Tinnitus Today June 1994 Vol 19, No 2

JUNE 1994 VOLUME 19, NUMBER 2
Tinnitus Today
THE JOURNAL OF THE AMERICAN TINNITUS ASSOCIATION
"To carry on and support research and educational activities relating
to the treatment of tinnitus and other defects or diseases of the ear. "
In This Issue:
The Whys and Wherefores of Hearing Protection Devices
5 Million - The Beginning to the End
A Message of Hope
There are Options
Tinnitus: The Cart of the Horse? ' ' .
Sounds Of Silence
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sounds caused by Tinnitus with the
Marsona Tinnitus Masker from Ambient
Shapes. The frequency and intensity of the
simulated sounds match the lOnes heard by
many tinnitus sufferers. These masking
devices are proven effective in assisting
many patients in adapting to their tinnitus.
\Yie cannot predict whether or not the
Marsona is appropriate for you, but the
probability of successful masking is well
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uses Jess than 5 watts of power, or about
as much electricity as a small night light.
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precise masking.
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The Marsona features over 3000 settings
adjustable center frequency, frequency
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The Tinnitus Masker has an ultra-high
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legibility, a frequency comparison chart,
and a built-in optional shut-off rimer.
The bedside Tinnitus Masker can be
purchased through Ambient Shapes for
hundreds less than purchasing another
brand through an audiologist or other
hearing professionals.
Size: L 8.75" W 5.85" H 3.12". Uses 110-120V AC
(220-240V available). Ul. and CSA approved
power supply.
I P.O. Box ;069 Hickory, NC 28603 I
- - -
Tinnitus Today
Editorial and advertising offices:
~ ~ ~ ~ ~ 9 ~ ~ ; ~ t u s Association. P.O. Box
5
Port- The Journal of the American Tinnitus Association
Executive Director & Editor:
Gloria E. Reich, Ph.D.
Editorial Advisor:
Trudy Drucker, Ph.D.
Advertising sales: AT A-AD, P. 0 . Box 5, Port-
land, OR 97207 (800-634-8978)
Tinnitus Today is published quarterly in March,
June, September and Decembef. lt is mailed to
members of American Tinnitus Association and a
selected list of tinnitus sufferers and professionals
who treat tinnitus. Circulation is rotated to 100.000
annually.
Volume 19 Number 2 Junel994
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.
Contents
The Publisher reserves the ri,ght to reject or edit
any manuscript received for publication and tore- 4
ject any advertising deemed unsuitable for Tinnitus
Today. Acceptance of advertising by Tinnitus To-
From the Editor
by Gloria Reich
day does not constitUte endorsement of the adver-
tiser, its productS or services, nor does Tinnitus
Today make any claims Of guarantees as to the ac-
curacy or validity of the advertiser's offer. The
opinions expressed by contributors to Tinnitu.< To-
day are not necessarily t.hose of the Publisher, edi-
tors, staff. or advertisers. American Tinnitus
Association is a non-profit human health and wel-
fare agency under 26 USC 501 (c)(3)
Copyright 1993 by American Tinnjtus Associa-
tion. No part of this publication may be repro-
duced. stored io a retrieval system, or transmitted
in any form. or by any means, without the prior
written permission of the Publisher.
ISSN: 0897-6368
Scientific Advisory Committee
Ronald G. Amedee, M.D., New Orleans, LA
Robert E. Brummett, Ph.D., Portland, OR
Jack D. Clemis, M.D., Chicago, L
John R. Emmett, M.D., Memphis, TN
Chris B. Foster, M.D., San Diego, CA
Barbara Goldstein, Ph.D., New York, NY
Richard L. Goode, M.D., Stanford, CA
W. F. S. Hopmeier, St. Louis, MO
John W. House, M.D., Los Angeles, CA
Robert M. Johnson, Ph.D., Portland, OR
Gale W. Miller, M.D., Cincinnati, OH
J. Gail Neely, M.D .. St. Louis, MO
Jerry Northern, Ph.D., Denver, CO
Robert E. Sandlin, Ph.D., San Diego, CA
Abraham Shulman, M.D., Brooklyn, NY
Mansfield Smith, M.D., San Jose, CA
Harold G. Tabb. M.D . New Orleans, LA
Honorary Board
SenatOr Mark 0. Hatfield
Mr. Tony Randall
Board of Directors
Edmund Grossberg, Chicago, L
Dan Robert Hocks, Portland, OR
Philip 0. Morton, Portland, OR, Chmn.
Aaron l. Osherow, St. Louis, MO
Gloria E. Reich, Ph.D., Penland. OR
Timothy S. Sotos, Lenexa, KS
Thomas Wissbaum, C.P.A., Portland, OR
6
11
12
15
21
23
24
25
The Whys and Wherefores of Hearing Protection Devices
by Barbara Tabachnick
5 Million - The Beginning to the End
by Brent Mower
Development Directions - Survey Results
by Brent Mower
A Message of Hope
by Beverly Robinson
There are Options
by Gail Wise, R. N.
Tinnitus: The Cart or the Horse?
by A. James Heins
The Doctor Is In
by Barbara Tabachnick
Profiles: ATA Advisory Committee Members
Robert Dobie, Alexander Schleuning
27 Fifth International Tinnitus Seminar Announcement
Regular Features
18 Questions & Answers
17 Media Watch: Tinnitus in the News
26 Tributes, Sponsor & Corporate Members, Professional
Associates, Special & Matching Gifts
Envelope Publications List, Donation Form
Cover artwork: "ln. Constant Flux", watercolor, by lana DeMartini. Inquiries to the
Blackfish Gallery, 3420 N. W. 9th Avenue, Portland, OR 97209.
From the Editor
by Gloria E. Reich, Ph.D.,
Executive Director
At this time of year our
thoughts tum not only to the joys
of summer but to the conse-
quence of the federal budget.
AT A has been vigorous in its
support of full budget funding for
the National Institute on Deaf-
ness and Communicative Disor-
ders (NIDCD) and routinely
prepares supportive testimony for the appropria-
tions committees of the Senate and House. Your
letters to your congressional representatives are
crucial in helping them to focus attention on fund-
ing tinnitus research. Please write to the repre-
sentatives from yow- state as well as to the chairmen
of the Senate and House appropriations commit-
tees. Also, letters to Senator Hatfield, from Oregon,
who serves as an honorary board member for A TA,
and to Senator Harkin, from Iowa, who is very
interested in hearing and tinnitus, are likely to
receive favorable consideration. Both of these men
serve on the Committee on Appropriations, of
which Robert C. Byrd of West Virginia, is Chair-
man. David Obey, of Wisconsin, is the new chair-
man of the House of Representatives Committee
on Appropriations.
To write to a legislator:
The Honorable (name of your senator or representative)
United States Senate (or) U.S. House of Representatives
Washington, DC (Senate zipcode is 2051 0; House zipcode
is 20515)
A Voice for tinnitus:
My name was recently put in nomination for
the advisory board of the NIDCD by Dr. James
Snow, Director of the NIDCD. Secretary of Health
and Human Services. According to our informa-
tion, Donna Shalala is the person who actually
makes the appointments to the advisory councils of
the NIDCD. Your supportive letters could help
convince her that it is important to have a tinnitus
representative on these planning councils.
To write to Secretary Shalala:
4 Tinnims Today/March 1994
Secretary Donna Shalala
Dept of Health and Human Services
Hubert H Humphrey Bldg
200 Independence Ave SW #615F
Washington DC 20201
More legislative concerns:
Many of us who experience tinnitus are also
hearing impaired and routinely require hearing
tests, other audiological services, and perhaps hear-
ing aids or tinnitus maskers. In the three major
health care bills now before Congress, these serv-
ices are limited, if they appear at all. In the Clinton
Plan (S 17 57/HR 3600) diagnostic services may
include hearing tests but no hearing aids except for
Medicaid eligible children. In the Well-
stone/McDermott plan (S491/HR 1200) profes-
sional services are covered, but hearing aids are
covered only upon a determination of a certified
audiologist or physician. And in the Coo-
per/Breaux plan (S 1579/HR 3222)professional
services are not defined and hearing aids would be
subsidized only in the case of individuals with very
low-income. If you have an opinion about these
issues you should be writing to yow- legislators
NOW!
From Overseas:
We recently received a book called "Treating
Tinnitus by Reading," by Masaaki Kitahara, M.D.
of Shiga University, Otsu Seta, Japan. Dr. Kita-
hara, who is also a member of the International
Tinnitus Advisory Committee, has previously pub-
lished a book, "Tinnitus," exploring tinnitus patho-
physiology and management for professionals.
This new work, a small paperback book with
charming illustrations, is directed to Japanese tin-
nitus sufferers and is an attempt to provide knowl-
edge and counsel about tinnitus in hopes of
achieving improvement. I mention the book to
remind you of the worldwide nature of tinnitus and
to thank Dr. Kitahara for his devotion to solving the
problem of tinnitus. Here is a short passage from
the book. (The Japanese version shows the writing
superimposed on a drawing of a smiling, contem-
plative monk with various characters and shapes
corning out of his ears.)
There is a temple called Daitok:u-ji in Kyoto.
The one hundred and ninetieth head Zen master of
the temple was a priest called Reverend Sesso. I
happen to have his writing "Hidden virtues are like
tinnitus." A Japanese priest compared virtuous
deeds that one accumulates without the knowledge
of others to tinnitus. He says it is all right if one's
good conduct is not known to anyone as long as it
is known to oneself as tinnitus is. I think it is
excellent Oriental wisdom to regard tinnitus this
way. What do you think?
Letter to the editor:
From Jonathan W. P. Hazell, FRCS, Unit
Head and Consultant Neuro-Otologist, Tinnitus
Clinic, University College, London, England
May I write to you in response to the article
w1itten by Barbara Tabachnick on the Tinnitus
Centre-Jastreboff & Co? I do feel that the article
does not accurately emphasise the importance of
the similarity of approach between Pawel Jastre-
boff and myself. When the Baltimore tinnitus cen-
tre was set up I was much involved in the training
of personnel, and the treatment approach was based
almost entirely, at that time, on the approach that
we have been developing in our clinic in London
over the years. Since the clinic started I have been
extremely happy to have been involved in the treat-
ment of patients within the tinnitus centre as a
member of their medical faculty. Pawel Jastreboff
in his visits to University College London, where
he is Visiting Professor, has equally participated in
our clinical activities here. One of the advantages
of this approach has been to develop techniques of
tinnitus therapy, by this kind of close interaction.
On both sides of the Atlantic, the concept of
how we are treating patients is based on the J astre-
boff neurophysiological model. In both London
and Baltimore there are some fairly precise proto-
cols in the tinnitus clinic because of the need to
collect research data and validate the effectiveness
of our approach so as not to inappropriately dupli-
cate our activities. The protocols are slightly differ-
ent and from time-to-time we develop differences
in emphasis, but the overall approach is, I believe,
essentially the same.
