appreciate hearing
about the results.
Q
Mr. K. in California says his tinnitus
sounds like 1,000 crickets. He has two
hearing aids but only uses one from time
to time. He adds that he sometime flies and
wonders if he should use earplugs while flying.
A
In the face of bilateral hearing loss, it
does very little good to use only one hear-
ing aid. I'd seriously recommend using
two hearing aids. That your tinnitus sounds like
crickets means that it has the pitch of about
2000 Hz. It is possible that hearing aids would
relieve tinnitus of that low a pitch. As for flying,
I recommend the use of earplugs for takeoffs
and landings and that you sit in an aisle seat
as far forward on the plane as possible.
(It's quietest there.)
Notice: Many of you have left messages requesting
that I phone you. I simply cannot afford to meet
those requests. Please feel free to call me on any
Wednesday, 9:30a.m.- noon and 1:30-4:30 p.m.
Pacific Time at 503/494-2187. Or mail your ques-
tions to: Dr. Vernon c/o Tinnitus Today, American
Tinnitus Association, PO. Box 5, Portland, OR
97207-0005.
SPECIAL DONORS AND TRIBUTES
ATA's Champions of Silence are a remarkable
group of donors who have demonstrated their
commitment in the fight against tinnitus by
making a contribution or research donation
of $500 or more. Sponsors and Professional
Sponsors have contributed at the $100-$499 level
Research Donors have made research-restricted
contributions in any amount up to $499.
Contributions to ATA's Tribute Fund will be
used to fund tinnitus research and other ATA pro-
grams. If you would like your contribution restrict-
ed for research, please indicate it with your gift.
1hbute contributions are promptly acknowledged
with an appropriate card to the honoree or family
of the honoree. The gift amount is never disclosed.
Our heartfelt thanks to all of these special
donors.
A1l contributions to the American Tinnitus Association are tax-deductible.
GIFTS FROM 4-16-99 to 7-15-99
Champions of
Sol Charen Arthur G. Kearney Bradley Ross Johnson & Johnson Max
Silence
Jim Chesnut Jack Kelly Barbara L. Sanders Pfizer Foundation Sylvia Eisenberg
(Contributions of $500
Guy R. Clark Katherine C. Kline Bruce A. Schommer Readers Digest Selma and Alan
Philip S. Collins Elliott Koidin Bryan Schwab Foundation Rothenberg
and above)
Craig Connelly Walter P. Kulpinski Palmer Sealy, Jr. US Borax, Inc. Susan R. Ericson
Joel Alexander
Capt. Thomas C. Henry G. Largey Robert w. Selig Charles E. Sikes
Julia R. Amaral
Crane, USN, Ret. Donald J. Larivee Marjorie Shaw-Kobe
Special Friends
Mrs. Sikes
Andrew Beaven
Roy W. Cronacher, Jr. Michael C. Lehner John V. Shepherd, Sr. Fund
Matthias B. Bowman
Elizabeth J. Curtis Charles B. Levitin Charles Siess
In Honor Of
Thomas W. Buchholtz,
Donald W. Davis Jeffrey Loder Hal Sitowiz
In Memory of
Franl<. Albano
M.D.
Dr. Robert M.
James 0. Chinnis, Jr.
Marvin N. Demchick Philip J . Longo Robert Lee Smith
Johnson
Ad vest, T nc.
Kathryn M. Dobrinski John H. Macfarlane Eugene J. Sobel
Judith E. Beaston
Steve Laubacher,
Joseph J. Demty
Bruce A. Downs Dan R. Malcore Thomas G. Soyster Ph.D.
Kenneth Donovan
Joyce G. Bethany
Jeanna L. French
Irene Duffield Constantine J. Malfese Maria Starr
Ross Coles
Stephen M. Nagler,
Susan Laimbeer
A.T. Evans Annette D. Mallory William F. Stevens
Pauline H. Goddard
M.D. , F.A.C.S.
John Malcom
Ray E. Fankhauser Grace P. Maresca Douglas H. Steves
Leroy S. Hollingsworth
Stephen M. Nagler,
Jack G. Mann
Marcy Feldman Peter A Marrinan Barbara F. Sturtevant
Mary Holtzman
M.D., F.A.C.S.
