December 1997 Volume 22, Number 4

Tinnitus Today
THE JOURNAL OF THE AMERICAN TINNITUS ASSOCIATION
"To promote relief, prevention, and the eventual cure of tinnitus for
the benefit of present and future generations"
In This Issue:
ATA's New "'Treatments Brochure"
"Tbday" Show Gets Results!
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Tinnitus
Editorial and Advertising offices: American
Tinnirus Association, P.O. Box 5 Portland, OR
97207, 503/248-9985, 800/634-8978,
http:/
Executive Director & Editor:
Gloria E. Reich, Ph.D.
Associate Editor: Barbara Thbachnick
Tlnmtus 7bday is published quarterly in
March, June, September, and December. It is
mailed to members of the American Tinnitus
Association and a selected list of tinnitus suf-
ferers and professionals who treat tinnitus.
Circulation is rotated to 80,000 annually.
The Publisher reserves the right to reject or
edit any manuscript received for publication
and to reject any advertising deemed unsuit-
able for Tinntlt.t$ Thday. Acceptance of adver-
tising by Tlnmtus Thday does not constitute
endorsement of the advertiser, its products
or services, nor does Tinnrtus 1bday make
any claims or guarantees as to the accuracy
or validity of the advertiser's offer. The opin-
ions expressed by contributors to Tinnitus
1bday are not necessarily those of the
Publisher, editors, staff, or advertisers.
American Tinnitus Association is a non-prof.
it human heahh and welfare agency under
26 USC 501 (c)(3)
Copyright 1997 by American Tinnitus
Association. No part of this publication may
be reproduced, stored in a retrieval system,
or transmitted in any form, or by any means,
without the prior w·ritten permission of the
Publisher. ISSN: 0897-6368
Scientific Advisory Committee
Ronald G. Amedee, M.D., New Orleans, LA
Robert E. Brummett, Ph.D., Portland, OR
Jack D. Clemis, M.D., Chicago, IL
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
Gary 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. MOler, M.D., Cincinnati, OH
J. Gail Neely, M.D., St. Louis, MO
Robert E. Sandlin, Ph.D., El Cajon, CA
Alexander J. Schleuning, II, 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
Willian1 Shatner, Los Angeles, CA
Legal Counsel
Henry C. Breithaupt
Stoel Rives Boley Jones & Grey,
Portland, OR
Board of Directors
Edmund Grossberg, Northbrook, JL
W. F. S. Hopmeier, St. Louis, MO
Sidney Kleinman, Chicago, lL
Paul Meade, Tigard, OR
Philip 0 . Monon, Portland, OR, Chmn.
Stephen Nagler, M.D., Atlanta, GA
Aaron I. Osherow, Clayton. MO
Gloria E. Reich, Ph.D., Portland, OR
Jack. A. Vernon, Ph.D., Portland, OR
Megan Vidis, Chicago, rL
The Journal of the American Tinnitus Association
Volume 22 Number 4, December 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.
Table of Contents
8 Air Bags - One Year Later
by Barbara Tabachnick
9 Book Review
by Harvey A. Pines, Ph.D.
11 ATA's New
11
Theatments Brochure"
by Barbara Tabachnick
14 Calling for Help
by Barbara Th:bachnick
14 New ATA Support Contacts
15 Tinnitus Survey Update
by Stefan P Kruszewski., M.D.
16 A New Director - A New Direction,
Oregon Hearing Research Center's Alfred Nuttall, Ph.D.
by Barbara Th:bachnick
18 {(Tbday" Show Gets Results!
by Cora Lee (Corky) Stewart
19 Bequests: Investments in ATA's Future
by Cora Lee (Corky) Stewart
23 Reducing Tinnitus - Food for Thought
by Gary Graybush
24 On the Road to ATA Awareness
by Pat Daggett
Regular Features
4 From the Editor
by Gloria E. Reich, Ph.D.
6 Letters to the Editor
20 Questions and Answers
by Jack A. Vernon, Ph.D.
25 Special Donors and Tributes
Cover: •untitled' by Gwen Manfrin. Inquiries to the Indigo Galle1y Fine Art & Jewelry,
311 Avenue B, Suite B, Lake Oswego, OR 97034, 503/636-3454
From the Editor
by Gloria E. Reich, Ph.D., Executive Director
You'll read about all sorts of exciting events
in this issue. These events don't just happen for
no reason. They happen because we - you and
ATA - cause them to happen. The publicity
generated by William Shatner about his tinnitus
has helped us bring tinnitus closer to being a
household word. For the first time ever we con-
ducted a survey to find out just how well-known
tinnitus is by the general public. Overall, 31% of
our respondents said they recognized the term,
and 53% ofthose were able to give a correct def-
inition of tinnitus. Clearly we have a job to do
to educate the other 84% of the public about
tinnitus. Why do we care? Because right now
prevention is the only cure. An educated public
who utilizes ear protection in noise has a better
chance to have lifelong good hearing and an
absence of ear ringing. Until medical research
provides the answers, those of us whose tinnitus
persists must make use of the currently effec-
tive treatments such as habituation, masking,
drugs, and an infinite variety of alternative
therapies that each seem to help small numbers
of sufferers.
You probably read, as I did, of President
Clinton's hearing problems. We don't know yet if
he has tinnitus but he does represent a genera-
tion of Americans who have enjoyed lots of
recreational noise. Ear, nose, and throat doctors
have said that about 85% of their hearing-
impaired patients have tinnitus, so the chances
are pretty good that this President, like former
President Reagan, hears tinnitus too.
4 Tinnitus Thday/ December 1997
ATA's advisory committee met at the conven-
tion of the American Academy of Otolaryngology
in San Francisco in early September. ATA relies
on this group of scientists to help set direction
for programs and especially to help us decide
which research projects should be considered.
Topics for discussion this year ranged from
support of ATA's new Strategic Plan to how to
educate the Health Maintenance Organizations
and other health insurers about the importance
of tinnitus diagnosis and treatment - and
coverage for same!
The next week found me in London. I
was officially on vacation but managed to spend
a day with representatives of the British Tinnitus
Representatives from BTA & ATA meet to discuss future plans
in London. Left to right, Jo Haze/by and Gloria Reich
Association. We're planning a meeting of the
International Tinnitus Support Associations
(ITSA) which will precede the Sixth International
Tinnitus Seminar in Cambridge, England, in
September 1999. I've since met with tinnitus
association representatives from Denmark and
Canada whose countries will be represented
along with others at the ITSA gathering. We'll
continue to provide information about these
meetings as they draw closer. Feel free to inquire
about specifics if you wish to attend. Remember,
you can reach our e-mail at tinnitus@ata.org, or
you can fax us at 503/248-0024. Both of these are
preferable to telephoning because, as you'll read
elsewhere, we've been answering thousands of
new calls as a result of the September 15th
"Tbday" show.
From the Editor <contffiued)
tack Shapiro and facqui Sheldrake-Lee
The Sixth Annual Conference on the
Management of the Tinnitus Patient was held at
the University of Iowa Hospitals on September
19th and 20th. ruchard 'TJ1er, Ph.D., is the chair-
man of these conferences that draw attendance
from health professionals worldwide. Eighty-six
participants from as far away as Australia and
Denmark heard guest of honor (and ATA's
advisory committee member) Robert Sweetow,
Ph.D., describe the benefits of a cognitive thera-
py approach to treating tinnitus. Sweetow stated
that any therapeutic approach to tinnitus relies
on excellent counseling for its effectiveness.
ATA was also represented by board member Dr.
Stephen Nagler whose presentation on hypnosis
was both informative and entertaining. My talk
was about self-help for tinnitus and also includ-
ed a presentation of ATA's new Strategic Plan.
This year, patients were invited to participate in
the meeting and several did, providing valuable
insight for the professionals who treat tinnitus.
Iowa Tinnitus Management Course. Left to right,
Robert Sweetow, Rich 'IJjler, and Gloria Reich
As usual, the highlight of the conference was the
post-meeting visit and dinner held in ruch's
octagonal barn - built in 1883 - at Secrest.
From Iowa I went to Washington, DC where
I attended the Second Biennial Hearing Aid
Research and Development Conference. This
meeting was sponsored by the National Institute
on Deafness and Other Communication
Disorders and the Department of Veterans
Affairs. Several hundred attendees addressed
the issues of Auditory Processing and Speech
Perception, Signal Processing, and Loudness and
Compression over a three-day period featuring
both platform and poster presentations. I was
able to bring tinnitus to their attention through
distribution of our literature and through ques-
tions and interactive discussions with other
participants. Most of the larger hearing aid man-
ufacturers were represented at this meeting and
seem interested in solving problems specific to
tinnitus patients as well as the more general
Left to right, Stephen Nagler, Robert Sweetow,
Anne Mette-Mohr, Norma Mraz, and Keld Wulff
hearing problems. The meeting took place on
the NIH campus at Bethesda in the Natcher
Auditorium which has state-of-the-art audio-
visual equipment making the presentations
easier to see and hear and consequently more
enjoyable.
As you read this, we'll again be on the road
for tinnitus. We hope to meet some of you along
the way.
This brings you our warmest wishes for a
happy holiday season.
Tinnitus Today/December 1997 5
Letters to the Editor
From time to time, we include letters from our
members about their experiences with Hnon-tradi-
tional" 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 your-
self 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.
M
y well-meaning friends tell me, "Your
tinnitus will get better when you're not
under stress."
It is easy to say, but for me, it just isn't true.
In 1981, my mother died, we lost our job, my
daughter married without our consent, my son
needed help to find a job to feed his family, and
we had to move three times. At that particular
time, at the conjunction of all those worries, my
tinnitus was as quiet as it has ever been since
the onset in 1972. A year later, all our problems
had been resolved, I inherited a sizable amount
from mother's estate, my money worries were
over, and I could hardly live because my tinni-
tus was so loud and disturbing.
The things that DO trigger more loudness
for me are: atmospheric pressure changes,
noises, waking after a long sleep - but not trou-
bles or stress. I dare say the phantom pains an
amputee has are no worse and no better during
periods of stress.
Virginia L. Lipp, 903/581-0371.
I
guess the air bag problem is old hat to read-
ers of Tinnitus Tbday, but to me it has just
exploded as suddenly as - well, an air bag.
I've been driving an old clunker with good
shoulder and lap belts for years and have felt
secure. But I need a new car and have just dis-
covered that I can't get one without air bags.
That didn't bother me. I'd buy my car and have
the air bags disconnected.
I already knew that if an air bag exploded on
me I'd be a statistic. I'm 5'1" tall; I weigh 100
pounds; I have tinnitus; and I pull the seat as far
6 Ti nnitus Today/ December 1997
forward as it goes. Even I know this is a scary -
perhaps lethal - combination. Everyone I know
whose air bag has deployed has suffered some
sort of reaction, and one woman (who is about
my size and who has tinnitus) is now profound-
ly deaf. That's why I planned to deactivate the
air bag in my new dream car.
