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Tinnitus Today June 1997 Vol 22, No 2

Tinnitus Today June 1997 Vol 22, No 2

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Tinnitus Today is published three times a year, Spring (April), Summer (August) and Winter (December), and mailed to the American Tinnitus Association members and donors. Circulation is rotated to about 75,000 annually.

The American Tinnitus Association is a nonprofit human health and welfare agency under 26 USC 501(c)(3).

1997 © American Tinnitus Association.

Tinnitus Today is published three times a year, Spring (April), Summer (August) and Winter (December), and mailed to the American Tinnitus Association members and donors. Circulation is rotated to about 75,000 annually.

The American Tinnitus Association is a nonprofit human health and welfare agency under 26 USC 501(c)(3).

1997 © American Tinnitus Association.

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Published by: American Tinnitus Association on Nov 30, 2012
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June 1997 Volume 22, Number 2

Tinnitus Today
"To promote relief, prevention, and the eventual cure of tinnitus for
the benefit of present and future generations"
In This Issue:
Elderly People and Tinnitus
Barometric Changes and the Ear
New Drug Research
You Can Overcome Your Tinnitus
Since 1971
Research- Referrals-Resources
Sounds Of Silence
Control your audible ambience with
sounds caused by Tinnitus with the
Marsona Tinnitus Masker from Ambient
Shapes. The frequency and intensity of I he
simulated sounds match the tones heard by
many tinnitus sufferers. These masking
del'ices are proven effective in assisting
many patients in adapting to their tinnirus.
We cannot predict whether or not the
Marsona is appropriate for you, but the
probabi lity of successful masking is well
The Marsona Tinnitus Masker weighs
less than rwo pounds to make transporting
easy and offers over 3000 specific frequen-
cy selections ro achieve high definition
The Marsona Tinnitus lvlasker
uses less than 5 watts of power, or about
as much electricity as a small night light.
Simple To Use
• Search the frequency range setting
to determine the specific "cenrer
frequency" of tinnitus sound(s) to provide
rrec.ise masking.
)r credit a1rd holders please call toll free. I
Order produet # 1550
Tinnitus Masker. Or send 3 check for $249.00 I
(FREE shipping & handlin)(). 1\C residents add
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Ambient Shapes, Inc.
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• Widen the frequency range around
specific "center frequency" ro add ambient
sound to enjoy the most pleasing personal
sound selection.
Marsona Features
The Marsona features over 3000 settings
adjustable center frequency, frequency
range, and volume conu·ol. Privacy head-
phones can be used but are not included.
The Tinnitus Masker has an ultra-high
frequency speaker, LED readout for easy
legibil ity, a frequency comparison cha11,
and a built-in optional shut-off timer.
The bedside Tinnitus Masker can be
purchased through Ambient Shapes for
hundreds less than purchasing another
Size: L 8.75" \XI 5.85'' 1:-1 3.12". Use!> 110·120\' AC
(220-240V <Wailable). ULand CSA approved
power supply.
- - - __ JI-------------------------
Editorial and advertising offices:
American Tinnitus Association,
P.O. Box 5 Portland, 0 R 97207, 503/ 248-9985,
800/ 634-8978, http:/ / www.teleport.com/ hata
Executive Director & Editor:
Gloria E. Rllich, Ph.D.
Associate Editor: Barbara 'labachnick
Tmmtus Tbclay is published quarterly in
March, June, September, and December. IL is
mailed to members of the American Tinnin1s
Association and a selected list of tinnitus suf-
ferers and professionals who treat tinnitus.
Circulation is rotated to 75,000 annually.
The Publisher reserves the right to reject or
edit any manuscript received for publication
and to rejet't any advertising deemed unsuit-
able for Tlnmtus Tbday . Accept<Jnce of
tising by Tlnnirus Tbd£•y does not constitute
endorsement of the advertiser; its products
or services, nor does Tlnmws Tbday make
any claims or guarantees as to the accuracy
or validity of the advertiser's offer. The opin-
ions expressed by contributors to Tlnmrus
1bday are not necessarily those of the
Publisher, editors, staff. or advertisers.
American Tinnitus Association is a non-
profit human health and agency
under 26 USC 501 (c)(3)
Copyright 1997 by J\merican Tinnitus
Association. No part of this publication may
be reproduced, stored in a retrieval system,
or transmitted in dny form, or by any means,
without the prior '"riucn permission of the
Publisher. [SSN: 0897-6368
Scienti fic Advisory Committee
Ronald G. Amedee, M.D., New Orleans, LA
Robert E. Brummett, Ph.D., Pottland, OR
Jac.k D. Clemis, M.D., Chicago, !L
Robert A. Dobie, M.D", San Antonio, TX
John R. Emmett, M.D .. Memphis, TN
Chris B. foster. M.D., La Jolla, CA
Barbara Goldstein, Ph.D., New York, NY
John w. House, M.D., Los Angeles, CA
Cary P. Jacobson, Ph.D., Detroit, Ml
Pawel J. Jastreboff, Ph.D., Baltimore, MD
Robert M. Johnson. Ph.D., Portland, OR
William H. Martin, Ph.D., Philadelphia, PA
Gale W. Miller, M.D., Cincinnati, OH
J . Gail Neely, M.D., St. Louis, MO
Robert E. Sandlin, Ph.D., El Cajon, CA
Alexander J . Schleuning, ll, M.D.,
Portland, OR
Abraham Shulman, M.D., Brooklyn, NY
Mansfield Smith, M.D., San Jose, CA
Robert Sweetow, Ph.D., San Francisco, CA
Honorary Directors
The Honorable Mark 0. Hatfield
Tony Randall, New York, NY
William Shatner, Los Angeles, CA
Legal Counsel
Henry C. Breithaupt
Stoel Rives Boley Jones & Grey,
Portland, OR
Board of Directors
Edmund Grossberg, Northbrook, !L
W. F. S. Hopmeie1; St. Louis, MO
Sidney C. Kleinman, Chicago. IL
Paul Meade. Tigard, OR
Stephen M. Nagler, M.D., Atlanta, GA
Philip 0. Morton, Portland. OR, Chmn.
Aaron J. Osherow, Clayton, MO
Gloria E. Reich, Ph. D., Portland, OR
Jack. A. Vernon, Ph.D., Portland, OR
Megan Vidis, Chicago, !L
The Journal of the American Tinnitus Association
Volume 22 Number 2, June 1997
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.
8 New Drug Research for Tinnitus
by Barbara Tabachnick
9 Elderly People and Tinnitus
11 Air Bag Ruling? - Still Up in the Air
by Barbara Thbachnick
12 Back Issues of Tinnitus 'Ibday
13 You Can Overcome Your Tinnitus
by Steven M. Nagler, M.D.
14 New Scientific Advisory Committee Members
15 Book Review
by Harvey A. Pines, Ph.D.
16 Sizing Things Up
by Barbara Thbachnicl<:
17 New Support Network Volunteers
1 7 'Thlldng to Myself
by Theris Aldrich
18 Barometric Changes and the Ear
by Barbara Thbachnick
24 ATA Across the U.S.A.
by Pat Daggett
Regular Features
4 From the Editor
by Gloria E. Reich, Ph.D.
6 Letters to the Editor
21 Questions and Answers
by Jack A. Vernon, Ph.D.
25 Tributes, Sponsors, Special Donors, Professional Associates
Cover: ·outdoor Still lile" (soft pastel) by Margaret Ackerman, P.O. Box 1099, Ignacio, CO,
81137, 970/884-2603. Ms. Ackerman is a professional artist and ATA member.
From the Editor
by Gloria E. Reich, Ph.D.,
Executive Director
Welcome to several people who
will be furthering the cause of
tinnitus and the ATA. You'll be
reading elsewhere in this issue
about three new members of
the scientific advisory commit-
tee: Pawel J. Jastreboff, Ph.D.;
Gary Jacobson, Ph.D.; and
Robert Sweetow, Ph.D. All are well-versed in
tinnitology and we look forward to their wise
counsel. At the same time we bid a grateful
farewell to advisor Richard Goode, M.D. who has
contributed greatly to ATA's growth and success.
ATA's board of directors also continues to
grow. The latest additions to our governing board
(who you'll read about in the next issue) are
Sidney Kleinman from Chicago, Illinois, and
Stephen Nagler, M.D. from Atlanta, Georgia. We
warmly welcome them and look forward to
working with them to further ATA's progress.
You may wonder how a person gets to be
an ATA board member. Well, one route to ATA
board service is to serve on a committee. That's
a good way to get to know the people who are
responsible for ATA's well-being and to deter-
mine whether you want to commit to the very
considerable responsibility ofbeing a board
member. If you'd like more information about
becoming seriously involved with ATA, ask me.
I'll be happy to answer your questions and
promise not to twist your arm too tightly.
Now, here's a way that everyone can help.
Write to your legislators in support of tinnitus
research. Every legislator votes on these kinds of
issues, primarily by their support of the National
Institute on Deafness and Other Communication
Disorders. Some legislators have a greater influ-
ence due to their membership on the appropria-
tions committees of the House and Senate.
These people are particularly important to con-
tact and we hope you'll write to as many as pos-
sible. Obviously you'll have the most influence
on the ones who've been elected by your vote.
Your own words are the most effective
means of communication but sometimes it's eas-
ier to modify a letter that's already been started.
Here's the general idea of what needs to be said.
4 Tinnicus 1bday/ June 1997
The Honorable :xxxxxxxx
United States Senate or
United States House of Representatives
Room Number X:XXX, x:xxxxxx Building
Washington, D.C. 20515
Dear Senator xxxxx:xx, Or,
Dear Congressman/woman :xxxxxxx,
I'm writing to ask you to support tinni-
tus research by voting for an increase in
the budget for the National Institute on
Deafness and Other Communication
Disorders (NIDCD). The President has only
recommended a 2.6% budget increase for
the National Institutes of Health (NIH)
which would mean a decrease in real dol-
lars available for research. Please support a
real increase in the NIH budget of at least
the 9% advocated by the Joint Steering
Please, also, consider becoming a co-
sponsor of Congressman Gekas' resolution
calling for a doubling of the NIH budget.
Once you've committed to increasing the
budget for hearing research, please remem-
ber to specify that some of it must be spent
on tinnitus research. Those of us who have
tinnitus are relying on you to help. We're
eager to receive effective treatment and get
on with our lives. That can only happen if
research identifies the cause of tinnitus and
suggests appropriate clinical interventions.
In my own experience with tinnitus ...... .
[Here's where you can tell your own story
about how tinnitus has affected your life,
both in the workplace and socially.]
I am a member of the American Tinnitus
Association, the only non-profit organization
devoted to promoting tinnitus research and
helping those who have it. You and your
staff can personally join the fight to cure
tinnitus by a pledge to ATA (#0514) in the
Combined Federal Campaign.
Please listen to me so that I won't have
to listen to these infernal tinnitus sounds
for the rest of my life. Your vote to increase
hearing and tinnitus research is crucial. I
thank you for your consideration.
Sincerely yours,
From the Editor (continued)
Below is a list of the most crucial House
Appropriation Committee members to contact.
Their Room numbers and Buildings are listed
after their names.