Andy Matthiesen
Joy A. Fogarty Wayne E. Maxon Arvinder Surdhar
Charles M. Howe
Jack Rodgers
Francine and Ray Arnold L. Mayersohn Fred D. Thompson
George Kies
Jack A. Vernon,
Jerome Ott
Foster Paul J. Meade William J . Tmman Ph.D.
Louise Parmley
John Frazier Robert J. Mennuys Lee Titus
Gini Linam
Sylvia Brown
Carolyn H. Peters
Lisa Freedman Annette Meskin James C. Totten
Mike and Georgina
Joan Cohen
Dan Purjes
Robin R. Fuller John M. Meyer Beryl A. Vogel
Li.nghor
Marriage Of
Steven A. Rothstein
Chester J. Mackson
Martha M. Smith
Gerald Otis Gates Matt Minninger Dorothy R. Waiste
Gladys V. Moore Stan Sanders and
Lewis E. Stengel, Jr.
Dr. Arthur Gelb Perrv Mitchell Walter W. Walker
Thomas ,T. Scolastico Barbard Thbachnick
Louis A. 11'ebino
Bob Goodman James A. Morris Kirby M. Watson
Stephen M. Nagler,
Jack A. Vernon, Ph.D.
Jane Green Gail L. Neale John L. Werner, E.D.D.
TRIBUTES M.D., F.A.C.S.
Jeannette E. Green Carole A. Nerney H.A. Wheeler
In Memory Of F. Helmut Weyrnar
Marlene Greenbaum Regine R. Nexsen David P. Y\1histler, Ph.D. Research Donors
Stephane W. Wratten
Elizabeth Grisbaurn Ruth E. Ochs Robert E. Williams
Helen Donovan
Judith H. Aberly
Sponsors
Harold P. Grout Geoff O'Connor David Winn
Kenneth Donovan
Judy Abrahamson
Manuel Feldman
(Individual
Thomas E. Guilbeau Robert C. Odie James G. Winn
Marcy Feldman
S. F. Accardo
Contributions
Philip J. Gutentag Michael D. Olander Brax Wright
Frances Gross
Virginia L. Adams
from $100 - $499)
Paul R. Haas Julian M. Olf Carter Wurts
Arlo and Phyllis Nash
Lawrence G. Adelman
Larry E. Ashmore
Larry E. Hall Phyllis R. Ongert Margaret E. Zechman
Sister Rose Kateman
En.v-in J. Alexy
Gerald Aus
Thomas P. Hall Karl E. Owen Kenneth Zerda
Sally Rice
Rich Alger
Joseph M. Baria
Ronin M. Hanna Gerald J. Palazzola Theo C. Allen
Steven Hanson Nick Paras
Professional
Joseph L. Kem, Sr.
Nicholas Andrews
T Larry Barnes
Suzanne Hanson William R. Patterson
Sponsors
Sandra Fuller
Mary Austin
Ned K. Barthelmas
Laura Hine
Earl F. Bates
Shya Hao Art Perry (Profe.ssioHal
Carol A. Jacob
David Azevedo
David Beason
Clayton R. Harris Ronald W. Perry
Contributions from
Thomas and Grace
Ruth v. Baer
Martin Berenberg
James and Colleen Shirley R. Perry
$100 $499)
Kern
Duane A. Baird
Debor and Charles
Hartel Richard A. Phillips Dennis L. Burrows,
Alan J . Woods
Annetre M. Ball
Bern
Dennis Hartley Elaine T Platt Ph.D.
Dora J. Koll
William 8. Bamforth
William D. Bethell
Margaret A. S. Hayes Mamie Poggio H. Wayne Cecil
Philip J. Bankard
John Beyer
Will iam F. Hendren Roben L. Pope Linda Centore, R.N.,
James Larson
Marie C. Bare
Richard Bouthiette
Elizabeth B. Hill Margaret L. Possert Ph.D.
Florence M. Barham
Arthur H. Bragg
Loren G. Hinkleman Marceline Powell Luiz H. Escudero, Jr.
Pauline Markowitz
Patricia A. Bartels
Lee Bronson
Lorraine Hizami David Racker Hearing Institute Child
Rosemary Coltin
Daniel W. Barthell
Jack E. Brown
James R. Hoffman Otis D. Rackley, Jr.,
&Adult
Ethel Gordon
John A. Basselini
Harry A. Bruhn
Kevin Hogan D.D.S.