The first blow came when the auto dealer
said, "Yes, theoretically we can deactivate the
air bag if you get a letter - I believe from your
senator - but in fact we will not do it." "Why?"
I asked. "The National Highway Traffic Safety
Administration (NHTSA) has strict rulings and
our lawyer won't let us." So I called NHTSA.
After several long and painful conversations
I can report the following: decisions involving a
new ruling are made not by an individual, but
by "the agency." How many people in the
agency? "About 500." When I asked when the
decision would be made, the spokesman said
"soon." When I asked what "soon" meant, the
answer was "soon means soon."
All this would be humorous except that too
much is at stake here. The delay of NHTSA is
unconscionable. Until that body, which holds so
much power, acts sensibly and allows an on/ off
switch, here's what many of us with tinnitus are
doing. We are not buying new cars. And we're
waiting, waiting - watching, watching.
Susan Dart, Saluda, NC.
I
nner ear infections are a major public health
problem in children, and are, in fact, one of
lhe major reasons for pediatric doctor visits.
I don't know if anyone has ever done a study to
find out how many people with tinnitus had ear
aches and ear infections when they were chil-
dren, but it seems likely to me that there could
be a high correlation.
A corresponding view comes from ophthal-
mologist Robert Herrick, M.D. (909/ 820-4051).
He feels that tear drainage into the inner ear is
a major cause of childhood ear infections, and
possibly tinnitus in adults. Dr. Herrick is the
discoverer and chief researcher of Punctal Plugs,
used by most optometrists and all ophthalmolo-
gists. The main purpose of the plugs is to
correct "dry eye" syndrome by blocking the
needed tears from draining. By blocking tears
from reaching the inner ear, the plugs have also
Letters to the Editor (continued)
cut down on sinus infections and that's why he
thinks it has a connection in ear disorders.
Byron Y Newman, O.D., 2501 E. Chapman
Ave., #105, Orange, CA 92869, 714/288-8282.
A
lthough I am a cochlear implant person, I
had been troubled at times by what I
thought was tinnitus. But through reading
your publication I can master my condition
much of the time, resulting from what l under-
stand of your journal. I keep back copies of
Tinnitus Tbday and loan them to others who
have head noise problems. Thanks for being
there.
Gladys Dickholtz, Alhambra, CA
I
was disturbed by Dr. Stephen Nagler's article,
"Tinnitus and Homeopathy - My View," in
your September issue of Tinnitus Tbday. The
article did not offer anything relevant to the
treatment of tinnitus. And it did not mention a
proposed homeopathic treatment to which it
could argue against. ATA has previously been
open to various treatments. My fear is that this
article is signaling a shift in your philosophy.
When I was diagnosed with tinnitus, I asked
my doctor about ginkgo. He passed it off as
being unproven and "anecdotal." Driven to near
insanity, I tried it anJ'i,;,ray with very positive suc-
cess. I've also experienced varied success with
other nutritional products. Had I listened to the
M.D., I would be miserable today.
Since tinnitus appears to have many causes,
it is logical that it will eventually have many
successful treatments. Unfortunately, each treat-
ment might only "cure" a small percentage of the
total population. If history is any indicator, such
"cures" will initially be discounted by the med-
ical establishment as unproven. If your publica-
tion becomes a mouthpiece for the medical/
pharmaceutical establishment, it will be a sad
day for tinnitus sufferers. Marc Heatherington,
Salem, OR, heatherington@juno.com
We forwarded Mr. Heatherington's letter on to
Dr. Nagler, whose comments follow.
While researching all the available literature
on homeopathic treatment of tinnitus in prepa-
ration for writing the article referenced above,
I was unable to find even one published article
which demonstrates to statistical satisfaction the
efficacy of any homeopathic medicament in tin-
nitus treatment. In the conclusion of my article I
suggested that in spite of that fact, I thought that
homeopaths and practitioners of traditional
Western medicine should try to work together in
the best interests of tinnitus sufferers because
"science" may not hold all the answers. I believe
such an approach (encouraging Western physi-
cians to be open-minded) is very relevant and
very much in keeping with the ATA's philosophy.
Stephen Nagler, M.D., F.A.C.S., 980 Johnson
Ferry Rd. NE #760, Atlanta, GA 30342,
404/531-3979.
Editor's Note:
In his homeopathy article, Dr. Nagler discusses
a non-scientifically based form of medicine from a
scientific perspective. He explains why "logically#
homeopathy should not work, even though for some
people it has. The American medical establishment
adheres to strict standards for research. Nagler
simply did not waver from them.
We occasionally receive objections to our letters
and articles that pertain to alternative therapies,
favorably or unfavorably discussed. In fairness, we
will continue to include discussion of all tinnitus
treatments that emanate from the "alternative East#
or the "established West" - in an attempt to bridge
the gap between the two.
I
n August of 1988, I was diagnosed with an
arthritic disease of the spine called ankylos-
ing spondylitis. I went to a doctor who
advised neck hyperextensions. (I was to move
my neck around with a backward tilt beyond the
normal limit.) The exercises were inappropriate
for my neck condition, as I came to find out.
Nevertheless I performed them to the point
where my neck vertebrae cracked very loudly.
One day in October of 1988, after having
done my hyperextension exercises, I developed
an extremely severe headache. An hour later, I
noticed a ringing in my ears. The headache last-
ed 36 hours, but the ringing became a perma-
nent part of my life and has continued for nine
years. With this constant ringing, a promising
electronics career evaporated and I have been
significantly underemployed ever since.
Tinnirus Today/ December 1997 7
Letters to the Editor (continued)
I am going public with my illness for three
primary reasons: 1) I hope that more doctors will
be willing to investigate this condition and
explore treatments. 2) Since I already had
advanced cervical spinal clisease, I should have
been warned to approach neck exercise very cau-
tiously. 3) I wish to generate int erest in tinnitus,
including my variety which is not easily diag-
nosed, in the hope that more research money
might be directed toward its treatment.
What happened to me is rare, but can occur
with upper cervical trauma such as whiplash.
Arteries, which can literally move in the brain in
response to repeated manipulations, lay on the
auditory nerves. In December 1989, I first saw
Margareta B. Ml?>ller, M.D. at the University of
Pittsburgh who mentioned this diagnosis as a
possibility. When arteties move onto cranial
nerves, they can cause vascular compressive
conditions such as neuralgia, hemifacial spasm,
dizziness, and tinnitus.
Since this is a mechanical shifting of arteries
in my brain, I believe that only the micro-
vascular decompression operation can help me.
(I tried the medication Klonopin with no effect.)
But until this procedure's success rate is much
improved, I will live with the constant ringing.
I work and live as normally as possible. But
having two incurable conditions makes life
much harder than it should be. Let us all hope
that with continued awareness and funding,
tinnitus of all origins will someday be treatable
and cured.
Brian McFall, 1722 Highland Ave. , #2B,
West Mifflin, PA 15122
The American Tinnitus Association and the
editors of Tinnitus 7bday welcome your letters.
Please let us know in advance if we can include
your address and phone number with your let-
ter in the event it is selected for publishing.
AIR BAGS ONE YEAR LATER
by Barbara Thbachnick, Clients Services Manager
At the time of this printing, the rule-making
committee of the National Highway Traffic
Safety Administration (NHTSA) has not yet
released its ruling pertaining to consumer
requests for choice regarding active vehicle air
bags. (Consumers in the U.S. have been asking
the transportation agency for a choice regarding
this safety feature for more than one year.)
Sma11 adults, the elderly, all children, and
the infirm are known to be at risk from air bag
deployment. The close proximity of a person's
head, neck, and chest to deploying air bags has
caused over 80 air bag-related deaths in this
country to date. Thousands of additional air bag
injuries - from minor to incapacitating - have
also been reported. Damage to the auditory
system from excessive air bag noise is included
in these statistics.
Under public pressure, NHTSA announced a
temporary plan earlier this year to allow deacti-
vation of air bags for people who requested it for
medical reasons. The agency was immediately
8 Tinnitus Thday/ December 1997
flooded with requests, and in response sent near-
ly 5000 letters authorizing air bag deactivation.
Most recipients of those authorizations have
since found that the documents carry little
weight. Mechanics and dealerships are simply
not honoring them. Liz Neblett, public affairs
specialist for NHTSA, apologizes for the lack of
compliance. "We can't force [mechanics] to do
the disconnects. I wish we could."
In the meantime, in the midst of a flurry of
air bag recalls and promises of "smarter" air bag
technology, car dealers are sitting tight, waiting
for the final word from the government. How
might the debate result? NHTSA offers a hint: a
retraction of the authorizations for air bag dis-
connects, allowing car manufacturers instead to
make air bag on/ off switches available to cus-
tomers by early next year. The comment has
already met resistance from some car manufac-
turers like Honda. Available or not, they say
they will not offer the switch. The pending air
bag decision - and potentially the decision
itself- leaves millions of tinnitus sufferers and
consumers of all kinds still up in the air.
Book Review
Jack A. Vernon, Ph.D. (ed.), Tinnitus: 'freatment
and Relief. Allyn and Bacon, 1998, reviewed by
Harvey A. Pines, Ph.D.
\Nhat more appropriate title for a book by
Dr. Jack Vernon than Tinnitus: Treatment and
Relief? For many years, Dr. Vernon has been a
source of helpful information for those seeking
relief from their tinnitus. His willingness to talk
and correspond with people about possible treat-
ments has become legend. His "Questions and
Answers" column in Tinnitus Tbday further
exemplifies these efforts. Now, in this new edit-
ed volume, Dr. Vernon has put his unique stamp
on a book that I believe will become a major
resource for the average person seeking answers
to tinnitus-related questions.
This volume assembles a wide range of
papers with a common focus - tinnitus treat-
ment and relief. W11ile reviewing this book I
could almost imagine Dr. Vernon saying to each
of the notable contributors, "Look, we need
information about your subject that the average
person can understand. Wtite what people need
to know in a way that doesn't oversimplify what
you have to say but does communicate it clear-
ly. And include some of the questions people
would be likely to ask about your topic along
with brief answers to those questions."
And, for the most part, that is what the
expert contributors to this book have done.
Reading the titles in this volume was like hear-
ing echoes of questions raised in my own sup-
port group. Indeed, a copy of this book should
belong to all our support groups. I can easily
envision reaching for this volume when a ques-
tion comes up at a meeting and saying, "Well,
let's see what's been written about this in Jack
Vernon's book."
Want to know about ginkgo? Look it up in
the index and find Dr. Ross Coles' discussion of
it. Wondering if there are any safe and effective
drugs to treat tinnitus? An entire chapter by Dr.