Robert B. Aderholt, AL
Sonny Callahan, AL
Jay Dickey, AR
Jim Kolbe, AZ
Ed Pastor, AZ
Randy Cunningham, CA
Julian C. Dixon, CA
Jerry Lewis, CA
Vic Fazio, CA
Ron Packard, CA
Nancy Pelosi, CA
Esteban E. Thrres, CA
David E. Skaggs, CO
Rosa DeLauro, CT
Garde Meek, FL
Dan Miller, FL
C.W Bill Young, FL
Jack Kingston, GA
Thm Latham, lA
John Edward Porter; IL
Sidney R. Yates, LL
Peter J. Visclosky, TN
Todd Tia hrt, KS
Anne Meagher Northup, KY
Harold Rogers, KY
Robert L. Livingston, LA
John W. Olver, MA
Steny H. Hoyer, MD
Joe Knollenbcrg, MI
Marin Olav Sabo, MN
Mike Parker, MS
Roger Wicker, MS
W, G. Bill Hefner, NC
David E. Price, NC
Charles H. Thylor, NC
Rodney Frelinghuysen, NJ
Joe Skeen, NM
Michael P. Forbes, NY
Nita M. Lowey, NY
Jose Serrano, NY
James T. Walsh, NY
David L. Hobson, OH
Marcy Kaptur, OH
RaJph Regula, OH
Louis Stokes, OH
Ernest J. Is took, OK
Thomas M. Foglietta, PA
Joseph M. McDade, PA
John P. Murtha, PA
Zach Wamp, TN
Henry Bonilla, TX
Tom DeLay, TX
Chet Edwards, TX
James P. Moran, VA
Frank R. Wolf, VA
Norm Dicks, WA
George Nethercutt, WA
Mark W. Neumann, WI
David R. Obey, WI
Alan B. Mollohan, YITV
More News ... .
A new prize has just been announced by
ATA. This $1,000 prize will be for the best tinni-
tus paper or poster given by a young investiga-
tor at the annual meeting of the Association for
Research in Otolaryngology (ARO). The prize
has been funded by board member Dr. Jack
Vernon and will serve to promote interest in
tinnitus research among scientists just getting
started with their careers. For more information
about applying for this prize, call me (503/248-
9985). ATA traditionally distributes information
about its tinnitus research projects in-progress
along with grant applications to interested
researchers at the ARO meetings. This year,
ATA's Scientific Advisors gathered at ARO to
address the deadlines and requirements for tin-
nitus research grants. It was decided to have two
deadlines for proposal submission: June 30th
and December 30th. Proposals will continue to
be read by at least five scientific readers who
will make comments and evaluate the proposals
for the final decision by ATA. Present at the
meeting were Robert Dobie, Gary Jacobson,
Mary Meikle, Jim Henry, Tho Zhang, Robert
Levine, Robert Brummett, Pawel Jastreboff,
Michael Seidman, Rene Dauman, Richard Salvi,
Yvonne Sininger, and Douglas Mattox.
Thank you for the astounding response to
last year's patient survey. We received 3, 716
completed surveys. The answers have been
coded, counted, and are now being entered into
the data base. We hope to include the results in
the next issue of Tinnitus Tbday.
Little did we know when we paid tribute to
Trudy Drucker in our last issue that it would be
a final tribute. On Sunday, February 16, 1997,
Trudy died "with her boots on." She colJapsed
just before the tinnitus self-help group was to
meet, where she and Joe Alam, her life-partner,
were going to turn over the reins to a new
leader. Trudy was a wonderful friend and an
inspiration to her students and colleagues. We'll
miss her.
Welcome to the world, Julia Randall, daugh-
ter of ATA's Honorary Board Member Tony
Randall and his wife, Heather Harlan. Julia was
born in New York on April 11th. Our best wishes
to them all.
Tinnitus Today/June 1997 5
Letters to the Editor
From time to time, we include letters from our
members about their experiences with unon-
traditionaz• treatments. We do so in the hope that
the information offered might be helpful. Please
read these anecdotal reports carefully, consult with
your physician or medical advisor, and decide for
yourself if a given treatment might be right for you.
As always, the opinions expressed are strictly those
of the letter writers and do not reflect an opinion or
endorsement by ATA.
h a n ~ you immensely for the help I have
rece1ved from the ATA publication
Tinnitus Tbday. I have learned a great
deal about tinnitus, particularly how to cope
with it. For me, the greatest help has been:
1. eliminating all caffeine from my diet
(including decaf drinks)
2. taking ginkgo three times a day
3. wearing earplugs on the plane, bus, metro
rail, and while walking on the streets of the city
4. finding a knowledgeable dentist who was
willing to help me with TMJ and has readjusted
my bite and reduced muscle spasms, which also
reduced my tinnitus.
I still have tinnitus but at least now I can
live with it. Thanks again.
Linda D. Peters, Coral Gables, FL
fter 18 months of suffering and visiting
numerous physicians, my tinnitus and
dizziness have decreased 60-70%, thanks
to an article I read in Tinnitus Tbday about the
possible link between tinnitus and TMJ. Within
two weeks after receiving a lower bite splint
from my TMJ dentist, I began to live a semi-
normal life again. The splint pulls my lower jaw
forward and away from my ear canal to take the
pressure off the TMJ joint when I eat, sleep,
and clench my teeth at night. I have cheated a
few times and eaten a meal without wearing my
splint. Sure enough, the ringing and dizziness
Jeff Bassett, Wadsworth, OH
6 Tinnitus Today/ June 1997
n the December 1996 issue of Tinnitus
Tbday, I read the letter to the editor from
Armando D. Soler, Miami, FL, and tears
came to my eyes. I developed hyperacusis and
tinnitus after I went in for an MRI scan in
August of 1994, the same month and year as
Armando. Like him, 1 was tested in a GE brand
MRI machine with a Tes1a 1.5 magnet! I was not
made aware of any dangers to my hearing or
given earplugs. I was given a pair ofheadphones
with music playing to wear for the scan. The
MRI machine was so loud that I could not hear
the music.
Upon exiting the machine, I could feel a
vibration in my head, extreme headache, dizzi-
ness, nausea, and I could not drive home.
Within one hour, both of my ears had a feeling
of fullness, pain, pressure, and a loss of hearing
acuity. I experienced an extreme sensitivity to
everyday loud noises and by November 1994, it
was accompanied by a high-pitched ringing in
both ears.
In December 1995, at the Oregon Hearing
Research Center, Dr. Robert Johnson matched
my tinnitus to a 5000 Hz pure tone and my
uncomfortable loudness levels (UCL) were
approximately 10 to 20dB lower than for most
listeners. I thank Dr. Johnson and Dr. Jack
Vernon for giving me support and hope for the
future after this life-altering experience.
Kerry K. Surman, Rodeo, CA
am a person who suffers severely from reac-
tions to MSG, sulfite, and aspartame. One of
my many symptoms was tinnitus. It was a
maddening sound. Now that I am careful to
avoid all the foods that contain these food addi-
tives, the tinnitus has gone away. It took over a
year for it to completely disappear. I use the
sound now to determine if I should continue to
eat a food that is ne'.v to me. The sound is very
slight now, a buzzing perhaps. Others who suffer
with tinnitus and who have food additive aller-
gies might get relief if they know the foods to
avoid. (Contact Aspartame Consumer Safety
Network, PO Box 78634, DalJas, TX 75378,
214/352-4268, or NOMSG Society, PO Box 367,
Sante Fe, NM, 87504, 800/BEAT-MSG.)
Diane E. Dalton, Albuquerque, NM
Letters to the Editor (continued)
developed tinnitus immediately after being
with an iodine-based dye while hav-
mg a CAT scan. I assumed it was an allergic
reaction to the dye because I had hives after the
injection as well. They told me the tinnitus
would only last 24 to 48 hours. That was two
years ago. The tinnitus is still with me.
In the beginning, it was absolutely intoler-
able. It made me physically ill. I thought 1
would lose my mind if I could not escape the
noise. I saw 12 specialists (ENT's, neurologists,
psychiatlists, etc.), none of whom could pin-
point the reason for my tinnitus or tell me it
could be relieved. Most of them told me to learn
to live with it.
Being a very determined person, I decided
to take this on as a challenge. I sought out infor-
mation and joined the local ATA tinnitus self-
help group and immediately realized I was not
alone. I met Frank Agosta, the group facilitator,
who has lived with tinnitus for 33 years. He
informed me that T must eliminate fear from my
mind. Fear is a "false experience that appears
real." And I was paralyzed by it! Since I'd had
the battery of tests that ruled out any serious
disease, I came to realize that T was left with a
"symptom," and that the key to helping reduce
the intensity ofthat symptom (tinnitus) was
total relaxation.
At that time, I was taking five Xanax tran-
quilizers a day just to function but I knew I had
to try to achieve total relaxation on my own. I
began hypnotherapy and to practice total relax-
ation every day. With all sincerity, it was the
first time I felt like my old self since the onset
of tinnitus.
My tinnitus has significantly improved. I no
longer take tranquilizers to survive. When I get
stressed, I can immediately take action to
relieve my anxiety. Proper nutrition is also an
important factor. (Caffeine must not be a part of
my diet.) It has been such a growth experience.
I realize that a positive approach to anything in
life will improve it.
Franca Jarosz, Dearborn, MI
have experiencing noise-induced tl.·nni-
tus for e1ght years. I am writing to extend a
cautionary note to those with tinnitus who
work or play in a high noise environment. If
you are using "in the canal" hearing protection,
be sure to have an audiologist confirm that the
plugs are providing the level of protection you
think they are. I recently started a new job in a
factory where noise levels are at 80-85dBa. 1 felt
safe using $45 custom-fit earplugs, but after two
months I began to experience a substantial
increase in my tinnitus. An audiologist con-
firmed my suspicion that the plugs were provid-
ing far less protection than they were supposed
to. In fact, at certain frequencies, they were
providing only 2-SdB of attenuation.
I was fit with another set of custom molded
earplugs that provided effective 20-30dB of pro-
tection. To achieve that level, the fit had to be
extremely tight and uncomfortable. The audiolo-
gist confirmed that the ear canal changes shape
with time, and the fit and effectiveness of
custom-fit plugs deteriorates with time. At work,
I have swallowed my pride and begun wearing
muff protectors, which are clearly more reliable
and effective. Again, don't assume your protec-
tion is working. Get it checked out with your
Gary McDaniel, Clyde Township, MI.
Our readers occasionally want to contact the
authors of the letters included in this column. Since
we protect the privacy of all who write to us, we do
not give out addresses or phone numbers unless we
have permission to do so.
When you write a letter to the editor, please state if
your address or phone number can be given to a
reader who might ask for it.
Tinnitus Today welcomes your letters to the editor.
All submisions
are subject to editorial
review and, if
chosen, might be
altered for brevity
and clarity.
Tinnitus Today/ June 1997 7
New Drug Research for Tinnitus
by Barbara 'Ttlbachnick, Client Services Manager
Pfizer Pharmaceutical, the drug company that
manufactures Xanax, has taken a giant step for-
ward in research: It is sponsoring a study to find
a specific drug that will relieve tinnitus. This is
the first study of its kind in more than a decade.
Dr. Paul Gupta, a representative from the
neurodegeneration laboratory at Pfizer, took an
interest in the subject of tinnitus relief after he
met James Kaltenbach, Ph.D. at the Association
for Research in Otolaryngology convention last
year. Pfizer's goal with this new research is to test
certain drugs on the cochlear nucleus to measure
their effect (if any) on the abnormal spontaneous
activity in the cochlea already demonstrated in
Kaltenbach's animal model. Kaltenbach's hypoth-
esis is that the abnormal activity in the cochlea is
the outward demonstration of subjective tinnitus.
Pfizer's research award to Kaltenbach for this
two-year project is $202,000.
This study does not overlap Kaltenbach's
recently NIDCD-funded project (see "NIDCD
American Tinnitus
Many of you have found this "organization"
on the Internet. Despite the similarity in names,
there is no connection between them and the
American Tinnitus ASSOCIATION.
Here is what we know about them:
+ For $9. 99, the foundation will send a piece of
paper that lists 50 Ways to Help your .
Tinnitus. (Some of our members have sent
this to us.)
+ The foundation advises that for an additional
$50 contribution they will send a personal-
ized outline of treatment.
+ They are not a registered 50l(c)(3) non-
profit organization.
+ We have not received a response to our
requests for information from them.
Our advice: Be careful.
