Tinnitus Today December 1997 Vol 22, No 4

7/30/2019 Tinnitus Today December 1997 Vol 22, No 4

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December 1997 Volume 22, Number 4

Tinnitus TodayTHE JOURNAL OF THE AMERICAN TINNITUS ASSOCIATION"To promote relief, prevention, and the eventual cure of tinnitus for

the benefit of present and future generations"

In This Issue:ATA's New "'Treatments Brochure""Tbday" Show Gets Results!

Since 1971Research- Referrals-Resources

Oregon Hearing Research Center'sNew Director, Alfred NuttallReducing Tinnitus -Food for Thought


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Tinnitus T o d ~ y Ed itorial and Advertising offices: AmericanTinnirus Association, PO. Box 5 Portland, OR97207, 503/248-9985, 800/634-8978,http:/ / w w w . t e l e p o r t . c o m / ~ a t a Executive Director& Editor:Gloria E. Reich, Ph.D.Associate Editor: Barbara ThbachnickTlnmtus 7bday is published quarterly inMarch, June, September, an d December. It ismailed to members of he American TinnitusAssociation an d a selected list of tinnitus sufferers and professionals who treat tinnitus.Circulation is rotated to 80,000 annually.Th e Publisher reserves the right to reject ored it any manuscript received for publicationand to reject any advertising deemed unsuitable for Tinntlt.t$ Thday. Acceptance of advertising by Tlnmtus Thday does not constituteendorsement of the advertiser, its productsor services, nor does Tinnrtus 1bday makeany claims or guarantees as to th e accuracyor validity of the advertiser's offer. The opinions expressed by contributors to Tinnitus1bday ar e not necessarily those of thePublisher, editors, staff, or advertisers.American Tinnitus Association is a non-prof.it human heahh and welfare agency under26 USC 501 (c)(3)Copyright 1997 by American TinnitusAssociation. No part of this publication maybe reproduced, stored in a retrieval system,or transmitted in an y form, or by any means,without the prior written permission of thePublisher. ISSN: 0897-6368Scientific Advisory CommitteeRonald G. Amede e, M.D., New Orleans, LARobert E. Brummett, Ph.D., Portland, ORJack D. Clemis, M.D., Chicago, ILRobert A. Dobie, M.D., San Antonio, TXJohn R. Emmett. M.D., Memphis,TNChris B. Foster, M.D., La Jolla, CABarbara Goldstein, Ph.D . New York, NYJohn W. House, M.D., Los Angeles, CAGary P. Jacobson, Ph.D., Detroit, MlPawel J. Jastreboff. Ph.D., Baltimore, MDRobert M. Johnson, Ph.D., Portland, ORWilliam H. Martin, Ph.D., Philadelphia, PAGale W. MOler, M.D., Cincinnati, OHJ. Gail Neely, M.D., St. Louis, MORobert E. Sandlin, Ph.D., El Cajon, CAAlexanderJ. Schleuning, II , M.D.,Portland, ORAbraham Shulman , M.D., Brooklyn, NYMansfield Smith, M.D., San Jose, CARobert Sweetow, P h.D . San Francisco, CAHonorary DirectorsThe Honorable Mark 0. HatfieldTony Randall, New York, NYWillian1Shatner, Los Angeles, CALegal CounselHenry C. BreithauptStoel Rives Boley Jones & Grey,Portland, ORBoard of DirectorsEdmund Grossberg, Northbrook, JLW. F. S. Hopm eier, St. Louis, MOSidney Kleinman, Chicago, lLPaul Meade, Tigard, ORPhilip 0 . Monon, Portland, OR, Chmn.