I believe the experience in Baltimore has been
very similar, as your straw poll of a few patients
might suggest. I would be very guarded about the
use of the word 'cure' without defining its exact
meaning. In our experience, patients do often lose
totally the perception of their tinnitus, although this
takes between one and three years of ongoing ther-
apy. (Ed. note: The word 'cure' was used only once
in the Patient Talk part of the article: "None have
been cured of tinnitus." The question remains: Is
tinnitus cured when a person no longer perceives
it? Or is tinnitus cured when the causal mechanism
has been eliminated? If one accepts the latter notion
then a cure is not possible until scientists are able
to identify the mechanism.)
Also, everyone can hear something if they
listen hard enough in a sufficiently sound-free en-
vironment. What happens to the vast majority of
our patients is that their tinnitus is greatly reduced
in volume and is no longer considered as having
any annoying or unpleasant properties. It is not
considered a medical condition, but simply a trivial
experience. Cannot this be the end point for which
we are generally aiming, and can now achieve?
On the homefront:
We've recently completed a minor remodel-
ing of the ATA offices in order to accommodate
eight full time employees in an area that formerly
housed four. Our individual offices became smaller
but remain pleasant and efficient as we embark on
programs and services to better serve you, our
members. One of the new features of our office is
the addition of voice-mail.
When you call the message will guide you to
press (1) if you are an ATA member requiring
assistance; press (2) if you would like to start or
renew a membership using Visa or Mastercard
(have your card number and expiration date
handy); press (3) if you are interested in informa-
tion about ATA and member services; press (4) if
you are a health professional ordering publications;
or press the two-digit extension number of the
person you wish to speak with and leave a message
on their voice mail if they're not in. For additional
help, press (0) to speak with the receptionist.
Tinnitus Today/March 1994 5
The Whys & Wherefores of Hearing Protection
Devices
by Barbara Tabachnick,
Client Services Coordinator
There was a time when hands cupped over the
ears could adequately protect against the din, such
as it was, of the unindustrialized world. This is no
longer the case. High-tech speakers, jet engines,
leaf blowers, and machinery of all types spill their
sounds invasively into our lives. Our modem world
has become a conspicuously noisy place, forcing
us to keep pace with hearing protection or pay a
devices to wear but to those with tinnitus, the
advantages dramatically outweigh the drawbacks.
The noise reduction rating (NRR) for HPDs
ranges from 12-33dB which means that the external
noise is reduced by that many decibels. Because
manufacturers determine the NRRs for their own
products in laboratory-controlled situations, these
non-standardized product ratings can't accurately
be compared. An alternative rating, and unfortu-
nately not the one advertised on products, is the RW
weighty price for chaos- ,.---------------------- ---,
(real world) per-
formance rating
which takes into
account product
ing to ignore the wis-
dom on the subject. It is
a fact that excessive ex-
posure to loud noise can
permanently damage
hearing. It is also a fact
that noise, aside from
being the most probable
tinnitus-instigator, is a
guaranteed tinnitus-ag-
gravator.
Powerful sound
waves, heard or un-
Bone
Conduct on
Paths
Ear canal
heard, enter the delicate .
ear if it is unprotected. 1 ) I
Oval WiNkw wj stpe
o;sielc$
aging, improper
fitting, and
other unpre-
dictable human
factors. RW rat-
ings vary so
substantially
from the NRRs
that it has be-
come standard
policy to cut the
NRR number in
half when deter-
An increase in the tinni- L----y---J
tus noise can follow this Ou1er Ear -). vhiros truo mining how
type of aural invasion, noise pro-
temporarily Or occa- The Ear: Reprinted with permission from Cabot Safety Corporation tectlOn a prod-
sionally permanently. uct actually pro-
The correct use of hearing vi des.
protection devices (HPDs) can quell the worsening It's important to be aware that seemingly mi-
of tinnitus in those situations, and help to preserve nor differences in decibels are not minor at all. One
the hearing one has - an immeasurable benefit for hundred times more sound energy enters the earin
tinnitus sufferers and non-sufferers alike. an 85dB environment than in a 75dB environment.
The minuses to HPD use exist. In noisy envi- Therefore 20dB of real protection is 100 times
ronments with sound levels both muffs and greater than lOdB.
plugs diminish speech discrimination. Muffs more Hearing protection devices are obtainable in a
so than plugs interfere with the wearer's ability to wide variety of shapes, costs, and degrees of effi-
locate the origin of a sound, a difficulty to which ciency to theoretically content every consumer. But
people typically cannot adapt. And because hearing of the many factors to consider when purchasing
will be diminished, all hearing protection users HPDs, the two that are crucial are buying what is
must remember to rely on their other senses in comfortable and buying what you will actually
critical communication/warning situations. HPDs wear.
admittedly aren't the most convenient or attractive
6 Tinnitus Today/March 1994
The Whys & Wherefores ... (continued)
Stock Ear Plugs
Formable - foam, silicone, wax
Formable ear plugs are inexpensive, well-tol-
erated, and are the most effective HPDs available
today, with NRRs ranging from 21-33dB. Foam
plugs are rolled (with clean hands preferably) and
inserted into the ear canal where they expand to the
shape of the individual canal. This explains the
perfect fit and high level of cornfmt. Using them
correctly, however, requires dexterity that may be
beyond the physical abilities of some. Wax ear
plugs are rolled until the material becomes malle-
able enough to be shaped into a ball and packed
against the entrance of the canal. Silicone ear plugs
are water proof and occasionally difficult to re-
move. Many of these plugs are available with a
connecting cord. This completely eliminates losing
one plug (you either lose both or none) and keeps
them handy around the wearer's neck. Most plugs
need to be reseated periodically since they can
work themselves out of position when the wearer
talks or chews.
Earplugs can be pur-
chased in drug stores,
hardware stores, safety
supply outlets, and gun
shops, and range in price
from 35 cents to $1 per
pair. Foam plugs can be
worn, removed, washed,
and reinserted for as long
as they continue tore-ex- 1 . . . - - - - - - - - - - - - - ~
pand. Silicone and wax lnserting anearptugwhilepullingup
plugs are intended to be on the pinna. Reprinted with pem_lis
discarded after only a few swnfrom Cabot Safety Corporallon.
uses. Because ear canal ir-
ritation can be caused by repeated use in a short
period of time, plugs are best for long-term wear.
Premolded
Made from a flexible but more rigid material
than foam plugs, premolded plugs need no rolling
and can be inserted into the ear quickly. They retain
their shape, come in different sizes (some people
need different sizes for their own two ears), provide
noise protection nearly equivalent to foam plugs,
and can have a life-expectancy of months if they're
regularly cleaned and checked for wear. Pre-
molded plugs, however, are less comfortable than
foam plugs and require a slow twisting action to
carefully break the seal when being removed.
Canal Caps
These small foam caps seal the entrance of the
ear canal without going into it. They are attached
to a flexible head band, are easily put on and
removed, but provide a low NRR of 17-2ldB.
Custom Ear Plugs
For every custom ear plug manufacturer, there
seems to be a unique version of custom ear plug.
The following general information lists only some
of the variations on this theme.
Sound/noise suppressors, sound molds, custom
solid plugs
Customized plugs are made from impressions
of an individual's ear canal. The molded castings
are usually made by audiologists, hearing aid spe-
cialists, or ENTs (some companies supply custom-
ers with kits to make their own ear canal
impressions) and are then sent on to the manufac-
turer. Custom plugs are made of soft vinyl, plastic,
or resin-type materials in a wide variety of colors.
They are more rigid than foam plugs but comfort-
able nevertheless because they are individualized.
The custom plug manufacturer will keep a casting
on file for up to six months in case a replacement
pair is needed. Because of the gradual changes that
occur in the shape of all ear canals, new plugs
should be made every three years. The noise attenu-
ation from custom plugs can be fairly high, be-
tween 27-29dB. The cost is also fairly high,
between $30 and $70 a pair.
Filtered, musician's plugs
Custom filtered plugs produce a "flat attenu-
ation" of sounds allowing all frequencies to be
heard but at a quieter level. The acoustic phenome-
non of flat attenuation is accomplished by narrow-
ing down (but not completely blocking off) the ear
canal passageway. Etymotic Reasearch originally
developed this technology for musicians who
needed hea1ing protection but who complained that
solid plugs blocked too many high tones and left
too much bass. Westone Labs and others make
Tinnitus Today/March J 994 7
gineering Manager for Cabot Safety Corporation.
The NRRs of these products are not additive, how-
ever. That is, a 30dB plug plus a 25dB muff will
not equal 55dB of protection. Even when the air
conductive pathway through the canal is com-
pletely blocked, the cranial bones will still conduct
sound into the ear. This natural bone conductive
property of the head limits sound attenuation to a
maximum total of about 45-50 dB.
Bone conduction is responsible for the per-
ceived amplification of one's voice - called the
.----------------------==----. "occlusion" or "ear plug" effect- heard
"""xi. ear canal when wearing plugs or muffs. Elliott
these plugs with interchangeable filters although
most are made with a single filter. The $50-$150
per pair price range reflects the great variety of
features and filter charcteristics. Custom filtered
plugs have an NRR of 15-20dB. (Etymotic Re-
search and Cabot Auditory Systems together pro-
duce the "ER-20 Hi-Pi ," a flat attenuation
non-customized plug with an NRR of 12dB and a
cost around $15 -good for those who want to try
out the sensation of flat attenuation without a big
initial expense.)
' ; entrance Berger suggests weruing ear plugs more
,''.
proper
improper
deeply inserted or earmuffs with a larger
volume earcup to help minimize the am-
plification.
Hearing Aids
Because standard in-the-ear hear-
ing aids are vented, the noise attenuation
they provide is limited to an approximate
External ear showing proper and improper earplug fir. Reprinted with permission from
Cabot Safety Corporation.
NRR of 15-20dB. (The larger the vent
size, the lower the rating.) Some new aids are
utilizing an innovative technology that automat-
ically turns the hearing aid off at a specific level
thus eliminating the dangerous amplification of
very high decibel noises. In-the-ear hearing aids
without that feature can be manually turned off to
provide this protection. If the noise environment
warrants it, the aids can be covered by muffs or
removed and replaced with higher noise reduction
rated plugs.
Muffs
Though more unwieldy than plugs, muffs are
a more comfortable HPD for people with sensitive
canals, canal obstructions, or for those who are
uncomfortable inserting anything into their ears.
They can be worn over in-the-ear hearing aids and
many are designed with a head band that can be
worn under the chin or behind the head. Contrary
to popular thought, the NRRs for muffs are usually
less than those offoam plugs, from23-29dB. Muffs
should not be worn over eyeglasses or if the wearer
has very thick hair. (Noise reduction is signifi-
cantly degraded if the earmuff cushion next to the
head is lifted away.) Muffs can last a few years but
the cushion should be checked every few months
for cracking or lack of spring back. In many muffs,
the cushion can be removed and replaced. Muffs
range in cost from $15 to $50 and are available from
mail order or safety supply companies. (See Dr.
Vernon's Q&A column.)