Robert Brummett has this question as its title.
Has your tinnitus thrown you into a state of
depression? Read what Drs. Dobie and Sullivan
have to say about "Antidepressant Drugs and
Tinnitus." Perhaps you are uncomfortable taking
drugs but want to do something about your tin-
nitus-related depression. Three of the best chap-
ters about the psychology of tinnitus that I have
read (and I'm a psychologist) discuss our mental
reactions to tinnitus and how we can modify
those reactions to decrease our distress. These
chapters would be equally useful to hearing pro-
fessionals seeking insight into the thinking of
tinnitus patients. Heard about "maskers" but not
sure whether they are really useful or exactly
what they do? Dr. Robert Johnson's chapter is
practically a reference work on the subject.
Wondering what gets stimulated with electrical
stimulation? See Dr. Steven Staller's chapte1:
Been diagnosed with hyperacusis and want to
know more about it? Jack Vernon and Linda
Press discuss this disorder. Want to know more
about the work of Drs. Jastreboff and Hazell on
habituation therapy? Read their chapter on their
influential neurophysiological model and learn
how it has been used to develop a treatment
protocol reported to be producing promising
results. And if you are, like me, a regular reader
of Dr. Vernon's Q& A column, check out the
unique question and answer section at the end
of each chapter.
It would be nice to say that every chapter is
as informative and well written as the ones I
have mentioned. Unfortunately, that is almost
never the case in an edited volume. You will
find a few technical papers that would be of
interest primarily to medical professionals.
However, these are only a minority of the chap-
ters. It would also have helped if papers on com-
mon topics had been grouped together and
appropriate headings placed in the table of con-
tents. But there is an index and the chapter
titles are very informative by themselves.
I'm told this is a book that
Dr. Vernon has been
working on for quite
a while. Well, it's
here, and it was
worth waiting for.
Dr. Pines is a psycholo-
gist and a tinnitus
support group facilitator.
He can be reached at
Canisius College, Dept. of
Psychology, 2001 Main St.,
Buffalo, NY 14208.
Tinnitus 'Tbday/ December l 997 9
TINNITUS


Treatment and Relief
edited by Jack A. Vernon, Ph.D.,
Professor Emeritus of Otolaryngology, OHSU
VERY SPECIAL PRICES:
ATA Members - $22 plus $4 postage
Non-Members - $27 plus $4 postage
(Published price- $26.95 U.S.I$37.95 Canada)
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By Fax:
503/248-0024
By Thlephone:
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Check, VISA, MasterCard
Rush delivery available on orders received by
Noon on December 12 - Call for cost
The 18th European Instructional Course
on
11
Tinnitus and Its Management''
April 5-9, 1998- Nottingham, England
This course addresses the causes, scientific back-
ground, investigations, and management of tinnitus. It
will consist of lectures with case discussions, videos,
practical demonstrations, and two workshop sessions.
The course is suitable for otologists, otolaryngologists,
scientists, technicians, and hearing therapists who are
involved in clinical or research work on tinnitus. The
course is held on the campus of the University of
Nottingham.
Course organizers: Jonathan Hazell and Ross Coles.
Faculty: Adrian Davis, David Baguley, Jean Baskill,
Thrry Buffin, Lucy Hanscombe, Altan Kayan, Margaret
Jastreboff, Laurence McKenna, Catherene McKinney,
and Jacqueline Sheldrake.
The course fee is £640 (residential), £560 (non-
residential). Both fees include comprehensive notes,
lunches, and dinners. The residential option also
includes bed and breakfast in a hall of residence. Early
application is advised. There is an upper limit of 80 del-
egates. Closing date for applications: February 27, 1998,
by which date all fees must be paid. Scholarships (cov-
ering course fee and accommodation, not travel) are to
be awarded- details will be supplied upon request.
For registration details contact: Julie Whittington,
Conference Nottingham, Regent House Clinton Avenue,
Nottingham NG5 lAZ, United Kingdom
'Tel: + 44 (0115) 985 6545 • Fax: + 44 (0115) 985 6533
Email: info@confnottingham. co. uk
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American Tinnitus Association -a 501 (c)(3) non-profit organization- Tinnitus Research and Resources since 1971
10 Tinnitus Today/ December 1997
ATXs New''Treatments Brochure''
by Barbara Tabachnick, Client Services Manager
Our new brochure, Tinnitus 'Iteatments- What's New, What Works, is designed to educate health
care providers - family doctors (who are most often the tinnitus sufferer's first medical contact)
internists, ear specialists, audiologists, psychologists - in fact, any professional who treats tinnitus
patients. Currently we are distributing these brochures to professionals who attend national health
meetings.
How You Can Help -
~ Write or call us for free Tinnitus 'Iteatment - What's New, What Works brochures to take to your
doctor or doctors. We'll send you up to 10 copies (or more if you have more contacts).
~ Please send us the names and addresses of the professionals to whom you give the brochures.
This is a tremendous help. We'll then send additional information about tinnitus and the ATA to
these new professional contacts.
So far, the doctors have been thrilled to get this information. We are thrilled, too, to relay to them
the scope of treatment options and to lay it squarely on the line about what to say, and what not to
say (most notably, "go home and live with it") to tinnitus patients. We want health professionals to
take this new brochure, and go home and work with it.
Please let us know ifyou can help.
(Excerpts from brochure)
Tinnitus Treatments
-"What's New
-"What Works
Tinnitus, a ringing or other noise in the
ears or head, affects more than 50 million
Americans.
For most, the symptom is annoying though
not intrusive. However, there are 12 million
people with chronic and distressing tinnitus who
are seeking answers and relief.
In the majority of tinnitus patient/ doctor
interactions, the answers do not come. Some-
times it is because a recommended treatment
does not work. Other times it is because the tin-
nitus sufferer is told by his or her physician to
"go home and learn to live with it" - a counter-
productive comment that has left untold num-
bers of sufferers feeling despondent. Most often,
it is because the health care provider does not
know of a treatment to suggest.
Tinnitus has become a very specialized field
in medicine. The long wait to get into tinnitus
clinics across the U.S. gives testimony to the
need for this focused care. But a person who is
troubled by tinnitus will usually see a family
doctor, an ENT, or an audiologist first. That is
where the cycle of appropriate tinnitus care
must begin.
Whatever your area of practice, the following
information can help you develop supportive
and effectual treatment plans for these very
special patients.
Causes of Tinnitus
The most common cause of tinnitus is expo-
sure to excessively loud noise - either a single
intense event (like a gun shot blast), or long-
term exposure.
A small percentage of tinnitus cases arise
from medical conditions. Hypertension, acoustic
neuroma, thyroid disease, vascular disorder,
temporo-mandibular jaw joint disorder, ear
infection, impacted cerumen, nutritional defi-
ciency, an aneurysm, multiple sclerosis, and
other disorders can produce the symptom of
tinnitus.
There are also more than 200 known
prescription and OTC drugs that cause or
exacerbate tinnitus. In some cases, the tinnitus
will lessen or disappear when the offending
drug is discontinued.
Patient Evaluation
A complete medical history of the patient
can identify or rule out an underlying physical
cause of tinnitus. In some cases, successful
treatment of a medical condition can relieve
the tinnitus.
T innitus 1oday/ December 1997 11
''T B h ''
reatments roc ure (continued)
An audiological evaluation of tinnitus will
establish the patient's baseline hearing level ,
plus the tinnitus pitch and volume levels. These
data are essential to know before any sound-
generating treatment can be prescribed and
used effectively. (Note: Tinnitus severity, as
rated by the patient, does not correspond to the
measured loudness or pitch of the tinnitus.)
The psychological state of the tinnitus
patient demands consideration. Chronic tinnitus
can cause sleep disruption as well as legitimate
and serious bouts of depression. The emotional
component of tinnitus must be examined and
addressed with equal strength.
Treatments That Work
Subjective tinnitus can be relieved by intro-
duction of specific sound, by medication, by
counseling, and by reducing stress. There is
published evidence of effectiveness for the
following treatments.
Clinical Masking. Wearable, ear-level maskers
produce a broad bandwidth of sound - usually
3,000-12,000Hz- that encompasses the fre-
quency and volume of the tinnitus. The neutral
masker sound is generally a more acceptable
sound than the tinnitus. Success with masking is
based on the observed phenomenon that non-
threatening external sound can bring relief to
the tinnitus ear.
A combination hearing aid and masker,
called a tinnitus instrument, is used most often.
(Approximately 70% of tinnitus patients have
hearing loss.) The hearing aid part is adjusted
first; the masker volume and frequency are
then set to a comfortable listening level.
Patients are monitored for six months to assess
improvements.
For some patients with hearing loss, the
use of hearing aids alone abates the distress of
tinnitus. Ambient sounds brought back to the
ear can effectively mask tinnitus.
Tinnitus Retraining Therapy (TRT). This new
therapy is a result of understanding how differ-
ent areas of the brain are involved in tinnitus.
TRT attempts to interfere with the tinnitus
12 Tinnitus Today/ December 1997
signal in the brain by introducing a broadband
frequency- usually 1,000-6,000Hz- through
wearable ear-level noise generators. These
instruments are set to a volume quieter than the
level needed to mask the patient's tinnitus.
Directive counseling is used to de-mystify-
the tinnitus for the patient, and is an essential
component to this therapy. For some patients,
the counseling combined with the advice to
avoid silence is sufficient.
Tinnitus Retraining Therapy gradually pro-
motes tinnitus habituation, wherein the patient
becomes no longer aware of and annoyed by the
tinnitus. Tinnitus patients are asked to wear two
noise generators a minimum of eight hours a
day for 18 to 24 months. 'JYpical improvement is
seen within six months. Patients are reminded
to "enrich" their environment with constant low-
level sound. Follow-up assessments are made for
several years. Hyperacusis, a super-sensitivity to
sound, can be treated with a variation of TRT.
Counseling. Depression and/ or anxiety can
accompany tinnitus. Sometimes a sympathetic
response from a well-informed physician can be
reassuring enough to reduce the tinnitus
patient's anxiety. Occasionally, professional
counseling and interim medications are needed.
Cognitive therapy can help patients alter the
way they react to their tinnitus through the
identification and elimination of negative
thought and behavior patterns. Many patients
also find it a great relief to talk about tinnitus in
a support group setting.
Drug Therapy. Various anesthetics, antide-
pressants, anticonvulsants, anti-anxiety agents,
and antihistamines are beneficial to some tinni-
tus patients. Nortriptyline (Pamelor), alprazolam
(Xanax), furosemide (Lasix), clonazepam
(Klonopin), and other medications have been
used to relieve tinnitus and associated sleep
disturbances.
The potential for undesirable drug side
effects must be weighed against the potential for
tinnitus relief. The published papers of these
and all tinnitus-related drugs are available from
the ATA bibliography.
