December 2000 Volume 25, Number 4

Tinnitus Today
THE JOURNAL OF THE AMERI CAN TINNITUS ASSOCIATION
"To promote relief, prevention, and the eventual cure of tinnitus for
the benefit of present and future generations"
Since 1971
Education -Advocacy - Research - Support
In This Issue:
Hair Cell Regeneration - Implications for Tinnitus Relief
Health Insurance and Tinnitus
Tinnitus Spouse Survival
When the Brain has Re-wired Itself
Tinnitus Today Readership Survey Results
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Editorial and Advertising offices: American nnnitus Association, P.O. Box S, Portland, OR 97207 503/2489985, 800/6348978 tinnitus@ata.org, www.oto.org
Executive Director: Cheryl McGinnis, M B.A.
Editor: Barbara Tabachnick Sanders
Tinnitus 'lbda]J IS published quarterly in March,
June, September, and December ll is mailed to
American Tinnitus ASsociation donors and a
selected list of tinnitus patients and profession-
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human and welfare agency under 26
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czooo American Tinnitus Association. No part
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Board of Directors
Stephen Nagler. M. D., Atlanta, GA, Chainnan
Dhyan Cassie, M.A., CCC-A, Medford, N.l
James 0 . Chinnis, Jr. , Ph.D., Manassas, VA
Claude H Gri7Mtrd, Sr., Atlanta, GA
Gary P. Jacobson, Ph. D., Detroit, Ml
Sidney Kleinman, J.D., Chicago, !L
Paul Meade, Tigard, OR
Kathy Peck, San francisco, CA
Dan Purjes, New York, NY
Susan Seidel. M.A., CCC-A, 'lbwson, MD
Tim Sotos, Lenexa, KS
RichardS. 'JYier, Ph.D., Iowa City, lA
Jack A. Vernon, Ph.D., Portland, OR
Honorary Directors
The Honorable Mark 0 . Hatfield,
U.S. Senate, Retired
'lbny Randall, New York, NY
William Shatner, Los Angeles, CA
Scientific Advisors
Richard S. 'JYier, Ph.D , Io,..,a City, lA,
Chainnan
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., Bethesda, MD
John R. Emmett, M.D., Memphis, TN
Barbara Goldstein, Ph. IJ., New York, NY
John W. House, M.D., Los Angeles, CA
Gary P. J,,cobson, Ph. D., Detroit, Ml
Pawel J. Jastrebofl: Ph.D., Atlanta, GA
William H. Martin, Ph. D., Portland, OR
Douglas E. Mattox, M.D., Atlanta, GA
Mary B. Meikle, Ph.IJ., Portland, OR
Stephen M Nagler, M.D., Atlanta, GA
J. Gail Neely. M. D., St. Louis, MO
Gloria E. Reich, Ph.D., Portland, OR
Alexander J. Schleuning, !1, M.D.,
Portland, OR
Michael D. Seidman, M.D.,
West Bloomfield, Ml
Abraham Shulmnn, M.D., Brooklyn, NY
Mansfield Smith, M.D., San Jose, CA
Robert Sweetow, Ph. D., San francisco, CA
Cover: French Door Series #J,
(mixed media on wood, lO"xll '),
by Sher Davidson.
Inquiries to: Indigo Gallery
504 S. Main Street
P.O. Box 728
Joseph, Oregon 97846-0728
541432-5202.
The Journal of the American Tinnitus Association
Volume 25 Number 4, December 2000
Tinnitus, r inging in the ears or bead 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
7 Announcements
8 Health Insurance and Tinnitus: Thking Small Steps
by Rachel Way
10 Tinnitus 'Ibday Readership Survey Results
by Barbara Tabachnick Sanders
12 Medical Intervention for Tinnitus
by Betty G. Weiss, M.S.
13 New ATA Member Benefits
by Jessie a Allen
13 On Board! Introducing Board Member Susan Seidel
14 Tinnitus Spouse Survival
by Ten'i Nagler, R.N.
15 Wben the Brain has Re-wired Itself
by Aage R. M@ller, Ph.D.
17 Annual Report
18 ATA's 'Thlephone, Letter, and E-mail Help Network
20 Expedition Hopeful Cure - My Adventure on Mt. Rainier
by Donna Brown
21 Research Update - 'Ibward the Cure
by Pat Daggett
Regular Features
5 From the Editor
Hair Cell Regeneration - Implications for Tinnitus Relief
by Barbara Tabachnick Sanders
6 Letters to the Editor
23 Questions and Answers
by Jack A. Vernon, Ph.D.
24 Special Donors and n:ibu tes
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advertising by Tinnitus 7bday does not constitute endorsement of the advertiser, its
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American Tinnitus Association Tinnitus 7bday/December 2000 3
FROM THE EXECUTIVE DIRECTOR
by Cheryl McGinnis, M.B.A.
This is a time for us to reflect
on our past while anticipating
an even brighter year ahead.
At the first Founders' Gala in
November; we paid tribute to
Dr. Gloria Reich, a pioneer in
tinnitus services. Gloria
served as ATA's Executive
Director for 20 years and
in the earliest years. She developed
tmmtus program services including education,
advocacy, research, and support. These programs
b.enefit people with tinnitus, healthcare profes-
sJOnals serving tinnilus patients, as well as the
public at large. Our programs raise awareness and
strive to help prevent tinnitus for future genera-
tions. This wonderful event drew members and
well-wishers from across the U.S. and abroad.
Dr. Reich continues to assist other countries as
they establish tinnitus associations.
During the spring and summer, Expedition
Hopeful Cure high1ighted a Colorado member's
climb of Mt. Rainier. Donna Brown offered to raise
tinnitus awareness as she met the challenge of a
glacial climb along with the challenges of tinnitus.
you all for your contributions in response
to this event. Over $85,000 was raised for
research. Helped by this, we expect to reach this
year's goal of $500,000 for research grant projects.
Current research grant projects are reported in
each issue of Tinnitus Tbda.y (see page 21 ).
Four public forums were held at sites in New
Louisiana (September 1999), Chicago,
Illm.Ols 111 March 2000, Voorhees, New Jersey in
Apnl 2000, and Washington, D.C. in September
2000. ATA forums include ample interaction
guests and speakers. Presentation topics
mcluded current research, treatment options, and
support networks. These public forums are pro-
moted in Tinnitus 7bclay, in local papers, and
through announcement flyers.
The ATA Web site has a new look. Many of
you may have already noticed the changes. While
the look has changed, all the featured sections are
retained with updated information. The site will
receive monthly updates as a service to members
and to people looking for information about
tinnitus. ln addition, we plan to open an ATA
4 Ttnmtus Thdlly/ l)ecember 2000 American Tinnitus Association
"members only" section on our Web site in
February. Find us on the Internet at vv-ww.ata.org.
.Another new benefit is a membership pin,
which \-\ e wtll send to all renewing members
beginning with those of you renewing your mem-
berships in January 2001. The ATA pin will pre-
sent conversation openers for each of you to raise
awareness of tinnitus. We know that not every-
one with tinnitus is aware of our organization
and the services ATA provides. A recent
survey of Tinnitus Tbday readers revealed that
of 1,518 respondents, 89% ranked public aware-
?ess of tinnitus to be important to extremely
Important (turn to page 10 for a summary of the
Our combined efforts to make the pub-
he, heallhcare professionals, and researchers
more aware of tinnitus are stronger than any
single voice - yours or your Association's.
These new membership benefits are in
addition to the longstanding services ATA pro-
packets sent to people seeking
mformattan about tinnitus, telephone support for
people who call our toll-free number, 50 self-help
groups throughout the country, tinnitus health-
care provider listing, tinnitus bibliography
service, catalogue of publications and videos
for purchase, a textbook program that includes
tinnitus education in high school health curricu-
lums, and Hear for a Lifetime, an educational pro-
gram offered to elementary classes providing
early prevention information to children. We also
award research grants to further the study of
tinnitus ;md provide tinnitus information to
healthcarc professionals. ATA provides these
programs because of your generous support.
Thank you.
. We wish you the very best of holidays along
with good health, prosperity, and happiness in
the New Year! D
Advertrseme11t
TINNITUS RESEARCH
Volunteers Sought for Drug Study
Contact:
University of California, San Diego
Depts of Otolaryngology
and Psychiatry
Thornton Hospital & Perlman Clinic
(858) 657-8596
From t h e E d ito r
Hair Cell Regeneration
Implications for Tinnitus Relief
by Barbara Tabachnick Sanders
Whenever science invents a
procedure or discovers a drug
or a gene that can correct
something wrong vvith the ear,
people with tinnitus get very
excited. And they have good
reason: Tinnitus relief has
been an unintentional out-
come of some of these inven-
tions and discoveries. For
instance, in 1976 a cochlear implant patient
reported that, along with her improved hearing,
her tinnitus was relieved when the electrical
implant was activated. Dr. John House followed
up with a study and learned that 34 out of 64 (or
53%) former!.)- deaf cochlear implant patients
were experiencing tinnitus relief after the implant
surgery.
Otosclerosis is a disease of the middle ear
bones that ultimately causes hearing loss.
Stapedectomy is a surgery that replaces diseased
middle ear bones with a prosthetic device, and in
more than 90% of cases, hearing is restored.
Probably by virtue of this procedure's ability to
restore hearing, some stapedectomy patients
report that their tinnitus is better after surgery.
Gentamicin, a drug that is toxic to the ear, is
sometimes used to relieve the chronic vertigo
associated with Meniere's disease. A high dose
of this drug is delivered into the inner ear through
a tiny tube aimed at the vestibular (or balance)
organ. The goal is to destroy vestibular hair cells
and knock out the dizziness, and for many vertigo
patients it works. Even though 30% or so of
patients have diminished hearing after undergo-
ing this procedure, tinnitus relief is an occasional
result of it.
In 1988, the news of hair cell regeneration in
the cochleas of chickens had "breakthrough" writ-
ten all over it. (Cochlear hair cells enable animals
to hear.) Then we looked closer at the research
and saw that scientists hadn't discovered how to
regenerate, or regrow, damaged hair cells in chick-
ens. They had discovered that chickens - and
other birds, fish, and amphibians, for that matter
-have inner ear hair cells that automatically
regenerate if damaged or destroyed.
Bird and mammal cochleas are similar in
structure in that both contain hair cells. Both also
contain supporting cells that physically hold up
and nourish the hair cells. But there is an impor-
tant difference: When mammalian cochlear hair
cells die, they do not grow back. When bird
cochlear hair cells die, nearby supporting cells fill
in the space of the dead cells and grow into new
hair cells and new supporting cells. Researchers
Ryals and Dooling have shown that a bird's abili-
ty to hear and understand sounds is restored after
hair cells die and then regrow. Amazingly, the
process is repeatable throughout the animal's
lifetime. But somehow it seems unfair. Birds do
it. Why can't we do it?
Mammals do have a somewhat related
regenerative ability. Although mammals cannot
regenerate damaged cochlear hair cells, some
mammals can regenerate damaged vestibular
hair cells. This ability is not directly related to
hearing, but it is a first cousin to it. Scientists
see the relationship too. One research idea being
considered is the transplantation of healthy
vestibular hair cells into a damaged cochlea.
According to longtime hair cell regeneration
researcher Douglas Cotanche, Ph.D., scientists
are also giving thought to transplantation of
non-human cochlear hair cells into the human
cochlea. Also, a chemical called heregulin is
being studied because it appears to increase
production of supporting hair cells in mammals.
As expected, the role of genetics is being
investigated as a means of restoring hearing.
Scientists have identified the Mathl gene that is
responsible for the creation of auditory hair cells
in mice. Mice born without this gene are also
born without hair cells.
The scientists' underlying hope of ali this
study is twofold: to discover what inhibits hair
cell regeneration naturally in mammals and to
discover what makes hair cell regeneration occur
naturallv in non-mammals. We are keeping a
close e y ~ e on hearing restoration and hair cell
regeneration research too. Tinnitus alleviation is
a possibility at any turn in these advancing fields
of study - and not just for the birds. U
American Tinnitus Association Tmnrtus 1(Jday! December 2000 5
Letters to the Editor
From time to time, we include letters from our
members about their experiences with non-
traditional treatments. We do so in the hope that
the information offered might be helpful. Please read
these anecdotal reports carefully, consult with your
physician or medical advisor, and decide for yourself
if a given treatment might be right for you. As
always, the opinions expressed are strictly those of
the letter writers and do not reflect an opinion or
endorsement by ATA.
T
hank you for the story, "Acoustic Neuroma:
A Success Story" by Rachel Wray (September
2000 Tinnitus Tbday). Like Mari Quigley, I,
too, have an acoustic neuroma. And also like
Mari, my own story is a success. My AN is very
small, about l em. When l was diagnosed, l was
devastated. Everything that I read regarding
surgery was terrifying. So I searched the Internet
for an alternative treatment for my AN and found
it - fractionated stereotactic radiotherapy -
which I learned about on the Acoustic Neuroma
Archive Web site (www.ANarchive.org). This won-
derful site is full of information, treatments,
names of doctors, and patient stories (mine
included). Thday, 18 months after my last treat-
ment, I am doing great. My last MRI showed that
my tumor is "dead," and my hearing is 92% in
my AN ear. Tinnitus is the only side effect. But I
have successfully completed tinnitus retraining
therapy, and tinnitus is no longer an issue in my
life. I am so grateful to everyone at the ATA, the
Acoustic Neuroma Association, the AN Archive,
and to God and my family. Without them, and
you, 1 would not have recovered as fast as I did.
