VOLUME 13, NUMBER 2, JUNE, 1988

THE AMERICAN TINNITUS ASSOCIATION

~ ~ ~
N E W S L E l l E ~
ON LOCATION ATA PUBLIC SERVICE
ANNOUNCEMENT FILMED AT
INDIANAPOLIS FEATURES 4-TIME RACE
WINNER AL UNSER, SR.
THE NOISE OF RACING IS EXCITING, BUT YOU
PAY THE PRICE IF YOU DON'T PROTECT YOUR
HEARING.
During the early years of his 30-year racing career, AI
Unser, like other drivers did not wear ear protection. As a
result AI has had a noticeable hearing loss and tinnitus for
the past five years. Fortunately, Indy drivers now wear
custom earplugs that incorporate two way radio
communication with the pit area allowing them to receive
important messages while they are driving and at the same
time protecting their ears. We are grateful to AI for having
volunteered time from his busy racing schedule to make a
public service announcement to help the American Tinnitus
Association get the word out about hearing protection. The
pictures accompanying this article were taken in May,
during the filming sessions for the PSA.
You can help ATA and AI Unser to "get the word out" by
contacting your local Television station's public service
director and asking them to air these announcements. We
will be happy to send tapes to any TV station requesting
them if they will let us know what size they can use.
(Usually 1", 2", or 3/4") We have already mailed
information directly to over 700 television stations so you
should be seeing the announcements very soon.
THOUGHTS ABOUT TINNITUS
MANAGEMENT FROM THE UK
by Jonathan W. P. Hazell, F. R. C. S. Consultant
Neuro-Otologist to the RNID (Editor's note: Dr. Hazell was
the 1987 recipient of the AT A-Hocks Memorial Award for
distinguished contribution to the field of tinnitus knowledge.
The article which follows was written as Dr. Hazell's
response to having received the award.) Part I appeared in
the March, 1988 ATA Newsletter.
Part II
My current scheme of tinnitus management goes as follows:
1) Proper otological investigation: Exclusion and
reassurance about serious pathology.
2) A thorough explanation of how the tinnitus is produced
3) Discussions about methods of symptom control
4) Looking for other things that may be causing distress
besides tinnitus.
Proper investigation is vitally important for two reasons.
Many people pay attention to their tinnitus only because it
enjoys a heightened significance. If you have a strong
feeling that the tinnitus means you have a brain tumour,
psychiatric condition or are likely to have a stroke, then it is
impossible not to listen to it. Proper reassurance may not be
achieved without a lengthy process of medical investigation
to exclude these possibilities, however unlikely they may be.
Because of the relative confusion about what tinnitus is, a
vast spectrum of different conditions exist which can result
in the referral of a patient with a label "tinnitus".
although the majority of patients seem to have mild inner
ear degenerative problems, a growing number come with
sounds produced by muscular contractions, open Eustachian
tubes (patulous eustachian tube syndrome) and sounds
transmitted from the vascular system and joints in the
cervical spine and jawbone.
Many of these conditions have a medical or surgical solution
but will never be identified if they are labelled as just
"tinnitus" and dismissed.
Explanation takes time but is often all that is necessary to
put the patient's mind at rest. The specialist needs a good
working knowledge of the auditory system (not something
that I acquired in my training in otolaryngology). The
psychologists in one multidiscliplinary team treating tinnitus
use what is called cognitive therapy. In its simplest form this
means allowing the patient to understand what it is that is
going on inside them. It works very well. Although some of
the techniques are difficult to apply and require special skill,
all tinnitus patients benefit from a basic understanding of
their condition.
Symptom control has been shown in our studies to help in
the process of natural adaptation. It is probably more helpful
to see it in that light, than to think of it as a treatment that
needs to be continued for all time. Very soon after I started
my research in 1974 I was extremely fortunate to have been
put in touch with Professor Jack Vernon, who was at that
2
time developing the tinnitus masker in Portland at the then
Kresge Hearing Research Laboratory. We started a
programme of our own in London in 1976 and opened a
tinnitus clinic at University College Hospital, where we
began fitting tinnitus maskers. Jack's help and guidance
over the years has been invaluable and our two departments
enjoy close links and a frequent exchange of visitors.
