September 2000

Volume 25, Number 3

Tinnitus Today
THE JOURNAL OF THE AMERICAN TINNITUS ASSOCIATION
"To promote relief, prevention, and the eventual cure of tinnitus for
the benefit of present and future generations"

Education -

Since 1971
Advocacy - Research -

In This Issue:
Masking in the Millennium
Tinnitus Research Consortium
Acoustic Neuroma: A Success Story
Filing a Successful Tinnitus VA Claim
Curing Tinnitus with a New Pair of Genes

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Tinnitus Tod~y
Editorial and Advertising offices: American Tinnitus Association, P.O. Box 5, Portland, OR97207 • 503/248-9985, 800/634-8978 • tinnitus@ata.org, www.ata.org
Editorial and Advertising offices: American
Tinnitus Association, P.O. Box 5, Portland, OR
97207 , 503/ 248-9985, 800/ 634-8978,
tinnitus@ata.org, http: / / www.ata.org
Executive Directo r: Cheryl McGinnis, M.B.A.
Editor: Barbara Thbachnick Sanders
Tinnitus Tbday is published quarterly in March ,
June, September, and December. It is mailed to
American Tinnitus Association donors and a
selected list of tinnitus patients and professionals who treat tinnitus. Circulation is rotated to
80,000 annua lly .
The Publisher reserves the right to reject or
edit any manuscript received for publication
and to reject any advertising deemed unsuitable for Tinnitus Tbday. Acceptance of advertising by Tinnitus Tbday does not constitute
endorsement of the advertiser, its products or
services, nor does Tinnitus Tbday make any
claims or guarantees as to th e accuracy or
validity of the advertiser's offer. The opinions
expressed by contributors to Tinnitus Tbday are
not necessarily those of th e Publisher, editors,
staff, or advertisers. American Tinnitus
Association is a non-profit h uman h ealth and
welfare agency under 26 USC 501 (c)(3).
" 2000 American Tinnitus Association.
No part of this publication may be reproduced,
stored in a retrieval system, or transmitted in
any form , or by any mean s, without th e p rior
written permission of th e Publisher. ISSN:
0897-6368 (print), ISSN: 1530-6569 (online)
Executive Director
Cheryl McGinnis, M.B.A., Portland, OR
Board of Directors
Stephen Nagler, M.D ., Atlanta, GA, Chairman
Joel Alexander, Park Ridge, NJ
Dhyan Cassie, M.A., CCC-A, Medford , NJ
James 0. Chinnis, Jr., Ph.D., Manassas, VA
Gary P. Jacobson, Ph.D ., Detroit, MI
Sidney Kleinman , Chicago, IL
Paul Meade, Tigard, OR
Kathy Peck, San Francisco, CA
Dan Pmjes, New York, NY
Susan Seidel, M.A. , CCC-A, Thwson, MD
Tim Sotos, Lenexa, KS
Richard S. 1Yler, Ph.D., Iowa City, IA
Jack. A. Vernon, Ph.D ., Portlan d, OR
Honorary Directors
The Honorable Mark 0. Hatfield, U.S. Senate,
Retired
Thny Randall, New York, NY
William Shatner, Los Angeles, CA
Scientific Advisors
Ronald G. Amedee, M.D., New Orleans, LA
Robert E. Brummett, Ph .D. , Portland, OR
Jack D. Clemis, M.D., Chicago, IL
Robert A. Dobie, M.D., Bethesda, MD
John R. Emmett, M.D., Mem phis, TN
Barbara Goldstein, Ph. D., New York, NY
John W House, M.D., Los Angeles, CA
Gary P. J acobson, Ph.D., Detroit, MI
Pawel J. Jastreboff, Ph.D., Atlanta, GA
William H . Martin, Ph.D., Portland, OR
Douglas E. Mattox, M.D ., Atla nta, GA
Mary B. Meikle, Ph.D., Portland, OR
J. Gail Neely, M.D. , St. Louis, MO
Gloria E. Reich, Ph.D., Portland, OR
Robert E. Sandlin, Ph.D., El Cajon, CA
Alexander J. Schleuning, II, M.D., Portland, OR
Michael D. Seidman, M.D.,
West Bloomfield, MI
Abraham Sh ulman, M.D ., Brooklyn, NY
Mansfield Smith, M.D., San Jose, CA
Robert Sweetow, Ph.D., San Francisco, CA
RichardS. 1Yler, Ph.D., Iowa City, !A

Cover: 'Put Your Best Fin Forward,"
watercolor, 20 1/ 2 x 27 3/ 4", by Jan
Rimerman. Inquiries to the Indigo Gallery,
504 S. Main Street, P O. Box 728, Joseph,
Oregon 97846-0728, 541-432-5202.

The Journal of the American Tinnitus Association

Volume 25 Number 3 September 2000
1

Tinnitus, ringing in the ears or head noises, is experien ced by as m any
as 50 million Americans. Medical help is often sought by those who
h ave it in a severe, stressful, or life-disrupting form.

Table of Contents
8
9

10

12

14
15
16
18
20
21
22

Masking in the Millennium
by Stephen M . Nagler, M.D.
A New Look at Lidocaine
by Barbara Thbachnick Sanders
Research Update - 'Ibwards the Cure
by Patricia Daggett
Lessons Learned - Filing a Successful Tinnitus Claim with
the VA
by An ATA Member
Updates in Resource Development
by Jessica Allen
Founders' Gala Invitation
Tinnitus Research Consortium
by James B. Snow, Jr., M.D.
Acoustic Neuroma: A Success Story
by Rachel Wray
On Board!
Hypnosis: Often Overlooked Therapy for Tinnitus
by Betty Weiss, M.S.
New Products in ATA's Catalogue

Regular Features
From the Executive Director
by Cheryl McGinnis, M.B.A.
5 From the Editor
Curing Tinnitus with a New Pair of Genes
by Barbara Thbachnick Sanders
6 Letters to the Editor
23 Questions and Answers
by Jack A. Vernon, Ph.D.
25 Special Donors and Tributes
4

The Publisher reserves the right to reject or edit any manuscript received for publication
and to reject any advertising deemed unsuitable for Tinnitus Tbday. Acceptance of
advertising by Tinnitus Tbday does not constitute endorsement of the advertiser, its
products or services, nor does Tinnitus Tbday make any claims or guarantees as to the
accuracy or validity of the advertiser's offer. The opinions expressed by contnbutors to
Tinnitus Tbday are not necessarily those of the Publisher, editors, staff, or advertisers.

@ Pri nted on recycled pap er
American Tinnitus Association

Tinnitus Tbday/ September 2000

3

FROM THE EXECUTIVE DIRECTOR
by Cheryl McGinnis, M.B.A.
We are celebrating for each
of you! Members of the
American Tinnitus
Association generously supported the spring campaign
for research funding hailed as
Expedition Hopeful Cure. I
am writing this note to you
mid-July, before Donna
Brown's actual climb to the top of Washington
State's Mt. Rainier occurs and before all of your
contributions are received. Thank you for your
generous contributions. Over the past year, tinnitus message boards have included threads of dialogues requesting additional funding to support
research that will benefit people who experience
tinnitus. Your Association has established a goal of
$500,000 in research funding during the fiscal
year July 2000 through June 2001. Expedition
Hopeful Cure donations are significant in helping
us meet this financial goal.
Approving research projects for funding is the
next practical step in meeting our research goal.
In November, the ATA Scientific Advisory
Committee will review research grant applications
to identify promising research projects that can be
approved for funding based on the merits of the
research and the potential findings, or outcomes,
of the studies. Prior to the next grant review, you
can read about research projects that were recently funded by the ATA (See Pat Daggett's article,
"Thwards (he Cure," on page 10).
Interestingly, while you as members of ATA
are well aware of the great benefit future research
holds current studies about the economic value
of America's investment in medical research are
coming to light. Nationally acclaimed economists
are reporting the tremendous contribution that
medical research has on the American standard
of living. Research commissioned by the Mary
Woodard Lasker Charitable Trust through the
initiative Funding First states, "Improvements in
health account for almost one-half of the actual
gain in American living standards in the past 50
years." Researchers have analyzed the economic
benefit of health status improvements as measurements of people's willingness to pay for choices
made in the marketplace. For example, they
I

4

Tinnitus Thday/ September 2000

American Tinnitus Association

measure responses to health information public information campaigns on such things as
highway safety, dangers of tobacco use, and the
like. Reportedly, life expectancy improvements
between 1970 and 1990 are worth $57 trillion, or
$2.8 trillion per year! While values of improvements in health status are included in these
results, future studies will look specifically at the
economic value of non-life threatening health
problems. Future reports are expected in support
of medical research funding.
Many visionaries were involved in developing
ATA's research grant program. However, we will
soon pay tribute to ATA's first executive director,
Dr. Gloria Reich, who served in that position for
20 years. Among her many other accomplishments we celebrate Dr. Reich's tireless efforts
to gai~ recognition for the need to fund tinnitusspecific research. She gave public testimony to
our U.S. Congress, ultimately gaining congressional support for tinnitus research funding
through the National Institutes of Health. And
thanks to your generous donations, the ATA
research program continues to grow. We will pay
tribute to Gloria on November lOth at ATA's first
Founders' Gala to be held in Portland, Oregon.
Our tinnitus community is invited to participate
in the Founders' Gala as we celebrate all of her
contributions. Your invitation to the Gala is on
page 15.
On behalf of the ATA, I extend heartfelt
gratitude to our retiring Board of Directors
Chairman, Paul Meade. He provided facile leadership through transition and growth of this organization over the past two years. We are grateful
that he will remain a leader on the Board of
Directors. In addition, two members of our Board
of Directors are recognized for their service:
Megan Vidis has completed a three-year term of
office as well as two years of service as Board
Secretary. Sam Hopmeier is recognized for completing six years on our Board of Directors and
for his commitment to continue as Senior Advisor
to the Board and Chairman of the Program
Committee. The ATA Board of Directors elected
Stephen M. Nagler, M.D., as Chairman; Jim
Chinnis, Ph.D ., as Vice Chair, Susan Seidel, M.A.,
CCC-A, as Secretary, and Joel Alexander as
Treasurer. ATA will gain great benefits from their
talents and dedication! II

