A publication of the American Tinnitus Association

Don’t Miss ATA’s 2017 Webinar SeriesThe webinars are part of your $40 ATA membership. You receive 5 free webinars per year.

Webinars are available for non-members at $25 per webinar. See back cover.

ATA’s webinar in September was on Vagus Nerve Stimulation (VNS) and featured presenters Michael Kilgard, Ph.D. and ATA Scientific Advisory Committee member, Dirk De Ridder, M.D., Ph.D. The live program was attended by many and one of particular interest to ATA’s membership.

Dr. Kilgard explained that “neural plasticity can be used to eliminate tinnitus if we can direct the appropriate brain changes.” He remarked that “we’ve been able to actually see the brain changes in tinnitus that goes with this [VNS] therapy…reduced activity in patients who received our therapy in exactly the region – auditory cortex - that we were trying to target by using sound therapy paired with vagus nerve stimulation.” Dr.

De Ridder commented on this therapy and stated “It’s not the sound alone that does it. It’s not the vagal nerve alone that does it, but it’s really the combination and the pairing of presenting the sound with simultane-ous vagus nerve stimulation that does the trick.”

Although VNS is not currently approved by the FDA, there are a number of trials that have been approved and scientists who are actively seeking new approvals in this area of research. Dr. De Ridder concluded that “from a practical point of view, there is real hope that physiology-based treatments such as paired vagal nerve stimulation and paired accumbens stimulation might be beneficial for more patients in the future.”

How to access ATA WebinarsAs a member of ATA you receive 5 free webinars per year and unlimited access to archived webinars with your $40 yearly membership. If you are not a member but would like to participate, the cost is just $25 per webinar. Follow the instruction below to access our webinars.

Directions to Watch Recorded & NEW Webinars:1- Log on at www.ATA.org using your computer, tablet or smart phone.

2- Access your Member User Account at the top of the screen.

3- Go to the Welcome ATA Members blue menu on the far right side of your screen.

4- Right below that is ATA Webinars. Click on that name. It will bring you to the page of recorded webinars. We’ve also included the PowerPoint™ presen-tations and the webinar script so that you can easily follow along at home with the presenters on the video.

5- To register for a NEW webinar click on Register for ATA Webinars in the box below “ATA Webinars.”

We hope you utilize and enjoy this member benefit. If you have questions about this or any of your other ATA member benefits, don’t hesitate to contact us at anytime at: [email protected]

ATA’s September 2016 Webinar Wrap-Up: Vagus Nerve Stimulation (VNS)by Jodi Asmus, ATA Communications Assistant

2 WINTER 2016 | Tinnitus Today

Tinnitus TODAY COMMITTED TO A CURE

Volume 41, Number 3 Winter 2016-17

Chris Vail-Rollins, Tinnitus Today, Editor

Tinnitus Today is the official publication of the American Tinnitus Association. It is published three times per year in April, August and December and is mailed to members and do-nors. Circulation is 56,000 annually.

The American Tinnitus Association is a non-profit human health and welfare agency under 26 USC 501(c)(3)

Board of DirectorsGabriel Corfas, Ph.D., Ann Arbor, MICol. John T. Dillard USA (Ret.), Carmel, CADaniel J. Fink, M.D., Beverly Hills, CAScott C. Mitchell, J.D., Houston, TXNorma R. Mraz, Au.D., Alpharetta, GA Randy Phillips, Great Falls, VA Bryan Pollard, Marlboro, MA Gary P. Reul, Ed.D., Issaquah, WALaGuinn Sherlock, Au.D., Severn, MDDavid M. Sykes, Lincoln, MA Joseph Trevisani, New York, NY Ted Turesky, Washington, D.C.Bradley Vite, Elkhart, IN Melanie F. West, Cave Creek, AZ Jinsheng Zhang, Ph.D., Detroit, MI

Honorary Board of DirectorWilliam Shatner, Los Angeles

Scientific Advisory CommitteeScientific Advisory BoardShaowen Bao, Ph.D., Berkeley, CASusan M. Bowyer, Ph.D., Detroit, MIDirk De Ridder, Ph.D., Dunedin, NZMarc Fagelson, Ph.D., Johnson City, TNMichael E. Hoffer, M.D. FACS, Miami, FLFatima T. Husain, Ph.D., Champaign, ILElisabeth Maria (Marlies) Knipper-Breer, Ph.D., Turbingen, GermanyMark S. Mennemeier, Ph.D., Little Rock ARJay F. Piccirillo, M.D., FACS, St. Louis MOLarry E. Roberts, Ph.D., Hamilton, ON, CanadaMaria Rubio, Ph.D., M.D., Pittsburgh, PAJeremy G. Turner, Ph.D., Jacksonville ILRoland Schaette, Ph.D., London EnglandGrant D. Searchfield, Ph.D., Auckland, NZAthanasios Tzounopoulos, Ph.D., Pittsburgh PAPim Van Dijk, Ph.D., Groningen, NetherlandsFanGang Zeng, Ph.D., Irvine CAJinsheng Zhang, Ph.D., Detroit MI

The opinions expressed by contributors to Tinnitus Today are not necessarily those of the publishers or the Amer-ican Tinnitus Association. This publication provides, for information purposes only, a variety of topics related to tinnitus.

ATA’s publication of any advertisement in any kind of media does not, in any way or manner, constitute or imply ATA’s approval or endorsement of any advertised product or service. ATA does not favor or endorse any commercial product or service.

Editorial and Advertising OfficeAmerican Tinnitus Association

P.O. Box 5, Portland, OR 97207main: (503)248-9985 toll-free: 800-634-8978email: [email protected] website: ATA.org

WINTER 2016 | Tinnitus Today 3

ASSOCIATION UPDATES2 Vagus Nerve Stimulation Webinar Wrap-Up Jodi Asmus, ATA Communications Assistant

4 Be your own BEST Advocate Melanie F. West

6 Letters to the Editor9 Q & A Answers to Members Questions LaGuinn P. Sherlock, Au.D., CCC-A

12 Make a Difference, Leave a Legacy17 Member Survey

ADVOCACY 13 To Refer When Necessary Daniel Fink, M.D., ATA Board Member

19 It’s All About Support Ted Turesky, Facilitator, ATA Board Member

20 Serendipity, Siblings and Advocacy Mari Quigley Miller, Group Leader and Patrick Quigley, Member

22 How I Helped Myself and Now Others Barry Sherman

SCIENCE & RESEARCH14 Bayesian Informed Effective Care & Table Michael J.A. Robb, M.D.

24 Desyncra - Neuronal Training Howard Vickers, Desyncra GM

PATIENT & MEMBER STORIES10 My New Me ... or how I am taming tinnitus Rick Lamarre ATA Member

26 Extra Sounds in My Ears Bill Pellerin, ATA Member

RECOGNITION28 ATA Special Donors & Tributes, Jack Veron Legacy Professional Members, Corporate Members

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Learn More about Tinnitus, Managing Your Tinnitus and Find Resources at: ATA.org


Be your own BEST Advocate

By helping yourself you help others

According to Merriam-Webster Dictionary there are three simple definitions of an advocate: 1) a person who argues for or supports a cause or policy 2) a person who works for a cause or group 3) a person who argues for the cause of another person in the court of law. In this issue of Tinnitus Today and in the issues to come you will have the oppor-tunity to meet people who have defined this word by their actions. They have stepped out not only to speak up for themselves, but they have advocated for others and in the process helped themselves.

Talk about TinnitusWhether you talk with your doctor about tinnitus and hyperacusis, make a presentation to a company, ask the theatre to turn down the volume or simply tell a friend about the symptoms of tinnitus or hyperacusis, you have made a difference. Think of the impact you could have if you wrote your congressman or senator requesting funding towards tinnitus or hyperacusis treatment and research.

We have to make some noise to silence tinnitus. If, as an organization, we are going to effect change and fund a mul-titude of solutions we have to talk about tinnitus and hyper-acusis. And, how can we do that? Just by speaking up at the appropriate time with the right people using science-backed information. ATA is your resource for information.

I hid my “silent disability” for years

Possibly like you, I stayed quiet about my tinnitus for years. I called it my “silent disability”. I was afraid to tell peo-ple about the condition because they couldn’t see it nor could they hear it. But, today there are diagnosises for the symptoms of tinnitus and hyperacusis. There are computer/phone apps that allow others to hear what you hear. And, there is research suggesting protocols and management programs along with devices that can offer a tremendous amount of relief. We need to advocate to educate.

Be your own BEST advocate

So, how can you be your own BEST advocate? ATA has made it easy for you. Two medical doctors have written an informative article in this issue that you can copy and take into your medical doctor or audiologist. You can also share the information with your business associates, friends and family. There is an informative table to cut out and keep and a survey to send back to ATA.

Approach local health care groups

Go to your local city or county health care administrator and ask if you can speak about tinnitus and hyperacusis. Set up a meeting to present slides and bring in brochures both of which are available from ATA. You can educate them on the options for tinnitus and the need to refer their patients to a professional who specializes in tinnitus and hyperacusis. Do-ing so will save them revenues while providing their citizens with valuable help.

Apply to your employer’s matching gift program

If your employer participates in a matching gift program, ask them if you may present information on tinnitus and hyper-acusis and have a fundraiser to benefit ATA’s research and mission of advocacy. Approximately two-thirds of companies with matching gift programs match employee donations to most 501(c)(3) organizations, which ATA is, or educational institutions. The other one third of companies match dona-tions to specific types of organizations, such as: educational institutions, health and human services and more. ATA will provide you with the tools you need to set up a presentation and fundraiser.

by Melanie F. West, ATA Chair

Who do you picture as an advocate – the lobbyist in Washington, your senator, congressman or a lobbyist? Have you ever pictured yourself as an advocate for tinnitus and hyperacusis?


You don’t have to take center stage to be an effective advocateIf you don’t personally like being in the spotlight here are a few things you can do to advocate for tinnitus:

1 Ask your local movie theater and restaurants to turn down the volume.

2 Go to the leadership of organizations, such as your place of worship, schools or businesses and request they reduce the volume of the music or noise.

3 Contact your congressman or senator requesting funding towards tinnitus or hyperacusis treatment and research.

Take the time to write an email or letter to the appropriate parties outlining the discomfort, lack of health safety and consequences of loud environments and back it up with information from ATA. You can make a difference. We just need to collectively keep making the effort.

Advocate to your healthcare providerRecently, while I was at my ENTs (Otolaryngologist’s) office for a routine screening, I discussed the need for ENTs to refer patients to tinnitus specialists and to not say “go home and learn to live with it” or that “there is no cure” because there are cures for certain types of tinnitus and these statements lead to hopelessness. He agreed that the doctors shouldn’t make those remarks and explained that he had just recently had a case where a patient was in his office in tears because an associate doctor had said those very words. My doctor assured me they are correcting their procedures and will not be making those statements. That’s progress. As to whether doctors will make recommenda-tions to tinnitus specialists will depend on the individual doctor. Years ago, I received a recommendation from ATA to a medical doctor who specializes in tinnitus and I’ve received a tremendous amount of relief from his advice and protocol.

Share ATA’s informationI will continue to take Tinnitus Today magazines to my doc-tors for them to learn about current research. Next time, like me, be your own BEST advocate and take in the ATA article in this issue which was written by doctors for doctors with the treatment options table. Why? So you can be your own BEST advocate for all of us to better treat the symptoms of tinnitus and hypercussis and to find a cure.

Thank you for supporting ATA, all you have done and all you will do to promote awareness of tinnitus and to help us find a cure.

You can make a difference. We just need to collectively keep making an effort and . . .

Make Some Noise to Silence Tinnitus

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ssociation Updates



Letters to the EditorTMJ and tinnitus connection = Somatic Tinnitus

Dear Tinnitus Today Editor: With two sentences, Tinnitus Today editor Jennifer Born changed the quality of my life. In the Fall 2015 issue she wrote in response to a letter:

“Interestingly, about two thirds of the individuals with tinni-tus are able to modulate the loudness (or pitch) of their tin-nitus by manipulations of the jaw or by applying pressure on certain neck and head regions. This phenomenon is clinically known as somatic tinnitus.”

I have endured pulsatile tinnitus on my right side for most of my adult life, and recently it was getting worse. I desperately sought solutions. I tried to describe to various doctors and specialists that my pulsing, throbbing noises were like a psychedelic strobe light – only with sounds instead of light. My doctors were only familiar with symptoms of ringing, the most common type of tin-nitus.

Because of the loud, staccato pulsing noises, I was hearing only half of conversations, TV, or movies. Audiologist tests showed normal hearing results. The irregular pulsing was worse in the early morning, late in the day, and through the night. During the day it was calmer, even quiet for stretches of time. I had noticed this pattern but could not maintain the quiet times.

