tinnitus today december 1999 vol 24, no 4

7/23/2019 Tinnitus Today December 1999 Vol 24, No 4

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December 1999 Vo lume 24, Number 4

Tinnitus TodayTHE JOURNAL OF THE AMERICAN TI NN I TUS ASSOCIAT ION"To promote re lief, prevention, and the eventual cure of tinnitus forthe benefit of present and future generations"

Since 1971Education -Advocacy - Research - Support

In This Issue: Alten1ative Management

of Tinnitus, Part I -Vitamins and Minerals

A Worldwide Lookat Tinnitus

ATA Self-Help Group Guide Progress Through Research


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Tinnitus T o d ~ y Editoial ond Advertising offices:Ameican Tnni tus Association, POBox5, Portland, OR 97207 503/2489985, 800/6348978 [email protected], http:jwww.ota.orgEditorial and Advertising offices: AmericanTinnitus Association, P.O. Box 5, Por tland, OR97207, 503/ 248-9985, 800/ 634-8978,[email protected], http:/ www.ata.orgExecutive Director: Steve Laubacher, Ph.D.Editor: Barbara Thbachnick SandersTinmtus 7bday is published quarterly in March,June, Septemberand December. It is mailedto American Tinn itus Association donors anda selected list of tinn itu s sufferers and professionals who treat tinnitus. Circulation isrotated co 80,000 annually.The Publisher reserves the right to reject oredit any manuscript received for publicationand to reject any advertis ing deemed unsuit

The Journal of the American Tinnitus AssociationVolume 24Number 4, December 1999Tinnitus, ringing in the ears or head noises, is experienced by as manyas 50 million Americans. Medical help is often sought by those who haveit in a severe, stressful, or life-disrupting form.Table of Contents

able for Tinnitus 7bday. ACceptance of advert is- 8ng by T i n n r t < - ~ 7bday docs not constituteendorsement of the advertiser, its products orservices. nor does Tinnitus Today make anyA Worldwide Look at Tinnitusby Dhyan Cassie, M.A., CCC-A

claims or g1.1arantees as to the accuracy orvalidity of the adveniser's offer. The opinionsexpressed by contributors ro Tinnitus Thday arenot necessarily those of the Publisher, editors,staff, or advertisers . Ame rican TinnitusAssociation is a non-profit human health andwelfare agency under 26 USC SOl (c)(3).Copyright 1999 by American Tinn itusAssociation. No part of this publication ma ybe reproduced, stored i n a retrieval system,or transmitted in an y form , or by any means,without the prior written permission of thePublisher. ISSN: 0897-6368Executive Di rectorSteve LaubacherPh .D., Portland, ORBoard of DirectorsPaul Meade, Tigard, OR, ChairmanJoel Alexander, Park Ridge, NJJames 0. Chinn is, Jr., Ph.D ., Manassas, VAClaude H. Grizza rd, Sr . Atlanta, GAw. F. S. Hopmeier, St. Louis, MOGary P. Jacobson, Ph .D., Detroit, MlSidney Kleinman, Chicago, ILStephen Nagler, M.D., Atlanta, GAKathy Peck, San Francisco, CAJohn Nichols, Scottsdale, AZDa n Putjes, New York, NYSusan Seidel, M.A., CCC-A, Thwson, MDTim Sotos, Lenexa, KSJack A. Vernon, Ph.D., Po rtland, ORMegan Vidis, Ch icago, l lHonorary DirectorsThe Honorable Mark 0. Hatfie ld,U.S. Senate, RetiredTony Randall, Ne,, York, NYWilliam Shatner. Los Angeles. CAScientific AdvisorsRona ld G. Amedee, M. D,, New Orleans, LARobert E. Brummett, Ph .D., Portland, ORJack D. Clemis, M. D., Ch icago, lLRobert A. Dobie, M.D., San Antonio, TXJohn R. Emmett, M.D., Mem phis, TNBarbara Goldstein, Ph .D. , New York, NYJohn w. House, M.D., Los Angeles, CAGary P. Jacobson, Ph.D., Detroit, MlPawcl J . Jastreboff, Ph.D., Atlanta, GAWill iam H. Martin, Ph.D ., Ponland, ORDouglas E. Mattox, M.D., Atlanta, GAMary B. Meikle, Ph.D., Portland, OR

11 Alternative Management of Tinnitusby Michael D. Seidman, M .D.

14 Winning by a Landslideby Cathie Glennon14 Mid-Atlantic Regional Tinnitus Conference15 Progress Through Research

by Cheryl McGinn is16 ATA Self-Help Group Guide17 Support Network Involves Many

by Cheryl McGinnis18 Celebrating Virginia!

by John Nichols19 A Moment to Remember

by Rachel Wray20 Meet ATA's New Scientific Advisory Committee Members22 A Reprieve from the Ringing

by Joseph WoodsRegular Features4 From the Executive Director

by Steve Laubacher, Ph.D.5 From the EditorSoaring

by Barbara Thbachnick Sanders7 Letter s to the Editor23 Questions and Answers


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FROM THE EXECUTIVE DIRECTORby Steve Laubache" Ph.D.As we leave summer andenter fall and winter,thoughts always turn tochange. This year with theapproach of the year 2000we are even more acutelytuned into the passage oftime and new beginnings.I know that all of us hereat the American TinnitusAssociation have changeon our minds as we reposition our associationto meet the needs of our readers and members.

ATA's Board of Directors has made a strongcommitment to make ATA the leader in addressing all of the issues that emerge from tinnitus.As evidence of this we have added three newstaff positions in the last month. We now have afull-time person working to insure that eachrequest for information is filled within a week ofreceiving the request. We have also hired a newperson to head up our Research and Supportprograms. This will enable us to keep up withscientific advances and pass that news on to ourmembers and the general public. Finally, wehave added a person to head up our Informationand Resource program and ou r GovernmentAffairs program. This will help us respond tothe thousands of calls that we receive asking forinformation and help, and keep us on top oflegislative efforts to fund research into th ecauses, treatment, and cure of tinnitus.

Just as exciting is our effort to begin to planfor the next three years of operation. Our LongRange Strategic Planning will help ATA se t goalsin a number of areas including education, advocacy, research, and support. Of course, thesegoals wil1 also carry a price tag. That is why weare endeavoring to significantly increase our fundraising an d public information capabilities. Theseplanning efforts have already begun at the staffand Board level. In early 2000, we will take all of

the ideas generated to the Strategic PlanningCommittee, who will try to reconcile and balancewhat will surely be ambitious goals. If you areinterested in serving on this committee, I encourage you to write to Cheryl McGinnis/StrategicPlanning Liaison here at the ATA headquarters inPortland. (Include your name, address, an dphone number.) Briefly list your background,your relationship to ATA if any, and why youthink you should be selected for membership onthe committee. We will seriously consider yourresponse.

We are all very excited about our future andremain open to your continued support. Bestwishes for meaningful holidays. IB

20th European InstructionalCourse on "Tinnitus and itsManagement"

April 9-12, 2000University of NottinghamNottingham, UK

The 20th annual course addresses thecauses, scientific background, investigation,and management of tinnitus with case discussions, practical demonstrations, an d workshopsessions. The course is suitable for otologists,audiological physicians, scientists, technicians,and hearing therapists who are involved inclinical or research work on tinnitus. Thecourse has CME accreditation.

Course fee: 660.00 residential, 580.00non-residentialRegistration: Julie Whittington, ConferenceNottingham Limited, Shire Hall, High

'Pavement, Nottingham NG1 1HN, UnitedKingdomTel: 0115 915 1383


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From th e Ed i t o rSOARING

by Barbara Tabachnck SandersI genuinely do not like tofly. Yes, it's intrinsic to ourway of life and I do it.But, I don't like it. Thegrowl of unfamiliarengines, the abrupt turbulence, and my ignorance

about what keeps that much metal up inthe air make me feel out ofcontrol. I sitthrough every flight in what I hope is constant telepathic communication with thepilot and the co-pilot. I carefully scan myallotted patch of sky out the window just incase I see something that would need to bereported to the cockpit. It's exhausting,believe me, flying the plane with only a sidewindow view.

'TWo months ago, I flew to New Orleans withfellow ATA staff Steve Laubacher, Pat Daggett,and Cheryl McGinnis for ATA's Tinnitus PublicForum. I did my job on the way there: I kept theplane airborne with my white-knuckled attentionto the situation.

The Tinnitus Public Forum was very wellattended, and even for me well-worth the trip.Our panelists, Drs. Mary Meikle, Richard Harlan,Michael Seidman, and Stephen Nagler, presentedan outstanding hour of tinnitus commentary. Thepanelists then answered another hour's worth ofquestions with help from the wise and wonderfulJack Vernon who was in the audience.

As for the presentations, Dr. Meikle's researchrevealed that people without hearing loss experienced greater tinnitus distress than those withhearing loss when first examined. Looking closer,Meikle found that the normal hearing subjects

Dr. Harlan's brand new ATA-funded researchis unfolding an d exciting: he is in the process ofdetermining if an increase in GABA (a chemicalalready found in the brain) will reduce theperception of tinnitus an d hyperacusis, a supersensitivity to sound.