Robin L. Moyer, 2934 Old Welsh Rd.,
Willow Grove, PA 19090, 215-659-2243,
prsmoyer@prodigy. net
I
have had tinnitus for over 30 years, which I
believe resulted from playing the trumpet in
bands through my school years and during
military service. I have been moderately success-
ful in reducing the level of my tinnitus with
niacin, magnesium, ginkgo, and kava kava.
I have noticed a definite elevation of my
tinnitus when I use a cellular phone. In fact, my
tinnitus screams for several days after I use the
cell phone, but eventually it calms back down
to its usual level. I now limit my cell phone use
to times of true emergency.
6 Tinnitus 7bday/ Dccember 2000 American Tinnitus Association
I understand that the cell phone is basically a
radio transmitter and receiver that exposes the
user to microwave radiation. This radiation could
possibly be impacting tinnitus, at least my tinni-
tus. Ce11 phones have received some negative
reviews, connecting them to health problems like
brain tumors and headaches, but the research
findings are inconclusive. My ce11 phone experi-
ence has lead me to consider using a hands-free
headset to keep the phone away from my head
and ears.
Jerry Miller, millerslaw@juno.com
I
have benefitted from the research that
Dr. Susan Shore has conducted in somatic
tinnitus. Thank you for providing the grant to
her. I was involved in a rear-end auto accident.
Thereafter, I began hearing a ringing at 12,000
Hz, constant and centered. I can modulate the
volume by clenching my jaw or tilting my head
all the way back. The insurance company sug-
gested that the ringing was from a deviated sep-
tum and not the auto accident, even though I
have never had a headache, an ear infection, or
head trauma, and the ringing started after the
accident.
Dr. Shore discussed her work and my condi-
tion with me at length, and introduced me to Dr.
Richard Salvi and Dr. Robert Levine who provid-
ed me with additional somatic tinnitus help. I
hope you continue your relationship with Dr.
Shore and continue funding her efforts.
Jerry Axton, Las Vegas, NY,
jerryaxton@msn. com
Editor's Note: A summary of Dr Shore's ATA-funded
research project is on page 22.
O
ne day, after I put peppermir:t
in my mouth, I not1ced that my bnmtus
seemed more intense. lt calmed down in
about four hours. I tried the candies again to see
what would happen, and it started the loud ring-
ing again. I find that peppermint in any form-
candy, mints, etc. - aggravates my tinnitus.
Spearmint isn't as bad, but it does aggravate it
too. r pass this along in the hopes that it may
help.
Alice Best, Butler, PA, 724-477-8748
S
pecial thanks to the ATA staff. They were of
great help to me as I prepared a claim for
damages that I suffered (increased tinnitus
(continued)
Letters to the Editor rcontinuedJ
and other problems) fol1owing a hit-and-run acci-
dent. 1b help my case, 1 purchased Dr. Vernon's
"Sounds ofTinnitus" audio tape, found an accu-
rate representation of my sound on it, and
re-recorded it onto a CD which saved the day -
and the case. The settlement judge was initially
negative and said that he'd had tinnitus and
"cured" it by stopping the use of aspirin.
However, I played the CD at a volume just below
what I hear. Apparently it was loud enough and
sufficiently disturbing to cause the judge to say,
"1\.lrn that of1 Mine was nothing like THAT."
Although this proof of injury was subjective and
not scientific, it did convey my agony and we
successfully settled for $50,000. The judge and
the insurance company had initially offered noth-
ing, so I attribute the results to Dr. Vernon's tape,
your staff, and the CD that we prepared to sup-
port my case.
Beverly DiGregorio, San Diego, CA,
619-224-4891
Ill am alone with the beating of my heart .... "
Lui Chi
I had pondered these words many times
before. But when I got tinnitus, they took on a
rather unexpected meaning. They so accurately
describe the feeling ofbeing totally alone with
only the inner sounds of tinnitus, trapped inside
a body with constant noise, with never a moment
of relief from it. For a while you feel panic and
despair. But, no matter what you are feeling,
life and those awful sounds go on anyway, day
after day.
Soon after my diagnosis, I decided my goal
was to get used to the noises so that tinnitus
wouldn't disturb my concentration or daily func-
tioning. When I learned it gets better over time
for most people, I felt encouraged. I did worry
that the dizziness, hyperacusis, and tinnitus
would get worse and that I would lose my hear-
ing. But when an audiologist told me that my
hearing might get worse over time, I felt that
someone had acknowledged my worry and I was
no longer alone with it. I feel lucky because my
tinnitus has gotten softer, and I have adapted.
As you struggle with your tinnitus, just know
that there are others who know what it is 1ike. It's
important to acknowledge the pain, the grief, the
fears, and the anger. It's also a lot easier to bear if
you can find people who listen and understand,
so that you are not alone with it. That makes a11
the difference in the world. And when you get
better, make a pact with yourself to let others
know that there is hope.
ATA member, Cleveland, Ohio
Announcements
The 7th International Tinnitus Seminar
This research conference offers the opportunity
for doctors, audiologists, and scientists from all
over the world to exchange treatment ideas, and
research and clinical findings related to tinnitus.
Posters and papers are invited.
Date: March 5-9, 2002
Where: Esplanade Hotel in Fremantle,
Western Australia
Seminar Chairperson: Pam Gabriels
For more information, contact :
2002 International Tinnitus Seminar
P.O. Box 581, Cottesloe, Western Australia 6011
Thl ephone/fax: + 61-8-9384-1249
Web: www. tinnitus. com. au
Free Captioned Video Lending Program
The National Association of tl1e Deaf provides
videos free to the hard-of-hearing public. These
videos are "open-captioned" - meaning that they
display English text like a subtitle right on the
screen. These videos will play in any VCR. No
special decoding device is necessary.
Contact: Captioned Media Program/ National
Association of the Deaf, 1447 E. Main St.,
Spartanburg, SC 29302
Thlephone: 864-585-1778 ext. 214, 800-237-6213
(voice), 800-237-6819 (TTY), 800-538-5636 (fax)
E-mail: info@cfv.org
Web : www.cfv.org
American Tinnitus Association Tinmtus Thday/ December 2000 7
Health Insurance and Tinnitus:
by Rachel Wray, Director of Advocacy and Support
When health insurance is cliscussed in the media,
the focus is usually on who has it and who doesn't.
In early October, for example, the Census Bureau
reported that for the first time in 12 years, the num-
ber of people in the United States with health insur-
ance coverage increased, although 42.6 million
people-about one in six Americans-still had no
coverage at all. But health insurance is much more
complex than a debate on the have's and have not's.
The majority of people who responded to the
Tinnitu..<; Tbday readership survey - 94.5 percent-
have some kind of health insurance. Only 44.4 per-
cent, however, have had tinnitus services covered by
their insurance companies-an unfortunate number
considering the costs associated with diagnosing and
treating tinnitus. Apparently, payment for tinnitus-
related care is not a priority for most health plans.
But for most tinnitus patients, attempting to secure
payment for healthcare is a frustrating necessity.
Hopefully, this can be made easier by understanding
why insurance companies make certain coverage
decisions, and how you can appeal those decisions
for healthcare reimbursement.
Private health insurance in America is relatively
new, a byproduct of the competitive post-World
War II labor market. Employers attracted skilled
workers by offering what we today call traditional
indemnity plans or fee-for-service plans. Only
later did managed care plans-which include
Preferred Provider Organizations (PPOs) and Health
Maintenance Organizations (HMOs), just to name a
few-enter the market. Tbday, managed care plans
cover nearly three-quarters of Americans with health
insurance.
Unlike Medicare, which is administered national-
ly, individual and group health plans are regulated
on a state-by-state basis. Mohit Gose, from the
American Association of Health Plans, explains,
"Health plans have to be licensed in every state
through an insurance commissioner. The states
determine who can be in business and what compa-
nies must cover." And each state has different regula-
tions-like coverage for mammograms or emergency
services. Hearing related services, however, are
rarely mandatory, so every insurance company with-
in each state is free to make its own decisions on
how much or how little to cover.
Far too often, patients who try to receive cover-
age from their health insurance companies find that
their tinnitus treatments are considered "experimen-
tal" or, worse, "not medically necessary," an ambigu-
8 Tinmtus Thday/ December 2000 American Tinnitus Association
ous term that, according to Susan Scheperle of the
National Association of Insurance Commissioners,
many organizations and companies "have not been
able to define." And even those companies that
attempt a more concrete definition still leave much
to guess. For example, Cigna HealthCare offers these
criteria for medical necessity: "the services are essen-
tial, approptiate for your condition, meet general
medical standards, and are provided at the correct
level, time, and setting"-but does not specify how
essential m appropriate are measured.
How do healthcare companies decide what to
cover? Insurance companies solicit professional opin-
ions from doctors, evaluate clinical research, and pay
close attention to what other insurance companies
offer. Offering services that the competition does not
can distinguish a carrier in the competitive managed
care market. Companies also carefully balance the
costs and benefits of service coverage-i.e., if the
company does not cover a particular health service.
could it result in future health problems that might
cost more?
Obviously, coverage is an inexact science. Max
Ranis, M.D., an otolaryngologist from Pennsylvania
and longtime proponent of insurance coverage for
ti1mitus services, describes the complexity of the
issue. He laments, "Most insurance companies don't
Common CPT Codes
According to the American Speech-
Language Hearing Association (ASHA), there
are no specific CPT codes for tinnitus assess-
ment. These are common examples of CPT
codes for audiological services, and your
provider may have ideas for adding more
descriptive suffixes to identify
tinnitus services.
92506: Counseling and evaluation
92557: Comprehensive audiological
evaluation
92567: 'IYmpanogram
92568: Acoustic reflexes
92587/ 92588: Otoacoustic emissions test
(limited/ comprehensive)
92590: Hearing aid evaluation
92599: Pitch and loudness match
92599: Speech and pure pone tolerance
99358: Pro1onged evaluation and
management service
Taking Small Steps
even pay for hearing aids or maskers. The bterature
is replete with evidentiary material, but [health
plans] consider them cosmetic." And even when
health plans consider covering tin nitus-related ser-
vices, the chronic nature of tinnitus- and the lack of
a universal cure-can be seen as problemat ic. Dr.
Ronis explains, "The heal th plans ask, 'Do these peo-
ple still have tinnitus when you finish?' The answer
is yes, but less."
When insurance companies fail to cover tinnitus
services, most patients are forced to cover the costs
themselves. In 1997, Americans spent $187.6 billion
out-of-pocket for healthcare services-roughly 5.3
percent more than they spent i n the late 1980s. A
1995 study states that despite managed care's con-
trolled costs, "Consumers may actually pay more due
to higher premiums, co-payments, and deductibles,
or full payment for services not covered." Plus, some
providers do not even try to bill insurance companies
and require payment up front for services received,
leaving the paperwork to you.
All of this adds up to a frustrating and potentially
expensive process. And because of different state
rules, insurance company reasoning, and a lack of
clinical studies on treatments like tinnitus retraining
therapy, there is no sure-fire method for securing
payment. But that does not mean you shouldn't try.
Gather your receipts, patient reports, and the
Current Procedure Thrminology (CPT) codes that
your provider uses for treatment to submit to your
insurance companies. CPT codes are common codes
used by doctors, hospitals, and insurance companies
to identify audiological services. Also, read your ben-
efits handbook carefully, noting which ser vkes are
covered and which are not. If your primary care
physician decides whether or not you can see a spe-
cialist, make sure he or she understands the benefits
of the treatment you seek, and provide research doc-
umentation if necessary.
Doi ng so does not guarantee your healthcare ser-
vices will be covered. But in the process of trying,
you have the opportunity to educate your health
insurance company and doctor on potentially useful
treatments for ti nnitus. Plus, the old adage about the
squeaky wheel is t rue: sheer numbers of tinnitus
patients making strong, informed arguments is
bound to impress even the most cost-conscious com-
pany. Finally, as treatments are studied in con-
trolled, clinical settings, the "experimental" tag will
be replaced with proven results that in time will
erase any doubts that such treatments are medically
necessary for improving the quality of tinnitus
patients' lives. a
Tips for Appealing
an Insurance Claim
If your insurance company denies your tinnitus-
related medical services claims, here are suggestions
to help you appeal the decision:
+ Managed care organizations are required to
publish procedures for filing an appeal Check
your member benefits handbook, the plan Web
site, or call the health plan administrator. Follow
the rules and timelines outlined in the appeal
requirements.
+ Find out why your claim was denied. The reason
will help determine the thrust of your letter. Was
it because the services were experimental, not
medically necessary, or simply not covered
under the member benefits?
+ 1alk to your primary care physician. Does
he/ she understand the effects of and treatments
for tinnitus? Is he/ she willing to write a letter in
support of your treatment choice?
+ 1b whom should your letter be sent? Check your
handbook to find the correct address and
recipient or department, and send the letter
certified mail with return receipt to guarantee
delivery.