A sleep study years ago had shown I had extreme bruxism (jaw clenching). I was also experiencing jaw pain, jaw locking, joint noise along with neck pain. I later learned there is a strong con-nection to TMJ (Temporomandibular Joint) and my pulsatile tin-nitus. Editor Born’s comments gave me a glimmer of hope. My dental hygienist gave me the name of a TMJ specialist, Dr. Jack Walz, DDS, practicing out of East Peoria and Bloomington,Illinois.

As I was rather skeptical of store-made mouth guards and was aware that Medicare would not cover the whole cost, I began treatment. Dr. Walz and his staff were extremely patient and kind, always listening to my specific issues while the doctor de-veloped my plan. Office visits were actually therapeutic, having someone who acknowledged my issues and gave me encourage-ment.

The procedure is based on wearing orthotic mouth pieces to sup-port my jaw and neck. For several weeks I wore a plastic orthotic guard on my lower teeth 24/7 plus an upper guard at night. Af-ter gradually decreasing the amount of time wearing the devic-es combined with simple mouth exercises, I began to see a huge reduction in my tinnitus. I was cautiously hopeful. My symptoms of jaw pain and locking were also reduced. Dr. Walz also prescribed physical therapy for stress reduc-tion of my neck and facial muscles caused by habitual jaw clenching. Grinding teeth is a reflection of in-tense muscle tension that somehow influences tinnitus.

This process varies but my treat-ment began in June, 2015 and by October of that year I was done with treatment. Now, one year later, I am thrilled to report my tinnitus has been reduced by over 80%. I truly did not think that was possible. I now wear only the upper device during the night, but indefinitely. It is a very small price to pay for peace. I also follow Dr. Walz’s advice to relax my jaw during the day using his mantra: “Lips together, teeth apart.”

An added very welcome benefit is improved sleep. Apparent-ly the bruxism and pain was interfering with sleep cycles. The nighttime guard insures I don’t clench and I wake up with much reduced pulsing, if any. Of course there are many causes of tinni-tus, as mentioned in the Fall 2016 Tinnitus Today cover story. But if anyone knows they clench or grind their teeth, a dentist special-izing in TMJ may change their life as mine was changed. I am very grateful. Joann Baker

Dear Ms. Baker:

Thank you for your encouraging letter. For people who have been diagnosed with somatic tinnitus it may be of great assistance. For those who suspect they may have somatic tinnitus, it may urge them to see a doctor.

Jennifer Born, the Tinnitus Today Editor was with ATA for 10 years. She resigned due to personal reasons, but while at ATA she assisted many members and people with tinnitus just like you. She will be missed by all at ATA. Thank you for sharing your story.

I am thrilled to report my

tinnitus has been reduced by over

80%.


Although most people do not experience tinnitus, hyper-acusis or hearing loss on a single event, many do. Just the sound of feedback from a speaker as a result of an untrained or inexperienced sound technician can change a person’s life forever. Insist that your church provide training before technicians are allowed to operate sound equipment. Pay attention to where you are seated relative to the speakers. ATA has brochures you can purchase that explain both tin-nitus and hyperacusis and the consequences of loud noise.* They are an economical means of reaching and enlighten-ing people in leadership or ownership to make the change. When they realize that they too may be exposed to the con-sequences of the symptoms they may change their tune, so to speak.

Many churches acknowledge and accommodate disabil-ities. By presenting the symptoms and causes in an un-derstandable manner, the leaders may consider offering a sound-proof room much like they do for nursing mothers. A placard at the front of the church when the music is about to be played could protect those concerned from entering. Plus, a quick announcement before the music begins would also allow a person to exit while still being able to be pres-ent during the quieter speaking and worship portions of the service.

Many members, Dr. Hopkins, have had your same concerns and questions. Let’s hope oth-ers will send in stories of what has worked for them to advo-cate for a quieter environment. In the meantime, the next time you head to church copy or tear out an article from Tinnitus Today to take to your church. Most public buildings have a comment box somewhere in the building. You can be your own BEST advocate for quieter environments for yourself and for others.

*NOTE: to order ATA brochures please visit our website at: ATA.org and select “Professional Resources” at the bottom of the page which will link you to our brochure order form.

The opinions expressed here are strictly those of the let-ter writers and do not reflect an opinion or endorsement by the American Tinnitus Association. If you are interest-ed in any treatment mentioned please consult with your healthcare professional to determine whether that treat-ment is right for you.

Music at church hurts my ears

Dear Tinnitus Today Editor:

I have some hearing loss, tinnitus and hyperacusis. I know the number one rule of hearing loss and tinnitus is to protect your hearing. I have learned to live with all of these issues thanks to TRT (Tinnitus Retraining Therapy), but one area in my life that I still struggle with is going to church.

My faith is a very important part of my life, but I cannot seem to find a church that is not too loud. I have a decibel meter app on my phone and the sound from the music is usually anywhere from 90 to 120 db. Even with earplugs I find it hard to handle the volume. I had custom earplugs made which work well, but part of me just doesn’t like loud environments anymore, even if my ears are protected. I don’t want my wife in that loud environ-ment either because I don’t want her to have any of the issues I have.

After reading the recent article in Tinnitus Today called “What is a Safe Noise Level” I am still looking for answers. Is the music in my local churches too loud at 90-120db, or is it fine for ap-proximately 30 minutes every Sunday? Is it causing harm to people in the congregation, possibly leading to hearing loss, tinnitus, or hyperacusis? Are there any precedents of indi-viduals getting their local churches to turn down the music? Any articles I could use? I remember during the ATA webinar on “Hyperacusis” becoming an advocate for noise reduction was mentioned. Anyway, those are my thoughts and questions. Thank you for your time, for the ATA and the Tinnitus Today journal. I read every word of it and also watch all the webinars, which are fabulous. David Hopkins, D.O.

Dear Dr. Hopkins: Thank you for your kind words about our publication. Your comments and questions about church music are echoed often to the ATA staff. Many a member has asked about the ability to express their faith in a building that “noise-wise” is uncomfortable or prohibitive. Whether the sound problem exists in a church, synagogue, temple or other edifice built to allow you to express your religious preferences they are typically public dwellings and should accommodate the at-tendees.

Restaurants, schools or other buildings geared to the pub-lic should also cater to the public at large. Environmental education is the best remedy. Copy the article you read, “What is a Safe Noise Level?” so you have the information at hand to discuss with the leadership. You may also do what many of our members have done and put together a slide presentation to present to your church’s board. Due to their non-profit status most churches have boards you can ap-peal to. ATA can assist you with slides for a presentation.

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ssociation Updates

1 The only way to say tinnitus is TINN-i-tus. FALSE. There are two ways to pronounce the symptom. You can say TINN-it-tus or tin-NIGHT-us. Both are medically correct. The reason you hear it pro- nounced both ways is because “itis” infers inflammation and there is no inflammation in tinnitus that we are aware of yet. Most doctors and clinicians pronounce the symptom TINN-it-tus and most lay people and the American Tinnitus Association pronounces it tin-NIGHT-us. Just don’t complain about your tendon-itis or the doc will start working on your elbow.

2 Men tend to have a higher prevalence of tinnitus over women. TRUE. Though most studies support this fact, not all studies have come to this conclusion.

3 There are no cures for tinnitus.

FALSE. There are possible cures for certain subpop- ulations of tinnitus such as people with pulsatile tinnitus or severe deafness that are fitted with a cochlear implant.

For more information regarding these topics go to ata.org, type in the subject into the search box and learn more.


Tinnitus Today’s New Editor

Health & Protection TipFACT or . . . Fiction?

Dear Readers:

My name is Chris Vail-Rollins and I am pleased to be the new editor of Tinnitus Today. ATA has prided itself on the quality of the articles, the research and the relevant infor-mation it provides its readers. I look forward to continuing that quality by providing you with inspiring stories; news-worthy reports; comprehensive research and practical tools that might help you manage your tinnitus or hyperacusis today.

For over 25 years I have worked as a writer and a graphic designer in the capacity of creative director for several national companies and also in a freelance capacity. I feel privileged to be able to help spread ATA’s message of help and hope for a cure to a much wider audience. This subject is close to my heart, as my husband is a tinnitus sufferer, so I will be looking at the articles, research, and tools from the same perspective as many of our readers.

A few new features have been add-ed to the journal. Look for the bite-sized facts and suggestions under management tools, prevention, advocacy, support and worldwide news in this and upcoming issues. They will bring you up-to-date in the world of tinnitus and hypera-cusis and may provide practical tips you can apply in your daily life. It is my goal to present research articles in an easy to un-derstand format to allow everyone to decipher this vital information.

Please send in your “Letters to the Editor.” ATA especially wants to hear ideas or treatments that have worked for you which may provide solutions and relief for other mem-bers and donors. If you have comments about articles that were written, the new format of the magazine or sugges-tions for future articles I’d like to hear from you. Send your

Chris Vail-Rollins

MRI

If for diagnostic purposes you are given a prescription for an MRI, Magnetic Resonance Imaging, here are a few precautions you can take to be comfortable and protect your hearing. A MRI machine can be very loud and rhythmic as it works its way up and down the area to be scanned and in some cases can take a fair amount of time to complete its processes depending on the area to be scanned.

A- Take your own earplugs to your appointment. Make sure they specifically fit your ears.

B- Most Imaging facilities provide ear protection earmuffs. Make sure that these provided earmuffs fit tightly over your ears with your earplugs inserted.

C- Speak up If the earmuffs and earplugs do not fit well or you are uncomfortable with the noise of the MRI.

D- The imaging facility usually gives you a button to push to alert the technician for your protection. Don’t be shy if you are uncomfortable. It’s important to protect your hearing . . . so push the button if needed.

Answers to ATA Members’ Questions

Q I have read about the impact on patients when they are prescribed ototoxic drugs. Specifically, has there been research based on taking a baby aspirin a day and its effect on tinnitus?A Tinnitus can be caused by aspirin, but only in very high doses (e.g., more than 600 mg). Aspirin-induced tinnitus is gen-erally reversible by stopping the aspirin. The typical baby aspirin dose is 81 mg and is not associated with causing tinnitus.

Q Is it possible to have tinnitus when there is no hearing loss?A Yes. Although there seems to be evidence of a correlation between hearing loss and tinnitus, it cannot be said that hear-ing loss is the cause of all cases of tinnitus, or that having no hearing loss prevents tinnitus. People learn to adapt to their decreasing hearing as the “new normal,” so even if you don’t think your hearing has worsened, and you experience tinnitus, the first thing you should do is have your hearing evaluated by a professional. If you have had a hearing exam and the test re-sults indicated normal hearing, it is possible that you may have hearing loss in a pitch region that is not routinely tested. If hearing loss is identified, use of hearing aids can help a lot with tinnitus.

Q I am completely deaf in one of my ears. Will any of the tinnitus maskers on the market today work for me?

A Applying sound into the deaf ear will usually not work. However, since tinnitus is perceived at higher level auditory structures in the brain, a masking or sound-generating device fit-ted to the hearing ear can be helpful.

Q Why aren’t many tinnitus treatments or management tools covered by insurance? A Historically, coverage of tinnitus treatment has been min-

imal, due in large part to insufficient research evidence that meets insurance industry standards to justify coverage. This is why research is so important, not only to help find a cure for tin-nitus, but also to identify clinical treatments with success rates that will justify full reimbursement. The Affordable Care Act currently does not mandate coverage for tinnitus treatment. In-surance typically covers hearing exams, tinnitus evaluations and in some cases, hearing aids. Many hearing aids have sound gen-erators built in to help with tinnitus. Insurance also typically cov-ers cognitive behavioral therapy, which has been shown to help with tinnitus.

Q How can I learn more about clinical trials in my area and whether I would be a good candidate for a study? A Clinical trials funded by the National Institutes of Health are posted on the website at www.clinicaltrials.gov. Other clinical trials not funded by NIH are conducted at universities and medi-cal centers; check your local area for studies in progress. Keep in mind that many clinical trials have strict criteria for inclusion in the study. Such criteria may include age, onset of tinnitus, oth-er health conditions, etc. Always seek the advice of your health care provider before joining a clinical trial.

Q How has the focus of tinnitus research shifted away from the region of the ear in favor of the various regions of the brain? A Some causes of tinnitus can be found in the ear itself, such

as ear wax, an ear infection, or damage to the inner ear. How-ever, the source of the tinnitus may be higher up in the auditory system, which starts at the ear and ends in the brain. The ear it-self only transmits sound, while all sound processing takes place in the brain; we hear with our brain, not with our ears. Research has shown that the brain can generate neural activity within the auditory system, in the absence of an external input (i.e., sound) from the ear. Another aspect of tinnitus is the reaction to the sound of tinnitus. Research shows that the limbic system, the part of the brain in which we experience anxiety, often lights up with activity as much as the auditory system when a person ex-periences tinnitus. When the reaction to tinnitus is reduced, the effect of tinnitus on things like concentration, sleep and mood is reduced. The more we learn about the various sources of tin-nitus, the more likely it is that cures will be found. In the mean-time, research findings help with treatment options.

