NA llONAL VOLUNTARY ASSOCIA llONS MEETING Sharing their concerns at the recent voluntary health agency meeting sponsored by the NINCDS Communicative Disorders Program were: (seated, L-R): Gloria E. Reich, American Tinnitus Association; Dr. Katherine L. Sick, acting deputy director, NINCDS; and Patricia Ann Clickener, Self Help for Hard of Hearing People. (Standing, L-R) : Albert T. Pimentel, National Association of the Deaf; Howard Rocky Stone, Self Help for Hard of Hearing People; S. Melvin Carter, Jr . , National Association of the Deaf; and Don L. Organ, Sertoma Foundation . NATIONAL VOLUNTARY ASSOCIATIONS MEETING At this meeting, the voluntary agencies presented their concerns about the needs for hearing, language and speech research. Some of the following material was presented to the conference by Gloria Reich, Executive Director of the American Tinnitus Association. Tinnitus, or ringing in the ears, affects more people than all of the other problems that are listed as concerns by the NINCDS. Most of the people who have tinnitus also have hearing loss; therefore, our concern is not only with tinnitus but with all hearing research. Hearing problems for many people are still in the closet and even for those who admit to them there is no white cane, no wheelchair to gain the consideration and concern of others . Hearing problems are truly life threatening. The disruption and stress imposed on one's life by tinnitus has driven people to suicide, to drug addiction, to severe mental illness, and into the arms of every promising treatment whether helpful or not. Tinnitus can cause a person to lose employment, to strain relationships with friends and family, and to deprive that person of necessary restful sleep that can enable him to effectively cope with the problem. With 37 million Americans suffering from tinnitus the need for research in this area is evident. Yet only limited funds have been available to support tinnitus research especially in comparison to the amount of support available for other neurological disorders. For example, if one compares the ratios between the numbers of people who are afflicted with a specific disorder and the amount of money expended to solve it the results are startling. Whereas $32 are spent for each cerebral palsy patient, $128 for each patient with multiple sclerosis or other demyelinating disorders, only $2 is spent for each patient with hearing and equilibrium problems . Why the disparity? Part of the problem may be the distribution of funds for basic versus applied research in our field. Certainly no investigator can deny the need for basic research. It seems imperative, however, since the charge of the NIH is to solve health problems, that this research be reduced to oractice if nearing problems are to be effectively treated. It would also seem appropriate that consideration be given to forming an institute devoted exclusively to hearing problems rather than be included as one small unit under the broad category of neurological disorders. The primary focus of this meeting is to allow different agencies the opportunity to inform the NIH about specific concerns of that agency and how the Federal Government can best help to serve patient needs. With respect to a relatively new organization such as the American Tinnitus Association a list like this could be interminable. However, two suggestions regarding ways that the NIH could be helpful to our needs seem reasonable. The first regards dissemination of information relative to investigations involving tinnitus research. It would be extremely useful to be made aware of the types of projects that are being funded in this area in an effort to coordinate and promote research efforts and to eliminate duplication of projects. Secondly, it seems essential that support be made available to young investigators in this field to become involved in research efforts directed towards helping tinnitus patients. This has long been a neglected area of study and considerable effort must be made to encourage more professionals to become involved in tinnitus research. Tinnitus is not a trivial problem. Our association alone has heard from over 50,000 people during the last six years whose lives are greatly affected by this problem and who need help. We need to be constantly reminded that HEARING IS IMPORTANT. Communication is the lifeblood of our existance. Quality of life should be the concern of all people. These problems are not insoluble - but continuing effort is needed to resolve them. Tinnitus appears to be causing more severe emotional problems with the younger