Biofeedback and Other Relaxation Techniques.
Since stress can aggravate tinnitus, tinnitus
patients benefit from learning stress-reduction
''T B h '' reatments roc ure (continued)
techniques. Biofeedback is a method of relax-
ation that allows the patient to control his or her
own heart rate, blood pressure, breathing, and
muscle tension. It is often used as an adjunct to
other tinnitus treatments. Other methods of
stress reduction include meditation, exercise,
yoga, self-hypnosis, and the use of relaxation
tapes.
Bedside Masking. Thbletop maskers produce
a stable broadband sound similar to FM static.
These adjustable devices are most useful at
night when the absence of ambient sound
enhances the focus on tinnitus. Several varieties
of tabletop maskers produce soothing environ-
mental sounds.
Alternative Treatments. Western medicine has
not yet solved the mystery of tinnitus. But when
tinnitus persists, so do tinnitus patients! Many
have turned to "alternative" health practitioners
(such as naturopaths, craniosacral therapists,
and chiropractors), and to the Internet to find
others with tinnitus in hopes of finding relief.
Herbal remedies, ginkgo biloba, vitamin
supplements, dietary modifications, and
acupuncture have all been tried with some
anecdotal success. Hyperbadc oxygen, magnets,
and lasers have been studied and used for
tinnitus relief outside the U.S.
What you can do for your tinnitus
patients
~ Listen to the patient's questions - and answer
them! Compassion and knowledge are formi-
dable clinical tools.
~ Suggest treatment options. Be willing to try
severaL For some patients, a combination of
treatments is more effective than a single
treatment.
~ Refer patients to professionals in different fields
when warranted. ALWAYS give the distressed
tinnitus patient somewhere to go, someone
to call, or something to do .
._ Stay informed about tinnitus. Clinician
training and continuing education classes in
tinnitus patient management are offered
year-round at professional meetings.
Journals, like ATA's Tinnitus Today, can keep
you apprised of new developments in the
field.
~ Encourage your patients to join ATA.
ATA members receive the quarterly journal
Tinnitus Thday, support network and clini-
cian referral directories, all of our brochures,
and discounts on related books and tapes.
~ Support the American Tinnitus Association.
With your annual professional membership
of $35, you receive the same benefits plus
free brochures for your patients. If you
actively treat tinnitus patients, you can
apply to join ATA's Professional Referral
Network.
Current Research
In the past few years, tinnitus research -
both laboratory and clinical - has taken off in
significant and hopeful directions. The National
Institutes for Deafness and other Communica-
tion Disorders and the ATA have awarded nearly
two million dollars for tinnitus research. The
most current research targets the brain's
involvement in the perception of tinnitus.
AboutATA
ATA's mission - to promote relief, preven-
tion, and the eventual cure of tinnitus for the
benefit of present and future generations - can
be fostered with your efforts.
Tinnitus is often as frustrating for the
patient to resolve as it is for the clinician to
treat. But a new fervor for this field of study is
bringing the hope of widespread tinnitus relief
closer every day.
On behalf of the
tinnitus sufferers in
this country, we
encourage your inter-
est and welcome your
support.
Tinnitus 1bday/ December 1997 13
Calling for Help
by Barbara Thbachnick,
Client Services Manager
If you are troubled, it can be a
godsend to find someone to
talk to. The better fortune
(although no trouble would be
the best fortune) is to find
someone to talk to who has
made it over the hurdles you
are just beginning to face.
'Trauma survivors are living proof that people
can indeed make it to the other side. They can
bolster others with information; soothe with
inspiration. They are a resource like no other
because they are, as Thomas Powell writes
I
"fluent in the language of the problem."
Sixteen years ago, ATA decided to build a
bridge between those who needed support and
those who could give it. And so, our support
network was born. A "network of one" at its
inception (a lone self-help group in New
Jersey), it is now a national and international
volunteer collective. Some people sign on as
group leaders, some as pen pals, some as tele-
phone contacts. Hundreds have joined and
retired from the network over the years.
Thday, an ATA Self-Help/Support Network
list is sent to every new ATA member. (If you've
misplaced your list, ask us for a new one.) We
encourage you to use it freely. And as you do,
you might find that you connect better with
some people than with others. It's completely
understandable. Many of us go through several
doctors, for example, before we find one who
seems to be a good fit.
When and how to call for help
It is acceptable to caU our support network
volunteers between 10:00 a.m. and 7:00p.m.
Some have noted special time preferences for
receiving calls. Check the listings. Please pay
attention to time zones if you are calling outside
of your own. (Note: the east coast is three hours
later than the west coast.) In an emergency, call
your doctor or local hospital. There is always a
way to speak with a physician, even after hours.
] 4 Tinnitus 1bday/ December 1997
When you call for support but reach an
answering machine, leave a message. However,
consider that children (and adults too) can acci-
dentally erase calls, and machines can fail to
copy entire messages. Call the support person
again in a day or so if you don't hear back.
If you reach the answering machine of some-
one who is not in a free calling area, absolutely
call back another time. If you want to be called
"collect," say so on the message and leave your
number. For most of our volunteers, it is finan-
cially out of the question to return long-distance
calls. Please remember that if it is long-distance
for you, it is long-distance in return.
All manner of people call for support. Some
will call everyone on the list regardless of the
distance. Others want only to talk to a "local,"
and on that front we can often oblige. (Many
volunteers have joined our network to fill a local
support network void.) Some people call only for
information and inadvertently find friendship.
One ATA member told me that while he has not
yet used the list we sent him, he keeps it fo1ded
neatly in his wallet and carries it with him at all
times -just in case. Sounds to me like he uses it
every day.
If you have the pluck and the heart and the
time to help others on the phone or as a tinnitus
support group leader, let us know. We could sure
use the help!
New ATA Support Contacts
To these and all of our wonderful volunteers, we
offer thanks, and thanks, and ever thanks.
New Support Group Facilitators
Lee Gulley
4318 Toll Gate Lane
Bellbrook, OH 45305
937/848-7079
and
Ruth Bradshaw
937/783-4613
New Support Pen Pal:
Vivien Oram
PO Box 191
Morrisville, VT 05661
Tinnitus Survey Update
by Stefan P Kruszewski, M.D.
Since my first two art1c1es were published in
Tinnitus Tbday, more than one thousand letters
have come to me from national and internation-
al locations. The response has been, unfortu-
nately, overwhelming. I use the word
"unfortunately" because the severity of the
problem and the ignorance on the part of the
medical community remain significant. As ATA
is already aware, we must do everything we
can to change the medical community's view
of tinnitus and its effects on individuals.
I continue to try to do my share. I speak and
write to individuals from around the country
and the world. I respond individually to every
letter. There is a reason for this. One, I believe
that everyone deserves a personal response.
Moreover, each story is different, necessitating
separate replies. Having suffered with tinnitus
for over nine years, I empathize with all persons
who experience this problem. I am still respond-
ing to letters that I received more than one
year ago.
Along with many of my responses, J sent
lengthy questionnaires regarding their tinnitus,
hyperacusis, and their thoughts relating to these
problems. The questions were detailed and
comprehensive. Perhaps as a measure of the
devastation of the difficulty, the response to the
questionnaires has been equally overwhelming.
The results of the questionnaires are
presently being tabulated and statistically ana-
lyzed with the intent ofbeing published in an
upcoming article. As I examine tinnitus in many
ways, I might be able to help define common
causes and remedies that could help others. As I
continue to interview people
with tinnitus, I am struck,
validated by the questionnaires,
that this disease is multifactorial.
In terms of this disorder
having multiple etiologies, I would
like to offer a sampling of comments
from the questionnaires thus far
received. The following answers, in
response to "which situations make tinnitus
worse,'' appear in at least 50% of the question-
naires received:
l. Stress and anxiety.
2. Diabetes and hypertension.
3. Any kind of hearing loss, with high
frequency hearing loss noted most often.
4. Changes in humidity.
5. Unexpected noises.
6. Sudden weather changes.
7. Cold weather.
8. Increase in "ringing" following sleep.
9. Significant life changes (divorce, bankruptcy,
retirement noted most often).
10. Diets high in fat.
11. Sedentary life styles.
12. Earlier history of head injury.
13. Earlier history of chronic loud noise or
music, in recreation or in work.
These variables also appear in almost 50% of
the answers thus far received:
1. Most individuals can precisely date the onset
of their tinnitus.
2. Herbs, such as ginseng and ginkgo biloba,
work for some people but not for others.
3. Most sufferers have seen at least five physi-
cians, of which usually four are specialists.
4. Alcohol and caffeine provide variable
responses in individuals.
5. Hyperacusis is often viewed as a separate
problem
At the end of March 1998, I will be doing my
final analysis of the questionnaires. In the
meanwhile, if you would like a questionnaire
(whether or not you have written to me previ-
ously), please write or call me for one. I only
ask that it be returned to me as soon
as possible. The more information 1
receive, the more information avail-
able for analysis.
Stefan P Kruszewski, M.D., is the
Medical Director of the Institute for
Behavioral Health, 450 Washington Street,
Pottsville, PA 17901
phone 7171621-5016, fax. 7171622-7720.
Tinnitus 'TOday/ December 1997 15
A New Director -A New Direction
Oregon Hearing Research Center's Alfred Nuttall, Ph.D.
by Barbara Thbachnick, Client Services Manager
Alfred L. Nuttall, Ph.D., assumed a profes-
sorship and the directorship of the Oregon
Hearing Research Center (OHRC) in the fall of
1996. With it, he assumed the imposing task of
filling the shoes of Jack Vernon - an icon quite
revered by tinnitus patients and clinicians alike
for his decades-long dedication to the study of
tinnitus.
How did Dr. Nuttall take to the task? As
any dedicated, nationally honored researcher
would- with great excitement. His two NIH-
funded research
grants came with
him from the Kresge
Hearing Research
Institute at the
University of
Michigan to OHRC.
Both grants are fund-
ed for approximately
five more years. The
focus of the
research: studying
the mechanical
responses of peri ph-
Alfred L Nuttall, Ph.D. ery hair cells in the
Organ of Corti, and investigating the blood flow
to the inner ear.
Will his research move us closer to under-
standing the mechanisms of tinnitus? Dr. Nuttall
strongly believes so. Below he discusses his
goals for the Center and the future of tinnitus
research in Oregon.
BT: Your research over many years has
focused exclusively on the physiology of
cochlear hair cells and cochlear blood flow.
Does tinnitus enter into the picture of your
research?
AN: Although my work is not specifically on
tinnitus, that is, the word tinnitus is not in the
title of the grants, the work is very important to
the understanding of various types of tinnitus.