DISCLAIMER: The views expressed are those of the author and do not reflect the official policy or position of the Departments of the Navy, the Army, the Department of Defense, or the US Government.

Dr. LaGuinn Sherlock is a clinical and research audiologist with over 25 years of experience in the field. She is actively involved in research evaluating the efficacy of treatments for tinnitus and hyperacusis. Trained in both Tinnitus Re-training Therapy and Neuromonics Tinnitus Treatment, and currently providing Progressive Tinnitus Management, she has provided evaluation and treatment services for tin-nitus and hyperacusis for more than 10 years. She is cur-rently a research audiologist with the Army Hearing Pro-gram, US Army Public Health Center, stationed at Walter Reed National Military Medical Center in Bethesda, MD. She is a member of the ATA Board of Directors.

LaGuinn P. Sherlock, Au.D., CCC-A


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ssociation Updates



My new me . . . or how I am taming my tinnitus

Rick Lamarre’s story

Jan 24 2014, 4:00am, I awoke to a high-pitched squeal and a feeling of fullness in my right ear. I thought I developed an ear infection overnight. Still an hour before I needed to get ready for work, I rolled out of bed for a quick trip to the bath-room. As I rose, the entire room made a sharp pivot to the left and I flopped helplessly to the floor.

Anticipating my wife’s concern, I quickly repeated “I’m al-right” while I pulled myself back onto the bed, “just a little clumsy.” I remember lying on the bed trying to convince myself that what I just told her was indeed true. Perhaps I just got up too quickly or tripped over some discarded clothes I left on the floor. But I knew something was terribly different.

A long road to a diagnosisThe bedroom felt different. What did that mean? Even I couldn’t explain it to myself. I knew it was an unreasonable thought, but I also knew I was right. The quiet was gone and the room felt unsteady. My ear felt like it was filled with ce-ment and what the heck is that screeching? After an hour more I told my wife something was wrong with my ear and I was dizzy. I asked her to take me to the emergency room. That began a several week journey of being treated with

antibiotics and steroids. Almost a month later, I finally saw my first ENT specialist who told me there might be some-thing more seriously wrong. She sent me to an audiolo-gist. That’s when my annoyance at my condition turned to anxiety.

The testing showed I had lost my low frequency hearing and the high frequencies were degraded. But what really shook me up was the word recognition test. Using only my right ear, the audiologist asked me to repeat words she just stat-ed. All I heard was “Say spurzt” “Say mumro” “Say durtnit”. I couldn’t understand anything. Now I’m scared. My right ear was incapable of discerning words and I couldn’t stop that sound! I had recently retired from the Air Force and found a good job in the civil service that required working with peo-ple every day and I needed to understand them.

I was diagnosed with SSNHL (Sudden Sensorineural Hearing Loss) and Meniere’s disease, which explained the dizziness. After a couple months of more steroids, ear injections and even hyperbaric chamber treatments, I had to face the reali-ty that my condition may be permanent. But even more dis-tressing, I realized I may never hear silence again.

I always thought the screeching in my head was temporary, which gave me hope and the strength to put up with the stress. But now, I realized I may have to live the rest of my life, every waking moment, with that horrible siren in my ear. I felt helpless and didn’t believe I could handle it.

My military career had prepared me for battle but this foe was differentThrough my entire military career, I had faced every chal-lenge head on. But this was different. This tormentor wouldn’t face me. It kept hiding behind my right ear no mat-ter which way I turned, demanding my attention, yet not al-lowing me to see it. I became hypersensitive to every sound, constantly reacting with a “fight or flight” response. I didn’t want to worry my wife, but I needed to talk about what was happening. Fortunately, I married a strong woman, the right woman, and we began researching tinnitus together.

I began a tactical search for a strategy to fight my symptomsWe checked medical sites, blogs and luckily found ATA. The ATA helped us to sort the fact from the fiction and gave us courage to find the right kind of help. But what concerned me most were the accounts of how depression commonly accompanies SSNHL. I understood completely.

My tinnitus threatened my career and stopped me from go-ing to public places like restaurants. Tinnitus is formidable, but if I succumbed to depression, I would not be able to fight

tinnitus at all. But how do I fight depression when tinnitus stole so many things I loved? I needed a strategy, some-thing I could control. Through our research, I began to un-derstand my new foe was actually within me.

I had to retrain my brain and become my own best advocateThe sound I hear cannot be heard by anyone else. My tin-nitus is partly my perception of a neurological response to losing my hearing. Okay, more plainly – it is in my head. And if I cannot stop the tinnitus of my unconscious mind, I had to train my conscious mind in neurologic combat.

Once I accepted there was no miracle drug to stay my tin-nitus, I focused on finding ways to help myself. With my wife’s support, I became my own best advocate.

I set aside my doubts and skepticism and embarked on cog-nitive retraining. I dove into relaxation techniques, habitu-ation and especially sound therapy. I found acoustic gui-tar was often soothing (Al Pettaway is one of my favorites with his soulful, invigorating music). I also discovered the sounds of Native American wood flutes, with its peaceful, low toned voice, relaxed and calmed me. While download-ing flute music one day it hit me, why not learn to play? The sounds helped, but what if I engaged myself mentally too?


After all, if I was to beat depression and go toe to toe with tinnitus every day, I needed a better mindset - something to look forward to. I’ve never played an instrument before, maybe this could be fun. I decided to create a “new me” to handle my “new normal”. The new me tries things the old me never considered and hopefully creates the right frame of mind to be strong against tinnitus. I bought a Native American flute.

The flute became one of my physical weapons against my neurological nemesisI’m not very musical, but the new me plays an instrument. The old me didn’t think I had it in me (the new me that is). My ever-patient wife probably doesn’t think I have it in me either, old or new, but I love her support. I’m not a great flut-ist, but in those moments all tinnitus sufferers know, when the noise spikes and seizes your attention, I reach for my flute. Sometimes it only takes a few minutes to find relief, as the playing engages my mind while simultaneously soothing my ear. It is one of my physical weapons for my neurological nemesis.

I am taking control back from the beastwhile creating a new lifeAs I begin to gain a measure of control, I am winning the courage to take more power. I am embarking on a new career of freelance writing. My busy office environment proved too stressful for my new normal. Well, alright, in-stead of fighting the hectic office battle every day, I changed my setting. Now I work at home where my allies of back-ground noise, my flute and mentally engaging work keep the tinnitus at bay. The old me didn’t have the courage to even attempt my longtime writing dream. The new me has the professional and personal well-being motivation to make this work.

The invisible beast is losing its psychological advantage. I am developing my mental and physical arsenal to win more of my daily battles. I can’t say my problem is solved. I have good days and bad days, just like many of you. At least now, I am empowering myself to take back my life. Perhaps it’s not the life I had envisioned. It certainly is not the “me” I ex-pected to be, but I think I’m going to like the new me.

Rick and wife Suzanne are both US Air Force Retiredand live in picturesque Gold Canyon, Arizona.

World Wide NewsThe British Tinnitus Association (BTA) announced their publication of the first edition of the new Annual Tinnitus Research Review. The BTA has invited experts in tinnitus to review relevant research published in 2015 with the aim of summarizing the highest quality and most relevant papers, giving both professional and lay readers an overview of the themes and developments in the field.

The hope is that this will encourage and inform busy clini-cians dealing with people with troublesome tinnitus on a daily basis. We hope this will inspire further research to be undertaken, building upon the new knowledge.

For more information on this review go to ata.org and search BTA Review. Roland Schaette, Ph.D. of the UCL Ear Institute, University College London, is a member of ATA’s Scientific Advisory Committee was published in this review.

Patient &

Mem

ber Stories


Make a Difference, Leave a Legacy

How can your life make a difference to future generations? Include the American Tinnitus Association in your es-tate giving. Provide hope to others who have tinnitus and hyperacusis. By including ATA in your will or trust, you can help support ATA programs like advancing research toward novel management techniques, pharmacological solutions or other state-of-the-art findings that might lead to cures for these conditions.

The Jack Vernon Legacy SocietyJack Vernon, Ph.D., created a legacy for all individuals who are challenged with tinnitus and hyperacusis. He was a vanguard in the quest to research tinnitus and hyperacusis. As a forefather he founded the American Tinnitus Associ-ation in 1971. Jack made a difference in helping people who suffer from tinnitus and you can too. By naming ATA in your estate plans and sharing with us that you have done so, you can become a member of the esteemed Jack Ver-non Legacy Society.

Your benevolent gift can ensure:• Your life changes the course of others’ lives who are less fortunate by providing educational opportunities and support through ATA programs.

• Your bequest in your will can represent something meaningful to you.

• Your experience or a loved one’s experience with tinnitus and hyperacusis leaves a legacy of hope for future generations with these conditions.

In lieu of flowers If you lose a loved one you can donate to ATA in their memory or request that people donate to ATA “in lieu of flowers”. You can honor your loved one and help others to understand tinnitus and hyperacusis and the challenges faced by those who suffer.

Your chance to “Pay It Forward”If there was a time when ATA helped you, either by pro-viding dependable information about tinnitus, providing resources to find a proper health care professional to show you how to manage your tinnitus, or by just giving you hope that you were not alone in your journey with tinnitus and hyperacusis, then this is your chance to pay it forward through your estate planning. We ask each member and donor to add ATA as a beneficiary in your will by contact-ing your lawyer or other estate planning professional, and explore the ways such a bequest can reduce your taxes.

If you’ve joined the Jack Vernon Legacy Society by making arrangements for ATA in your estate plans, thank you. If you would like more information, please contact us. Clip and send us the slip below. Like Jack Vernon, you too can leave a legacy to create a quieter world free of tinnitus and hyperacusis.

Your help provides future hope and solutions for tinnitus and hyperacusis sufferers

q I want to make a difference, please contact me to discuss the Jack Vernon Legacy Society and estate giving opportunities to support ATA.

q I have already made arrangements for supporting ATA in my estate plans. Please enroll me as a member of the Jack Vernon Legacy Society.

For more information, complete and send this slip to: American Tinnitus Association, P.O. Box 5, Portland, OR 97207

name: ____________________________________________________

address: _________________________________________________

city, state, zip: ____________________________________________

phone day: ___________________ evening: ___________________

email: ___________________________________________________

For more information please contact ATA at 800-634-8978 or email [email protected].

ANONYMOUS (3)Paul A. BaumlRichard L. BehrMonte BeilharzVirginia BlackmanGerald L. Bray, LCSWJohn U. Buchman, M.D.

G. Cheston Carey, IIICarl L. Cochrane, Jr.Simon D. CouvierJules H. DruckerJoy A. FogartyDrs. Norman & Gilda GreenbergMarcene M. Herron

Richard & Estella Hoag Charitable FundGinger L. HoilandRichard IannaconeBen L. JonesHarold M. Kahn, Jr.Clifford L. KohlerScott C. Mitchell, J.D.

Gary P. Reul, Ed.D and Barbara T. ReulEdward P. RosenbergJames W. & Virginia SoudrietteNeil D. ValentinoDemler D. & Wanda WeiszMelanie F. West

Jack Vernon Legacy Society


To Cure When Possible, To Treat Often, To Comfort Always, and To Refer When Necessary!

Almost every day someone affiliated with the American Tin-nitus Association - a staff person, a board member, a support group leader, or an ATA member - is told by someone with tin-nitus, “I just saw a specialist and was told that I had tinnitus, that there was nothing to be done, and that I should just go home and learn to live with it.” Those with sensitivity to noise (hyperacusis) often report the same sad experience. Some of them then burst into tears. They feel alone. They feel aban-doned. They feel hopeless.

The right advice can make all the differenceIn 2016, not only is this advice hurtful, it is wrong, and per-haps even unprofessional. If a physician or audiologist isn’t familiar with tinnitus, doesn’t feel comfortable treating someone with tinnitus, or doesn’t feel that he or she has had much success treating patients with tinnitus, that’s okay. No health professional is trained to treat every condition, even diseases or conditions commonly included within that professional’s specialty. No one health care provider can keep up with all the new information that is published daily in thousands of medical and scientific journals. New drugs and devices are being approved for many diseases or condi-tions including tinnitus and hyperacusis. Although a single cure has not been found for tinnitus or hyperacusis there are a multitude of possible solutions to treat the symptoms and allow sufferers to gain a measure of relief and control over their symptoms.