+ For your appeal, the Center for Health Care
Rights (CHRC) suggests including clinical
information, doctors' opinions, and studies
published in medical journals. "Be sure to show
how the treatment you want is the best choice,"
they advise. "The opinions of doctors who
specialize in trealing your condition will be given
more weight than those of non-specialists.
Opinions of doctors who specialize in treating
similar conditions are relevant also."
+ Discuss the potential costs of not treating your
tinnitus. For example, many people with tinnitus
report increased stress or sleeplessness, which
can affect other body functions as well as quality
of life.
+ Be direct. Stat e specifically what you would like
your health plan to cover. Also, include a brief
synopsis of what steps you have taken to treat
your t innitus, when you first experienced
tinnit us, and other pertinent health history.
+ CHCR suggests a brief statement about "why you
believe the treatment you seek is medically
necessary or, if it applies, is not an experimental
treatment."
+ Attach any relevant correspondence between you
and your insurance company or doctor.
+ Finally, if you encounter problems with your
insurance company's appeals process, contact
your stat e's insurance department. For a listing
of stat e insurance regulatory agencies, visit
www.hiaa. org/ cons/ sta te_insurance.htrnl.
Ameiican Tinnitus Association Timntus Thday/ December 2000 9
Tinnitus Today Readership
by Barbara Tabachnick Sanders, ATA Director of Education
We want to heartily thank the 1,518 people who
the Tinnitus Tbday readership survey, which
was mcluded in the June 2000 issue. The 1,518
surveys returned represent an 8.4% response rate.
(A total of 18,024 surveys were sent.) You have given
us a terrific heads-up on what you want from ATA
from Tinnitus Tbday, from your doctors, and for '
yourselves. Here is a synopsis of your comments.
(Note: A survey was accepted as valid if at least
76% of its questions were answered. Therefore, the
total for each answer might not add up to 100% .)
Demographics
. !he of survey respondents (96%) are
unmtus patwnts, 4% are family members or friends,
and 3% are health professionals. That totals 103%.
Some who responded to the survey also
have_ tmmtus. Seventy-two percent report having
heanng loss, and 39.5% say they have hyperacusis.
Length of ATA membership
Over 7 years: 26%
6-7 years: 10%
2-5 years: 45%
0-1 years: 16%
not a member: less than 1%
Age Gender
Under 25 years
less than 1%
70t years
28%
40-55 years
25%
Level of education completed
Postgraduate
(5+ years)
33%
Vocational or
technical school
5%
Grade school
1%
High school
14%
Female Mole
32% 59%
Current employment status
Disabled
4%
Part-time
9%
Full-time
32%
Not employed outside
of the
3%
Unemployed
2%
Retired
46%
10 Tinnitus 7btlay/ December 2000 American Tinnitus Association
Causes of tinnitus
Nearly 50% of survey respondents identify noise
- from work, recreation, or military activities - as
the cause of their tinni tus. Although 39% indicate
have served in the armed services, only 17%
mdicate that their tinnitus was caused by military
service. Other tinnitus causes identified are: medica-
tion (14%), illness (12%), head trauma (7%), air bag
(less tJ:tan 1% ), and others ( 19%) including TMJ,
acoustic neuroma, barotrauma, surgery, heredity,
stress, menopause, ear cleaning, neck injury, radia-
tion, marijuana, allergies, and flying with a cold.
Thirty percent state that they do not know the cause.
How you rank the importance of AlA's services
This chart shows the combined number of
responses of very important and extremely important.
Bibliographic Service 30%
Self Help Groups 44%
Publication Soles 44%
Regional Metting SO%
Conservation/Prevention 54%
Medkol Referrals 66%
tnformotion end Referrol70%
Workshops for Professionols 71%
Public Aworness 71 %
Tinnitus Today 83%
Research 94%
Research
0 300 600 900 t200 1500
As seen in the previous chart, 94% of survey
respondents overwhelmingly rank research as ATA's
most important service. They identify treatments for
relief (87%) as the research area of most interest,
followed by pharmacology (65%), how the brain
works (56%), and alternative approaches (55%).
Other survey responses echo this preference.
Responders choose research as the most important
topic addressed in Tinnitus 7bday. Also, 26% want
information about volunteering for research studies.
Tinnitus Today
Respondents rank Tinnitus 7bda.y as ATA's second
most important service, with 33% asking for more
frequent issues. For 94% of respondents, Tinnitus
Tbday is their primary source of tinnitus information.
What you usually or always read in Tinnitus Today
Ninety percent of respondents usually or always
read Dr. Vernon's Q&A column, confirming what we
had suspected. Respondents also read research
updates (87% ), Letters to the Editor (86% ), From the
Editor (65%), From rhe Executive Director (59%),
advocacy articles (56%), support network updates
(53%), advertisements (36% ), and the tributes list
(29%).
Survey Results
Topics you want to see addressed in Tinnitus Today
Tinnitus 7bday readers rate new research, medica-
tions for tinnitus, and alternative therapies at the top
of topics of interest. In answering this question, most
survey responders selected more than one topic.
New research: 8696
Medications for tinnitus: 81 96
Alternative therapies: 69%
Coping strategies: 5296
Medical insurance: 3596
Hearing aids 'Hearing loss: 33%
Social Security/ Veterans benefits: 3196
Hyperacusis: 26%
Volunteering for research studies: 26%
Meniere's disease: 20%
TM.J: 18%
Legal issues: 17%
Hypnosis: 17%
Acoustic. neuroma: 12%
Other: 796
- TRT, cures, nutrition, pulsatile tinnitus,
cognitive therapy, prevention, hair cell
regeneration, gene therapy, sleep, surgical
treatment, masking devices, chemical toxicity,
quiet appliances, analysis of products
advertised in Tinnitus 7bday, and jokes.
Most, but not all, Tinnih1s 7bday readers welcome
advertisements in the journal. We continue the prac-
tice for a few important reasons: Ads have been very
useful to some patients, doctors, and audiologistS
through the years. Ads also generate income for ATA.
Although we do not endorse the products that are
advertised as a matter of policy, we do only accept
ads from advertisers who offer a full money-back
guarantee on their products.
More than half of respondents (54%) would like
ads for relaxati011 and self-hypnosis tapes and CDs.
Book ads were selected by 42%, educational tape/CD
ads by 39%, and sound device ads by 29%. Others
suggest ads for earplugs, hearing aids, noise cancella-
tion devices, and natural therapies.
ATA Membership Benefits
\s additional benefits of ATA membership,
responders would like to receive monthly newsletters
(43%), how-to advocacy guides (35%), more frequent
publications of Tinnitus 7bday (33% ), and membership
cards (33%). 111ey also suggest more support groups,
chapters, 24-hour hotline, political action, information
to give to doctors, a chat room, more research, a more
technical version of Tinmtlls 7bday, and a less techni-
cal version of Tinnitus 7bday Some want no additional
sen'ices preferring that resources go to more research.
We are pleased to report that a total of 9696 of
respondents are satisfied to extremely satisfied with
their AT/\ membership. Of those who have personally
contacted ATA for information, 94% rate the customer
senricc they received as good to excellent.
Internet
Sixty-six percent of respondents have Internet
access, but only 36% say they use it to find informa-
tion about tinnitus. Interestingly, only 32% have
visited our Web site ('www.ata.org.). Almost half of
the survey respondents ( 47%) want us to sponsor
an Internet message board. (We're considering it.)
The question about receiving Tmmtus 7bday over
the Internet rather than through the mail drew quite
an emotional response from the vast majority (89%)
opposed to the idea of an e-Tinmtus 7bday." The
"no's" were underlined and rewritten in capital let-
ters with exclamation points al the end. We got the
message! Tinnitus 7bday will continue to be printed
and mailed to all members (which was always our
intent). We will also post current issues of Tinnitus
7bday on our site's "member's only" section, due to
open in February.
Insurance
A total of 1,434 survey respondents (94%) have
health insurance. Of those, 637 report that some tin-
nitus-rrlated services are covered by their insurance
policies. These covered services include: hearing
tests (622), hearing aids (119), masking devices (47),
and TRT therapy (39). Other services (107) are cov-
ered too: surgery (for acoustic neuroma, cochlear
implants, etc.), MRis, CAT scans, drugs, office exams,
electrical stimulation, counseling, acupuncture,
biofeedback, and ear cleaning.
Advocacy & Support
If support groups were available in their areas,
an encouraging 37% of respondents say they would
att<nd. If local training were offered to become a tin-
nitus support group leader, 33% say they would seek
training.
Seventy-seven percent of respondents feel that
tinnitus public forums are important to extremely
important. In addition, 23% would travel to a nation-
al tinnitus conference 200 miles awav or funher.
1\velve percent of respondents h ~ v e already
contacted an elected official about tinnitus or noise
abatement issues. Many more (73%), however, say
that they want ATA to take a role in influencing
federal budget allocations for tinnitus research.
Strategic planning efforts are just beginning that
wil l decide ATA's activities for the next three years.
111ese survey responses are now part of the dialogue
that will help determine ATA's future. Thank you for
speaking out. m
We want to thank Susan Gnest, M PH , from the Oregon
llcan11g Research Center, for her help with the compila-
tron of this survey.
American Tinnitus Association Tinmtus Tbdc1y. December 2000 11
Medical Intervention for Tinnitus
by Betty G. Weiss, M. 5.
Max Ronis, M.D., Professor Emeritus at
Temple University Hospital in Philadelphia,
Pennsylvania, is a renowned researcher and
lecturer on medical intervention for tinnitus. He
believes that since tinnitus is a symptom and not
a disease, a very careful examination of the
patient should start with an in-depth history. In
his own words, "Evaluate the patient from A to Z."
Tinnitus is defined in terms of its location (in
one ear, in both ears, in the head), its characteris-
tics (continuous, intermittent, pulsatile, clicking),
and its impact on a person's l ife (tolerable or
intolerable). In order to determine any contribut-
ing factors and an appropriate treatment, the
patient should be examined in order to rule out all
active disease processes or conditions that can be
managed by medical intervention.
Dr. Ronis also suggests exploring other areas
that are associated with tinnitus, such as:
+ Diet: Eliminate use of caffeine, salt, cider
vinegar, soft drinks, and alcohol.
+ Household products: Eliminate use of per-
fumes, antiseptics, cleaning chemicals, and
suntan lotions.
+ Prescription medications: Reduce or elimi-
nate use of drugs that list tinnitus as a side
effect or have a toxic effect on the ear.
+ Over-the-cou nter drugs: Reduce or elimi-
nate use of aspirin or aspirin-type products
(Empirin, Ecotrin, Bufferin, ibuprophen,
Anacin, Midol, Pepto Bismol, and Aleve) and
some antihistamines.
+ Social activities: Have weight lifting, scuba
diving, and hunting caused or worsened your
tinnitus? Is there a history of related condi-
tions, like stress, vigorous strain, head or baro-
metric trauma, decompression, emotional
problems, pain, or blackouts? Do you have a
family history of hearing loss and/ or tinnitus?
The otolaryngologic examination may reveal
medical and non-medical conditions that con-
tribute to tinnitus. In the external and middle
ears, there may be interference in the mechanical
conduction of sound. These include obstructive
cerumen (earwax), foreign bodies or excessive
hair in the ear canal, inflammation and/or infec-
tion, abnormal air pressure from a blocked
eustachian tube, growths, perforations, or a
change in the mobility of the eardrum and/ or
ossicular chain (middle ear bones). Medical
and/ or surgical management may reduce the
frequency or intensity of tinnitus or cause it to
disappear completely.
12 Tinnirus '10day/ December 2000 American Tinnitus Association
Contractions of the muscles (the tensor
tympani and the stapedius) in the middle ear in
response to loud sound have been shown to result
in spasms. The muscles of the palate can also
spasm, which could produce tinnitus similar to the
sounds of swallowing. The treatment options
include cutting the tendons of the muscles or
injecting medicines into the palate.
Thmporal mandibular joint dysfunction
(referred to as TMJ or TMJD) exacerbated by jaw
movements often mimics an ear problem since it
is characterized by pain in the ear, a sensation of
fullness, and clicking noises. Relief may be
obtained through the use of dental appliances.
The otic capsule that houses the inner ear has
a single blood supply with separate branches going
to the auditory (hearing) and vestibular (balance)
systems. Many individuals with vascular condi-
tions have reported tinnitus that beats in rhythm
with their pulse. This type of tinnitus (pulsatile) is
often difficult to treat since it can occur when
there are changes in blood flow to the heart
and/ or to the neck, a glomus j ugularis (blood)
tumor in the middle ear, inflammation or constric-
tion of blood vessels, increased blood viscosity, or
diseases of the red cells or the white cells.
The audiologic evaluation provides important
information that enables the ENT physician to
make diagnoses about the function of the inner
ear and the auditory pathways. Permanent hearing
loss and damage to the neural structures involved
in the transmission of sound waves may occur
simultaneously with tinnitus and with other symp-
toms such as fullness in the ears, dizziness, loss of
balance, and headaches.
According to Dr. Ronis, treatment of tinnitus
has four components:
1. Resolve medical/surgical issues
2. Implement acoustic therapies
3. Counseling and educat ion
4. Pharmacological management
Focusing on the last component, tinnitus is
treated with many pharmacological products.