As we found out how to use maskers and learnt how to
counsel and instruct masker wearers, our "success rates"
improved dramatically. It is still the most effective means of
symptom control that we know, although of course not
everybody is helped, and we constantly need to look to new
techniques, and new strategies of masking, e.g. instruments
which will specifically induce residual inhibition. With
tertiary referrals, we still find the commonest cause of
failure of masking is wrong fitting, or lack of counselling.
This does not mean to say that other units who were not
fitting maskers did any less well, and one of our nearby
hospitals in London had a team of psychologists headed by
Dr. Richard Hallam, (ATA Newsletter, January 1986) who
were using psychological techniques including relaxation
and cognitive therapy to extremely good effect. We got very
enthusiastic about drug therapy at one point, particularly the
use of membrane stabilizers like carbomazipine or Tegretol
and tocainide, which has since been withdrawn from general
use in the UK. Although we had some spectacular results in
the early days, these were not maintained. We have a
programme of electrical stimulation using a cochlear
implant with a round window electrode which has been
developed in the UK and we have patients who are using
low frequency sinusoids to produce electrical suppression
(or is it electrical masking?) We are constantly examining
new possibilities, even areas of alternative medicine where
claims have been made. The problem with symptom control,
by whatever means, is that if it is not seen as part of a
process of natural adaption then there is bound to be
disappointment.
Our most recent masker study looked at the long term
results after some five or six years. 43% were still using
their maskers for more than an hour a day. In those who
were still wearing maskers 26% had not adapted to the
tinnitus and found it worse, or a least as bad as when it first
started on their life and the annoyance it caused. In this
group there was a general increase in masker use compared
to the start. In those who had completely adjusted to the
tinnitus, were rarely worried by it, and often unaware of it
( 14%) the masker usage had dropped by over half in terms
of hours per day. Those people no longer wearing their
maskers at all (44%) were divided into two groups. 27% of
this group professed not to have been helped or to have
tinnitus which was just as annoying as when it started. 63%
had adapted to their tinnitus over this period and were no
longer worried by it. It is very important to take this into
account when assessing the effect of any treatment on
tinnitus. It would be very easy (but inaccurate) to say that
those who no longer use their maskers had not been helped.
The long term continued use of any treatment which brings
about an abrupt change in the tinnitus may militate against
the natural adaptive process. Adaptation requires the
individual to ignore the tinnitus and this may be more
difficult if efforts are constantly being made to vary its
intensity. Nevertheless there is a third group, somewhere in
the middle of the two previously described where adaptation
to the tinnitus occurs only as long as a masker is available
for use. It was also interesting that of those no longer using
their maskers in this study, 48% said that they were not
prepared to return them even if their money was refunded.
Like having an aspirin in the cupboard in case of headache,
the possession of a device which can control or at least
moderate the symptom gives added confidence for coping.
In some 40% of the patients we see there are other problems
adding to the distress caused by tinnitus. Often the other
problem is the major one. For instance there may be a recent
bereavement, domestic or work difficulties, financial
problems or other unrelated illnesses. Often there have been
previous periods of depression and the onset of tinnitus is
yet another "last straw to break the camel's back". In some
patients (very often those where there is no abnormality on
the audiogram) the tinnitus seems to us to be of quite low
intensity but there is a great deal of distress and these "other
factors" turn out to be supremely important. The tinnitus
may be used as a "flag waving exercise" to attract attention.
The individual is very distressed, and the tinnitus is very
evident so it gets identified as the cause of the problem. It is
often easier to go to a physician complaining about a noise
in your ear, than contemplate visiting a psychologist or a
psychiatrist because of feelings of depression or anxiety
about less well defined problems or difficulties. The
physician or specialist should see this as an opportunity to
sort out what may be a very long standing problem or
anxiety and point the patient in the direction of appropriate
and expert help, rather than lose interest because the whole
thing appears to be "psychological".
In the UK there are now special clinics for tinnitus sufferers
in hospitals all around the country, and over 100 self-help
groups belonging to the British Tinnitus Association, the
AT A's sister organisation (the BTA was started by Jack
Ashley, the deaf Member of Parliament with severe tinnitus,
in 1979.) The British Tinnitus Association has undoubtedly
given enormous support and help to tinnitus sufferers
throughout the country, just as the AT A has in the USA.
Things have been slow to get under way on the other side of
the English Channel, although in the last five years there has
been excellent work in Scandinavia and the start of the
German Tinnitus League was closely associated with the
Third International Tinnitus Symposium in Munster,
organised by Professor Harald Feldmann. More clinicians
are becoming aware of what is available, and increasing
3
numbers of papers reporting conscientious research continue
to appear in the professional literature.