patient, especially if that patient has otherwise normal hearing. Indications are that the patient with an inveterate hearing loss is better able to cope with tinnitus than the patient who is suddenly and unaccountably afflicted with tinnitus. An older person is more likely to show signs of depression than the younger patient who may be facing problems related to social adjustment. Many people in the medical profession tend to regard tinnitus as trivial. The patient is simply told to learn to live with it. This makes patients angry and often drives them to seek less reputable means of relief. Many drugs are known to exacerbate or even cause tinnitus and yet we find many instances where these ver y drugs are being prescribed to relieve that patient's tinnitus. There is much information to be gained from the patient histories presently being entered into the tinnitus data registry. Little is actually known about the extent to which tinnitus impedes speech discrimination. Something that many patients complain of . Why does masking work? In successful applications tinnitus is diminished, even to the point of vanishing entirely for short or long periods of time (residual inhibition). Improper masking techniques, however, are worse than n o t n ~ n g . Energy at the wrong frequency can make the tinnitus worse. There is a great need to properly train clinicians in the techniques of measurement, evaluation, fitting and management of tinnitus. These clinicians must be able to recognize when one or another form of treatment is indicated. The importance of amplification along with masking needs to be emphasized. Amplification allows the patient to hear better and communicate better. Often when amplification is used in conjunction with masking, lower levels of masking noise are needed in order to achieve masking. There needs to be greater recognition and discussion of the patient's psychological problems. The attempt should be made with tinnitus sufferers to help improve the quality of their lives throug.h counseling. Suggestions can be made for ways to alleviate stress. Tips on coping can be shared. The recent inauguration of the tinnitus self- help program around the o. s. has been very successful. There are presently more than 30 self-help coordinators working to establish groups in their areas. National Voluntary Associations Meeting continued There has been a barrage of interest from the suffering public. Recent PSA announcements on TV that were jointly sponsored by Better Hearing Institute and ATA brought more responses to BHI's hotline than ever before. ATA knows from past experience that any article or mention of tinnitus in the media brings a new flood of mail from those afflicted with the problem. In calendar year 1982 ATA has already answered over 6000 new inquiries . These are people who are not already on our rather substantial mailiing list. It has been said that hearing problems are not as important as other medical problems because they aren't life threatening. Well they are life threatening to those people who are so distraught that they attempt suicide. Some succeed. They are to those whose lives are so disrupted that there is no longer any joy in living. They are to those who have lost their jobs, are depressed, anxious, and lonely in what appears to be an uncaring worl d. If the young mother cannot give love and support to her children because she is afraid that the incessant noise in her head will make her deaf, or craz y, or both. Can you tell that woman that her problem is trivial? What of the phys icians who can no longer listen to vital sounds through the stethoscope? Are we to tell them that the interfering sound of t he tinnitus is unimportant? The former music teacher who hears entire songs or symphonies -- can we reassure this otherwise stabl e person that this auditory imagery is not a sign of severe mental pathology? Certain people are at risk for these sorts of disorders. Just from observing the histories of patients who are seeking help for tinnitus we find a disproportionately large group who have had noise damage. The veterans, airline pilots, machine operators, musicians, cannery workers, foundry workers, sawmill workers, the list is endl ess . The stay-at-home isn' t safe either. Power lawnmowers, vacuum cleaners, chainsaws, all of these and, of course, the stereo system, all generate enough sound pressure to harm the ear. For the tinni t us patient who is severely troubled by the problem, every day can be a tragedy. An otherwise pr oductive life can be shattered. Not trivial? Humbug, we say. Stick it in