Anti-anxiety medications, anticonvulsants, and
tricyclic antidepressants are groups of drugs used
to treat various conditions including depression,
anxiety, seizure, panic, pain, muscle spasms, dizzi-
ness, and tinnitus. 'Trade names include Ativan,
Klonopin, Tranxene, Thgretol, Librium, Xanax,
Wellbutrin, Paxil, Triavil, Elavil, Zoloft, Atarax,
Sinequin, and Valium. Varying degrees of success
have been reported with these drugs for tinnitus.
Caution should be exercised. Some of these drugs
can be habit-forming or addictive.
(continued)
NEW ATA MEMBER BENEFITS
by Jessica Allen, ATA Director of
Resource Development
ATA Members receive lapel
pins!
Renewing members will
receive a very special ATA
lapel pin with their renewals
starting January 1, 2001.
Please proudly display your ATA pin on your
jacket, dress, coat, or hat to bring more aware-
ness to your friends and neighbors about tinnitus
and about our search for new methods of treat-
ment and relief. We hope that when you wear the
pin, it will remind you that you are not alone and
that ATA is working for you to find a cure.
More good news for ATA members
ATA will be launching its revised Web site in
December. Along with a new look, the site will
also contain some new features. One of them -
which will open in February- is a "members
only" section. This section will contain special
updates and information only available to ATA
members. To gain access to that section of our
site, each member will be given a personal num-
ber to enter. Your special number will be listed
on your new ATA membership card. The cards
will be mailed to all current members beginning
January l, 2001. The membership card will also
contain ATA's phone numbers, fax number, and
Internet address. You will now have your ATA
contact numbers and Web site passcode on one
convenient card. We are very excited to make this
benefit available to all our valued members. B
On Board!
Introducing Board Member
Susan Seidel
ATA Board Member and
Board Secretary Susan Seidel,
M.A., CCC-A, was an audiolo-
gist for 41 years and a tinni-
tus self-help group leader in
Baltimore for 15 years. She
retired from audiology and
her support group last year
but definitely not from help-
ing ATA. Seidel shares her
vision for this organization:
"I hope to be able to share whatever expertise
I have to further ATA's self-help program. I'd also
like to see ATA become the organization that all
audiologists and ENTh reach out to for their con-
tinuing education. And we're doing it. A few uni-
versities now require course work in tinnitus
management for their doctoral programs in audi-
ology. This is a first. I think it happened because
of the research dollars that we've made available
and because we're becoming more visible. I
believe that the more we get Tinnitus 'Ibday and
our phone number out there, the closer we get to
becoming the resource for tinnitus. Our next step
is to push the medical field to require tinnitus
education in the ENT curriculum. We can do that
too!" 0
Medical Intervention for Tinnitus (continued)
Medical intervention in the treatment of tin-
nitus has gone beyond the realm of traditional
treatments. Other treatments include ultrasonic
current applied to the mastoid bone, electrical
stimulation of the eardrum, acupuncture, hypno-
sis, and the placement of magnets near the ear.
These treatments are not proven effective scien-
tifically, but some patients report that they help.
Some people are finding relief from tinnitus
through the use of herbs such as Ginkgo biloba
and kava kava, hormones like melatonin, and
with megadoses of vitamins and minerals. Dr.
Ronis cautions that these products may vary in
their stability since they are not subject to FDA
control, that there are questions about the appro-
priate doses, and that some of them do not differ
in effectiveness from placebos. Ronis advises
patients to weigh the "gain versus risk factors" in
determining which options to use in the treat-
ment of tinnitus. He further suggests that a
patient has a better chance of achieving maxi-
mum benefit from a treatment if there is a
healthy and respectful interaction between the
patient and his or her health care provider. B
Ms. Weiss is an audiologist with Ear, Nose, and
Throat Consultants, P.C., in Philadelphia,
Pennsylvania.
Dr. Ranis's lecture is featured on ATA's Mid-Atlantic
Tinnitus Conference video, Part I. See order fonn
on inside back cover.
American Tinnitus Association Tinnitus Tbday/ December 2000 13
Tinnitus Spouse Survival
by Terri Nagler, R.N.
Day 1:
"You know, my ears are ringing."
"Really? Botl1 of iliem?"
"Yeah."
"Hmm. Maybe it was the red wine. It always
makes me feel stuffy."
Day2:
"I still have that buzzing in my head today."
"Hmm, maybe it was the curry .... or the pollen."
"Yeah, maybe. Hope it's the pollen. I'll never gjve
up Thai food!"
Day3:
"The noise is pretty loud now."
"Hmm, maybe it's the Relafen. I think tinnitus is
a possible side effect of non-steroidals."
"Yeah, 1 think I'll stop it.
Four months and thousands of miles, dollars,
and prayers later, my husband, Stephen, and I
started to come to grips with the fact that an
unwelcome visitor had taken up residence his
head and in our home. We elin1inated the
possible offenders: alcohol, caffeine, spices,
herbs, medications. We blamed everything from
the leafblower to rock concerts. We sought help
and advice from a score of specialists - from
internist to acupuncturist. Every physiological
and psychological cause was explored.
We had the ultimate good news/bad news
diagnosis - tinnitus. It won't kill you, but at
times you just might want to kill yourself. One
noted specialist concluded our unsuccessful visit
to his clinic with, "You've got a beautiful family
and a lot to live for. Go home and get on with
your life." Easier said than done.
Over the ensuing months, Stephen suffered a
host of psychological and physical symptoms
related to this severe intrusive tinnitus including
pwfound depression, a 30-pound weight loss,
insomnia, overwhelming nausea, bruxism (teeth
grinding), fearfulness, increasing inability to
function at work, and an uncertainty that fueled
his sense of despair about himself and his future.
As spouses, we must appreciate the real phys-
ical and psychologjcal toll that tinnitus takes on
those who have it. Tinnitus is invisible - no cast,
14 Tinnitus 7bday/ December 2000 American Tinnitus Association
no limp, no cough, no definitive way to measure
its presence or severity. This left my husband
with the added burden of continually explaining
his head noise, defending his sanity, and justify-
ing his misery.
As a nurse, I understood the impact that tin-
nitus was having on Stephen. It is much the same
with any life-altering illness or injury. However, I
found myselfbecoming impatient, weary, and
annoyed with the incessant questions, our redun-
dant conversation, and his constant need for reas-
surance. At one point I actually thought, "How
bad can this really be?" I decided to find out.
I placed a portable radio in a purse with a
shoulder strap. It was "tuned" to white noise -
the static between FM radio stations - at the
level of loudness that roughly matched his
tinnitus. Then I carried it around with me as I
performed several routine household functions.
Within iliirty minutes I noticed that I was clench-
ing my teeth and feeling irritable. After an hour,
I turned the !%?$# thing off and tended to my
full-blown headache.
It's easy to become a bit blase about their
suffering when they look so normal. But imagjne
what it would be like if you had to endure a
screaming vacuum, siren, or kettle following you
from room to room. Could you think creatively,
make critical decisions, do anyiliing substantive
in an atmosphere of unabated noise? How would
the loss of silence and its uncertain return affect
your day, your work, your relationships, and
your life? The importance of supportive human
contact cannot be overemphasized.
Meeting his or her psychological needs may
be the greatest challenge for the spouse. I person-
ally focused on three areas that I felt complicated
my husband's recovery and affected our family
life.
First, 1 redirected what I viewed to be faulty
or distorted thinking. Cries of "I can't get out of
bed! My ears ring all the time! I'm useless, I can't
do anyiliing!" were met with reality-charged
responses like, "I'm changing the sheets, NOW!
You seemed to enjoy watching the Braves last
night. You can feed the cat and drive carpool."
When I heard, "I don't think that I'll ever get bet-
ter!" I pointed out what he did accomplish while
reminding him that there was no finite time line
for recovery and that we would continue to work
towards resol ution.
(continued)
WHEN THE BRAIN HAS RE-WIRED ITSELF
by Aage R. Meller, Ph.D.
The brain is "plastic" (change-
able) and the connections
between the different parts of
the brain can change. This is
known as neural plasticity -
which means that the brain is
not "hard wired" like electrical
equipment. Pain, muscle
spasm, and tinnitus can be the
results of changes in the wjring of the brain.
Tinnitus can cause great distress for those
who have it as well as for those who treat it. One
problem is that conventional tests usually do not
show any sign of disease, and the only informa-
tion that the physician has is the patient's
description of his or her trouble. The lack of tests
that can help to diagnose the problem and find
out where the problem is located naturally makes
treatment difficult. Tinnitus is intuitively associ-
ated wjth the ear and it is therefore often
assumed that it is caused by something going
wrong with the ear. While it is true that some
forms of tinnitus indeed are caused by disorders
of the ear, many forms of tiimitus, particularly
the more severe fonns, are caused by changes in
the nervous system. It is the nervous system that
makes it possible to hear the sounds that reach
our ears.
It has been known for many years that chil-
dren's brains change as they grow. We now know
that the function of the adult brain can also
change, and that connections between different
parts of the brain can open and close and parts of
the brain can become more sensitive or more
(continued)
Tinnitus Spouse Survival (continued)
Second, I sought to combat his inertia by
encouraging simple, purposeful tasks that could
be achieved within the framework ofhis short-
ened attention span. These included short-term
community projects as well as household chores.
Several times each week I insisted that he join
me for a simple outing - a trip to the park or the
bookstore - to break his routine and demon-
strate that he could "do something."
Third, I found it necessary to set some limits
with regard to the discussion of tinnitus. While he
was consumed with every facet of it, I still need-
ed to attend to many other aspects of our daily
life and it was not always convenient to stop mid-
stream to chat or listen - again. Devoting a spe-
cific time to talk about tinnitus allowed me to
listen without distraction, and it let him know
that he had my undivided attention to express
the anger, fear, and isolation that he felt.
Over time, I compiled a list of "Tinnitus
Spouse Survival Tips" that are based on my not-
so-scientific research with a patient population of
one. They are, however, the result of my objec-
tive observations as a nurse and my subjective
experience as a wife. I hope that the reader might
find value in them as well.
+ Learn as much about tinnitus as possible.
+ Thke notes and ask questions. Become your
spouse's medical liaison and advocate.
+ Don't underestimate the value of good psychi-
atric or psychological intervention for your
spouse and for you.
+ Challenge distorted thoughts. Accentuate what
is positive, and acknowledge but redirect nega-
tive thinking.
+ Get your spouse moving. Exercise, outings, and
chores will build a resume of success that you
can use to fight feelings of worthlessness.
+ Decrease as much extraneous stress in your
lives as possible. (This may not be the year to
make quilts for everyone on your Christmas
list.)
+ Be compassionate and commiserate on occa-
sion, but be tough when there is too much
whining.
+ Be patient. Successful treatment is probable
but this is not strep throat! No 10-day course of
Amoxil here.
+ Maintain your social contacts and outside
interests. Without any personal outlet you will
become less effective in your supportive role.
+ Keep yourself physically and emotionally fit.
Your spouse and your family need you and you
deserve it! R
American Tinnitus Association Tinnitm 7bday/ December 2000 15
WHEN THE BRAIN HAS RE-WIRED ITSELF (continued}
active. This is mainly caused by changes in the
ability of nerve cells to transfer information from
one part of the brain to another. Recently, we've
learned that the mature brain can grow new
nerve cells - something that was regarded as
impossible just a few years ago. This new insight
has thus revealed that the mature brain is "plas-
tic" and can change the way it functions in ways
that are similar to learning. This discovery has
changed our view on tinnitus as well as on pain
and some forms of muscle spasm.
Normally the ear is connected to parts of the
brain that can distinguish different sounds such
as speech. After that, the information is sent to
olher parls of the brain Lhal are involved in
understanding the meaning of speech. Music
sounds are interpreted by parts of the brain that
are involved in enjoyment of sounds. The differ-
ent parts of the brain must be connected to the
ear in the right way in order for our hearing to
function normally.
Many people with tinnitus hear sounds as
unusually loud or unpleasant or that evoke fear.
It is possible that the information is being sent to
the wrong part of the brain because the wiring of
the brain has changed. One known factor that
can cause these changes is a lack of input from
the ear, like in silence or when hearing has been
damaged.
We normally use only one of the two routes
that connect the ear with the parts of the brain
that perceive sound. The route we use is called
the classical ascending auditory pathway and it
leads from the ear to the auditory part of the
cerebral cortex where some interpretation of
sounds is done. From the cerebral cortex, the
information about sounds is sent to brain centers
that can extract the meaning of sounds. As the
information about sounds travels along this
"information highway" it is analyzed in the differ-
ent clusters of nerve cells (called nuclei) that are
located along this pathway.
Tinnitus may be caused by some nerve cells
in these nuclei being too sensitive so that they
act on their own instead of waiting for sounds to
arrive. That could explain some forms of tinnitus.
When sounds appear to be stronger than normal
(hyperacusis), it may be a result of nerve cells
being too active. When sounds are unpleasant or
cause fear, it is possible that information is reach-
ing parts of the brain that are not normally
involved with sound.
16 Tinnitus Thday/December 2000 American Tinnitus Association
Tinnitus could reach other parts of the brain
by way of the other route - the non-classical
ascending auditory pathway. Although little is
known about this part of the brain, we do know
that it processes sounds differently and it con-
nects to completely different parts of the brain
than does the classical pathway.