For the future we can at least anticipate the same sort of
advances in masking devices as have been achieved in
hearing aid technology over the past 50 years. We can
identify increasing numbers of small groups who have
surgically manageable conditions, previously presenting as
tinnitus without any obvious cause. The big leap comes
when we begin to be able to repair the rattles in the old
motor car! Will we be able to replace damaged hair cells in
the cochlea with colonies grown from human foetal ears
which have not yet developed antigenicity? Such a concept
which has never been tried anywhere fills many of us with
revulsion, and in many countries such experimentation is
banned. However transplantation of similar material is
feasible in animals, and eventually such techniques will be
tried (though of course not by us!).
In the meantime keep smiling and drive round the potholes.
SOURCE REFERENCES
Hazell, J. W. P., Wood, S.M., Cooper, H. R., Stephens, S.
D. G., Cocoran, A. L., Baskill, J. L., Sheldrake, J. B. 1985 A
clinical study of tinnitus maskers. Brit. J. Audiol. Vol. 19
Hazell, J. W. P. 1987 "Tinnitus" Ed. Hazell. Pub. Churchill
Livingstone, London, UK and New York, USA.
Hazell, J. W. P., Sheldrake, J. B., Meerton, L. J., 1987
Tinnitus masking - is it better than counselling alone?
Proceedings of the 3rd International Tinnitus Seminar,
Munster, GDR.
COMBINED GIVING CAMPAIGNS AND ATA
by Harvey Abrams, Ph.D. (Veterans Administration)
Federal and State employees have a unique opportunity to
make charitable gifts to the AT A through the Combined
Federal Campaign for Federal and Military Employees and
the State Employee Campaign for Municipal and State
Workers. Contributions can be made as a one time gift or
through payroll deduction.
Participants in the combined campaigns have a choice of
designating up to 5 individual recipient agencies from
among hundreds participating. If an employee does not
designate, then over 85% of the undesignated gift will be
distributed among United Way agencies. Although UW
represents many deserving agencies, AT A is not one of
them. AT A is a member of another umbrella organization -
the National Voluntary Health Agencies (NVHA)- which
counts among its 50-plus members, the Arthritis Foundation,
American Lung Association, the Muscular Dystrophy
Association, and American Diabetes Association. The
important thing to remember is that if you do not
specifically designate the AT A as a recipient, little, if any of
your contribution will be received by ATA.
When it comes time for the next Combined Campaign at
your workplace, please consider participating and remember
-Designate!
ADDITIONAL INFORMATION FROM THE
1986 PATIENT SURVEY
The pamphlet "Infonnation from the AT A Tinnitus Patient
Survey" reported the percent of people answering for each
of the items in the questionnaire. Two of the questionnaire
items related to specific helpful treatments for tinnitus. Item
#22 "Have you tried any fonn of treatment for your
tinnitus?", where 67.7% of the people responding answered
'no', 30.6% answered 'yes', and 63 specified relief from
another fonn of treatment; and Item #23, "Is there anything
else you know of that helps to relieve your tinnitus?" where
695 people answered yes, and listed one or more treatments.
What follows is the breakdown of the helpful "other"
interventions that were reported by these 758 people.
PHYSICAL IN1ERVENTIONS ............. ......... .
Number
Reporting .............................. . Description
189 .. . ................................ MASKING,
includes background noise, running water,radio, white noise.
28 . ......................... HEARING AID OR AIDS
18 ..................................... MASSAGE,
includes myotherapy, acupressure, positional changes
17 .................................. DENTAL-TMJ,
includ.es use of dental splint, regular dental work
16 .................................... EARPLUGS,
includes all kinds
15 ........................... EAR WAX REMOVAL
14 ....................... EXERCISE, Physical activity
12 ............................ PRESSURE CHANGE,
includes Valsalva maneuver, atmospheric change
8 ...................................... SURGERY,
includes stapedectomy, shunt, cochlear implant
8 .................................. CHIROPRACTY
7 .................... HEAT/COLDAPPLIEDTOEAR
DRUG AND DIET IN1ERVENTIONS
Number
Reporting .............................. . Description
47 .......................... DIET MODIFICATION,
includes low sugar, low salt, low fat
26 ............................. USE OF VITAMINS,
includes minerals
25 ......................... CAFFEINE A VOIDANCE
20 .................. USE OF ALCOHOL, WINE, BEER
19 ......................... ALCOHOL A VOIDANCE
15 ........................... USE OF NARCOTICS,
includes sleeping pills, Valium
13 .......................... ASPIRIN A VOIDANCE,
includes other similar drugs
8 ....................... USE OF ANTI-HISTAMINE,
and other allergy controls
8 ................................ USE OF ASPIRIN,
and similar drugs
4
3 .................... BLOOD PRESSURE CONTROL
2 ......................... WEIGHT, GAIN OR LOSS
2 ......................... USE OF OTHER DRUGS,
includes anti-biotics, penicillin
1 .............................. USE OF DIURETICS
1 .................... USE OF CNS ACTIVE DRUGS,
includes tegretol, mysoline etc.