8 Tinnitus Today/ June 1997
Funds $870,383 in Tinnitus Research" Tinnitus
'Ibday, March 1997.) Says Kaltenbach: ''It comple-
ments it. The Pfizer study is designed to target
two additional questions not addressed by the
NIDCD study. First, does the increased sponta-
neous activity result from modifications to a spe-
cific class of receptor in the cochlear nucleus?
And second, can the increased spontaneous
activity following sound exposure be reversed by
application of drugs to the surface of the
cochlear nucleus?" Kaltenbach will attempt to
measure the activity before and after the drug
applications to assess the drugs' effectiveness. If
a drug reverses the abnormal activity in the
cochlear nucleus, it is hoped that the same drug
would have the potential to reverse noise-
induced tinnitus. That would be the next level of
study, says Kaltenbach. He concludes (and we
concur), "This project with Pfizer will bring us
one very important step closer to the develop-
ment of a pharmaceutical treatment for tinnitus."

The ASA Summer Series on Aging offers
half-day and full-day intensives designed
to provide cost-effective, practical and
high-quality training on the cutting-edge
issues of today and tomorrow.
In conjunction with the Summer Series, ASA is sponsoring,
together with The National Council on the Aging and the
National Asian Pacific Center on Aging, Public Forums on
Welfare Reform: The Aging Community Speaks Out!
SAN FRANCISCO, july r-1o • SEATTLE, july 14-17
CHI CAGO, july 16-18 • CLEVELAND, july 21-23
PITTSBURGH, july 23-25 • NEW YORK CITY, july
For additional information and to receive a catalogue call
(800) 537-9728, fax (415) 974-0300, email info®asa.asaging.org
or write to the American Society on Aging, 833 Market Street,
Suite 511, San Francisco, CA 94103-1824.
Elderly People and Tinnitus
Article reprinted with permission from the Royal
National Institute for Deaf People, On-Line
Newsletter; London, july 13, 1996
Tinnitus is frequently seen as an "old age
thing,'' occurring twice as often in those over 60
than in younger people. Next to hearing loss it is
the most commonly reported ear problem.
Research suggests a prevalence of tinnitus pre-
sent always or often in 21% of people in the age
group 50-79;
16% in 61-70 year olds; 4% in the
18-30 age group;
and of continuous tinnitus in
20-42% of 70 year olds.
Hearing Loss
Hearing loss is very common in elderly peo-
ple and it increases with advancing age. Its effect
on auditory disability (problems with hearing
conversation and the television), and on life in
general, can be escalated by tinnitus.
increasing loss of hearing can accentuate the
internal sounds of tinnitus and make the inter-
vention oflow noise therapy or masking tech-
niques more problematic and less effective.
There is a notorious under-usage of hearing aids
by all age groups - only about 20% ofthose who
could benefit actually have them. This includes
elderly people, many of whom have had a signif-
icant hearing disability for many years by the
time they get to the hearing aid clinic. The social
and communication frustrations and strains of
such increasing, untreated deafness could easily
make existing tinnitus worse. The controls on
hearing aids and noise generators (maskers) are
often small, which might make them difficult to
operate (let alone put in and take out) for any-
body with arthritic or other manual dexterity or
upper limb function problems.
Elderly people seem more prone to experi-
encing auditory imagery, which takes the form
of songs or music. It has been described as the
mental conversion of conventional tinnitus into
music or song, found most commonly in old age
when it may be an early sign of a confusional
state, but not of a serious psychosis.
It is associ-
ated with hearing difficulties, and often occurs in
people who have been musicians, singers, or
music lovers in the past. Improving sensory
input either by more appropriate hearing aid
fittings or the use of noise generators may help
reduce the hallucinatory experiences.
Health and mobility problems
Many elderly people have multiple patholo-
gies which may compound the problems of
tinnitus and decrease tolerance to it. Mobility
difficulties that can interfere with a range of
everyday activities can also make it hard to get
to a doctor, hospital, or local tinnitus group -
and to simply get out and away from tinnitus.
Debilitating conditions can lower confidence
and self-esteem, and the motivation to seek
help. Insomnia and poor or fragile sleep may
prolong distressing tinnitus, or be caused by it.
It is not unknown for confusion, dementia, or
aggression to lead to a refusal to accept tinnitus
as a personal, internal sound, and to blame
neighbors or others for the unwanted, disturbing
noises. Stresses created by the demands of
caring and being cared for can easily aggravate
tinnitus. Experiences of treatments and care for
other ailments can naturally raise the expecta-
tions of similar levels of care and treatment for
tinnitus, which is not always forthcoming.
Many of the factors associated with depres-
sion are to some extent also associated with old
age - e.g., loss and bereavement, low self-
esteem, and helplessness. Although depression
doesn't appear to be significantly more preva-
lent in older people, it is quite closely associated
with residential care.
Tinnitus 10day/ June 1997 9
Elderly People and Tinnitus (continued)
Elderly people quite often take a number of
different drugs for their mul tiple conditions and
diseases, increasing the risk of drug interactions
and other adverse reactions, which may also
include tinnitus. Tinnitus may also be related to
the continuous use of drugs such as quinine sul-
phate for night cramps, aspirin for thinning of
the blood, hypnotics, and diuretics. The aging
nervous system seems to be increasingly suscep-
tible to many commonly used drugs - so if a
medication is to "trigger" tinnitus it may do so
more readily in an older person.
Isolation and loneliness
Social isolation often follows retirement
or bereavement, and the loss of netw·orks of
family, friends, and neighbors. A lonely routine
with few diversions to minimize tinnitus will
inevitably place it in the foreground of daily life
- described in an American study as "boredom
with excess time with little to do but listen to
one's tinnitus."
Ageist attitudes from doctors can result in
elderly patients being turned away as too expen-
sive or unrealistic to treat. With tinnitus it's all
too easy to dismiss old people who have it with
What do you expect at your age?" and
have to learn to live with it."
Elderly patients themselves may have
different treatment expectations, some based on
previous ENT experiences, which focus on oper-
ations, pills, and cures, rather than on an open-
10 Tinnitus Today/ June 1997
ness to therapies such as counseling or cognitive
therapy. A basic premise of counseling is that
people can change if they wish.
Vernon & Press (1996Y highJight the impor-
tant role of the clinician in providing reassur-
ance and counseling for tinnitus patients who
are often anxious about the future. Patients need
to know that there is no reason to expect that
tinnitus will become more severe with age.
Thompson (1995)
argues that to treat older
people as if they are in need of care and atten-
tion, simply because they are old, is not only
viewing old age in predominantly medical
terms, but can be a considerable source of
oppression and distress. He also says that the
fact that an older person may need care and
attention should not be equated with illness. For
example, the sick role may appeal to the person
concerned and may be taken on board, thereby
creating dependency and acting as a barrier to
It's important not to be all doom and gloom
about older people and tinnitus, to think only in
terms of what can't be done and of the extra
problems old age presents in dealing with tinni-
tus. Most elderly people are healthy in both
body and mind and lead independent and
unsupported lives. The retirement years can
bring great opportunities for involvement and
personal development.
1. Geriatric tinnitus: causes, clinical treatment and
prevention, V. Ross, K Echevarria, B. Robinson. J.
Gerontol Nurs, Oct 1991, 17 (10), pp. 6-11.
2. Tinnitus - a study of its prevalence and characteristics,
A. Axelsson & A. Ringdahl. Br. Jnl. of Audiology 23,
pp. 53-62.
3. Epidemiology ofTinnitus and its Clinical Relevance,
Adrian Davis. Course Notes from the 16th Tinnitus and
its Management Course, Nottingham School of
Audiology/ MRC Institute of Hearing Research/
RNID 1996.
4. Tinnitus in Old Age, U. Rosenhall, A. Karlsson. Scand
Audioll99l, 20 (3), pp.l65-171.
5. Hearing Loss in the Elderly, SDG Stephens in A Guide co
the Care of the Elderly, HMSO 1996.
6. Definition and Clarification of Tinnitus, Dafydd Stephens
in Course Notes from the 16th Tinnitus and its
Management Course, Nottingham School of
Audiology/ MRC institute of Hearing Research/
RNID 1996.
7. 'Tinnitus in the Elderly, Jack Vernon, Linda Press, in
Proceedings of the 5th Jntemational Tinnitus SeminM.
American Tinnitus Association, Gloria Reich, Ph.D. , and
Jack Vernon, Ph.D., (eds.) 1996.
8. Age and Dignity - Working with Older People, Neil
Thompson, Arena 1995. ISBN 185742 2511.
Air Bag Ruling?
by Barbara Th.bachnick, Client Services Manager
The National Highway Traffic Safety
Administration (NHTSA) advises us that the
issues surrounding air bag disconnections, on-off
switches, and the redesign of this safety device
are still "under consideration." According to
Dorothy Nakama from NHTSA's legal depart-
ment, the agency received a wide range of com-
ments about these devices and is therefore
taking its time to examine the opinions and
(hopefully) decide well. Nakama did not know
when NHTSA would announce its decision.
Over the last few months, we have heard
from several ATA members who had written to
NHTSA for "deactivation authorizations" and
were granted them. That was the good news.
The not-so-good news was that most of these
people are still unable to find mechanics who
will deactivate the bags.
A representative from American Honda's
Consumer Affairs Department reports that
they've received many calls from frantic car
owners who want their air bags disconnected or
on-off switches instal1ed. But legally, Honda
says, their hands are tied. American car manu-
facturers must equip cars with safety features as
prescribed by NHTSA. Until NHTSA makes its
ruling known, Honda customers are being
referred to the National Mobility Equipment
Dealers Association (NMEDA) at 800/833-0427
for information about equipment - like pedal
extenders - that can be used to make air bag-
equipped vehicles less dangerous. (NMEDA
members specialize in vehicle conversions for
the handicapped.) Honda also suggests that their
customers contact NHTSA directly (202/366-
1836) to register concerns.
NMEDA's Executive Director, Becky Plank,
says that the National Highway 'Traffic Safety
Administration is sending out mixed messages
daily on the issue of air bags. "On the one
hand," she says, "they've told us, 'If a person has
an exemption from us then you can disable
their air bags.' Then three minutes later they
say, 'If we were in your shoes, we would never
disable an air bag.' Our members don't know
what to do, and so they're probably not doing
Still Up in the Air
the disconnects. We're trying to follow NHTSA's
guidelines but we never know if it's a 'yes' day
or a 'no' day."
Members of NMEDA are facing their greatest
confusion to date: air bag manufacturers will not
revealed the secret of air bag disconnection -
even to them. (Air bags must be turned off for
some vehicle conversions, like the instaUation of
horizontal steering.) According to Plank, techni-
cians who disable air bags have essentially
taught themselves how.
Important to note: Not everyone who is
exposed to a deploying air bag will have his or
her ears injured by it. But who is susceptible?
Richard Price, Senior Research Scientist for the
U.S. Amw Research Laboratory, recently con-
ducted a study which determined that 10-15%
of the population is '' susceptible" to hearing
damage from loud impulse noise, like that of an
exploding air bag. (The air bags in this study
produced 166-170dBs when they deployed.) This
susceptible population includes children, people
who already have some hearing loss or other
hearing disorder like hyperacusis or tinnitus,
and "people who don't see it coming." (In the
face of oncoming danger, a person's ear muscles
can contract and offer some protection.) And
there are those, said Price, who have healthy
ears but who are just plain susceptible. The
percentage of tinnitus cases that would be wors-
ened by deploying air bags is not yet known.
If you choose to wear ear plugs or muffs
while you drive to hedge against the potential
noise, be aware that some states have motor
vehicle laws against it. Contact your DMV A let-
ter of explanation from your doctor might be all
that you need to override the restriction.
More as we hear ...
... to the "NIDCD Funds $870,383 in Tinnitus
Research" article in Tinnitus Today, March
Principal investigator should read:
Robert A. Levine, M.D.
Tinnitus Thday/ June 1997 ll
Back issues of Tinnitus Today now available!
The following is a list of the featured topjcs
in each issue. Almost every issue contains Dr.