your ear l JOIN THE FIGHT AGAINST TINNITUS! JOIN ATA NOW!!! Your donations are needed to continue A TA 's services such as the production of this Newsletter. Please help! I ANNUAL CONTRIBUTION AMERICAN TINNITUS ASSOCIATION Regular Member $ 1S or more 0 Sustaining Member $ 25 or more 0 Professional Member $100 or more 0 Benefac tor SSOO or more 0 YOUR GIFT IS TAX DEDUCTIBLE COMMUNICATIVE DISORDERS PROGRAM VOLUNTARIES MEETING LIST OF PARTICIPANTS American Cleft Palate Association American Tinnitus Association Consumers Organization for the Hearing Impaired International Association of Laryngectomees National Association of Councils of Stutterers National Association of the Deaf Self Help for Hard of Hearing People Sertoma Foundation Speech Foundation of America The Suzanne Pathy Speak-Up Institute, Inc. Publications have been received from three of these organizations and we have found them to be a gold mine of information. Each of these organizations provides information and services that are briefly alluded to in their names. If you write to them and ask for these services we hope that you'll remember to support them with your donations as well . Here are the names and addresses of just a few of the agenaies that be of to the tinnitus and/or hearing inpaired person. Names of other voluntaPy may be from The National I nstitutes of Health, Bethesda, MD 20205. COHI/T, Cons umers Organization ror the Hearing Impai red, Inc. P.O. Box 8188 Silver Spring, MD 20907 OUT/T, Organization for Telephone, Inc. P. 0. Box 175 Owings Mills, MD 21117 Use of the SHHH/T, Self Help for People, Inc. P. 0. Box 34889 Bethesda, MD 20817 Hard of Hearing POINT OF VIEW ED. NOTE: Dr. Gardner recently addressed the organizational meeting of the Bergen County Tinnitus Selfhelp group, and has kindly consented to allow th1s matenal to be published in the ATA Newsletter. The reader will recall that this column is printed from time to t i me to allow the expression of varying points of view regarding t inni tus. COPING WITH TINNITUS Richard A. Gardner, M.D., Associate Clinical Professor of Child Psychiatry, Columbia University, College of Physicians and Surgeons. It is important to remember that tinnitus is a symptom of a wide variety of disorders. In some cases medical treatment of the underlying cause can be effective in reducing or even removing the symptom entirely. Accordingly, thorough medical evaluation, preferably including otorhinolaryngolical (ENT) and neurological examinations, is extremely important. When such evaluation and treatment is unsuccessful in alleviating the symptom then, and only then, may the following advice prove applicable. It is also important to appreciate that the advice provided below has proven useful to me. It may not prove useful for other individuals for reasons such as the fact that their tinnitus has different causes from mine or that their personality structures are different from mine. My tinnitus began on November 18, 1978 when I was 47 years old. It came in association with a viral gastroenteritis. However, I had a maternal aunt, who died last year at 92, who had suffered with tinnitus for about fifty years. In addition, my maternal grandfather suffered with tinnitus throughout his adult life. This may suggest a genetic-constitutional predisposition. Since my mid-thirties I have noted a bilateral symmetrical hearing loss at high frequencies (confirmed by audiograms) . It is unclear whether such hearing loss was secondary to acoustical trauma or was an early manifestation of presbycusis (the hearing loss associated with advancing age). My tinnitus is most often localized in the center of my head. On occasion, however, it sounds bilateral, i.e., I can localize it in each of my ears simultaneously. It also fluctuates from low distant hums and whistles to high-pitched, cricket-like sounds. Clearly, those whose tinnitus is different from mine may not find the advice below useful. I suspect, however, that people with varying types of tinnitus may still find some of my advice and information of value. An important element in the discomfort one suffers with tinnitus is the attentional one. To the degree that one does not pay attention to it, to that degree may one find relief. I believe the following analogy is applicable . If one is sitting in a room in which music is playing, one bears the music if one decides to listen to it. If one is involved in a conversation, the music may not be heard even though it is still very much there. Accordingly, if a person leads an active life, in which one is involved in many absorbing activities, the