1 ............................ DIABETES CONTROL
PSYCHOLOGICAL IN1ER VENTIONS
Number
Reporting .............................. Description
144 ......... IGNORE IT, KEEP BUSY, DISTRACTION
104 .................... SLEEP, REST, RELAXATION
43 ................................. AVOID STRESS
37 .......................... QUIET ENVIRONMENT
28 ........................... POSITIVE THINKING,
includes hypnosis, self-hypnosis, meditation, relaxation
tapes, psychological counseling
SURVEY,RESULTS::NOWAVAILABLE
TO RECEIVE A FREE COPY OF THE SURVEY
RESULTS MENTIONED IN THE ABOVE ARTICLE,
SEND A L ~ ( } E S E L F ~ ADDRESSED STAMPED (25)
ENVELOPEWITH THE WORD 'SURVEY' WRITTEN
IN THE LOWER LEFf HAND CORNER.
FEDERAL AGENCIES' RESEARCH AND
TREATMENT ACTIVITIES
FACT SHEET ON TINNITUS prepared for the Honorable
Daniel P. Moynihan, U.S. Senate, March 1988, may be
requested from:
U.S.General Accounting Office, P.O.B. 6015,Gaithersburg,
MD20877
The frrst five copies are free. Additional copies $2.00 each.
ATA FELLOWSHIP BRINGS NOTED
RESEARCH SCIENTIST TO OHSU
TINNITUS CLINIC
Dr. Pawel Jastreboff of Yale University spent several days
sharing tinnitus information with the staff of the Oregon
Hearing Research Center and the American Tinnitus
Association. Dr. Jastreboff's current research relates to
understanding the physiological correlates of tinnitus. A
special seminar sponsored by AT A was presented at the
Oregon Hearing Research Center in which Dr. Jastreboff
spoke about "An animal model for tinnitus". There are
currently several articles by Dr. J astreboff about this topic in
press. Watch for one in the next ATA Newsletter.
the condition. He called it hyperacusis,
or hypersensitive hearing. His clinic had
seen a handful of others with the
condition, and most had also had
tinnitus. What was unusual was that
none of the patients had any measurable
hearing loss, most -- like this 32-year-old
-- had no impressive noise history, such
as years of exposure to loud sounds in
the workplace. In some cases,
hyperacusis came on suddenly, without
any discernable provocation.
The patient corresponded with
others who had hyperacusis, some living
in other countries. He and his parents
contacted ear specialists and other
doctors throughout the country, hoping to
. obtain information that might help in
treating hyperacusis. It would be more
reassuring if noise was the only apparent
cause, but contact with other sufferers
and doctors revealed that was not the
case.
In fact, several medical instances
of hyperacusis turned up. Oral surgeons
say that hyperacusis is seen frequently in
patients who undergo jaw and facial
operations, but its duration generally
ends a few weeks after the surgery.
Dentists who specialize in treating TMJ
syndrome (temporomandibular or jaw-
joint problems) report that hyperacusis
and tinnitus are sometimes symptoms
associated with TMJ disease. In
addition, neurologists say they see
hyperacusis in Tay-Sachs disease, a rare,
inherited disorder of the central nervous
system seen in infants and small
children. In addition, audiologists and
otolaryngologists report cases of
hyperacusis in patients who have been
exposed to noise, frequently a single
event or a single blast, such as from a
gunshot or a cordless phone.
The general feeling among
medical specialists is that hyperacusis is
a comparatively rare problem, one that
sometimes improves or resolves itself
over time. During its acute phases,
however, it can be devastating,
disrupting lives and psyches, and costing
patients jobs, money, and relationships.