Today, there is so much to offer those who have tinnitus or hyperacusis that the appropriate advice a physician could give would be, “You know, you clearly have symptoms of tin-nitus (or hyperacusis). I don’t treat many patients with your condition. I’m going to refer you to a specialist who does.” Another bit of helpful advice would be, “There are millions of people in the United States with your condition. There is an organization that advocates for those with tinnitus and hyperacusis, funds research with the goal of an eventual cure, and has a lot of useful information on their website. It’s called the American Tinnitus Association, or ATA.”

For many people, just learning that they have a real diagnosis, and a medical condition with a name, is a relief and assures them that they are not going crazy. There may be something altered in their peripheral or central auditory system. There are many treatments that can be tried, and the chance of ob-taining some relief is real.

Many different treatments may be effectiveFor people with tinnitus and hyperacusis, there is no “one size fits all” treatment or management. Many different treatments can be effective when used for the right patient. This often requires both time and skill, but the improvements are real. See Table I in this is-sue, compiled by Michael J.A. Robb, M.D., a former member of the ATA Board of Directors and the ATA Scientific Advisory Commit-tee. He has compiled a list of therapies and current rates of effec-tiveness on this Table I and has included an accompanying article.

Support Groups are availableATA support groups around the country provide useful sci-entific and clinical information as well as social networks for those with tinnitus and hyperacusis. Often, those with an ailment or condition know even more about what works for themselves than their health professionals do.

Education & information is available for health care professionalsOne of ATA’s activities is to help educate health profession-als about tinnitus and hyperacusis. In 2014, for example, in partnership with the American Academy of Otolaryngol-ogy-Head and Neck Surgery, the ATA published an article about the evaluation of patients with tinnitus. ATA has had booths at major medical meetings to help educate doctors about these conditions. ATA Board member Bryan Pollard organized a session on hyperacusis at the 2016 meeting of the Association for Research in Otolaryngology. Members of ATA’s Scientific Advisory Committee organize sessions at other meetings and tinnitus conferences about the basic and clinical science of hearing, tinnitus, and hyperacusis. High quality scientific research is published about tinnitus and hy-peracusis in leading medical journals, including research sup-ported by the ATA and its members. ATA is available to help any health professional find the tinnitus and hyperacusis in-formation, resources, research and specialists they may need to help their patients.

Table I can be used to augment discussions about therapeu-tic decisions, considering the severity of symptoms and the likelihood of success. To Hippocrates’ time-honored apho-rism- “to cure when possible, to treat often, to comfort always”- I would humbly add, “and to refer if necessary.”

Daniel Fink, M.D., ATA Board Member

Helpful advice for health care providers and patients

Dr. Fink is an internist in the Los Angeles area. He has both tinnitus and hyperacusis. He serves on the board of ATA. He writes about noise and hearing issues in a variety of journals and online sites.

A

dvocacy

To Bayesian Informed Prior Probabilities for Effective Tinnitus and Hyperacusis Care

There are many causes of pulsatile (the sound in the ears is in sync with the heart creating a “pulsing, whooshing or thump-ing” sensation) tinnitus and non-pulsatile tinnitus. Causes in-clude complex vascular disorders, cerebrospinal fluid pressure abnormalities, noise induced hearing loss, head and neck in-jury or spasm, closed head injury, viral/stress ear infections, Meniere’s disease, tumors, and many others. The cause and effect explanations for tinnitus are varied and thus, a single cure is illogical. Cures are more logical.

The numerous treatments and management strategies can be confusing for both patient and physician. The good news for tinnitus and hyperacusis patients is that Bayesian statis-tical inference or analysis in medicine has exploded in recent years. This means the probability distributions (a set of curves before and after research) of obtaining effective tinnitus treat-ment or management are becoming known based on the cur-rent research of the Table 1 interventions that has already de-termined those who have obtained relief.

What is Bayesian Statistical Inference?To oversimplify, Bayesian Statistical Inference provides a log-ical, quantitative framework to the process of combining new research and valid old data to better understand the effec-tiveness of tinnitus treatment. Modern computing makes this an extremely powerful statistical method and works to the patients’ advantage. Doctors and patients can use Bayes-ian analysis to summarize evidence, assist decision-making, and improve the probability of obtaining effective treatment or management. Moreover, future tinnitus research using Bayesian methods could become the new standard. It can be applied immediately in many medical scenarios. The English mathematician, Reverend Thomas Bayes (1702-1761), de-veloped Bayes’ theorem along with future help from Laplace and Price. The theorem is defined as the probability of ob-serving event A (tinnitus relief) given that B is true (patients have already obtained tinnitus relief given a similar clinical scenario) while factoring in other probabilities like preva-lence and likelihood ratios. The key terms are the prior dis-tribution, the likelihood ratio and the posterior distribution.

Michael J. A. Robb, M.D.

New Research ofTreatments

Please see www.bayesian.org (the International Society for Bayesian Analysis, ISBA) for more information.

Success is broadly defined for this article as a tinnitus cure and/or a medical inter-vention that either results in tinnitus relief or improves the patient’s quality of life. What is most important to understand is that each interven-tion listed in Table 1 is effective and will likely help you 1) re-duce the tinnitus perception or even cure the tinnitus and/or 2) manage tinnitus and improve your quality of life. In other words, we have a reference table that can be used to estimate if a given tinnitus treatment will be successful in a patient. As a bonus, these informed treatments may lead to more suc-cessful and relevant data that may be combined with future research to enhance future probability of success.

A note of caution, the meta- analyses, rigorous Cochrane re-views and academic guideline papers that have been pub-lished on tinnitus treatments over the past two decades do not include Bayesian analyses yet. The result of this omission may do more to limit and bias the doctor’s analysis and judg-ment and actually delay effective and safe care. Bayesian sta-tistics are being used in many areas of medicine already and I predict tinnitus and hyperacusis studies will benefit from a Bayesian approach during this century and beyond.

Tinnitus is Very Difficult to StudySince tinnitus is very difficult to study, successful tests may be defined differently based on factors like, the authors’ bias, the patients, complexities of tinnitus, study-design, placebo vs. comparison groups, treatment, outcome measures, and sev-eral others. The scientific community has recently developed robust, uniform outcome tinnitus rating scale measurements which have not been adopted routinely worldwide yet. How-ever, waiting for more private or government-funded, place-bo-controlled or comparison group research is no excuse to delay the pursuit of thorough tinnitus workup and available care now. The interventions in Table 1 can serve as our guide.

Accounting for the Placebo EffectThe placebo effect in tinnitus research may be as high as 40%. Outcome measures have not been standardized but powerful new tinnitus rating scales are now available for worldwide use. It is very difficult to study tinnitus rigorously but ATA-funded researchers know how to design the most ro-bust trials. Clinicians must help patients as best possible given the current level of scientific data augmented by their exper-tise and therapeutic patient-physician relationship.

The good news is that the probabilities for success listed in Table 1 are greater than the probability of a placebo effect or generalized counseling. This table provides encouraging treat-

Dr. Robb enjoys the private practice of oto-neurology in Phoenix, Arizona, is a former board of director and scientific ad-visory committee member of the American Tinnitus Association and is currently president of the Association of American Physicians and Surgeons.


ments available now. In fact, the research cited here offers us an “informed Bayesian prior” – not just an expert or flat prior – which can be used therapeutically and for future research de-sign. The priors are capable of influencing beliefs, optimizing decision-making and improving research.

Medicine is Both a Science and an ArtPatients are unique and no single treatment strategy will work if a therapeutic patient-doctor relationship is not established ideally over a two year time frame. “Fast food medicine” con-sults lasting 5-20 minutes are a clear recipe for disappointment and failure unless the patient is given scientifically-based hope, counseling and therapeutic tools.

Remember medicine is both a science and art dependent on a therapeutic doctor-patient relationship. The success of tinnitus treatments are maximized with time, experienced counseling and intensive, individualized clinical visits. Not to be overlooked is the power of optimization of general health and wellness, neuromuscular relaxation, stress and sleep management, com-bined with customized tinnitus, hearing and sound sensitivity treatment strategies, and regular follow-up over the period of one to two years.

A Word on Negative and Adverse EffectsWhat is the probability of a negative or adverse effect if the pa-tient is given only dismissive, pessimistic, negative counseling? How many of you have heard “You will just have to learn to live with it”? We know this is still happening based on patient re-ports to the ATA. Well, the outcome is likely heightened frus-tration, fear, anxiety, panic, depression, hopelessness, despair, confusion, insomnia, chronic ill effects of stress, and even an increased suicide risk. Conversely, improving one’s quality of life with the treatments summarized here is probable not just possible. The probability of an effective management strategy or even a cure is much higher than a drug study placebo effect and also higher than general counseling. The basic/clinical sci-ence and technology have never been better for the tinnitus and hyperacusic patient.

However, physician’s bedside manner and counseling need sig-nificant improvement according to the patients’ reports. The best solution is for patients to be proactive with their health and strive to develop a good patient-doctor relationship over a two-year time frame. Neither settle for suboptimal medical ad-vice nor believe there is no hope for control and relief when we know more about the ear, the brain, tinnitus and hyperacusis than ever before. If your doctor believes nothing can be done for tinnitus, then the data in Table 1, filled with informed Bayes-ian prior probabilities for improving your quality of life, may be enough to adjust the doctor’s opinion in your favor. This is how Bayesian statistics work. Using complex math and computers, new relevant data updates prior beliefs. More than one com-plex question can be addressed in a single research study. To-day’s posterior becomes tomorrow prior which then strength-ens the future research. Hopefully, this article will help you and your physician update prior held negative beliefs using this new powerful and relevant data for success to reach a logical and scientifically-based positive belief.

Patients are the Best AdvocatesThe internet is filled with promises of miracle cures with poor, flawed or non-existent supporting research. Patients may think they have tried everything for tinnitus but this is not true. Arming yourself with Bayesian statistics such as Table 1 en-hances the decision-making process between you and your physician. The clinical practice guideline: tinnitus by Tunkel et al, published in Otolaryngology Head and Neck Surgery, October 2014 states: “(d) educate patients with persistent, bothersome tinnitus about management strategies; (e) rec-ommend a hearing aid evaluation for patients who have per-sistent, bothersome tinnitus associated with documented hearing loss; and (f) recommend cognitive behavioral therapy to patients with persistent, bothersome tinnitus.” Table 1 fea-tures the prior probabilities of improved quality of life for these guideline recommended interventions including group tinnitus counseling, hearing aids, combination units (hearing aid plus tinnitus relief sound generator), cognitive behavioral therapy and various sound generators. The current tabulated research facilitates immediate therapeutic decision-making and future clinical research.

Also keep in mind that the authors of the strict Cochrane ev-idence-based reviews of tinnitus research conclude that 1) there is no negative or adverse effect to the common treat-ments studied such as amplification, masking, counseling and sound therapy and 2) more than one treatment may be opti-mal for a given patient. Furthermore, they clearly state in their conclusions that lack of strong evidence is not indicative of lack of effectiveness. In other words, it won’t hurt to give it a try and it will probably help!

Find a Doctor, Audiologist, Counselor and a StrategySuccess should be defined as a beneficial therapeutic result that improves quality of life. The American Tinnitus Associ-ation (www.ata.org) is one good resource for finding reliable information as well as specialists in your region of the coun-try. The Bayesian informed probabilities for improving one’s quality of life are hereby summarized in the success column of Table 1 and can be used immediately to influence beliefs and therapeutic decisions. The majority of the treatments re-viewed here indicate that 55-96 out of 100 patients will ex-perience an improved quality of life if they decide to pursue and complete a known effective, indicated treatment. As you can see, the odds are truly in your favor, so let the individual-ized healing journey start anew with your trusted, experienced physician and audiologist.

Recommended reading material:Tyler, R. The Tinnitus Consumer Handbook, 2nd Ed., Auricle Ink Publishers, Sedona, AZ, 2016

Bauer, C. Tinnitus and Hyperacusis. In: Cummings Otolaryngology Head & Neck Surgery, Fifth Edition Mosby/Elsevier, 2010

Shiley, S., Robert Folmer, R. & McMenomey, Tinnitus and Hyperacusis. In: Cummings Otolaryngology – Head & Neck Surgery, Fourth Edition, Mosby/Elsevier, 2005.


Research &

Science

See corresponding References on page 31 and at ATA.org

Bayesian Informed Prior Probabilities for Effective Tinnitus and Hyperacusis Care TABLE I Michael J. A. Robb, M.D.