Jack Vernon's Q & A column, information about
self-helping, and (from September 1994 to the
present) Letters to the Editor.
The cost per issue:
$2.50 (member price); $5.00 (non-member
price) Current issue - Dec. 1988
$1.00 (member price); $2.00 (non-member
price) Sept 1988 - April1975
See the table below for shipping cost. For orders
outside the U.S., add $5 to the total shipping
Most issues of Tinnitus Tbday produced in the
last three years are in good supply. A few, how-
ever, are available only as photocopies. Every
effort will be made to send the originals.
March 1997 - NIDCD-funded Tinnitus
Research, TI:'eatments for Subjective Tinnitus;
Similarities between Tinnitus and Chronic Pain·
Air Bag update
Dec. 1996- Air Bag Safety- Air Bag Risk;
Interview with researcher Jos Eggermont, Ph.D.
Sept. 1996 - Ototoxic medications; Silent
Dental work; Interview with researcher James
A. Kaltenbach, Ph.D.
June 1996 - Multi-Therapies TI:'eatment;
Celebrities with Tinnitus
March 1996- Tinnitus and the Law;
Otosclerosis; Interview with researcher Pawel J
Jastreboff, Ph.D.
Dec. 1995- Masking; William Shatner and
ATA; De-stressing Techniques
Sept. 1995 -Fifth International Tinnitus
Seminar; Doctor to Doctor - Tinnitus Patient
Evaluation; Elementary School Hearing
Conservation program
June 1995 - Electrical Stimulation; Cochlear
Implants; Temporal Bone donations; Ginkgo
biloba and animal research (PHOTOCOPIES
12 Tinnitus 1bday/ June 1997
March 1995 - Drugs and Tinnitus Relief
December 1994 -Alternative Therapies; Sleep
September 1994 - TMJ; Ototoxicity
June 1994 - Hearing Protection Devices
March 1994 -Auditory Habituation; Thles of
Tinnitus Recovery (PHOTOCOPIES ONLY)
December 1993 -Alternative TI:'eatments;
Ginkgo; Research Plan (PHOTOCOPIES ONLY)
September 1993- How Tinnitus is Generated;
June 1993 - 'TYpes of Hearing Loss
March 1993 - Anatomy of the Ear; Research
December 1992 - TMJ
September 1992 - Industrial Liability Case
June 1992- ATA history; Monitoring Your
March 1992 - Interaction of Earmold
Acoustics, Real Ear Resonances, and Tinnitus
Masker Responses
December 1991 - Fourth International
Tinnitus Seminar; Personal Injury lawsuits
September 1991 - Tinnitus in the Nursing
Home; Research report; Cochlear implants
June 1991 - VA Info; Hyperacusis; Research
March 1991 -Noise and Tinnitus; There is
Hope; Tony Randall
December 1990- Tinnitus Measurement·
Drug Therapies
September 1990- Older Americans and
Tinnitus; Research Report; ADA
June 1990 - Cognitive Therapy; Amplification
March 1990 - Noise-induced Hearing Loss in
Musicians; Vestibular Disorders; Tinnitus in the
14th Century
December 1989- Tinnitus Patient
Management; Allergy potential (ALL PREVIOUS-
The following issues are available as photo-
copies only:
September 1989 - Tinnitus Severity Scaling;
Consumer Tips; Tinnitus in the 16th Century
June 1989 - Tinnitus in Burnt-out Meneire's
March 1989 - Combined TI:'eatment for
Intolerable Tinnitus; Care for Hearing Aids and
December 1988- Hyperacusis;
Pathophysiology of Tinnitus; Al Unser and Jeff
Float (FIRST ISSUE AS Tinnitus Tbday)
You Can Overcome Your Tinnitus
by Stephen M. Nagler, M.D., F.A.C.S.
Stephen M. Nagler, M.D.
The following is an excerpt from
the inspiring presentation made by
Dr. Nagler at ATA's recent California
regional meetings. D1: Nagler is the
Medical Director of the Southeastern
Comprehensive Tinnitus Clinic in
Atlanta, which will be opening its
doors this summer.
I am sure that all of you
who suffer with tinnitus
have known individuals
who've said, "Oh yeah, I've
noticed crickets in my ears sometimes, but it
never bothers me - why don't you just ignore
it?" Your mental response is, "This guy doesn't
have a clue."
I am sure that all of you have known well-
meaning individuals who've said in a reassuring
tone, "Oh yes, I had tinnitus. It bothered me for
a while, but I learned to live with it, and so will
you." Your response is, "That guy may have had
tinnitus, but he didn't have MY tinnitus. There's
tinnitus .... and there's damn tinnitus. And I've
got damn tinnitus." Have you all been there?
Let me tell you something. I know what it's
like not to be able to fall asleep at night because
of the noise of a jet turbine in my head. I've
been there.
I know what it's like to be incredibly
exhausted in the afternoon following a restless
night, but to not want to take a two-hour nap
because I knew I'd wake up with twice the roar
I started with. I've been there.
Back Issues (continued)
ATA Newsletter
Sept. 1988 Jan. 1986 March 1982
June 1988 Sept. 1985 Nov. 1981
March 1988 June 1985 July 1981
Dec. 1987 March 1985 Feb. 1981
Sept. 1987 Oct. 1984 Oct. 1980
June 1987 May 1984 July 1980
March 1987 Dec. 1983 Apri11980
Dec. 1986 Aug. 1983 Jan. 1980
Sept. 1986 Feb. 1983 July 1979
June 1986 July 1982 Jan. 1979
I know what it's like to see the audiologist's
eyes practically fall out of his head during tinni-
tus matching, because he was thinking, "Now
this is impressive." I know what it's like to want
to beat my head against the wall because of the
noise. I know what it's like for my stomach to
knot up with nausea at the thought of putting
food in my mouth because of the trains going by
in my head.
I know what it's like as an adult to want to
put my head on my 80-year-old mother's lap so
she can rub it and make things quiet ... and I
know what it's like to see tears in her eyes
because she can't help. I've been there.
I know what it's like to want to die.
I know what it's like to see a loving wife sick
with worry and fear. And I know what it's like to
just about fall apart when a five-year-old son
looks at his father's ears and says, "Daddy, I
wish I could just reach in there with my fingers
and pull that bad noise out so you could be
happy again." I've been there.
So I think I know damn tinnitus. And I'm
here to tell you that you can overcome it. The
ladies and gentlemen who are addressing you
today have dedicated a considerable amount of
their professional lives to assisting tinnitus suf-
ferers in overcoming tinnitus and in taking
charge of their lives again. The health care pro-
fessionals next to you in the audience are doing
the same. And the ATA is helping numerous
investigators to obtain funds to press on with
high quality research. You can overcome your
tinnitus. I know. I've been there.
Sept. 1978
Shipping and Handling
If your order Please
May 1978
subtotal is: add:
Jan. 1978 UP 1D $5.00 $ 1.00
Oct. 1977
$ 5.01-24.99 4.00
June 1977
25.00-49.99 6.00
March 1977
50.00-74.99 8.00
75.00-99.99 10.00
Oct. 1976
100.00-149.99 15.00
June 1976 150.00 and over 20.00
Aug. 1975
Tinnitus lbday/ June 1997 13
ATA's New Scientific Advisory
Committee Members
Gary P. Jacobson, Ph.D.,
is the Director of the
Division of Audiology for
the Henry Ford Health
System, and has served in
that capacity for almost 10
years. Prior to that, Dr.
Jacobson was the Section
Chief of the Audiology
Division at the VA Medical
Center in Cincinnati, Ohio,
Gary P Jacobson, Ph.D. and Director of the Clinical
and Intraoperative Evoked Potentials programs
for the Departments of Neurology and
Neurosurgery at the University of Cincinnati
Medical Center. He is on the editorial board of
the journals Brain Tbpography, American Journal
of Audiology, and the International Tinnitus
Dr. Jacobson is past president of the
American Society of Neurophysiological
Monitoring (ASNM) and is the current Audiology
Subcommittee Chairman of ASHA's Council of
Professional Standards. He has published widely
in the areas of clinical and intraoperative neuro-
physiology, tinnitus, and outcomes research in
audiology, neurology, and speech-language
Pawel Jastreboff,
Ph.D.,Sc.D., moved from
Yale University to the
University of Maryland at
Baltimore in July 1990 to
continue his research on
tinnitus and establish the
Tinnitus & Hyperacusis
Center. Dr. Jastreboff had
proposed a neurophysiologi-
cal model of tinnitus and
Pawel Jastreboff, Tinnitus Retraining
Ph.D. Sc. D. h . 1988 b d
' T erapy m , ase on
his research on the phyiological mechanisms of
tinnitus. The objective of his present research is
14 Tinnitus ibday I June 1997
to determine the mechanisms of tinnitus and
design new methods of tinnitus and hyperacusis
Dr. Jastreboffreceived a Ph.D. in
Neuroscience and Doctor of Sciences Degree
(Neuroscience) from the Polish Academy of
Science. He did his postdoctoral training at the
University ofTokyo, Japan. He holds Visiting
Professor appointments at Yale University School
of Medicine and at University College London
and Middlesex Hospital, London, England.
------. Robert Sweetow, Ph.D., is
the Director of Audiology
and Associate Clinical
Professor in the Dept. of
Otolaryngology at the
Medical Center of the
University of California, San
Francisco. He received his
Ph.D. from Northwestern
University in 1977, his
Master of Arts degree from
Robert Sweetow, Ph.D. the University of Southern
California, and his Bachelor of Science degree
from the University of Iowa. Dr. Sweetow has
lectured worldwide, and is the author of numer-
ous textbook chapters and over 60 scientific
articles on tinnitus and amplification for the
Book Review
by Harvey Pines, PhD
Gloria E. Reich, Ph.D., and Jack A. Vernon,
Ph.D. (eds.), Proceedings of the Fifth International
Tinnitus Seminm·. American Tinnitus
Association, Portland, Or., 1995. $25.
Perusing these Proceedings is like touring a
very large museum: each of the 13 sections
resembles a hall with many exhibits. Visitors of
different backgrounds will find some exhibits
more interesting and comprehensible than
others. When taken together, however, these
Proceedings convey an extraordinary range of
activity presented in over 125 papers by "scien-
tific investigators, medical practitioners, and
individuals concerned with the manifest and
diverse causes, treatments, and ramifications of
tinnitus,'' circa 1995.
At the outset of the tour, note the welcoming
address by the Director of the National Institute
of Deafness and Other Communication
Disorders (NIDCD). In it he describes "crucial
areas" for future tinnitus research identified at a
recent NIDCD workshop. One of these areas is
"etiology and pathogenesis" - what makes tinni-
tus happen, why is it so different from one indi-
vidual to the next, what is the role of genetic
factors, etc. Other crucial research areas identi-
fied by the NIDCD group are the development of
tools for detection and assessment of tinnitus,
the need for animal models of this disorder,
investigation of the function and dysfunction of
the cochlea - the organ critical for transforming
physical sound energy into the nerve impulses
that ultimately become our experience of sound,
and the role of "central mechanisms," i.e., what
occurs in the brain when we experience tinnitus.
If vou are interested in any of these topics
h a v e ~ look at the following sections of the
Proceedings: Aetiology; Mechanisms; Animal
Model/Objective Measures; Assessment
Measures; Epidemiology and Demographics; and
some of the papers in Instrumentation and
Medical/Clinical. Thke special notice of papers
by Hazell, Jastreboff, and their associates, pre-
senting different aspects of a neurophysiological
model of tinnitus with broad implications for
several of the crucial areas of research noted
above. Examine the research designs and litera-
ture reviews offered by Newman, Salvi,
Shulman, 'JYler, and Vernon, as examples of how
to ask and answer questions about tinnitus in a
manner that commands the respect of govern-
ment funding agencies and the scientific
community as a whole. These papers also give
the rest of us an appreciation of just how diffi-
cult it is to conduct tinnitus research that has
real scientific value. And don't neglect the fine
papers by Coles of the U.K., Lenarz of Germany,
Hallberg of Sweden, and Matsuhira of Japan,
among others. The need for regularly scheduled
international conferences on tinnitus is clearly
brought home by the geographical diversity of
high quality research in these Proceedings.