Combined Plugs and Muffs
The greatest possible noise reduction avail-
able today will result from combining muffs and
plugs, according to Elliott Berger, Acoustical En-
Electronic Sound Plugs
These battery-operated, adjustable, custom
plugs closely resemble hearing aids in that they
amplify ambient sounds but only up to 92dB. At
that point, they protect as a plug would with an
NRR of 18dB. "SoundScopes" by Starkey's Ornni
Hearing Systems are used primarily by hunters or
shooters who need to hear especially well but need
protection from bursts of very loud noises. Their
cost: approximately $500 a pair.
Active Noise Cancellation/Quieting Devices
Noise cancellation technology has piqued the
interest in no small way of those who want or need
The Whys & Wherefores ... (continuedJ
a quiet environment. Research in this field has led
to the development and/or use of noise cancellation
in helicopters, submarines, aircraft cabins, and
MRI scans. For everyday noisy situations, how-
ever, this technology has not yet made a particu-
larly successful crossover.
For those who want to try noise cancellation,
it is available in the form of a battery-operated
headset attached to a small, wearable computer
pack. NCT's "NoiseBuster," ANVT's "NQlOO,"
and Bose's Aviation headset are three such devices
and cost $149, $189.95, and $785 respectively.
(The Bose headset was designed for the special
communications and acoustical needs of aviators
and astronauts.) The noise cancellation headsets
contain tiny internal microphones that electroni-
cally sense certain sounds, then exert their own
equal and opposite wave pattern to "cancel" the
incoming sound. According to William Clark PhD,
of the Central Institute for the Deaf, the incoming
sound wave can be negated up to 18dB, if the ideal
listening situation exists and if the sound wave is
of a very low frequency only - around 300 Hz. As
external sounds approach 1000Hz, however, the
noise cancellation capability of these devices is
nearly non-existent. Dr. Clark's biggest concern is
that people will mistakenly think their hearing is
protected with noise cancellation devices when in
fact it is not.
The good news about these devices is that they
enhance the quality of personal stereos (which can
be connected to the noise cancellation headsets) by
filtering out typical low frequency distortion, and
they offer some relief from low-pitched rumbles
E-A-R ID-FITM Earplugs.
HI-FI earplugs have a patented acoustical damping network to give
wearers the best of both worlds. Protection from moderate noise,
while maintaining undis-
turbed sound quality. damper nng
Say good-bye to those
"blocked-up" feelings. -Qit- iJY.W*
HI-FI earplugs are the ideal .. ;: ... _; 1 t t
choice for moderate noise areas, t
and in environments where eartip stem end cap
protection is required yet sound quality must be maintained. Compared
to conventional hearing protectors, HI-FI earplugs may also improve
speech perception in noise for normal hearing and hearing impaired
individuals. Perfect for concert attendees and many musicians.
For more information, write or call today.
More uniform attenuation Natural, clear sounding Triple1fange comfort
One size Washable
Cabot Safety Corp., Auditory Systems Div.
5407 West 79th Street, Indianapolis, IN 46268, 317/692-6555, 800/624-5955, FAX 317/692-6770
and hums. The bad news is that they leave all high
frequency sounds intact which many find annoy-
ing, and they have no effect on the subjective
internal noise of tinnitus.
While AT A offers no specific product en-
dorsement, your individual lifestyle and sensitivi-
ties will lead you to the right hearing protection.
The following is a list of manufacturers/distribu-
tors who can be contacted directly for product lists
and local outlets. These are just a few of the many
who thankfully have made hearing protection a
science as well as a priority.
HEARING PROTECTION DEVICES - Manufacturers / Di s tributors
1. Muffs 2. Custom Plugs 3. Stock Plugs 4. Noise Cancellation
All-American Mold Lab (2) Etymotic Research (1,2,3) MSA (1,3)
226 sw 6th 61 Martin Lane PO Box 426
Oklahoma City OK 73125 Elk Grove Village IL 60007 Pittsburgh PA 15230
800/654-3245 708/228-0006 800/MSA-2222
ANVT (4) Flents Products Co Inc (1,3) NCT (4)
PO Box21673 PO Box 2109 800 Summer St
Phoenix AZ 85036 Norwalk CT 06852 Stamford CT 06901
800/858-ANVT 203/866-2581 800/278-3526
Bilsom Inti. Inc. (1 ,3) Great Lks Earmold Lab (2,3) North Specialty Products (1 ,3)
5300 Region Ct PO Box 477930 2664-B Saturn St
Lakeland FL 33801 Cleveland OH 44147 Brea CA 92621
800/733-1177 800/842-8184 714/524-1655
Bose Corp. (4) Hear Saver Ltd. (2,3) Pacific Coast Labs Inc (2)
The Mountain Ad 428 Millen Ave Unit 26 PO Box 7981
Framingham MA 01701 Stoney Creek, ON L8E 3N9 San Francisco CA 94120
800/242-9008 CANADA 800/351-2770
Cabot Safety Corp {1,3)
905/662-8016
Santa Barbara Medco Inc (2,3)
5457 W 79th St Hocks Hearing Products (2,3) PO Box 6843
Indianapolis IN 46268 PO Box6616 Santa Barbara CA 93160
800/225-9038 Portland OR 97208 805/683-1486
David Clark Co (1)
800/654-6257
Siemens Hearing Conserv (1 ,2,3)
Box 15054, 360 Franklin St lnsta-Mold Products Inc (2,3) 13043 E 166th St
Worcester MA 01615 PO Box439, Cerritos CA 90701
508/756-6216 Oaks PA 19456 800/998-9787
Earmold Design Inc (2)
800/523-4081
Starkey Labs Inc {2)
3424 E Lake St Howard Leight Industries (1,2,3) PO Box 9457
Minneapolis MN 55406 4061 Glencoe Ave Minneapolis MN 55440
800/334-6466 Marina del Rey CA 90292 800/638-4641
Emsee Labs (2)
800/225-8083
Westone Labs (2)
36141 US 19 N 3M Occup Health & Safety (1 ,3) PO Box 15100
Palm Harbor FL 34684 OH & ESD, Bl 275-6W-01 Colorado Springs CO 80935
813/785-5554 3M Center 800/525-5071
Emtech Labs Inc (2)
St Paul MN 55144
Wilson Safety Prod (1 ,3)
PO Box 12900 Mid-States Labs (2) PO Box 622
Roanoke VA 24022 PO Box 1140 Reading PA 19603
800/336-5719 Wichita KS 67201 610/376-6161
800/247-3669
10 Tinnitus Today/March !994
$5 Million - The Beginning to the End
Research Endowment to be Established by A TA
High-quality, innovative research holds the
key to breakthroughs in effective tinnitus treat-
ments and eventually to relief. While a handful of
dedicated scientists and clinicians have spent their
lives researching the causes of and treatments for
tinnitus, significantly more needs to be done to
make more rapid and effective strides in eliminat-
ing tinnitus as a health problem.
With the exception of ATA, not one entity
exists today which is totally focused and committed
to ending tinnitus. Not our government. Not any
foundation or medical institution. A TA must be-
come the leader in both the direction and funding
of tinnitus research. We have the opportunity to
take advantage of major breakthroughs in medicine
and technology which holds the promise to bring
to people with tinnitus what they want most, a cure.
That challenge can be met, will be met, with
your help. Our Board of Directors voted at their
most recent meeting to commit to raising $5 million
by ATA's 25th anniversary in 1996 - $5 million
which will be used exclusively for research. These
funds will be used for seed projects having the
ability to demonstrate their underlying ideas which
might attract additional funding from the federal
government. Proven larger projects for which ad-
ditional funding will speed the research process
will also be funded. As a group of concerned,
focused and generous individuals, AT A will be the
champion in the fight against tinnitus.
You can become a significant part of this
effort by giving your financial support to this cam-
paign. Become a part of our "Dollar A Day for
Tinnitus Research" initiative by pledging one dol-
lar per day for the next three years to ATA's
restricted research campaign. Or become part of
our Honored Grant Program. Your support, in any
amount, will bring us closer to our goal.
Our Board has committed to personally rais-
ing funds for this campaign. Our development of-
fice is seeking new sources of funding through
foundations (see related story on Streisand Foun-
dation) and corporate partnerships. It will take a
concerted effort from all of us to reach this goal.
Not only do we need your financial support, we also
need you as fund raising partners. There are many
ways you can help.
Please use the envelope in the center of this
magazine to become a Charter Supporter of our
Research Endowment. You will be a pioneer. Or
call Brent Mower at (503) 248-9985, ext. 18, to
discuss other giving or volunteer opportunities.
We'll keep you apprised regularly of our pro-
gress towards the $5 million goal. More impor-
tantly, we'll show you where your research dollars
are being spent, and bring you the results of com-
pleted projects as quickly as they are received.
We're excited. We hope you will be too!
STREISAND FOUNDATION
AWARDS AT A $25,000
Barbra Streisand, through her personal foun-
dation, has awarded ATA a grant of $25,000 in
support of research efforts on tinnitus. Ms.
Streisand, who has tinnitus, made the contribution
in response to AT A's appeal for research funding
in connection with our $5 million research endow-
ment campaign. The efforts of AT A Board member
Ed Grossberg and A TA Referral Dr. Douglas Mor-
gan in assisting the ATA staff in reaching Ms.
Streisand were instrumental in this effort.
We would like to prepare a special package of
appreciation for Ms. Streisand for which we need
your help. Please send per-
sonal thank you notes,
cards, or letters to Ms.
Streisand in care of AT A.
We'll make sure they get to
her.
Send your note of thanks
or appreciation to:
Ms. Barbra Streisand
c/o ATA
P. 0. Box 5
Portland, OR 97207-0005
Let's show her just how grateful we truly are.
Development Directions
by Brent Richard Mower
MEMBERSHIP SURVEY RE-
SULTS REVEAL USEFUL AND EN-
COURAGING NEWS
Over 500 valuable AT A supporters
returned completed membership surveys
from the December, 1993 issue ofTinni-
tus Today. This type of feedback is very
important to us in shaping the services
we offer and setting our goals in accord-
ance with your needs and desires. Thank
you to everyone who took the time to respond.
Fortunately, the results of the survey indicate
an overall satisfaction with AT A and the services
we provide. That doesn't mean there aren't areas
we can improve, services we can expand, or differ-
ent directions we should follow. Your input was
and is very valuable. And we do listen.
The following is a summary of your responses
to the survey and our plan of action in each of the
areas you addressed:
l . Rank ATA Services in order of importance.
Top five areas designated as most important
(in order) were:
Financial support for tinnitus research.
Publication of Tinnitus Today.
Workshops and seminars for physicians and
medical providers.
Lobbying and advocacy for tinnitus with Fed-
eral Government.
Public awareness/education and prevention
programs.