Dr. Seidman has a Bachelor's degree in nutrition and a medical degree in otolaryngology. Heblends those discipbnes for his tinnitus patientsand offered our audience a taste of alternativetreatments for tinnitus and for general goodhealth . (See Dr. Seidman's article, p. 11.)

The audience was intrigued (and entertained)by Dr. Nagler's presentation on the philosophy ofTinnitus Retraining Therapy, or TRT. Naglerspoke with the wisdom of an experie?ced t i ~ n i -tus clinician and from his own expenence w1ththe therapy that h elped him overcome his tinnitus. His explanation of the "directive counseling"component ofTRT had its own soothing effect.He explained that when patients understand themechanisms of their tinnitus, when they learnwhat they can expect from a treatment, whenthey recognize that their negative attitudestowards their tinnitus perpetuate the intrusiveness of the tinnitus, and when their hea1thproviders are skilled in tinnitus care and.arecaring, then the healing process has not JUStbegun - it is well underway. Th e whole forumseemed like directive counseling in action.

When the presentations and the Q&A sessionconcluded, dozens waited for one-on-one timewith the doctors who graciously stayed. Manypeople there expressed interest in d e v e l o ~ i n g . alocal support network (none currently eXlsts mNew Orleans). And we expressed our eagernessto help.

I was back on a plane the next day, bound forhome. Th e turbulence was unnerving from NewOrleans to Denver. We landed in Denver in thedark (which made it hard for me to check outsidefor obstacles) then changed planes for the last legof the journey. Within minutes of takeoff forPortland, I felt a tumble of dreaded turbulence.We climbed through it, leveled off for a moment,


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Letters to the EditorFrom time to time, we include lettersfrom our members about their experiences with "non-traditional'' treatments.We do so in the hope that the information offered might be helpful. Please readthese anecdotal reports carefully, consultwith your physician or medical advisor,and decide for yourself ifa given treatment might be right for you. As always,the opinions expressed are strictly thoseof the letter writers and do not reflect anopinion or endorsement by ATA.Hyperocusis and EarmuffsI've had constant tinnitus for at least 20 years.To date, I appear to have no hearing loss. At random times, I have hyperacusis [a super-sensitivity to sound] so loud that the sound of newspaperpages being turned causes me ear pain.

Several years ago, I bought the Howard LeightThunder 29 earmuffs with a noise reductionrating (NRR) of 29 dB. I've found it very helpfulin keeping the noise of vacuum cleaners, garbagedisposers, an d neighbor's power mowers fromworsening my tinnitus. When my husband isgoing to indulge in a hobby that I find painfullynoisy, he hands me my earmuffs and "domesticharmony is preserved." I often use the earmuffsin conjunction with earplugs if I anticipate aloud noise exposure. Their new earmuff product,called the "Leightning," has an NRR of 31 and isnoticeably quieter than my old Thunder 29,perhaps because my Thunder 29 is on its thirdse t of replacement pads.

A caveat: On long car trips, my hyperacusiscan be triggered when I use both earplugs andearmuffs. Long-duration use of hearing protectiondevices is associated with onset of hyperacusisoften enough in my case that I would cautionanyone who has both tinnitus and hyperacusis tonot overuse these devices.

Patches for TinnitusI have had tinnitus for 27 years. After readingMr. Perkins' Letter to the Editor (in the March1999 Tinnitus 'Ibday), I decided to try wearing th e

'fransderm Sc6p patch behind one of my ears.(I have tinnitus in both ears.) I t did make mytinnitus go away, however I experienced severedizziness, disorientation, and a dry mouth. I couldonly wear it for two days. (I t is interesting thatthis medicine is usually used to stop dizziness.)

My doctor suggested that I cu t the patches inhalf since a whole one was clearly too strong forme. Now I wear half a patch for three days at atime on one side and then another half patch forthree days on the other side. I t sometimes maketh e tinnitus quieter for me.

Mi17ie Card, ATA memberStop Caffeine!After I noticed a sudden ringing in my rightear, I was diagnosed with tinnitus by two differentdoctors. Both told me that there was nothing anyon e could do about it . I started making inquiriesmyselfby phone, reading medical information inmagazines and newspapers, and talking to anyonewho knew anything about tinnitus. "Stop YourIntake of Caffeine" grabbed my attention in amagazine. So I cut out 100% of my caffeine intakeincluding teas, soft drinks, and even decaffeinated coffee (which actually has a small amount ofcaffeine in it). For some reason , it seemed to helpme. My tinnitus started to ease off. From ringingin the ear, I started having buzzing. As the dayswent by, the buzzing faded away until i t completely disappeared. I don't know if my tinnituswas temporary and would have disappeared anyway, bu t I feel compelled to share this information with you.

Mirtha Wincele, 1344 Bayview Circle, Weston,FL, 33326, 954- 389-0881ATribute to Bob JohnsonI first became aware ofATA and the KresgeHearing Research Lab (now the Oregon HearingResearch Center) through good friends living inOregon. Subsequently, I visited Oregon and in1982 underwent tests at Kresge. Dr. Robert


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the perception so that tinnitus ceases to havean impact on the patient's life. Sound therapyprovides significant help in that process.A study at Harvard Medical School demonstrated that functional magnetic resonanceimaging (fMRI) for patients with one-s ided

tinnitus provides an objective way to measurethis kind of tinnitus. Another study at EatonPeabody Laboratory, Massachusetts Eye and EarInfirmary, showed that fMRI provides a meansfor studying tinnitus in humans by enablingbrain activity to be spatially mapped in a noninvasive way.Dr. R. J. Salvi, from the Hearing Research Lab

at the University of Buffalo, identified patientswho could alter the loudness of their tinnitus by

ATA Board Member Susan Seidel and

oral-facialmaneuvers, thenused positronemission tomography (PETscans) to identify the regions ofthe brain thatwere activatedwhen these subjects reported asignificantchange in theloudness of theirTA EYeeutiue Director Steve Laubacherin Cambridge. tinnitus. He

found that these patients showed widespreadbrain activity when exposed to tone bursts, plusaberrant activity in limbic areas that may contribute to the emotional impact of tinnitus inthese patients. Once again, research is showingthat the limbic system might be involved. Thesenew means of neuro-imaging (fMRl and PET)will likely play a valuable role in tinnitusresearch in the new millennium .

An interesting presentation by P.A. Gabrielsfrom Karrinyup, Western Australia, emphasizedthat continual or intermittent tinnitus is a goodwarning sign for musicians that they might bedamaging their hearing. Although a routine hear-ing test might no t reveal a hearing problem, atest called Otoacoustic Emissions can measurechanges when a temporary change in hearingoccurs after noise exposure. This can alertmusicians (and other noise-exposed individuals)to impending permanent damage and explain

Birmingham, England. Although Seidel foundpositive results through her survey, other resu1tswere inconclusive.

A study at Sal1gren's University Hospital inSweden stressed that intervention must occurwhen patients have depressive an d anxietyrelated symptoms, as these symptoms can alsoenhance tinni tus suffering.

Intensive patient-counseling and positivereinforcement were stressed in several talks.The patient must understand the symptom an ddevelop a tool to manage the tinnitus noise byinterrupting the "feedback loop" between his orher emotions and tinnitus. A study in Switzerlandemphasized a holistic approach to removing hindrances which tend to interfere with tinnitustherapy.

An ear, nose, and throat physician from Indiatold me that very few rural people complain oftinnitus. They have a saying that to hear tinnitusis to hear the gods speaking to them. That issomething to think about!

Selwyn Hall, Cambridge UniversityThe American Tinnitus Association, through

its research funds, has helped support many ofthe studies presented at this international conference. The advances that we have achieved wiUprovide a momentum that will carry us into the21st century with a new level of understanding.We were all encouraged to see such prestigiousinstitutions and such great minds from aroundthe world accepting this challenge. a


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ALTERNATIVE MANAGEMENT OF TINNITUSby Michael D. Seidman, M.D., F.A.C.S.Dept ofOtolaryngology-Head and Neck Surgery, Co-Chair ofthe Complementary/A ltemative Initiative, Medical Director -Tinn itus Center; Henry Ford Health System, 6777 W. Maple Rd.,W. Bloomfield, MI 48323, Office: 248-661-7211, Lab: 313-876-1016, E-1'nail: [email protected]

Complementary and alternative medicine(CAM) practices are diverse. They represent apotpourri of interventions that vary based uponthe culture and background of their communityof origin. Acupuncture is considered mainstreamin Asian countries but is clearly considered alternative in the U.S. Similarly, herbal medicine ispracticed widely in Europe, Pakistan, an d Tndiawhile its use in America is limited. Thus, what isconsidered alternative here is often mainstream orthe primary therapy in other parts of the world.