From the Editor

Curing Tinnitus with a New Pair of Genes
by Barbara Tabachnick Sanders
If your father, grandfather, and
you all have blue eyes, you
would be correct in assuming
that your eye color is hereditary. But if your father,
grandfather, and you all have
tinnitus, could you correctly
make the same assumption
about tinnitus? We have heard
hundreds of reports over the
years about familial tinnitus. So if you have ever
jumped to that conclusion yourself, you are in
good company. But would you be correct?
1b solve this and other genetic mysteries, a
scientific undertaking called the Human Genome
Project was begun in 1990. The goal of the
Genome Project is to identify all 100,000 human
genes and their functions, and determine the
sequencing of the billions of chemical base pairs
that make up our DNA. In the United States, the
Human Genome Project is funded by the National
Institutes of Health and the Department of
Energy. The full enterprise, however, is international in scope and involves partnerships with
nearly 50 research centers in ten countries. Each
center was assigned its portion of this massive
decoding project.
The human genetic maps that are expected to
result from the Genome Project will help doctors
identify genetic predisposition to disease, improve
the diagnosis of disease, and enable the development of custom-designed drugs for each patient
and each genetic problem. Most amazingly, scientists believe that they'll eventually learn how to
replace impaired genes with healthy ones. The
project is unfolding dramatically. In May 2000, a
scientific team from six countries announced that
they had finished mapping Chromosome 21 which
is linked to Down's syndrome and may lead to
clues about Alzheimer's disease. Chromosomes 5,
16, and 19, just decoded in April 2000, contain
genes that if defective could lead to genetically
linked forms of colorectal cancer, leukemia,
diabetes, and kidney disease.
While scientists have not yet discovered a
"tinnitus gene," they have identified faulty genes
that are responsible for a few rare varieties of
hearing loss, temporomandibular joint (TMJ)
dysfunction, Meniere's disease, and acoustic
neuroma - ailments that commonly include
tinnitus as a side effect. It's a tantalizing connec-

tion. You can almost wrap your arms around the
idea of a damaged gene, or perhaps genes,
responsible for chemical or electrical activity in
the auditory cortex or elsewhere in the brain that
causes the perception of tinnitus. As Jack Vernon
has suggested all along, maybe our ears are either
"tough" or "tender" by genetic design.
For now we speculate: If tinnitus - or the
predisposition to tinnitus - is gene-based, will
scientists be able to correct the damaged gene or
just predict it in susceptible individuals? And if
they can correct or replace the damaged gene,
will they be able to do so after the tinnitus is
present and make the tinnitus go away? Genetic
science gives rise to a body of ethical questions
too : Should genetic testing be done to identify a
person's predisposition to a disease if there is no
known treatment for that disease? How will a
person be affected by the knowledge of his or
her predisposition towards a disease? How will it
affect the individual's employment or health
insurance opportunities? And who will have
access to this expensive testing?
The Human Genome Project was originally
expected to conclude in 2005 . But because of significant advances in technology - unanticipated
at the beginning of the project - the estimated
completion date has been moved up to 2003 . The
public can follow the project's progress on the
Human Genome Web site during these very exciting final two-and-a-half years of discovery. We do
not have long to wait for our answers. II

Resource:
www.ornl.gov /ThchResources/H uman_ Genome/ home.html

Genome: All of the genetic material in the
chromosomes of a particular organism.
Chromosome: A structure in the nucleus of
a cell composed of protein and threads of
DNA. Number of human chromosomes in
each cell: 46
DNA: The chemical carrier of genetic
information found inside the chromosome.
Gene: A unit of heredity; an ordered
sequence of chemicals located in a DNA
thread in a chromosome. Approximate
number of human genes dispersed throughout 46 chromosomes: 100,000

American Tinnitus Association

Tinnitus Thday/ September 2000

5

Letters to the Editor
From time to time, we include letters from our
members about their experiences with "nontraditional" treatments. We do so in the hope that the
information offered might be helpful . Please read
these anecdotal reports carefully, consult with your
physician or medical advisor; and decide for yourself
if a given treatment might be right for you. As
always, the opinions expressed are strictly those of
the letter writers and do not reflect an opinion or
endorsement by ATA.

A Friend Speaks Out
By opening and closing my mouth and contorting my face muscles, I am able to experience
some tinnitus relief. I'm sure there are other factors responsible for the tinnitus reduction like, for
example, what I'm doing now: diverting my attention away from the noise by writing to you. I also
spend a lot of time with my Web TV and consequently have little time to feel sorry for myself.
In a recent conversation with my friend, Alec
Dyson Brown (poet, writer, columnist), I discussed my hearing loss and tinnitus then handed
him a copy of Tinnitus Tbday . So impressed was
he with my story and with your publication that
he devoted part of his column to it in our local
paper, The Herald News. He has allowed you to
share it with your readers. Continued good luck
on your fine work. 508-679-6808, norol@webtv. net.
Tinnitus by Alec Dyson Brown
·(AprilS, 2000, The Herald News, Fall River, MA)

A fellow senior emeritus spoke a word which I
had often seen in print, but which I had always
mispronounced. He spoke it correctly, and fervently,
having been afflicted with it for some years: Tinnitus.
He also gave me an informational magazine,
Tinnitus Today, a journal of the American Tinnitus
Association, which I read through - not for its possible inspiration to an ode, but for its informative and
empathetic writing.
While afflicted with a minor hearing impairment,
less than my friend's, I do not share his constant
noise in the inner ear; day and night, which miscolors what he hears of outside origin.
I reflected on how fortunate I felt for not being
afflicted. In those midnight hours I stand by my window looking out at a motionless, windless, darkened
complex, when the silence is so complete it is almost
palpable.
My friend, whose dependence on a hearing aid is
total, told me of his complete anguish, almost terror
- emotions felt when he once lost his device and was
forced to function without it. His graphic description
made my minor condition seem trivial. If nothing
6

Tinnitus 'Ibday! September 2000

American Tinnitus Association

else, the conversation with Norm Brettschneider
brought into sharp focus the empathy we should have
with any degree of hearing loss or impairment.

Cutting Down on Caffeine
Several years ago, I asked a hearing aid
dispenser if anything had been discovered that
would help tinnitus. He responded, "How much
coffee do you drink?" Since that was not something I wanted to hear, I paid no attention. More
recently, I had an exam from an audiologist. She
told me that she had cured her tinnitus by eliminating all coffee, decaf, caffeinated sodas, caffeinated teas, and chocolate. She claims her
tinnitus is a thing of the past.
I have cut back on caffeine for six weeks now
- from eight cups of coffee a day to one cup of
coffee a day. And I have to admit that the sounds,
both loudness and shrillness, have diminished
appreciably. For what it's worth ....
Virginia H. Laddey, Califo rnia,
valaddey@jp s. com.

Star 2000 for Hyperacusis
After having disabling hyperacusis and severe
tinnitus for over 19 years, I became a prisoner
in my own house. Everything exacerbated my
tinnitus. All outside noises were intolerable and I
could not participate in any family activities. In
desperation, I called Dr. Jack Vernon who had
acoustics and hearing aid expert, Jim Nunley,
make a pair of experimental tinnitus-hyperacusis
behind-the-ear units for me. The Star 2000 was
born.
The Star 2000 does not generate any sound.
It processes incoming sounds and suppresses all
loud sounds to prevent any discomfort. The
device amplifies low-level sounds up to normal
level which prevents overprotection. I have been
testing these units under all types of conditions
since 1996. Jim Fenwick of Fenwick Hearing
Instruments (800-464-9714) now custommanufactures the units and has taken the device
to another level.
I can now go out with confidence and lead a
normal life again. Car horns, sirens, and other
noises are now tolerable. I can do chores around
the house and even use a hammer. The Star 2000
suppresses it all. I've progressed to the point
where I can listen to TV and the stereo at a normal volume without anything in my ear. My
thanks to Dr. Jack Vernon who pioneered the
whole experiment.
Richard Bum at, Dallas, Pennsylvania

Masking

Ill

the Millenni urn

by Stephen M. Nagler, M.D.
Ask most hearing healthcare professionals to define
"masking," and likely you
will be told that masking is
the state wherein an externally generated sound covers the tinnitus such that
the tinnitus cannot be
detected. (That was certainly my understanding of the
concept of masking until
very recently - first as a tinnitus patient and,
subsequently, as a hearing healthcare professional
who treats tinnitus patients.) Ask further about
masking and the conversation might result in a
discussion of "residual inhibition," the phenomenon whereby the tinnitus might not be detected
for a period of time after removal of the masking
sound. You might learn of the "faucet" test for
maskability: When tinnitus cannot be detected in
a shower or while water is running in the sink, it
is much more likely to be successfully masked
than tinnitus that can still be detected under such
circumstances. The conversation with a knowledgeable hearing healthcare professional might
even progress to consideration of various "masking curves," again with the concept that masking
involves the inability to detect the tinnitus in the
presence of the masking signal.
asking took on a whole new light in my eyes
a short time ago at a breakfast meeting with
Dr. Jack Vernon, the "father" of modern tinnitus
masking. I had just completed a casual survey of
several tinnitus authorities, all of whom defined
masking in the manner I just described in the
opening line of this article. Dr. Vernon seemed
surprised, actually somewhat dismayed, that he
had not been able to adequately convey to the
tinnitus community that masking should not be
defined in terms of "covering" the tinnitus;
rather it should be defined in terms of "relief."
Specifically, Dr. Vernon sees masking as the
immediate achievement of some degree of relief from
tinnitus through the use of external sound.
Inherent in this definition is the concept that
the source of the external sound can be through
the environment, through the use of tabletop
devices that make sound, through the use of
hearing aids to enhance environmental sounds,
through the use of wearable "tinnitus maskers," or
through the use of combination amplification/
masker units, commonly called "tinnitus instruments." More importantly, inherent in this defini-

M

8

Tinnitus 'Tbday! September 2000

American Tinnitus Association

tion is the concept that the tinnitus does not have
to be totally covered by the masking sound in
order for the tinnitus patient to achieve relief.
ost importantly, however, is the fact that in
M
order to achieve success in a formal masking
program, considerable time must be devoted to
educating the patient with respect to the nature
of tinnitus, the nature of sound, and how external
sound can be used in a variety of ways to achieve
relief. Call it teaching, call it counseling, call it
what you like - effective individualized counseling is as important to masking as it is to Tinnitus
Retraining Therapy (TRT). It is virtually impossible to have a successful treatment protocol when
the concept of success is not defined, conveyed,
and agreed upon by clinician and patient. The
methodology for achieving that success must be
reviewed with the patient in detail, and the
rationale behind that methodology must be
clearly understood by all concerned. In the new
millennium, it is unrealistic to take the position
that the inability of a masking sound to render
the tinnitus signal completely undetectable is
equivalent to a failure of masking. Masking can
succeed beautifully under just such circumstances! It can provide great relief.
innitus patients today have access to a variety
T
of effective methods that can bring relief
while they await the coming of "the cure." There
are pharmacological approaches such as alprazolam, psychological modalities such as cognitive
behavioral therapy, and neurophysiological
approaches such as TRT. There are also
hypnotherapy, biofeedback, temporomandibular
joint and musculoskeletal approaches, and certainly masking in all its varied forms. Indeed the
greatest challenge may be in choosing the optimal method or methods for effecting relief with
respect to the incredible degree of individual
variation among tinnitus patients. In evaluating
the more esoteric approaches, it might be helpful
to step back and reassess the value of the immediate relief achieved by the mere introduction of
externally generated sound. It might thus be
helpful to reassess masking - and to reassess
how a wide spectrum of externally generated
sounds might be employed very simply to provide significant relief.
like to end with a plea to the tinnitus
! would
patient and a plea to the tinnitus clinician. To

the patient: While waiting for somebody to develop an actual cure, please do not deny yourself
the significant benefits of tinnitus treatments that

(continued)

A New Look at Lidocaine
by Barbara Tabachnick Sanders, ATA Director of Education
We have known for 20 years that lidocaine
can reduce the loudness of tinnitus for some
people when it is administered by a slow I.V.
(intravenous) drip into the vein. The tinnitus
relief that results from the lidocaine I. V. usually
lasts for the length of time that the drug is being
injected. Because lidocaine is a local anesthetic
as well as an anti-arrhythmic heart medication
with potential for serious side effects, it has not
been a practical long-term treatment for tinnitus.
Researchers have been looking for an oral equivalent to lidocaine, but so far without success.
A new lidocaine study at the Shea Ear Clinic
in Memphis indicates a remarkable success
rate for the use of lidocaine in the treatment of
tinnitus. In this study, lidocaine was given intravenously as well as by surgical injection into the
ear. (The eardrum is pierced with a laser; the
lidocaine is then injected through it and into the
cochlea's round window niche.) Both procedures
last for two hours and are done on three consecutive days. The Shea study cites successful tinnitus