As you have read elsewhere in this issue we
are intensely focusing our energies on directing and
funding tinnitus research, and have made this the
primary mission of AT A. We will continue to
publish and perhaps expand Tinnitus Today as we
have more information to include. We are con-
stantly looking for ways to improve the content of
the magazine and ask that you call or write us with
your suggestions. We have not had the resources to
conduct workshops or seminars for clinicians, but
we are developing partnerships with leading uni-
versities and medical centers to assist us in expand-
ing this area. As a non-profit, we are somewhat
restricted by law as to the lobbying we are able
to do, but we will continue to meet with govern-
ment officials to present our issues, and will
provide you with information and advice on how
to do the same. We are expanding our public
education process by attending more health fairs,
related conferences, and vigorously promoting
the use of our literature in medical institutions,
hospitals, doctors' offices, community health
centers, and libraries.
2. How well informed do you believe you are
on how ATA contributions are allocated?
11% Very well informed
56% Satisfied
33% Need additional information
We're happy to hear that the majority of our
contributors are satisfied with the information we
provide regarding how their donated dollars are
spent. But a sizeable number of you want more. We
will begin giving you more information through
Tinnitus Today. Additionally, our audited financial
statement is available to anyone who requests it.
We ask that if you request a copy, you enclose
$2.00 to cover the cost of copying, handling and
postage.
3. How would you rate the quality of Tinnitus
Today in meeting your informational needs about
tinnitus and the activities of AT A?
41% Excellent
49% Good
8% Fair
2% Poor
To those of you who rated the quality as fair
or poor, we apologize. We want to hear from you
specifically as to how we can improve the quality.
Again, we're happy to see that the substantial ma-
jority of you view Tinnitus Today favorably. But
we want to strive for a higher percentage of "Ex-
cellent" responses. Please continue to write to Dr.
Reich with your editorial comments and sugges-
tions - we do care about what you think and what
you desire.
Development Directions (continued)
4. Please list two areas of Tinnitus Today you
like best.
The overwhelming top area was the Questions
and Answers column. Keep those questions com-
ing! Regular columns of the ATA staff came in
second. The third most popular area was a more
general request for articles from others with tinni-
tus, what treatments they have tried, and how they
cope. In order to include more of this type of
inf01mation, we wil1 begin a letters to the editor
column in our next issue. Please share your expe-
riences with us.
5. Please list two areas of Tinnitus Today you
like least.
Very few of you responded to this question,
and of those who did, almost half indicated there
was no least liked area. That is satisfying to hear.
Individually, we did pick up some good sugges-
tions from the survey pertaining to Tinnitus Today
and are working to incorporate them into our edi-
torial process. (13 of you didn't like my column-
I'm crushed!)
6. Please rate the quality of any brochures or
books you have purchased from AT A in terms of
meeting your needs in providing help or informa-
tion.
18% Excellent
31% Good
9% Fair
2% Poor
40% Have not purchased
While we are pleased that half of you rated this
material as good or excellent, we would like to hear
specifically about what is and what isn't helpful or
useful in our brochures and books. You are our best
and most constructive critics. If you haven't pur-
chased our informational books or brochures be-
cause they don't meet your needs, we would
appreciate hearing from you as well.
7. Did you see a health care provider from the
Referral Network Directory?
20% Yes
80%No
We were a little surprised by this response. It
takes a lot of effort to find health care providers
interested in being part of the network. If this is
truly an area which provides little benefit, we need
to understand that and use our resources accord-
ingly. From those of you who have not used a
health care provider from the Referral Network,
please let us know why.
8. If yes, how would your rate the quality of
care and attention you received from that individual
or clinic?
20% Excellent
34% Good
19% Fair
27% Poor
The ratings in this area concern us. While over
half of you who had seen a health care provider
from the Referral Directory felt good about the
quality of care, nearly half of you were disap-
pointed. We need to hear why. Please write us with
either general comments about your experiences,
or if they concern a specific clinician or doctor,
outline for us with whom and what your disap-
points were. While keeping you anonymous, we
will address your concerns with the health care
provider and request feedback from him or her.
9. Have you participated in an AT A sponsored
self-help group in your area?
14% Yes
34%No
52% No groups in my area
Again, while self-help groups are not appro-
priate for everyone, we're concerned that so many
of you have not participated. We need to determine
the underlying causes for this to again determine
the amount of resource we put into this area. Please
let us know why you don't choose to participate in
areas where a group is available. If there are spe-
cific problems, we would like to address them.
Obviously, a substantial number of you do not have
a support group available to you in your area. You
can help us change that by volunteering to be a
group facilitator and sharing responsibilities with
Development Directions (continued)
others in the group. We'll lead you every step of
the way.
10. If yes, how would you rate the quality of
support and information you received from that
self-help group?
28% Excellent
33% Good
33% Fair
6% Poor
Self-help group leaders - keep up the great
work! We know the amount of time and energy you
put into organizing and keeping these groups going
and we sincerely appreciate it. For those of you who
rated the quality of your support group as fair or
poor, please let us hear from you specifically as to
what improvements you would make in your
group. We'll attempt to incorporate the good ideas
in all groups, as well as address any specific group
needs. Of course, your individual comments will
remain anonymous.
11. If AT A organizes an annual meeting or
conference for people with tinnitus, would you
consider attending?
72% Yes
22%No
6% Maybe
This is very encouraging. While planning and
organizing the Fifth International Tinnitus Seminar
here in Portland next year is probably the only
major meeting we have the resources to put to-
gether in the near future, your positive response to
this question has put us in the planning stages for
Cutoff Date for Receiving
Tinnitus Today
The 15th of the month previous to publica-
tion is the last day we can receive your dues re-
newal and assure you will receive the next issue.
Example: If your donation arrives after August 15,
you will miss the September issue. The first issue
you would receive is December.
14 Tinni1us Today/March 1994
holding either an AT A annual meeting in one loca-
tion, or holding several regional meetings. If you're
willing to volunteer to help us plan and organize
such a meeting in your area, please let me know.
12. If yes, how far would you be willing to
travel and what would be a reasonable conference
fee (travel and lodging not included)?
Average acceptable distance about 300 miles,
although about 20% of respondents indicated dis-
tance would not be a factor in their decision as to
whether or not to participate.
Average acceptable conference fee was about
$80, with a range from free to $1,100.
This feedback will be of great assistance in
planning such a conference.
We truly appreciate the time you took to give
us your opinions about ATA. Your opinions are
very important to us and will assist us in planning
our activities and directing our resources to most
appropriately meet your needs and desires. Most
importantly, we need to hear from you on a regular
basis with your ideas, suggestions or opinions,
especially as they pertain to the issues raised in this
survey. We will listen and take action!
Tinnitus Bibliography
Supplement #6, listing articles published since the
Fall of 1992 is now available. The price is $25.00, mem-
bers price $15.00.
The Tinnitus Bibliography is a list of over 2500 ti-
tles and sources of writings relating to tinnitus. Many of
the articles are available in hard-copy. You may specify
a particular area of interest for a subject search. For ex-
ample, if you want to know about the relationship of
drugs to tinnitus you would specify a subject search
about drugs.
The complete Tinnitus Bibliography is $75.00,
members price is $40.00. Subject searches are $10.00
each, members price $5.00.
To order, please use the form on the envelope en-
closed with this magazine.
A message of hope
by Beverly Robinson
You cannot imagine what it is like to live with
a permanent piercing whistle in your ears that
shatters every nerve in your body, unless you are
anot?er tinnitus .sufferer. I was told repeatedly by
medical professiOnals that I would just have to
learn how to live with my tinnitus. I refused. Either
I would flnd reljef or cease living .
. In 1989 and 1990 I was a Peace Corps volun-
teer m the West Indies. I left behind a son
. 0 '
a career m the brokerage business, and all the
and technology in America. I quickly
unmersed myself in the West Indian culture and
attended a nighttime street party in a remote village
on the island of St. Lucia. There were buoe clusters
ofhi-fl speakers playing reggae music enough
to be heard all over the village. I happened to walk
past such a cluster just as they were tumed on full
blast. it was dark, I was not seen by the people
who catapulted me into my own pri-
vate Inlsery. I was left deaf in my right ear for about
a week. However, I was plagued with a whistle that
like a boiling tea kettle on a high flame
wtth no way to ever tum it off. I couldn't sleep
concentrate, think, work, or live a normal life. '
The Peace Corps sent me to Washington, D.C.
for neurological tests. They exhausted every re-
source and specialist and ruled out a brain tumor or
any other organic reason for tbis demonic noise. I
was finally diagnosed with subjective tinnitus that
had no cure.
Since stress is suspected to exacerbate tinni-
tus? the Peace Corps medically discharged me and
I did not to my tropical island. I had no job
or a place to live so I stayed in Washington to begin
an to Workers' Compen-
sattOn and Disability benefits. I tried two different
jobs but had to quit them because I could not
concentrate from lack of sleep. Since I was so
exhausted, I couldn't walk across the street without
a panic attack at the sight of oncoming fire
engmes or any other source of loud noise that
would intensify my tinnitus. If I had the strength, I
would run for cover in a building. The underground
metro system was overwhelming, and the public
buses weren't much better with metal on metal ,

Beverly Robinson and West Indian villagers 1993
rattling windows, and screeching brakes. Since I
was so run-down, I contracted pneumonia. The
antibiotic, Augmenten, was prescribed, which in-
tensifled my tinnitus beyond belief. We had to
with medications. All the while, my
medical bills were skyrocketing. I would have
lost my mind if it wasn't for my devoted
friend who checked on me daily.
I was eventually able to collect Workers'
Compensation because I was injured on the job.
However, it took several letters from a congress-
man to qualify me for disability benefits. Because
my tinnitus could not be measured, I had to find
someone who would believe my disablino condi-
. 0
tl.on. Once I prevailed and had my claim accepted
etght months later, I left the overwhelmino noise of
the large city. Before I left, my gave me
a for Xanax to help me sleep and deal
With the paruc attacks associated with loud noises.
Xanax gave me back my life.
From there, everything began to work for me.
I immediately got a teaching job in upstate New
York. While in my new, rural town, I walked past
a house with a sign that said: "Otolaryngologist." I
A Message of Hope (continued)
walked in and asked if the ear doctor had a magic
cure for tinnitus. The receptionist suggested I set
up an appointment Dr. Del Monico examined my
ears and told me exactly what I knew I would hear.
"There is no cure for tinnitus." However, he had
me talk with his audiologist who tested my hearing
and uied to match my tinnitus sound with her
equipment. We reached a noise at 12,000 Hz that
negated my noise so we had a match. Her eyes met
mine with the most compassionate look and she
asked me how I was able to live with such a
dreadful noise. I knew at that moment, I had found
help.
She immediately suggested we try some
maskers. The maskers look like in-the-ear hearing
aids and generate a competitive but pleasant sound
that reduces the awareness of the tinnitus for many
patients. I thought it was worth a try. She called
Starkey Labs in Minneapolis and had two maskers
made to fit my ears. Each masker has two control
settings. I could change the frequency and volume
as my tinnitus changed. Since taking Xanax, my
tinnitus had become cyclical and gave me some
days of suppressed noise. T was beginning to have
quieter days. On bad days, I used the maskers for
instant relief and on quiet days, I didn't need them.