One branch of my research covers the basic
physiological mechanisms of the inner ear hair
cells, how they function, and how they are
destroyed by ototoxic effects. We are also study-
ing how the outer hair cells are controlled by
16 Tinnitus TOday/ December I 997
the input they receive from nerve fibers.
Changes in the response of hair cells in the
cochlea - or the loss of the hair cells altogether
- are very likely responsible for some forms of
tinnitus. So research on hair cell mechanisms
will definitely lead to an understanding of the
forms of tinnitus pathology related to those hair
cells. Other types of tinnitus, like those that
originate in the central nervous system, might
have entirely different mechanisms and my
research doesn't cover that area.
BT: In one of your current research projects,
you are studying the effects of salicylate on the
blood flow to the inner ear. Tinnitus is a well-
documented result of excessive salicylate. Can
you project how your research wil1 further our
understanding of this?
AN: Salicylate, like some toxic venoms, is
one of those very interesting drugs that can be
helpful or toxic depending on the dose. Drugs
like these become research tools. For example,
we know that salicylate affects the blood flow in
the inner ear, and has an independent effect on
the hair cells in the inner ear. Now we want to
know exactly how salicylate affects blood flow, if
the changes in blood flow are linked to tinnitus,
and if an abnormally low cochlea blood flow
causes or enhances tinnitus because of the con-
current effect of the salicylate on the hair cells.
It's in these details that we will find some of the
answers.
BT: What have your studies shown regarding
inner ear blood flow and endolymphatic
hydrops?
AN: The study ofhydrops (or Meniere's dis-
ease) is difficult because there is no really good
animal model yet for Meniere's that mimics all
of the symptoms. Animals that are surgically
given endolymphatic hydrops have reduced
hearing but no vestibular irregularity, which is
the most common symptom of Meniere's. The
newest research on hydrops has shown that
hydrops itself causes not only hearing changes
but changes in the reactivity to the blood supply
in the inner ear. The accumulation of fluid in
the endolymphatic space causes, as we know,
changes in the inner ear like pressure changes
or ion imbalances. These changes cause subse-
quent effects on the cells in the Organ of Corti
A New Director <continued)
and on the blood flow to the inner ear. It
appears that the hydrops doesn't actually
change the blood flow. It causes the blood flow
to be non-reactive to stress. So when the ear is
stimulated by noise which should increase
the blood flow, the ability of the blood to flow
properly is diminished.
BT: Having focused so much of your
research on inner ear hair cells, can you specu-
late how close the scientific community is to
achieving human hair cell regeneration?
AN: Human hair cell regeneration still
seems distant. The work on auditory hair cell
regeneration is succeeding in lower animal
forms but not in higher mammals. The animal
research is so important, though. It's the founda-
tion of our scientific progress, and we still have
an enormous amount to learn. I'm pleased to
say that some of this work is being carried out
here at OHRC. It's hard to say when basic dis-
coveries will move from the research bench to
the clinic. However, things can happen quickly.
An example that it does happen, a shining exam-
ple, is the cochlear implant that moved very
quickly from the lab to the clinic.
What might move quickly from the lab to
the clinic is this: When hair cells are lost, there
is a gradual loss of function of the whole audito-
ry system. It would be to our advantage to learn
how to preserve the rest of normal auditory
function even if we can't regenerate the cells.
It might be possible to do, to preserve the neural
elements, with drugs. If people who become
deaf are then treated with whatever drugs are
found to work, those people become better
candidates for cochlear implant success.
BT: The Tinnitus Clinic, under the leader-
ship of Dr. Bob Johnson, has been an integral
part of OHRC for more than 20 years. Now that
Dr. Johnson is retiring, what are your goals for
the clinic?
AN: The Tinnitus Clinic will remain an
important focus for us - and not just as an
outpatient clinic. Researchers need to know that
tinnitus is a clinically critical condition, so
devastating to individuals. The researchers at
our tinnitus clinic can see this by their proximi-
ty to the tinnitus patients. We have also been
looking to bring in new investigators who are
doing the best possible science, and who are
lending their interests to tinnitus research.
We've found a marvelous combination of those
talents in Dr. Billy Martin who just accepted the
position as the new director of the Tinnitus
Clinic. Billy will also be Director of Audiology.
We know he will strengthen the tinnitus
program.
BT: What is your ultimate goal for the
Oregon Hearing Research Center?
AN: 1b bring together even more investiga-
tors to fill out the research program. We've
recently acquired new research space here
which is a tremendous opportunity. Oregon
Health Sciences University is on the cutting
edge of auditory research. We have scientists
studying the vestibular as well as the auditory
system. And we'll have Billy Martin's tinnitus
research lab and clinical program here early
next year. 1b expand, we're conduct ing faculty
searches in areas such as the physiology of audi-
tory nervous system and molecular biology. I'd
like to see OHRC with five or six main labs
which would provide a really dynamic and
fertile environment for discovery.
BT: What part has Jack Vernon played in all
this, in the transition from one hearing research
director to another?
AN: Oh, that's the best part of the story!
Jack is a marvelous individual and deserves the
respect and admiration of his patients. I'm very
fortunate to have him as an advisor. He is so
generous with his time with me, and he spends
one day a week available to patients by phone.
And he's still involved with research projects!
This center has enjoyed 20 years of internation-
al good will - all because of his efforts. Jack
and I see each other once a month at least to
discuss progress and ways we can promote the
success of the Center and the grov-.rth of the
Tinnitus Clinic. Personally, I wouldn't have it
any other way!
Alfred L. Nuttall, Ph.D., Director, Oregon Hearing
Research Center; can be reached at Oregon Health
Sciences University, 3181 Sam Jackson Park Rd. ,
NRC04, Portland, OR 97201-3098, 503/ 494-8032.
Tinnitus 1bday/ December 1997 17
{(lbday" Show Gets Results!
Thanks Due to All for Patience During Telephone Tie Up
by Cora Lee (Corky) Stewart,
Program Development Director
When the NBC uTbday" Show did
a segment on tinnitus
September 15 it was "good news
- bad news" personified!
First on the "good" list is that
they not only chose to do the
segment but that they involved
ATA in the planning. They
filmed an interview with William Shatner and we
provided considerable background information
plus the names of several tinnitus experts as
potential participants. The producer chose
Stephen M. Nagler, M.D., F.A.C.S. to be in the stu-
dio fielding questions from the show's co-host
Matt Lauer. This, too, is high on the "good" list.
Dr. Nagler is well-versed in tinnitus as both doc-
tor and sufferer and has proven to be a popular
and articulate tinnitus spokesman at ATA
Regional Meetings. Besides, even before he was
elected ATA Director, he was an outspoken advo-
cate of membership in ATA, so we were confident
that he would cover all bases.
We were not disappointed. Mr. Shatner told
how an explosion on the Star Trek set left him
(and co-star Leonard Nimoy) with tinnitus. He
demonstrated the sound he hears and eloquently
conveyed the gamut of emotions experienced by
tinnitus sufferers, even admitting considering sui-
cide before finding help. Using an ear model and
a sound simulator, Dr. Nagler followed with a suc-
cinct explanation of just what tinnitus is, how it
can sound, how it can happen, and the affects it
can have on the sufferer. Despite the need to do
so "quickly," he was able to tick off the four
things a person should do if he or she has or
'
suspects having, tinnitus:
"The first thing is to find a board-certified
ENT doctor, or an otologist, an ear doctor, who is
in tinnitus, so you won't wind up
With the 'Go home and learn to live with it! We
don't need that anymore. It's inappropriate,
unacceptable. The second thing is to join the
American Tinnitus Association in Portland
I
Oregon. Very, very important. You get flooded
with information and data. The third thing is to
protect your auditory system. Tinnitus doesn't
cause hearing loss. Hearing loss doesn't cause
tinnitus. But as your hearing becomes worse,
tinnitus becomes more apparent. So the two
things to do in that regard are to avoid silence.
18 Tinnitus "TOday/ December 1997
Sound is good for the auditory system. And avoid
loud noises; protect yourself from loud noises.
And the fourth thing to do is write to your con-
gressman; we need money*. We need money so
that I'm out of a job. We need a cure. All we have
is very good treatment, but we don't have a cure."
(* money for research. ATA receives no Federal

Viewers did what Dr. Nagler said to do - they
called ATA. That was very good. So what was
"bad" about the situation? Telephone overload!
As careful stewards of the funds entrusted to
us by contributors, we keep operating expenses to
a minimum by having just what is necessary to
do the job (only one office, a small staff, volun-
teer support, etc.). We recently upgraded our
telephone system to get greater voice mail
capabilities; under normal conditions (around
3,000 calls a month) it will be adequate for sever-
al years. We are investigating alternative arrange-
ments for the special occasions when it is
strained (such as the airing of the "TbdayN Show),
but we are moving cautiously to minimize cost.
Also, you don't just add extra lines at the snap of
a finger. And, even if you could, who would
answer them? And how do you know when you'll
need them? It's like a store gearing up for holi-
days - except that is a predictable event. We're
seldom aware in advance when such publicity
will happen or what sort of response it will gen-
erate. When we do have control, we encourage
writing to us; our response v.rill be just as fast.
At any rate, even knowing about the •'Jbday•
Show in advance, we had to bite the bullet and
make do with our existing set-up which did,
indeed, get swamped. From the first showing on
the east coast (5:30 AM our time), all eight of our
telephone lines were filled and continued to be
for the next three weeks. Many callers got busy
signals; others were shunted into unexpected
"mail boxes" and several were told by the auto-
mated attendant that the mail boxes were full.
Understandably, a few got angry, but most perse-
vered to eventually get through. In the first two
weeks, we processed 7,000 new requests for
information (and even managed to talk with one
or two existing members as well).
We greatly appreciate everyone's patience
and perseverence this time and for future "media
hits." These are important events for ATA. They
do much to further awareness and understanding
of tinnitus and, hopefully, will greatly add to ATA
membership. And that is very, very good.
Toll-Free Really Isn't
Most of the calls received as a result of the
11
Thday" show came over ATA's 800 number.
That means they were free to the caller but it
is important to note that ATA pays for each
and every call on a per-minute basis.
Staff and
volunteers give
personal
attention to every
ATA contact.
Robin Jennings, ATA Mail
Services Coordinator
Evelyn Peasley, ATA
Program Services Assistant
A. Jean Warner, Volunteer
Cathie Glennon, ATA
Database Manager
Maia Dock, ATA's
Secretary/Receptionist
Arnold Kagan, Volunteer
-
Barbara Blaine, Volunteer
BEQUESTS:
Investments in ATXs Future
by Cora Lee (Corky) Stewart,
Program Development Director
During the past year, ATA received proceeds
from three bequests. Mary Rose Cami11eri of
Manchester, Connecticut bequeathed the
Association $85,529; Anna Sherman of Chevy
Chase, Maryland provided $3,000; and Adam
Dean Moser of Bradford, Pennsylvania included
ATA in his will for $68,832.