One high priority area identified by the
NIDCD is that of "intervention" - how can we
intervene to alleviate the distress of those who
have tinnitus? This concern is well represented
in the Proceedings by sections on Alternative
Treatments, Drugs, Psychological/Rehabilitation,
and Self-Help Workshop. As a tinnitus support
group leader, I was especially intrigued by Jo
Hazelby's title of "Certified Tinnitus Counselor"
in the U.K. and the excellent course curriculum
she completed to qualify for this position. The
ATA might well consider sponsoring such a
course so that self-help volunteers and others
could learn to make use of Thbachnick's well-
described listening skills and strategies for run-
ning a support group, as well as the insights and
experience available in Drucker's, Eayrs' and the
Saunders' papers. 1 was particularly intrigued by
Dees' presentation suggesting that four clear
stages of tinnitus tolerance can be delineated, a
concept derived from the work of R.S. Hallam,
one of the great pioneers of contemporary tinni-
tus research. An interesting Ph.D. thesis awaits
a young investigator willing to undertake a rig-
orous empirical validation of this stage model.
Visitors to the Pmceedings will also note
relatively new concerns with special popula-
tions, e.g., children and the elderly, legal issues,
and the use of computer technology to facilitate
research and clinical efforts.
In summary, whatever your specific interest
or level of sophistication it will be difficult not
to find an attention-getting exhibit in the
Proceedings of the Fifth Intemational Tinnitus
Seminar. This is a "must have" volume for pro-
fessionals and lay persons alike.
Tinnitus 'lbday/ June 1997 15
Sizing Things Up
by Barbara Tabachnick,
Client Services Manager
A woman asked me recently to
describe the most successful
tinnitus support group I knew
of - how it was run, when and
where it met, how many peo-
ple attended it. She was inter-
ested in starting a group
herself and wanted to fashion
it after a proven model of success.
'TWo ATA support groups came instantly to
mind. The first one was one that ran for 15
years, conducted in classroom style (chairs in
rows facing front), and was led by a former col-
lege professor who had tinnitus. Medical profes-
sionals spoke frequently at these every-other-
month afternoon meetings. This popular group
had an academic flavor to it and a typical
turnout of 40 attendees. The other group that
came to mind has been meeting monthly for 13
years. The facilitator is an audiologist who her-
self has tinnitus. She occasionally brings in
guest speakers, often does positive visualization
exercises with the group members, and always
reserves time for 'round-the-room discussions
(they sit in a circle). A turnout of 25 attendees is
typical for this "warm and fuzzy" group.
I stepped back and looked at the rest of our
support groups, and it was striking - the variety
of shapes, sizes, patterns, textures. Some of our
groups are very casual and meet twice a year;
others are comparatively formal with dues, min-
utes, lending libraries, and meetings every
month. Some groups have had extensive local
media exposure (TV appearances, feature stories
16 Tinnitus 'lbday/ June 1997
in newspapers); others struggle with stubborn
newspaper staffs to get meeting announcements
in the calendar section. Some meet at hospitals;
others at libraries. Some groups have "a group
within the group"- a committee of helpers who
assist the leader with mailing newsletters, con-
tacting guest speakers, arranging for refresh-
ments, and doing whatever else needs to be
done. Other groups are run top-to-bottom by
lone leaders - some who can't find the helpers,
and others who really like doing it aU them-
selves. Most groups are not facilitated by "pro-
fessionals" of any kind. (A credentialed
facilitator is gratefully welcomed but not an
indicator of a group's greater worth. Experience
with tinnitus and readiness to help are the most
esteemed credentials.) By and large, a group's
style is a reflection of the personality of the
individual who leads it.
Still, success is hard to gauge. Some groups
last for more than a decade; others disband after
a year. Since they all do the work they are
intended to do for however long they do it, a
group's duration isn't an accurate yardstick of
success. And most of ATA's groups do not gener-
ate the audience size of those two groups and
would therefore not measure up if numbers
alone told the tale. (The average number of
attendees is 11.) One of our facilitators phoned
me some time back, feeling discouraged by a
small turnout at her meeting. She felt that the
only tangible measure of her effort was the
count of heads that walked through the door. I
asked her to tell me how the meeting went. "It
was actually good," she said. "The four of us all
had plenty of time to talk. I think everyone left
feeling better." "And if only one person had
shown up ... ?" I asked. She said, "I think that
would have been okay too." Lucky for us, the
definition of success is for the choosing.
If your interest is piqued at the thought of
helping others, and you have the time to do it,
please write to us for details. If you want to find
a support contact near you, write for your local
list. Our support network covers the country-
a warm and ample garment, woven on the loom
of experience. Thy it on for size. See if it fits.
Jack Vernon's Lecture on
Video Tape -Available Now
In January, 1997, Oregon Health Sdences
University's (OHSU) Marquam Hill Lecture
Series featured a lecture on tinnitus by Jack A.
Vernon, Ph.D. Dr. Vernon is the former Director
of OHSU's Oregon Hearing Research Center and
a recognized pioneer in tinnitus research. In this
VHS video of that lecture, Dr. Vernon discusses
the origins of tinnitus treatment and the con-
temporary applications of masking, hearing aid
use, and other treatments for tinnitus relief. His
formidable knowledge, practical experience, and
gracious manner highlight the hour.
Cost: $20 (shipping included)
Running time: 59 minutes, 20 seconds
Send check to:
OHSU - Office of Community Relations
Attn: Terry Erb
3181 Sam Jackson Park Rd., 1101
Portland, OR 97201-3098
Thank You and Welcome
to our New Support
Network Volunteers
Our New Support Group Facilitators:
Christina Hewitt
(former telephone-only contact)
27 Trail Edge Circle
Powell, OH 43065
614/ 885-4140
Donna Brown
458 Hickory Pl.
Bloomfield, CO 80020
303/ 469-1683
John J. Nichols
10450 E. Desert Cove Ave.
Scottsdale, AZ 85259
Jenny and Hugo Blad
6813 Sunsey Blvd.
Greely, Ontario K4P1M6
613/ 821-0083
.. . and Our New Telephone Contact:
Gloria Ann Stanetti
4705 Avenida La Mirada
Joshua Tree, CA 92252-1622
Talking to Myself
by Theris Aldrich
Be convinced that you have untapped
sources of strength:
courage to face the unknown,
determination to cope with the
and will to endure that from which
there seems no escape.
Decide that you determine your quality
of life:
choose to be a part of life's mainstream,
focus on building reciprocal
dismiss all depressing thoughts.
Know that you can accomplish a sort of
regenerate your power of self-
teach your consciou.:mess to soar above
anxiety and stress,
allow peace and serenity to muffle
the clamor of tinnitus.
From Never Again 1b Know A Noiseless Shooting
Star, a tinnitus poetry book edited by Daphne
Crocker-White, Ph.D.
To order, send $10 plus $1.50 shipping
and handling to:
Daphne Crocker-White, Ph.D.
1290 Howard Ave. #323
Burlingame, CA 94010
Make checks payable to:
Tioga Trading Company
(California residents, add 85<t; tax per
Dr. Crocker-liVhite is generously donating all
profits from this book to ATA.
Tinnitus Thday/ June 1997 17
Barometric Changes and the Ear
by Barbara Tabachnick, Client Services Manager
People often express concerns - to their
doctors and to us - about the effect that flying
might have on their tinnitus. It is an understand-
able concern. Ears often "pop," feel plugged, or
ache during or after flight. Technology has
attempted to alleviate these problems.
Commercial aircraft cabins are pressurized to
duplicate a stable air pressure equal to an 8,000-
foot elevation. But with constant altitude
changes during take off and landing and an
average cruising altitude of 35,000 feet, the on-
board pressurization systems toil to keep pace
with the fluctuations. The slight imperfections
still inherent in these systems cause our ears to
occasionally feel a discomfort known as "baroti-
tis" or "aerotitis."
On the Ground
Sudden weather changes are always accom-
panied by sudden barometric pressure changes.
When these occur, we sometimes hear about it
from our members. Air pressure changes can
temporarily alter the tinnitus of individuals who
are sensitive to that influence. In a study at the
Oregon Hearing Research Center's Tinnitus
Clinic, 128 (or 20%) of 639 patients expe-rienced
a temporary change in their tinnitus when the
pressure inside their ear canals was deliberately
increased. Three percent noticed a worsening of
their tinnitus; 17% experienced a reduction in it.
Where>s the Air?
The middle ear is a cavity filled with air.
The air (or barometric) pressure inside the mid-
dle ear is always equal to - or trying to be equal
to - the air pressure of its
~ ; ; ; ; : ! : ! ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ - outside environment. To
facilitate this pressure
equalization, the eustachian tube
(which connects the back of the
throat with the middle ear) acts as a
two-way vent. During take off in an
airplane, the ear moves from higher
pressure on the ground to lower pres-
sure in the air. The higher pressure in
the middle ear easily escapes through
the eustachian tube on its way to
18 Tinnitus Thday/ June 1997
match that of its environment. Although the
tympanic membrane (or eardrum) can bulge
outward as a response to the lesser outside pres-
sure, this passive venting of air out through the
eustachian tube during take off rarely causes a
problem for people and their ears.
The reverse process causes slightly more
concern. The eustachian tube resists the inward
flow of air pressure during descent. And as the
outside pressure increases, the tympanic mem-
brane is pushed inward and can cause pain.
Robert Sweetow, Ph.D., Director of Audiology at
the University of California, San Francisco
Medical Center, explains, "When there is equal
pressure on both sides of the eardrum, there is
comfort. When there is unequal pressure, there
is discomfort."
Tinnitus and Flying
While tinnitus has occurred as a result of fly-
ing, it is a very rare occurrence. Statistics from
the Oregon Hearing Research Center's Tinnitus
Data Registry corroborate this. Out of a recent
Registry sampling of 238 patients, two patients
associated the onset of their tinnitus with ''baro-
trauma"- a physical injury, specifically to the
eustachian tube or the eardrum, caused by
changes in atmospheric pressure. One of the
two patients indicated that the barotrauma
occurred while scuba diving; the other, while
flying with an ear infection.
Murray Grossan, M.D., anENT in Los
Angeles, writes, "I have seen very few patients
whose tinnitus was actually caused by flying."
He has seen a fair amount of patients whose tin-
nitus resulted from scuba diving. Excessive and
sudden pressure changes from diving "slam the
cochlea" and do the damage. At 33 feet below,
the air pressure is twice the pressure on the sur-
face. Grossan states that when diving, "it is nec-
essary to clear the ear about every five feet of
descent or ascent."
Robert Sandlin, Ph.D., Director of the
California Tinnitus Assessment Center in San
Diego, says, "Flying does not normally cause the
onset of tinnitus." He states that people who
experience some exacerbation of their tinnitus
while flying are those who might experience tin-
nitus exacerbation when exposed to other simi-
lar noises.
Barometric Changes and the Ear (continued)
Dr. Gary Jacobson, Director of Audiology at
the Henry Ford Hospital, writes, "I have had
patients tell me that their pre-existing tinnitus
was temporarily worsened following air travel.
Barotrauma, however, occurs infrequently as a
result of commercial air travel."
Sound Levels On-board
To further his understanding about tinnitus
and flying, Dr. Jacobson searched for informa-
tion about sound levels in commercial aircraft
cabins. He states, "We found just one paper
addressing this issue (Viellefond et al., 1977).
The investigators reported only that noise levels
were high, and that the acoustical spectrum of
the noise was distributed over the low, less dam-
aging (to the organ of Corti) frequencies."