This non-classical pathway connects the ear
to parts of the brain that deals with emotions.
While the classical pathway only deals with
sound, input from other senses mixes with sound
in the non-classical pathway. Nerve cells in that
part of the brain not only respond to sound but
also to touch of the skin, which may affect the
way lhese nerve cells conduct information about
sound. We have earlier shown that electrical
stimulation of a nerve in the wrist can change
the way tinnitus sounds and that was taken as a
sign that the non-classical auditory nervous sys-
tem is involved in some forms of tinnitus. It may
be that the opening of this non-classical pathway
causes sounds to become unpleasant and some-
times evoke fear. Dr. Richard Salvi's research
group in Buffalo, New York, has recently shown
evidence that this area in the brain, generally
known as the limbic system, is activated by some
forms of tinnitus.
The involvement of the non-classical pathway
in tinnitus also explains why some people with
tinnitus can change their tinnitus by touching
their skin or by making muscle contractions or
changing their gaze, as has been shown by A.T.
Cacace, Ph.D., and co-workers.
It should be possible to reverse the changes in
the brain since they are not caused by damage to
tissue. But as yet, we do not know exactly how to
do that. We do know that silence and strong
sounds can cause changes in the connections in
the brain. This fact should make us avoid these
conditions as much as possible. People with tinni-
tus should avoid silence, too, even if sound is
unpleasant.
This new understanding of how the auditory
nervous system works and how connections
between different parts of the brain can change
has helped us understand tinnitus better. Such
progress naturally improves our possibilities to
treat and prevent tinnitus. 1m
Dr. M ~ l l e r is a researcher at the University of Texas
at Dallas, Callier Center for Communication
Disorders.
Annual Report of the American Tinnitus Association
July 1, 1999 - June 30, 2000 + Fiscal Year Highlights
ATA Strengthens Financial Position
Reorganization, support from large foundations,
bequests, and generous member contributions create
strong financial base.
New Executive Director for ATA
Cheryl McGinnis, M.B.A., is named ATA's new Executive
Director replacing Steve Laubacher, who served as ATA's
executive director for one year. McGinnis has a master's
degree in business administration and a bachelor's
degree in audiology and speech pathology, plus a back-
ground in primary healthcare planning.
New Boord Chairman & Boord Members
+ Stephen M. Nagler, M.D., is elected Chairman of the
Board.
+ Paul Meade retires as Board Chairman after 2 years of
service in that role. Meade continues as an active
Board member.
+ ATA welcomes new Board members Joel
Dhyan Cassie, John Nichols, and Kathy Peck.
+ RichardS. 'JYler, Ph.D., is elected Chairman of the
Scientific Advisory Committee.
+ The Scientific Advisory Committee adds new mem-
bers: Mary Meikle, Ph.D.; Michael Seidman, M.D.;
Douglas Mattox, M.D.; and Mansfield Smith, M.D.
ATA's Programs Update
Education
+ 10,000 educational brochures and Tinnitus Tbday's are
distributed to health professionals and patients at nation-
a] conferences for the American Academy of Audiology,
Association for Research in Otolaryngology, AARP, and
the Mid-Atlantic Regional Tinnitus Conference.
+ Quarterly issues of Tinnrtus Tbday are published featur-
ing articles on alternative treatments, a worldwide look
at tinnitus, TRT vs. masking, sudden pressure changes
and tinnitus, musicians and tinnitus, advances in
research, hormones and tinnitus, and the Tinnitus Today
readership survey.
+ ATA develops new introductory patient materials.
+ "Hear for a Lifetime" elementary school titmitus preven-
tion program is distributed to 40 school districts in
the U.S.
Advocacy and Information & Resources
+ ATA's Advocacy department is formed to address govern-
mental funding for tinnitus research and hearing conser-
vation issues.
+ Advocacy department assumes responsibility for public
forums. 1\IJI.:s public forums in New Orleans and Chicago
draw 300 attendees; the Mid-Atlantic Regional Tinnitus
Conference in New Jersey draws 400 patients and
healthcare professionals.
+ Tinnitus Thday features articles on noise in the movies
and quiet (and not-so-quiet) appliances.
+ ATA responds to over 12,000 initial requests for
tinnitus information.
Research
+ Three new research projects are funded for the study of
magnetic resonance imaging (MRT) of tinnitus, cognitive
behavioral therapy as a tinnitus treatment, and the effec-
tiveness of tinnitus retraining therapy (TRT). Three addi-
tional ATA research projects continue investigations of
tinnitus habituation, mechanisms of tinnitus in the
brain, and the role of GABA and other neurotransmitters
in generating tinnitus.
+ Scientific Advisory Committee convenes to identify
research projects of excellence and advise tJ1e Board of
Directors on scientific matters.
Statement of Finondol Position
Cash
Receivables
Inventory
Investments
Prepaids
Fixed Assets
Thtal Assets
Payables
Accruals
Deferred Income
Thtal Liabilities
Unrestricted
Net Assets
'Temporarily Restricted
Net Assets
1bta1 Net Assets
Thtal Liabilities and Net Assets
Expenses
Support
22%
Research
33%
Unexpended
Revenue
$281,695
19%
Management
and General
Administration
$63,334
4%
Revenue
Program Expenditures
$ 844,318
6,361
8,975
377,322
13,677
45,752
$1,296,405
$ 25,249
2,497
5,750
$ 33 496
$ 622,916
639,993
$1,262,909
$1,296,405
Educotion
39%
Advocacy
6%
Advertising
$20,792
1%
Soles
532,822
2%

51,194,466
81%
Copies of audited financial statements cmd independent
auditor's report are available on request.
Support
+ Year 1999-2000 adds new ATA tinnitus support groups
for a total of 50, and adds new !ITA telephone, email,
and letter support contacts in the U.S. for a total of 133.
+ The ATA's Professional Provider Network inc1udes the
names, addresses, phone numbers, areas of specialty,
and tinnitus-related services provided by interested
health care givers. The network now includes 408
health providers.
American Tinnitus Association Tinnitus 7bday/December 2000 17
ATA's Telephone, Letter, and
E-mail Help Network
ATA's Help Network consists of compassion-
ate individuals who volunteer their time, experi-
ences, and guidance to tinnitus pabents. Whether
they participate by phone, letter, or email, the
Help Network volunteers are part of a vital sup-
port link that offers advice and empathy. Call or
write today for information about coping tech-
niques, local healthcare resources, or just to hear
from a helping friend who knows what you're
going through. The next issue of Tinnitus Tbday
will include the listing for the U.S., Canadian,
and international tinnitus self-help groups.
Alabama
Mitzi Cahn Larry S. Brown
Hawaii Indiana
Benjamin C. Franklin
1439 Bonita Ave. Raymond James &
Paul Yamashige Georgian.n K. Maloney
118 Nolen Ln.
Berkeley, CA 94709 Assoc., Inc.
Honolulu, HI 221 Oakridge Pl.
Alabaster, AL 35007
510-527-9075 1200 N. Federal Hwy.
808-526-1405 Decatur, l N 46733
11100
205-6649409
'Ierrance L. Stiles
B. Clark
219-728-9941
Donna L. CoDins
21297 Meteor Dr.
Boca Raton, FL 33432
Honolulu, Hl 96815
Cupertino, CA 95014
561-750-3315 Iowa
1109 Union Chapel Rd.
lbrownl@32z. rjf.com
808-923-8768
Harvey Joanning,
Union Grove, AL 35175
B. Martin Brinitzer
256-753-2222
Penn Valley, CA
Mort Gulden Idaho Ph.D.
Herbert Hilton
530-432-3507
5179G Europa Dr.
Alvin Whitehouse
Ames, lA
Geraldine A. Busch
Boynton Beach, FL
Rt. 4, Box 251
515-232-4831
3521 Countrywood Ln.
Chico, CA
33437
Old 'Ibwn, ID 83822
joanning@iastate.edu
Birmingham, AL 35243
916-343-5625
561-369-0831
208-437-2158 Ray Thylor
205-234-4 215
Colorado
Miriam G. Bloomfield
Illinois
36 3rd St. S.
Arizona 6435 Mill Pointe Circle P.O. Box 219
Paul Murphy
F. P. Pete Clements Del Ray Beach, FL 33484
Bruno Bertucci
Central City, TA 52214
PO. Box 1184
Louisville, CO 561-496-4967
Highland Park, IL
319-438-1814
Sun City, AZ 85372
303-665-7990 irvbloom@att.net
847-432-7161
Kentucky
602-407-6945
Edith V. Phlllips
Thomas J. D'Aiuto
Ma..,.; and Jean
Robert C. Fay
2221 19th St.
Thrnpa, FL
Thnnenbaum
Barbara S. McQueary,
Boulder, CO 80302 Morton Grove, IL 60053
R.N.
Dewey, AZ
813-925-0011
Radcliff, KY
Naomi M. Anderson
ispyttpd@cs.com
84 7-966-8171
rcjf@northlink.com
Colorado Springs, CO
Walter J. Czarnecki
502-351-6715
California
Lorraine F. Cramer
719-392-1054
Pen Pal Network
1303 N. 17th Ave.
Ruth R. Middleman,
Vicki Kadosh
Connecticut Coordinator
Melrose Park, IL 60160
Ed. D.
Tarzana, CA
William S. Brill
434 Lewis Blvd. SE
708-345-7642
4600 Bowling Blvd. 1t308
818-525-3416
161 Maplewood Ave.
St Petersburg, F'L 33705 Myrtha Castellvi
Louisville, KY 40207
yafal23@yahoo.com
502-458-4427
Milford, CT 06460
727-823-4240 Bolingbrook, IL
Norman Baker
203-878-1999
lenni_cramer@yahoo. 630-739-2872
Mark Goodan
403 s. Mesita Pl.
Raoul Wagman
com
Marion H. Schenk
Somerset, KY
W. Covina, CA 91791
403 Elm St.
Alex Ravetti 1 Bank One Plaza II lLI-
meg52@gate,\7ay .net
626-967-8815
New Haven, CT 06511
Cape Coral, F'L 0103 Louisiana
Gloria Stanetti
203-865-3226
941-772-8956 Chicago, IL 60570
Phyllis B. Flesher
Joshua 'free, CA
Steven J. Mann
vessinaro@aol.com 773-281-3750
9534 Royalton
760-369-8203
23 Pequot Dr.
Lester H. Lemke Michael O'Malley, O.D. Shreveport, LA 71118
Bob Lewicki
E. Norwalk, CT 06855
Cape Coral, FL 8505 S. Kedvale Ave.
EDis E. Auttonberry
Blue Jay, CA
203-866-9405
941-945-2759 Chicago, IL 60652
2520 Swiss St.
boblewicki@aol. com
Florida
Jeffrey P. Caine
773-284-2211
West Monroe, LA 71291
Jim R. Camomile 36141 US Hwy. 19 N. Gladys Jackson 318-396-4348
7853 Standish Ave.
Thna E. Spence Palm Harbor, F'L 34684 RR 2, Box 105
Maine
ruverside, CA 92509
6909 Plum Lake Ln. E. 727-785-5554 Franklin, IL 62638
909-681-9859 Jacksonville, FL 32222
Georgia
217-484-6444 Linda E. Dowell
J RCa mom ile@world-
904-779-2975
Judith Schwegman
PO. Box 1076
net.att.net Arlene M. Jewell
Shirley G. Perry
3500 W. Chautauqua Rd.
Gardiner, ME 04345
Lola C. Wilson
Keystone Heights, FL
Powder Springs, GA
Carbondale, IL 62901
207-582-9482
Thstin, CA
352-4 73-0010
770-943-0059
618-457-6637
Katharine Olga Dutton
714-731-0933 cjewell@southeast.
sperry@virginconnect.
jcsb@midwest. net P.O. Box 1027
gulf. ne
com
Warren, ME 04864
John Rhodes
COTOna, CA Ben and Shirley Cohen
James A. Morris
207-273-2197
Jbsilas@webtv. net
2871 Somerset D ~ : ltH411
Powder Springs, GA
Lauderdale Lakes, FL
707-943-3648
Wayne E. Maxon
Oxnard, CA
33311 Perry L. Carter, Jr.
805-486-6460
954-733-7960 126 Steeplechase Rd.
justwayne@earthlink.net
Savannah, GA 31405
912-238-1 700
18 Tinnitus 7bday/ December 2000 American Tinnitus Association
Maryland Missouri
Judith Dunne, MA,
Oregon Tennessee
George E. Scott, Jr. Dick Viney
CCC-A
1246 Chesapeake Dr. 19 Maple Ct IIA
55-19 Metropolitan Ave.
Betty .Mathis Joseph L. Akins
Churchton, MD 20733 Branson, MO 65616
Ridgewood. NY 11385
Milwaukie, OR 1802 Knickerbocker Ave.
301-261-5259 417-334-7685
718-381-8696
503.059-1618 Chattanooga, TN 37405
Shirley and Mort
Nevada
starrr@erols.com
Jean Lavagn.ino
423-756-4160
Rosenhaft
Ira F. Broiter
121 E. Hilliard Ln. Tcresia Guinn
Silver Spring, MD
Da,rid A. Barber 48 Hamlet Dr.
Eugene, OR 97404 345 Hwy. 79 N.