There is an astounding increase in both useand acceptance of complementary and alternativemedicine by the American population. Accordingto the Journal of the American Medical Association, 40% of people in the U.S. have used someform of alternative therapy. However, it is estimated that more than 70% of Americans who useCAM do not tell their conventional physiciansthat they do. This probably has many derivativesincluding th e fact that most physicians in the U.S.tend to distrust these forms of intervention. Sincemost physicians do not have much experiencewith alternative therapies, their opinions are notusually based on first-hand knowledge. I believethat skepticism is healthy and prudent. I alsobelieve that as physicians we must be willingto consider all types of medical management -complementary and alternative included - forthe health and well ness of our patients.The alternative therapies presented belowrepresent additional avenues of therapy to try inthe pursuit of relief from the often intolerablesymptom of tinnitus.Part I -Vitamin and Mineral TherapiesBecause there is not one cause of tinnitus,there is likely not on e cure. However, it is considered imperative that people with tinnitus adhereto an excellent diet based on all food groups and

been shown to result in tinnitus. By adding thesevitamins to the diet, it is possible that the tinnituscan be treated.

Since there is no hard science about dosagesfor tinnitus relief, the dosages stated throughoutthis article are suggestions only. Th e recommended length of time to try these therapiesis 3-6 months .B Vitamins

Most B-complex vitamins cannot be stored inthe body an d must be replaced daily from foodsources or supplements. B vitamins help maintain healthy skin, eyes, muscle tone, and supportthe functions of the liver and central nervoussystem. They are also extremely important inhelping to deal with depression , stress, andanxiety. The variety of B vitamins are normallytaken together, but occasionally one B vitamin isused to treat a particular disorder. Deficiency inB vitamins can result in weakness, low bloodcounts, skin and hair problems, nervousness,poor night vision, tinnitus, and hearing 1oss.1

Vitamin B-complex supplements appear to beeffective in some patients with tinnitus by providing a stabilizing effect on the nerves. Onlyanecdotal evidence is available regarding thistreatment method.Vitamin B-1 (Thiamine)

The Recommended Dietary Allowance (RDA)for B-1 is 1.5 mg per day. Some patients havenoted that vitamin B-1 supplements relieve theirtinnitus. Th e mechanism of action seems to bevia a stabilization of the nervous system, especially in th e inner ear. Daily dosages rangingfrom 100 to 500 mg have been used.Vitamin B-3 (Niacin, niacinamide, nicotinicacid)

Vitamin B-3 is essential for the properbreakdown of carbohydrates, fats, and proteins.Vitamin B-3 also supports circulation, healthyskin, and aids in the functioning of the centralnervous system.

Niacin, at any dose, can result in a flushor pins-and-needles-like sensation, a natural


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ALTERNATIVE MANAGEMENT (continued)There is no accepted standard niacin dosingfor tinnitus. crypica1ly, though, I recommend

beginning at 50 mg twice pe r day. If there isno improvement after two weeks, the dose isincreased by 50 mg at each interval to a maximumdose of 500 mg twice pe r day. If there is no appreciable response in 3-4 months, then it is not likelythat niacin will be ofbenefit. Higher doses can beused, but the patient is advised to have liver ftmction tests. (Doses exceeding 1000 mg per day cancause liver toxicity.) High amounts should beused with caution by those who are pregnant andthose who have stomach ulcers, gout, glaucoma,diabetes, and liver disease.

There is no clinical proof for the effectivenessof niacin in treating tinnitus. However, there arenumerous anecdotal reports of response to niacinto treat tinnitus. 2,3Vitamin B-12 (cobalamin, cyanocobalamin)There may be some correlation between thedecline in vitamin B-12 levels an d the increasingprevalence of tinnitus in the elderly. Also, a studyby Shemesh, et al., showed a high prevalence(47%) of vitamin B-12 deficiency in patients withchronic tinnitus. This deficiency was more widespread an d severe in th e tinnitus group that wasassociated with noise exposure. This suggests arelationship between vitamin B-12 deficiencyand dysfunction of the auditory pathway. Supplemental B-12 was found to provide some reliefinseveral patients with severe tinnitus.4

The RDA for vitamin B-12 is 2 meg. for adults,2.2 meg. for pregnant women, an d 2.6 meg. fornursing mothers.5 Because B-12 is poorly absorbedwhen consumed, a suggested daily dose is 1000meg. Vitamin B-12 is better absorbed if it is dissolved under the tongue, and best absorbed if it isgiven by injection.Vitamin B-6 (pyridoxine)Vitamin B-6 is water soluble and cannot bestored in the body. I t is involved in the breakdownof carbohydrates, fats, and proteins an d in th emanufacturing of hormones, red blood cells, andenzymes. Vitamin B-6 is also required for the production of serotonin, a brain neurotransmitter thatcontrols our moods, appetite, sleep patterns, and

include brewers yeast, carrots, chicken, eggs, fish,avocados, bananas, and whole grains. The RDAfor vitamin B-6 is 2 mg per day, bu t most B-complex formulas contain between 10 to 100 mg of it.Vitamin B-6 is one of the few vitamins that

can be toxic. Doses up to 500 mg per day areuncommon bu t safe. However, doses above 2000mg pe r day can lead to irreversible neurologicaldamage.Folic Acid (folate)Folic acid is a water soluble nutrient belonging to the B-complex family that seems to have astabilization effect on the nervous system. Thismight explain the anecdotal evidence regardingthe supplementation of folic acid in certainpatients to alleviate their tinnitus. Th e dosagesrange from 400 to 800 meg pe r day and usuallyrequired two to four months to achieve results.6ZincZinc is a mineral involved in the functionof more than 100 important enzymes. Mild deficiency causes growth retardation in children.More severe deficiency is associated with growtharrest, infertility, poor wound healing, behavioralchanges, taste and smell disorders, and tinnitus.

Studies have shown a high content of zinc inthe inner ear. This finding prompts speculationon the role of zinc in inner ear function. A correlation between low zinc levels and tinnitus hasbeen reported.7 In an uncontrolled trial byGersdorff et al., zinc given in closes ranging from10 to 25 mg was found to reduce tinnitus. 8 (TheRDA of zinc in adults is 15 mg pe r clay.) Ochi,et al., demonstrated that patients suffering fromtinnitus had a significant decrease in zinc levels,and that supplementary closes of 34-68 mg of zincover two weeks significantly dec reased tinnitus.Excellent results were also found with combiningniacin with 25 mg zinc gluconate twice a day.7Zinc therapy, when prescribed in high doses(90-150 mg per day), is often accompanied byblood tests to monitor copper levels. Copper andzinc compete for absorption, so chronic ingestionof zinc may result in a copper deficiency.Calcium


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have experienced improvement in their tinnitusafter starting a regimen of vitamin and nutrientsupplementation that included calcium.9 Dosagesranged from 1000 to 1500 mg per day for severalmonths.MagnesiumMagnesium is essential for the function ofenzymes and is critical for cell development. Thismineral is also required for nerve conduction andtransport of small molecules across the cell; deficiency could result in a variety of abnormalitiesand medical problems, including tinnitus. 10

In a study by Attias, et al., 300 young healthymale military trainees were repeatedly exposedto high levels of noise. Each recruit receivedeither 167 mg of magnesium or a placebo daily.Permanent hearing loss was significantly morefrequent and more severe in the placebo groupthan in the magnesium group.People in large cities are exposed to potentiallydamaging loud noise on a daily basis. Studies haveshown that noise exposure causes magnesiumto be excreted from the body. I t is possible thatsupplementing with magnesium could reducenoise-induced ear damage and thus reduce thelikelihood of new onset tinnitus. Few studies havedocumented that magnesium relieves tinnitussymptoms, but many patients have experiencedrelief with this method. A suggested dose is 250-1000 mg per day.ManganeseManganese is a mineral that supports theimmune system, regulates blood sugar levels, andis involved in the production of energy and bonegrowth.The RDA for manganese is 2 mg per day.Since the average daily intake of manganese fromfood sources is 2-9 mg, deficiencies of this mineralare relatively unusual. Foods high in manganeseinclude avocados, blueberries, nuts and seeds,egg yolks, whole grains, legumes, and green leafyvegetables. Anecdotal evidence has shown areduction of tinnitus in certain patients aftersupplementation with manganese. 29B

Referencesl . Delva M: Vitamin B12 Replacement: Th B12 or not to Bl27Canadian Family Physician 1997; 43: 917-922.2. Tolonen M, Vitamins and Minerals in Health and Nutrition.E Horwood: New York, 1992.3. Sheehy T, ed itor: Vitamin Deficiency and 7bxicity. Medcom,Garden Grove, CA, 1985.4. Shemesh Z, Attias J, Ornan M: Vitamin Bl2 Deficiency inPatients with Chronic Tinnitus and Noise-Induced HearingLoss. American Journal o[Otola1yrrgology 1993; 14: 94-99.5. National Research Council (U.S.): Subcommittee on theEleventh Edition ofRecommended Dietary Allowances.

National Academy Press. Washington. D.C., 1997.6. Balch J, Balch P: Prescription for Nutritional Healing.2nd Edition, Balch Publishing, 1997.7. Ochi K, Ohashi T. Kinoshita H: Serum Zinc Levels in

Patients with Tinnitus and the Effect of Zinc Treatment.foumal of the Oto-Rhino-Laryngological Society ofJapan 1997;100 (9): 915-9.