Masking

(continued)

offer relief. Moreover do not fall victim to the
erroneous philosophy that any treatment falling
short of offering total relief is not worthy of consideration. Just because you have tinnitus ... does
not mean you must suffer from tinnitus. And to
the hearing healthcare professional treating tinnitus patients: While there is nothing wrong with
having a "favorite" treatment approach, I ask you
to remain open-minded. Every legitimate tinnitus
treatment is designed to afford relief. Become
familiar with several approaches; become facile
with several approaches. Do not subscribe to the
"one size fits all" school of healthcare. Do not
insist on using your favorite approach with a
patient when there might be an easier, simpler,
less expensive, or more direct method of achieving the relief your patient seeks. Spend the extra
time needed to discover what will result in
genuine patient satisfaction, bearing in mind
individual variations and individual needs. To
achieve true success, then, treat the patient not the tinnitus. B1
Dr Nagler is the director of the A lliance Tinnitus
and Hearing Center in Atlanta, Georgia, and new
Chair of ATA's Board of Directors.

relief after one year for ten out of 12 ears studied. The researchers, however, began the study
with 71 ears and have not yet explained this "loss
of ears" discrepancy in their report. Additionally,
all of the subjects in the study took Xanax for 30
to 60 days after the surgery. (Xanax is an antianxiety medication already known to reduce tinnitus loudness levels.) Some patients were given
antidepressants in addition to Xanax following
surgery if their emotional states warranted it.
The introduction of these drugs, plus the absence
of a "control" in the study (where some patients
would have been given inactive drugs to test for
the placebo effect), make it difficult to assess the
true value of the new lidocaine claims.
Lidocaine is still a fascinating medicine.
Something about it affects the chemistry in the
brain and causes a brief interference with tinnitus perception for some people. This new lidocaine research, however incomplete it might be,
could well spark new research interest in this old
tinnitus drug. 1B1

Help Network
by Rachel Wray, ATA Director of Support
In nearly every issue of Tinnitus Tbday, we
pay tribute to our generous self-help group facilitators - those compassionate souls who are on
the front lines of tinnitus support and resources.
In addition to our over 50 self-help group facilitators the American Tinnitus Association is also
ble;sed to have over 125 Help Network volunteers
- people who write letters and e-mails and talk
on the phone to tinnitus patients worldwide.
If you haven't accessed the Help Network yet,
now's your chance. Listings are available by calling the American Tinnitus Association at 800-6348978. Soon you'll be able to search for volunteers
near you on our newly designed Web site. Pick up
the phone and learn from people who have found
ways to manage their tinnitus, or try e-mail. More
and more of our volunteers are reachable on-line.
And if you're looking for a volunteer opportunity, we're accepting applications from ATA
members who want to share their tinnitus management ideas with others. We especially need
volunteers in the northern Rockies - Montana,
Wyoming, Idaho, and Alaska-and in New
England - Rhode Island and Vermont. 19
American Tinnitus Association

Tinnitus Thday/September 2000

9

RESEARCH UPDATE
Towards the Cure
by Patricia Daggett
ATA Director of Research
With the advancement of
Cheryl McGinnis to the
directorship of the ATA,
I am pleased to assume
the responsibility of coordinating the grant proposal
process. I am ably supported
by the efforts of the
Scientific Advisory Committee, consisting of 22
extremely qualified hearing healthcare clinicians and researchers. Three projects, which are
described below, were approved at ATA's March
2000 Board meeting. A total of $170,250 has
been distributed in support of these studies.
New grant proposals received by August 1
will be evaluated by the Scientific Advisory
Committee in preparation for recommendations
to be made at the November 2000 Board
Meeting.

ATA's Newly funded Research Studies
Jennifer R. Melcher, Ph.D .,
Massachusetts
Eye & Ear Infirmary
Imaging Human Tinnitus
Grant Award: $47,750
We are using functional
magnetic resonance imaging
(fMRI) to study the brain in
tinnitus patients. Functional
magnetic resonance imaging
can see the workings of the brain so it can be
used to identifY brain areas that function abnormally in people with tinnitus.
We have shown that 1) fMRI can detect
responses to sound in brain structures ranging
from the cerebral cortex to the lowest auditory
centers, and does so with unprecedented
precision and, 2) fMRI can provide an objective
measure of tinnitus in sufferers with tinnitus in
one ear and otherwise normal hearing. These
findings are a step toward understanding tinnitus in its many forms.

Our previous tinnitus studies identified
abnormalities in the inferior colliculus, a major
auditory center in the brain. Here, we propose
investigating other brain centers (cortical and
subcortical, auditory and nonauditory). These
investigations will provide new insights into
where and how tinnitus arises.
Being able to see brain abnormalities in
tinnitus sufferers using fMRI opens many new
possibilities for developing and testing tinnitus
treatments. For example, treatments can be
evaluated separately for patients with different
patterns of fMRI abnormalities. This is important
because different abnormalities might be effectively ameliorated by different treatments.
Ultimately, fMRI might be used to determine the
most beneficial treatment for a given individual.
John McQuaid, Ph.D., San
Diego VA Healthcare System
Shannon Robinson, M.D.,
University of California,
San Diego
Outcome of Cognitive Behavior
Therapy for Tinnitus
Grant Award: $29,000
There is evidence that
the level of distress and disability caused by tinnitus stems from attention
focused on the perceived noise. Our project will
test whether training in specific skills of distraction, activity planning, and changing unhelpful
thinking will decrease focus on tinnitus.
Participants will complete a standard medical
work-up and receive treatment if the symptoms
have a treatable cause. If tinnitus continues to be
disruptive, patients will be randomly assigned to
receive eight weeks of "manualized" Cognitive
Behavior Therapy (CBT) either immediately or
after an eight-week waiting period. (''Manualized"
means that the treatment has a set of specific
exercises. Patients get a workbook to keep and
have exercises to do between sessions that help
them learn the new skills.)
Cognitive Behavior Therapy may be a useful
treatment for tinnitus because it teaches specific
coping techniques to decrease the impact of
tinnitus. These skills can potentially improve

(continued)
10

Tinnitus Thday/September 2000

American Tinnitus Association

Tinnitus Today

ATA WEB SITE
RE-LAUNCH

Readership

Surveys

When ATA launched its first Internet site
over two years ago, it was right on the cutting
edge of cool. What a wonderful resource, we
thought. What a terrific way to help people
learn more about tinnitus and our organization.
Alas, Web sites age ridiculously fast and our site
is no exception. So we decided to give it a
facelift by rearranging information, including
more helpful resources, and updating the look.
Check out these changes by going to
www.ata.org. And watch out for our new
"Members Only" section, where soon you'll be
able to access Provider and Self-Help Group
listings, get late-breaking news on research and
other program areas, and read Tinnitus Tbday
on-line. (Don't worry, members. You'll still get
Tinnitus Tbday in the mail.) Ill

Towards the Cure

Keep Them Coming!
We can still count your Tinnitus Tbday
Readership Survey (the insert in the June
2000 issue) if it is postmarked by September
25, 2000. For you, the postage is free. For us,
the information is priceless. Please, make
your opinion known. Send in your survey! II

(continued)

patient functioning, well-being, and reduce
emotional distress. The few studies of CBT and
tinnitus to date have had significant limitations.
This current study provides the first test of CBT
using a manualized intervention, a wait-list control group, and sufficient sample size to detect
differences between groups.
RichardS. TYler, Ph .D.,
The University of Iowa
A Preliminary Investigation on
the Effectiveness of Tinnitus
Retraining Therapy
Grant Award: $93,500
Tinnitus Retraining Therapy
has been reported to have
80% success rates, but it has
not been tested in a controlled investigation. Based theoretically on a
habituation model, where the brain learns to
ignore continuous stimuli that are insignificant.
Retraining Therapy involves two main parts:
Directive Counseling, and the use of wearable
low-level noise generators. The tinnitus must
be perceived above the noise for habituation to
occur.

This research will have direct and immediate
clinical relevance. Professionals and patients are
eager to seek out new treatments that promise
success. An unbiased controlled investigation is
essential for validating any treatment. If Tinnitus
Retraining Therapy is more effective than masking or counseling alone, then more professionals
will want to learn this procedure, more patients
will seek retraining therapy, and more patients
will be helped. If Tinnitus Retraining Therapy is
shown to be no more effective than masking or
counseling, professionals should focus on more
efficient therapeutic techniques. This outcome
will therefore be of direct benefit to patients as
well as professionals. a
(Funding made possible by a gift from the Gerald T and
Dorothy R. Friedman New York Foundation for Medical
Research.)

American Tinnitus Association

Tinnitus Thday/ September 2000

11

Lessons Learned

Filing a Succe

by An ATA member
This article discusses my successful approval
for service-connected disability compensation for
tinnitus in the absence of military medical treatment records. The approval was granted under a
June 1999 loosened VA evaluation criteria. The
VA term is "Presumptive Service Connection."
The injury incurred as the result of my exposure
to sudden, high traumatic noise levels of artillery
fire in military operations over 20 years ago.
Below are my insights and presentation tips to
assist others in the process.

Collecting the documents
1. Buy a notebook and establish a log.
2. Locate your service separation records.
3. Telephone the national VA number:
800-827-1000. This number connects you to the VA
office nearest you . Have pencil and paper at hand
as there are several keys to punch. Record those
keys. You will be phoning often over the next few
months. Request the necessary forms to file for a
service-connected injury. If you do not have a VA
claim number, request the forms for that also .
I found the VA personnel most helpful.
4. Write to the Federal Records Center (FRC):
Army Branch (substitute your service branch),
Federal Personnel Records Center, 9700 Page Ave.,
St. Louis, MO 63132
Request copies of your medical and personnel
service records. Enclose copies of your service
separation papers. Use certified mail and include
a "return receipt request." In your letter, type
your service branch serial number and date of
separation. (Have all documents mailed to you,
not to the VA. Likewise, request that all of your
medical records from hospitals and doctors be
returned to you . Do not rely on the VA to write
to external addresses on your behalf.)
5. Other than filing for a claim ("C") number, do
not return any of the forms to the VA yet. Wait
until you have all your FRC papers, doctors
statements, audiograms, etc. You will be better
informed to present your case on the VA "statement" form. The VA forms are not compatible
with typewriters or word processors. However, fill
in the small boxes with your "C" number, date,
etc., and sign the form. In the middle of the form
print, "See attachments." This will give you the
flexibility to thoroughly document and support
your claim.
6. If the FRC does not reply to your request for
medical and personnel records in three weeks,
write to your local congressional representative
12

Tinnitus Thday/ September 2000

American Tinnitus Association

and attach a copy of your initial letter. Request
that his or her staff write to the FRC on your
behalf. If you do not receive the records in three
weeks, call your Washington congressional office
and follow up with a fax.
7. You must visit a tinnitus specialist who, after
examining you, agrees to prepare a statement
that "it is reasonably possible" that the active
duty incident you describe in your claim could
have triggered your tinnitus. Search the Internet
for research papers that link high-level noise
exposure to hearing damage and tinnitus. Present
these technical studies to your doctor and to the
VA. (See the VA's "Show Current Disability"
requirements below.) It's helpful to be under the
care of a tinnitus specialist for at least 12 months.
When all of these documents are in your
hands, review and compare them against the VA
requirement. Make your decision at that point
about pursuing a claim.