Sometimes just one masker was all I needed.
The constant fluctuations in my condition,
however, were wearing me down emotionally.
Each time the tinnitus left, I thought I was cured.
Then when the noise came back, it came back with
a vengeance and threw me into despair. Months
passed and the despair became disabling. I was on
an emotional rollercoaster. My audiologist and
ENT referred me to Dr. Zoppa, a psychiatrist in
Utica, NY, with experience treating the depression
that follows on the heels of tinnitus. He immedi-
ately increased my Xanax dosage and put me on
Wellbutrin, an antidepressant. After about three
weeks, the despair abated and I could handle peri-
ods of change. My heavenly episodes of remission
were increasing in quality and length. I was no
longer obsessed with the noise or the fear of its
return. My life was somewhat back to normaL
Tinnitus will not kill you. However, the depression
is deadly. My psychiatrist knew the depression had
to be treated.
The quality of my life is improving daily .I get
a massage every two weeks to reduce the build up
of stress and toxins, and have chiropractic adjust-
ments to help the tension in my neck and shoulders.
I volunteer at a nursing home which helps me to
count my blessings. I belong to a church commu-
nity that surrounds me with love and support. My
teaching job allows me to get outside of myself and
help teenagers become better readers. I have
learned to be on the lookout for those things that
exacerbate my tinnitus. Caffeine and sugar are
stimulants that seem to trigger my tinnitus. I have
had to avoid shopping malls because I believe there
is a high frequency security system that may be
triggering my tinnitus. I noticed while driving
across the country that my tinnitus bothered me at
high altitudes. Traveling by airplane does not
bother me at all.
I'm stil1 searching for new kinds of masking
and recently obtained Marpac's Marsona Tinnitus
Masker purchased directly from the distributor ( 1-
800-999-6962). This masker works well for me at
work and at home. I read about the 321 Q Masker
in Tinnitus Today (Microtek Manufacturing) and
had my audiologist order one for me on a thirty-day
free trial. It replaced my in-the-ear maskers at night.
I now experience periods of remission for a
month at a time. I think in large part due to the
combination of medication and masking. When the
noise returns, it is quieter, and I can use one masker
and forget the tinnitus. I used to be consumed by
tinnitus's tormenting noise, and now it is just an
occasional annoyance. Hope prevailed and I found
relief even though I had been told that all I could
do was learn to live with
it. I am very lucky be-
cause I found compas-
sionate people who went
the extra mile to provide
me with help.
Media Watch: Tinnitus in the News
by Cliff Collins, Oregon freelance writer. Please
send clips, noting source and date, to Media
Watch, PO Box 5, Portland, OR 97207.
Right in the heart of the town where the ma-
jority of the country's music is produced, The Los
Angeles Times kicked off spring with a timely
report, "Turning down the racket" (March 2, 1994 ).
The story appropriately focuses on preven-
tion, outlining the dangers -- and the sometimes
bitter. unexpected consequences-- of loudly played
rock music. The article noted that individuals differ
in their susceptibility to noise damage, with some
more vulnerable than others.
Dr. John House of the House Ear Institute in
Los Angeles, who is interviewed in the story, once
told me that three people can be sitting next to each
other at a rock concert, and perhaps only one will
experience problems. For example, the piece opens
and closes by focusing on ATA member Elizabeth
Meyer of Portland, who told the reporter that her
tinnitus and hyperacusis occuned after a single
loud exposure to a concert.
"I've heard the phrase tough ears and tender
ears,' and you never know (beforehand) which
ones you have," Meyer said.
The article said the institute several years ago
launched a Hearing is Priceless, or HIP, campaign
with Mix magazine and a group of musicians to
distribute earplugs and produce educational videos.
Bassist Nathan East said he began wearing custom-
molded earplugs after his ears developed tinnitus,
but he said he worries about those in the audience.
As Kathy Peck-Denny, co-founder of Hearing
Education and Awareness for Rockers (HEAR),
once was quoted as saying, someday everyone will
realize that all the musicians and every member of
the audience are wearing earplugs; and maybe then
they'll think, "Why don't we just tum down the
volume?" I'm waiting.
More warnings:
Several other articles warn of preventable tin-
nitus and draw the connection between noise and
ear/head noise. One, which ran in The Orlando
Sentinel and other papers, pointed out that certain
occupations are inherently threatening to the ears,
some jobs that normally aren't considered. It inter-
viewed a Florida dentist who said he suffered dam-
age in the same ranges as his high-pitched drill's
whir.
Gannett News Service did a succinct story
emphasizing the dangers of car speakers. The arti-
cle opens with a sad recounting by a 20-year-old
male who typically ignored his parents' warnings:
He already has destroyed 20 percent of his hearing.
A doctor who gives school presentations then says
reoular car radios, not just the huge "boom" sys-
t e ~ s , also can be deceptively dangerous. Listeners
driving on a freeway where the road noise may be
at 85 decibels then tum up the radio above that level
in order to hear it.
A 17 -year-old high-school girl in Santa Rosa,
California, wrote in her local paper some sensible
advice to her peers: "If you listen to your music too
loud now, you may not be able to hear it 20 years
from now." Then, while recognizing that her own
ears are "buzzing" and outside sounds diminished
after regularly playing her W alkman at full volume,
she admits she needs help: " I think there should be
support groups for people who are trying to prevent
their early hearing loss." A novel idea.
Therapies:
Prevention (March) had an interesting brief on
severe tinnitus and depression. Researchers once
thought symptoms of depression wouldn't go away
until the noise did; but a "study suggests that tack-
ling the depression first may give life back to
sufferers of severe tinnitus, and in doing so, it might
make the tinnitus less loud," the story says. Sub-
jects taking nortriptyline, an antidepressant drug,
were able to function better, and some reported
decreases in tinnitus loudness, said researcher Dr.
Mark Sullivan of the University of Washington
Medical School. (The study is cited in Archives of
Internal Medicine, Oct. 11, 1993)
The Boston Globe's health column on tinnitus
discusses several therapies that are helping some
people. Quoting ATA's Brent Mower, the piece
names masking and others.
Questions & Answers
by Jack A. Vernon, Director, Oregon Hearing
Research Center, Portland, OregonPlease send
questions to Q&A, PO Box 5, Portland, OR 97207.
Q: Ms. S. from Missouri asks,"Whatis the quiet-
est vacuum cleaner available? I am in the market
for one and I wonder what decibel ratings are
available with which to evaluate vacuum cleaners.
I don't want to make my tinnitus worse."
A: Hoover made a vacuum cleaner years ago that
was very quiet -- almost silent. The result was that
they couldn't sell it so they quit making it! Compa-
nies are once again responding to public outcry for
quiet appliances. In Consumer Report's 1994 Buy-
ing Guide, three canister models were given a "very
good" quiet rating - Miele's S2801, Panasonic's
MC95-30, and Princess's 3-PN93. Three uprights
were given a "good" quiet rating- Panasonic's MC
6250, Amway's Clear Track, and Royal's ProSe-
ries 7470. (All of the others were quiet-rated as
"poor.") Ms. S., I don't know how quiet these are
compared to that original Hoover, but it's certainly
a place to start.
(Ed. note: The reference librarian at your local
library can usually help you by telephone to find
the "quiet-rated" appliances in Consumer Reports.)
Ms. S., regardless of the vacuum cleaner you
choose, plan to wear very effective ear protection,
such as eannuffs, when operating it. The earmuffs I
use when woodworking with power tools is the
"Thunder 29" by Howard Leight Industries. They are
the best muffs I know of and are available from Safety
and Supply Co., 595 North
Columbia Blvd., Portland, OR
97271 (503/283-9500) at a
cost of about $18 or $19.
If the Thunder 29 does
not block out enough sound
even if you wear earplugs un-
der the muffs, then perhaps
there is someone in your
household who would be will-
ing to at least share the vacu-
uming duties with you.
Whatever you do, if your tin-
nitus is even temporarily in-
18 Tinni1us Today/March 1994
creased after a period of vacuuming, don't continue
doing it. A clean house is important but not at the
expense of your tinnitus.
Q: Ms. B. in California indicates that she has
pulsatile tinnitus which is synchronous with her
heart beat. She indicates that exercise and eating
raw vegetables has helped.
A: Ms. B. has not asked a question about pulsatile
tinnitus but I'd like to take this opportunity to pass
along some possible information about pulsatile
tinnitus. Benign Intracranial Hypertension (BIH)
apparently can have pulsatile tinnitus associated
with it. Thus it might be recommended for those
with pulsatile tinnitus to see a neurologist and
discuss the possibility of testing for BIH which is
medically treatable.
Q: Ms. L. in Connecticut indicates that she wants
to start her family but that she has been taking
amitriptyline for depression, which is no longer a
problem. She needs the amitriptyline to help her get
to sleep, but indicates that she has now learned to
deal with her tinnitus. Knowing that drugs of al-
most any sort are not recommended during preg-
nancy, she asks what do other women do in a like
situation.
A: There are non-medication ways to induce
sleep, and I would recommend that you try the one
we often recommend to tinnitus patients: FM
static. (Static is a white noise which means it con-
tains all frequencies from about 20 Hz through
20,000 Hz.) Simply detune the FM (it must be FM)
radio between stations so as to only hear the static.
Another solution would be to use a sound generator
such as the Marsona 1200A which is capable of
producing soothing sounds such as rain sounds,
water falls, wave sounds, wind sounds, etc. with
which to induce sleep. Marpac Corp., the makers
of the Marsona 1200A also makes a bedside tinni-
tus masker. Both the sound generator and the tin-
nitus masker are available from Ambient Shapes.
(See advertisement inside the front cover of this
issue.)
Questions & Answers (continued)
I hope this is of help to you Ms. L., but I also
would like to hear from other women who may
have experienced and solved this same problem.
Q: I continue to get letters from readers who find
that the presence of a head cold or the flu relieves
their tinnitus. You may recall it was suggested that
the increase in body temperature might be the thing
which reduced the tinnitus. Two letters came in this
time and each made an interesting suggestion.
Ms. P. from Massachusetts indicates that not
only does the head cold or the flu relieve her
tinnitus but also that snuffling will produce blief
bouts of similar tinnitus relief.
Mr. C. from Georgia indicates that not only
does the cold or flu relieve his tinnitus but that hot
showers do the same thing, giving relief lasting
from a few minutes to several hours.
A: We have to ask, "what do snuffling and show-
ers have in common?" The obvious answer is that
both make sounds, and I suspect that it is the
residual inhibition produced by the masking effect
of those sounds that has provided the temporary
relief. In both cases, I would recommend that it
might be helpful to try wearable maskers. If any of
you will obtain the cooperation of a healing aid
dispenser, I will gladly try to help them help you
with the fitting of wearable maskers. Remember
that wearable maskers are fit on a money back
guarantee so you have very little to lose and possi-
bly much to gain. In your case, Mr. C., try the
"Faucet Test" to determine if it was the sound of
the shower or the heat of the shower that helped
your tinnitus. The Faucet Test is merely to stand
near the kitchen sink with the water running full
blast. If the sound of the running water covers up
or blocks out your tinnitus, then it was the sound
of the shower that did it.