Donald C. Gasaway, M.A., Hearing
Conservation Specialist for Aearo Company, has
been co11ecting noise data on North American
and European aircraft for 25 years. He shared
his findings: The noisiest interior parts of com-
mercial aircraft with wing-mounted jets (like the
737) are at the wing and toward the rear.
Midwing seats are always more noisy, he said,
because the air conditioning and pressurization
systems are housed under the wings. Aircraft
with tail-mountedjets (727, DC-9, DC-10, and
the 800 series) usually have the highest interior
noise levels. During take off and landing, their
cabin levels have been measured to be as loud
as U6dB(A), although just for a few seconds.
Average cabin noise levels range from 78 to
86dB(A). The quietest seating space on wide-
body jets is at the front - not in the curved
nose of the plane (where it's noisy because of
air friction) but instead where the body of the
aircraft becomes cylindrical.
Frederic Silberman, a patient of Dr. Jack
Vernon's, found additional information when
he contacted Boeing. Boeing engineers advised
him to not sit near doors, galleys, or lavatories
and that it was quieter "upwind" of the engines
(closer to the front of the plane). With a hand
held sound level meter, Silberman found that
aisle seats were somewhat quieter than window
Earplugs on the Plane
Earplugs undeniably block some noise. But
how do they affect the pressurization of the mid-
dle ear during flight? E1bott Berger, Senior
Scientist, Auditory Research for Aearo Company
(makers of E-A-R® foam earplugs), states that
their Classic (PVC) foam plugs allow air to seep
into and out of the ear canal at a gradual rate.
Jeff Madigan, Industrial Audiologist for earplug
manufacturer Howard Leight Industries, con-
firms that the cell structure of foam earplugs
allows the plugs to "breathe." This gentle seepage
appears to help the ears adapt in flight. Jack
Vernon, Ph.D., former Director of the Oregon
Hearing Research Center, offers this ancillary
advice: Wear earplugs during take offuntil cruis-
ing altitude is reached, put plugs back in before
descent, and keep them in for half an hour after
The House Ear Institute developed special
earplugs, called Ear Planes®, to help slow the
rate of pressure change while flying. These
molded plugs have small flanges and a thin filter
through the center that allow for gradual pres-
sure changes. Ear Planes® are available in adult
and pediatric sizes. (Take note: If your ear canals
are different sizes, these plugs might not fit.
Insert the plugs ahead oftime to be sure.)
A 1977 study, conducted by the United States
Air Force (USAF) School of Aerospace Medicine,
measured the effects of E-A-R® foam plugs dur-
ing altitude changes in flight. In the study, 30
subjects wore the earplugs from take off till land-
ing. All 30 reported pain-free flight in addition to
a reduction of on-board noise. E-A-R® foam
earplugs have since become a standard item of
issue to USAF flight crews and passengers.
In a separate report, the USAF reveals that
over a 22-year period of time, there were six
cases of barotrauma associated with earplug use
during flight. In all six cases, the earplugs used
were premolded (not foam) and airtight.
If You Have a Cold
According to Dr. Jacobson, patients with
upper respiratory illnesses might experience
middle ear infections following air travel which
could result in transient tinnitus. Dr. Sweetow
suggests that the swelling of the eustachian tube
can be reduced with the use of a nasal spray
(like Afrin) or a decongestant (like Sudafed)
prior to flight. A spray decongestant can be used
an hour before landing too. Of course, clear all
Tinnitus 1bday/ June 1997 19
Barometric Changes and the Ear (continued)
medications with your doctor. If you have an
upper respiratory infection, it is always the safest
(though not always the most practical) choice to
postpone your flight.
How to Open the Eustachian Tube
Chew, swallow, sip on fluids, yawn, open the
mouth wide (though not over-wide if TMJ dys-
function is also a problem), or pinch the nostrils
while swallowing. All are strong activators of the
muscle that opens the eustachian tube. One can
also do the "Valsalva Maneuver" - gently blow air
out through the nostrils while pinching the nose
and closing the mouth - to ease discomfort dur-
ing descent. When doing this maneuver, it is
important to use the cheek and throat muscles
only (never use force from the chest or
diaphragm) to push air out of the nose. The
maneuver forces air back into the middle ear.
Do tl1is as soon as the plane begins its descent,
and continue doing it every few minutes until the
plane has landed. An additional tip: Ask a flight
attendant to make sure you are awake before the
Priced at $620. 30-day money
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The Stereo Therapy Tinnitus Masker unit contains five different fundion·
sedions. Each sedion con be used separately, or all sedions con be used at
the same time. The various fundions ore eosUy understood and controlled.
The five fundion·sedions present many clifferent sounds and noises critical
in masking and treating tinnitus. Some of its major functions are:
A Jl$YWoo<ousfic equo&zer allows complete Hexibiity in the p10gromming of mUlic f01 therapy
and reloxonoo. A se<Wrove noise processor creotes o wide wriety of surf sounds. From plocid
rolling wom to stormy seas, stote-of·thwrt modulation circum mcke o wide variety
of souros. White noises or filtered noises 01e mode possible through o VOiioble bondposs filter.
• All effem con be heord directly, or modified t!uough the ps)'{hoocousfic equoflzer, along wi1b
individool volume settings. The sine-wove generator con produce single tones from 85Hz up to
20 kHz with completely isoloted frequency ond volume control. A diognoslic citwn makes n
; possible to set the oufJXJI volume of the <reefed noise ond tone in pertect harmony to the
music program masking the tinnitus. The dynamic heodphooe omp con be set in bolooce oro
vol001e. Reor mounted switches used for vorioos left/rightlistooing levels. Also o switdl for
::; CD /line sensitivity (high/low level) to recording etm (Stereo) for toping individually tailored
masking progmms.
The-state-of-the-art design incorporated throughout the Synphonie Relax 2
makes it the most innovative and effective tinnitus masking and thenitpeuticl
system available anywhere.
infonnalion 01 to place an Older:
• • g. campbell• route#2 • p.o.box 288 vinton, VA 24179
20 Tinnitus 1bday/June 1997
plane begins its descent. A sleeping person
might not be swallowing often enough to help
the pressurization process.
Millions of people - with and without tinni-
tus - fly without negative effect. Fortunately
for those who want to avoid flying, there are
other less controversial ways to go. But if flying
is desirable or unavoidable, clearing the
eustachian tube and wearing appropriate
earplugs can help the experience be what every
flight should be - uneventful.
Aearo Company, 7911 Zionsville Rd., Indianapolis, IN
46268, 800/ 225-9038, for E-A-R® foam earplugs
Cirrus Air Technologies, 800/327-6151, for Ear Planes®
Howard Leight Industries, 7828 Waterville Rd. , San Diego,
CA 92173, 619/ 671-1357, for Max® foam earplugs
Oregon Hearing Research Center, Tinnitus Data Registry
c/o OHSU, 3181 S.W. Sam Jackson Park Rd., N-RC04,
Portland, OR 97201-3098
American Academy of Otolaryngology, Ears, Altitude and
Airplane 'ITavel, 1978.
Brown, T.P., Audecibel, Middle ear symptoms while flying:
Ways to prevent a severe outcome, March 1995.
Clarke, Maureen, Travel Holiday, Ear Care in the Air,
March 1996.
Hazell, J.W.P., British Tinnitus Association Newsletter, Flying
and the ear, vol.19, 1983.
Petrysh)rn, W.A., ATA Newsletter, Ifyou have a cold, don't
fly, December 1987.
Schwade, Steve, Prevention, Read This Before You Fly,
June 1996.
Soli, S.D., Physiological principles of middle ear discomfort
due to changes in air pressure, and potential methods for
reducing discomfort with a pressure-regulating earplug,
House Ear Institute, 1996.
USAF School of Aerospace Medicine, Evaluation ofV-SlR
and E-A-R® Earplugs for use in flight, Report SAM-TR-77-1,
Feb. 1977
Vernon, Jack, Tinnitus Tbday, Questions & Answers, p.8,
September 1992
Questions and Answers
by Jack Vernon, Ph.D.
Ms. K. in Alabama asks, "I have seen
several designations of different kinds
of studies but I don't understand the
differences. The terms are: (1) double-blind,
placebo- controlled study, (2) open study, and
(3) double-blind, cross-over study. Can you
explain these to me?
(1) A double-blind, placebo- controlled
study is one in which half the patients
(usually called subjects) in the study
are given the active drug and half are given a
placebo, that is a sugar pill. This procedure is
used to reduce the effect of suggestion. It is
double-blind when neither the patients nor the
experimenters know who is receiving the active
drug and who is receiving the placebo. All
patients are told they will receive the active
drug. When the study is completed, the code is
broken and the results recorded. If the active
drug does no better than the placebo, the drug
is considered of little or no value as a treatment.
It is also important, in my estimation, that the
effect of the drug be measured in tinnitus
studies. For example, in the Xanax study, the
patients' reports about their tinnitus were
recorded. In addition, the loudness of their
tinnitus was measured before and after the
treatment. For those who obtained tinnitus relief
from Xanax, the average measured tinnitus
loudness was 7.5dB SL (the level above hearing
threshold for that sound) before treatment and
averaged 2.3dB after treatment. 1b my way of
thinking, the loudness measures were possibly
more objective than the reports from the
(2) A double-blind, cross- over study is one
in which half the patients are given the active
drug and half are given the placebo and neither
the experimenters nor the patients know who is
getting which. At the end of the drug treatment,
the two groups of patients are reversed - those
who received the placebo are given the active
drug, and those who received the active drug
are given the placebo. Unfortunately, it is often
the case that side effects reveal the presence of
the active drug thus defeating any meaningful
cross-over design.
(3) An open study is where everyone knows
that only the active drug is being used. 'TYpically
an open study is used to determine whether or
not the drug works. Open studies often precede
more detailed studies.
One final comment about the "placebo
effect." In most drug studies the placebo effect
can be as high as 35%, that is 35% of those on
the placebo obtained the same relief as did those
on the active drug. In tinnitus studies where a
placebo- control is used, the positive placebo
response is often not over 5%. That may indi-
cate that tinnitus patients are not as susceptible
to suggestion as are patients with other health
Mr. T. from Amarillo, Texas said that his
ear problems began six years ago with
an ear infection that did not clear up
with either the insertion of tubes in the ears or
by taking oral antibiotics. He recently changed
ear specialists and learned that he had a growth
closing up the ear canal. The physician did a
skin graft and cleaned out the ear canal. (The
first ear doctor thought that the growth in the
ear canal was the eardrum!) The substance is
once again growing in that ear, and the other
ear is closed off completely by the same sort of
growth. The tinnitus and his hearing are worse
in that ear.
Mr. T, you have a real and correctable
physiological problem. If the canal is
filling in again, the growth can be
removed. Perhaps you could return to the physi-
cian who did the original canal plasty.
Remember, it's like a see saw. As hearing goes
down, tinnitus goes up.
Ms. B. of Colorado writes, "I recently
had a bad cold and the doctor put me on
E-Mycin. After the first day of taking the
drug, my tinnitus got louder. By the end of the
10-day therapy, my tinnitus was almost unbear-
able. I've been off the E-Mycin for seven days
now and the ringing is stil1 just as loud. Will it
return to its usual level or will it stay at this
Tinnitus 'Ibday/ June 1997 21
Questions and Answers (continued)
Ms. B., at the first sign of increased
tinnitus, you should have contacted your
physician. In fact, you should have told
your physician about your tinnitus prior to tak-
ing any medication. I am confident that your
tinnitus will return to its original level but it will
take time, a lot of time. Sometimes these things
take months to correct themselves. Don't get
discouraged by the slow progress. I hope that
future research will provide some way to get
unwanted effects out of the ear as fast as they
can get into the ear.
Ms. B. from Wisconsin writes that her
"roaring is terrible" and it is located all
over her head. She goes on to say that
taking 0.5 mg ofXanax three times a day was
beginning to provide tinnitus reliefbut that her
physician took her off the Xanax. She also indi-
cates that she loves her Spectra 22 but that it
does nothing for her tinnitus.