Tips to assist the processing of your claim
1. Be persistent. (The approval process for my
claim took 15 months.)
2. Set up a filing system.
3. Do not send any original documents.
4. Follow up each call to congressional offices
with a fax confirming your conversation. Faxes
get attention; e-mails do not.
5. When you receive requests for additional documents from the VA, respond with a copy of the
letter you previously mailed with the documents
attached. This relieves the VA evaluator from
having to search his or her files for your previous
documents.
6. Buy a six-figure-select number stamp with an
inkpad at an office supply store. Stamp every
sheet of paper with your "C" number on the top
and bottom.
7. If you use staples, place them at a 45-degree
angle in the upper left-hand corner - not
parallel to the paper top.
8. When telephoning and letter writing, be
gracious and respectful . ("For your convenience,
I am attaching ... ")
9. When transmitting documents, send only
copies - never the originals - and send them by
certified mail with return receipt requested. 'JYpe
"Certified Mail" at the top of a certified letter.
10. Visit the local Disabled American Veterans
(DAV) office or other service veteran's assistance
counselors to obtain assistance completing forms.
Many VA sites have a DAV advisor.

stu/ Tinnitus Claim with the VA
11 . TYpe with a computer word processor if
possible in normal business format.
12. List each attachment with its subject in the
body of the letter (e.g., A, B, C).
13. At times, it is wise to quote the VA's own
words back in explaining your claim.
Note that VA compensation is tax-free and
retroactive to the month of your first filing.
Read the VA requirements below. Under each
requirement paragraph, describe your tinnitus
disability and how it influences your life. I've
inserted some examples.
I hope the above helps. If you prevail and win
your claim, send your first check to the ATA in
honor of Dr. Jack Vernon who has assisted so
many of us with this tinnitus burden. I did.

For most of these conditions, you must submit
medical evidence, preferably a doctor's statement
or a treatment record, which shows that the condition first appeared within one year after discharge. Longer time limits apply for certain other
medical conditions.
[Examples: Exposure to extreme, traumatic
sudden noise from artillery fire; extensive
110 + db noise exposure during aircraft flights.]
3. Show Linking Evidence: Your claim must
include medical evidence, preferably a doctor's
statement, showing a reasonable possibility that
the disability you now have was caused by injury
or disease which began or was made worse during
military service. Your own statement that your
current medical condition was caused by what
happened to you in service is not sufficient.
If you claim that you have a new medical condition, which was caused by an already serviceconnected condition, you must submit medical
evidence, preferably a doctor's statement, showing
a reasonable possibility that the new disability
you have was caused by your service-connected
condition. Your application is complete only when
the above requirements are met. If your application is not complete, the law states that we must
determine that your claim is not well-grounded,
and we cannot assist you in obtaining additional
evidence.
[Your doctor must write this. Suggest that
he or she quote the VA's words using the
term "reasonable possibility."] a

The following excerpt, from the VA's "What You
Need 'Ib Know about Well-Grounded Claims," ·
explains what is needed to support your claim. Be
sure to include this requested information on - or
attached to - the first claim forms you send in.
A claim for service connection for a particular
disability is complete, or well-grounded, when
there is evidence that shows you have a current
disability that is related to your military service.
It can be related to service either because it first
began while you were in service or because a
disability you had before service was made worse
in service. Either way, if you want to establish
service connection for a particular condition, your
Editor's Note . The ATA suggests that you direct
evidence must meet three (3) requirements:
questions regarding your VA claim to your local
1. Show Current Disability: Your claim must
VA center.
include medical evidence of a current disability.
Medical records or a doctor's statement, which
contains a diagnosis of your disability, best shows
this.
Advertisement
[Example: Sleep disturbed by ear ringing.]
2. Show an Injury or Disability Based Upon
Military Service: Direct Service Connection:
Learn Lip Reading
This means you are applying for compensation
Compensate
for noise, distortion & tinnitus
for a condition that began or was made worse
with
the
I
See
What You Say program
during military service. We must have evidence,
which shows you had an injury or disease during
Self-Help Video & Manual
service. Your own written statement describing
"Instruction and practice are imaginative,
easy to follow and enjoyable."
what happened may be sufficient in some cases,
Journal Self Help for Hard of Hearing People
depending on the nature of the disease or injury.
Send Check or Money Order
Credit Card Orders
Presumptive Service Connection: This means
800-549-1540
$49.00 +$4.00 S&H (Calif. res. $3.55 tax)
you are applying for compensation for a medical
Hearing Visions
q~ )'a
condition that first appeared after service, not
P.O. Box 16040
<»....., ~o
during service. There are several conditions
San Luis Obispo, CA 93406
<?~~ ·
covered by the law, which allows service connecwww.lipreading.com
l!'Q'
tion for conditions, that first appeared after service. These are called "presumptive conditions." American Tinnitus Association Tinnitus Thday/ September 2000 13

Hearing Loss?

Updates in Resource Development
by Jessica Allen, ATA Director of

ATA attends AARP "Celebration 2000"

Resource Development

More than 40,000 American Association of
Retired Persons (AARP) members attended their
May convention in Orlando, Florida. This year, a
special emphasis was placed on health and fitness.
In response, The American Tinnitus Association
participated in the event by sharing space named "The Hearing Resource Center" - with five
other national hearing organizations. The Hearing
Resource Center was a popular destination for
many attending the meeting. ATA volunteers from
Orlando and 'Thmpa provided encouragement and
helpful information to the thousands of convention attendees who visited us there. Volunteers
included Betty and Lewis Fisher, Kim Rippetoe,
and Thomas D'Aiuto. We send a special thank you
to the dedicated ATA self-help groups in Florida.

ATA receives $100,000 gift
for Research
The Gerald J . and Dorothy R.
Friedman New York Foundation
for Medical Research has generously donated $100,000 to the American Tinnitus
Association for tinnitus research. The gift was
made possible through the generosity of Gerald J .
Friedman, M.D . Dr. Friedman, who suffers from
Alzheimer's disease, was born October 11, 1913. He
graduated from New York University College of
Medicine in 1927, and completed his residency at
Bellevue Hospital in 1941 . He served as Major,
Chief of Medicine, during WWII.
Highlights of his brilliant medical career
include service as Chief of Medical Intensive Care
Unit at Beth Israel Medical Center, and Chief of the
Cardiac Review Board of the New York City Department of Health. In addition to his numerous clinical and hospital appointments, he became the
National Medical Director of the United Parcel
Service in 1957 and continued in this position
throughout his career. His responsibilities included
prevention of disease and injury and the promotion
of optimum health, productivity, and social adjustmt:mt of UPS employees throughout the United
States and Europe.
We are extremely grateful to Dr. Friedman,
his staff, and his family for their generous support
of ATA.

Donna Brown's Climb
Dear Members,
Thank you for showing your support of the ATA
by contributing more than $80, 000 for research in
response to Donna Brown's intent to raise tinnitus
awareness during her climb. So far, 2, 404 donors have
made contributions to Expedition Hopeful Cure.
Donna, afflicted with tinnitus for the past four years
and an avid mountain climber, wanted to show the
world that her tinnitus was not going to stop her from
doing the things she enjoyed. We applaud her courage
in climbing Mt. Rainier on July 29 and 30, 2000 in
honor of tinnitus awareness and research.
The Board, staff, and volunteers of the ATA want
to thank Donna and our incredible members. Through
our combined efforts this year, we are able to allocate
more than $500, 000 to tinnitus research.
Thanks again, members'

14

Tinnitus Tbday!September 2000

American Tinnitus Association

Mark Your Calendars -

November 10, 2000!

If you haven't already reserved your seat, it's
not too late. The ATA is celebrating its first
Founders' Gala honoring our past executive director, Dr. Gloria Reich, for her 20 years of service to
tinnitus research and awareness.
The black-tie fund raising gala includes
dinner, speakers, and dancing on Friday evening,
November 10, 2000, with a special research presentation the following Saturday morning. Tickets for
the Gala are $125 each or $1,250 per table of 10.
All proceeds go to the American Tinnitus
Association. 1m

The Gloria Reich $10,000
Challenge Grant
Every dollar you contribute to ATA will be
doubled! 'IWo anonymous donors will match
every gift that Tinnitus Tbday readers give to
ATA in honor of Dr. Gloria Reich up to a total
of $10,000. The amount of the Challenge Grant
will be announced at the Founders' Gala on
November 10, 2000 .
Dr. Reich served as ATA's Executive Director
for 20 years and has done much to bring tinnitus
awareness to the public and to prospective
researchers. If you want to participate in the
Challenge, simply place your contribution in an
envelope addressed to :
ATA - The Gloria Reich Challenge Grant
P.O. Box 5, Portland, Oregon 97207

(Please write "GRCG" on the memo line of your
check.) For credit card donations, phone
1-800-634-8978 and mention the Challenge.
Thank you'

American Tinnitus Association Founders' Gala
The Board of Directors of the American Tinnitus Association
requests the pleasure of your company
Friday, November 10, 2000 at six-thirty in the evening for dinner and dancing
Governor Hotel Grand Ballroom, 611 SW lOth Avenue, Portland, Oregon
Black tie
Please join us for our first Founders' Gala, honoring Dr. Gloria Reich,
the first Executive Director of the ATA, for twenty years of outstanding service.
ATA guests will be offered special rates at the historic Governor and Benson Hotels.
In addition, a presentation by ATA's Scientific Advisory Board
is scheduled for Saturday morning, November 11, 2000.
Seating is limited, so please return the "save-the-date" form below by October 15, 2000.
Ifyou have any questions, please call 800.634.8978 extension 219.
We look forward to celebrating this landmark event with you.

Save the Date- November 10, 2000
I will be attending the celebration.

0

0
0
0

0

Please reserve _ seats: $125 each
includes dinner, wine, dancing, speakers,
and Saturday morning tinnitus research
presentation
Please reserve a table for ten: $1,250
Please reserve a Patron Table with preferred seating, special gift, program listing, and souvenir photo: $5, 000
Payment enclosed
Bill me later

Name
Address

ciw ________________________________
State ________ Zip __________________
Phone _______________________________

Or, call 800.634.8978 to pay by credit card.
American Tinnitus Association

Tinnitus Thday/September 2000

15

THE TINNITUS RESEARCH CONSORTIUM
by James B. Snow, Jr., M.D.
The Tinnitus Research Consortium is supported by a philanthropist who wants to accelerate
progress in basic and clinical tinnitus research.
The Tinnitus Research Consortium seeks to benefit the countless millions of tinnitus sufferers
throughout the world by clarifying the state of the
knowledge in tinnitus research, attracting scientists to the problem of tinnitus, and devising
promising tinnitus research approaches and
strategies. The Consortium promotes tinnitus
research through the stimulation and support of
scientifically meritorious research projects.
The Tinnitus Research Consortium consists
of 12 accomplished basic and clinical scientists,
some of whom have worked on the problem of
tinnitus before, and some who have not. Those
who have not previously worked in tinnitus
research can be expected to apply a fresh perspective, and involving them is a way to bring additional cutting-edge scientists to the problem.
Those who have worked in tinnitus research lend
experie nce to the effort. They meet twice a year
for two days for brainstorming, developing new
requests for applications and reviewing progress
reports. Each application received in response to
requests for applications is reviewed for scientific
merit by three members of the Tinnitus Research
Consortium's 74 Scientific Reviewers selected on
the basis of the expertise required for the review.
A second level of review of each application is
carried out by the Tinnitus Research Consortium
to make funding recommendations to the sponsor.
In June 1999, the Tinnitus Research
Consortium issued two requests for applications
for clinical trials of electrical stimulation of the
auditory system for the suppression of tinnitus
and the management of tinnitus with selective
serotonin reuptake inhibitor antidepressants.
Based on the competition among applications,
two awards of approximately $300,000 each over
a three-year period were made.
One of these initial awards has gone to Jay T.
Rubinstein, M.D ., Ph.D., from the Department of
Otolaryngology at the University of Iowa, for his
project entitled Electrical Suppression of Tinnitus.
The subjects of this clinical trial are individuals
with cochlear implants and individuals with mild
to moderate sensorineural hearing loss. The study
involves the use of patterns of electrical stimulation that have the potential for suppressing
tinnitus without producing an audible sound.
This project began January 1, 2000 .
16