Q: Mr. S. from California asks, "I wonder if
anyone has had expelience with the new antide-
pressant medication P AXIL? I have been using it
for three months now, and I can say it has turned
my life around."
A: Mr. S' s statement is more positive than you
think. He goes on to say that he has hyperacusis as
well as tinnitus and had been suffering severe ten-
sion headaches all of which have either disappeared
or markedly improved as a result of the Paxil. As
usual, I warn each of you readers that Mr. S' s report
is just that, the anecdotal report of one patient. But
please remember it is from the patient that we learn,
so we thank you Mr. S. for what could become
important information. Were we to get more similar
reports, we would conduct a properly controlled
Paxil study, just as was done for Xanax. So if any
of you have had expelience with the drug Paxil,
please let me know the results. One final comment
about Mr. S.'s report. He said that originally he
took 10 mg. every day but that now he only takes
5 mg. five days a week.
Q: Ms. B. from Calfornia states that her doctor
gave her a high dose of cortisone and that it relieved
her tinnitus for several days. Subsequently, a lower
dose of cortisone had no effect. Both Ms. B and her
physician considered it too risky to continue with
high doses of cortisone. Thus Ms. B. asks if there
is anything else that might give her similar relief.
A: Ms. B., you say you have tried biofeedback,
maskers, acupuncture, medication, etc., all to no
avail. So many people have tried an improper fit-
ting of maskers that I now have strong doubt when-
ever a patient says that masking does not work. We
have seen many patients who have come to our
clinic stating that masking did not work for them
but then we found that masking could be made to
work. Most frequently the patient had been fitted
with one masker when they had bilateral tinnitus
and needed two, or they had been fitted with tinni-
tus maskers in the face of a hearing loss where the
only possible solution was the combination unit
with hearing aids and maskers combined in one
unit. (Often called tinnitus instruments.) Now,
dear reader, please don' t misunderstand me, there
are patients for whom masking does not work. In
our clinic, where I feel proper fittings are accom-
plished, we found in one study of 1,279 patients
masking was successful in 68%. In another study
Questions & Answers (continued)
of 1,199 of our patients, masking was successful in
72%.
Ms. B., do the "Faucet Test" suggested above
and call the results to me (503-494-8032). Also,
when you say medications, do you mean you have
tried Xanax? If so, with what dosage? Here, too,
we find mistakes where the patient is prescribe
Xanax but in a dosage too small to be effective.
Q: Mr. M. from Louisiana indicates that origi-
nally his tinnitus sounded like crickets but that
suddenly one evening the right ear blocked, hearing
in that ear disappeared, and a loud roaring began.
The next day his physician gave him a cortisone
shot and the problem cleared up. His tinnitus has
continued in both ears but whenever he experiences
a flare-up, a shot of cortisone does the trick. He
currently takes allergy shots and the number and
severity of flare-ups has diminished. Mr. M. asks
if allergy is the source of much tinnitus.
A: I have no doubt that allergy can contribute to
or even cause tinnitus. The Tinnitus Data Registry
started and maintained in our laboratory indicates
that 47% of the patients seen here (about 4,500 all
total) have no known cause associated with their
tinnitus. I now wonder how many of those patients
might have had allergy as the cause. I know of a
few of our patients who on their own discovered an
allergy which led to complete relief of their tinni-
tus. One patient found he was allergic to wheat
products and that eliminating wheat from his diet
completely relieved his very severe tinnitus. Have
any of you had a similar experience? If so, may I
know about it?
Mr. M.' s tinnitus was a cricket sound and that
means that it was composed of two tones rather
close together in frequency such as 3000 Hz and
3050 Hz. Is the present tinnitus that you experience
still a cricket sound, and do you have hearing loss?
If the answer is yes to both questions, I would
suggest that you try a fitting with hearing aids to
see if they will mask the tinnitus. Low-pitched
tinnitus, (such as cricket sounds) can be, in some
cases, masked by causing the patient to better ap-
preciate environmental sounds which are primarily
restricted to frequencies below 4000 Hz. The topic
of masking leads us to the next question.
Q: Mr. T. from California writes, "I have heard
about and read about masking of tinnitus but I don't
understand it. Seems to me that you have simply
replaced one sound for another and what good does
that do? As an engineer, I think I should be able to
understand the masking procedure but I don't."
A: Mr. T., you may not be on the side of the angels
but you sure are on the side of the legion. We have
heard the same comment from the majority of the
patients we see in our Tinnitus Clinic where mask-
ing is the first effort to provide relief of tinnitus.
We explain masking in this manner: frrst of all,
masking uses a noise which, in itself, is more
acceptable than a screeching high
pttched tone. Second and more importantly, the
masking sound is an external sound, and we all
routinely ignore external sounds provided they are
continuous, not too loud and not interesting. If you
ignore a sound which has covered up your tinnitus,
you have automatically ignored your tinnitus.
Masking also puts you, the patient, in control of
when you will and will not hear your tinnitus
instead of the tinnitus controlling you. A lesser
aspect is that the tinnitus means something is wrong
in your auditory system, whereas, the masking
sound is a man-made sound about which you have
little concern.
Mr. T. , I would suggest that you try the Faucet
Test indicated above, and if that gives a positive
effect, you will see that masking provides immedi-
ate relief of your tinnitus. For most folks, it is not
necessary to try masking for an extended period of
time in order to realize the benefit. You will know
immediately.
Q: The final question is mine. I sometimes feel
that I ask more questions of you than you do of me.
I apologize for that but remember that we learn
from you, the patient, rather than the other way
around. So I have to ask questions, and I hope you
don't mind answering them. Indeed, I thank each
of you for taking the time to write in to Q &A's.
There are Options
by Gail Wise, R.N., C.,M.S.N., Continuing Educa-
tion Coordinator in the Department of Nursing
and Allied Health Sciences at Morehead State
University in Morehead, Kentucky. She also
teaches Community Health Nursing in the bacca-
laureate nursing program. In addition, she is an
educational consultant for several area hospitals.
Last July I experienced an episode of what
was diagnosed as Meniere's disease. During the
initial diagnosis I had severe tinnitus, pain and
pressure in the left side of my face, distorted hear-
ing in my left ear, and occasional mild dizziness.
The only symptom that remains six months later is
mild, sporadic tinnitus.
All of the symptoms were stress producing,
but I felt I could not tolerate the noise. Although
my hearing has always been excellent, I have ex-
perienced a ringing in both ears as long as I remem-
ber. However, the noise that started six months ago
was different. This noise was more like the low
hum of a machine greatly amplified.
Following is an excerpt from a rather Lengthy journal I maintained.
7/1J93 7/19/93 He said I would learn to live with it, patted
When I got out of bed this morning, I had a I honestly think I will go insane if this noise me on my arm. and left. I went to speak with
dull pain behind my left ear and a stiff neck. does not stop. Nothing I do helps. I go back hi s audiologist. He repeated basically the
7/2/93 to the ENT tomorrow. same information- you wiiJ just have to
I noticed two or three times today that cer- 7/20/93 learn to live with it. 1 am so frustrated. I
tain noises in my left ear bad a strange sound The doctor ordered a hearing test and pre- don' t think the ENT listened to me and of-
(somewbat like noises coming through water scribed Zaroxolyn 5mg. I took the first dose at fers no hope for improvement.
or down in a tunnel.) 4 p.m. when 1 returned home from the doctor. 8/13/93
7/3/93 By 8 p.m. I was dizzy and nauseated. The tinni- I had an appointment with another doctor to-
The same sounds happened two or three rus, pressure, pain, and distorted hearing was day. This physician is anENT who special-
times again today. gone. The diu.iness lasted about four hours. izes in Meniere's disease. After spending
7/4/93 7/21/93 about 10 minutes with me be concluded I
I am consistently having difficulty bearing (still My left ear is normal. No tinnitus. No pain had Meniere's disease. He went on to say 1
sounds like noises traveling through water.) or pressure. No hearing problems. No dizzi- would probably go completely deaf in my
115193
ness. left ear. Also, there was a good chance the
7/22/93 dizziness would become so severe I might
My family and I are on vacation. Today I
went to a walk-in clinic in Virginia Beach
where the physician said there appeared to
Normal 11ot be able to fuuction in day-to-day activi-
7 ;
23
/93 ties. He noted that the same symptoms might
appear at anytime in my right ear. He said
that I should start a low salt diet and decrease
be fluid behind the membrane. He ordered Tinnitus starting again.
Naldecon and Ceclor. 7/24-7/26/93
caffeine intake (which might or might not
7/12/93 Tinnitus worsening. help.) 1 tried to explain I bad not added salt
I continue to take the Naldecon and Ceclor. We 7/27/93 to my food, eaten high sodium foods. or con-
just arrived back borne. My hearing is much Tinnitus and pressure worse than before I sumed caffeine for over six years. He pro-
worse and the noise is terrible. I went to a fam- started taking the dimetic. I went to my fam- ceeded to say he was sure 1 ate more salt
ily practitioner here today. He changed my anti- ily practitioner because I suspected I had than I realized in such foods as bologna. At
biotic. I was so miserable I called the ENT's shingles. He conftrmed I had herpes zoster that point I decided not to repeat l had not
office who comes to town for weekly clinics. I on my back. I started taking Zovirax today. I eaten lunch meat, bologna, or other high so-
have an appointment with him tomorrow. also went back to the ENT. He diagnosed me dium foods for the last six years. He said
7/13/93 as having Meniere' s disease. He said there is there was nothing he could do and gave me a
The ENT said he saw nothing wrong with nothing to do, and I would have to learn to prescription for Elavil. (He had a copy of my
my ear. He prescribed a course of prednisone. live with it. He prescribed Valium for dizzj. previous record in front of him, but I don't
7/17/93 ness. I do not think! need Valium since the believe he looked at it.) He asked what diu-
1 do not feel like I can tolerate the terrible dizziness has been fairly insignificant. T need retic 1 was taking and wrote another prescrip-
noise J have in my left ear. I feel like some- something to relieve the intolerable tinnitus. tion for Zaroxolyn (after asking me how to
one is constantly beating the side of my He said there was absolutely nothing to do spell it and saying he bad never heard of it.)
head. 1 cannot concentrate
00
anything. for the tinnitus. He said he did not want to He said to make a return appointment for
7/18/93 see me for six months. J told him I did not four months. I am more upset than before.
1 cried most of today. 1 cannot eat I am so up- feel J was coping ':"'ith the n ~ i s ~ and did not This ENT was even more discouraging and
set over this noise. know how to continue funct:Jomng normally. listened to me less than the first.