ATA staffers were both surprised and sad-
dened by these significant gifts. You see, these
were three friends we didn't know we had. Adam
Moser's membership lapsed in 1987; to the best
of our knowledge, Mary Camilleri only had con-
tact with us in 1993; and we have no record of
any contact from Anna Sherman. That means
they were probably not aware of research and
treatment advances made in the past few years
or of the expanded efforts of ATA. That makes
their validation of our work doubly appreciated.
But because we were unaware of their intentions,
we sadly never got to thank them.
Everyone knows that the lives we lead are the
result of the choices we make - or don't make.
Careers, relationships, and quality of life are far
too often determined by the lack of a decision.
Estate planning is a prime example of people
making the choices they want rather than leaving
everything to chance. We all know this, yet
whether due to apathy, ignorance, or procrastina-
tion, few act. Seven out of ten Americans die
without an up-to-date will.
Estate planning options are many but the
advantage of doing it early is that you can often
realize financial and income tax benefits while
supporting organizations important to you during
your lifetime. Obviously, this would be ATA's
choice since we like to keep our members
around. If you've already included ATA in your
planning, please let us know so that we can prop-
erly thank you. If not, we would be happy to
work with you or your advisors in the develop-
ment of a plan that best meets your personal and
family objectives. Please write for information or
cal1 503/248-9985 x18. (See also this issue's insert
about Year-end Gifts.)
You can be confidant that any gift, bequest, or
trust for ATA is a financially sound investment in
the future.
Tinnitus Today/ December 1997 19
Questions and Answers
by Jack A. Vernon, Ph.D.
As those of you who have written to me
know, I personally respond to every letter I
receive. However, please understand that due to
the confines of space we just cannot include
every question and answer in this column.
And thank you for writing! I hope each of
you will feel free to continue asking questions
of me. I also hope that each of you will not be
shy about providing answers to the questions of
others.
[Q]
Mr. J. S. from California asks if depres-
sion can make tinnitus worse and if so
what can be done about it.
Other patients have expressed the same
concern about depression. In many
cases the tinnitus is the cause of the
depression. However, Mr. S. had bouts of
depression prior to developing tinnitus. Thus
in Mr. S.'s case, a treatment for depression is
indicated. The question is how to treat the
depression without also making the tinnitus
worse. As many already know, anti-depressant
medications that are in the tricyclic family can
exacerbate tinnitus (temporarily). We therefore
often suggest the non-tricyclic drug Wellbutrin
for depression.
But I would like to bring to your attention
something I recently read in the Berkeley
Wellness Letter. Their article, "A Better neat-
ment for Depression," discussed the effect of a
plain old weed called St. John's wort. (The word
"wort" comes from the Old English word for
plant and this particular plant was named for St.
John because it blooms around June 24th which
is the birthday of St. John the Baptist.) Unlike
most herbal"remedies," St. John's wort has been
studied extensively, albeit not in the United
States. For example, present day AIDS
researchers are studying its possible antiviral
activity. Evidentially St. John's wort has been
used extensively for depression in Germany.
One estimate indicates that in 1994 German
physicians prescribed 66 million daily doses of
St. John's wort for depression. One study pub-
lished in the British Medical Journal reviewed
23 studies of St. John's wort, three of which
20 Tinnitus Today/ December 1997
were directed at depression. The results indicat-
ed that St. John's wort was somewhat more
effective than the usual drugs prescribed for
depression - including Prozac. There were no
reports of serious side effects in those studies.
There was also no evidence that St. John's wort
worked against very serious depression. The
U.S. National Institutes of Health is planning an
extended study of St. John's wort. The Berkeley
Wellness Letter concludes that there is no rea-
son why one should not try St. John's wort for
mild or moderate depression providing one does
not take it in conjunction with other anti-depres-
sant medications. The reported minor side
effects include gastrointestinal discomfort,
fatigue, dry mouth, and slight dizziness. The
active ingredient in St. John's wort is the
chemical hypericin. For interested readers,
Drs. Bloomfield, Nordfors, and McWilliams
have written a book entitled "Hypericum and
Depression." It is published by Prelude Press
(800/543-3101) in paperback for $7.95.
Ms. P. in New Hampshire indicates that St.
John's wort has greatly reduced her tinnitus, but
one flower does not make a spring. If any of you
try St. John's wort for depression, I will be most
interested in the results and especially interest-
ed to know if it has any effect upon tinnitus.
[Q]
Mr. A. in Pennsylvania indicates that
he has heard about a microvascular
operation performed in Pittsburgh that
relieves tinnitus. Can we provide any informa-
tion about this procedure?
The microvascular decompression
operation for tinnitus is performed by
Dr. Peter Janetta at the University of
Pittsburgh Medical College, Department of
Neurosurgery, 200 Lothrop Street, Suite B-400,
Pittsburgh, PA 15219, phone number
412/647-6778. I discussed this operation with
Dr. Janetta and while I have great respect for
him, I came away from our discussion a bit
uneasy. The purpose of microvascular surgery
is to move small blood vessels that are imping-
ing upon the hearing nerve. But I have not seen
evidence that confirms the presence ofblood
vessels on the hearing nerve. And if they are,
perhaps that is the natural condition for all hear-
ing nerves. I did understand that the surgery
Questions and Answers (continued)
was more successful for patients who had their
tinnitus for less than two years. Mr.A., do con-
tact Dr. Janetta for more direct information
about his procedure.
[Q]
Ms. R. in Illinois sent advertisements for
two herbal remedies for tinnitus both of
which claimed that "thousands have
found relief' and that it '
1
stops ringing in the
ears." She also asks if the following have any
effect upon tinnitus: burdock root, dandelion
root, echinacea root, kelp, aloe, goldenseal root,
and/ or slippery elm bark.
I have limited faith in items that have
not been through the FDA where safety
and efficacy can be tested and demon-
strated. Indeed without FDA guidelines to fol-
low, there is no guarantee that the product even
contains the indicated contents. Most likely this
is an array of herbal treatments for a variety of
complaints, but to my knowledge none of them
have an effect upon tinnitus. Most likely, too,
they will not hurt or help you so if you try any
of them let us know the results.
[Q]
Ms. T. from Illinois asks if any thing
is done for tinnitus patients whose
problem was induced by a single loud
sound? She also asks if there will ever be a cure
for tinnitus.
First about the single loud sound
producing tinnitus. The damage
produced to the inner ear by loud
sounds is a time/intensity affair. Very loud
sounds even over short durations can produce
damage to the inner ear and less loud sound
over longer durations can produce similar
damage. It doesn't much matter which kind of
sound trauma was produced. The resulting
tinnitus, which may be temporary, usually has
a high-pitched tonal quality. And as far as the
treatment is concerned it is the same. I confess
however that sometimes I think the tinnitus
from a single loud blast is more difficult to
relieve if one is using masking for the relief.
Regarding sound trauma let me remind you that
people vary tremendously in their susceptibility
to such damage. Some people have stone ears
and can accept or tolerate a great deal ofloud
sound without any damage to hearing while
others have paper ears and even slightly loud
exposures can produce hearing losses and tinni-
tus. Of course there are all grades of toughness
in between. In your case Ms. T., the pistol was
fired offwith others around yet only you devel-
oped tinnitus causing me to conclude that the
others have tough ears and you have tender ears.
Regarding the possibility of a cure for tinni-
tus, let me say here that I am confident that a
cure will be found - at least for some forms of
t innitus - and that it seems to hinge upon tech-
nical advancements in brain scanning devices.
[Q]
Ms. A. from Minnesota indicates that
she has tried the faucet test several
times but can always hear her tinnitus
over the water sounds. Even when she tun1ed
the radio on real loud in addition to the water
sounds she could sti11 hear her tinnitus. "Why,"
she asks, "does masking with external sounds
not work for me?"
Ms. A., masking does not work for every-
one and you may be one such person.
An alternative answer could be that you
have a hearing loss and that the hearing loss is
in the pitch region which corresponds to the
pitch of your tinnitus. In this situation, you are
unable to hear the part of the water sounds that
are required to mask your tinnitus. If your tinni-
tus is high-pitched and if you have a high-fre-
quency hearing loss, then I would recommend
that it might be possible to mask your tinnitus
with a tinnitus instrument which is a combina-
tion hearing aid and tinnitus masker. Since your
tinnitus seems to be in one ear for a time switch-
ing back and forth, it might be possible to use
one tinnitus instrument (made by Starkey Co.)
which can be shifted from ear to ear according to
need and with properly fitted ear inserts.
Notice: Many of you have left messages requesting
that T phone you. I simply cannot afford to meet
those requests. Please feel free to call me on any
Wednesday, 9:30a.m. -noon and
1:30- 4:30p.m. (503/494-2187)
Please send your questions to:
Dr. Vernon c/o ATA, Tinnitus Thday,
PO Box 5, Portland, OR 97207-0005.
Tinnitus Today/December 1997 21
THE SEARCH IS OVER!
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audiologists, and individuals with
tinnitus found that this new digital
system masked (sonically covered)
tinnitus to their utmost expectations.
A common observation was that the
technology effectively masked tinnitus at
significantly softer and more comfortable
volume levels than conventional maskers or
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Another important system feature is that it
produces a spatial sound field that
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distracts attention from tinnitus.
These technological processes have been
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Three COs function together as a
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CD #1 "Digital Masking" provides five
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daytime use while you may be involved in
other activities. It is probable that several of
the masking ranges are appropriate for your
tinnitus.
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provides five digital masking ranges
combined with relaxation messages and
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22 Tinnitus Today/ Uecember 1997
Reducing Tinnitus
by Gary Graybush
Some part of my auditory system was dam-
aged in 1993 after a severe reaction to a pre-
scription medication. That's when my tinnitus
first started. There are now many physiological
and environmental factors that affect this dam-
aged area that did not affect it previously. To the
extent that I can influence these factors I am
I
able to reduce the severity of my tinnitus which,
at its worst, prevented me from working.
Because of the damage to my auditory sys-
tem, pressure changes (internal vs. external ear)
that were automatically balanced in the past
appear to be not so automatically balanced now.
Meteorlogic, climatic, elevation, and situation
factors now become more influential. For me,
high pressure weather systems are better than
low pressure systems. Warm temperatures are
better than cold temperatures. Low altitude is
better than high altitude. (There was an immedi-
ate and significant reduction in my tinnitus
upon moving from the mountains of
Pennsylvania to the sands of Florida.) Normal
blood pressure is better than elevated blood
pressure. Even relaxed facial muscles are better
than tense ones. A lack of physical activity and
fresh air are factors. Anything that affects the
blood flow in my auditory system is now a fac-
tor. Anything.