Tinnitus Thday/ September 2000

The other initial award was made to Murray
B. Stein, M.D ., from the Department of Psychiatry
at the University of California San Diego, for his
study of the outcome of the selective serotonin
reuptake inhibitor antidepressant, paroxetine
(Paxil), in individuals who suffer from tinnitus.
In the past, tricyclic antidepressants have been
found to be of value, particularly in individuals
with tinnitus who also have depression. Dr. Stein's
clinical trial will study individuals who suffer
from tinnitus with and without depression to
determine if a representative of this new type of
antidepressant has benefit in the management of
tinnitus. This study began on May 15, 2000, and
will likely continue for three years.
The Tinnitus Research Consortium, with the
help of distinguished behavioral psychologists,
reviewed the existing animal models of tinnitus
and came to the conclusion that several existing
animal models of tinnitus deserve further study
and refinement and that additional animal models
of tinnitus should be developed. In December
1999, the Tinnitus Research Consortium issued
two requests for applications for basic research:
1) to refine and extend the animal perceptual
models of tinnitus to add to the knowledge of the
psychoacoustic parameters of tinnitus in the existing animal behavioral models of tinnitus or to
develop new acute or chronic animal behavioral
model of tinnitus, and 2) to correlate behavioral
parameters of tinnitus with physiological, biophysical, molecular biological or imaging
parameters in existing animal perceptual models
of tinnitus to gain knowledge of the mechanisms
responsible for the generation of tinnitus and the
site(s) of the generation of tinnitus. More outstanding applications were received than could
be funded. Three awards, ranging from approximately $260,000 to $300,000 over a three-year
period, were made on July 1, 2000 .
Jennifer R. Melcher, Ph.D ., from the
Massachusetts Eye and Ear Infirmary, received
one of these awards for her project entitled
Imaging Human Tinnitus. She proposes to use
functional magnetic resonance imaging (fMRI) to
study activity in the parts of the brain known to
be part of the auditory system as well as other
parts of the brain. Improved resolution now
allows fMRI activity in response to sound to be
monitored throughout the central auditory pathway. The purpose of the study is to determine if
the percept of tinnitus is associated with abnormally elevated activity in the auditory pathway
and, if so, where. The study will be carried out in

American Tinnitus Association

audiometrically normal and hearing-impaired
individuals. The American Tinnitus Association
is also supporting research by Dr. Melcher and
her team on fMRI in tinnitus.
Another of these awards has gone to
David B. Moody, Ph.D., from the Kresge
Hearing Research Institute of the Department
of Otorhinolaryngology of the University of
Michigan, for his project entitled Determination
of Tinnitus Parameters in Individual Subjects.
The purpose of this research is to develop a new
animal model that, unlike existing animal models, depends on the response latency or speed
with which the subject responds to a stimulus
change. Dr. Moody will be employing strategies
used to study the stimulus effects of drugs which,
like tinnitus, cannot be turned on and off by the
investigator. Ultimately such a model could be
used to study the effect of agents that might
relieve tinnitus.
The third award was made to Jinsheng
Zhang, Ph.D., from the Department of
Otolaryngology at Wayne State University, for
his project entitled Neural Correlates of SoundInduced Tinnitus. The purpose of this research is
to study the hyperactivity in the dorsal cochlear
nucleus that has been found in animals with
noise-induced tinnitus. Dr. Jinsheng and his colleagues want to know if the hyperactivity arises
in the dorsal cochlear nucleus or if it is induced
there by hyperactivity in other auditory centers.
Furthermore, they plan to apply neuroactive
agents to the dorsal cochlear nucleus to determine the role that inhibitory and excitatory pathways might play in modulating the hyperactivity.
The Tinnitus Research Consortium is pleased
that so many cutting-edge research issues can be
addressed in depth by these five grantees. It is
anticipated that another request for applications
will be published through the email system of the
Association for Research in Otolaryngology on
December 1, 2000. This request for applications
will be somewhat less structured than the first
four requests for applications in the sense that it
will seek to allow the scientific community
greater latitude in presenting their promising
research ideas. The request for applications will
solicit research on the mechanisms of and the
site(s) associated with the percept of tinnitus.
The overall plan is to award on average two
three-year grants of $100,000 per annum each
year; and when the plan is fully developed, it will
provide approximately $600,000 per annum to
support tinnitus research.

The Tinnitus Research Consortium appreciates the contributions to this research by the
University of Iowa, the University of California
San Diego, the Massachusetts Eye and Ear
Infirmary, The University of Michigan and Wayne
State University and commends their outstanding
efforts to advance knowledge on tinnitus. Ill
Dr Snow is Convener/Correspondent for the
Tinnitus Research Consortium, and the Former
Director of the National Institute on Deafness and
Other Communication Disorders, an institute of the
National Institutes of Health.

Free

Tinnitus
Public Forum

Washington, D.C.
The American Tinnitus Association's
free Tinnitus Public Forum series continues
Monday, September 25, 2000, from 7:00 to
9:00p.m., at:
ASAE Conference Center
1575 "I" Street NW
McPherson Square METRO
Washington, D.C.
Our guest speakers will be Robert Dobie,
M.D., from the National Institutes of Health,
Barbara Goldstein, Ph.D., from the Martha
Entenmmann Tinnitus Research Center, and
Stephen Nagler, M.D., from the Alliance
Tinnitus and Hearing Center.
The forum will include presentations on
tinnitus research, clinical treatments, and
the future of ATA, followed by a question
and answer session with the audience. Don't
miss this special opportunity to learn more
about tinnitus from the nation's top
researchers and clinicians.
Please RSVP to the ATA at 800-634-8978,
ext. 211. H

American Tinnitus Association

Tinnitus 7bday/ September 2000

17

Acoustic N euron1a: A Success Story
Still others choose the "wait and see" approach
since acoustic neuromas typically grow very
slowly. This latter approach wasn't available to
Mari; her tumor was growing far too fast. But the
other two treatments, microsurgery and radiosurgery, were intimidating to a woman who has
modeled for 15 years, loves to sing and dance in
theatre productions, and lives an active Southern
California life.
Still vacillating and collecting all the information possible, a friend told her to go with her gut.
Her gut said surgery. "I didn't want to have something inside of me," she reasons now. And ultimately, "I turned it over to God. I have my faith,
[and] that's what really helped me through this."
She also had faith in her surgeon, who had
successfully removed over 4,000 acoustic neuromas. Mari explains, "It's really important that you
go to the right doctor. Not many know how to do
this right." She went into the surgery with the
same confidence and upbeat attitude that have
marked her life before and since.
After spending six days in the hospital-and
nearly three days in the intensive care unit-Mari
went home to begin recovering. She shares a
litany of after effects from the surgery: "I had to
learn to walk again. My balance nerve was cut.
I couldn't hear in my left ear. My right ear was
ringing. My eye wouldn't shut. I had the worst
headaches." And yet, she says, "I'm a real positive
person, and I wanted to move forward." She adds,
"I couldn't just feel sorry for myself."

by Rachel Wray, ATA Director of Advocacy and Support
"A walking miracle, that's what I call myself"

Mari Quigley isn't exaggerating; she's just
being honest. Just over three years ago, this
TUstin, California, woman was diagnosed with an
acoustic neuroma-a benign tumor that forms on
the eighth cranial nerve beyond the inner ear.
The tumor-also called a vestibular schwannoma- was already affecting her hearing and tinnitus, and it was growing. A miracle seemed too tall
an order. However, as Mari puts it, "Sometimes
you have to go through something really bad to
appreciate the good."
ari started experiencing tinnitus, which can
be a symptom of an acoustic neuroma, in
M
1995. But it wasn't until1997, when tinnitus
began affecting her health, that she and her
doctor scheduled an MRI to rule out any physiological cause. The MRI revealed a gray mass about
.6 millimeters wide pressing against the intertwined auditory and vestibular nerves that make
up the eighth nerve. Her doctor wanted to watch
the growth's progress over time. Mari remembers,
"I had to wait four more months, knowing something was going on. The waiting was horrible."
Later that year, another MRI revealed that the
tumor was growing a millimeter per month. Most
acoustic neuromas grow very slowly-and sometimes not at all for many years. As they expand,
they crowd and eventually displace normal tissue,
and if left untreated can actually start growing
into the eighth nerve. Ultimately, if the tumor
gets too large, it presses against the brainstem,
interferes with brain functions, and can even
cause death. That Mari's schwannoma was growing so quickly caused some concern. "My doctor
asked, 'What are you feeding this thing?'"
Decisions needed to be made. Acoustic neuromas have several treatments-none ofwhich, on
the surface, is especially inviting. Microsurgery is
the most frequent option, but negatives can
include loss of hearing in the ear with the tumor,
facial paralysis, loss ofbalance, decreased mental
alertness, and headache, nausea, and vomiting.
Others opt for stereotactic radiation therapy,
which exposes the neuroma to isolated bursts of
radiation over three to six weeks. This, too, has
its downsides: five to ten percent of tumors will
continue growing after radiation. Radiation can
also affect hearing, balance, and facial numbness,
but these side effects are less pronounced than
those after surgery.

18

Tinnitus Tbday/ September 2000

er recovery was swift for so invasive a proce-

H dure. As the vestibular nerve in her good ear
began compensating for the loss in the other, her

balance was restored. "I was at the gym two weeks
after the surgery. I got on the treadmill, hung on,
and did the exercises my doctor suggested." Mari
soon found that rejuvenating her body was as
important as rejuvenating her mind and spirit.
Her "physical therapy for [her] brain" included
taking classes at a nearby college.
But though the neuroma was removed, and
though her recovery was swift, her tinnitus was
as present as ever. "I have tinnitus in both ears.
They're different sounds, but the tinnitus is
always there," she says matter-of-factly, and it's
obvious that she has come to a certain level of
peace and acceptance of her condition. This
acceptance didn't happen overnight, however.
After her surgery, with her ears roaring, Mari
turned to the American Tinnitus Association for

American Tinnitus Association

help. "I'm the kind of person who looks for
answers; I look for support."
Sensing the best way to support herself would
be to support others, she formed the Orange
County Tinnitus Support Group in 1998.
Immediately, the tools for self-help became clear:
Thlk about coping strategies and share personal
experiences about tinnitus. The result, Mari
found, was a friendly, compassionate group of
people who provided concrete resources and
meaningful assistance during a difficult time.
She says, "It's a really nice group, sometimes big,
sometimes little. People tell me 'I love your meetings' [because] I focus on sharing our strengths
and hopes with each other."
s someone who has experienced so much in
such a short time with grace, Mari could easily disallow support group members who are
inclined to feel sorry for themselves. Instead, she
welcomes their pain: "You never take away that
anger or frustration or pity. You say, 'I know how