In that way, of course, it is like severe
tinnitus, and those unfortunate enough to
have hyperacusis frequently have tinnitus
also, a double threat to their peace of
mind. But just the fact that it sometimes
does improve over time 'is reason to
hope.
Today, the 21-year-old is 34, and
after reaching their zenith nearly three
years ago, his hyperacusis and even his
tinnitus have diminished in severity --
extremely slowly -- certainly -- but
surely. Dr. Vernon and other experts
believe hyperacusis differs from a
condition known as recruitment, an
abnormal growth in the perception of
loudness that is not uncommon in people
with hearing loss. For them, loud noises
are painful. For those with hyperacusis,
all sounds are uncomfortable.
- What is it that makes a small
percentage of the population develop
hyperacusis while the vast majority does
not? Does this patient's increased
sensitivity to light, making night driving
almost impossible, relate neurologically
to hyperacusis? Why do people with no
history of hearing problems, no exposure
to abnormally loud sounds, and even no
hearing loss, sometimes develop the
disorder inexplicably?
These questions can be answered
only if enough researchers take an
interest in the problem to seek answers.
If noise was the only factor in causing
hyperacusis, everyone with noise
exposure, tinnitus or hearing loss would
also have hyperacusis. Fortunately, that
is not the case, but science must take
heed of the few who do.
Page 5

BEST WISHES NEIGHBORS!
We have recently had word from
Elizabeth Eayrs of Toronto, Ontario, that
the incorporation of the Tinnitus
Association of Canada has been
completed. We wish you great success
and look forward to exchanging news
and views often. Canadians are welcome
to continue their membership in AT A
and we are quite sure that the TAC will
welcome members from the states.
ATA TINNITUS BIBLIOGRAPHY
A GROWING DATABASE FOR YOUR USE
The ATA now offers a Tinnitus Bibliography containing
nearly 1700 references listed in alphabetical order by author.
It is available to ATA members for $25.00 (plus $1.00
shipping and handling for orders from outside the United
States). We also offer a bibliography search service from
which members may obtain listings of articles on a
particular subject area of tinnitus. Some of these subject
headings are TMJ, physical trauma, noise, diving & tinnitus,
and hearing loss. For these and other subject listings, there is
a basic search fee of $5.00 plus an additional charge of .25
per source over 15 sources. For more information contact:
this office, mentioning "Bibliography".
A quick tally of publications about tinnitus during 1987
revealed the following numbers of papers on these named
topics:
NUMBER ... .... . ...... .. ......... ... .... SUBJECT
OF PAPERS
1 ............ ...... . ...... .. .. . .. .... ANIMAL MODEL
1 ..... ........... .......... ... .... .. ......... . ATA
1 . ........ ..... ............ .. .. . ...... . . . ... ... BIOFEEDBACK
1 ............................................. EPIDEMIOLOGY
2 ...... ... . . ...... ... . . . ... . . ..... GENERAL TINNITUS TOPICS
2 .. .. ...... ........ . ..... .. . ............... HISTORY, THEORY
10 ............ ... .... .. . . .... . ... MANAGEMENT OF TINNITUS
4 .. ......... .... ..... . MEDICAL, AUDIOLOGICAL EVALUATION
2 .. ................ . .... . . . ........... . .. ...... . NEUROLOGIC
4 ... ........ . ......... . . . .. .. ...... NOISE INDUCED TINNITUS
2 ......... . ............ . . . ... . ........... .. .. .. OTOTOXICITY
1 ....................................... OBJECTIVE TINNITUS
11 ....... .. ...... .... .... ... ....... PSYCHOLOGICAL ASPECTS
6 .......... .... ... . . ..... .. ... ....... . . ....... .... PULSATILE
1 .................................................. SELF-HELP
3 .......... .. . .. ... .. . .. ........ . ..... TINNITUS IN CHILDREN
1 ......................... TINNITUS WITHOUT HEARING LOSS
5 ......................................... TMJ DYSFUNCTION
2 . ........... .. .......... TREATMENT OF TINNITUS: ALLERGY
2 ........... . . ...... . . ........... .. .. .... COCHLEAR IMPLANT
1 ... . .......... .. ..... . ....... . ... .. ......... .. ... . ..... DIET
31 . ............. . ............ DRUG MANAGEMENT- MEDICAL
5 ................................. ELECTRICAL STIMULATION
7 . . ........... . .. ..... .... . ... . .... HEARING AIDS - MASKERS
NEW ATA BOARD MEMBER
Philip 0. Morton, Portland, Oregon, Vice President of
Gaylord Industries, has been elected to serve on the AT A
Executive Board. Phil, himself a tinnitus sufferer, has been
instrumental in establishing one of the Portland self-help
groups and is an active campaigner for noise control.