Based on my personal observations and
extensive reading (Fit for Life, Rodale's Complete
Book of Vitamins, and more), I am sure that the
food I eat has a significant impact on many of
the above factors. For example, saturated fat
intake has a negative influence on me. So, too,
cholesterol. Keeping my sodium intake to a
minimum is also important. I've become a strict
vegetarian (no meat, fish, dairy) and have
restricted my intake of simple carbohydrates
and any foods that are processed or chemically
treated. The vitamins and minerals that I need
I get from my food selection and vitamin
supplements. I focus on vitamin C E the B
I I
series, zinc, beta-carotene (for vitamin A), potas-
sium, magnesium, and iron. In the morning I
eat fresh fruit. Through the rest of the day I eat
whole grains (oatmeal, brown rice), pasta, pota-
toes and other vegetables, tofu, peanuts, and
more fruit. I eat all foods in small portions
throughout the day, and have learned how to
Food For Thought
build up energy for activity and reduce energy
for rest. My "calorie from saturated fat" target is
always "as low as I can go.'' I drink distilled
water and caffeine/sodium/alcohol-free bever-
ages. Eating like this away from home is some-
times a challenge. But I do it. There is always
a way. In a non-tinnitus situation, I might not
take such a strict stand. But since tinnitus is
so relentless, I have to be just as relentless.
The healthier I eat, the better I feel - with a
seemingly parallel improvement in my tinnitus.
I've learned that some medications can
adversely affect tinnitus. I used to take medica-
tion for anxiety (partly due to tinnitus) but it
produced so many side effects that I had to stop
- fortunately for me in retrospect. (If you are
taking medication, consult your doctor on this as
I did. Note, too, that some vitamins and some
medications might not be good in combination.)
In addition, I've tried to discipline myself to
reduce stress and anxiety in natural ways, by
removing myself from negative situations that
I cannot change, by making time to slow down.
The result has been less stress = less tinnitus =
less need for medications = more natural ways
to good health = less tinnitus.
What I am doing is not a quick fix because
I believe it will take months and years to slow
down, stop, and reverse some of the damaging
processes that have been going on in my body
for years and perhaps decades. The combination
of the stress in today's world, difficult individual
circumstances, and poor nutritional habits may
have set many people up for a variety of mal-
adies, like tinnitus. I still have tinnitus, but it has
steadily improved from the "dark days" of the
past. I think that my unwavering commitment to
implementing the theories and information that
I have acquired has resulted in that improve-
ment. But I have been through enough with
tinnitus so far to know not to be completely sure
about anything with regard to it. It still can be
annoying for reasons beyond my understanding,
and my life is still affected by the restriction it
imposes. I believe I am following some good
leads but I'm sure I only know half the story.
Gary Graybush, 2138 Black Hawk St. ,
Clermont, FL 34711-8074
Tinnitus Today/ December 1997 23
On the Road to ATA Awareness
by Pat Daggett, Administrative Director
Entertainer Engelbert Humperdinck dis-
cussed his tinnitus in the September issue of
"Las Vegas Style" magazine, which I happened to
read while representing the ATA at this year's
International Hearing Society (IHS) Convention
in Las Vegas. I immediately directed information
about the ATA and its services to him and hope
that we v.rill
American Tinnitus Associattoi• be able to
Pat Daggett, left and Malvina Levy
enlist his
support in
the future.
TheiHS
convention
itself
included
approxi-
mately 1100
hearing aid
specialist registrants, with more than 2,000 total
attendees, including family members and
exhibitors. The ATA booth was busy, with lots of
interest in our new brochure, "Tinnitus
Treatments - What's New, What Works"
designed for hearing professionals.
At the close of the II-IS Convention, I met
Gloria in San Francisco for the lOlst Annual
Meeting of the American Academy of
Otolaryngology (AAO). There was a strong inter-
national representation in the 9,000 plus regis-
trants for this event and the ATA booth was
stripped of all available printed materials!
Approximately 1,000 new contacts were added to
the mailing list. Again, the new "Treatments"
brochure was popular.
Pre-exhibit opening events included a meet-
ing of the International Tinnitus Forum, which
featured a panel discussion on "Intratympanic
Drug Therapy."
Also, during the AAO meeting in
San Francisco, the ATA Scientific Advisory
Committee met to discuss the current programs
and projects included in the new Strategic Plan,
as well as research proposals. It was agreed that
an effort will be made to obtain approval of
insurance coverage for tinnitus tests, assess-
ments and therapies from l-IMO's as the AAO
negotiates with these groups.
24 Tinnitus 'Tbday/ December 1997
I was asked to participate in Malvina Levy's
support group session, held at her clinic in San
Francisco. It appears to me that this group illus-
trates how people who experience tinnitus are
making an effort to learn as much as possible
about their condition and how this information
applies to their specific case. This group had
done its homework.
The third week in September found me and
my husband, Walt, in Chicago, at the American
Academy of Family Physicians annual conven-
tion. Although physician registration was at
more than 6,000, the location of our booth
(away from the main traffic flow), as well as
miscommunication with the service staff in the
exhibit hall, made for a frustrating experience
compared to previous years. Although the fami-
ly physicians had a difficult time finding us,
those who did were enthusiastic and eager to
talk with us. Hopefully, next year the meeting
will be functioning at its previous high standards
- at least from our point of view!
While in Chicago, I did get the opportunity
to meet with Cheryl Raisenen's support group
and ATA Board members Sid Kleinman and
Megan Vidis. (The new Vidis baby, Eli, slept
through most of the activity at a local Chinese
restaurant and was admired by all.)
The myriad details involved in this kind of
outreach get somewhat easier with experience,
(airline and hotel reservations; application for
exhibit space; ordering of furnishings for the
booth; shipping of display and materials; assem-
bling display and manning the booth; etc.) but
each location seems to have its own nuances.
The challenge to have everything come together
as planned is ongoing but when it does, it's a
satisfYing experience. Look out world, we're out
to get your attention!!
Welcome to the World
Eli Vidis Newman
Born 8/4/97, 6 lbs., 8 oz.,
20 in. long, very dark hair.
Congratulations to ATA
Board Member Megan Vidis
~ ' - ' - ~ = - - . - : . . . J and husband Rich Newman!
SPECIAL DONORS and TRIBUTES
ATA's Champions of Silence are a remarkable
group of donors who have demonstrated their com-
mitment in the fight against tinnitus by making a
contribution or research donation of $500 or more.
Sponsor Members and Professional Associates
have contributed at the $100-$499 level. Research
Donors have made research-restricted contributions
in any amount up to $499.
acknowledged with an appropriate card to the
honoree or family of the honoree. The gift amount is
never disclosed.
Our heartfelt thanks to all of these special
donors!
All contributions to the American Tinnitus
Association are tax-deductible.
ATA's Tribute fund is designated 100% for
research. Tribute contributions are promptly
GIFTS FROM 7-16-97 to 10-15-97.
Champions of
Gladys Justin Carr Joseph Koppelman Alfredo C. Teti Maurice H. Miller,
Silence
Frederick W. Champ David J. Kovacic Wesley J. Thren Ph.D.
Kenneth R. Cherry Marianne M. John D. Tormedis John T. Murray, M.D.
(Membership
Gary R. Chirlin Krockover William R. 'Ibwer, Jr. Carl M. Nechtman,
Contributions of $500
Donald J. Cook Marie J . Kunkel Dan Vallimarescu M.D.
and above)
Daphne Suzanne Paul Lembo Megan Vidis Meredith K. L. Pang,
Joe H. Anderson, Jr.
Crocker-White, Gary E. Lanterman Eugene P. Vukelic M.D.
Matthias B. Bowman
Ph.D. Dr. Herbert A. Levin Linda A. Wain house Milagros E. Rios-
Rob M. Crichton
Mary Kay H. Davis Sondra Limeburner Thomas K. Webb Walker, M.A.,
Michael D. Deakin,
Richard S. Dirkes John R. Lucas Rita Weisner CCC-A
C.P.A.
H. Renwick Dunlap Joe Luoma Dr. T. Marty J. Lewis Romett, M.D.
Philip Espinosa
Joseph H. Eagan Romulus E. McCoy, Jr. Whiteman, David J. Sand, M.D.,
Ray Faragher
Josephine M. Elias Thomas F. McNulty Treasurer Clayton F.A.C.S.
Jean and Lou Fockele
Jeffrey A. Ferenz Richard L. Meiss School Employees Jeffrey R. Schlesinger
Gordon Family
James and Donna F. N. Menalls Foundation, Inc. Patricia Simonetti
Foundation, Inc.
Fijolek Mr. and Mrs. Charles Barry Whitesell Helena Solodar, M.S.
Ronald K. Granger
BrianT. Fitzpatrick Moon Bryan B. Williams Donna S. Wayner,
Christopher v.
Julius Flores, ll James C. Murphy Christopher R. Wilson Ph.D.
Houghton
Martin E. Fossler M. Frank Norman Gladys C. Young Harold Wenger, M.D.
Marian B. Lovell
Howard L. Franques, Teresa L. O'Halloran
Professional
James F. Wuth,
Adam Dean Moser
Jr. Thomas R. Ogren M.S.P.A.
Dr. and Mrs. Jack B.
Janice Garfinkle William Lee Parker,
Sponsors
Corporations with Nagler
Perry Gault Ph.D.
(Professional
Michael O'Malley,
Robert Gilliam Bobby R. Payne
Membership
Matching Gifts
O.D.
L. Kirk Glenn Harvey A. Pines,
Contributions from American Express
Ann L. Price
Nancy Gliko Ph.D.
$100-$499) ARCO
Sponsor Members
Andrew Good Chris Pracht
Nancy J. Ahrens, B.C.- BankAmerica
Jane Green ,Jerome A. Rich
H.I.S. BP America Inc.
(Membership
William N. Guill Beverly and Mel
Ronald G. Amedee, John Hancock Mutual
Contributions from
Robert R. Harmon Rosenthal
M.D. Life Insurance
$100-$499)
Avis L. Hartley Andrew J. Rosser
AJan J. Arnold, M.D. Company
Frank R. AJlocca
Patcy Andrews
AJfred E. Heller Emest Sagues
John Seymour Berry Johnson & Johnson
Saul Hertzig, President Jack Salerno
Bruce S. Bloom, M.D. Family of
John J. Banavige
Charles Hertzig Edward R. Samuels
Natasa Bratt, M.S. Companies
Ivan H. Behrmann
Foundation Jean L. Schmidt
Neil M. Daniels, Ph.D. J.P. Morgan & Co.
Fran Belkin
Manny Hillman Marlene K. Shaw
Stephen Epstein, M.D. Incorporated
M. Craig Bell
Max Horn Terry N. Sherman
Jack R. Erwin, M.D. Reader's Digest
William D. Bethell
Larry C. James, Jr. Marshall C. Smith
Elio J. Fornatto, M.D.