A

Acoustic Neuroma
Facts
Acoustic neuromas are very rare: two to three
thousand new cases are diagnosed in this country
each year-or about one per 100,000 Americans.
Though one-sided tinnitus is a symptom of this
kind of tumor, the two do not go hand in hand.
"The majority of unilateral tinnitus is not [caused
by] acoustic tumor," cautions Dr. Alexander
Schleuning, a doctor of otolaryngology and head
and neck surgery at Oregon Health Sciences
University. He continues, "They're very slowgrowing-about a millimeter per year is average
when they're good size," and even slower than
that in the early stages of growth. The size of the
tumor determines the severity of symptoms.
Small: less than 1 centimeter (10 millimeters = 1
em). Symptoms include unilateral tinnitus, hearing loss in one ear, feeling of fullness in the ear,
and balance problems.
Medium: 1.0 - 2.5 em. Hearing loss and balance
problems worsen.
Large: 2.5 - 4.0 em. New symptoms (facial
tingling and numbness, facial pain, disequilibria)
show up.
Giant: greater than 4 em. Vision loss and
persistent headache develop.

you feel' and 'You're going to get better."' Her
instinct is to "change the mindset- get them
thinking away from the negative" -and help
them to ask what they can do to make it better.
In addition to her support group, Mari
speaks about tinnitus on local radio stations and
other venues to help teach people about prevention and treatments. "Helping other people
helps me," she says, as if that explains her
remarkable recovery from the tumor and her
graceful coping of tinnitus. Perhaps a better
explanation can be found in Mari's unwavering
enthusiasm, optimism, and, perhaps most
importantly, her belief in miracles. II
7b attend the Orange County Tinnitus Support
Group, call 714-505-3466. The group meets the first
Saturday of each month on the second floor of the
St. Joseph Outpatient Pavilion, 1140 W LaVeta, in
Orange, Calif

There are several treatments for acoustic
neuromas. The two most common are:
Microsurgery: Surgeons drill through bone to
dissect the tumor away from the seventh (facial)
nerve. Occasionally, doctors can save the hearing
nerve, but they always sacrifice the vestibular
nerve. Microsurgery has significant side effects,
which are usually worse during the first 72 hours
after surgery. In 89% of cases, the acoustic neuroma is completely removed by microsurgery.
Radiosurgery: Multiple doses of radiation are
delivered externally to the tumor area over the
course of three to six weeks. While less invasive
than microsurgery, radiosurgery doesn't always
kill the tumor. Or, if it does, the death of the
tumor is slow, sometimes taking as long as 18
months. Radiosurgery has a 90% successful
"control rate" - either shrinking the tumor or
arresting its growth. Like microsurgery, radiosurgery has its side effects, including balance
problems.
According to the Acoustic Neuroma
Association, many people who undergo procedures for tumor removal have no post-surgical
facial problems or additional hearing loss, and
88% of post-treatment patients were able to
resume normal life activities.
These two treatments are much more
complex in application. But in the hands of
experienced doctors, acoustic neuroma patients
can successfully recover and find their lives
improved iri many ways. B
Resources: Acoustic Neuroma Association, PO. Box 12402,
Atlanta, GA 30355, (404) 237-8023, http:/ /anausa.org
American Tinnitus Association

Tinnitus Thday/ September 2000

19

On Board!
New Chairman of the Board Stephen M. Nagler, M.D.
Our incoming Chairman of the
Board, Stephen M. Nagler, M.D.,
has served as an ATA Board member and Vice Chair since 1998, and
is currently the director of the
Alliance Tinnitus and Hearing Center in Atlanta,
Georgia. We are very grateful to Dr. Nagler for
investing his time in this voluntary role.
Dr. Nagler writes:
"As ATA's new Chairman, my personal thrust
will be to push for increased ATA membership,
for the promotion of more quality and relevant
research, and for developing productive relationships among our sister organizations in other
countries, because even though we are the
American Tinnitus Association, tinnitus is hardly
an American phenomenon. My thrust will also be
to promote advocacy both in the areas of noise
legislation and governmental funding for tinnitusrelated research, and to educate physicians and
audiologists who, with the exception of a refreshing handful, are largely ignorant and insensitive
to the needs of tinnitus patients. I want people
with tinnitus to know that even though today
there are no universal cures for tinnitus, there
are effective treatments for tinnitus."

New Board Member Dhyan Cassie,
M.A., CCC-A
ATA extends a very warm welcome
to new Board member Dhyan
Cassie. Cassie is an audiologist and
coordinator of the Tinnitus and
Hyperacusis Management Centers
at The College of New Jersey in Ewing, and of
ENT Professional Associates in Haddonfield, New
Jersey. She continues to lead the tinnitus support
group she founded several years ago.
Ms. Cassie writes:
"I feel honored to be elected to the Board
of Directors of the ATA. My goal is to help the
medical community become more aware of
the resources that are available to the tinnitus
patient. I have a passion to make tinnitus alleviation a challenge to healthcare givers so that they
offer hope to their patients. My goal is for no one
with tinnitus to be turned away by a doctor with
'go home and live with it.' I will also work to provide support and information to tinnitus patients
through the ATA Self-Help Network."

20

Tinnitus Thday!September 2000

American Tinnitus Association

Thank You to Paul Meade, former
ATA Chairman of the Board
Paul Meade has served on ATA's
Board of Directors since 1996 and as
its Board Chairman since 1998. As
he turns the Chairman's gavel over
to Dr. Nagler, Meade looks back
over these years and shares his thoughts:
"The ATA is in a position now to truly pursue
its mission. We have an outstanding staff and
Board in place and a clear direction for our future.
Is the ATA where I hoped it would be two years
ago? Absolutely yes!"
We are delighted that Mr. Meade will continue
to serve on the Board of Directors.

Thank you to Sam Hopmeier, former
ATA Board Member
W.F.S. (Sam) Hopmeier, BC-HIS,
has served both on ATA's Scientific
Advisory Committee (from 1989 to
1994) and on the Board of Directors
(from 1994 to 2000). Hopmeier
reflects on his many years of service to ATA:
"I've had the opportunity to see ATA evolve
and I'll tell you, some very exciting things are
coming. Gloria Reich did a fabulous job getting
ATA started and building it into a very important
provider of help to people with tinnitus throughout the country and around the world. Now, with
a new executive director, a dedicated and capable
staff and a determined and inspired Board of
Dire~tors, we have everything we need to be successful in the years ahead. I'm very pleased."
Hopmeier has agreed to continue as Chair of
the Program Committee and offer his assistance to
the Board as a Senior Advisor.

Thank you to Megan Vidis, former
ATA Board Member
Over the last three years, Megan
Vidis served as an ATA Board
member, Board Secretary, and Chair
of the Human Resource Committee.
During this time, she also gave birth
to Eli (in August 1997) and Jonah (in April 2000).
Vidis is pleased to have been the first woman on
ATA's Board and is very excited about its current
direction. She writes:
"This organization is really poised for greatness. We're finally in a position to expand our
membership base and offer tangible hope to
people with tinnitus. There is no reason to be
anything but optimistic about ATA's future."
Ms. Vidis will continue to serve ATA on the
newly formed Legal and Advocacy Committee. Ill

HYPNOSIS: OFTEN OVERLOOKED THERAPY FOR TINNITUS
by Betty Weiss, M.S.
On Aprill, 2000, a group of 300 tinnitus patients,
family members, and professionals gathered in
Voorhees, New Jersey, to attend the Mid-Atlantic
Tinnitus Conference. The conference organizers,
Dhyan Cassie, M.A. , Gail B. Brenner; M.A., and
Linda Beach, assembled an impressive group of
speakers. I was assigned the honor of summarizing
some of the salient findings of three sessions:
Dr Richard J. Salvi's "What's New In Tinnitus
Research," Dr James M . Sumerson's "Hypnosis:
Often Overlooked Therapy For Tinnitus," and Dr
Max L. Ron is's "Medical Intervention For Tinnitus ."
These synopses will appear in this and the next two
issues ofTinnitus Thday.
In 1772, Dr. Franz Anton Mesmer theorized
that there was a power that could be used to treat
the human body. He called this power "animal
magnetism" and claimed that it had medicinal
properties through the induction of a trance-like
state. At first, people flocked from all over Europe
to the Mesmer Clinic to be cured of a variety of
conditions.
Mesmerism did not receive support from the
scientific, medical, or political communities. It
was considered so controversial that a French
Commission led by Benjamin Franklin studied its
effectiveness. Mesmer was deemed a charlatan
and his system of treatment, now recognized as
hypnosis, fell into disrepute.
Under the leadership of Milton H. Erikson,
M.D. , (1901-1980), there was a revival of interest
in hypnosis. Suffering from multiple conditions
including physical limitations resulting from two
bouts of polio, Dr. Erikson developed a high level
of skill in concentration, and in observation of
bodily movements, speech patterns, and other
forms of communication. It is through his contributions that we have an understanding of trance
and the relationship between the hypnotist and
the subject.
In the dictionary, hypnosis is defined as an
artificially induced state resembling sleep, but
characterized by exaggerated suggestibility and
continued responsiveness to the voice of the
hypnotist.
Everyone has experienced hypnosis or trancelike behavior in one way or another. It is a natural
phenomenon. Often the unconscious mind will
take control in a familiar situation as if it is on

"automatic pilot." Driving home from work, you
might reach your destination without remembering how you got there or the details of the trip.
James Sumerson, M.D., Medical Director of
the Ciell Institute in Voorhees, New Jersey, is an
otolaryngologist who uses hypnosis as a form of
tinnitus treatment. He describes hypnosis as an
altered form of consciousness in which the
patient is not asleep but is aware of his or her
surroundings and will respond normally in
emergency situations. In this altered state, the
patient's mind and body are relaxed, and the
patient's mind is focused on a subject that the
therapist selects.
According to Sumerson, hypnosis is
psychotherapy in a shortened form. He does
not use it to cure tinnitus. Indeed, the treatment
strategy is geared to develop a complete understanding of all the factors that may be contributing to a person's state of being. Among the many
questions considered are: What are the factors
that may trigger tinnitus? Why is it tolerable at
some times and intolerable at others? How can
one obtain relief? On tinnitus matching tests,
tinnitus rarely gets louder than 10 dB compared
to a patient's threshold of hearing. Most tinnitus
is only 3 dB above the threshold of hearing. Why
is such a soft sound perceived as being so loud?
Why are there so many emotional consequences?
If a patient chooses to undergo hypnosis at
the Ciell Institute, Sumerson suggests a minimum of six sessions. Initially, the patient is
evaluated with regard to resistance / susceptibility
to hypnosis. Post-hypnotic suggestions may be
used to allow rapid induction in subsequent
weeks. During hypnosis, Sumerson uses auditory
and visual imagery and desensitization. After
applying techniques such as age regression and
ego strengthening, he tries to get the patient to
experience tinnitus while in a trance and to
reduce it to a less intense form.
It may also be possible to regress the patient
to a time when he or she felt or heard something negative that may have contributed to the
tinnitus. If the event is tolerable, a hypnotist
can try to change the negative effects to positive
ones through indirect suggestion or by giving the
patient permission to give up the sound: "You are
listening to a sound that makes you feel good."
"You do not have to listen to the noise in your
ears." Thpes made during sessions can be used to
induce self-hypnosis and to reinforce indirect
suggestions.