PROBABILITY OF SUCCESS

82-95%

81%

68-96%

38-60%

50-60%

34-95%

55-85%

64-93%

32-88%; Cohen’s d medium to very large

effect sizes = 0.5-2.05

75-89%

Cohen’s d medium effect size = 0.59 at 6 months

17-49%; Cohen’s d medium effect size = 0.78

Cohen’s d medium effect size = 0.54 - 0.7

Approx. 80%; Success rates are similar to its individual compo-nents: counseling, sound therapy,

amplification & CBT

36%-77%; Cohen’s d medium to large effect sizes = 0.44-1.24

50-91%

54-75%

56%

76%

61-79%

67-74%

5-40%

TINNITUS CHARACTERISTICS

Objective, pulsatile

Subjective, pulsatile

Subjective, non-pulsatile


Subjective, non-pulsatile or pulsatile & usually intermittent

Subjective, non-pulsatile but may be cacophonic with complex cyclical tones


Subjective, non-pulsatile with mild, moderate or severe hearing loss

Usually subjective non-pulsatile but TRT may help those with non-surgical pulsatile tinnitus

With or without subjective tinni-tus, hearing loss or prolonged sound-induced exacerbation

Usually subjective, non-pulsatile

Subjective or objective non-pulsatile or pulsatile

Subjective, non-pulsatile usually




Subjective, non-pulsatile, steady and tonal






TINNITUS ETIOLOGY

1- Dural arteriovenous fistula or other vascular malformation

2- Benign intracranial hypertension

3- Otosclerosis or otospongiosis

4- Acoustic neuroma (vestibular schwannoma)

5- Meniere’s Disease (endolymphatic hydrops)

6- Single-sided deafness secondary to virus, stress, toxin, infection, trauma, tumor, surgery, other

7- Tinnitus, hearing loss


9- Many causes: mild, moderate or severe tinnitus with or without hearing loss or hyperacusis

10- Decreased sound tolerance (DST) or hyperacusis from various causes

11- Various causes with or without hearing loss and/or hyperacusis

12- Various causes

13 Tinnitus associated with distress, anxiety & depression


15- Tinnitus & mild or moderate hearing loss

16- Hearing loss

17- Hearing loss

18- Non-pulsatile tinnitus with or without depression

19- Hearing loss with anxiety, panic, sleep disturbance

20- Hearing loss with anxiety, insomnia

21- Hearing loss with depression and insomnia

22- Tinnitus of variable causes

TREATMENT OR MANAGEMENT

Endovascular neurosurgery

Rx, shunts, weight loss or weight reduction surgeryMiddle ear reconstructive surgery (stapedotomy, stapedectomy)

Surgery, stereotactic radiotherapy

Transtympanic treatment with medica-tion; endolymphatic shunt surgery

Cochlear implant

Amplification (hearing aids)

Combination Instruments (hearing aids plus sound generators)

Tinnitus Retraining Therapy (TRT)– counseling & sound therapy based on Jastreboff neurophysiological model

Tinnitus Retraining Therapy (TRT)

Tinnitus Retraining Therapy (TRT) based group counseling

Tinnitus education & counseling

Cognitive Behavioral Therapy (CBT)

Tinnitus Activities Treatment (TAT)

Masking

Customized acoustical stimulus (Neuromonics®-music & noise therapy)

Customized desynchronizing/ neuromodulation tonal stimulus (DeSyncra®)

Repetitive transcranial magnetic stimulation (rTMS)

Alprazolam

Clonazepam

Nortriptyline

Placebo responses in drug studies or responses in wait list control groups



Member SurveyATA is constantly working to improve our services to the tinnitus and hyperacusis community…and we need your help!

By taking this short survey you can help ATA and researchers discover how to best meet your needs. Please share your opinions by completing the short survey below.

All survey questions are optional but we ask that you answer everythingthoroughly. ATA wants to meet your specific needs and improve the programs and services we provide. Your responses are anonymous.

When complete, remove this page from the magazine and return it to ATA in the attached donation envelope.

Thank you in advance for your time, ideas and support! See next page

You may also complete this survey online at:

www.ATA.org/survey

About You and Your Tinnitus1. What does tinnitus most-often sound like to you? (Select one)q Ringing/Single toneq Crickets/Cicadasq Siren/Screechingq Whooshing/hissingq Clicking/Pulsingq Other________________

2. Where do you perceive tinnitus? q Just my left earq Just my right earq Both earsq In my head/Not in my ears

3. What is the nature of your tinnitus? q It is constant, always at the same volume and soundq It is constant, but the volume and/or sound changesq It is intermittent, it comes and goesq I no longer experience tinnitus

4. What do you believe most caused your tinnitus? (Select one)q A sudden, loud noiseq Listening to music or attending loud events (sports, concerts)q Work activities/loud environment dailyq Military activitiesq Physical injury (TBI, whiplash) or medical surgeryq Illness (virus, cold, ear infections, etc.) q Recreational activity over time (boat- ing, diving, hunting, motorcycling, etc.)q Physiological reason (earwax buildup, TMJ, grinding teeth, etc.)q I do not knowq Other__________________

5. How long have you had tinnitus? q Less than one yearq 1 to 3 yearsq 4 to 10 yearsq More than 10 years

6. On a scale of 1-10, how much does tinnitus impact your life on a daily basis? 1 = tinnitus is barely noticeable; 10 = tinnitus is the most impactful thing in your life________

7. What best describes how tinnitus affects your day-today life? (Select all that apply)q I barely notice itq It is annoying, but does not impact my lifeq It is annoying and does impact my lifeq I have trouble sleepingq I have trouble concentratingq I feel regular anxietyq I feel socially isolatedq I am unable to workq I have ongoing depression

8. Do you have any of the following associated conditions? (Select all that apply)q Hearing lossq Hyperacusis (Sensitivity to normal sound)q Meniere’s Diseaseq Misophonia (Sensitivity to repetitive sounds)q Sleep Problemsq TMJ-Related Jaw Problemsq Anxietyq Depression or other diagnosed mental health issue

9. Please select your genderq Maleq Female

10. Please select your ageq 18-30q 31-40q 41-55q 56-69q 70+

11. Please select your highest level of educationq Some High Schoolq High School diplomaq Vocational/Trade Schoolq Some Collegeq College degreeq Post-graduate degreeq (MD, PhD, MA, MS, etc.)

12. Do you regularly see a health care provider who treats tinnitus/hyperacusis? If so, what kind of provider? Write in only top 3 priorities ranked by: 1) First most important, 2) Second 3) Third._____ None

_____ Primary Care Provider

_____ Audiologist

_____ Otolaryngologist (ENT), Otologist

_____ Oto-Neurologist, Neurologist

_____ Psychologist, Psychiatrist

_____ Behavioral Health Therapist

_____ Alternative Care Provider

Continued on following page.

About You and ATA13. What do you believe is the primary function of our ATA? Write in only top 3 priorities ranked by: 1) First most important, 2) Second 3) Third._____ Awareness of tinnitus (T) and hyperacusis (H)

_____ Research advancement or cures

_____ Education on management of T & H

_____ Education on T & H research and trials

_____ Advocacy to obtain government budgets toward research

_____ Advocacy to require quieter public environments

_____ Insurance coverage for T & H treatment

_____ Insurance coverage for hearing screening tests

_____ Information about treatments for T & H

_____ Provide T & H health professionals in my community

_____ Educate health care professionals with tinnitus specific training to most effectively treat patients

_____ Support groups in my community

_____ Online or phone support for T & H

14. What information would you like presented in the magazine, on the website or in a webinar? q Detailed scientific research articlesq Research studies, but written or spoken in easy-to-understand languageq Updates on treatment options that are currently available. q Personal stories from people who have successfully managed their tinnitusq Prevention options and education.q Information about products and services that may help tinnitusq Public policy updates from Washington, DCq Questions and Answers from hearing health professionalsq Events & seminars discussing tinnitus & hyperacusisq Trials for tinnitus & hyperacusisq ATA activities across the nation

15. What resources are most helpful to you in managing your tinnitus? Write in only top 3 priorities ranked by: 1) First most important, 2) Second 3) Third.

_____ Health care professionals

_____ Devices (hearing aids, sound generators, neuromodulators, etc.)

_____ Cognitive Behavioral Therapy

_____ Tinnitus Retraining Therapy

_____ Progressive Tinnitus Management Program

_____ Other tinnitus management

program ________________________ ________________________________

_____ Medication

_____ Lifestyle modifications (diet, stress management, environment)

_____ Job change, disability

_____ Mindfulness training

_____ Relaxation techniques

_____ Supplements

_____ Alternative therapy______________ _____________________________________ Nothing helps my tinnitus

16. What content would you like posted on the ATA website or on social media? Write in only top 3 priorities ranked by: 1) First most important, 2) Second 3) Third._____ Up-to-date worldwide news on tinnitus or hyperacusis_____ Talk on various topics related to tinnitus and hyperacusis_____ The latest research by tinnitus & hyperacusis researchers

You and Your ATA MembershipFor your membership fee of $40 annually you receive three issues of Tinnitus Today magazine, 5 educational webinars free ($25 value), rich content such as manage-ment tools, health care providers, research, support, prevention tips and up-to-date news on the website.

19. If ATA could provide you one new member benefit, what would that be? ________________________________________________________________________________

20. How do you feel about your ATA membership? (Select all that apply)q The $40 annual membership fee is worth it.q The membership benefits have improved. q Very satisfied q Generally satisfied q Very unsatisfiedq I’m not an ATA Member q I want to donate, but not be a member

21. Do you like helping ATA and researchers with surveys so we can advance the research for tinnitus and hyperacusis?q Yes q No q Please add any other comments or ideas you would like to share. ________________________________________________________________________________________________________________________________________

_____ Support group locations and events_____ Webinar presentations _____ Clinical recommendations_____ Oto-toxic medications_____ Trials being conducted around the world_____ Prevention tools for tinnitus & hyperacusis_____ Tinnitus & hyperacusis conferences with presenters

17. What advocacy efforts would you like to see ATA engaged in? Write in only top 3 priorities ranked by: 1) First most important, 2) Second 3) Third.q Lobbying for tinnitus and hyperacusis research funding in Washington, DCq Advocating for Medicare/pvt insurance coverage for hearing screeningsq Advocating for Medicare/pvt insurance coverage for hearing aidsq Educating primary doctors, ENTs, Neurologists, Audiologists regarding tinnitus & hyperacusisq Advocating for lower cost management solutionsq Advocating for public policy to require quieter public environments

18. What are your priorities for ATA as a donor or member?q Research funding to discover cures q Education & webinars on promising researchq Education for management of tinnitus and hyperacusisq Community support onlineq Support groups in-person


In 2010, I was assisting Drs. Josef Rauschecker, Amber Leav-er, and Anna Greenwald at Georgetown University with their neuroscience research on tinnitus. Interested in participating in the laboratory’s MRI study, people with tinnitus were phon-ing and emailing – and many needed help. After one of these calls, Dr. Greenwald pointed out that the D.C. area could ben-efit from a local support group.

Although I don’t have tinnitus, I could see the need for a support groupI agreed, but I was hesitant about having a central role in a group that served to ameliorate a condition with which I had neither expertise nor intimate experience as I do not have tinnitus. Torn, I reached out to ATA to express my interest in starting a group, figuring that having more information would help resolve my ambivalence. As I read the support group manual ATA sent, it became clear to me that recruit-ing guest speakers, experts in some aspect related to tinni-tus and/or hyperacusis, was going to be a critical aspect of the support group. With guest speakers, my concerns over having a central role were relieved.

It’s All About Support

ATA made it relatively easy to get startedGetting started was surprisingly smooth. I found a free ven-ue with audiovisual equipment, ample space, and – most im-portantly – minimal noise. Then, I reached out to ATA to an-nounce the meeting to ATA members in the DC/Baltimore/Northern Virginia area. I quickly received emails from people eager to attend the meeting and join the group.

We held our first meeting in the fall of 2010. Our featured speaker was Jennifer Born, former editor of Tinnitus To-day, who gave an overview of “ATA’s mission to cure tinnitus.” Roughly fifteen people with tinnitus attended and asked pointed questions. I transcribed the meeting and distributed the minutes to the new email list for those who were unable to attend.

My goal, as a support group leader, is for members to be-come educated about tinnitus. Over the past six years our group has learned about tinnitus from its most preeminent researchers, advocates, and health care professionals, as well as from each other. During meetings, the group is atten-tive, curious, and respectful of one another, which promotes a healthy learning environment. Members propose experts they would like to invite, and I then extend invitations.

Because I do not have tinnitus and I am not a health care pro-fessional, I am limited in the information and counseling I can provide to new members. Thankfully, Ann Ramsey and Carl Varner, two experienced members, advise new members on approaches to managing their tinnitus. It’s a team effort that benefits everyone.