Anthony F. Jahn, M.D.
Joan and Mark Lappin
Tekla Bekkedal
James Holtshouse James E. Reeves Elliot Wineburg, M.D. BeltoneLedford
J . Charles Bruse
Doris and Samuel Douglas Reilly
Elizabeth Wolfson
Hearing Aid Center
Mark H. Buick
Fred zemke
ZO!,'l'afos Family
William A. Burgin
Horowitz, M.D. Steve Richardson
Corporations with
Robert K. Meredith
Charlene Bennett
Lee Burton
Gilbert Hudson Sheffield Richey
Anna M. Brown
Sam Berkman
Curtis E. Calhoun
RobertS. Humphreys Jeffrey A. Ristine
Gifts Elizabeth A. Lee
Louise Bernotas
Barbara Young Camp
William H. Hurt Charles w. Robinson
Arco Foun ation, Inc.
Jean Siemienski
Jack C. Berry
Frank T Carnella
Joan Imber Robert W. Roper
Chase Manhattan
Sydney M.ohn
Janice A. Billig
'Terrence J. Caulfield
Elmore Jenkins Doug Rosenberg
Foundation
E. Victoria Mohn
William G. Sittler
Gregory W. Chadwick
George C. Juilfs Jennie E. K.
Hoechst Corporation
Susan Moreland
Robert E. Blake
Pamela D. Chandler
Joseph J. Juska Rosenblum
Foundation, Inc.
Andy Matthiesen
Norman Bleckner
John Kapteyn Dolores Rosoff
J.P. Morgan & Co., Inc.
Richard F. Boelter
American Tinnius Association Tinnints TOday/September 1999 25
SPECIAL DONORS AND TRIBUTES (continued)
Eddie Bond
Mildred S. Bonwit
Bruce Boston
Alain G. Boughton
Rita Bourque
Joan L. Boyer
Stephen J. Boyle
Eugene Bradin, D.D.S.
James W. Brady
Adelia Bratsos
Merlin R. Bretzman
Lauran Bromley
Pastor John Broomall
Sarah Broshous
Donna F. Brown
Karen L. Burke
Judith E. Caldwell
John J. Calli
Thrry R. Canter
Mildred E. Card
Daniel Carrillo
William D. Casale
Doug Cecil
Isabelle Chapman
Carol Jean Chatterton
Martha Chaykosld
Bruce H. Chilcote
Charlotte M.
Christensen-Johnson
F'lossie Anita Clark
Iris V. Clark
John P. Clark, Jr.
Bruce D. Clow
Frank S. Cognato
Joan Cohen
Robert . Collawn
Mary J. Collins
Mary L. Collins
John S. Conklin
Gail E. Conley
FoKConner
James J . Comrada
Anna J. Conwell
Donald J. Cook
John H. Cordonnier
Vivian Cornwall
Elizabeth S. Coston
Ward S. Cottrell
Capt. Thomas C.
Crane, U.S.N., Ret.
Fred Cucchiara
Raymond M. Dabler
r
Dennis M. Daly
Pierre David
Phyllis M. Deatherage
Dana L. Degeest
Sandi L. Delorey
Chandler S. Dennis
Carole Desnoes
Timothy D. Dobbins
Paul J. Dorweiler
Nancy Doyle
Howard 0. Dugger
Mary Ellen Durfee
Sanford Ebner
Joan Echols
Judith M. Eda
Wayne Edward
Vivian Ehrlich
Robert w. Eichert
Robert Elassad
Dr. Robert Ellington
Abraham Ely
Ron and Joyce Evans
'!yler D. Evans
B. Farrington
James T. Fehon
Judith Feld
Sylvia Feldman
Sol Fingar
August E. Firgau
Rudy J. Fleischacker
Vicki H. Flynn
Bernice Foster
Antonio Frace
Myer Frank
Edward J . F'ranskowski
Joana L. Frick
Chuck Fuller
George N. Gaston
David Gena
Maj. Leo A. Gendron
Joseph Genovese
Elaine M. Germont
Gerald Gevertz
Betty Gibbs
Ed Gioscia
Gloria Giunta
Barry S. Goldberg
Ethel Gordon
Victoria Graor
Norman and Gilda
Greenberg
Marianne R. Guay
Beth c. Haidt
Betty C. Hall
'
-
....:..