There are Options
Friends and family tried to help me, but could
not identify with hearing such strange noises. My
worst experiences came from the doctor visits. If I
had followed the doctors' advice I would probably
have given up hope. I entertained the thought of
quitting my job because of their dire predictions. If
I had not been a nurse, I might have taken Valium
and Elavil simultaneously when neither were
needed. Also, I could have become hypokalemic
since a potassium supplement was not ordered with
the prescribed diuretic, and I was not encouraged
to eat foods high in potassium.
During the worst days, I prayed a great deal.
I also started a journal. Writing helped relieve my
anxiety, but this documentation also served as a
means of noting foods or behaviors that seemed to
help or worsen the symptom.
"COPING WITH TINNITUS"
e STRESS TREATMENT
e TINNITUS MANAGEMENT IS OFTEN
COMPLICATID BY ANXIETY AND STRESS
e NOW A UNIQUE CASSETTE PROGRAM IS
AVAILABLE DESIGNED TO PROVIDE DAllY
REINFORCEMENT AND SUPPORT FROM TilE
STRESS OF TINNITUS WITHOUT COMPLEX
VALUABLE OmCE TIME
The program consists of one cassette tape of Metronome
Conditioned Relaxation and two additional tapes of unique
masking sounds which have demonstrated substantial benefit
\ whenever the patient feels the
need of additional relief. These
9
9
0 recordings can be used to induce
$ 0 1!11 "aodiiO\l sleeping or as a soothing back
!)()
drop for activity and can be played

'
1
on a portable cassette player.
All ORDERS MUST BE ACCOMPANIED
reNTE BY CHECK, VISA, MASTERCARD,
OR INSTITUTIONAL P.O.
6796 MARKET ST., UPPER DARBY, PA 19082
Phone (215) 352-0600
Unfortunately before the episode was com-
plete I developed herpes zoster and lost 25
pounds in two months.
Fortunately, I became a member of the A TA
and located a physician in Dayton, Ohio
who was willing to work with me regarding
solutions. His three simple words "there are
options" were exactly what I needed to hear.
Tinnitus sufferers, remember there are numer-
ous options. Do not lose hope even if your physi-
cian offers no hope. Seek another physician or
health care professional if necessary. Join the AT A.
Evaluate what works best for you.
There are options!
WANTED HEARING
AIDS AND/OR
MASKERS IN ANY
CONDITION
Donate your old instruments
to AT A and receive a receipt for a
tax-deductible donation.
What happens to the aids you
tum in? Old aids can be recycled for
parts and plastic, and sometimes are
repairable and can be used in pro-
grams to help people in underdevel-
oped countries.
Your discarded aid could give
someone less fortunate the gift of
hearing. Please help in this meaningful way. Simply package
them (a small padded mailing bag is fine,) and send to:
ATA, PO Box 5, Portland, OR 97207-0005.
If you are using UPS or another alternate shipper - our
street address is 1618 SW First A venue, #417,
Portland, OR 97201. PH: (503) 248-9985.
Tinnitus: The Cart or the Horse?
by A. James Heins,Ph.D. ProjessorojEconomics,
University of Illinois
In his Q. and A. column of the September
1993 Tinnitus Today, Jack Vernon makes the inter-
esting observation that treating depression in order
to relieve tinnitus "has the cart before the horse."
Not really. Would treating depression in order to
repair insomnia have the cart before the horse?
People with depression endure a host of symptoms,
including tinnitus. The point of treating the depres-
sion is to ameliorate the symptoms. Relief from
symptoms is precisely the cart.
After suffering from tinnitus for about two
years and blaming my agonies of insomnia, ten-
sion, and malaise on the ringing in my ears, I
decided to review the medical literature on my
worst agony, insomnia. (I think it was Margot
Asquith who said, "people who have never experi-
enced true sleeplessness cannot possibly know
what it means; insomnia is akin to insanity.") Sleep
research quickly led me to depression, and
shortly I saw myself emerging from the
pages. I was suffering from depression. Just
as clearly the pages shot forth my remedy,
amitriptyline.
I presented my fmdings to my physi-
cian, and he ordered up amitiiptyline in the
small dosage of 25 mg per day. (I weigh
about 200 pounds and carry 62 years.)
Needless to say it changed my life; I sleep,
I am more at peace with the world, and I am
less preoccupied with my well being. And,
while the ringing in my ears is just as loud,
I live with it a lot better.
It is an open question whether tinnitus
causes depression, or depression causes tin-
nitus. Regardless, we are left with no alter-
native but to treat the symptoms. If treatincr the
. . . 0
nngmg ameliorates other symptoms of depression,
fine. If treating the other symptoms of depression
relieves the ringing, equally fine. In reality, there is
no cart, and there is no horse. I urge people who
suffer greatly from tinnitus to explore the possibil-
ity they suffer from depression. Exploration cannot
burt; but as it did with me, it may restore the world
to beauty.
I should add that I actually take amitriptyline
only four to five months per year. I do not need it
for months at a time, and I have been told by
professionals that amitriptyline is actually more
efficacious if nQ1 taken all the time. Of course, your
physician or psychologist might see this issue dif-
ferently. Also, your physician may prescribe nor-
triptyline or another antidepressant depending on
the confluence of your symptoms. My reading of
the research is that amitriptyline is particularly
therapeutic for insomniacs. In any event, good
luck.
The Doctor Is In
by Barbara Tabachnick,
Client Services Coordinator
Do you know how to be a
support giver to others with tin-
nitus? And how about being a
support taker - do you have
what it takes? In many cases,
the answer to both of these
questions is yes.
Many who have expressed
interest in being a part of
AT A's Tinnitus Support Network have done so
with some hesitancy. They aren't sure how much
help they can be and, despite our assurance that any
helping effort is a winning one, they are afraid to
fail. I think fear is a good thing when it makes us
workharderatsomething.Butwhenfearparalyzes
our efforts it's time to look harder at it. To remove
the mystique of being a helper, I would want to
know how the "quality" of help is measured.
In the January 1994 issue of Psychological
Science, Christiansen and Jacobson's article re-
views hundreds of studies comparing the effec-
tiveness of self-directed/mutual helping,
counseling by professionals and counseling by
paraprofessionals (someone, like a physician, or
teacher, who is not actually a counselor but who
can act as one). Based on these studies empa-
thetic support in a casual group setting or on a
one-on-one basis has an effectiveness that is
measurably high. In fact, the differences in ef-
fectiveness were quite small when the helpers
involved were known to be compassionate, trust-
worthy, and genuinely interested people.
Christiansen and Jacobson noted that cer-
tain types of problems, such as fears and depres-
sion, were more readily resolved with
self-helping than were habit problems such as
smoking. Also, some people who have a cau-
tious, "high-resistant" personality responded
more favorably to self-directed therapy, while
others with a more compliant personality re-
sponded better to psychotherapy. However, re-
gardless of the problem or the personality,
everyone who received some sort of support felt
better than those who received no support at all.
Help is literally everywhere - caring doc-
tors, friends, family members, self-help groups,
and others with tinnitus. Often overlooked,
though, is the helper within. Albert Schweitzer
said, "The patient carries his own doctor inside
him," expressing his belief that we all have the
capacity to effect positive emotional and physi-
cal changes in ourselves. Yet how will you know
if your innate ability to self-help will be enough
to make you feel better? How will you know if
reaching- ont for vnnr own hf>ln will rP:::tllv h ~ l n ?
And how will you know if the compassion and
support you extend to others hits the mark? A
single answer comes to mind: Let us help you
try.
With great thanks, we welcome our new
additions to the Tinnitus Support Network
Support Group Coordinators:
JeanieLavagnino, 121 Hilliard Ln, Eugene
OR 97404, 503/689-8076
Capt. Doug Melton, 205 Yoakum Pkwy
#1512, Alexandria VA 22304, 703/212-7060
Telephone and Letter contact:
Bonnie Hausler, 3426 Gomer St., Yorktown
Hts NY 10598, 914/245-8694 (11arn-6pm)
If you are interested in starting a support
group or in becoming a telephone contact,
please call us (503/248-9985) or write for our
Self-Help Packet.
Profiles
Alexander J. Schleuning, II, M.D., new advisory committee member.
Dr. Schleuning is not new to tinnitus. He has been associated with the Oregon Tinnitus
Clinic from its inception in 1976. This clinic was described in an article he co-authored for
the Ear, Nose and Throat Journal in 1977. Since then, Dr. Schleuning has published more than
a dozen articles about tinnitus, primarily using masking to treat tinnitus, but also including
drug studies, patient management and implantable hearing aids.
Dr. Schleuning graduated from Stanford University and the University of Oregon
Medical School and served in the U.S. Army after completing his residencies. He has
held the position of Chairman of the Department of Otolaryngology at Oregon Health
Sciences University since 1980, having been at the time of his appointment one of the
youngest men to be so honored.
He has been a member of numerous medical and scientific organizations throughout
his career and currently serves as a member of the committee on hearing and equilibrium of the American
Academy of Otolaryngology-Head and Neck Surgery, and as a member of the Accreditation Council for
Graduate Medical Education Residency Review Committee. Locally he serves as a board member for the
Portland Center for Hearing & Speech, advisor to the David DeWeese Hearing Center for Children, and
board member of the Tucker-Maxon Oral School.
Dr. Schleuning is a member of the local planning committee for the Fifth International Tinnitus
Seminar and will be welcoming delegates to visit the new Oregon Health Sciences University hearing
research facilities that are hoped to be completed by early 1995. We are proud to welcome Dr. Schleuning
to the advisory committee and look forward to his involvement in AT A programs.
Dr. Robert A. Dobie, new advisory committee member.
Dr. Dobie is a professor and chairman of the Department of Otolaryngology-Head
& Neck Surgery at the University of Texas Health Science Center at San Antonio. Prior
to coming to San Antonio in 1990, he was professor of Otolaryngology-Head & Neck
Surgery at the University of Washington and director of the Virginia Merrill Bloedel
Hearing Research Center.
Dr. Dobie' s research interests in tinnitus have involved him in studies of the
interactions of tinnitus with psychiatric disorders, drug treatments of tinnitus (using
diuretic and antidepressant drugs), and studies of electrical tinnitus suppression. His
curriculum vitae lists over 125 publications.
After undergraduate and medical school education at Stanford University, Dr. Dobie
remained at Stanford for internship and residency in otolaryngology, finishing his specialty
training in 1975. His career was punctuated by additional training in auditory physiology in
New Orleans, and in otoneurosurgery in Zurich. Throughout his career, he has divided his time among
research, teaching and clinical practice. In addition to tinnitus, Dr. Dobie's research interests include auditory
evoked potentials, clinical trials in otology, and noise-induced hearing loss. His research has been funded by
ATA, the Deafness Research Foundation, the Veterans Administration, and the National Institutes of Health.
Dr. Dobie serves on the editorial boards of Laryngoscope, Otolaryngology-Head and Neck Surgery,
and the American Journal of Otology. He is presently a member of the Board of Directors of the Deafness
Research Foundation, the council for Accreditation in Occupational Hearing Conservation, and the Board
of Trustees of the American Otological Society Research Fund. He is past president of the Association for
Research in Otolaryngology. A member of many professional and scientific organizations, he has been
honored by election to the Collegium Oto-Rhinologicum Arnicitiae Sacrum.