Washington, DC Tinnitus Support Group

Starting a Support Group is a great way to advocate for Tinnitus

by Ted Turesky, Facilitator, ATA Board of Director

To find a support group in your area go to ata.org and click on support network. If you want to become a support group facilitator email ATA at: [email protected]. To submit an article about your support group, submit the article to: [email protected].

Ted Turesky with Tom Lobl, PhD. ATA’s past Chair, Board of Directors

Tom Lobl speaking at a Washington, DC Support Group meeting

ADVOCATE during worldwide

Post on your social media sites, send emails to your friends and business associates. Prepare a press release for your local media or call a reporter and ask them to cover a story on tinnitus or hyperacusis during this week.

ADVOCATE for awareness of tinnitus & hyperacusis

Tinnitus Awareness Week February 6–12, 2017


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Serendipity, Siblings and the Path to Advocacy

Mari Quigley Miller’s story

You might feel like nobody in your life understands what it’s like to live with tinnitus. Well, I’m here to tell you that you’re not alone and in my and my brother’s case we are together!

I first developed tinnitus in 1995, initially in just one ear and then in both. For the first few months, life was very difficult. I could not sleep, I felt very claustrophobic, and I was so sensitive to noise that I couldn’t drive, go to the mall, or par-ticipate in other aspects of daily life. I was even suicidal for a period of time.

About a year later, I began to experience dizziness and a slight shooting pain on the left side of my face. The diz-ziness and pain would come and go, but the tinnitus was continuous. Then the hearing in my left ear began to seem muffled and distorted. I spent thousands of dollars going to doctors, dentists, and other health professionals in a search for answers.

I finally found help at the House Ear Clinic in Los Angeles, California, where I met Dr. William Slattery and his team. They saved my life. They found that I had a fast-growing acoustic neuroma, which is a non-cancerous tumor in the ear canal and if left unchecked can become life threatening. I decided to have the growth surgically removed so that it would be completely gone from my head and my life. Oddly enough, my brother would also later develop tinnitus and this same acoustic neuroma. (See Patrick’s story on the fol-lowing page.)

After my surgery, I had to learn to walk again, I couldn’t hear with my left ear, my left eye wouldn’t shut, the left side of my face was paralyzed, and my tinnitus was very loud. How-ever, two weeks after the surgery, I’d recovered to the point where I could walk on a treadmill, and my balance and facial control had improved.

Never take your tinnitus lightly You must rule out other conditions that might be caus-ing the symptoms, such as acoustic neuroma, high blood pressure, and others. If I hadn’t sought treat-ment, I may not be here to tell you my story today.

I took steps to manage my tinnitus symptoms. I found that I was allergic to gluten and eliminated it from my diet. I got braces on my teeth and addressed my TMJ (inflamed joints in the jaw). I started eating healthier, taking supplements (especially vitamin B), and adding lots of exer-cise to my routine. I also took more showers because I found that the sound of water could mask my tinnitus.

I decided to help myself while helping others as an Advocate for TinnitusIn 1998, after my surgery, I contacted the American Tinnitus Associa-tion to find out how I could help others learn to manage their tinnitus symptoms as I had. I began in ATA phone support and later I start-ed a tinnitus support group in Orange County, California. I also founded the first Walk for a Cure with the American Tin-nitus Association in 2009, where we raised $50,000. Today I have my life back, continue to enjoy and learn more about tinnitus with my work as a Tinnitus Self Help Coordinator and am enjoying life while waiting for a cure.

Check out my website to learn about some options for man-aging the symptoms of your tinnitus. Try a variety of them until you find what works best for you.

Mari Quigley Miller is a Tinnitus Self Help Group Coordinator in Orange, California. Check out her group at: http://www.wix.com/mariquigleymiller/oc-tinnitus-self-help-group


Mari (second from the right) with some of her support group members.

Remember that you are not alone. Stay positive. Take action to manage your tinnitus so you can enjoy life while you wait for a cure! Mari Quigley Miller



The 1970’s- I was living large and LOUD: Rock n’ Roll Concerts, hunting, motorcycles with straight pipes, a 15 month tour of duty in Vietnam with concussive devices - typical 70’s guy lifestyle which I continued (minus the war) into the 90’s

Fast forward 15 years later and I’m wondering what is that loud buzzing in my head? I’m a tough guy with a “Type A” personality, grew up in freezing cold Hibbing, Minnesota, never used novocaine at the dentist, so I think I can handle anything... but, what’s this? I tell my sister Mari about this sound in my head and she helps me confirm that it is in-deed tinnitus, as she had been suffering with the condition for many years before it made its presence known in my head. My tinnitus symptoms were not nearly as debilitat-ing as my sister’s for which I counted my blessings.

Staying busy and speeding through lifeI handled my tinnitus by doing the tough guy thing and just ignored it. I focused (and continue to do so) on staying busy working, snow skiing, windsurfing, mountain biking and more as I live in Hood River, Ore-gon, which is a sport nut’s heaven. Not every-one’s symp-toms can be ignored but, I managed (most of the time) to pretend the sounds just weren’t there. I didn’t even want to watch videos, or read articles to learn more about tinnitus. I just focused on my work in the printing industry and the sports I love. Sometimes the loud sounds would get to me and nearly drive me crazy but, denial seemed to work for me most of the time.

Patrick Quigley’s story

Serendipity stepped into my path.I went along using my “Tough Guy Denial” method for many years. By then, my sister Mari had really become in-formed and involved in being an advocate for ATA and was also a Tinnitus Self Help Coordinator. In 2009 Mari came to ATA’s headquarters in Portland, Oregon, as she was or-ganizing an ATA Charity Walk. I work in the printing indus-try in Portland and Mari knew I had special non-profit group printing rates so she introduced me to the staff there. Then I really did learn more about tinnitus as working with ATA’s printed informational pieces taught me about techniques and products to help me with my tinnitus symptoms.This working relationship with ATA truly has been serendipitous for me!

How serendipity and ATA Saved My Life!Although my knowledge and methods for handling my tin-nitus were better, I continued using my “Tough Guy Denial” method until my body started to yell at me. I began having spells of vertigo and actually falling during my sporting activities. Also, my hearing was degenerating even more. I tried to shake it off as temporary or age related but, it just kept getting worse and I couldn’t ignore it. I mentioned my vertigo and falls when I was at ATA headquarters for a printing job and the staff told me to go get an MRI right away to be sure to rule out any other cause. Well, the ser-endipity of having my sister introduce me to ATA saved my life. It turned out I also had an acoustic neuroma just like her except on the opposite ear area. The acoustic neuroma had been slowly growing for 10-15 years. It was pressing on nerves between my skull and my brain causing the vertigo and making the tinnitus even worse. It really could have been life threatening if I had not had my connection to ATA through my sister. I had the surgery in 2014 at OHSU/Vet-erans hospital and am feeling 120% better than before. If it wasn’t for ATA’s quick recommendation to have an MRI, I would not be here today!

ATA saved my life.

Patrick windsurfing on the Columbia River east of his home in Hood River, Oregon.

I am and will continue to be a member and an advocate for ATA and Tinnitus for Life! Patrick Quigley

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Learn More about Tinnitus, Managing Your Tinnitus and Find Resources at: ATA.org22 WIiNTER 2016 | Tinnitus Today

How I helped myself and now advocate for others

Barry Sherman’s story

In December of 2012 I was on the third floor of our house and noticed that my left ear felt like it was stopped up. I began shaking my head as you would when you have water in your ear after getting out of a pool and I also noticed a slight ringing or buzzing sound in my ear. I went to see an ENT physician who gave me a hearing test and then stated I had near perfect hearing with a slight loss at the high frequency level and it was called tinnitus. He told me there was no known cause, no cure and I would have to learn to live with it. I left feeling like I had some rare disease. I felt very alone and upset. So began my journey with tinnitus.

I was attending a community college at the time. The loud classrooms and the taking of tests in total silence were very difficult for me. While many of my professors didn’t know anything about tinnitus, the college administration was very accommodating in allowing me to complete some of my classes online and I was able to earn a degree. I soon lost interest in computers and reading, two of my favorite pastimes, as my ear was constantly ringing.

Around January of 2016, my tinnitus took a turn for the worse when I began working in a factory. The noise in the factory usually canceled out the ringing but it quickly became worse at night. Within weeks, I was waking up

after only 2-4 hours of sleep. The loud rhythmic ringing in my ear woke me up like a fireman is awakened by the sound of a fire alarm. However, for me, the alarm did not stop and I woke in a state of agitation, confusion and felt like I

was sleep walking. Believe it or not, I had no trouble falling asleep because I was suffering from sleep deprivation. For 90 days I slept in my clothes because the tinnitus was very loud upon waking which made me so agitated and tired that I had to act quickly. My treatment approach was to stagger up the stairs, sometimes almost falling, to get to my com-puter so I could turn on YouTube™ and listen to Yanni music videos at full volume. This at least helped mask the noise in my head.

ATA’s website gave me much needed information in just 5 minutesAs my symptoms had gone on for so long I felt hopeless and wondered if I could go on this way. I saw doctor after doctor and began doing intensive research on the internet. Online I found the American Tinnitus Association’s website and in 5 minutes found more valuable information than I had previously received from all of my doctors combined. Using the noise sample on ATA’s website, I was able to hear and identify the sound of my tinnitus. I was hearing a frequency between 4500 and 7000 kHz. Some people hear crickets, others a whooshing sound or cicadas and the list goes on. Finally, because of ATA, I felt I had some hope and direction.

I decided to go on the offensive to get relief It was at this point I decided to find more help. I went through a series of tests including a CAT scan, MRI, MRA, a sleep study test and met with an ENT/Allergist specialist to determine if I had pulsatile tinnitus. In some cases, pulsatile tinnitus sufferers have a benign tumor that can be removed which can also delete the tinnitus. However, I found out that I did not have pulsatile tinnitus, which only effects 5% of tinnitus sufferers.

I am now self-employed as a house painter, as I was in the past, because it allows me to be outdoors much of the time and take breaks whenever I need them. I wear music headphones when I work inside which helps drown out the tinnitus.


So where was I to go from here? While I continued to become more sleep deprived, I was prescribed several drugs which didn’t help. At my wits end, I called ATA and told them my story. They sent me a copy of Tinnitus Today and the headline read “Make Some Noise to Silence Tinnitus.” I made an immediate decision that I was going to go on the offensive to find more help for myself and others!

I continued my research on the internet and listened to my music videos. I found a product called the Sound Pillow™ that had good reviews from tinnitus sufferers. With the strong support of my CareSource case worker the company paid for my Sound Pillow.

2 solutions gave me relief and hopeOne night, I came upon an article that discussed anti-de-pressants and listed the drug Remron (an older anti-de-pressant) as one of the only ones that did not make tinnitus worse. I was lucky that my doctor, Matthew Noordsij-Jones, knew what I was going through. He looked at the article and immediately called in the prescription. My Sound Pillow had also arrived. I had been through a lot up to this point. I had seen multiple doctors, had multiple tests and had multiple disappointments. My ninety days of sleep deprivation had made me a raging, caffeine driven, work-aholic lunatic who had lost over 40 pounds. That night I took the medication, turned on my sound pillow and went to bed at 9 p.m. I didn’t wake up until 6 a.m. Nine hours of sleep without waking up and the tinnitus was bearable upon waking! I felt like a miracle had happened and knew I had a fighting chance now that I was finally able to sleep.

I decided to share my research and create awareness of childhood and teenage tinnitusNow that I had found solutions to make my tinnitus man-ageable and I decided I was going to make a PowerPoint presentation to help other tinnitus sufferers like myself. I began contacting agencies to make appointments to pres-ent my information. Through further research and conver-sations with Scott Armbruster of Sound Pillow and Melanie West, CEO of the ATA, I began compiling articles regarding research of ringing in the ears among children and teenag-ers. I thought hearing loss and tinnitus usually only affected people over 50. Something had to be done. I presented my information to the director of my local crisis hotline and recently to the community college I attended. I then set my sights on my insurance company, CareSource, a nonprofit health plan that provides member-centric health care cov-erage and is one of the nation’s largest Medicaid managed care plans. After bringing up the idea to Jessie Reed, my Life Coach at CareSource, a meeting was set to take place in a few months. During this waiting period, I took on a large painting job for a family who had moved to Dayton, Ohio. I spent nearly 3 weeks painting their house. After work-

ing there a week, a strange thing happened. While I was talking to Cecelia, the mother, the children began arguing, as kids often do. I told Cecelia that we had to go to another room because I had tinnitus and the noise was raising my stress level. She exclaimed, “You have tinnitus? So does my daughter.” She explained that her daughter, Cesi, was 8 years old and had gotten tinnitus when she was 4 years old. I knew that I had get to them involved in my CareSource presentation.

The main goal of my presentation was to train doctors and professionals to stop telling patients: “We do not know what causes tinnitus, there is no cure, and you will have to learn to live with it.”