tinnitus will not be heard as much. I myself do not usually hear my tinnitus when actively involved with the treatment of my patients, writing books, or even when absorbed in a variety of meaningful social and recreational activities. Some patients may profit from a hypnotherapeutic approach in which the therapist helps the patient "not pay attention" to the tinnitus. This is similar to hypnotherapeutic suggestions that help patients direct their attention away from pain. A second important element in coping with tinnitus is the attitudinal. Shakespeare's Hamlet said it well: "There's nothing either good or bad, but thinking makes it so." If one views the tinnitus as a horrendous curse, then it is more likely to produce depression. If one can merely view it as a noise, that is not pain, then it may be less of an irritant. Young lovers may consider tbe crickets on a summer night to sound almost like music. The view that one ' s tinnitus is "only a noise" can help make it less stressful. There are rare individuals who can actually come to view their tinnitus as a pleasant sound. These people are clearly fortunate. Although I am certainly not in this category, when one thinks about them it can help one view the tinnitus more realistically. There are some patients who probably can be helped by a bypnotherapeutic approach in which they are helped to associate the tinnitus sound with pleasant auditory experiences such as babbling brooks, waterfalls, ocean scenes, etc . (Perhaps one can only judge the effectiveness of such a procedure by actually trying it. Recent ATA Newsletter articles have emphasized the importance of ~ prejudging therapeutic procedures.) Another reassuring thought that can sometimes be helpful is the awareness that with ..u..m.e., most tinnitus patients feel less distress. In some patients this is the result of an actual dimunition in the intensity of the tinnitus as time passes. In others, there has been no change in the intensity, but the person gets used to it and is thereby less distressed. The old advice "learn to live with it" has some validity especially if the professional provides help with this learning process. Some people find tinnitus maskers helpful. My own experience has been that the masker can predictably work to counteract all sounds in my bead. However, the price I pay for this "relief" is a constant sound in one of my ears. No matter which ear I put the masker in, I have the sensation that it has "pulled" the noise out of my head into the ear to which the masker is a t t a c ~ e d . My tinnitus, however, normally fluctuates; whereas the masker does not. Accordingly, to leave the masker on for long periods of time would provide me with a noise that would be louder than the one that I might experience after the tinnitus has naturally reduced itself to lower levels. In addition, the masker draws attention to a noise, which is just the opposite of what one wants to do. Accordingly, I, personally, stopped using my maskers after about a year. However, I recognize that this is my own individual experience and that there are others who probably find them quite useful. It is important for tinnitus sufferers to avoid situations which may intensify their tinnitus by producing further hearing loss. (The overwhelming majority of tinnitus sufferers have a hearing loss that has predisposed them to the development of the tinnitus.) The worst thing is to place oneself in a position where one is exposed to loud sounds over an extended period . We are living in a time where we are ever exposed to various kinds of acoustical trauma. Probably the greatest recreational offenders are those who play amplified music. Unfortunately, such amplification is becoming ever more prevalent--to the point where it is hard to avoid it. Rock concerts are well known to be acoustically traumatic. Legitimate theaters are also now amplifying their music considerably. Most nightclubs and cafes similarly are exposing their patrons to acoustical trauma. Coping with Tinnitus continued Receptions at weddings and Bar Mitzvahs are typically exposing the guests to traumatic levels of music. Flying in jet planes is probably not traumatic, however, flying propeller flights (especially over long distances) probably is. Many of the subway lines in large cities expose the riders to an acoustically traumatic environment. Although it is difficult to avoid all these sources of noise trauma, I believe that the tinnitus sufferer must avoid them--even at the expense of offending others. Our true friends will be sympathetic to our declining an invitation that