8. Paaskc P, Kjems G, Pedersen C: Zinc in the Management ofTinnitus. Annals of0to7 Rhino/ Laryngo/1991; 100: 647-649.9. Letters to the Editor. Tinnitus 7bday. p. 6, Sept. 1997,

,June 1999.10. Attias J, Weisa, G, Almog S, Shahar A, Wiener M, et al:Oral Magnesium intake reduced permanent hearing lossinduced by noise e.xposure. Am J Otolaryngology 1994;IS: 26-32.

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14/29

WINNING BY ALANDSLIDEby Cathie Glennon, Director ofResource DevelopmentI've seen the results of a major landslide here in Oregon. Just looking atit you can imagine the earth slip, thethousands of cubic yards of wet earth,rocks of all sizes, and trees begin to slide.Around here, landslides have causedhouses to fall halfway down hillsides.Once a landslide starts, there is no wayof stopping it.

A person doesn't often witness such power.We're riding a landslide right h ere at ATA,

although it is a landslide with far more positiveconsequences. This landslide is one of excitingfocus and movement toward our mission anddeepening support for the organization.

This is an extremely exciting time for theAmerican Tinnitus Association. With new staffmembers hired, each harboring rich talents andgreat ideas about how we can reach our goals,and with a re-energized Board of Directors, ATAis taking a new look at how we can educatepeople to avoid getting tinnitus, provide servicesto people who have tinnitus, and supportresearch to eventua1ly eliminate tinnitus. Ifyou're an ATA. member, you are an importantpart of what's happening around here too.

And still the landslide grows. The Board ofDirectors and staff are staging the first time everAnnual Campaign. This fund raising campaign,happening right now, invites donors to givespecial gifts beyond annual membership . OurBoard of Directors, our staff, and other closeagency volunteers are all making a financialcommitment to ATA's Annual Campaign. Ourgoal: a tinnitus-free future. Such generosity hasbeen wonderful to see.

An envelope and additional information areat the center of this Tinnitus 7bday. Please addyour support to the Annual Campaign and bepart of the winning landslide!Cl

Mid-Atlantic Regional Tinnitus ConferenceVoorhees, New Jersey8:30 a.m.- 4:30 p.m.April 1, 2000What's New in Tinnitus Research and ManagementGuest PresentersSteve Laubacher, Ph.D., Executive Director ATARichard Salvi, Ph.D., University ofBuffaloStephen Nagler, M.D., F.A.C.S., Atlanta, GAMax L. Ronis, M.D. , F.A.C.S. , Philadelphia , PAJames Sumerson, M.D. , F.A.C.S., Voorhees, NJThis one-day conference is patient-oriented.Professionals will receive current informationregarding tinnitus research and treatments.Topics+ Current research and what it means for thepatient

ulties

-Registration (Deadline: March 10 , 2000)Name - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -Address_________________________________Phone __________________________________

Please enclose $15 per patient, $25 per couple,$45 per professional (CEUs offered)Fees include lunchMake checks payable to:Mid-Atlantic Regional Tinnitus ConferenceMail registration form and check to:Mid-Atlantic Regional Tinnitus ConferenceCeill Institute, Staffordshire Professional CenterBuilding A, Suite 1001307 White Horse RoadVoorhees, New Jersey 08043


15/29

PROGRESS THROUGH RESEARCHby Cheryl McGinnis, Director ofResearch and Support

I had a wonderful opportunity to meet withdedicated researchers and clinicians who serveon the Scientific Advisory Committee during myfirst two days with .ATA. (I spent my first day withATA on a plane to New Orleans for the ScientificAdvisory Committee meeting.) The focus of thiscommittee is to increase ATA's responsiveness tothe research needs of individuals with tinnitusand to providers who treat tinnitus patients (see"Meet ATA's New Scientific Advisory CommitteeMembers," p. 20). Th this end, the committee collects research requests, conducts grant reviews,and recommends grant awards. Tinnitus Thdayreaders will continue to receive summaries ofresearch funded by ATA and results from thesefunded research projects as they are completed.One such completed project is from Xi Lin,Ph.D., Chief, Section on Neurobiology at theHouse Ear Institute in Los Angeles, California.Dr. Lin conducted a $40,500 ATA-funded researchproject entitled, "A cellular model for qu inineinduced tinnitus." Dr. Lin reports on his findings:

Quinine is a compound found in the bark ofthe cinchona tree. It is used in many tonic drinks asan _additive for its taste. Clinically, it is widely prescnbed to treat malaria and leg cramps. Overdose ofquinine has widespread side effects, including severetinnitus and high frequency hearing loss. However,the mechanism ofquinine-induced tinnitus isunclear to date. Many plausible theories speculatedthat an increased "nerve spiking" rate probablyundalies tinnitus.

In a grant application submitted to theAmerican Tinnitus Association, we proposed analternative theory: that quinine abnormally prolongsthe duration of he nerve spikes, which amplifies thesignal in the auditory nerve, which ultimately resultsin tinnitus. In the past year, we examined the effectofquinine on the function of both spiral ganglion~ e u r o n s and hair cells, which are two key cell typesm the ear responsible for turning the mechanicalvibration of sound in the air into nerve impulses. Wespecifically investigated how quinine interacted withimportant cellular components on the membrane ofneurons and hair cells.

Our results demonstrated that when the func

that ultimately the stronger signal is sent to the higher auditory centers in the brain, which then resultsin tinnitus perception.

Data gathered in our experiments should give us hintson the mechanism of someforms of innitus and suggestions for new therapeutictargets for the design oftinnitus-relieving drugs. Forexample, certain potassiumchannel openers that arealready being used clinicallyto treat high blood pressure

Xi Lin, Ph.D. and angina could be testedto see i f hey shorten thetime span of the auditory nerve spikes. This wouldpresumably reduce tinnitus as well. B

NOW AVAILABLE THROUGH ATA!MENIERE'S DISEASE-WHAT YOU NEED TO KNOWby P J. Haybach, R.N., M.S.; editor; JerryUnderwood, Ph.D .; published by VestibularDisorders Association, 336 pages, 1998$24.95 (for ATA members), $27.50 (fo r nonmembers)The author offers a fine layman 's lesson onthe auditory system, then clearly outlinessymptoms of Meniere's (dizziness, fullness inthe ears, t innitus, hearing loss), the 11attack"and its aftermath, and the known medical,dietary, an d surgical treatments. Also included: precise drawings, resource directory, andglossary.Meniere's Disease - What You Need to Know isa reassuring, comprehensive guide for people


16/29

ATA SELF-HELP GROUP GUIDEATA's self-help group leaders and locations in lished throughout the year and will be listed inthe U.S. are listed below. The list is offered as subsequent issues of Tinnitus Tbday. If you would

assistance to individuals interested in participat- like to start a group in your area please write,ing in self-help activities. New groups are estab- e-mail, or call ATA.ARIZONA Steve Ratner, BC-mS Susan Rezen, Ph.D. , NEW JERSEYJohn J . Nichols Tinnitus Group of CCC-A Linda Beach10450 E. Desert Cove Ave. Palm Beach County Worcester State College South Jersey TinnitusScottsdale AZ 85259 57978 Brook Bound Ln. 486 Chandler St. Support GroupWorcester MA 01602(480) 860-5758 Boynton Beach FL 33437 (508) 929-8551 Ceill Instituteemail: (800) 732-9217 1307 White Horse [email protected] (561) 495-2002 day Seeking new leader Voorhees NJ 08043Charles Fleming (561) 734-4853 evening MICHIGAN (856) 346-0200 and8220 E. CaUe Potrero ILLINOIS Frank Agosta MaryA nn HalladayThcson AZ 85715-2906 PO Box 92174 (856) 429-5055 and(520) 885-1049 Reginald Thomas Warren MI 48090-017 4 Lynn Wolfe-mail: 1467 E. 55th Pl. (810) 979-4370 (856) 665-5165