I spent hours preparing information packets for the attend-ees with as many articles as I could find and links to ATA and other websites so they could read and use them later. I sent my PowerPoint to both Melanie and Scott for their re-view. Their support gave me confidence in my presentation. They literally helped save my life and were a great inspira-tion to me. I felt like I found a long-lost sister and brother.

Was all of my work worth it? You bet it was. CareSource was very receptive, and the Medical Director, Dr. Craig Thiele, was impressed with all the research I had done. He explained that it would take some time to decide how they would use the information and what channels to use in their organization. Cesi, the 8 year-old girl, made quite an impression at the meeting. Her mother, Cecelia, further reinforced the need for more awareness of tinnitus research and resources. Dr. Thiele spent time speaking with Cecelia and Cesi after the meeting to get more information and to thank them.

Make the decision to take charge of your tinnitus treatment and advocate for othersWith my tinnitus, I had to make a decision; to let it rule my life or learn to live with it and seek help. I did and I continue to “make some noise to silence tinnitus.” I encourage every tinnitus sufferer to do the same and not allow tinnitus to run your life. Take charge of your treatment and get involved. By the way, that annoying noise in my ear is still ringing but, it is not going to ruin my life. I am in control, not the tinni-tus. I will continue my research to keep my tinnitus in check and I will never stop making noise about tinnitus and hear-ing loss. It doesn’t really matter if people don’t understand my tinnitus. One day they will. Many years ago, a mother decided to start an organization called MADD, Mothers Against Drunk Driving. Look where that organization is today. Everything starts with a mustard seed.

Perseverance, secret of all triumphs. Victor Hugo

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Cornelia’s and Cal’s journey to regain their freedom from tinnitus

After many years of ringing in her ears, Cornelia was certainly ready to move onfrom her tinnitus. . .

The persistent, high-pitch tone was constantly present throughout her daily life and few distractions seemed to offer any relief.

This summer Cornelia chose the Desyncra™ for Tinnitus therapy that employed CR® Neuromodulation to present tailored, therapeutic tones targeting her specific tinnitus profile. She listens to the tones several hours a day, while continuing with her everyday activities. The quiet yet audi-ble tones are designed to fade into the background, allowing Cornelia to get on with life, whether having coffee with a girlfriend or watching a movie.

A time commitment to regaining freedomSix hours of therapy a day feels like quite a commitment to Cornelia, yet it is also clear to her that this time is an invest-ment in the future possibility of regaining her freedom from the many years with tinnitus.

There was little benefit from the therapy, at least not for the first few days. Too soon to tell, according to the manufactur-er, yet it felt almost too long to wait for Cornelia. But within a few more days, Cornelia started to notice some initial changes – her tinnitus was not quite as annoying as before and the volume seemed to be perhaps a little lower. In fact, after 3 weeks, at the first follow-up appointment with her audiologist, Cornelia was reporting a noticeably lower pitch and a clear sense of improvement.

Cornelia was not the only patient using Desyncra at Best Hearing clinic that day. Cal was also in the clinic, having just started the therapy one week before. And both Cornelia and Cal were certainly well aware that the therapy takes time – approximately 3-8 weeks for symptoms to start to reduce, according to the manufacturer, Desyncra.

At her 8-week follow-up appointment, Cornelia’s tinnitus pitch had changed yet again – having increased to where it was previously. Obviously this was a frustrating experience that carried with it a fear that the tinnitus could be back to

where it was two months before. Cornelia worried this new therapy would join the list of unsuccessful attempts to con-quer her tinnitus. Yet by the next follow-up appointment the tinnitus proved to have changed still further – and distinctly for the better.

Persistance and patience pay offEach follow-up appointment involves a detailed pitch-match to determine where the patient’s tinnitus currently is, so that the therapy can be periodically fine-tuned to the exact nature of the tinnitus. In previous sessions Cornelia had found it difficult and concerning – she had a clear sense that a lot de-pended upon the success of the session – not least because success with the therapy holds the hope of regaining the life she had before her tinnitus began. And yet this time, she was visibly less anxious and a more relaxed and care-free side of Cornelia was regaining the upper hand. She had also been noticing that her hearing was improving; somehow her tinni-tus was interfering less with her ability to listen to what was going on around her.

Left to right: Dr. Pam Best, Cornelia Honchar, Cal Meeker andDr. Suzanne Krumenacker

neuronal training for a quieter future

Have patience with all things, but, first of all with yourself. Saint Francis de Sales

Article by Howard VickersDesyncra, General Manager



It also seemed difficult for Cal to know if there had been any significant change in his tinnitus. And yet he had noticed that he was sleeping more easily – so much more so in fact, that he was no longer taking valium to sleep through the night: a promising sign just one week into the 36-week therapy.

3,000 patients have walked this path with CR® Neuromodulation Both Cal and Cornelia were optimistic with their chosen therapy – the initial improvements were positive and sug-gested that their brains were responding to the therapy’s stimulation of the auditory cortex. And knowing that 3,000 patients have already walked this same path with CR® Neu-romodulation is certainly reassuring for them as they set out on their journeys. And yet this is not without trepidation; the stakes seem high and it is not always easy to track the initial changes in tinnitus symptoms.

There are many patients who have been fortunate enough to have undergone EEG scans that give a visual sense of the change in neural patterns in the brain. This would certainly offer some welcome reassurance, perhaps even “instant gratification” that the therapy is having the desired effect. Yet most patients have to practice their skills of patience until they experience the benefits for themselves. Chang-es in neural behavior may be the mechanism, but it is the reduction in tinnitus symptoms and the improvements in everyday life that are the real fruits of success.

Before Therapy

After Therapy

A Technology Like No Other Coordinated Reset Neuromodulation was initially devel-oped for the treatment of Parkinson’s symptoms and then applied to other neurological conditions including epilep-sy, migraine and tinnitus. These neurological conditions all share a hyperactive neuronal behavior in different parts of the brain.

Regardless of the neurological condition, the therapy is designed to disrupt the hyperactive, synchronized neuronal behavior and reduce the patient’s symptoms. The technology was developed by Professor Peter Tass in Germany and is now being further developed and refined in other research centers including Stanford University, University of Washington, Veterans Affairs Portland and other sites in Europe.

QUICK FACTSDesyncra™ for Tinnitus therapy

therapy name: Desyncra™ for Tinnitus

technology used: CR® Neuromodulation

therapy duration: 36 weeks (minimum)

mode of employment: therapeutic tones tailored to the tinnitus

hardware/device: iPod with custom earphones

availability: audiology clinics

See list of providers at: desyncra.com


Research &

Science



Extra sounds in my earsI’ve learned to live with

It sounds like a very high frequency (high-pitched) tone in my right ear. This tone is accompanied by a hearing loss in that ear, and, perhaps, some hearing loss overall.

I remember the days when, with old standard definition TV receivers, I could hear the 15.75 KHz sound of the flyback transformer from the set. If you have no idea what that is, just know that 15.75 kHz is a very high audio frequency. It was loud enough to be annoying, but I was some-what pleased that I could hear such a high frequen-cy sound. Good hearing, I

thought. Nowadays, the high-definition sets don’t make that noise, and I couldn’t hear it if they did.

Something ironic: when I was in high school and college I had a summer job fixing and calibrating audiometers, the devices that check the hearing of school children (or did so at the time) and the devices that check your hearing when you went to the doctor. Now, they’re all computerized and provide a better indication of your ability, or lack thereof, to hear sounds at various frequencies.

Having a high-pitched sound in your ear at all times is dis-tracting. It’s especially distracting when I’m in a quiet place. In noisy surroundings the sounds tend to mask the tinnitus and it becomes less noticeable, but, in a way, it becomes a bigger problem. In a crowd (at a party or a restaurant) all of the voices tend to clash with each other making the person I’m trying to listen to less intelligible. Most of the time I can get the gist of what’s being said and reply accordingly, but often I get it wrong, leading to providing a reply that doesn’t fit in the conversation. Simply nodding usually gets me by.

One-on-one conversations in quiet places are the best. I’ve found that I have little trouble hearing and understanding others in this context. If the room has a lot of echo the inci-dent and the reflected noise can clash causing difficulty understanding.

I went to the doctor to see if they had any help for me. Af-ter running a test with their audiometer, and doing a scan to make sure there was no problem identifiable in my head, they sent me on my way without anything to offer. Thanks very much!

A connection to ATAI have been a friend for many years with Scott Mitchell who also has tinnitus. Scott, who is now an ATA board member, introduced me to ATA which has really given me more in-formation than any other source to date.

Staying active while enjoying my hobbies and music helps me deal with my tinnitusSo, I’m living with tinnitus. It’s a handicap, but at almost 70 years of age I have a few other handicaps. Don’t we all. None of this stops me from going to the YMCA 2 or 3 times a week and getting in a rather strenuous workout. I have been a member of the Houston Astronomical Society since 1990 and I enjoy studying and measuring variable stars and sharing my findings with professional astronomical organi-zations.

I know that the music I hear is not the music I heard before tinnitus, but it’s good enough and continues to be enjoy-able. My tinnitus didn’t stop me from going to see a Janis Joplin live tribute show at my local theater. I’ve been to the Houston Symphony Orchestra concerts a few times and the

Bill Pellerin, an amateur astronomer, studies variable stars to measures their brightness. He shares his findings with professional astronomical organizations.

Bill Pellerin’ story


sound is quite good, a tribute to the outstanding acoustics of the concert hall.

Plays are sometimes problematic, since often there is no amplification. Buying the more expensive tickets to be near-er the performers helps, but it’s easy to miss some plot points due to hearing difficulties.

It doesn’t stop me from watching TV or movies or enjoying recorded music. Sometimes I turn on the closed captioning capability on the television when the actors are speaking fast, quietly, and with an accent. Only once have I asked for a closed captioning device in a movie theater, and it turned out I didn’t need it.

I added a sound bar to my television set which makes the sound louder and clearer than it is from the television set speakers. A guest was here a few days ago and asked if I could turn the sound down. Too loud. I did. The guest asked if I was hard of hearing, and I said, “Yes, I am.”

Waiting for a cure.Time marches on and I suppose that someday I will need a hearing aid or something else. What I hope for is something

that fixes the problem. Something that makes the noise go away. Something that makes the hearing come back. Is that too much to ask? Probably, but with ATA’s ongoing funded research these hopes just might be possible.

Bill Pellerin and wife Lori enjoy life in Houston, Texas. They don’t let Bill’s tinnitus slow them down.

Did you know . . . We have ATA “Information about TINNITUS” brochures for Sale?It’s a great way to advocate for better understanding of Tinnitus and Hyperacusis issues.

For pricing and to order these “at cost” brochures call ATA at 800-634-8978 or email us at: [email protected]

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Patient &

Mem

ber Stories


$100,000+ Estate of Roy A. Gummersheimer

$50,000-$99,999 Estate of Virgina HavermalePatrick J. and Carol Welsh

$20,000-$49,999 Gumpertz Charitable Gift FundJim L. Schiller

$10,000-$19,999 AnonymousChristopher L. FooteJohn L. and Adelaide W. Zabriskie Fund

$5,000-$9,999 Mary F. FlorsheimD. Scott JohnsonWillis and Jane Fletcher Family Fund II at the San Diego FoundationWolf Creek Charitable FoundationJames Richard Yourtee

$1,000-$4,999 Anonymous (2)Estate of Gladys BarzJohn R. and Linda BatesVirginia BergmannPeter D. BonannoJohn and Margaret Chickering Family Gift FundClay S. ColemanThomas C. Crane, USN, RetJohn A. D’AngeloCharles Robert DavisStephen W. DeFilippisJohn T. DillardJames and Donna FijolekDaniel Fink, M.D.Fog House FundJeanna L. FrenchJames S. and Sandra GranberryRonald K. and Donna Mae GrangerJosephine K. GumpHallas Family Foundation

William H. Hurt, WWH FoundationDavid M. IsquithJames L Everett, Jr., M.D., Bay HealthKen Lin Fund of the New York Community TrustEdwin L. and Mildred A. KunkelThomas Lobl, Ph. D.Joe LuomaJohn MalcolmDon W. MathewsScott C. Mitchell, J.D., C.P.A.Roger M. Moak, EsqNorma R. Mraz, Au.D., Mraz Audiology Consulting, Inc.Olson Family FoundationWarren PalmerPortland General Electric Co.Gary P. Reul, Ed.D. and Barbara T. ReulCarol L. RieskeWilliam L. Ritchie, Jr.Robert W. RoperKarl and Karen SchmidtMartin E.SegalAnna M. SharkozyLorna StaffordThe Herman FoundationF. Helmut and Caroline Weymar Twin Chimney, Inc.Thomas R. WarrenFred Werber, M.D.