entails such trauma. Although many of us cannot make our tinnitus better, we can at least do something to avoid making it worse. Another avoidable way in which tinnitus can be made worse is taking certain medications. It is common practice for physicians to prescribe anti-depressant medication for tinnitus sufferers. I t i s not generally well known that the most commonly used anti-depressants can, on occasion, Produce tinnitus, or exacerbate an already existing tinnitus. The Physicians' Desk Reference mentions tinnitus as an adverse reaction to imipramine (Tofranil), desipramine (Norpramin), and amitriptyline (Elavil). The July, 1980 issue of The American Journal of Psychiatry (pp.854-855) contained an article describing the tinnitus side effects in four patients on imipramine therapy. These patients did not previously suffer with tinnitus, experienced tinnitus when placed on i mipramine, and enjoyed an alleviation of the tinnitus when the dose of anti-depressant was reduced. There is no question that there are many tinnitus patients who are receiving increasingly higher doses of anti-depressant medication. For many, they are being made worse, not better, by the anti-depressants. Although the causes of tinnitus (and there are many) are only poorly understood at this point , there is good reason to believe that research will learn much more about the causes and treatment of tinnitus. Whether such breakthroughs will occur in our lifetime cannot be known with certainty. Unfortunately, the amount of money being spent on tinnitus research is only an infintesimal fraction of what should be allocated at this time. Any influence one has in getting government funding for such research should be utilized. Letters to congressmen, senators, and people whose influence would count in this area could prove useful. Financial contributions to such research is vital. At this point the American Tinnitus Association appears to me to be the organization that is most actively involved in such research and donations to that group would, in my opinion, be the best and most judicious place to send one's contributions. We tinnitus patients must resign ourselves to the fact that we may never enjoy the pleasures of complete silence, walking through the woods alone, quietly enjoying a beautiful scene, or just sitting in silence and relaxing. This is indeed a deprivation. However, it is a loss of a pleasure; it is not a physical pain. Because of this, I find it easier to vacation at a beach, where I can sit on the sand and allow the background waves to compete with and "mask" my tinnitus. Although I still, at times, will seek solitude by walking in the woods, I find it much harder to enjoy this experience. In closing, my final conclusions on how to best cope with tinnitus are that the traditional advice seems to be the best: "try to ignore it" and "learn to live with it." If we lead active lives, involving ourselves in those things that provide us with interest and enjoyment, we are less likely to be bothered by our tinnitus (or other irritants, for that matter). If we are weighed down by other problems, it is likely to cause us to feel worse about our tinnitus. I would not like the reader to conclude with the feeling that I have completely "conquered" my tinnitus and that it still is no longer a source of distress. I too have my "ups and downs" and I too get depressed over it from time to time. However, I do believe that the above considerations have been helpful to me and I hope they will be of help to others as well. TINNITUS THERE'S THE TINTINNABULATION OF A BELL THAT ISN'T THERE; THE SHRIEKING OF A WHISTI.E THAT'S WITH US EVERYWHERE; THE RUSHING OF A RISING WIND; IT'S MORE THAN WE CAN BEAR! IT'S DIFFICULT FOR OTHERS TO APPRECIATE OUR PLIGHT: THIS PLAGUE OF NOISY EARS THAT'S WITH US DAY AND NIGHT. by Hazel Robinson Stone, Revised July 2, 1982 MEMBERSHIP INFORMATION The American Tinnitus Association is a non-profit organization dedicated to the support of research about tinnitus and other hearing disorders. ATA provides information about tinnitus to those who have the probl em as well as to those who are studying it. Support for our work comes entirely from your donations, there is no government or institutional support. Anyone can be a member of ATA by making a donation. Such a donation will automatically put you on the list to receive the ATA NEWSLETTER. We have recently had to trim our Newsletter list in order to keep our costs within bounds. Anyone who had never made a contribution, or had not contacted us within the last four years, was dropped. If you