The Journal of the American Tinnitus AssociationVolume 22Number 4, December 1997Tinnitus, ringing in the ears or head noises, is experienced by as manyas 50 million Americans. Medical help is often sought by those whohave it in a severe, stressful, or life-disrupting form.Table of Contents8 Air Bags - One Year Later

by Barbara Tabachnick9 Book Rev iew

by Harvey A. Pines, Ph.D.11 ATA's New 11Theatments Brochure"by Barbara Tabachnick

14 Calling for Helpby Barbara Th:bachnick

14 New ATA Support Contacts15 Tinnitus Survey Update

by Stefan P Kruszewski., M.D.16 A New Director - A New Direction,Oregon Hearing Research Center's Alfred Nuttall, Ph.D.by Barbara Th:bachnick

18 {(Tbday" Show Gets Results!by Cora Lee (Corky) Stewart

19 Bequests: Investments in ATA's Futureby Cora Lee (Corky) Stewart23 Reducing Tinnitus - Food for Thoughtby Gary Graybush

24 On the Road to ATA Awarenessby Pat Daggett

Regular Features4 From the Editorby Gloria E. Reich, Ph.D.6 Le tters to the Editor20 Questions and Answers

by Jack A. Vernon, Ph.D.25 Special Donors and Tributes


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From the Editorby Gloria E. Reich, Ph.D., Executive Director

You'll read about all sorts of exciting eventsin this issue. These events don't just happen forno reason. They happen because we - you andATA - cause them to happen. The publicitygenerated by William Shatner about his tinnitushas helped us bring tinnitus closer to being ahousehold word. For the first time ever we conducted a survey to find out just how well-knowntinnitus is by the general public. Overall, 31% ofour respondents said they recognized the term,and 53% ofthose were able to give a correct definition of tinnitus. Clearly we have a job to doto educate the other 84% of the public abouttinnitus. Why do we care? Because right nowprevention is the only cure. An educated publicwho utilizes ear protection in noise has a betterchance to have lifelong good hearing and anabsence of ear ringing. Until medical researchprovides the answers, those of us whose tinnituspersists must make use of the currently effective treatments such as habituation, masking,drugs, and an infinite variety of alternativetherapies that each seem to help small numbersof sufferers.

You probably read, as I did, of PresidentClinton's hearing problems. We don't know yet ifhe has tinnitus bu t he does represent a generation of Americans who have enjoyed lots ofrecreational noise. Ear, nose, and throat doctorshave said that about 85% of their hearingimpaired patients have tinnitus, so the chancesare pretty good that this President, like formerPresident Reagan, hears tinnitus too.

ATA's advisory committee met at the convention of the American Academy of Otolaryngologyin San Francisco in early September. ATA relieson this group of scientists to help set directionfor programs and especially to help us decidewhich research projects should be considered.Topics for discussion this year ranged fromsupport of ATA's new Strategic Plan to how toeducate the Health Maintenance Organizationsand other health insurers about the importanceof tinnitus diagnosis and treatment - andcoverage for same!

The next week found me in London. Iwas officially on vacation but managed to spenda day with representatives of the British Tinnitus

Representatives from BTA & ATA meet to discuss future plansin London. Left to right, Jo Haze/by and Gloria ReichAssociation. We're planning a meeting of theInternational Tinnitus Support Associations(ITSA) which will precede the Sixth InternationalTinnitus Seminar in Cambridge, England, inSeptember 1999. I've since met with tinnitusassociation representatives from Denmark andCanada whose countries will be representedalong with others at the ITSA gathering. We'llcontinue to provide information about thesemeetings as they draw closer. Feel free to inquireabout specifics if you wish to attend. Remember,you can reach our e-mail at [email protected], oryou can fax us at 503/248-0024. Both of these arepreferable to telephoning because, as you'll readelsewhere, we've been answering thousands ofnew calls as a result of the September 15th"Tbday" show.


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From the Editor


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Letters to the EditorFrom time to time, we include letters from ourmembers about their experiences with Hnon-traditional" treatments. We do so in the hope that theinformation offered might be helpful. Please readthese anecdotal reports carefully, consult with yourphysician or medical advisor, and decide for yourself ifa given treatment might be right for you. Asalways, the opinions expressed are strictly those ofthe letter writers and do not reflect an opinion orendorsement by ATA.My well-meaning friends tell me, "Yourtinnitus will get better when you're no tunder stress."