[email protected] Chicago IL 60637 Jack Berman Dhyan Cassie MA, CCC-ACALIFORNIA (773) 761-6599 19625 Greenwald Dr. College of New JerseyINDIANA Southfield MI 48075 Dept Lang Comm SciMalvina Levy, MA Georgia Smith (248) 352-1646 2000 Pennington Rd.SF Hearing & Speech Ctr Ewing NJ 08628-07181234 Divisadero 728 E. 7lst St. MINNESOTA (609) 771-2822San Francisco CA 94115 Tndianapolis IN 46220 'freva Crane Lainie Ganley(415) 921 -7658 (317) 255-9216 International HearingSeeking new leader No. Jersey TinnitusNelly A. Nigro Foundation Support Group10755 Holman Ave. #4 Patty John 701 25th Ave. S Holy Name HospitalLos Angeles CA 90024 6440 Lively Ln. Minneapolis MN 55454 718 Thaneck Rd.(310) 474-9689 Evansville 1N 47720 (612) 339-2120 Teaneck NJ 07666Mari Quigley (812) 424-4903 Brad Kuhlman, Ph.D. (201) 833-71771161 Packers Cir. #lQQ KANSAS St. Cloud Hospital Suzanne Hohorst Meth,Thstin CA 92780 Elmer Jennings 1 NW-Rehab Pain MA, CCC-A(714) 505-6861 707 S. Lightner Management NW Covenant Med CtrLarry Strom Wichita K.S 67218 1406 6th Ave. N 24 Jardine St.IN BALANCE-Vestibular (31 6) 682-6033 St. Cloud MN 56303 Dover NJ 07801Wellness Support Group e-mail: [email protected] (320) 255-5679 (973) 989-3634PO Box 1135 LOUISIANA Earl J Schmidt NEW MEXICOos Gatos CA 95031-1135 80 Woodhill Rd.(408) 395-7334 Dou glas Kees St. Cloud MN 56301-5132 Myrna Calkins"l.rww.best.com/Nlyceum/ PO Box 470 (320) 252-5448 1409 Girard Blvd. SEinbalance/ Thibodaux LA 70302 MISSOURI Albuquerque NM 87106COLORADO (504) 447-9041 (505) 268-87.54MARYLAND Charles Abegg NEW YORKichard L. Marr 2339 GilrosePO Box 481624 Ann DePaolo St. Louis MO 63114 Lisa KennedyDenver CO 80208-1624 1109 Kathryn Rd. (314) 428-8171 Long Island Tinnitus(303) 292-6408 and Silver Spring MD 20904 pager (314) 510-5966 GroupDonna Brown (301) 622-9672 Marie Richter, MS, CCC-A 808 Garden Dr.(303) 469-1 683 and Seeking new leader Hear America, Inc. Franklin Square NY 11010Luann Kirsch Susan J. Seidel, 1 2352 Olive St. Blvd. (516) 486-6746(303) 980-4226 MA/CCCA St . Louis MO 63141 Elayne MyersFLORIDA Greater Baltimore Med Ctr (314) 514-7800 40 Pennyroyal Rd.6701 N. Charles St. Edna K. Young Malta NY 12020Diane Bootz Thwson MD 21204 (518) 899-48858004 Joffre Dr. (410) 828-2142 1808-C NW O'Brien Rd.Jacksonville FL 32210 Lee's Summit MO 64081 Harvey PinesCanisus


17/29

SUPPORT NETWORK INVOLVES MANYby Cheryl McGinnis,Director ofResearch and SupportSupport to members is whatthe American TinnitusAssociation strives to provide. The combined effortsof ATA's members, Board,committees, and staffcontribute to the benefitsgained from all of the programs ATA provides. Our Self-Help Network is anexample of a program that our members provideto one another with assistance from the ATA staff.

Past issues of this journal reveal that whenyou get to know one support group, you've donejust that - become familiar with just one supportgroup! Each group is unique; the uniquenessesreflect each group's interests, members, frequency of meetings, numbers, an d leader. The list oftinnitus support group leaders and telephonesupport contacts is 200+ strong with even moremembers interested in starting groups in theirareas. That's a lot of uniqueness!

My involvement with ATA is new, just overone week at the time of this writing. (By the timeyou read this issue of Tinnitus 7bday I will havebeen here a couple of months.) I suspect I amnot the only one new to the American Tinnitus

Association. Many of you reading this may benew to ATA, too, and may wish to know how toaccess th is network. Here's how: Each new ATAmember receives a regional list ofATA SelfHelp/Support Netv.rork leaders and volunteers.If, however, you need a new list or one from adifferent locale, call or write us for it. If you arean aficionado of the Internet, you can look to ourWeb page (www.ata.org) and peruse the selfhelp/ support network entries. Individuals whoare interested in volunteering as leaders or telephone contacts can contact us either by phone,e-mail, regular mail, or the ATA Web site. We inturn have resource material to assist volunteersas they start new groups. These materials includesuggestions for meeting topics, organizationaltips, and samples of public service announcements for your local newspapers .

In the next few months, the ATA Boardand staffwill be looking at all ofthe factors thatinfluence our future. With direction from thisplanning process and feedback from our members and support volunteers, I look forward tostrengthening the Self-Help Network, implementing improvements where they're desired,and sharing the strengths that exist with all ofyou. In the meantime, we welcome questionsand comments about any of the ATA programsand encourage you to contact us.B

ATA SELF-HELP GROUP GUIDE (continued)OHIO OREGON Judy Brivchik TEXASLee Gull ey Marsh a Johnson, MS, 75 Hershey Ave. Deborah Sa un ders4318 Thll Gate Ln. CCC A Lancaster PA 17603 22610 Powell HouseBellbrook OH 45305 OR Tinnitus/ Hyperacusis (717) 393-4279 Katy TX 77449(937) 848-7079 and Treatment Center Ed Cho rl e (281) 347-7927Ruth Bradshaw 545 NE 47th #212 (41 2) 781-9102 and Milly Walker, MA , CCC A(937) 783- 4613 Portland OR 97213 Ph yllis Praisn er 2001 Wynchwood Dr.Shar on Hepfn er , M.A, (503) 233-5925 (412) 823-9124 Austin TX 78746CCC-A PENNSYLVANIA meetings at: (512) 327-3004Univ ENT Specialists Pittsburgh Hrg/ Spch/ Df222 Piedmont Ave. #5200 Ed Bailey 1945 5th Ave. VIRGINIACincinnati OH 45219 5805 Mille r Rd. Pittsburgh PA 15219 Dav id M. Smith(513) 475-8443 Hermitage PA 16159-6820 PUERTO RICO Northern Virginia TinnitusCh ristina He wit t (724) 346-5828 Ca rmen Colon Support Grp27 Trail Edge Cir. Gail B. Brenner, MA , Caparra Thrr Tinnitus 6501 Byron Ave.


18/29

Celebrating Virginia!by John Nichols, Phoenix Support Group Coordinator andATA Board MemberVirginia Fitzgerald was born on October 3,1914. She raised three children and workedmany years for the Boy Scouts and for BrighamYoung University. In 1968, Virginia was in anautomobile accident and suffered whiplash. Sheexpetienced horrible head noises immediatelyfollowing the accident, and felt th at she wasgoing mad . Specialists examined her and foundthat she had tinnitus. She was relieved to knowthat she was not going crazy and was determinedto live a normal life as best she could.

One morning in 1982, newly retired Virginiawas watching a television program that focusedon senior citizens. One of the program's guestswas Gloria Reich, who was then the ExecutiveDirector of the ATA. After the program, Virginiawrote to Gloria and learned for th e first timeabout ATA's support groups. Virginia wasn't ready

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to start one just yet, but she tucked the information away for another time.When Virginia movedto Phoenix in 1985,she decided she wasready and contactedthe ATA again. InFebruary of 1986, withATA's help andVirginia's tenacity, thePhoenix TinnitusSupport Group met forthe first time. Eightpeople attended thatfirst meeting. Fiftycame to the secondmeeting.

Our group has been meeting regularly sincethen - almost 14 years now - largely due toVirginia's persistence and dedication. Over theyears, she also provided a "lifeline" telephoneservice to more than 1,800 people who werestruggling with tinnitus. Without her, many mightnot have survived. I know because I am one ofthose many.

Virginia retired from ou r group in 1995 andturned over the group responsibilities to me. As alawyer who was forced to retire at age 54 due tosevere tinnitus, I find that helping others takesmy mind off of my tinnitus. I have personallyhelped over 600 new people cope with theirtinnitus since taking over the group .

The entire group membership and I arevery grateful to Virginia Fitzgerald - now grandmother of 17 and great-grandmother of 30!Without he r pioneering efforts, continued inspiration, an d leadership, the Phoenix Tinnitus Groupwould have ceased to exist long ago. She is ourguardian angel. Thank you, Virginia. You are areal gift.

And Happ Birthday! B


19/29

A Moment to Rememberby Rachel WrayDirector ofAdvocacy andInformation &ResourcesDo you remember theday you fell in love? Theminute you first became aparent? How about themoment in life when youfelt proudes t? Happiest?Strongest?

Now this question: do you remember whenyou first got tinnitus?Since I came to the American TinnitusAssociation in early September, I have been continually amazed by the number of people whocan pinpoint the year, the month, the day, eventhe precise quarter of an hour when they firstexperienced phantom noise in their ears. Dozens

of people have told me their stories: a Fourth ofJuly party in 1976, a construction job in '92, atour of duty in the Korean War . .. Perhaps I'vejust spoken to people blessed with keen memories, but I suspect not. I suspect many of youknow when tinnitus came into your lives; I suspect it is a milestone that you mark as carefullyas weddings and births, anniversaries and deaths.

Certainly others don't know why they havetinnitus or from where it could stem, and all th ereminiscing in th e world simply cannot fill in theblanks. But from both kinds of tinnitus patients- those who remember, those who don't - Ihear a similar urgency to answer other kinds ofquestions: Why aren't there warning signs onportable stereos or industrial equipment? Howcan we teach young people about the dangerouseffects of excess noise? What am I entitled to forthis unintentional bu t still hurtful effect on myears? And why don't we, as a society, take agreater interest in protecting one of our mostimportant resources, our hearing?