Laurence Hall
Esther M. Hamblen
Norma M.
Hammerberg
Lisa Hammock
Stephen Hanson
Steven Hanson
Penny Harmening
Darwin W. Harris
Jesse Harry
Doris E. Hart
Donald D. Haynsworth
Elizabeth S. Helfman
S. Dale Hess
Peter Heyne
Thea D. Hodge
Evelyn E. Hogan
Gail R. Homan
Julian Hoogstra
Rosa Huang
C. Belle Hudson
Richard Hughes
Carl Isackson
Nathan v. Jyer
Linda Jack
Paul Jackson
Lucille J. Jantz
Lawrence E. Jensen
Ellise S. Johanson
Michael E. Johnson
Ronald L. Johnston
Dorothea R. Jones
James W. Jones
Jana Kaiser
John P. Keehn
Bryan P. Kennedy
John T. Kennedy
John B. Kidd
John F. Kilstrom
Suzy Kim
John E. Kinney
Luann F. Kirsch
Frank L. Klein
Heinz Kleuker
Frank V. Koenig
Sandra Kohl
Georgian Kolber
James E. Komer
Steve M. Konneman
Carl Koos
Lance Kroetz
Virginia C. Kuehner
Joseph A. Kuhn
Harold Kurtz
J crry J. LaForgia
Robert N. Lando
Pau I T. Larsen
Markus N. Larsson
Margaret R. Layton
Barbara Lemming
Abraham D. Levitt
Harry Levitt, Ph.D.
Ernest D. Lewis
Gary W. Lightner
Virginia A. Lobsinger
Marilyn Lipkin
Virginia L. Lipp
Lowell P. Lippman
Frank W. Little
Donald H. Lease
John Anthony
Lombardi
Agnes Longtin
Griffin Lovett
Ernest A. Lucci
Nick Luis
Anthony C. Lunn
Joyce E. and Wilbur
Lust
Mikey Lustberg
James E. Lyons
Chester J. Mackson
Edward and Frances
Madasz
Earl S. Maeser
Julia B. Malone
Carolyn F. Mann
Sylvester V. Manzo
Robert E. March
Nicholas F. Marco
Gregory P. Markowiec
Thomas E. Marler
Richard L. Martin
Angela Mas
Donna W. Masterson
Arnold L. Mayersohn
Alex A. Mazzucco
Salvatore Mazzucco
Theodore H. McCade
Sheila M. McLaughlin
Carolina Mearns
Richard Mecca
Anne B. Medbery
Ruth L. Meier
Sarah Melamed
Jill Meltzer. M.A.T.
Marvin Mesker
Ernest G. Michel
Bernard J. Michels
Dorothy Miller
Leo A. Miller, Jr.
Douglas Minniear
Carlos and Janis Mize
Arthur E. Molin
Julie Morin
Richard Monagle
Dorothy C. Monahan
Anthony M. Moniak
David A. Moore
Stanley R. Moore
Jewel D. Morgan
Don L. Morrill
Julie Morin
Philip T. Morrow
Ann Moscola
Frederick J. Moyer
Joseph F. Mudrovic
William G. Mulvey
Andrew J. Murphy
Mae Nachman
Rita Nadelman
Jim Neal
Lloyd E. Neal, Jr.
Stuart L. Nicol
Alfred H. Norling
Donald G. O'Brien, Sr.
Mary E. O'Brien
Laverne A. O'Hare
William D. Odbert
Sevgin Oktay
Margaret M. Olert
Mark Owyang
Joseph G. Oyler
Joyce Pacheco
Leonard J. Pacifico
William E. Paland
William D. Paradis
Bernice R. Pardue
Jon Paris
Charles R. Paroubek,
Jr.