Welcome aboard, Phil!
6
MARK YOUR CALENDAR FOR
SEPTEMBER & OCTOBER MEETINGS
TINNITUS FORUM
September 26, 1988, Washington, DC, Grand Hyatt Hotel,
7:30p.m.
Discussion of medical and social aspects of tinnitus
featuring prominent ear, nose & throat specialists who will
be attending the annual meeting of the American Academy
of Otolaryngology. Come and hear AT A's advisors speak
about the latest treatments and techniques for relieving
tinnitus. No reservation needed.
TINNITUS CONFERENCE
October 22, 1988, Philadelphia, PA, Elwyn Institutes, 9:00
a.m. to 5:30p.m. Day long meeting featuring well known
speakers about tinnitus and short workshops where you may
learn more about how to understand and cope with your
tinnitus. You may correspond directly with the conference
organizers. Your registration will cost $10 if completed
before June 30th, $15 from July 1 to the deadline of August
31. "Tinnitus Conference '88", P. 0. Box 351, Voorhees,
NJ 08043. Or, write to ATA for a registration form.
ANNUAL GIFTS FOR 1988 ARE DUE
ONLY WITH YOUR SUPPORT CAN ATA CONTINUE
TO PROVIDE INFORMATION ABOUT TINNITUS AND
FUND TINNITUS RESEARCH. PLEASE BE
GENEROUS!
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enclosing my annual contribution to support tinnitus
research and education
___ $15- $24 Contributing Member
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Your contribution in any amount will be greatly appreciated
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PLEASE: Help us to keep your Newsletter coming to you on
time by providing us with a change of address in advance of
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they do provide us with a new address (at 30 each)- but
you usually don't receive that issue.
TINNITUS TODAY
ATA NEWSLETTER TAKES ON NEW LOOK
With the December 1988 issue, the ATA Newsletter will
become known as Tinnitus Today. The new magazine will
be more colorful and will contain even more information to
help people with tinnitus. You will be seeing more
advertisements because it has become necessary for us to
find additional sources of funds to produce the Newsletter.
It turns out that this new policy will benefit AT A members.
First, it means that your donations will be able to be directed
toward research projects, and second, you will be able to
read about items that can make life easier and more pleasant.
7
Watch for articles and information you can use about new
products. Contact us if you wish to advertise a product
having potential benefit for tinnitus patients. The AT A
board has set advertising guidelines. Products advertised in
Tinnitus Today are not endorsed by AT A but the advertisers
will have conformed with these guidelines.
COMING NEXT
The next AT A Newsletter will include a research article
about work being done at Yale University to develop
techniques for measuring the electrophysiological correlates
of tinnitus. There will be an article directed toward the
consumer to help you make more informed choices
regarding tinnitus treatment. We will also be reviving a
popular column "Tell me doctor ... ", in which your questions
about tinnitus are answered.
Authors may submit articles to AT A for possible publication
in the Newsletter. These articles should be double spaced
on 8 x 11 inch paper and should not be longer than about
1500 words. It is desirable to send a black and white glossy
photo of the author or of the subject of the article for
publication. A TA retains the right to select and edit articles
as it sees fit. Scientific articles must conform to generally
accepted styles and be properly referenced.
"COPING WITH TINNITUS"
e STRESS MI\NAGEMENT & TREATMENT
e TINNITUS MI\NAGEMENT IS OFTEN
COMPLICATED BY ANXIETY AND STRESS
e NOW A UNIQUE CASSETTE PROGRAM IS
AVAILABLE DESIGNED TO PROVIDE DAILY
REINFORCEMENT AND SUPPORT FROM THE
STRESS OF TINNITUS WITHOUT COMPLEX
INSTRUMENTATION & VALUABLE OFFICE TIME
There is a growing interest in psychological methods of tinnitus
control such as systematic relaxation procedures which help the
patient cope with the tension of tinnitus.