301-438-2034
Carson City, NV Hauppauge, NY I I 788
541.0898076 Humboldt, TN 38343
Barbara J. Williams
775-882-8814 516-626-1017
Richard C. Speedy
901-787-7019
2704 Summerview Wa}
New Hampshire
Samell (Sarme) Ogus
765 N. 9th St.
Texas
11202 John Washuta
East Hampton NY
Harrisburg, OR 97446
James R. Salter
Annapolis, MD 21401
631-324-6218
541-995-8608
410-224-8330
1276 Route 9
sogus@suffblk lib.ny.us Michael H. Ayers
11040 Creekmere Dr
Stoddard, NH 03464
Dallas, TX 75218
Massachusetts
603+l6-7077
George Malchow
Bend, OR
214-328-1221
Susan Rezen, Ph.D.
roadrunner@cheshirc.
26 Footbridge Rd
541-389-3937
net
P.O. Box 70
Pennsylvania
Carlton Dale Mobley
State College
Columbraville, NY 12050
3805 Hollis
486 Chandler St.
Shirley Baldasaro
518-828-3218
Yolanda Kapalo
Ft. Worth, TX 76111
Worcester. MA 01602
20 Palmer St
Hoffman
1940 Michigan Ave
81"'-831.0146
508-929-8551
Claremont, NH 037-13
63 Gansevoort Rd.
W. t-lifflin PA 15122 Sam Urso
srezcn(a worcester.edu
603-542-4889
S. Glen Falls, NY 12803
412-466-0963 1005 Laredo Ct.
Ernest B. Johnson New Mexico
518-793-24 22
Timothy F. Hreboc il<
College Station, TX
54 Pembroke St. Jack C. Fuller
Elaine 1\1. l"airbank
McKeesport, PA
77845
41 2-673-I 513
409-696-6280
Mitrlhorough, MA 01752 1\lbuquerque, NM
16 Pine Cir.
Shirma \t. Huizenga 505-294-4206
Sauquoit, NY 13456
Mark A. Rains
Irene Duffield
Franklm, MA jacfull@aol com
315-737-0522
358 Lamp Post Ln.
4923 Rollingfield Dr.
508-520-6641
New Jersey
Tberis Aldrich
Hershey, PA 17033
San Antonio, TX 78228
Linda \1. Hastie 2357 '' Main Rd.
717-533-8366
210.084-5609
Jamaica Plain. MA
Robert Zecklcman
Silver Creek, NY 14136
Wilbur E. Klotz Utah
617-524-2329
16 Riverside Dr Apt. F2
716-934-1837
S. Williamsport, PA
Aaron Remley
Mike M. Mills
Cranford, NJ 07016
Susan M. Grant
570-323-5873
65 Riverside Ave. tt30
973-425-2613
wklotz@webtv.net
Payson, UT
t-lcdford, MA 02155-4604
Jessica Moore
Niagara Falls, NY
Kathleen l\tunley
remlcys_west@yahoo.
7 Galloway 'Thrr.
716-298-507 4
com
MILLSY1919@aol.com
North Carolina
Archibald, PA
Robert L. Ehrmann,
Kinnelon, NJ 07405
717-876-2747
Virginia

Kathleen Krivak
Barry Whitesell
munleyg@microserve.
Lynn Haddon
Waban, MA
Hasbrouck Hts, "'J
4410 Brookhaven Dr.
net
5ll8 Longshadow Ct.
617-527-8426
201-288-3038
Greensboro, NC 27406 Rosemary E. Hartman
Midlothian. VA 23112
Michigan
Chris Martin
336-674-1885 111 Red Fox Pl.
804-7 44-3393
151 Wall St.
Ann N. 1bcado
Media, PA 19063 Richard R. Frampton
Dorothy Blair Eatontown, NJ 07724 9228 Fairway Ridge Rd.
610-356-6816
4248 Botetourt Rd.
Southfield Ml Warren F. Thdor, Jr.
Charlotte, NC 28277 George Kelly
Fincastle, VA 24090
248-354-3384 Jackson NJ
Susan S. Partin
1622 Winton Ave.
540-473-2325
William J. Haskin 732-928-1639
Elktn.NC
Havertown, PA 19083
rcconrre@aol.com
1408 Surrev Dr Wilma Ruskin
336-835-3438 Morris Rubinoff Washington
Westland, Ml 48186
Acoustic Neuroma
North Dakota
Wynnewood, PA
7'34-595-4927
Association
610-642-7145
Keith R. Field
Frank E. Weaver Princeton, NJ
Dorothy M. llout
moruby@ li nc.cis.upenn.
1609 NW 85th St. tt205
14810 Sama Rosa 609-683-4650
PO. Box 226
cdu
Seattle, WA 98117
Detroit, Ml 48238 wruskin33@'aol.com
Wyndmere, ND 58081
206-783-71 OS
f<w7164(.(l--aol.com John R.-ry, M.S., M.A.,
701-439-2630
Rhode Island
kficld@halcyon.com
Minnesota
f-A .<\.A
Ohio
William J. Lynch, Jr.
Richard D. Curtis
Garden State Balance & )lary Jo Lo\'e
P.O. Box 329
251 Rainier Ln.
Dolores L. Carcl.inal
Narragansett, RI 02882
Port Ludlow WA 98365
20 E. Exchange St.,
Hearing Centt:r 838 Suntree Dr.
-101-295-2-132 Stellajoe E. Staebler
83 Rt. 37 West Westerville, OH 43081
ki\302
1bms River, NJ 08755
South Carolina
PO. Box 594
St. Paul, MN 55101
61-1-846-8810 Centralia, WA 98531
li51-215-4620
732818-3610
Joyce A. Knapp
Barbara Uyeda
frank H. Se11
Robert Aurandt
llarry F. Hochman 2631 Mill race Dr.
Pelion, SC
Liberty Lake, WA
Maplewood, MN
Whitehouse Station, NJ Columbus, 01 1 43207
803-894-4764
(;12-771-9948
908-832-7641 614-497-2631
ruyeda(!;' pbtcomm.net
unstoppable.sell@big-
planet.com
llonce and Efrom
New York
Jeffery P. Bassett
Ralph D. Gentry
Wisconsin
Abramson
Sharon Wcinhaus
P.O. Box 328
135 Edgewater Dr.
711 Oak Ridge Rd. New York, N\
Wadsworth, OH 44282
Anderson. SC 29624 Jeffrey J. Selles
Hopkins, MN 55305 212-758-0791
Richard J. Compton
864-224-8578 1605 Norse Pkwy.
612-935-0757 Robert J. Luthmann
70 E. Galbraith Rd. tt3
Barbara S. Raper
Stoughton, WI 53589
Bonita \t. Kucala
Box It) Annandale
Cincinnati, OH 45216
107 Moore Ct.
608-873-8825
13657 74th Pl. N. Staten Island, NY 10312
Simpsonville, SC 29681
jsc:lles@ix. netcom.c:om
864-963-891 5
.Maple Gro,e, MN 55311 718-948-2659
612-194-3554 John RC.)CS
South Dakota
Harold L. Larson J47 42nd St
Helen J. llersrud
St Cloud, Ml:\ Brooklyn, NY 11232
Rapid City SO 57701
320-253-2160 718-768-2451
waldoh@ rapidnet.com
harrylars@hotmail.com
American Tinnitus Association Tinniws fb<Wyl December 2000 19
EXPEDITION HOPEFUL CURE
MY ADVENTURE ON MT. RAINIER
by Donna Brown
I decided to climb Mt. Rainier for a number of
reasons:
I. to raise funds for tinnitus research
2. to increase public awareness of tinnitus
3. to fulfill a personal goal
4. for adventure and challenge
5. because I got tired of hearing "learn to live
with it" from doctors and decided to take
back some control and do something posi-
tive in spite of having tinnitus.
In one way or another, I met
all of these goals.
The journey started on my
birthday, July 29, 2000. I headed
up the trail with a 40-pound pack
on my back filled with food,
water, clothing, gear, and an
anticipation of reaching the
14,410-foot summit that weighed
heavier than the pack. Also shar-
ing this dream were 22 other
climbers and 7 guides. Our first
goal was to reach Camp Muir at
the 10,000-foot level where we
would camp overnight and awak-
en early the next morning to con-
tinue our summit climb.
I started ascending, roped to five other climbers,
and had the feeling ofbeing pulled up the mountain.
I kept up despite my tendency to get tangled in the
rope while coordinating the dance of "rest step, pres-
sure breathe, huff puff, pant, pant" and trying not to
stab myself in the foot with my axe.
We crossed snowfields, jumped over huge
crevasses, and made our way over rocks and loose
gravel, scraping and slipping at every step. We
stopped to rest after 2
1
/2 hours, and l threw my pack
and myself down in the snow in a state of exhaus-
tion. We'd reached 12,000 feet and l feared I had
reached my limit. Just sitting on my pack was an
effort. On any climb, the decision
to proceed or turn around is a
challenging one, and one never
easy to make. I needed to make
that decision fairly quickly; my
companions were already pack-
ing to head up the mountain.
But I could barely stand up.
The decision was made for me.
A guide helped me stand up and
said he was sending me back
with another guide and other
exhausted climbers. Their deci-
sion to send me back down was
probably a wise one, since they
had to consider the safety of the
group as a whole.
The trek started on a paved
trail that eventually turned into
an immense, steep snowfield. The
ascent up Muir Snowfield was an
arduous six-hour trek, and despite
using poles and heavy moun- Donna Brown and ATA flag on Mt. Rainier.
As l roped into the descending
team, feeling sick in stomach and
heavy of heart, I glanced back
over my shoulder for one last
look at the majestic panorama
above me. This one sight, as if
Rainier was giving me consola-
tion, came in the form of an
taineering boots, I was soon wind-
ed and lagged behind my companions. Each step was
a supreme effort due to the altitude and steep slope
of the snowfield. Suddenly, when I thought I couldn't
take another step, I heard the guide yell, "We're
here!" I couldn't believe my eyes or my ears for that
matter: No tinnitus the whole climb! There was
Camp Muir only a few feet away. I made it to my
first destination.
After a quick supper, it was early to bed but I
didn't get much sleep. All 23 of us were packed into
a tiny hut like sardines, side by side in our sleeping
bags. At midnight, we got the wake up caU and I
quickly sprang into action, donning warm clothing,
headlamp, boots, crampons (spikes attached to boots
for traction on ice and snow), harness, and ice axe.
20 Tirmitus Thday/ December 2000 American Tinnitus Association
orange glow from my former companions' headlamps
illuminating lhe darkness and winding up the moun-
tain as far as the eye could see. It was an incredible
sight.
The descent from Muir was a bit easier than the
ascent, as we glissaded (slid on our bottoms) down
the snowfield. When I got back to my room, I reflect-
ed back on the climb and was upset with myself for
not reaching the summit, even though only 13 out of
23 climbers made it to the top.
At this writing, I still feel disappointed in that I
might have let people down who were pulling for me
in this climb. But then I remind myself of what I did
accomplish. First, I took tinnitus (and myself) to an
all-time high. I've climbed many "fourteeners" in
Colorado where I live, but have always started the
Research Update
by Pat Daggett,
Ali1 Director of Research
The following reports are from
two researchers whose ATA-
funded tinnitus studies are now
completed. Three new grant
proposals are being evaluated
by ATA's Scientific Advisory
Committee for funding consid-
eration at the end of this year.
Tinnitus researchers are invited to download a
copy of the grant application from our Web site
(www.ata.org). The next deadline for submission of
grant applications to ATA is December 31, 2000.
Using auditory reorganization to minimize
perception and facilitate habituation of
tinnitus
Principal Investigator:
Robert W. Sweetow, Ph .D.
University of Califomia
San Francisco, CA (UCSF)
An abundance ofresearch indi-
cates that certain procedures can
be used to modify the function of
portions of the brain used in hear-
ing. This ability of the brain to
reorganize itself is termed cortical plasticity. In this
investigation funded by the ATA, we tested the
Toward the Cure
theory that tinnitus can be eliminated or minimized
by altering the way sound is perceived (organized) in
certain regions of the brain, specifically the auditory
cortex.
Our approach differs from the traditional
approaches ofbiofeedback, counseling, habituation,
and masking. For example, when sound generators
are used in combination with directive counseling as
is done in tinnitus retraining therapy, the goal is to
alter the patient's cognitive response to tinnitus and
eventually allow for habituation. It can take 18 to 24
months before patients recognize changes with this
approach.
Our research project was based on studying
children with language impairments. Children with
language impairments often have auditory temporal
processing problems. (Understanding speech is based
on the ability to differentiate one speech sound from
another in a time sequence.) Computer exercises
were used to train the children to attend to specific
auditory stimuli. Their temporal processing abilities
improved, as did their language comprehension. The
finding that attention was necessary to cause these
changes has potential significance to the treatment
of tinnitus.
We hypothesized that similar methods could be
used to retrain the auditory cortex to minimize tinni-
tus perception in a shorter period of time than by
current approaches. We used computer controlled
auditory tasks with game-like interfaces that focused
(continued)
EXPEDITION HOPEFUL CURE (continued)
climb from a higher elevation - 8000 to 10,000 feet
above sea level. In terms of actual elevation gain on
Mt. Rainier, f climbed 7000 feet starting at the .5000-
foot elevation and reaching the 12,000-foot. elevation.