As the new director ofATA's expanded advocacy department, these queries thrill me, for theyall hinge on the question underlying all activism:what can I do? An event, a milestone, occurredand profoundly changed your lives, and nowsomething - however that something is defined

ATA wants to help you make changes, too-in your lives and in the lives of others. Ouradvocacy department will help you contact yourmayor or representatives or President. We'll putyou in touch with lawyers, experts, an d likeminded individuals. We'll brainstorm with youto figure ou t how to get warning signs on machinery or where to go for information about SocialSecurity disability payments. We can't promisethat we'll have all the answers, but we do havethe same urgency as you: the need to do something, anything, to lessen the effects of excessnoise in our society, to raise awareness of theseverity and scope of the ailment, and to helpyou help yourselves.

ATA has never before devoted so much stafftime to advocacy-related issues, and I look forwardto making this department responsive to theneeds and ideas of tinnitus patients. But bewarned: I'll depend on your desire to inducechange as much as you'll depend on me. If you'relike so many of the ATA members I've spokenwith over the past few months, you rememberwhen and maybe even how you got tinnitus, andyou know how you've felt every day since. Nowimagine what a milestone it would be to take thefirst steps to preventing tinnitus, or to help othersunderstand what it is and what it has meant foryou . That's a moment you'll never forget. II

VOLUNTEERS SOUGHT FOR STUDYDennis Fitzgerald, M.D., is conducting ablinded study with the use of zinc, niacin,

lipoflavinoid, and Ginkgo biloba extract foradults in the Washington, D.C. area who havebilateral (two-sided) tinnitus.You may be eligible to participate if you are21 years of age or older and have had constanttinnitus for at least on e year. Patients withMeniere's disease and fluctuating hearing loss

are excluded from the study.Dr. Fitzgerald is conducting thi s research

study in his office at:Physicians Office Building


20/29

Meet ATA's New Scientific AdvisoryCon1n1ittee Men1bersMichael Se idman, M.D.

Dr. Seidman is an otolaryngologist at the Henry Ford Hospitalin Detroit, Michigan. One ofthe new members of A T ~ s Scientific Advisory Committee,he approaches tinnitus (and anhearing disorders) with thetraining of a medical doctorand with a personal interestin nutrition as a means ofhealing. We recently asked him how he is able to

blend conventional medicine with complementary(or alternative) medicine. How do his patientsreact when he asks them about their vitaminintake? And what do his colleagues say? Hereplied: "Forty percent of the American population is taking vitamins an d herbs an d trying otherso-called alternative treatments for their healthproblems. I f we as doctors are no t asking the questions of our patients, then we're not treating ourpatients. As for other doctors, I don't know whatthey think. (Maybe I'm not listening to them!)But I am the co-chair of the Complementary/Alternative Initiative at Henry Ford Hospital, sothey must think that what I'm doing is okay."

As for serving on A T ~ s Scientific AdvisoryCommittee, he says, "I'm truly honored to be amember of this brain trust. The committee mem-bers are highly skilled an d motivated people withgood ideas. I also believe that while a cure fortinnitus is inevitable, we need to be receptive to avariety of treatment options for tinnitus in themeantime. I think that being open-minded is theonly way to be."Mary Meikle, Ph .D.

Dr. Meikle's pass ion for tinnitus-centered research plus herlong affiliation with ATA madeher election to the ScientificAdvisory Committee a naturalchoice. We asked Dr. Meiklehow she sees her role as anATA Scientific Advisory

basic ~ a b o r a t o r y ] research techniques. I alsofeel that it's important for ATA to allocate itsresources wisely, to make sure the budget isreally well thought out. Although tinnitus isclosely linked to hearing impairment, I feel A T ~ s research emphasis should be directly linked totinnitus."Gloria Reich, Ph.D.

Dr. Reich, the formerExecutive Director ofthe American TinnitusAssociation, is now an ATAScientific Advisory Committeemember, and clinical associateprofessor in the Departmentof Otolaryngology at OregonHealth Sciences University.She comments about this

unusual transition an d her vision for the future."I know that many of you have experienced

the transition to retirement. I have the uniqueopportunity to continue to serve the organizationthat was my first priority for 25 years. TheScientific Advisory Committee has always been asource of advice on long-term research planningfor the ATA. For example, a few years ago, thecommittee suggested that ATA should sponsorresearch into the mechanisms of tinnitus andinto finding better treatments for tinnitus. Thosesuggestions have guided A T ~ s acceptance ofresearch grants up to the present time.

"I feel that ATA has been going in the rightdirection witl1 research. I t was particularlygratifying to listen to at least ten presentationsat the recent International Tinnitus Seminar inCambridge that came from ATA-supportedresearch. ATA's Scientific Advisory Committeeshould consider its charge to be to advise theBoard about which types of research will get thebiggest bang for the buck, an d to select the bestof these for ATA funding." 9Nex.t Issue: Meet new ATA Scientific AdvisoryCommittee members RichardS. 7Yler; Ph.D., andDouglas Mattox., M.D.

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21/29

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TOLL FREE(877) TINNITUS(846-6488)www.sou ndpi IIow.comATA Bibliography Update

The 1999 Tinnitus Bibliography Supplement is now available with references to 281new articles. This supplement to the originalbibliography is available for $10 ($15 fornon-members). The complete bibliography,including the new additions, is available for$40 ($75 for non-members). Individual articlereferences from th e Proceedings of he FifthInternational Tinnitus Seminar 1995, are nowincluded in this update. See the order form onthe inside back cover of this issue.

Proceedings of he VIth International TinnitusSeminar, 1999, has been publish ed and can beordered over the Internet (www.tinnitus.org).ATA is not handling the sale of this book;however we can provide you with a copy ofthe order form if you do not have access tothe Internet. Call Pat Daggett at 800-634-8978,ext. 215. 1m

Q. What's the most effective andaffordable tinnitus maskeron the market today?A. The Tinnitus Relief SvstemRecommendedby ENTs a11dAudiologists worldwide.

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22/29

A Reprieve From the Ringingby Joseph WoodsLng ago, growing up in the piney woods ofSouth Thxas, I spent many long, lazy afternoons along the creek at the back of ou rfamily home. I really enjoyed the quiet, th e gentle sounds of nature, the small waterfalls, thesounds of the wildlife.

All of that changed one afternoon in thelate 1960s on a gunnery range while training forVietnam. (I joined the Navy Reserves in order toavoid the draft and the war. But being young andstupid, I real ized too late that reservists werebeing sent to Vietnam.) We were not providedwith ear protection on the gunnery range. Andwhen we boarded the bus for the return trip tothe base, I realized that I could not hear a thingexcept for the ringing in my ears. Most of myhearing returned the next day, but the ringinghas continued to this day.

Returning to the states after my tour of dutyin Southeast Asia, 1began a search for the qu ietthat I longed for. And I am happy to say I foundan excellent way to get a reprieve from the ringing. In the spring of 1976, I learned a type ofmeditation that I have enjoyed twice a day, everyday since that time. During meditation, my innerdialogue stops and a vast wonderland of innerpeace fi lls me. When I meditate, the ringing inmy ears becomes a d istant memory and I enjoythe quiet as much as I did as a boy along thatquiet Thxas creek.

Ifyou would like to try to meditate, si t quietlyon a couch or in a comfortable chair. Start tobecome aware of your breath. Do no t lay down or

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have any support for your head. (You might fallasleep.) Visualize your energy as a large wheelstarting to slow down. As thoughts fill your head,let them go. When I do this, I drift off into asilent world and I am able to relax. I meditatedseveral times before I was able to enter a silentworld, bu t I enjoyed the relaxation from the first.

When I meditate,the ringing in my ears

becomes a distantmemory ...

You might feel a little dizzy when you firstrouse yourself ou t of meditation. This is normaland a breath of fresh air or cold water on yourhands or face will clear your head. For me, eachmeditation period lasts about 30 minutes. After Icome out of my meditation, the calming effectlasts for hours.

I am careful to wear ear protection when Iam around loud noises to keep the tinnitus fromgetting worse. And I always carry earplugs in mywatch pocket just in case. But when I want abreak from my tinnitus and the stressful worldin general, meditation offers me the quiet thatI need. BMr. Woods can be contacted at P.O. Box 1455, CedarCrest, NM 87008, 505-281-2718, [email protected]

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23/29

QUESTIONS AND ANSWERSJack Vernon 'sPersonal Responses to Questions from our Readersby Jack A. Vernon, Ph.D., Professor Emeritus, OregonHealth Sciences UniversityQ TWo gentlemen,who have askedto remain anonymous, indicate that their

tinnitus increases whenthey take Viagra. They aski f others have observedthe same effect.AWe have receivedno other suchreports, but thenpatients might be reluctant to comment about their use of that drug.

(I did not ask the two gentlemen if the resultwas worth the price.) In that so many Americanmales use Viagra, and that so many Americanmales also have tinnitus, it must be the case thatsome male tinnitus patients have used Viagra.I ask those of you who have used Viagra to giveus a report on its effect upon your tinnitus.Please be assured that your comments will beheld in the strictest confidence.Q r. G. from Brazil writes to ask whatcan be done about musicians and thepotential hearing damage to which theyexposed themselves.AThis is a very difficult question. Themusicians with whom Thave hadinteractions are very reluctant to use ea rprotection and refuse to give up their professionregardless of the consequences. I routinelyrecommend musician's earplugs because theymight provide adequate protection while alsomaking it possible for the musicians to hearsufficiently well to properly perform. Those whoactually try the musician's earplugs say that themusic sounds better. Dr. G., it would be a verygood idea to measure the musician's hearing oncea month in order to provide objective evidence ofthe effects of the loud exposures.