Subjects with tinnitus are being taught ways to relax as part of a
total tinnitus program which may include hearing aids, tinnitus
maskers and progressive muscle relaxation based on principles of
conditioning. Relaxation procedures are usually easily mastered and can be performed daily in the
patient's home environment. It has been demonstrated that the relaxation response can release muscle
tension. lower blood pressure and slow heart and breath rates.
A.
ASSOCIATED
HEARING
CENTERS
A relaxation method has been developed entitled Metronome Conditioned Relaxation (MCR) which
has successfully treated for many years chronic pain. tension headaches. insomnia and many other
conditions.
The program consists of one cassette tape of Metronome Conditioned Relaxation and two additional
tapes of unique masking sounds which have demonstrated substantial benefit whenever the patient
feels the need of additional relief. These recordings can be used to induce sleeping or as a soothing
backdrop for activity and can be played on a simple portable cassette player.
ALL ORDERS MUST BE ACCOMPANIED BY
CHECK VISA, MASTERCARD. OR INSTITUTIONAL P. 0.
6796 MARKET ST., UPPER DARBY, PA 19082
Phone (215) 528-5222
TRIBUTES
The A TA tribute fund is designated 100% for research. Thank you to
all those people listed below for sharing your memorable occasions
in this helpful way. Contributions are tax deductible and are promptly
acknowledged with an appropriate card for the occasion. The gift
amount is never disclosed.
IN HONOR OF CONTRIBUTOR
Margaret Pfister ...... ..... . . ...... .......... . Edward Pfister
John F. Grove .... .... . ..... .. . .. .. ... ....... . Martha Grove
Larry Morgan ................................ Susan Morgan
John Brady ... .... ............. ....... .... . Elizabeth Brady
Jos. J. Pappas, M.D ... .... .. ....... ....... Mrs. M.J. Friedman
Eric M. Kraus, M.D ... ......... ..... ........ Madalyn Mancuso
Mrs. Lew Kern ........................... Jean & Joe Wolfson
Fortunato Barquero ............ .. . . ......... Peggy M. Salazar
Sam Kaplan ......................... Mr & Mrs Sam Eisenberg
Donna L. Gary .................................... Mr. Gary
Marjorie Youngen ........................ J. Richard Youngen
Mary Cassel ........................... J. Alam & T. Drucker
Carolyn E. Packer .... .................. . J. Alam & T. Drucker
Amber N. Perc .......... ......... .. .... J. Alam & T. Drucker
Maria V. Rivero .......................... Mrs Mario A. Luque
Dr.Jack Vernon .. .. . ....... ....... ..... ...... . ..... M.Lang
Peg & Jim Doyle ........................ J. Alam & T. Drucker
Ron Savio ........ .. ...... ... . ............ . Ronald A. Savio
David Ney . ..... (: .: ......................... .. Wilma Ney
Mrs. S1dney Zaron , ! , t: .... Jean & Joe Wolfson
Bruce Julien, M.D .. ......... ... . .. .. .. .. .. Jean & Joe Wolfson
Samson A. Mandell ................... Mr & Mrs Sam Eisenberg
Charlette J. Snyder ...... . .. .. .... .. ...... Rose & Alfred Polen
Karen's Birthday ; ........................... Rosalie K. Erlich
Michelle A. Stone ....................... J. Alam & T. Drucker
Carol Kaplan .. . ....... .. ..................... Helen Kaplan
Nancy Poindexter . ..... . ... .. .................. Flora H. Bell
Dr,Jack Vernon ............................ James L. Shapley
Louis Lytton, M.D ......................... Jean & Joe Wolfson
Dr. Jack Vernon ... .... . . . . ........... . ..... Pearl Silverstein
Father's Day ............................... Anthony Sciveres
Velma C. Carl . .... .... .. ... ..... . ..... . ... . .. Velma C. Carl
IN MEMORY OF CONTRIBUTOR
Margaret Willis ... .. .... . ..... .. .............. Sam Goldberg
Alois Kabacinski .... ... . . .. .. . ........... .. Harry Kabacinski