(continued)
American Tinnitus Association

Tinnitus Thday/ September 2000

21

NEW
PRODUCTS in

Full Set (2 videos, 4 hours total) :
Salvi, McGinnis, Ronis, and Sumerson
$40 (ATA members), $45 (non-members)
Single videos (1 video, 2 hours):
Salvi, McGinnis, and Ronis
$25 (ATA members), $28 (non-members)
Salvi and Sumerson
$25 (ATA members), $28 (non-members)

ATXs Catalogue

Tinnitus: Learn to Live WithOUT It VHS video, 2 hours

Mid-Atlantic Tinnitus Conference VHS 2-video set, 4 hours total
This two-video, patient-oriented set features :
- In two
separate sessions, tinnitus researcher Richard
Salvi, Ph.D., explains the use of PET scanning
to identifY portions of the brain involved in
tinnitus perception, and prospects of future
brain/tinnitus research.
+ "Medical Intervention For Tinnitus" - ENT
physician Max Ronis, M.D., discusses the
function of the auditory system, a variety of
drugs and treatments for tinnitus relief, and
foods that might make tinnitus worse.
+ "Tinnitus: Moving Forward" - ATA's Executive
Director Cheryl McGinnis, M.B.A., discusses
ATA's mission, program and research goals, and
our work towards increasing tinnitus awareness.
+ "Hypnosis: Often Overlooked Therapy For
Tinnitus"- ENT physician James Sumerson,
M.D., offers a one-hour primer on hypnosis for
tinnitus, complete with live demonstration.
Those of you who could not attend the conference
will appreciate this clear and comprehensive
material.

+ "What's New In Tinnitus Research"

Stephen M. Nagler, M.D., discusses the theories
and practical applications of TRT - Tinnitus
Retraining Therapy. Patients write: "This video is
an excellent source of information on TRT. I now
understand habituation. This offers a lot of hope
to us all." "There is nothing like straightforward
information. This video is 'anti-learn to live with
it' material." "The TRT explanations are the best
I've seen." It's the best we've seen too.
1 video, 2 hours total: $40 (ATA members),
$45 (non-members)

Proceedings of the Sixth International
Tinnitus Seminar- Now on CD!
The Proceedings, edited by Jonathan Hazell, is the
esteemed collection of 135 tinnitus research
papers that were presented at the International
Tinnitus Seminar in Cambridge, UK on
September 5-9, 1999. The CD includes the complete text, graphs, and index of the printed book
(583 pages) and is readable with Acrobat Reader
(included). PC and MAC compatible
The CD version of this research collection gives you
a tinnitus research encyclopedia on your computer'
1 CD: $30 (ATA members), $33 (non-members)
See our order form on the inside back cover.

HYPNOSIS: OFTEN OVERLOOKED THERAPY FOR TINNITUS
Sumerson regards biofeedback as another
form of hypnosis that can be used to treat
tinnitus. During the biofeedback process, the
individual is instructed to use auditory or visual
stimuli to gain voluntary control over reactions
(like heart rate and skin temperature) produced
by the autonomic nervous system. If one can
learn to control heart rate, blood pressure, skin
temperature, and brain wave activity, it is possible
that one can learn to control tinnitus or, at least,
control one's reaction to tinnitus.
For Sumerson, the goal and hope is that
patients with tinnitus will learn through hypnosis
to develop the coping mechanisms necessary to
handle the emotional components of this mystifYing condition. Ill
22

Tinnitus Thday/ September 2000

American Tinnitus Association

(continued)

Resources: James Sumerson, M.D., F.A.C.S., Staffordshire
Professional Center, 1307 White Horse Rd., Bldg. A, #100,
Voorhees, NJ 08043, 609-346-0200
For referrals to local hypnotherapists, contact:
• American Board of Hypnotherapy, 2002 E. McFadden
Ave. #100, Santa Ana, CA 92705, 800-872-9996
• American Society of Clinical Hy pnosis (ASCH), 130 E.
Elm Ct. #201, Roselle, IL 60172, 630-980-4740 (The ASCH
asks for written requests.)

Dr. Sumerson's complete presentation on hypnosis
and tinnitus, recorded at the Mid-Atlantic Tinnitus
Conference in April 2000, is available through ATA
as part of a four-hour; two-video full conference set,
or on a single two-hour video along with Dr. Richard
Salvi's presentation.

QUESTIONS AND ANSWERS
Jack Vernon's Personal Responses to Questions from our Readers
by Jack A. Vernon, Ph.D., Professor Emeritus,
Oregon Health Sciences University

Q

Mr. B. in Wisconsin
asks, "Can tinnitus be
so severe as to cause
the inner ear to hurt and in
turn cause headaches?"

A

The quick answer to
your question is no .
However, if headaches
are persistent and frequent,
I'd suggest that you consult a
neurologist. As you well
know, we can have two things wrong with us at
the same time. And just because they occur at the
same time does not mean that they are related.
On the other hand, it is a common experience
that the stress and tension produced by headaches
can exacerbate tinnitus and vice versa. This could
be happening to you.

Q

Mr. P. from Florida writes, "I have had my
tinnitus since ~hildhood and thus have
gotten used to It. About the only time my
tinnitus bothers me is when it interferes with my
ability to hear high-frequency sounds and to
distinguish some spoken words. If I treated my
tinnitus, would it eliminate these problems?"

A

Most likely it is not your tinnitus that
causes the problems you have indicated.
It is much more likely that the problems
are due to some high-frequency hearing loss. I
would recommend that you try properly fitted
hearing aids that will cost you only the expense
of the ear molds and the audiologist's time if they
do not solve your problems.
Mr. ~-from New Jersey writes, "I have
a mild form of tinnitus. It is a quiet
humming, which I do not hear 90% of
the time. At the age of 77, I find that I need hearing aids but I'm afraid that they will make my
tinnitus worse. I have heard that loud sounds
can make tinnitus worse and hearing aids make
sounds louder. What does research reveal about
this?"

Q

A

Hearing aids are perfectly safe. Indeed
as hearing increases tinnitus generally
decreases, thus it is possible that hearing
aids will reduce your tinnitus. Moreover, digital

hearing aids are equipped with compression technology that reduces the intensity of accidental
loud sounds which are a common part of our
everyday environment. I congratulate you on the
decision to acquire hearing aids. They will not
only improve the quality of your life but they will
make things nicer for all who are associated
with you.
Mr. W. from Maine has read that tinnitus
is produced by certain brain cells and that
removal of that particular portion of the
brain would cure tinnitus. He asks if any additional investigations been made along these lines.

Q

A

The brain cells involved in the perception
of tinnitus, not the production of tinnitus,
have been identified. Eventually it may
be possible to inactivate this brain area and cure
certain kinds of tinnitus. But there are several
problems with this kind of thinking. For one
thing, if the 'tinnitus perception" brain area is
removed, another area in the brain area (perhaps
an adjacent area) might take over the function of
the removed part. It would be extremely important to first determine what, if any, other functions would be lost by the removal of that brain
tissue. It may be possible to locally anesthetize
that brain area and carefully measure what other
functions are involved. Clearly a great deal of
investigative work is needed. But in my opinion,
this '1Jrain work" that researchers are doing
provides us with a great deal of optimism.
1

~r. G. fro~ Virginia asks if it's possible if
his excessive exposure to gun fire noise in
1973 caused his tinnitus that showed up
in 1993.

Q
A

Yes, such a thing is possible. I would guess
that you have had tinnitus in a very weak
form all along. But it wasn't until 20 years
later, when you developed sufficient hearing loss
(especially in the high frequencies), that the
tinnitus became apparent. Anytime hearing
decreases, one common effect is an increase in
the loudness of tinnitus. If your military medical
records do not include a mention of tinnitus
dating back that far, your case would be challenging- but not impossible - to prove in a court of
law. (See "Lessons Learned - Filing a Successful
Tinnitus Claim with the VA," page 12.)
(continued)
American Tinnitus Association

Tinnitus Thday/ September 2000

23

QUESTIONS AND ANSWERS

Q

Ms. L. from Thxas writes that she has
tinnitus but her concern is the
osteoarthritis in her knees. Rather than
have her use a pain killer, since many pain medications contain drugs that can cause tinnitus,
her physician suggests that she have injections
of SYNVISC, which will relieve the knee pain by
serving as a lubricant for the knee. Her question
is this: Will SYNVISC exacerbate tinnitus?

A

You have introduced a new treatment
approach to arthritis in the knee, one
which could very likely help others. In
my opinion, your physician has recommended a
unique and very interesting treatment which
according to the literature can produce relief
lasting three months or more.
SYNVISC is made up of hylan, a natural
chemical found in normal joint fluid. This
therapy (the company is clear that this is not

(continued)

a drug), provides lubrication for the knee and
acts as a "shock absorber" to cushion the knee
joint. For the treatment, SYNVISC is injected into
the knee joint once a week for three weeks.
Information about insurance coverage and other
details is available from SYNVIC (800-982-8292 or
http:! /us.synvisc.com) .
Of course, I suggest that you discuss this procedure thoroughly with your physician. There
are some contraindications and side effects listed
in the company's literature, but tinnitus is not
among them. Please keep us informed as to how
you make out with this treatment.

Notice: Many of you have left messages requesting
that I phone you. I simply cannot afford to meet
those requests. Please feel free to call me on any
Wednesday, 9:00a.m. -noon and 1:00- 5.·00 p .m.
Pacific Time (503-494-2187). Or mail your questions
to: Dr. Vernon c/o Tinnitus Today, American
Tinnitus Association, PO. Box 5, Portland, OR
97207-0005.

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24

Tinnitus Thday/September 2000

American Tinnitus Association

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SPECIAL DONORS AND TRIBUTES

ATA's Champion Members are a remarkable group
of donors who have demon crated their commibnent in
the fight again t tinnitus by maldng a contribution or
re earch donation of 1000 or more. Su taining
Member have given memberships or research dona­
tions at the 500-$999 level. Contributing r !embers
have given membershlps at the $250-499 level.
upporting , 1embe have given memberships at the
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restricted contributions in any amount from SlOO to
$499.
Champion
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Vanakkeren
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Konicek
Susan Laimbecr-F'ord
lohn �talcolrn
Loren Parmlc,
Huben G. Phipps
Kenneth A Pre ton

Members

(Contnbutions of
$1000 and abot"t:)

Su.sta

Carol and Al Mar.;ella
Paul J. Meade
Jerome On
Cnroh'fl H. Peters
Tony Randall
Martha I Smith
Jack A Vernon. Ph.n.
Laura Winston

g

(Conr11b11no11s of
$500-999)

Elisabeth L Bruhe,m
Thomas \\ Buchholtz,
MD.
Central 11 Communicy
foundation. Inc.
Mary Kay H. Davis
Jeanna L. French
John E Hayes, Jr.
1arian 8 Lovell

Contributing
Members

(Contnbut1011s of
250-499)

Lois Bowman
Jack D. Clemis, 1 0.
Roben L Coley
Rob M Crichcon

Contributions to ATA's Tnoute Fund will be used to
fund tinnitus research and other ATA programs. lf you
would like this contribution restricted for research,
please indicate it with your donation. Tuoute contribu­
tion are promptly acknowledged with an appropriate
card to the honoree or family of the honoree. The gift
amount is never disclo ed.
Our heartfelt thanks to all of these special donors.
All contnbution to the American Tinnitus
Association are tax-deductible.
Patricia Day
Midiael 8. Field
0. Jeanne Frantz
James . Go1<l
Jane Green
Tum Hatlrop
Eli:wbeth Hill •
W F Samuel Hopmeier,
BC-Hl
George C. JujJfs
Anders Lewendal
Peter A 1arrinan
Phvllis G. N •xon
Michael D. Olander
Thomas J. Patrician
Bruce A. SChomrner
Roger lrudeau

Dan Vallimarescu
Dame) H. Walker
Thomas K Webb
David Winn
Supporting
Members

(Conmbut,ons of
SJ00-:!49)

Greg Armstrong
Calvin Anke
Roben :\. Bailenson
Joseph M. Baria
£me Barnard
T. Larry Barnes
Ned K. Banhelma
John Banlett

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Thoughts on Tinnitus Retraining Therapy