want to keep receiving the Newsl etter you must let us know, either by making an annual donation, or by telling us that you are unable to donate but wish to receive the information anyway. One last word of explanation that might be helpful. Our mailing list is organized by Zipcode into about 20 different files. If you send us a change of address, it must contain your old address as well as the new o n e ~ o r d e r for us to find it. ATA has answered over 6000 new inquiries thi s year between January 1, and June 15. We 're doi ng our best to keep up with t he mail and we appreciat e your patience. INVASION OF THE NOISEHEADS Trudy Drucker At the last wedding reception I went to, the joyful union was celebrated with four hours of continuous screeching rock and disco music. I came home with bleeding ears and my tinnitus, which had previously responded to masking, became and remained intractible. Yes, I wore ear protection, but, as I found out later, even my excellent plugs could not screen out enough of what was an assault of about 115 decibels. This kind of experience is no longer unusual. Technology, ignorance, and selfishness have spawned a generation of noiseheads who are quite wllling and able to burn out your ears along vi th their own. Our parks are savaged by somebody's racket-making gadget behind every bush; at public pools one must stay underwater to avoid the circle of competing radios; musical theatre has become an assault instead of an entertainment; nearly every shop pounds its customers ears with loud taped or broadcast music. In my pleasant town, the sound of portable noise machines is sometimes louder than that of auto traffic. There isn't a good local restaurant where I can get a weekend dinner without conversation-stopping "entertainment." The physical-fitness club programs its exercises to rock music, so we can lose our hearing along with our cellulite. A local college celebrates term-end with a rock-concert party so loud that complaints come from a half-mile away. Churches and synagogues advertise pop-music "worship services. At some school functions with mandatory attendance, the music is loud enough to be painful and dangerous. Even kindergartens and nursery schools dose their innocent charges with "disco parties that can be beard for blocks. I know some people who reg-.llarly flee their own home to escape their son's stereo. If you don't have some teen-aged rockhounds at home, odds are that your neighbor does, and they will drive you mad if you open your windows or sit out on your lawn. Ask these darlings to turn down the noise, and you will be informed that "if it's too loud, you're too old pops as yet another ten agonizing decibels are wrenched from the ubiquitous machines. Hy nephew and niece, cultivated professional people in their twenties, can't make it through a social evening or a dinner party without demanding "background music." Denied it, they soon exhibit the restless, haunted look of the deprived addict. The young folks don't function without the sense-saturation of very loud music. They can't eat without noise, read without noise, work without noise, study without noise, or (if I read the subtle ads correctly) make love without noise. Of course, the noiseheads pay dearly for ANDY CAPP their miserable addiction. The violence at rock concerts, and the tragic, suicidal, drug-ridden lives of so many rock performers, is testimony to the unacknowledged pain of extreme noise. (Rats exposed to the sonic equivalent of two hours at a rock concert have become cannibalistic and eventually died of heart failure.) A study among a large unselected group of college students indicated significant hearing loss in about fifty percent. Dr. Jack A. Vernon of the Kresge Hearing Research Laboratory finds "sixty-five- year-old ears in twenty-five-year-old people." Tinnitus, once chiefly an affliction among older people exposed for many years to industrial noise, is now a hidden epidemic among young people. Nobody who has this condition needs to be told it can mean a lifetime of hopeless torment. The newest implement for torture and danger is the ear-plug portable sound system. A university audiologist estimates that at the usual volume at which these instruments are played, about 100 to 120 decibels are delivered directly into the ear -- enough to cause permanent hearing loss after fifteen minutes. A young man in my community wore one of these devices while crossing a railroad track, and was killed by the train be couldn't hear coming. There will be other deaths, and unfortunately not all among users. Along with the jogger