Ruth Milazzo ..... . ............. . ............ .. Ben Milazzo
Edgar Tunsch .. .... . ..... ... ... . ........ . Mrs. Edgar Tunsch
Inez Farina .......................... ..... . . . Daniel Farina
Lawrence H. Sanders .................... .. . Kathy M. Sanders
Winnie DeYoung ............................ Myrtle D. Hardin
Winnie DeYoung .. . ........................... Winnie Jones
John N. Christos ............................ Norma Christos
Lou Tinker .......... . .. ............. .. . ..... John R. Veglia
Bill Dennis .. .... . .. ..... .... . . . ............... Edith Dennis
H. J. Jax Pieser .. .... ..... ..... .... . Mr & Mrs Efrom Abramson
Dr. A. B. Baker ..................... Mr & Mrs Efrom Abramson
For more tnformation wrtte to
AMERICAN TINNITUS ASSOCIATION
P.O. Box 5. Portland. OR 97207
A corporatton under the laws of Oregon
ADORESS COAAECTION REQUESTED
ISSN: 0897-6368
8
William Wertchafter ................... . . Mr & Mrs Joe Wolfson
Mark Blumenfeld . . ....... . ......... . .. Claire & Jacques Simon
Mrs. Marion Ogull ........ ... .. ..... .. .... ... ... . Louis Ogull
Gertrude Westphal ....................... Antoinette Westphal
William Behlke ..................... Mr & Mrs Efrom Abramson
M. Arnold Lyons ......... . ....... .. . Mr & Mrs Efrom Abramson
Phil Theilen ........................ Mr & Mrs Efrom Abramson
Nat Weissberger .. ... .................... Jean & Joe Wolfson
Leibowitz' sister .... . . .. ............. . ... Jean & Joe Wolfson
Walter Holcomb ... ... ... ......... ..... Jessie M. Jones-Cobb
Edward Camiel ......................... Mr & Mrs Mike Kriger
Ida Elefson . . . . . . . . . . . . . . . . . . . . . . . . . . . . Mr & Mrs Mike Kriger
Irving Soroka . . . . . . . . . . . . . . . . . . . . . . . . . . Mr & Mrs Mike Kriger
Rose & Jacob Berliner .... .. .... ........ ... . . .. Mrs. M Manus
Edyce S. Rubin ............................ Sarla W. Samson
Florence S. Press .. .. .... ....... ..... .. .... Sarla W. Samson
Gisella Huppert ..... .. ........ . .. ....... ... Sarla W. Samson
Lew Kern .......................... .. .. Jean & Joe Wolfson
Milt Rutledge . . . ..... ............ . .. .. .... Leona M. Rodwell
Max Gold .... .. .... ... .... . ..... . . Mr & Mrs Efrom Abramson
Jules Gerstel .. ........... . ......... Mr & Mrs Efrom Abramson
Burt Horowitz ........ .. . ..... . ..... Mr & Mrs Efrom Abramson
Beth Ross'father .......................... Ms Rhoda P. Levin
William F. Cramb . ... .... .. ... .. .... .. .. Mrs Harold L Nuckolls
Lee Guber ............................. Jean & Joe Wolfson
Amy Olson . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Phyllis Nash
Leonora Maldarelli ....... ... ............ .. .. Ralph Maldarelli
Edwin Hattori . ..... . ... . . . ........ .. ......... . Lillian Hattori
Jack & Richard Plevinsky ............ . ... . .... Ida C. Plevinsky
SPONSOR MEMBERS: FEBRUARY to MAY, 1988
Alexander Alex Lynda J. Martin
H. R. Matern, M. D. Alice A. Bauer
Sidney Cobb
Jessie Jones-Cobb
Gardner C. Cole
Dwight De Sheng
Dr. Trudy Drucker
Sidney Gall
Michael Gilman
Raymond H. Grenier
Lynda Hoffman
Marie D. Jeffrey Fdn.
Edward G. Kalinowski
Mrs. Norman C. Kinsey
Laura P. Kleppick
Richard D. Zujko, M.D.
Alan B. McDaniel, M.D.
Patrick S. McGuinness
Stanley E. Moore
W. S. Nelson
Ronald A. Palmieri
Elmer Richter
Daniel Ross
Nelson L. Savidge
Marion Schenk
Benjamin A. Trustman
Duane D. Walters
Antoinette Westphal
Thomas W. Winstead
ATA GRATEFULLY ACKNOWLEDGES RECENT BEQUESTS
FROM THE ESTATES OF PEOPLE WHO HAVE PROVIDED
SUPPORT FOR TINNITUS RESEARCH BY MENTIONING ATA IN
THEIR WILLS.
Emagene Faye Veal, Oregon
Valverda Knight, California
Gilbert L. DeRosia, New York
NON PROFI T ORG
US POSTAGE
PAID
PERMIT NO 1792
PORTLAND. OR