Jean A. Black
Edith J. Johnson Peter F. Smith
Chris B. Foster, M.D.
Mario J. BonelJo
L. Craig Johnstone Raymond and Sylvia
Soraya Hoover, M.D.,
Ronald R. Bowden
George C. Juilfs Smith
1Seng Hung-Cheng,
Charles T. Brown
JoAnn Karkenny Ronald Snow
M.D.
Leffie Burton
Lois S. Keeney Martin V Socha
PaulJ. Jones, M.D.
Ellen M. Camp
Waldemar Kissel, Jr. Rkhard H. Spencer
Robert J. Kohlenberg,
William J. Knight Walter P. Strumski
Ph.D.
Tinnitus 1bday/ December 1997 25
SPECIAL DONORS and TRIBUTES (continued)
TRIBUTES
In Memory Of
Louise Barrows
Ken and Gunda
Arf.c;ten
John E. Greve
(Birthday;
Joanne's
twin brother)
Jim and Joanne
Cooper
Rosalyn Miller
(Mother)
Sylvia Eisenberg
Susan Moreland
Stephen M. Nagler,
M.D., F.A.C.S
Ken Otremba
Mr. and Mrs. John H.
Schleter
Sylvia Selzer
Sylvia Eisenberg
William Siegel
Mrs. Betty Friedman
In Honor Of
Joseph G. Alam
(Birthday)
Rosalie and Jim Traver
Ed Connolly (Road
to Winning)
Ed Connolly, Jr.
Pawel J. Jastreboff,
Ph.D., Sc.D.
Stephen M. Nagler,
M.D., F.A.C.S.
Stephen M. Nagler,
M.D., F.A.C.S.
Dr. and Mrs. Jack B.
Nagler
Eli Vidis Newman
(celebrating
birth of)
Board of Directors of
the American
Tinnitus
Association
Stephen M. Nagler,
M.D., F.A.C.S.
Megan Vidis
Robert E. Sandlin,
Ph.D.
Stephen M. Nagler,
M.D., F.A.C.S.
Jack A. Vernon,
Ph.D.
Stephen M. Nagler,
M.D., F.A.C.S.
Susan Partin
RESEARCH
DONORS
Robert H. and Arlene
Adams
Sally A. Anderson
Beti E. Argun
Marilyn J. Ash
Frank Asterita
Sylvia Aviles
Laverne Bachmayer
J. C. Baker
Paul B. Bakkom
Joshua S. Barclay
Nancy L. Bardach
Colleen Beckman
Christine L. Bell
Su7.annP. BP-rry
Major Joseph Berson
Lonnie Blackwell
Diarmuid Boran
Bernard J. Bork
Fay W. Botnick
Richard T. Brand
Agnes Braun
Karen L. Burke
Helen S. Burkey
Michael W. Burnham
Maria Helena Untura
Caetano
Timothy P. Caire
Elaine Candiotte
Johanna K. Carmassi
Pauline S. Caylor
David S. C. Chew
Daniel E. Clifford,
D.D.S.
John F. Coker
Donald J. Cook
Dale L. Crawford
Kathleen M. Creely
Wendy Csoka
Glen R. Cuccinello
Sarah D. Davis
Marian R. Dawson
Angela F. Delvillar
Mary T. Dempsey
Michael J . Denson,
B.C.-H.I.S.
Floriana Difabio
Lynn Ditlove
Patricia S. Dostalek
Otto J . Drescher
Doyle K. Ellis, Sr.
Eugene C. Edminster
Robert W. Eichert
Doris M. Eiswert
Maxine Eldon
Doyle K. Ellis, Sr.
E. Lillian Feldstein
Betty L. Ferdinand
Joseph W. Fe1ioli
26 Tinnitus Thday/December 1997
Harriet L. Flaccus
Ann D. Foley
Franklin L. Fountaine
Mary L. Francis
Howard L. Franques,
Jr.
Rex L. Frazer
June A. Freedman
Isaac Frishman
Jack C. Fuller
Richard J. Gambatese
Joel Garris, M.D.
Patrick J. Gibbons
Gillett Hearing Aid
Center
Ed Gioscia
Janet M. Gnall, Ph.D.
Robert A. Gold
James P. Griffing
Gregory W. Grim
Hugh Grogan
lhrahim Hamideh
Robert W. Hamilton
Clayton R. Harris
James and Colleen
Hartel
Nancy A. Hartnett
Margaret H. Hartwein
Maurice H. Heins
Margaret P. Heppe
Vincente G.
Hernandez
E. Alan Hildstrom
Bill K. Hissam
George R. Hoffman
Betty L. Holiday
Suzan M. Housworth
Martha B. Hunt
Martha E. Iacobucci
Rein Ise
Cyril D. Ja1on
Ruby James
Rita Grethen Jarrard
Mrs. Eldred M.
Johnson
George C. Juilfs
Jo Ann Karkenny
Howard R. Katz
R. L. Keheley
Donna Kingston
Waldemar Kissel, Jr.
Catherine C. Knighton
Peter Kobelansky
Michael D. Krouth
Carol N. Kulp
Robert Labertew
William J. Landolt
JudiS. Lane
Norman J. Law
Phillip W. Lazier
Janice M. Leary
Lorraine L. Lewis
Monique Lipham
Duncan Macinnes, Jr.
Walter W. Malinowski
Robert B. Marcus
Arlene G. Margolis
Ted Maupin
Mary J. McAlindon
Martha M. McCardell
Tommy D. McComas
Robert E. McGorman
Mary Lou Mikowski
P. June Miller
Frank R. Morea
Michael G. Moren
Charles R. Moretz
Julie Morin
Donald Lee Morris, Jr.
Arthur E. Myers
Emil Natelli
Jackie Nelson
Jerry E. Norris
Thresa L. O'Halloran
Joseph Opitz
Charles F. Orlofsky
John K. Oscarson
Michael F. Otero
Roxanne G. Parker
Walter Pedersen
Jean A. Pinkepank
Marilyn E. Prigge
Mary T Pugh
Victor Pultman
Robert Pumarejo
Major Leonhard Raabe
Ruth Rasor
George A. Rebh
Douglas E. Rehder;
M.A. , CCC-A
George Reimer
Geraldine Reuther
Judy T. Robinson
Joann J. Rozier
Joan M. Schad
Jennie M. Schlmnoski
John F. Schmidt
J. D. Scroggie
Raphael F Segura, Jr.
Calvin Self
Gloria E. Senno
Ervin Sepp
Robert M. Shames
Charles Sikes
C. Daniella Siroskey
Sandy Slutsky
Dawn T. Smith
Patricia A. Smith
Patricia M. Smith
Ruth T. Stanway
Roland 0. Swanson
Albena Tenukas
David A. Theisen
Vi T. Thurmond
Dan Tonkel
May Toren
John D. Tormedis
Jean E. Towle
Stephen P. 'Itostorff
Martin J. Underhill
Thomas E. Underhill,
D.D.S., M. D.
Donald A. Vassallo
Richard W. Veeck
Wayne F. Wallace
Tim C. Waller
Nancy Waters
Ida Virginia Weimer
Marvin S. Weinreb
Elaine Weiss
Daniel J. Wenz
Marcye B. White
Barbarajene Williams
Bryan B. Williams
Madeline G. Woodruff
Stephane W. Wratten
Richard W. Wright
Shirley A. Wrzesinski
Doris E. Yantis
Cecilia Yeo
Herman Young
Robert Young
Robert L. Young
Kathy Zachok
Marilu Zrimc
Happiest of Holidays
AMERICAN TINNITUS ASSOCIATION
P.O. Box 5, Portland, OR 97207-0005
Forward and Address Correction
'Tis the
The Holiday Season ... a time of good will ... special remembrances ... greetings from
friends ... and a flood of requests for contributions.
You won't find an ATA appeal in your mailbox. It's not that we don't need contributions -
we certainly do (the Association's existence depends on them), but we honor your past
support too much to spend any of it on extra expensive mailings.
B e s i d e s : ~ we believe you are already committed to the fight against tinnitus and will give
what you can to ATA without persistent nagging from us.
That said, we would like to point out the benefits - to you - of planning charitable gifts,
both present and future.
TAX ADVANTAGES :
ATA is a 50I(c)(3) organizatiotl which means tha.t all donations it receives are tax-deductible; such gifts ar voluntary,
without expectation of anythitlg tangible itl return.
We know that ATA supporters contribute oot for personal tax considerations but because they believe in the work rhe
Association is doing. However, we would be remiss if we didn' t point our that there truly are sigoificanr tax advantages for
qualified charitable donations. As an example, if you are in the 28% tax bracket and have given $5000 ro ATA during
1997. you will save $1,400 on your taxes. Other savings when you file your tax return:
A GIFT TO ATA OF: $1,000 $ 1500 $2,000 $2.500 $5,000 $10,000
J..ETS YOU OEDUCf: $280 $420 $560 $700 $1,400 $2,800
Your gift can be the accumulation of several donations throughout the year, bur ro take advantage of the deduction, it
must be given by December 31 -this is what prompts the flood of year-end appeals from charitable organizations.
YOUR GIFT TO ATA CAN TAKE MANY FORMS :
X Giviog CASH (by check or charged ro your VISA or MasterCard) is the obvious and easiest way to show your suppon
while realizing immediate tax benefit.
X Transferring appreciated SECURITiES or STOCK can be one of the more advantageous ways of contributing. If owned for
more than one year, the deduction taken can be for the full fair market value of the srock (in addition, capital gains taxes
are bypassed).
X TRUSTS permit truly planned giving and can even include the ability to derive immediate benefits for you or your F.unily
while providing immediate or later benefits for ATA. The variety of options for trusts are many- bur a financial or legal
advisor can help you design one char best firs your needs.
X Including ATA in your WILL is the way to perpetuate your support of ATN.s efforts on behalf of tin nitus sufferers. Within
your will, a bequest can be of a stared dollar amounr, specific property, or a certain percentage of the residuary estate. We
can provide you with a sample statement that can help execute the document that will accomplish your personal objectives
within the laws of your state.
X BENEFICIARY DESIGNATION of ATA is another way of providing for a furure legacy without changing your will. This
can be done with your life insurance policy, IRA or other retirement plan, or savings account (spousal consent may be
required). You can even provide lifetime income for family members by leaving retirement assets in a trust that eventually
benefits ATA.
Any gift, bequest or trust for ATA is a financially sound investment in the futzere. we will be happy to work with you
and/or your advisors in developing a mutually beneficial and satisfling plan.
This information is based on d:u3 available at priming: it does not constinue legal or financial advice :md should noc be rdjed upon as a $Ubsticmc: for professional counseL

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