Melanie F. WestWilliam H. Hurt, WHH FoundationRonald S. and Kathryn K. ZagelJinsheng Zhang, Ph.D

$500-$999 AnonymousGary A. BleibergFrank K. BolandSharon E. BowyerGail B. Brenner, Au.D., Tinnitus & Sound Sensitivity Treatment Center of Philadelphia, PCJoel N. BryanKenneth R. CherryLee and Kristine ClementGeorge Crandall, Jr.Larry R. CrockettDavid DanielGregory F. DonahueJanice Dungan, Au.D., Audiological ServicesFrederick R. Entwistle, M.D.Dwight W. and Anne L. FawcettJohn W.FingerJoseph J. Fisch Fund of the Jewish Community FoundationD. Jeanne FrantzAlison Kay FrenchArthur Gelb, Ph.D.

Special Donors & Tributes


Continued on page 30.

ATA thanks all donors whose generosity helps fund ATA’s research and support programs. The list below includes donations received from July 2016 - October 2016. If you contributed during that time and don’t see your name, or if it is incorrect, we want to hear from you. Please contact us at 800-634-8978 or emailus at [email protected] to correct any inaccuracies.Donations to ATA are tax deductible to the extent provided by law.

ATA Corporate MembersATA thanks the following organizations for their ongoing support of the association and the tinnitus community.

Gold Level Corporate Members

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Silver Level Corporate Members Bronze Level Corporate Members


TruDentaLife Changing Dentistry

aurismedical.com neuromonics.com otonomy.com

starkey.com restoredhearing.com

Recognition


Susan Adams, Center for Hearing & CommunicationJennifer Auer, Au.D., F-AAA, CCC-A, Audiology by the SoundRandall Bartlett, MA., Tinnitus & Audiology Center of Southern CaliforniaCarol Bass, All Ears AudiologyLisa A. Blackman, Hearing Healthcare CenterGranville Brady, Jr., Au.D., FAAA, Tinnitus Center at Williamsburg CommonsGail B. Brenner, Au.D., Tinnitus & Sound Sensitivity Treatment Center of Philadelphia, PCAnne Carter, Ph.D., Pasadena Hearing CareCentral Oregon Audiology and Hearing Aid ClinicCarol Clifford, Au.D., Albuquerque Hearing & BalanceLois N. Cohen, LCSW, ACSW, BCDJenifer Cushing, Au.D., A & A Hearing GroupAli Danesh, BSc, M.S., Ph.D., Labyrinth AudiologyStelios G. Dokianakis, Au.D., Holland Doctors of AudiologySara Downs Au.D., Hearing Wellness CenterJanice Dungan, Au.D. BA, MA, Appalachian AudiologyRobyn Edgson, B.S., BC-HIS, Hearing Associates of Las VegasLisa Fox-Thomas, Ph.D., CCC-A, F-AAA, CHC, UNCG Speech & Hearing CenterAmanda Frazier, ASI Audiology & Hearing InstrumentsBelinda Gonzales, HIS, NuSound Hearing CenterMaryRose Hecksel, Au.D., Audiology & Hearing Aid Center

James Henry, Ph.D. Cathy Henderson Jones, Au.D., Hear the World FoundationMelanie Herzfeld, Au.D., Hearing and Tinnitus CenterBruce Hubbard, Ph.D., Cognitive Health GroupDavid Illich, Au.D., Professional Hearing AssociatesKent Jarratt, LCSW, Omni Wellness Marsha Johnson, Au.D., Oregon Tinnitus & Hyperacu-sis Treatment CenterJeannie Karlovitz, Au.D., CCC-A, FAAA, Advanced Hearing SolutionsJason Kaufman, D.C., Scottsdale NeurologyEdward W. Keels, MA, CCC-A, Hear Now Hearing Aid CenterJennifer Klimczak, Au.D., Avalon Hearing Aid CentersNichole Kovel, Au.D., F-AAA, Elite Hearing of Colorado SpringsDeborah Lain, M.S., MSC, Hope for TinnitusJoanne LaPorta, MA, CCC-A, Accent on HearingJennifer Larmann, Au.D., A & A Hearing GroupCindy Leeb, Au.D., A & A Hearing GroupMalvina Levy, Au.D., Hearing and Speech Center of Northern CaliforniaAndrea Liacouras, Au.D., A & A Hearing GroupHa-Sheng Li-Korotky, Au.D., Ph.D., M.D., Pacific Northwest AudiologyMatthew Lyon, MA, El Paso Hearing Aid & Audiology CenterRobert Mario, Ph.D., Mario Hearing and Tinnitus ClinicsDiane Markva, Au.D., Fauquier Hearing Services

Emily Martinson, Au.D., Ph.D., A & A Hearing GroupJill B. Meltzer, Au.D., North Shore Audio-Vestibular LabMichael Messina, H.A.S., Clarity Hearing Aid SolutionsJohn Molina Au.D., Colorado Hearing Specialists, Inc.Norma R. Mraz, Au.D., Mraz Audiology Consulting, Inc.Stephen M. Nagler, M.D., FACS, Atlanta Tinnitus ConsultantsElizabeth Patterson, Au.D., REM Audiology Associates, PCAndrea Pernick, Au.D., South Miami Audiology ConsultantsJulie Prutsman, Au.D., Sound Relief Hearing CenterAnn Rhoten, Au.D., Kentucky Audiology & Tinnitus ServicesMichael J. A. Robb, M.D., Robb Oto-Neurology ClinicTiffany Sexton, Au.D., Lifestyle HearingSamantha Sikorski, Sikorski Hearing Aid CenterCindy Ann Simon, Au.D., CCC-A, South Miami Audiology ConsultantsMurray Steinfeld, HAS, BCHIS, ACA, Hearing Solutions of the Palm Beaches, LLC

William Stubbeman, M.D., TMS PsychiatryCarolyn Whitcomb, Au.D., Hearing Evaluation Services of BuffaloDiane E. Williams, Au.D., Better Sound AudiologyShannon Wrabel, Au.D., A&A Hearing Group

Professional Members- Gold Level Dan HamelbergPeter HillIBM CorporationAlbert D. JeromeDavid Michael KeeterKenneth W. & Margaret Rose G. KistlerHerb and Sondra KupersmithJohn P. & Terry Ann LeopoldSteve Martin Charitable FoundationDennis S. & Phyllis Krison MalingerNorma M. MasellaOwen S. Mudge ,Jr. , Esq & Kimberly B. Hancock-MudgeRoland NadeauRobert J. NeulandWilliam F. & Sheila A. OwenRobert C. & Laurie A. PenceRichard E. Popovits, Jr.Evelyn M. RandallMichelle T. & John F. Rutledge Jr.Christopher S. SandersonJonas and Viviane SchultzSunish ShahWilliam ShatnerGeorge G. Vaught, Jr.Albert W. Vor KellerGerda WassermannCleo S. & Judith A. WeibelDelmer D. & Wanda WeiszGordon F. WineyJames C. Woods &Christine C. Woods-De RaelNancy K. WuthrichJohn A. Wunderlich

$301-$499 Kent E. BacklundRichard L. BehrJoyce BettencourtLois M. ClarkTheodore J. Eckberg, M.D.Eduardo Gonzalez FiolKyle HarrisCol. Horace Humphries, Jr.William J. KennedyGary W. MalerJill B. Meltzer, Au.D. North Shore Audio-Vestibular LabCameron R & Marcia H. Murray of The Barbara Murray Charitable Gift FundThomas PannoEnrico ReguzzoniEdward M. ResovskyMichael J. A. Robb, M.D., Robb Oto-Neurology ClinicJose L. RuizStephen SecristDave SimpsonVirginia Farm Bureau Mutual Insurance Co.Daniel H. WalkerWilla L. & Raymond D. Young

ATA thanks the following healthcare professional and researchers for their participation and support as ATA Professional Member. For more information on ATA professional Member-ship, visit ATA.org

Donors Continued from page 28

1, 2, 4 ,5 = Shiley, Folmer & McMenomey 20053 = Chang & Cheung, 2014; Lima Ada et al, 2005; Shiley, Folmer & McMenomey 2005; Sobrinho et al, 2004; Ayache et al, 2003; Szymanski et al, 2003; Sakai et al, 1995.6 = Mertens et al, 2016; Pan et al, 2009; Shiley, Folmer & McMenomey 2005; Ruckenstein et al, 2001; Souliere et al 1992; Ito & Sakakihara, 1994.7 = Henry et al, 2015; Bauer, 2010; Folmer & Carroll, 2006; Trotter & Donaldson, 2008; Del Bo & Androsetti, 2007; Sandlin & Olsson, 1999; Surr et al, 19858 = Henry et al, 2015; Sweetow & Sabes, 2010; Sandlin & Olsson, 19999 = Henry et al, 2016; Jastreboff, 2015; Tyler et al, 2012; Bauer & Brozoski, 2011; Henry et al, 2006; Jastreboff & Jastreboff, 2003; Sheldrake et al, 1999; Lux-Wellenhof, 1999; Bartnik et al, 1999; Heitzmann et al, 1999; Herraiz et al, 1999; Jastreboff, 1990.10 = Jastreboff 2015; Madeira et al 2007; Jastreboff & Jastreboff, 2003

11 = Henry et al, 2007; Jastreboff, 1990.12 = Henry et al, 2016; Bauer & Brozoski, 2011; Tyler et al, 201213 = Hesser et al, 2011; Hoare et al, 2011; Robinson et al, 200814 = Tyler (personal communication, 2016)15 = Henry et al 2016, 2006; Tyler et al, 2012; Schleuning & Martin 2001; Sandlin & Olsson, 199916 = Davis et al, 2007, 2008; Vieira et al, 2011; Wazen et al, 201117 = Hauptmann et al, 2015.Williams et al, 2015; Tass et al, 2012.18 = Folmer et al, 201519 = Johnson et al, 200320 = Han et al, 201221 = Dobie et al, 1993, 198922 = Henry et al, 2016; Kreuzer et al, 2016; Folmer et al, 2015; Johnson et al, 2003; Dobie et al, 1993.

Scientific References- Beginning numbers correspond to numbers on Table I on page 16


Donations Made In Memory Of Herb BormanRobert G. Diener, Ph.D.Michael F. HaarJames HessEdward and Nellie KosloskyMary Meikle, Ph.D. David NowakLinda NewellKarol NiederfringerFlorence B. RaaschAnton TalsmaEvelyn TeuneJack Vernon, Ph.D.Donald Webb

Donations Made In Honor OfPaul CatherwoodJason Chaves Jason Cohen John Deatley John DissLinda J. Hall Frank D. HillmanDavid HjortlandGregory B. JonesMarjorie KobeStacey KupersmithSharon LemkeLoretta MarshJim McLeodScott MitchellAlan Niederfringer

Norman RobertsHans SchildermanWendy SpitzerDr. Stephen NaglerKyle Sutton

Matching OrganizationsANONYMOUS (4)Bank of AmericaBenevityBP Fabric of America FundBTIG Charity DayBxtel, LLCThe Capital Group Companies Charitable FoundationEricsson Matching Gifts ProgramGlobal ImpactIBM Corporation


International Biscuits & Confections, LLCJMT Charitable FoundationMarkel CorporationMedtronicMicrosoftPfizer FoundationPortland General Electric Co.Resource Marketing Arkansas, IncSIU School of MedicineThe Oakland Athletics Community FundUS ConcreteWellington Sheilds & Co., LLCWells Fargo Advisors, LLC

Recognition

Don’t Miss ATA’s 2017 Webinar Series

Clinical Aspects of Tinnitus

Neuromodulation

Sound Therapy

JANUARY 10, 2017David Baguley, Ph.D., MBAPlus, Announcement of Tinnitus Awareness Week- Worldwide

MARCH 14, 2017Jinsheng Zhang, Ph.D.

Webinars are part of your $40 ATA membership. You receive 5 free webinars per year. ATA’s Webinars are available for non-members at $25 per webinar.

MAY 9, 2017Richard Tyler, Ph.D.

PO Box 5Portland OR 97207-0005

The Neuroscience of Tinnitus

To Be Announced

SEPTEMBER 12, 2017Larry Roberts, Ph.D

NOVEMBER 14, 2017Watch our website for updated information.

All webinars are on Tuesday Nights (U.S.) at 8 pm Eastern, 7 pm Central, 6 pm Mountain and 5 pm Pacific Time.

Visit our website for more resources to manage tinnitus and hyperacusis at:

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A publication of the American Tinnitus Association · Chris Vail-Rollins, Tinnitus Today, Editor...

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Transcript of A publication of the American Tinnitus Association · Chris Vail-Rollins, Tinnitus Today, Editor...