John D. Parsons
Thomas J. Patrician
Virginia T. Patton
26 Tinnitus Thday/September 1999 American Tinnitus Association
Reginald J. Pearce
David Pearl
Hillary Pearson
Ruth A. Pearson
Vera J. Pech
Mary K. Pecha
Gerard Perin
Portia Perino
John D. Perkins
Barbara Perrin
Shirley G. Perry
.Rudolph J. Persico
Henry H. Peterson
Shirley Y. Peyton
Arthur J. Phillips
Jerry Pickens
Judith Piepsney
Robert D. Poeta
Judy Pohlod
Thd Pollock
Artis w. Porter
Marian I. Pospisil
Bruce K. Powell
Helen M. Pratt
Pam Pratt
Harvey Rabin
Michael A. Randolph
Herbert B. Ray
Allen Raymon
Gary L. Reed
Richard E. Reeves
Donald L. Reinking
Karen Reissmann
Gloria Reubenstone
Curt W. Rhodes
Edward A. Richards
Sheffield Richey
Lolly Rickert
Michael J. Robb, M.D.
Barry J. Robbins, M.S.
c. H. Roberts
Douglas Robinson
Marjorie J. Robinson
Miriam C. Roman
William S. Royce
James G. Rudd
Mike Rutland
Mark J. Salas
Grace Sanders
Robert H. Schmidt
Daniel Schneider, M.A.,
FAAA
Karen Schramke
Luverne Schroeder
John T. Schulte
James M. Sheeran
Dale Shropshire
L. J. Siebenaler
William J. Simon
Lynn H. Simonson
Thelma M. Sjostrom
Roberta E. Slavitt
Patricia A. Smith
Patricia M. Smith
Regina P. Smith
Sheila C. Smith
Walter A. Snell
Mary B. Somers
Jennie E. Spence
Larry Stafford, SFC
USA Ret.
Jeffrey B. Stallings
Elizabeth Standage
Nick Stcavish, Jr.
Eugene Stengel
Harold Stidolph
Eleanor G. Stitt
Thd Stojek
Orloff w. Styve
Mireya Sucre
Daniel J. Sullivan
Mike Sullivan
Mary E. Swanson
Diane Syme
Robert L. Szabo
Marjorie B. Tahaney
Daniel R. Thlbot
L. Tatum
'Terry G. Tatum
Thomas M. Taylor
James B. Thmple
Richard G. Teutsch
Gwendolyn D. Theriot
Judy E. Thewes
Jorge A. Theye
Frederick C. Thompson
Karen M. Thomson
Mr. and Mrs. Charles
Tittle
Michael J. lbrtorella
Bryan 1Toutman
Gary D. Urban
Sophia Valenti
Van Vangele
Joseph A. Verdon
Robert S. Vordenberg
Linda L. Wade
James F. wagner
Julie Johnston Walter
Sherry L. Waherscheid
Harold A. Waters
Donald Way
Phoebe Welch
Annette Wellman
Helen I. Wells
Joseph H. Welsch
Roger L. Wentz
Leon Wexler
Glenrose Weymouth
Martin F. Whalen
Erdean 0. White
Barry Whitesell
Mr. and Mrs. E. D.
Whitesell, Jr.
Lawrence S. Wick
Linda Wickman
Mildred B. Williams
Eliz.abeth Williger
Dr. Susan I. Wilner
Wendi Wilson
Shirley L. Wireman
Nancy J. Wolke
Virginia S. Wood
lracema B. Woolley
Katherine S. Wootton
James Wright
Norma York
Robert L. Young
John G. Youngs
Henry Zacek
Richard G. Zebert, Jr.
An open-to-the public lecture by
Tinnitus Researchers and Physicians
- for patients and professionals -
AT A's
Tinnitus Public Forum
Monday, September 2 7, 1999
7-9 p.m.
New Orleans Hilton Riverside
New Orleans, Louisiana
Guest speakers:
ATA's Executive Director, Steve Laubacher, Ph.D. ,
ATA Board Member, Stephen M. Nagler, M.D. , and Members of ATA's
Scientific Advisory Committee: Mary Meikle, Ph.D.; Ronald Amedee,
M.D.; Michael Seidman, M.D.; and Richard Harlan, Ph.D.
Guests will speak on new aspects ol tinnitus treatment and research.
There is no charge lor this event.
An open Question and Answer session follows the panel lecture.
See inside (page 19) for more details.
AMERICAN TINNITUS ASSOCIATION
P.O. Box 5, Portland, OR 97207-0005
Address Service Requested
Non-Profit Org.
U.S. Postage
PAID
American Tinnitus
Association

Tinnitus Today September 1999 Vol 24, No 3

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Tinnitus Today September 1999 Vol 24, No 3

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September 1999 Volume 24, Number 3

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