Judith E. Beaston
Rancine and Jules
Belkin
Deborah and CharJe5
Bern
Willi m D. Bethell
Judy C. Bezek
Lisa A. Blackman,
M.A,CCC-A
Rodney J Bogg
John W. Borden
Gordon and Bcttv B
Boyd
John E. Boyle
Dorothy M. Brahm
tichacl Braverman

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Tinnirn Today 'September 2000

25

SPECIAL DONORS AND TRIBUTES
Knox Brooks
Carol A. Brown
Jack E. Brown
Thomas R. Brown
Harry A. Bruhn
Helen S. Burkey
Dennis L. Burrows,
Ph.D.
Lee Burton
Curtis E. Calhoun
Stephen C. Carlson
Frank T. Carnella
Howard C. Cavner
Merle C. Chambers
Linda Champlin
Pamela D. Chandler
Isabelle Chapman
Kathleen M. Coates,
M.A.,CCC-A
Gardner C. Cole
James J. Corless
Harry A. Cornell
Thomas C. Crane,
USN, Ret.
Douglas D.
Crawford
Floyd Cross
Dennis M. Daly
William DeLoach
Marvin N.
Demchick
Joseph J. Demty
Lewis G. Desch
A. J. Diani
Carl D. Distefano
Kathryn M.
Dobrinski
John L. Dosen
Ralph C. Duchin
Irene Duffield
Gretchen Durkin,
M.D.
L.D. Dusseau
Robert W. Eichert
Robert N. Ellington
Ray E. Fankhauser
Bud Fisher
David E. Flatow
Joy A. Fogarty
Francine and Ray
Foster
Duncan C. Fowler
Marvin Freedman
Brian Friedland
Joe Galando
Jeremy T. Garland
Jeanne B. Gaylord
Charles W. Gilbert
Joyce C. Goldberg
Bob Goodman
Richard E.
Goodman
Laverle H. Gordon
Barry Granat
Marlene
Greenebaum
Harold P. Grout
Chris Gustafson
Philip J. Gutentag
Paul R. Haas
Larry E. Hall
Thomas P. Hall
John E. Hammill
Robin M. Hanna
Steven Hanson
Robert R. Harmon
Robert Hedstrom
Lynn Heiter
Saul Hertzig
Elizabeth B. Hill
Lorraine Hizami
Jan C. Hoffmaster

26

Julian Hoogstra
Daniel E. Horgan
Doris Horowitz and
Samuel Horowitz,
M.D.
Gilbert Hudson
Richard L. Huggins
Steve Huntsberry
William H. Hurt
Steven M. Huyck
H. June Ivins
Eileen Jaranowski
Andrea Jeffery
Elmore Jenkins
Robert L. Jeske
Archie Johnson
Oscar S. Johnson,

Elizabeth Vanpatten
Jerome Vanzeyl
David and June
Varn
Jacqueline Verdier
Beryl A. Vogel
Howard G.
III
Phyllis R. Ongert
Wachenfeld
Robert W. Osteen
Eliot Wagner
Lyman E. Ostland
Helene J.
Wasserman
Stephen B. Paine
Jerry Pair
Robert F. Weimer
Howard Weingrow
Alfred J. Pandiani
Meredith K. L.
Fred and Sharon
Weinhaus
Pang, M.D.
George A. Pappy, Jr. Phillip Weisser
John L. Werner,
John D. Parsons
III
Sandra C. Parsons
E.D.D.
L. Craig Johnstone William R. Patterson Dorothy C. Werth
Louis I. Jones
Janis T. Pedersen
H. A. Wheeler
Greg Kaminski
Robert and Laurie
John Whyte
David Kaplan
Pence
Josephine C.
Williams
Eleanor Kapner
Kathleen S.
John Kapteyn
Petraglia
John E. and Janet
Wolf
Jack Kelly
Kurt T. Pfaff, M.A.,
Paul R. K.ileny,
CCC-A
Robert E. Wolons
Ph.D.
Gena Lou Woywood
Stuart Pomper
Harry L. King, M.D. Jay L. Pomrenze
Brax Wright
Mary Lee Kirk
Richard E. Popovits, Jack B. Young
Carl Koos
Jr.
Fred Zemke
Joseph Koppelman Marceline Powell
Paul W. Zerbst
George P. Kotarides, Edwin S. Presnell
David E. Zimmer
Jr.
Geraldine E.
Marilyn K. Zion
Carol N. Kulp
Prostek
RobertS. Kupor
Otis D. Rackley, Jr. Research
Allan S. Kushen
Rose M. Rainona
Donors
Gilbert Labrie
Douglas Reilly
(Contributions
Adella M.
Catherine S. Reitz
up to $499)
Labudovich
W. Roberts
James V. Allen
Donald J. Larivee
Richmond
Alberta M. Ash
Jerry Lastelick
Robert Gene Richter Gerald Aus
Michael C. Lehner Barry J. Robbins,
Edgar P. Bailey
Donald A. Levin
M.S.
Judith E. Beaston
Gary W. Lightner
Charles W. Robinson Michael H. Beck
WarrenS. Line, Jr., Francis E. Robinson Howard G. Bernett
Linda
Ronaldson
M.D.
Larry Birenbaum
Diane C. Lister
Robert W. Roper
Hetty L. Bixby
Jean R. Ljungkull
Jennie E. K.
Sanford Blaser
Philip J. Longo
Rosenblum
Frank Boland
Catherine M. Lynd Beth and Scott Ross Mario J. Bonello
Malcom
Ira D. Rothfeld,
Richard Bou thiette
Macpherson
M.D., P.C.
George S. Bovit
Dan R. Malcore
Richard E. Rush
Don Brice
Stewart Sandman
Vince A. Mangus
Richard Burnat
Dan 0. Martin
Bryan Schwab
L.W. Burton
William G. Scott
Richard L. Martin
Leffie Burton
W. Gordon Martin
Wayne C. Secord
Raymond L. Buse,
Wayne E. Maxon
Robert W. Selig
Jr.
Arnold L.
Harlan W. Smith
Kerrie C. Cart
Mayersohn
Larry L. Smith
Marcia Carter
Kristin E. McAbier Mark A. Smith
Jean Cinader
Carol P. McCurdy
Helena Solodar,
Frank S. Cognato
Guy E. McFarland,
M.S .
Kenneth B. Cohen
E. Wayne South
M.D.
Mary Collura
Marvin Mesker
Theodore R. Stanley Michael Gary
Annette Meskin
Ronald L.
Connor
Evelyn A. Metzgar,
Steenerson, M.D. Rob M. Crichton
M.A.,CCC-A
Howard C. Stidham Pierre David
Frank Milgram
Thomas C. Strafuss John J. Delucca
Barbara F.
Alexander Miller
H. Renwick Dunlap
Sturtevant
Sarah P. Minges
Eric D. Eberhard
Matt Minninger
William B Stutler
Ada Eisenberg
George Minor
Orloff W. Styve
Thm Fawcett
Perry Mitchell
Ellen Svaco
Harold Feld
Diane and John
Michael Mizutani
Marian Feldheim
Edward A. Moos
Swett
Jeffrey A. Ferenz
Guillermo Morales- Lawrence Switzer
Mary A. Floyd
Orozco
JeffreyS. Thshman George N. Gaston
Lois Theissen
Scott M. Nelson,
John Jay Ginter, III
William J. Tillman Kristina Goodson
M.D.
Stuart Noble
Emery Z. Toth
Lynne A. Grader
James C. Thtten
Paul Noe

Tinnitus Thday/September 2000

Donald G. O'Brien,
Sr.
Thomas R. Ogren
William George
Ohaus
Charles T. Ohlinger,

American Tinnitus Association

(continued)

Murray Grossan,
M.D.
Donald D. Guito
James P. Hammitt
Lawrence E. Happ,
Sr.
James and Colleen
Hartel
Paul W. Hastey
Charles M. Helzberg
Julian Hoogstra
Donald Hunsberger
Lucille J. Jantz
Fletcher S. Johnston
Fawz1 Kawash
Lois S. Keeney
Henry B. Keese
Bernard 0. Killoran
Joseph Koppelman
David J. Kovacic
Glen Kratzke
Catherine C.
Lambeth
Helen Leahy
Palmer R. Long
Terrence Maclean
Vince Majerus
Nathan Markowitz
Richard L. Martin
John D. Maxson
Richard L. Meiss
John L. Mercer
F. N. Merralls
David S. Metlicka
George A. Meyer
Anton P. Milo, M.D.
Jerry Monnin
Lori Moraga
Richard E. Mueller
James C. Murphy
Leonard Nimoy
Donata Oertel,
Ph.D.
Jerome A. Olson
Jerome Ott
Joseph G. Oyler
Allan F. Pacela
Meredith K. L.
Pang, M.D.
Randy L. Parks
Carolyn H. Peters
Anthony S. Petru
Viktor Pokorny
Richard E. Popovits,
Jr.
Bruce K. Powell
Norma Price
Jerome A. Rich
Marnita M. Riddle
Thomas J. Rodgers
Susan P. Schindelar
Stephen M.
Schwarcz, D.D.S.
Wanda M. Shannon
Robert J. Shapiro
Peter F. Smith
Joseph Souto
Lorna J . Stafford
James J. Steponik
Natalie P. Stocking
Barbara F.
Sturtevant
RuthM. Swan
Judith J.
Tharrington
Katz, Abosch,
Windesheim,
Gershman &
Freedman
Donald V
Thompson
Fred D. Thompson

Gino Thzzi
Emil Vonkoehler
A. Gary Voyten
Gerda Wassermann
Shirley L. Weddle
Stefany Welch
Mary L. Williams
James W. Wilson
Gladys C. Young
Terry Younghanz
Adelaide W.
Zabriskie, Ed.D.,
C.F.A.

Malcom
Macpherson
Richard S. Martin
Leonard and Ann
McCue
Sharon Meola
George Milne
William George
Ohaus
Margot O'Neill
Kathleen S.
Petraglia
Rock Spring Club
Joseph A. Sauchelli
TRIBUTES
Julie Shannon
Marie and Doc
In Honor Of
Slaght
Jonah Vidis
Richard W. Stockton
Newman
Stephen M. Nagler, Diane and John
Swett
M.D.
Barry Rosenblum, W. H. Thurelle
Howard G.
M.D.
Wachenfeld
Peggy Sue Zabol
George and Barbara
Jack A. Vernon,
Wagner
Ph.D.
John E. and Janet
Dennis M Daly
Wolf

In Memory Of

Florence Altus
Marcy Feldman
Isabel Feld
Harold Feld
Marge Fenwick
Margaret Johnson
William Clark
Hiller
Elizabeth Hiller
Gary R. Jenks
Kirk Jenks
Lillian P.
Markowitz
Nathan Markowitz
Sally Michalski
Margaret Barrett
Jack B. Nagler
Jerome Ott
Robert
Marcy Feldman
Robert G. Pierce
American Tinnitus
Association
Bell Rosenbloom
Marcy Feldman
Selma and Alan
Rothenberg
Susan R. Ericson
Jeannette
Schwartz
Marcy Feldman
Marion Sehl
Judith Dugan
Glenda Prior
Elizabeth P.
Hagemann
Elizabeth Allen
Nowell A. and
Moira M. Blake
Peter L. Bockius
Gordon and Betty B.
Boyd
Janet B. Davidson
Joyce Farrel
Nisha Flint
Olin and MaryJane
Friant
Michael Gannon
Joseph Gatti
Thna and Richard
Korngut
Walter H. Kuhn
Jack b!. Lambdin
Dr. and Mrs. Alan
Lee

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AMERICAN
TINNITUS
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Address Service Requested

P.O. Box 5
Portland, OR 9720 7 -0005

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