Ms. B., since Xanax was helping you and
since it also helped with sleeping, I
think you should discuss your problems
with your prescribing physician and try to
return to taking it. The Spectra 22 is a cochlear
implant. (Note: One has to be proven deaf to
qualify for the cochlear implant.) I think that
with special equipment it might be possible to
reduce your tinnitus via electrical stimulation
through your Spectra 22. One of the very first
v:: treatments for tinnitus
\ ~ was the use of electrical
' Pl .-- stimulation of
. -
the ears con-
ducted by a
German physi-
cian in 1802,
just one year
after Volta had invented the
battery! The German physician
found that anodal (positive) current
delivered to the ears relieved tinnitus
for as long as the current was flowing.
22 Tinnitus lbday/ June 1997
The problem is that anodal current is an unbal-
anced current and, as such, can cause tissue
damage. But a balanced current could be
arranged and induced through your electrodes to
see if relief for you is possible. You could contact
the Spectra company and suggest this idea to
them. I will gladly explain to them what I think
might be of help to you. Also, you can try mask-
ing with water sounds through your Spectra 22.
If that worked, it would be a fairly easy matter to
add a masking generator to your implant. If lis-
tening to water sounds through your implant has
no effect on your tinnitus, then we would know
one of two things: 1) masking is not possible, or
2) we have yet to determine the proper input to
effect masking. 1 hope we can get the cochlear
implant companies interested in pursuit of this
Mr. M. from Ohio asks if any studies are
~ e i n ~ done with ''noise cancellation" and
In order for noise cancellation to work,
it is necessary to be able to detect the
noise that is to be canceled. Once that
noise is detected, it is then phase-reversed
(played back against itself) thus effecting the
cancellation. Present-day noise cancellation is
effective for noises up to 1500 Hz. As you know,
tinnitus usually is at a pitch much above 1500
Hz. The average for tinnitus patients at our
Tinnitus Clinic is 7000 Hz. Some years ago, I
experimented with phase reversal, using a tone
that duplicated the patient's tinnitus. I thought it
might be possible to effect cancellation by
reversing the phase of the presented tone. I slow-
ly rotated the phase through 360 degrees in an
effort to find some phase relationship where can-
cellation of the tinnitus was produced. Of the 35
patients we tested, only two noticed a difference
- they thought that their tinnitus had developed
a "roughness" at about 135 degrees of phase
although the tinnitus was still clearly present.
There were no cases of cancellation of tinnitus.
I think research of this sort is worth pursuing. I
just don't know how to suggest that it be done.
Questions and Answers (continued)
Mr. K. in Ohio asks, "Are you aware
of any research on tinnitus and
Dilantin, Mysoline, and Thgratol have all
been used with tinnitus patients. These
drugs are anti-epileptic (anticonvulsant)
medications. Some years ago, scientists in New
Zealand were treating epileptic patients with
these medications when one such patient report-
ed that the treatment had stopped her tinnitus.
They proceeded to treat tinnitus patients with
these same drugs. The success with them has
been moderate. I think that the patients who arc
helped with these drugs are those for whom the
brain loci for the perceptjon of their tinnitus
happens to coincide with the brain seizure area.
I remain convinced that brain mapping will ulti-
mately provide a cure for at least some forms of
Mr. S. from New York asks if flying is
advisable for those with tinnitus. He
indicates that he wears hearing aids.
Unless you have Eustachian tube prob-
lems, flying should be no problem. I do
recommend that you remove the hearing
aids and insert earplugs for take off and landing.
Also, the aircraft engine noise is less the farther
forward you sit on the plane. Unless you have
experience to the contrary, I would say that fly-
ing is okay for tinnitus patients. I encourage you
to try to live your life as normally as possible,
but always take the precaution to protect your
ears from loud sounds.
(See "Barometric Changes in the Ear; • page 18)
Mr. Me. in New Jersey comments that
since tinnitus is a symptom similar to
pain, why not treat tinnitus with pain
When something is wrong in the body,
the usual signal of that condition is pain.
Tinnitus is a signal that something is
wrong somewhere in the hearing system (and
sometimes elsewhere in the body too) . I suppose
that if it turns out that the brain center responsi-
ble for tinnitus is also a brain area responsible
for the perception of pain, then use of pain med-
ication might be helpful for tinnitus.
Ms. B. from Massachusetts presents an
interesting and often asked question:
What is the difference between recruit-
ment and hyperacusis?
Hyperacusis is a collapse of loudness
tolerance wherein almost all but the
quietest of sounds are perceived as
being uncomfortably loud. Recruitment is simply
the rapid growth of loudness for those sounds
that are located in the pitch region containing
hearing impairment. I can illustrate this differ-
ence better in the following diagram.
I Recruitment
Normal Loudness
Discomfort level
------1-·-·-·-·-·-- - - - - - - - - - - - - -
~ · / ~ - - 1 Hyperacusis Loudness
Discomfort level
Sound Intensity
In the diagram above, note that the recruit-
ing ear reaches about the same loudness level
as the normal ear but does so in a very rapid
fashion. Recruiting occurs only for those tones
for which there is a hearing impairment.
Hyperacusis patients, on the other hand, find
that all sounds are uncomfortably loud. Many
of these patients judge that they have super-
sensitive hearing ability but that isn't true.
In fact, many of these patients actually have
hearing impairment.
Despite my retirement, I hope each of you will feel free to
continue to ask questions of me. I also hope you will not be shy
about providing answers to the questions of others.
Notice: Many of you have left messages requesting that I
phone you. 1 simply cannot afford to meet those requests. Please
feel free to call me on any Wednesday, 9:30a.m. - noon and
1:30 - 4:30p.m. (503/494-2187). Please send your questions to:
Dr. Jack Vernon cl o ATA, Tinnitus Today, PO Box 5, Portland,
OR 97207-0005.
Tinnitus Thday/June 1997 23
ATA Across the U.S.A.
by Pat Daggett, Assistant Director
The ATA participates in a number of
national hearing-related conventions each year
in an attempt to educate hearing professionals
about tinnitus and about our services. This year,
we're off and running!
We started the year
at the Thi-State
Hearing Association
meeting in February.
That association
includes hearing
equipment specialists
from Washington,
Oregon, and Idaho.
The meeting site this
Gail Brenner. MA, CCC-A, left year was in Coeur
and Pat Daggett, right d'Alene, Idaho, in spite
of wintry conditions
which threatened to snow people in or out of
the area. One of the more creative features of
this meeting was a check-off list of all exhibitors
which required each
registrant to visit the
booths in order to be
eligible for prizes.
Exhibitors were thus
insured of at least one
contact with each
attendee. Then it was
up to each of us to get
our message across.
Since the family
Dan Soler physician is usually
the first professional
contact a tinnitus patient makes, it was decided
that we should let them know about the ATA
and its services. Attendees at the March conven-
24 Tinnitus Thday/June 1997
Dhyan Cassie, MA, CCC-A,
right and Paula Bonillas,
Hearing Health editor, left
tion of The College of
Physicians exceeded
6,000 and proved to be
a receptive target.
Most of these profes-
sionals expressed frus-
tration because there
is no ready answer for
tinnitus and were
pleased to have some-
where to send patients
for information and
support. It was also
rewarding for me to
meet with local
Philadelphia hearing professionals such as Lisa
Blackman, Gail Brenner, and Billy Martin, who
are part of the ATA network. Dr. Robert Sataloff
gave a well-received presentation to the local
tinnitus support group
which I was able to
attend. The opportuni-
ty to visit facibties
where tinnitus
patients are treated
was also a welcome
The American
Academy of Audiology
chose Ft. Lauderdale
Richard 7yle1; Ph.D. as the location for its
9th annual conven-
tion. Gloria and I attended this meeting which
included a presentation by Jastreboff and Gold
on "Tinnitus Retraining Therapy." More than
700 enthusiastic audiologists requested informa-
tion about tinnitus from us during the course of
the three-day meeting. Our job was facilitated by
the use of a card machine, which recorded the
name and address of each visitor to the booth.
(Our data entry personnel here at home much
prefer the printouts from those machines over
the handwritten lists of the past!) Members of
our professional and support networks who vis-
ited the booth were: Gary Jacobson, Craig
Newman, Susan Gold, Rich 'I)rler, Pawell
Jastreboff, Robert Sweetow, Gail Brenner, Dhyan
Cassie, Donna Wayner, Sharon Hefner, Larry
Brown, and Dan Soler. Good to see you all!
Tributes, Sponsors, Special Donors,
Professional Associates
Champions of Silence are a select group of donors demonstrating thei r commitment in the fight against tinnitus by making
a contribution or research donation of $500 or more. Sponsors and Associates contribute at the $100-$499 level. ATA's trib-
ute fund is designated 100% for research. We send our thanks to all who are listed below for sharing memorable occasions
in this hopeful way. Contributions arc tax deductible and are promptly acknowledged with an appropriate card. The gift
amount is never disclosed. GIFTS FROM 1-16-97 to 4-15-97.
lsabel Feld Robert C. Sittig
In Memory Of In Honor Of
of Silence
Kathryn E. Fitzsimmons James W. Soudricttc
1Tudy D r u c k e ~ Ph.D. Ernest C. Auer, Jr.
Margaret Fleming Richard H. Steckler
Thomas W. Buchholtz,
Mary A Floyd Howard C. Stidham
Nancy Ahrens, BC-HIS Ernest s. and Bena L.
Joy A. Fogarty Michael M. Sul livan
Adele Alam Auer
John Alam
Frances Autio
Gerald Cunningham
George N. Gaston Larry Sweeden
Bob Bachmann, on behalf
Laura Autio
Robert R. Deskovick
Veva .J. Gibbard Daniel K. Thrkington
Donna and Robert
James S. Gold Jeffrey S. Thshman
of Mr. Halk's German
Brett Blasdel
Elleke Mesdag
James A. Gomes Pat Thucr
Mr. and Mrs. Nicholas
Claude H. Grizzard
Irene S. Harrison Flemming Thpp
E. Lawrence Gibson
Edmund J. Grossberg,
Dennis D. Heindl Emery Z. 1oth
Thomas Dupree, Jr.
Heindl Family Howard S. 'n1rner
Frances Blanquer
Mark Graham (for your
William H. Little
Foundation Scott 'n1rner
Rose Cartaxo
Vince Majerus
Mark Herritz Arlene B. VanNordcn
Peggy and Jim Doyle and
Donna and Harold
Steve Martin
Dorothy R. and John Elizabeth VanPatten
Jules Drucker
Helen Pappas
Hiltner Robert .J. Veltkamp
J. Stephen Enlow
Christopher V.
Schoenstadt Family
Andrew Hrivnak, JTJ Joseph E. Wall
Mr. and Mrs. Edward
Houghton (for your
Robert C. Incerti Edward R. Weiss birthday)
William P. Roberts
Edward A. Iovino Delmer D. Weisz
Ford, Jr.
J.T. Wilson
James L. Schiller, C.F.P.
Elizabeth A. lvankovic Robert M. 'Nhictington
Anna Frisbie
Richard A. Gardner,
Sandra Sweat
Sponsor Members
Kurt Jensen David L. Williams
M.D., P.A
O.W. Sweat
H. E. "Bud" Adams
Nils P. Jensen Joseph H. Williams, Jr.
Bill and Cindy Gold
Jack Vernon, Ph.D.
Frank Albertini
Kenneth W. Jones John A. Wunderlich
Louis w. Halk
Frank Long
Jo Nell Alexander
Col. Henry B. Keese Marilyn K. Zion
MaryAnn Halladay
Thomas Steinberg
Mike Kim
Earl £. Anderson
Donald King
Kathy Hatfield
Corporations with
Anthony Antunes Labiby Joseph
Gerald W. Ape!