J helped ATA raise over $85,000 to continue research
for an eventual cure for tinnitus thanks to all of you
who contributed so generously to Expedition Hopeful
Cure. In that respect, I accomplished my main goal.
And besides, if my climb inspired at least one person
to make his or her own dream come true and not let
tinnitus interfere with doing the things they love to
do, then I reached my summit after all. B
A lot of people were instrumental in helping to
make this dream a reality. 1 wish to thank the follow-
ing people and companies for their media and
financial support for my climb:
Joe Southern, reporter
Daily Times Call, Longmont, CO
Barbara Byrnes Lenarcic, reporter
Northglenn-Thornton Sentinel, Northglenn, CO
Claudia Hibbert-BeDan, reporter
Broomfield Enterprise, Broomfield, CO
Marian Jones, reporter
Fox News, New York, NY
Gary Massaro, rep01ier
Rocky Mountain News, Denver, CO
The North Face, Boulder, CO
Also, my heartfelt thanks to the follo,>\Tlng people
at ATA: Barbara Thbachnick Sanders for being recep-
tive to my hair-brained idea in the first place, to
Jessica Allen and Cheryl McGinnis for all their
encouragement and support, and to Lisa Freeman for
her creativity and energy in coming through with the
ATA flag and T-shirts.
Last, all my love and appreciation to my husband,
Gary, who stood by me every step of the way.
Ms. Brown is a tinnitus self-help group leader - and a
mime - in Denver, Colorado, and can be contacted at
303-469-1683.
American Tinnitus Association Tinnirus Thday/ December 2000 21
Research Update (continued)
on timing and pitch/loudness characteristics to direct
the reorganization ofbrain functions. Each research
subject was asked to do these exercises for one hour
per day, five days a week for a six-week period. The
exercises required each participant to listen to a
sound, and either reconstruct the sound from short
auditory segments, or recognize the sound from a
series of similar sounds. The sounds were adjusted
based on the subject's individual tinnitus match
characteristics and consisted of chords, frequency
sweeps, shaped noise, and tones. The sounds were
generated from a computer program and were then
transmitted via high quality earphones and set to a
comfortable listening level.
Of the 16 participants who began the project,
a total of nine completed the six-week training
program. Eight of the nine subjects had varying
degrees of hearing loss.
While none of the subjects reported a substantial
decrease in the level of tinnitus, one indicated a sub-
stantial change in the quality of her tinnitus: three of
the four "sounds" disappeared entirely. It was inter-
esting to note that the one subject whose tinnitus
loudness match and minimum masking level
changed substantially for the better did not report
subjective improvement in the loudness, annoyance,
or quality of life items on the questionnaire.
We were unable to learn if the lack of change in
tinnitus was related to a lack of achieving cortical
plasticity. If it did not o c c m ~ several variables might
have been involved. For example, while the learning
exercises we employed have been proven to facilitate
changes in the way the brain reorganizes itself, we
might not have used the best stimulus to achieve
these changes for tinnitus. In addition, the duration
of the training cycle (SL'< weeks) might not have been
long enough. Furthermore, the full range of the train-
ing stimuli might not have been audible to those with
hearing loss. Despite the lack of apparent positive
results from this experiment, we believe that this
general approach to attain tinnitus reduction is
worthwhile and should be further explored. The
authors wish to thank the American Tinnitus
Association for its generous support of this project.
The Role of the Trigeminal Ganglion -
Cochlear Nucleus Projection in the
Modulation of Tinnitus
Principal Investigator.
Susan E. Shore, Ph.D.,
Medical College of Ohio
The aim of this project was to
determine if an established path-
way between the trigeminal gan-
glion and the cochlear nucleus
(from the facial nerve to the
brain) plays a role in the genera-
tion and/or modulation of somatic tinnitus. Somatic
tinnitus is the kind that can be altered by manipulat-
ing regions of the head and neck, as in clenching the
22 Tinnitus 7bday/ December 2000 Ametican Tinnitus Association
jaw. According to researcher Robert Levine, approxi-
mately two-thirds of patients have a somatic compo-
nent to their tinnitus.
The first part of this study further explored the
anatomical pathway to the ventral cochlear nucleus
(VCN) from the trigeminal ganglion. In an earlier
study, we demonstrated that the ganglion sends a
projection to the cochlea in addition to its projection
to the cochlear nucleus. The question remained: Did
the same cells project to the two regions? We were
able to show that trigeminal ganglion cells in the
same region project to both places. We think that,
in some cases, the same cell may project to both
regions.
We then wanted to determine if by electrically
stimulating this pathway we would produce changes
in the spontaneous rate of its neurons. (An increase
in spontaneous rate of cochlear nucleus neurons has
been associated with the presence oftinnitus.)
Electrical stimulation was applied to the trigeminal
ganglion at levels ranging from 10 - 1000 mA (thou-
sandths of an amp). An increase in spontaneous
activity was observed in the majority of VCN
neurons. Spontaneous nerve activity increased as
the level of current was raised.
These results support our hypothesis that the
trigeminal ganglion-cochlear nucleus pathway may
play a role in the generation and/or modulation of
somatic tinnitus. Future pharmacological studies are
needed to determine if intervention with chemicals
in the brain (agonist and antagonist neurotransmit-
ters) can also change the spontaneous activity in
the cochlear nucleus and perhaps reduce tinnitus,
ultimately in the human. II
Publications Resulting From this Work:
Shore, S.E., Vass, Z., Wys, N. and Altschuler, R.A. The
trigeminal ganglion innervates the auditory brainstem.
Journal of Comp. Neurol. 419:271-285, 2000.
Shore, S.E., Vass Z, Wys, N and Altschuler, RA. The
trigeminal ganglion innervates the auditory brainstem.
Abstracts of the Association for Research in Otolaryngology,
St. Petersburg Beach, FL, p. 37. 2000.
Shore, S.E., Lu, J. 1bgeminal ganglion effects on neurons
in the cochlear nucleus: Spontaneous activity. Abstracts of
the Society for Neuroscience, November, 2000.
A Special Thank You to
Personal Growth Technologies
Personal Growth Technologies is donating a
portion of the proceeds from the sale of each
Tinnitus Relief System to the ATA to further
tinnitus research. The generosity of Personal
Growth Technologies in assisting ATA's
research efforts is deeply appreciated.
QUESTIONS AND ANSWERS
Jack Vernon's Personal Responses to Questions from our Readers
by Jack A. Vernon, Ph.D., Professor Emeritus,
Oregon Health Sciences University
Q
Dr. 0. in Minnesota
writes that a patient
of his has tinnitus
which was induced by the
antibiotic Thbramicin. In
addition, his patient has
chronic and severe pelvic
pain. Dr. 0. writes, "My
patient has been treated with
Ativan which has significant-
ly improved his pain and his
tinnitus. His family and I
want to continue him on Ativan but his psychia-
trist wants to treat him with electroshock therapy.
Can you comment?"
A
In as much as your patient is obtaining
relief with Ativan, I see no reason to stop
its use. My philosophy is to stay with what
works. Ativan is an anti-anxiety drug that requires
monitoring but is most likely enhancing his
sleep, something that electroshock therapy most
assuredly would not do. If the Ativan treatment
for tinnitus is less than complete, perhaps you
could prescribe an increased level of it.
Q
Mr. W. from N01ih Dakota is a
tinnitus/hyperacusis patient who has
read about the Star 2000, a special hearing
device designed for hyperacusis patients. He asks
my opinion about obtaining a Star 2000.
A
The Star 2000 had a problem. It was tested
by one hyperacusis patient who gave rave
reviews. But it was also tested by another
- Dan Malcore of the Hyperacusis Network -
who, in contrast, gave the Star 2000 a negative
review because it produced an audible mechanical
sound that could annoy people with hyperacusis.
This had the effect ofinspiring the individual
who made the Star 2000 to improve it - and
make the Star 2001! According to Jim Fenwick
(800-464-9714), the audio engineer who built the
Star 2000, the new Star 2001, devices are 100%
digital, with four programmable memories that
can be adjusted by remote control to accommo-
date and compress a variety ofbackground
sounds. And they are mechanically much quieter
than their predecessors. Because of the new tech-
nology involved in their design, they're quite
expensive: $2295 per pair including the remote
control. But they do come with a money-back
guarantee.
In many ways, the Star 2001 is ideal for
hyperacusis patients. It seals the ear canal,
which, I know, goes against the theory that
hyperacusic ears must not be over protected. But
it will allow people who are supersensitive to
sounds to go out into the real word and interact
without fear of being exposed to a sudden shriek
or siren. If a loud sound comes along, the device
compresses it to 65 dB so that the ear is not over-
stimulated. To compensate for sealing the ear
canal, the Star 2001 amplifies low-level sounds up
to 65 dB, which is not over-protection. To my way
of thinking about hyperacusis, the Star 2001 is
doing exactly what is required to effect recovery
ofhyperacusis provided the patient also listens to
pink noise at a maximum comfort level for two
hours a day (without wearing the Star 2001
devices). The pink noise will help the ears slowly
adjust to regular environmental sound.
Q
Mr. R. of New Jersey writes that he is 78
years old and cannot remember when he
has not had tinnitus in both ears. He
recounts a history of working in very noisy
places which most likely caused his tinnitus and
some of his high-frequency hearing loss. He has
been seen by several otolaryngologists and neu-
rologists and by a few audiologists, all of whom
told him that there was nothing that could be
done for tinnitus. Then he saw the audiologist
who conducts the self-help group he attends. She
told him to get fitted with two hearing aids which
she said would relieve the tinnitus and might
even make it go away. As a result, he purchased
two hearing aids which cost $2000 only to find
that they had no effect upon his tinnitus and so
he returned them. He asks, "Why didn't the hear-
ing aids relieve the tinnitus?" He also indicates
that lack of sleep is his main problem.
A
Mr. R., I assume that you have high-
pitched tinnitus which is usual for patients
with your history of noise exposure. In a
survey of 1514 tinnitus patients, 73% had tinnitus
at pitches between 4000 and 16000 Hz. Most of
those pitches are above the level of sounds that
we hear in our environment. And environmental
sounds are what hearing aids amplify. So, it is my
guess that your hearing aids were amplifying
(continued)
American Tinnitus ASsociation Tinnitus 7bday/ December 2000 23
SPECIAL DONORS AND TRIBUTES
ATA's Champion Membe.rs are a remarkable group
of donors who have demonstrated their commitment in
the fight against tinnitus by making a contribution or
research donation of $1000 or more. Sustaining
Members hav-e given memberships or research dona-
tions at the $500-$999 level. Contributing Members
have given memberships at the $250-499 level.
Supporting Members have given memberships at the
$100-499 level. Research Donors have made research-
restricted contributions in any amount from $100 to
$499.
Contributions to ATA's 'Iiibute Fund will be used to
fund tinnitus research and other ATA programs. If you
would like this contribution restricted for research,
please indicate it with your donation. nibute contribu-
tions are promptly acknowledged with an appropriate
card to the honoree or family of the honoree. The gift
amount is never disclosed.
Champion Members
(Contributions of $1000 and
above)
Cornelius R. Duffie
Claude H. Grizzard, Sr.
Dan Robert Hocks
W F Samuel Hopmeier,
BC-HIS
Bruce Martin
H. George Moellenhoff
Stephen M. Nagler, M.D.,
FACS
Randall Phillips
Hubert G. Phipps
Sustaining Members
(Contributions of
SS00-999)
Warren S. Bender
Thomas W. Buchholtz, M.D.
John Buchman, M.D.
Dwight w. Fawcett
Raymond Gadue
Van Joe Luoma
Sara Beall Neal
Alfred L. Nuttall, Ph.D.
Dan Pmjes
Alexander J. Schleuning,
M.D.
Susan Seidel, M.A.,CCCA
Joel Sussman
Edmund G. Thussig
Contributing Members
(Contributions of
$250-499)
Ronald G. Amedee, M.D.
Elisabeth L. Bruheim
Robert E. Brummett, Ph.D.
Donald C. Calarco
James 0. Chinnis, Jr., Ph.D.
Rob M. Crichton
John E. Hayes, Jr.
William J. Knight
Anthony R. Magana
George A. Meyer
Stephen M.Nagler, M.D.,
FAGS
Wilfred Palmer
Richard Purdy
Michael R. Shepherd
Walter P. Strumski
Joseph P. Wechselberger
Supporting Members
(Contributions of
$10()..249)
Betty Adams
F. Edwin Adkins
Wendell M. Ahem
Arthur Altarac
Betty J. Anderson
David R. Anderson
Frederick J . and Jane C.
Artz
Charles Ash
Lane Ayres
Byron and Patricia BackJar
Bruce G. Barndt
Dee H. Barnett
David D. Bedworth
Muriel Beery
Reed A. Bell
Elliott H. Berger
Mark D. Bixby
Ernest Bonyhadi
Robert J. Bradley
Gai l B. Brenner, M.A.,
CCC-A
Laird C. Brodie
Jeffrey Brown, M.D., Ph. D.