who can't hear an auto born, there is the motorist who can't hear an ambulance siren and the pool lifeguard who can't hear your child's cry for help. You don't have to take this. Obviously, avoid, when you can, any occasion of painful and dangerous sound. A physician I know won't attend any wedding or bar--mitzvah reception -- including those of his own children -- if there will be amplified music. Find out what your child is forced to listen to in school. Hound your town officials into passing and enforcing regulations against the public use of noise machines, including ear-plug sound in circumstances that would pose a hazard to others. Walle out of shops and restaurants that batter your ears, but only after you tell the manager why you are leaving. If a public institution such as a school or recreation area makes too much noise, collect some neighbors and go the the board of governors. A threat to dry up tax support can work wonders. Even minor skirm.isbes can be won here and there; for example, your cabdriver and your hairdresser can play their radios or collect their tips, but not both. You have a right to the sound of silence. Fight for it. Ms . D-rucker is a patient of" the Kresge Hearing Research LaboratorJ . She has a Ph . D. in English and is a Fellow of the American Medical Writers Association. With thanks to the Field Newspaper Syru:licat. "THE CARD THAT SPEAKS FOR YOU, WHEN YOU CAN'T" National Safety Council Information Card These plastic cards, about the size of a credit card can be read at the site of an emergency. You, who receive this Newsletter, have been offered the opportunity to purchase these cards at a substantial savings and to make a contribution to tinnitus research at the same time. When you buy these cards for $7.50, the Hedex Company will make a $1 . 00 contribution to ATA for each one. This represents a savings to you of $3.70 over the regular price. Here's how to get one: 1. Send a business size, self-addressed envelope and 25 cents for each application form to MEDEX INC., Suite 419, 35 Cordova Road, Santa Fe, NM 87501 . (You will receive instructions along with the form telling how to complete it.) 2. For ATA to receive a contribution mention this reference number:01059-384. We think that many of you will find these cards worthwhile. JOHNO. PUBLIC 10QMAIN Sf ANYTOWN, USAOOOOO lfo FO" ..... I lOti ON MICI!Of'll. -........,.,., aw...
r_A...,._; FILM NO 00000 UtU- a.- 0.0.. -- o._ ....... .... .,. ,..., ""'"'""',.. n4 ... ., ,,.,. f'O+J t U "'l 1>0111 "<11'4' be<>d Coni upWo ... '= "'"' J Hotel C'-'rwf card ctoee to .,.. I 10 t ,.,., eftll - ""' tt at ltlm u .. a lltftQhl J'et.l ... Mclo!l,_., - 11y ...,.,.., ...,,.,. .s!.- ,._ ...,. - m .. 'Wiv Ill' l ... .,.._,, Inc-#._ .,_,.,. MEDICAL INFORMATION CARD - In an emergency, the "National Safety Council Medical Information Card provides paramedics, physicians and hospital medical teams with vital medical data about the victim. Above are the front and back of the card. The rescuer need only bend the card to read the victim's medical history contained on microfilm through the optical lens , saving precious time when medical treatment is needed under emergency conditions. TRIBUTES The ATA Tribute Fund is designated 100% for tinnitus research. Thank you aLL those peopLe Listed beLow for sharing your memorable occasions in this heLpfuL way. Contributions to the tribute fund are tax deductible and wiLL be promptly acknowLedged with an appropriate card for the occasion. IN MEMORY OF William Hale, Jr. Mary (Nancy) Sabbey Mary May Mrs. Peter Oliver Horgan Trott Roy Jeremiah Samuel Slosberg Gary Kowaleski John Kowalewski Mrs. Pete Spaan Etta Hayman Jaleely Tahan Mrs. Eve Kirsch W. D. Stubblefield Mrs. Josephine Bolanda Hiss Jeanette Bolanda Hr. Leo Impellizzeri Mrs. Diane Impellizzeri Etta Hayman Joseph Luczynski Catherine Casco BIRTHDAY Katherine Krawec Bebe Novicb Jay Novich Jim Traver Ro Traver Mrs. Leo Kahn Bill Hart Jean Novich Mary Cassel Gilbert Cassel Leslee Cassel ANNIVERSARY Hr/Hrs Reuben Askanase IN HONOR OF Mr.& Mrs. John H. Gary Hr.& Mrs. Lawrence Maher Dr .& Mrs. P. Silverstein Henry & Doris Adams Erin Abbott R. w. Hocks Rose & Alfred H. Polen Theodore Kowaleski Theodore Kowaleski Jake DeYoung Burton Zitkin Trudy Drucker & Joe Alam Hr.& Mrs. Harold Linden Mr.& Mrs. Charles T, True S. F. Impellizzeri S. F. Impellizzeri S. F. Impellizzeri S. F. Impellizzeri Burton Zitkin Theodore Kowaleski Hr. Paul Casco Michael & Anne Szwec J. Alam & T. Drucker J. Alam & T. Drucker J. Alam & T. Drucker J. Alam & T. Drucker Mr.