Thomas J. Kingzett
Mary Anne Ketabchi Matching Gifts
Shirley E. Kodmur
Audiological Consulting
Mike Aquilante
Ronald T. Krasnitz
Joel F. Lehrer, M.D., BP America
David M. Bartlett
RobertS. Kurz
Williston Park, NY
F.A.C.S. Citicorp
Sam Berkman
Carol A. Bauer, M.D.
Mary L. McMahon Philip Morris
R. John Bishopp
Sonny Lan
Prof. Erol Belgin, Ph.D.
lrmtraud Muller
Barbara B. Bixby
Clide V. Sonny Landreth,
Gail B. Brenner,
Carmen O'Brien
Research Donors
Richard A. Bolt
Andrea Ouida
Elcnor Adams
Dorothy M . .Brahm
Eric C. Larson
Sidney N. Busis, M.D.
Edna Petrovic
Helen D. Adams
Glenn M. Brewer
\"lilliam Don Lovell
M. Monica Dietsch
Ruth and Nick Rainone
Nannie R. Allen
Alan L. Brock
William A. Lupton
Norman Frankel, Ph.D.
Dick and Pat Smith
Earl W. Alvord, Jr.
Robert L. Brown
Robert L. MacLarkey
Edward w. Gallagher,
Julia 'fesh
Sally A. Anderson
Richaid A. Burns
Annette D. Mallory
Virginia and William
Nicholas Andrews
Mary R. Camilleri
Phil E. Marshall
George W. Hicks, M.D.
Mrs. Frances R. Autio
Linda Champlin
W. Gordon Martin
Kenneth M. Jones
Jim Ecker
ran '!faquair Ball
Keny N. Chatham,
Mruy K. Matson
William Hal Martin,
Mr. and Mrs. Arlo Nash
Bill Bannister
Colin L. McMaster
Ph.D. James A. Bargar
Paul J. Meade
Sue Fuschino
Clary Childers
David L. Mehlum, M.D.
Joseph Fishman, BC-HIS
Rita A Barkus
James M. Mock
Peter A. Mercola, Jack Barnett
Guy R. Clark
Earl R. Moore
Walter Hoch
Irma A. Barrett
Gardner C. Cole
Sylvia Eisenberg
Dia11a Connolly
Sara Beall Neal
Melvin Mock, BC-HJS Vincent C. Bartolo
Caroline S. Nunan
William H. Moretz Jr.,
Charles Kilier
Marvin Baskin
Richard R. Cortright
Ruth E. Ochs
Catherine R. Kiker
Thelma P. Batchelder
Daphne Suzanne
Crocker-White, Ph.D.
Gerald Palazzola
Stephen M. Nagler, M.D.
Frances Kuntz
Sara Rouse Batchelor
Pierre David
R. J. Palombit
Thomas J. Norwood,
Mr. and Mrs. Arlo Nash
Ccmil Bayrakci, M.D.
Walter z. Davis
Randy L. Parks
Russell Nash
John J. Beaumont
Edwin De Vilbiss
Thomas J. Patrician
Edward J. Riedinger, Mr. and Mrs. Arlo Nash Bard Beu tier
Jeffrey J. Derossette
Mike Petroff
BC-HIS Selma and Alan Mary L. Beck
John L. Dosen
Keith Price
Richard L. Ruggles, M.D. Rothenberg Nancy Benevento
Robert J. du Brul
Margaiet w. Ratchford
Mishail Shapiro, D.O. Susan R. Ericson Lillian Benin
H. Eaton
Patrick R. Richards
John G. Simmons, M.D.
George Roupas
Jeanne B. Betcher
Eric D. Eberhard
Loretta M. Rose
Frank A. Skinner
Margaret K. Leventis Harvey Binder
Gerard Evans
Howard Rothenstein
Reter Thambazis, D. M.D.
Mary Vivian Schafer
Sally Bishop
Edmund B. Ruttledge
David K. Woodruff,
Cannen Plavec
RJchard C. Blagden
Stephen G. Sayegh
Helen Zaborowski
Lorraine E. Blake
Palmer Sealy, Jr.
Harry Zimmerman,
Paul Sestito
Sanford Blaser
Mr. and Mrs. Paul Bergin
Tinnitus Thday/ June 1997 25
Tributes, Sponsors. • • (continued)
Jane M. Borden Mary C. Foreman Norma Kratz Rose M. Rainona
Adolph Bourdaa Ernest W. Fowble William J. Krestik Col. Ret. Raymond Randt
E. Raymond Bowden Salvatore Fragliossi R. W. and Susan Krinks Delin Ransdell
Robert J. Bradley Herbert Frank William E. Kuster Barbara S. Raper
Mrs. Cecile T. Brennan Rose Friedman Cary J. Kutzler Herman B. Raymond
Kay M. Breyer Viola L. Fuchs Jerry J. Laforgia Scott Rayow
Margaret C. Brickey Richard A. Gardner, M.D. Blanche A. Lagasse Matthew T. Read
Riva Bromberg Perry Gault Sonny Lan Florine E. Reid
Jytte A. Brooks Gabriel B. Gavino Robert N. Lando Linda Reiman
Gwendolyn A. Brown Maj. Leo A. Gendron Mary A. Lange Richard A. Reinhardt
Ruby A. Bryant Florena Genzink Donald J. Larivee Rev. Daniel Reynolds
Charles P. Bulkey Abraham Gevorgian Mrs. Grace C. Leath Tom Rifai
Patricia L. Buntele Charles W. Gilbert Robert L. Lewis Raymond A. Ritter
Dorothy M. Burnham Madge Glass Alfred Lieberman Selma R. Robey
Michael W. Burnham Danny Graham Willard Littlehale Vernon Robinson
JefTrey L. Burton Carl Granitzer Ann Lotesto Steven P. Rocco
Thomas A. Butts Edith M. Green Betty B. Lotz Susan E. Roof
Mary Howard Cadwell Eleanor C. Green William Don Lovell Shirley R. Roos
Inez C. Campbell Dorothy S. Gregory Eleanor Man11nino Robert W. Roper
Ralph Carmen Mat:jorie E. Gremmel Mario Mantovani, M.D. James G. Rudd
Woodrow Carr Arlene H. Griest Thomas E. Marler Jack Russo
Gayle R. Cawood Jane A. Grunewald Mary K. Matson Barbara A. Ruta
Sol Charen William Gulla ,John E. Mattos Jack Salerno
J. R. Claridge Gary W. Hafers Richard J. McBride Hildegard R. Salkeld
Valerie Clinton John Haleston Michaelann McGuire Beatrice L. Sandler
Thomas R. Coffey, II Richard E. Haney Mildred Barnes Meadows Frank A. Scafuri
.Joseph L. Cohen James C. Hansberger Edward J . Megerian Charles Scaglione
Ronald H. Cohen Mary E. Harker Ruth L. Meier Chester Scarci
Ann L. Coker Rita Harrison Richard L. Meiss Herman J. Schechter
Clifford S. Collins Margaret A. Harrod Ruth A. Meister Martin F'. Schmidt
James J. Contrada Mr. and Mrs James A. Lawrence E. Mercker Michael K. Scholnick
Donald J. Cook Harvey, Jr. Patrick Michael. Jr. Arlene Schreder
Jack S. Cooley Russell S. Haydon Gary L. Miller Eileen Schuettinger
John B. Corcoran Lela LaRose Hays Jack M. Miller Doreen Scott
Catherine Cotter Fernando Hazan Richard J. Minogue David Shaine
Capt. Thomas C. Emmett E. Hearn Victor B. Miron Abu Siddeeq
Crane, USN Ret. Lester L. Berglund Jackie Moliis Frederic Silberman
Daphne Suzanne Carlos R. Hernandez Joseph M. Morgan Vincent Silvestri
Crocker-White, Ph.D. Carl L. Herrington Eugene v. Moriarty Elsie R. Simas
Priscilla Crombie Mark Herritz Rebecca Morrison Richard M. Simpson
Glen R. Cuccinello E. Alan Hildstrom Jeff Morse Fernando Sisto
Ted A. Curreri William s. Hodges Louis G. Moser Thelma M. Sjostrom
Timothy G. Curry Eva Hofman Thomas F. Mottard Jack N. Skiver
William P. Curry Julian Hoogstra Mary Moulton Bernard S. Skolarus
Robert J. D'Attilio Alan A. Horak Barbara J. Myers Frances J. Smith
Flamey Damian Jack Huang Dr. Norman Namm Larry L. Smith
Mrs. Betty W. Davis Joseph H. Huber Verna M. Nauman Randall S. Smith
Sarah D. Davis John R. lntorcia Alfred Q Nervegna Richard C. Smith
Wilburn F. Delancey Olga R. Jackson Ronald M. Neufeld Leona Sobie
Robert B.Dellbrugge Lucille J. Jantz Lyle G. Newcombe Diane Solowjow
Jennifer Dempsey Georgia Johnson Tim Nierhake Anthony Sommo
Charles C. Dennen Kenneth M. Jones Thomas E. Nunnally Rudolph Sonnberger
Lewis G. Desch Frank J. Kaplarczyk Paul M. Olinski E. Wayne South
O'Neil N. Destefano Lucille Karsh Neysa Orraca Delmer L. Sparrowe
M. Bernice Dinner Deann and James Kasper Elsie L. Owen Charlotte P. Spector
Rosa and William Dixon John P. Keehn Richard Palmesi Martin E. Spriggs
Frances Kaufman Doft Henry C. Keene, Jr. Mary F Paone William E. Stanley
Virginia R. Dooley Henry B. Keese Mrs. Doreen D. Parsons Mary V. and Richard
Jra F'. Doud R. L. Keheley Robert C. Parsons Stanton
Jack Drake Robert J. Kellner Thomas J. Patrician Linda Steinberg
Trudy Drucker, Ph.D. Johnetta E. Kelly Jean L. Paulson Edward L. Steinman
Virginia M. Dublanc Shirley M. Kimel Carlton H. Phillips Natalie P. Stocking
Clarence E. Dunn, Jr. Howard G. King Donald L. Pierce Leilani L. Stoody
James Eisenbacher Louise M. King Robert D. Pitcher O.W. and Sandra H. Sweat
Linda D. Elliott Gerald F Kiplinger Jay L. Pomrenze Joseph A. Swliga
Paul T. Fabrizio Alan D. Kirby Barbara Press Mrs. Anna H. Szczechura
Edith H. Feder Richard s. Kittell Kei£h Price Barbara Joan Tanner
Frederick w. Feedore Carole B. Knapp Geraldine E. Prostek Irene G. Tartaglione
Robert J. Fendrich Patricia A. Koehler Albert J Quattromanj, Sr. Abraham Thubman
Betty L. Ferdinand Frank V. Koenig Eldon Radtke John J. Thelen
Larry C. Focht Maijorie Kovach James V. Ragano Kent J. Thompson
26 Tinnitus Today/June 1997
Willard C. Thorn
Domenick T. Thrrillo
Anthony 1i'one, Jr.
Barbara 'Troy
Suzanne 0. 'Truss
Lona S. Urovsky
Elizabeth Vanpatten
Margaret C. Vinson
Dorothy R Waiste
Joseph E. Wall
Francis W. Warren, Jr.
Glenn L. Weiand
Delmer D. Weisz
Helen I. Wells
Roger L. Wentz
James P. Weston
Regina V. Wexler
James S. \o\fhyte
Ruth and Arthur F. Wicks
Carol Williams
Louise II. Williams
Melissa Windham
James G. Winn
Peter Wojtkiewicz
Helen Wolfberg
Frank C. Wonderly, Jr.
C. Rollins Wood
Irene B. Wood
Phyllis R. Wood
Paul D. Woodring
Robert S. Wright
Kenneth Zerda
Anthony J. Zigment
Fran.k •Milan" Zilinek
What do advance reviewers say about the proceedings?
* All I ever wanted to know about tinnitus!
* Professionals will find this an excellent Resource.
* Even with all the technical information,
* this is must reading for anyone with tinnitus.
Order your copy now!
At only $25 it is also affordable!
To order or for additional information
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