Charles Brownold
Ted Bryan
Glen Powell
A. Paul Ca.merino
Gladys Justin Carr
C. Scott Carter
Dhyan Cassie, M.A., CCC-A
Robert D. Chambers
Frederick W. Champ
Laruent Charriere
Mary K. Christiansen
C. Dennis Clardy
Guy R. Clark
Bob Cobe
Christine Coleman
John A. Coleman, Jr.
Donald J . Cook
Bill Creeden
Chris Gronberg
Ronald H. Dailey
Dennis M. Daly
Lillian Dangott, Ph.D.
Robert A. Daniels
Pierre David
Donald W. Davis
Elizabeth Davis
Patricia E. Davis
Jerry Down
H. Renwick Dunlap
Theodore J. Eckberg, M.D.
John R Emmett, M.D.
Ann R. English
Douglas Fabick
Dwight W. Fawcett
James T. Fehon
Gail A. Fleming
David E. Flint
Elio J. Fornatto, M.D.
Our heartfelt thanks to all of these special donors.
All contributions to the American Ti nnitus Association
are tax-deductible.
Gifts from 7-2-00 to 10-1-00
Benjamin C. frankli n
Katherine L. French
James L. Frisk, M.D.
Robin R. f'uller
Richard J. Gambatese
Lawrence Gelb
LaiTy L. Gentry
Joseph M. Gillis
Shirley Gittelsohn
L Larry Goldman
W.J. and Helen Gotschall
C. Lee Gough
J. Douglas Green, Jr.
Jeannette E. Green
Paul Green
William E. Gromen
Edmund J . Grossberg, CLU
Kenneth M. Grundfast, M.D.
John F. Hallgren
Frank M. Hanna
Mary E. Harker
Ricki Harrison
Floya D. Hawkins
Jo Hazelby
Dennis D. Heindl
Jacob w. Heller
William F. Hendren
S. Dale Hess
Manny Hillman
'Thd Hofmeister
Kevin Hogan
Roger W. Hollander
Judith K Horning, M.A.,
CCC-A
Raymond Houghland
John W. House, M.D.
Eric Jacobsen
Gary P. Jacobson, Ph. D.
Judi th A. Jacobson
Anthony F. Jahn, M.D.
Lucille J . Jantz
Elias Jiron
Marsha Johnson, M.S.,
CCC-A
Ruth M. Johnston
Thm Johnston
Bob Jones
Harold S. Karpe
Lois S. Keeney
Michael Kelton
Katherine C. Kline
Marvin Kowit
E. Joseph Kubat
Floyd E. and J<aren
Kuehnis, Jr.
Stacey Kupersmith
Jed A. Kwart!er, M.D.
Tissot Pascal Lala
R. Gregory Lamb
Fred R. Lawson
Gerald A. Leone
Herbert A. Levin
Frances H. Lewis
ShuN. Chau Li
Randolph Lundberg
Michael J. Lurey
,Jimmie Mae Heng
David R. Marshall
Stuart l. Mayer
Richard Mayes
Edward Mazza
John McDonald
Anne Holmes McKay
Paula Lee McLean
Thomas F. McNulty
Richard Melms
Jimmy C. Meyer
Robert L. Minelli
William F. Morrissey
Andrew J . Murphy
James C. Murphy
Jeffrey Nobel
'Teresa L. O'Halloran
Michael O'Malley, O.D.
Ayo A. Ogunlusi, M.C.D.,
CCC-A
CurtisS. Olson
Justin Osteen
.Burt Otterson
Karl E. Owen
Mark Owyang
Joseph G. Oyler
William E. Paland
Owen M. Fanner
James L. Paradise
Phil R Pearcy
William J. Pedersen
Jean E. Pepper
Dow V. Perry
Hubert G. Phipps
Viktor Pokorny
Stephen and Linda Press
Marilyn E. Prigge
Dan Purjes
An ne M. Randisi
Brent Repp
Bill Retherford
Robert Reynolds
Lee and Margaret Richey
Joseph Ringelstein
Jeffrey A. Ristine
Ray Robidoux
Joel Rolli ns
Lynn Rosemurgy
Nancy M. Rosen
Bradley Ross
Richard L. Ruggles, M.D.
Eileen Sahakian
Larry Schaub
Donna Scheckla
Susan P. Schindelar
Evelyn J. Schwert.!
Susan Seidel, M.A.,CCCA
Thomas F. Sheehan, O.F.M.
Ronald C. Sheffey, M.A.
CCC-A
Frank Shekosky
John Shoch
Frank A. Skinner
Kimberl y Skinner. M.S.
John s. and Sheila C. Smith
Robert R. Smith
Willian1 P. Smith
Eugene J. Sobel
Martin V. Socha
Henry M. Sottnek
Joseph Souto
Thomas B. Speer
Shirley Stockfleth
Dr. S. Jerome 'Thmkin
Daniel K. Thrkington
Bradley S. Thedinger, M.D.
William J. Tillman
John D. Thrrnedis
Christina L. Vanfossan
Marc R. Vincent
Mirko B. Vukovich
Rita Weisner
John L. Werner, Ed.D.
David P. Whistler, Ph.D.
Rosalie Wiesenthal
Allan P. Wolff, M.D.
Virginia S. Wood
William R. Wrigh
Larry w. York
Research Donors
(Contributions of
$100 ro 499)
Gerald Aus
John Seymour Berry
Walter Blood
Sharon E. Bowyer
Rosalie Davis-Green
Michael D. Deakin, CPA
Thelma D. Dry
Elza Feld
D. Jeanne Frantz
Richard and Barbara Gilbert
'Thd Hofmeister
Ann Klimczak
Walter L. Larsen
Dennis Manarchy
Edward F. McLaughlin
John R. Patrick
.Bert Pearl
Bradley Ross
RichardS. Schweiker
Joel Smith
Lawrence S. Wick
John A. Wunderlich
Carter Wurts
TRIBUTES
In Honor Of
Joseph G. Alam
Jim and Rosalie Traver
Charles Goldstein
Marvin A. and Frances
Welsch
Stephen M. Nagler, M.D.
Greg Armstrong
Jack A. Vernon, Ph.D.
Mary Jane Lillis
24 Tinnitus Thday/December 2000 American Tinnitus Association
QUESTIONS AND ANSWERS (continued)
sounds well below the pitch of your tinnitus and
thus had little chance of masking or relieving
your tinnitus. There is, however, a special device
called the tinnitus instrument - a combination
of a high-frequency hearing aid and a tinnitus
masker. You adjust the high-frequency hearing
aid first in order to get your high frequency
hearing up to the best level possible and then
add in the masking sound which contains high-
frequency sounds. This should mask and thus
relieve your tinnitus. Since sleeping is also a
problem, I would recommend that you wear two
in-the-ear tinnitus instruments and try sleeping
with them. The Sound Pillow by Phoenix
Productions (877-846-6488) might also help
you solve your sleep problems.
Q
Mr. W. from Texas wrote to say that he had
an unusual tinnitus, which he did not
understand. He described it as a "cricket"
tinnitus. He also explains that he has a high fre-
quency hearing loss and he knows many other
people who also have hearing losses but do not
have tinnitus. What, he asks, is wrong with him?
A
First of all, Mr. W., your cricket type tinni-
tus is probably a combination of two tones.
We have found that cricket tinnitus is most
SPECIAL DONORS AND TRIBUTES
(continued)
In Memory Of
Florence Benaszek
Shirley Majcrcak
Elizabeth (Becky) Capriotti
Eleanor B. Gordon
Sylvia Gordon
Shelly Forman
Eli7.abetb (Betsy) Hagemann
Hans and Sally SOlmssen
Anna ;'.lcDonough
James A. and Lyn S. 'Tremble
Irving lllirman
Judith Snyderman
Jack Moody
Richard and June Blackburn
Kimberly and Jay Blain
John and Beverly Bambino
Sylvia Brown
Carolyn C. Carpp
Irene T. Franett
Lucy B. Han
Gavl L. Henze
Jacobson, Lawrence, & Assoc.,
PLLC
Thm and Nancy Jensen
Constance A. and Michael E.
l\lcLean
Larry Murante
Karen Omahen
Marlene Parry
Jim and Larry Thggle
John and Cleo Webb
Doris Wolfstone
Father of Joe and Denise
Maggio
Stuart and Marcy Feldman
Ccilia Wilson
Marcy Feldman
Sister of Mr. and MIS. Leonard
Zaretsky
Sylvia Eisenberg
Corporations With Matching
Gifts
American Express
ARCO Foundation
BP Amoco Corporation
Celanese Americas Foundation
Chase Manhattan Foundation
Fannie Mae Foundation
John Hancock
Johnson & Johnson
Phillip Morris
Union Pacific Resources
US Borax, lnc.
US West Foundation
likely a combination of 4000 Hz and 4060 Hz.
That combination of tones almost always match-
es what other tinnitus patients describe as crick-
ets. We also find that cricket tinnitus is a bit on
the unusual side. In one survey of over 2000
patients, cricket tinnitus appeared less than 10%
of the time. However, we should also point out
that cricket tinnitus is usua1ly easily relieved by
masking. There is nothing especially wrong with
you, and your hearing loss may or may not be
related to your tinnitus. There are many folks
who, with age, acquire hearing loss without
tinnitus. Mr. W., ifyou have not tried masking to
relieve your tinnitus, may I suggest that you do
so. Because the pitch of your tinnitus is in the
upper region of our environmental sounds, hear-
ing aids alone might provide the masking you
need for tinnitus and, at the same time, improve
your ability to hear. It is clearly worth a try.
Notice: Many of you have left messages requesting
that I phone you. I simply cannot afford to meet
those requests. Please feel free to call me on any
Wednesday, 9:00a.m.- noon and 1:00-5:00 p.m.
Pacific Time (503-494-2187). Or mail your questions
to: Dr. Vernon c/o Tinnitus Today, American
Tinnitus Association, P.O. Box 5, Portland, OR
97207-0005.
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Tired of Tinnitus keeping you awake? Is masking keeping your spouse awake?
Finally, here's the product that will help you both sleep--THE SOUND PILLOW.
Let two wafer-thin micro-stereo speakers nestled within a plush full-size
pillow ease your Tinnitus troubles today. With a speaker jack that fits most
radios, cd players, and televisions, the Sound Pillow delivers the soothing
masking sounds you need (and your partner will really like this) without
disturbing others. Finally, a sound device that allows you to comfortably
and affordably mask tinnitus. Call and order your Sound Pillow today so
both of you can sleep better tonight.
$39.95
(for A.T.A. members)
$49. 95 regular price
TOLL FREE
(877) TINNITUS
(846-6488)
www.sou n d pi II ow. com
Advertisement
Alliance Tinnitus and Hearing Center
Stephen M Nagler, M.D., FAGS- Clinic Director
introduces a two-hour educational videotape
"Tinnitus: Learn to Live WithOUT It"
Thoughts on Tinnitus Retraining Therapy
This video is not merely a vision for the future,
but it discusses very practical approaches to
tinnitus treatment today. It is designed primarily
as a source of information for the tinnitus patient
and family, yet it contains material of value for
the hearing healthcare professional as welL
To purchase your copy today call
404-531-3979, visit our website: www.tinn.com,
or mail a check payable to:
Alliance Tinnitus and Hearing Center
980 Johnson Ferry Road, NE, Suite 760
Atlanta, GA 30342
$40 plus $4 S/H (Georgia residents add sales tax)
i\ducrtisemcm
Q. What's the most effective and
affordable tinnitus masker
on the market today?
A. The Tinnitus Relief Svstem
Recomme11ded by ENTs a11d Audiologists worldwide.
"The most effective and enjoyable, clinically-proven
tinnitus relief product on the market
Mlcheal LaRouere, M.D.
Michigan Ear Institute
Provides Tinnitus Relief 15 Different Selections
Relieves Stress Portable
Induces Sleep Money-Back Guarantee
"The Tinnitus Relief System has
provided me a great deal of relief
and a period of relaxation I have
not received from other
Barbara Rakish, Madison, MS
"Akhough there is no cure for
tinnitus yet, your system is the
next best thing for tinnitus relief
in my opinion. Thanks!"
Rick Stern, Lincoln, NE
For a free CD or for more information call:
18005514467
or check us out on the web:
www.tinnitus-relief.com
AMERICAN
TINNI TUS
ASSOCIATION
Address Service Requested
Advertisement
P.O. Box 5
Portland, OR 97207-0005
You May Not Need To
Loolc Any Further.
Introducing the
Tranquil,T" a revolu-
tionary new Tinnitus
Sound Generator that
can help you win your
battle with tinnitus
and greatly improve
your qual ity of life.
This tiny device, il1
combination with a comprehensive tinnitus
program that addresses the psychological
and neurological aspects of tinnjtus can
signifi cantly reduce symptoms in most
patients. The Tranquil'" doesn' t interfere
with hearing and can be worn at night
while you sleep.
'fr-.mqu.il Benefits:
Discreet size - fits compJetely in ear
Can be wom while sleeping - potentiaiiy
accelerating retraining therapy
Doesn't interfere with hearing
For ltjree consumer brochure
on the nunquil"', cull or write:
C C 3 : 1 ~ 1
General Hearing Instruments
Consumer Affairs Division P.O. Box 23748
New Orleans, LA 70183-0748
Call toll-free (800) 824-3021
Visit our website at: www.generalhearing.com