& Mrs. John Hayer J. Alam & T. Drucker J. Alam & T. Drucker J. Alam & T. Drucker J. Alam & T. Drucker J. Alam & T. Drucker Mrs. Gerald S. Gordon Self-Help Group Kick-Off Joseph G. Alam Speedy Recovery,L.Levine Hr.& Mrs. Ray Foster Mother's Day Sylvester Alam, P.C. Sidney Tow Eliot R. Tow Hr. Arnold Weiner Betty Friedman Tinnitus Sufferers Mrs. Walter E. HeMann Father's Day Sylvester Alam Easter Greetings to Aunt Trudy & Uncle Joe American Tinnitus Assoc. Hr.& Mrs. Wm. s. Hart Bergen Cty.Self-Help Group Dr. Trudy Drucker -upon completion of scholarly paper"Sexuality as destiny: the shadow lives of O'Neill's women" Joseph G. Alam SELF-HELP GROUP INFORMATION SELF-HELP GROUPS " ROARING SUCCESS"! Since the last Newsletter when we gave you the names of people who were willing to start self-help groups for tinnitus several of these groups have bad their first meetings and some have bad second and third meetings. These groups are active in the states of New York, New Jersey, Massachusetts, Pennsylvania, Kansas, California, Ohio, South Carolina and the province of Ontario. Other groups are in the process of forming. Please contact this office if you want to join a group. Or, if there isn't a group active in your area, write to us and we'll help you get one started. Here are some of the things that have been reported from the groups. Patients shared their helpful hints for tinnitus relief. These ranged from the control of diet, to exercise, stress reduction techniques and supportive counseling. Surprisingly few people know about masking and often those who do have had inadequate evaluation and fitting and therefore are likely to have found this treatment wa nting. Those who have had success with masking, and we're sorry to say that these patients come from relatively few clinicians, are enthusiastic and anxious to share their success stories with others. Some suggestions that were heard included exchanging telephone numbers among group members so that if someone is having a particularly bad day with their tinnitus they can call a friendly, sympathetic person for a talk. Already many people have found a sympathetic ear through this ldnd of network. PUblished by the The self-help group is a good place to get together with people who can share experiences about tinnitus. It's often surprising how much better things look when you find that you're not alone with a problem. It was suggested that the arrangement of seating at meetings should be comfortable and allow each person's face to be clearly seen by everyone else when s/he is speaking. Often a person who bas tinnitus has difficulty in hearing conversation clearly in a group situation. Guest speakers at meetings have been well received and have provided useful information for patients about the kinds of treatments available, and about their efficacy. Host of all, however, the real bonus from these meetings is getting people together who share the common affliction of tinnitus and allowing them to talk about their experiences. TINNITUS ON TAPE A cassette tape containing about ten minutes of tinnitus sounds and coTTmenta:ry by Dr. Jack Vernon is avaitabZe fol' use by the seZf-heZp gl'oups . If yoUr> gl'oup would Zike one of these tapes an Ol'diJl' may be placed with the ATA office. The cost is $5. 50 postpaid. AMERICAN TINNITUS ASSOCIATION A private non-profit corporation under the Zaws of Oregon The American Tinnitus Association Post Office Box 5 Non-Profit Organ. U.S. Postage PAID Permit No. 1792 Portland, Oregon Medical Advisory Board Jack o . a ...... " o. O n ~ . Illinoi s llav1d o. o.wee..,, 11. 0. PorUand, O<egon Join R. !lnllett, II. D. Meqllwl, 'l'enne!ISH Howard P. llouse, M. D. Los Angelu, c.l1forn11 lloben H. Jolwleon, Ph. D. Portland, O<egon 1\erle a:..avrence, Ph. D. 1oM Atbor, IUc:higan Jerry Northern, Ph. 0. Denver, COlorado George P. ReEd, H. 0. Syracuse, New York llobert E. Sandll.n, Ph.D. SOn Oieqo, California Abrahalll Srol.Jnan, H. D. New York, New York !Uicold G. Tabb, 11. D. - Orleans, I..OuiSlan.> eoard o( puectors Rllbert HOcks, OlatllMTI Portland, Oregon Clone . Retch, txec.Olt. PorUand, Oregon Olarles truce, M. D. Oownc!y, caltfocnta 'lhoo>a.a W1Silbaum, C. P . II. Portland, O<egon ti<r>OrACV 01 Cf:ctpCS Del a-. - of Rep. Ret . Downey, Califomu Honorable M.Uk Katheld united States ~ t e t,gol Qltmr;el Henry c. Breithaupt Stoel,Rives,Boley,Frser & Wyse Portland. Oregon 97207 (503) 2489985 ADDRESS CORRECTION REQUESTED
(Critical Issues in Neuropsychology) Louise Margaret Smith, Hamish P. D. Godfrey (auth.)-Family Support Programs and Rehabilitation_ A Cognitive-Behavioral Approach to Traumatic Brain Injury-Springer .pdf