Q r. S. from Virginia indicates that herecently attended a stockcar race atIndianapolis where he used form-fittedearplugs and earmuffs. During the three hours ofthe event he experienced no discomfort but afterwards his tinnitus was increased. He asks if he isflirting with permanently increasing his tinnitus?A think the chances are very good that continuing to attend auto races may very wellpermanently increase your tinnitus. Youhad a temporary effect the first time but repeatedperformances could produce an undesirabletinnitus increase and perhaps some hearing lossas well. Knowing that you enjoy auto racing, Iwould suggest that you try something other thanthe passive protection of earplugs and earmuffs.I suggest active noise cancellation. This technologysamples incoming low-frequency sound thenreverses the phase and plays it back against itselfwhich effectively eliminates the sound. Onedevice I know about is the ProActive 3000 headse t from Noise Cancellation Technologies, Inc.(One Dock Street, Stamford, CT. 06902, 203-961 -0500). This unit is sold on a 30-day money-backguarantee. I have not tried the ProActive 3000 atan auto race but I have tried it on an airplane.I've found it very effective for canceling out lowfrequency rumbling sounds while also providingsome passive protection from the higher frequency sounds with the device's earmuffs. If you giveactive noise cancellation a trial, le t us know theresults.

QMrs. B. from Illinois indicates that shecannot understand why her tinnitus canbe so loud and ye t her physician cannothear it. After all, he can hear a baby's heartbeatbefore birth. Why then can he not hear loudtinnitus?baby's heart beat is an objective sound- one everyone ca n hear - whereas your

tinnitus is a phantom sound that ca n onlybe heard by you. I t is a lo t like pain. No matterhow severe your pain is, it can only be experi


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QUESTIONS AND ANSWERS (continued)

QM ~ . from California asks about dentaldnlhng. She asks if she can preventdamage to her ears or an y increase inher tinnitus by being pu t to sleep with generalanesthesia for the dental work. She also asks i fearplugs will be helpful.A he problem with the dental drill is thatmuch of its sound is conducted to the earsvia bone conduction. Wearing earplugs will

only partially protect your ears and general anes-thesia will only prevent your awareness of thesound. I recommend that you ask your dentistto drill in short spurts, five seconds on andten seconds off. Sound damage to the ears is atime/intensity function. And although we cannotcontrol the intensity, we can control the time.

QMs. C. in California writes to indicate thather father has hyperacusis but withouttinnitus. She wants to know about thetreatment for hyperacusis.A ost hyperacusis patients do have tinnitus,so what you describe is unusual and thatarouses my suspicions. You see, there is

some confusion between hyperacusis and recruit-ment. Hyperacusis patients find all but thevery quietest sounds to be uncomfortably loud.Recruitment, on the other hand, is a fast groV\rth?f l o ~ d n e s s in the pitches where there is hearing1mpa1rment. I assume that your father is elderly,and I would recommend that he have his hearingtested, and especially tested for recruitment. If,as I suspect, he suffers from recruitment thereIare hearing aids that provide special attenuation(called compression) in the recruiting areas. Sucha procedure could make life much nicer for yourfather.Q Mr. I. from California states that histinnitus started some years ago as a con-sequence of construction work and a

fondness for hard rock music. Gradually headjusted to his tinnitus and it was of little bother.Recently at a basketball game, a ball hit himdirectly in his t innitus ear which caused a signifi-cant increase in his tinnitus. He asks, "Since Ihave to play a masking sound very loud to maskthe tinnitus, will that damage my hearing? And isthis increase in my tinnitus permanent?"

An my experience, your tinnitus increase is

temporary bu t it can take weeks or evenmonths to return to normal. Did the blowto your ear cause a rupture in the eardrum? Ifthat is the case, healing may take longer and yourear should be examined by an otolaryngologist. Ifyour hearing has decreased as the result of tym-panic membrane (eardrum) damage, that couldbe the cause of the tinnitus increase. For the timebeing, I suggest that you avoid the loud masking.

Q Mr. L. in Virginia descrbes an interestingsituation with his hearing. He has poorhearing, one ear being worse than theother. Interestingly, when he has an ear infectionin the better ear, his hearing improves and thetinnitus decreases. He asks i f he is going to losehis hearing.think the much more interesting question1s why does your hearing improve withear infections? There is one possibleanswer to that question: you could have adisarticulation (or misalignment) of the middleear bones which is somewhat corrected by fluidsof infection. I think you should have a boneconduction hearing test to see if my guessing iscorrect. If it is, then you could have a middle earprosthesis surgically implanted to restore hearingin that ear. And if your hearing is nearly back tonormal, your tinnitus could be greatly reduced.I suggest that you discuss this matter with anotolaryngologist.

Notice: Many ofyou have left messages requestingthat I phone you. I simply cannot afford to meetthose requests. Please feel free to call me on anyWednesday, 9:00a.m.- noon and 1:00- 5:00p.m.PST (503-494-2187). Or mail your questions to:Dr. Vernon c/o Tinnitus Today, American TinnitusAssociation, P.O. Box 5, Portland, OR 97207-0005.


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SPECIAL DONORS AND TRIBUTESATA's Champions of Silence are a remarkablegroup of donors who have demonstrated theircommitment in the fight against tinnitus by making a contribution or research donation of $500 ormore. Su pporting and Contribu ting Memb ers

have given memberships at the $100-$499level.Research Donors have made research-restrictedcontributions in any amount up to $499.

Contributions to ATA's 'D:ibute Fund will beused to fund tinnitus research an d other ATA programs. If you would like this restricted for research,please indicate it with your contribution. Tributecontributions are promptly acknowledged with anappropriate card to the honoree or family of thehonoree. The gift amount is never disclosed.Our heartfelt thanks to all of these specialdonors.

All contributions to the American Tinnitus Association are tax-deductible.GIFTS FROM 7-16-99 to 10-15-99

Champions ofSilence(Contributions of$500and above)Bruce MartinAndy Mattl1iesen Supportingand Fran BelkinContributing M. Craig Bell Joan CompridoRober t H. CrittendenDaphne Suzanne

Timothy L. Drake,BC-HJSDon Morse Jean A. BlackPhil ip 0. MortonMichael O'Malley, O.D.Charles Powell

Members Rod Bonse r Crocker-White, Ph.D. Glen L. EdwardsLaura R. Enr ightLeonard EverettJames D. FavilleMa rcy FeldmanJeffrey A. FerenzDavid E. FlatowMary A. Floyd

Susan Bently (Contributions from Gladys Justin Carr Sean CulkinJohn Buchman, M.D.William Cohen$100-$499) Michael B. Cartmell Pierre DavidDan PUJjes J. C. Baker H. Wayne Cecil Leah Deats

Rob M. CrichronCornelius R. DuffieMarian B. LovellLarry SimmonsEdmund G. TaussigDe lme r D. WeiszRobert W Wien

Thomas V Barker, M.D. Frederick W. Champ Laura S. DefeliceWilliam M. DertouzosCarl D. DistefanoJerry Down

Bruce E. G. Barndt C. Dennis ClardyDavid D. Bedworth Beryl Clark

Van Jo e Luoma Mur iel Beery E. Landon Collins Elio J . Fomatto , M.D.(continued)

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Because Carol refused to accept her ENTs ' statements,"There is nothing you can do about it. You 'll just have to getused to it," she tried everything she could think of to getrelief, but to no avai l. She couldn't eat or sleep, and allowedherself to be a guinea pig for anyone who offered a possib lecure. Just as she was about to give up, she heard about atreatment called TINN ITUS RETRAINING TH ERAPY (fRl) thathad been developed by a neuroscientist, and out of desper