Tributes, Sponsors, Special Donors
The A TA tribute fund is designated 100% for research. Thank you to all those people listed below for
sharing memorable occasions in this helpful way. Contributions are tax deductible and are promptly ac-
knowledged with an appropriate card. The gift amount is never disclosed.
GIFTS FROM 21-94 to 4-27-94 RANDALL & ELSIE DUCOTE A OQUINN ROBERT H HOSEA MD
IN MEMORY OF KATHERINE A ELBERFELD FLORENCE S REICH JOHN W HOUSE MD
Joseph Bachmayer BERNARD FISHMAN PHILIP N RICE PAWEL J JASTREBOFF PHD
LaVerne Bachmayer SHIRLEY P FOGELBERG BERNARD RICHARDS ALAN JOHNSON MD
Irving Gardner RAYMOND I FRANCINE FOSTER LYNN ROSEMURGY SUSAN KARPF M ED
Trudy Drucker/Joseph Alam ROBIN R FULLER JACK SALERNO DAVID C KELSALL MD
Peter Nicholas DR ARTHUR GELB RICHARDS SCHONWALD HENRY T KLEINER MD
The Wolff Family KEN P GELINAS EVELYN J SCHWERTL VALERIE P KRINEY MAICCCA
Charles E Parson VEVAJ GIBBARD BRUCE A SHACHAT MICHAEL LAROUERE MD
Larry & Nan Stocking JOSE V GORBEA JOHN M SIMMS RICHARD C LAUCKS MD
Ray C ROD GRANBERRY JR GARY SINGER E ROBERT LIBBY
Annie F Percival COLIN D GRANT-WATTERS J DARYL SLATE MALCOLM H LIGHT II MA
Alan & Selma Rothenberg DONALD B HAAKE LUTHER J SMITH II MD BERNARD LIPIN MAICCCA
Susan R Ericson JOHN R HAFER MAXWELL SOLOMON FRANK H LONG MD
Beverly Usdan CYRUS 0 HARPER THOMAS E STEGMAN NICHOLAS L YGIZOS MD
Claire Simon A JAMES HEINS HOWARD C STIDHAM PETER A MERCOLA MSEE
Marion Wansing DANIELE HORGAN LAURENCE C STOCKING STEVEN J MILLEN MD
Jeanne & Max Mileur ROBERT B HORN JAMES C STORIE DR MAURICE H MILLER
IN HONOR OF WILLIAM H HURT ORLOFF W STYVE DOUGLAS H MORGAN DDS
Julie A Alam-Birthday ROBERT C INCERTI DANIEL K TARKINGTON JOHN T MURRAY MD
Trudy Drucker/Joseph Alam JAMES IRVING FRED D THOMPSON C RANDALL NELMS JR MD
Mora C Emin-Birthday LUCILLE J JANTZ JIM THOMPSON SCOTT M NELSON MD
Trudy Drucker/Joseph Alam JOHNNIE W JOHNSON MICHAEL L TORTORELLI DRJERRYLNORTHERN
Mr & Mrs Scott Fearer-61 st RUTH M JOHNSTON WILLIAM R TOWER JR THOMAS J NORWOOD
Anniversary DR/MRS STANLEY KARP ARLENE B VANNORDEN MSPACCC
Judy Brivchik HAROLD S KARPE DELMER D WEISZ PETER M PEARLMAN MS/CCC
Jack Mulligan WILLIAM J KEARNS HAROLD E WELLS ANTHONY M RAIA MD
Bergen Tinnitus Group JOHN BKENT ADELAIDE W ZABRISKIE JOHN AlSEY MCD
Rebecca Rubin-Birth MARVIN KOWIT PAUL W ZERBST J LEWIS ROMETT MD
Trudy Drucker/Joseph Alam GLIDE V SONNY LANDRETH Ill RICHARD RUGGLES MD
SHARON ANN LEMKE
HEARING AID DONATIONS
ROBERT SALTSMAN JR MSC
SPONSOR MEMBERS
PAULLENCHUK 469 pre-owned Hearing Aids ANNE & PETER SEAMANS
CHARLES L ADAMS DANJ LOGAN and Maskers have been re- ERIC T SHEBAR
RICH ALGER PETER J LUBALIN ceived and recycled. Thank you. MICHAEL D SEIDMAN MD
LAVERNE BACHMAYER JOHN MALCOLM We'll be glad to receive more! FRANK A SKINNER
ELIZABETH S BENNETT A F MARTIN DONALD G SMITH DDS
DEBORAH & CHARLES BERN BRUCE MARTIN FOUNDATION GIFT ROBERT M SOUTHARD BC-HIS
CHARLES T BINTZ ED LEIGH MCMILLAN II Barbra Streisand Foundation BRADLEY THEDINGER MD
ROBERT BOEMER THOMAS F MCNULTY TRIDENT OTOLARYNGOLOGY
CHARLES T BROWN DR DUANE D MEAD
PROFESSIONAL ASSOCIATES
JOSEPH P VELEK MD
WILLIAM E BROWN JR JOHN MEIDELL NANCY J AHRENS ROBERT J WEISS
RAYMOND L BUSE JR PEGGY MEISELS RICARD W AMBROSE ELLIOT WINEBURG MD
MCLAREN BEATTY ANDREW METRICK F OWEN BLACK MD RICHARD D ZUJKO MD
A PAUL CAMERINO ALEXANDER MILLER
GAIL B BRENNER MAICCCA
BARBARA YOUNG CAMP EARLR MOORE JACK CLEMIS MD MATCHING GIFTS
MAN TAK CHAU MARY T/JAMES MORAN NEIL M DANIELS You might be able to double
C DENNIS CLARDY RICHARD E OFFERDAHL A JEFFREY DANSON MD or triple the size of your gift
ROBERT COLE DENNIS W ORGAN JOHN A EMMETT MD to the American Tinnitus
RICHARD W COOPER BENJAMIN OSSMAN JACK R ERWIN MD
Association by taking ad-
PATRICK M COSTIGAN PAUL OVERLAY LAWRENCE T ESCHELMAN MD vantage of your employer's
GREGORY CROUCH DR ALLAN F PACELA
BARBARA ESSES MD
Matching Gift Program. Many
PAUL JOHN DANIS HELEN PAPAS ROBERT S FEEHS MD companies have matched con-
L D DAUGHERTY RANDY L PARKS DR NORMAN FRANKEL tributions to ATA. We urge
PIERRE DAVID THOMAS J PATRICIAN GREGORY FRAZER PHD you to ask if your employer
AJ DIANI HARVEY A PINES
EDUARDO GO MD
will match your gift. Or call
RICK DILSIZIAN TYRONE E POWELL W F SAMUEL HOPMEIEA BC-HIS ATA for the names of compa-
TRUDY DRUCKER D STEWART PRECYTHE nies that match contributions.
26 Tinnitus Today/March I 994
Fifth International Tinnitus Seminar
Next Year in Portland, Oregon
Fifth quadrennial meeting, July 12-15, 1995,Port-
land Marriott Hotel, Portland, Oregon, USA. Spon-
sored by the American Tinnitus Association.
The Fifth International Tinnitus Seminar
brings you the best in the field of tinnitus - most
distinguished speakers, the most provocative ad-
dresses and panels, and the latest in research find-
ings. This meeting is the preeminent quadrennial
event for all scientific investigators, because we
offer a carefully crafted program that transcends
the boundaries of specialties and explores tinnitus
from a variety of perspectives.
The 1995 Tinnitus Seminar features cutting
ed<Ye research while at the same time integrating
b D.
research findings to clinical treatments. 1verse
poster presentations highlight specific research
questions and findings, all in a format allows
the audience time to absorb, react, and d1scuss the
data one-on-one with individual presenters.
In addition to the impressive scientific pro-
gram, the Fifth International Tinnitus Semi-
nar offers exhibits featuring the latest
equipment, publications, and services,
and opportunities to network with col-
leagues at social events. Another key at-
traction is the satellite meeting of the
International Tinnitus Support Associa-
tions; the self-help group leaders work-
shop; and the special sessions devoted to
leqal issues related to tinnitus.
Don't forget the lure of the Pacific Northwest
itself. Portland has a splendid array of museums,
monuments, restaurants, theaters, and most of all
its surrounding natural attractions; the Columbia
River Gorge, Mt. St. Helens, now 13 years past her
great eruption; the Pacific coast; Mt. Hood, where
you can probably ski in July; the high desert
try of Eastern Oregon; gateway to crlllsmg
or California entertainments. These are JUSt a few
of the special attractions you can enjoy with your
entire family.
Registration forms and hotel information will
be mailed to those people presenting papers or
posters. Registration materials may also be re-
quested by calling the ATA office after January 1,
1995. (Tel: (503) 248-9985, Fax: (503) 248-0024),
E-Mail: reichg@ ohsu.edu
The most important component of the Fifth
Intemational Tinnitus Seminar is the participation
of those involved in tinnitus research. New compo-
nents for 1995, featuring legal issues and self-help
have been included by popular demand The Inter-
national Tinnitus Advisory Committee is con-
stantly looking to improve the quadrennial
by incorporating your ideas.'
and submissions. For more mformat10n on pro-
grammatic issues, or to seek advice on your sub-
mission, please contact Jack A. Vernon, P.h.D.,
Co-Chairman, at (503) 494-8032, or Glona E.
Reich, Ph.D., Co-Chairman, at (503)248-9985.
See you in Portland in 1995!
Yes! I'm looking forward to being part of the
Fifth Intemational Tinnitus Seminar. Please send
me the following information.
0 1 am an investigator and wish to present a paper
about my tinnitus studies. Please send specific in-
structions for proposal preparation.
0 1 am a Self-Help Group leader or member and
would like to attend the sessions about tinnitus sup-
port. Please send me information about how to en-
roll in the Self-Help workshop.
0 1 am a lawyer representing clients with tinnitus:
I'm interested in attending the Legal Aspects of Tin-
nitus presentations. Please send me information.
0 I'm an AT A member who would like to register for
the entire Tinnitus Seminar, attend all the meetings
and ancillary activities, but I will not be presenting a
scientific paper.
Name _________________________ __
Affiliation ------------------------
Street Address
City/State/Zip---------------------
Phone (with area code) ______________ __
FIFTH INTERNATIONAL TINNITUS SEMINAR
JULY 12-15,1995
PORTLAND,OREGON,USA
AMERICAN TINNITUS ASSOCIATION
P.O. BOX 5, PORTLAND, OR 97207-0005
ADDRESS CORRECTION REQUESTED
Non-Profit Org.
U. S. Postage
PAID
American Tinnjrus
Association

Tinnitus Today June 1994 Vol 19, No 2

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Tinnitus Today June 1994 Vol 19, No 2

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JUNE 1994 VOLUME 19, NUMBER 2

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