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SPECIAL DONORS AND TRIBUTES (continued)Marvin Freedman Wilfred Palme r TRIBUTES Phoebe J. Bowles Ted Hofmeister Maj. Leonhard RaabeRobert F. Fuller Janis T. Pedersen l o Memory Of Eleanor P. Boyle David G. Holmes Shirl ey RavenshorstRichard J . Gambatese Mary Ann Perper Norman Erdmann L. W. Bradford Janet V. Hughes Allen RaymonJeanne Gaylord Marilyn E. Prigge Arlo aJld PhyUis Nash Robert J. Bradley Larry Hurley Rev. Daniel ReynoldsAndre A. Giger Donald E. Pul len Mrs. Alvin Jung Conley Branham E. Hunter Hurst Victor J. RichmondJoseph M. Gillis Richard Purdy Larry Christ Dr. Robert S. Bressler Bill Isenberger Kim RippetoeJohn Givogre Anne M. Randisi Cleo v. Kronenberger Cmd.: 0. Davis Brown, Patricia A. Jackson David RoadmanL. Kirk Glenn Tamara Rath Warren Peters III, Ret. David P. Jankofsk y Cynthia N. RobinsonDavid H. Goodman Bill Retherford Eli7.abeth C. Bryan Kevin Johnson Loretta M. RoseC. Lee Gough Margaret Richey Joseph L. Kern , Sr. Ernest J. Buckles R. L. Keheley Matthew P. RossArthur Gould Steve Ronzone Mary Finn Val Burkhead Hanna Kelemen William C. RostLynne A. Grader Lynn Rosemurgy Gregory G. Helmkamp Michael W. Burnham Joseph C. Kincaid Ann H. RothDonna Graham Edward P. Rosenberg Tim and Mary Lou Leffie Burton Roberta Kitzmiller Bill RoupMark S. Graham David Royalty Kern Timothy P. Caire Karl E. Knorps Andrew P. RowjohnRichard P. Gross Ernest Sagues Charles M. Seibert Frank Callozzo Peter Kobelansky Stephen RuleauRuper t Haller, Jr. Jack Salerno Lou Kraus Peter E. Campbell Kit Kolenda Adam J. SawoskiJohn E. Hammill Jean L. Schmidt Claire and Jacques Marie A. Campo Donald Komrska Sally A. SchiroFrank M. Hanna Richard S. Schonwald Simon C. Scott Carter David J . Kovacic Joann A. SchlaeppiC. Douglass Harper William T. Nerine Shatner Stephen Catalano Lance Kroetz William SchwartzJerry D. Harraman Schreitmueller Susan L. Gold, CCC, Dolores Childers JudiS. Lane John ScimecaEdward T. Harry, Jr. Richard s . Schweiker SPA Evelyn Childress Frederick S. Leimer Mario Scort.aAvis S. Hartley Ed Scott J erry Storch Clara E. Clement Alberta Lenke Raphael F. Segura, Jr.Charles M. Helzberg Jean W. Sedlar Dr. Herbert A. Levin Michael Clerc Thomas J. Levins Fr. Thomas F. Sheehan,(Charles M. Helzberg Marc A. Seftel, M.D. Lola C. Coleman Edward M. Lewicki OFMPhilanthropic Fund Dr. Carl Slocum Kenneth Woll Arthur B. Collier Renato Lopez Nancy B. Sheffieldof the Jewish Martin V. Socha Arlo and Phyllis Nash Louis N. D'Ascoli Patricia K. Love Rex ShirleyCommunity Henry M. Sottnek Ester Zepkin Philip Daguanno Claus W. Ludeke Barnard E. ShraderFoundation of David B. Stewart. Imogene S. Mitchell Dennis M. Da ly Lisa Lukavich Leo C. SivleyGrt>..ater Kansas City) Shirley Stockfleth William Michael William J Lynch. Jr. Joel SmithPeter F. Herschend Walter P. Strumski rn Honor Of Daniels Robert G. Lyon John L. SmithS. Dale Hess Roben F. Sutherland Joseph G. Alam Charles and Jane Dare Lou Malchie Martin SnyderManny Hillman JeffreyS. Tashman (Happy Birthday) Susan Dart George Malchow Elizabeth H. SpencerThd Hofmeister Pat Tauer Jim and Rosalie 'fraver D. M. Deardorff Penny Malone Frank X. StaudingerRobert B. Hom Fred D. Thompson Debbie Karlinsky Shirley A. Derkas Scott Marshall Natalie P. StockingSteve Huntsberr y Alton B. 'Tbdd Betty Friedman Gilles C. Desbiens Kathryn A. Martin Sally SwansonH. June tvins John D. Thrmedis Cheryl Lee DeSouz.a Regina Martinez Sarah J . TaylorLarry C. James, Jr. Betty A. 'froyanek Stephen M. Nagler, Jack Dorado Ca rol G. Mathews Bob G. ThompsonRobert L. Jeske Marc R. Upchurch M.D., F.A.C.S. G. Roger Dorey Julianne Mattimore Eva VanDitmarRuth M. Johnston Christina L. VanFossan Phyllis Ann Wiley Virginia R. Doyle Edward Mazza Nell VermeulenTom John ston Elizabeth VanPatten Patrick Rey nolds, Jr . Virginia M. DuBlanc Mary J. MeA lindon Peggy VirgilL. Craig Johnstone Elena Vejarano Beryl Clark Miriam Eidlitz James L. McDermott Lee K VorisekThomas Kag le Jack A. Vernon, Ph.D. Ja ck A. Ve rnon, Ervin G. Erdoes Elaine McDonald Pauline WallaceHarold S. Karpe Thomas K. Webb Ph.D. Scott M. Estelle Evelyn McEvoy Barry WeeksMegan M. Kerschbaum Delmer D. Weisz Paul A. Bauml Eva.n Feldman Sadie McFarland Lee A. WeidnerWaldemar Kissel, Jr. Stefany Welch Rex Rew Betty L. Ferdinand Roy Messick Wilmer H. WelshMary Kleeman Martin G. Wild Robert S. Rivers Fred W. Folsom David S. Metlicka Daniel YeagerJoseph Koppelman Robert E. Wolons Jack Salerno Franklin L. Fountaine Stanley Miody Milton ZerkinDavid J. Kovacic Virginia S. Wood David B. Stewart Johanna Frankel Pat A. Miracle Gertrude ZokalMarvin Kowit Robert B. Wright Phyllis Ann Wiley Ja n Gale Brian MooreE. Joseph Kubat Eric Martin Wunsch Jack Gandrey Charles R. MoretzAllan S. Kushen Larry w. York Research Donors Rosalie Gansecki Quida MorrisJeff Lamb Corporations with Don Abelson Jacqueline Garofalo WiUiam F. MorrisseyJi m Laney Frances L. Abrams Stephen P. Gazzera Stephanie Mue nzbergJudith Larson Matching Gifts Roy B. Acoff Barry L. Geib Gerald Joseph MurphyDr. Herbert A. Levin American Express Mike B. Adams Otto Genoni Emil NatelliSondra Limebumer Foundation George A. Anderson Antoinette R.Gibson Lillian M. NehringJohn H. Macfarlane Bank of America Helen M. Anderson Kathleen L. Gillespie Charles H. NervigAnthony R. Magana Chase Manhattan Sally A. Anderson Gene and Ruth Gilmer fred NewmanKristin E. McAbier Foundation Patty Andrews Christine Graf Carol 1\. NillesJoseph J. McCarthy Fannie Mae Foundation Sayad Anwon Richard P. Gross Eleanor and JoeRomulus E. McCoy, Jr . J.P. Morgan & Co., Inc. Joel Asher Stanley Grumet NotarpoleJohn McDonald Phillip Morris Catherine M. Bailey Joe Guzzo Scott R. OlsonAnne Holmes McKay Companies, lnc. Bob Baker Joanne Haggerty Carl F. PetersBru ce F. Meyers US West Foundation Everett Beach John C. Hamlin Sara J. PetersScott C. Mitchell Andrew Beaven Ronald H. Ashida, Robert Peterson.Joseph Monteferante Special Friends Howard G. Bemett Ph.D. Susan G. PhillipsRon Moran Fund Aug ust Belmont Mae Heng 1\my W. PhillipsJohn J. Nichols ln Memory of Alfred J. Bertolone Ken neth C. Henry Nicholas J. PialoglousTeresa L. O'Halloran Dr. Robert M. Gary A. Billey Margaret P. Heppe Armando PortaroCharles T. Ohlinger, rrJ Johnson Miriam G. Bloomfleld Abby S. Herman Lynn PriorRoger A. Olayos Ron Hedenskog Joan Bonawitz E. Alan Hildstrom Steven ProeWarren Palmer David Shaine Garrison Botts Eva Hofman Donald E. Pullen


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28/29

Here we are, face to face with the year

At a timelike this,who canresisttrying tosee into thefuture?

Think about afuture wherepeople withtinnitus havecomplete access tomedical profes-sionals who areknowledgeable,helpful, andcaring abouttheir condition.

Think abouta futurewhereeffective booksand brochures,Internet informa-tion and audioand videom aterials a reeasy to get andeasy to learnfrom.

Think about afuture whereany personcan join otherswith tinnitus foremotional supportand sharedinformation.

Think abouta futurewhere ourchildren andgrandchildren

are taught atan early age toprotect theirprecious hearing;a future wherekids actually doturn down thevolume to avoidgetting tinnituslater on in life.

Think about afuture wherepeople withtinnitus speak outpowerfully with acollective voice toseek recognition,empathy, andgreater financialbacking fromthe federalgovernment.

Think abouta thrillingfuturewhere a bandof researchers,working diligently,finally finds acure for tinnitus.


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These visions of the future aren' t just

~ ~ e r i c a n TinnitusAssociation isworking every

day towardthese vital goals.Your AnnualCampaignsupport willhelp make thisfuture a reality. Peaseconsidernow makingan additional

donation tothis specialcampaign. Yourgift beyond yourbasic membership support istruly a gift toall of us whowant to maketinnitus a thingof the past.

Ue theattachedenvelopeto send yourtax-deductibledonation toATA's AnnualCampaign.

And joinus incelebration

of a tinnitus-freemillennium .

tinnitus today december 1999 vol 24, no 4

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