I t is easy to say, but for me, it just isn't true.In 1981 , my mother died, we lost our job, mydaughter married without our consent, my sonneeded help to find a job to feed his family, andwe had to move three times. At that particulartime, at the conjunction of all those worries, mytinnitus was as quiet as it has ever been sincethe onset in 1972. A year later, all our problemshad been resolved, I inherited a sizable amountfrom mother's estate, my money worries wereover, and I could hardly live because my tinnitus was so loud and disturbing.

The things that DO trigger more loudnessfor me are: atmospheric pressure changes,noises, waking after a long sleep - but not troubles or stress. I dare say the phantom pains anamputee has are no worse and no better duringperiods of stress.

Virginia L. Lipp, 903/581-0371.

I uess the air bag problem is old hat to readers of Tinnitus Tbday, but to me it has justexploded as suddenly as - well, an air bag.I've been driving an old clunker with goodshoulder and lap belts for years and have feltsecure. But I need a new car and have just discovered that I can't get one without air bags.That didn't bother me. I'd buy my car and havethe air bags disconnected.I already knew that if an air bag exploded onme I'd be a statistic. I'm 5'1" tall; I weigh 100pounds; I have tinnitus; and I pull the seat as far

forward as it goes. Even I know this is a scary -perhaps lethal - combination. Everyone I knowwhose ai r bag has deployed has suffered somesort of reaction, and one woman (who is aboutmy size and who has tinnitus) is now profoundly deaf. That's why I planned to deactivate theair bag in my new dream car.

The first blow came when the auto dealersaid, "Yes, theoretically we can deactivate theair bag if you get a letter - I believe from yoursenator - but in fact we will no t do it." "Why?"I asked. "The National Highway Traffic SafetyAdministrat ion (NHTSA) has strict rulings andour lawyer won't le t us." So I called NHTSA.After several long and painful conversationsI can report the following: decisions involving anew ruling are made not by an individual, butby "the agency." How many people in theagency? "About 500." When I asked when thedecision would be made, the spokesman said"soon." When I asked what "soon" meant, theanswer was "soon means soon."All this would be humorous except that toomuch is at stake here. The delay of NHTSA isunconscionable. Until that body, which holds somuch power, acts sensibly and allows an on / offswitch, here's what many of us with tinnitus aredoing. We are no t buying new cars. And we'rewaiting, waiting - watching, watching.Susan Dart, Saluda, NC.

I nner ear infections are a major public healthproblem in children, and are, in fact, one oflhe major reasons for pediatric doctor visits.I don't know i f anyone has ever done a study tofind ou t how many people with tinnitus had earaches and ear infections when they were children, but it seems likely to me that there couldbe a high correlation.A corresponding view comes from ophthalmologist Robert Herrick, M.D. (909/ 820-4051).He feels that tear drainage into the inner ear isa major cause of childhood ear infections, andpossibly tinnitus in adults. Dr. Herrick is thediscoverer and chief researcher of Punctal Plugs,used by most optometrists and all ophthalmologists. The main purpose of the plugs is tocorrect "dry eye" syndrome by blocking theneeded tears from draining. By blocking tears


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Letters to the Editor (continued)cut down on sinus infections and that's why hethinks it has a connection in ear disorders.Byron Y Newman, O.D., 2501 E. ChapmanAve., #105, Orange, CA 92869, 714/288-8282.

A lthough I am a cochlear implant person, Ihad been troubled at times by what Ithought was tinnitus. But through readingyour publication I can master my conditionmuch of the time, resulting from what l under-stand of your journal. I keep back copies ofTinnitus Tbday and loan them to others whohave head noise problems. Thanks for beingthere.Gladys Dickholtz, Alhambra, CA

I was disturbed by Dr. Stephen Nagler's article,"Tinnitus and Homeopathy - My View," inyour September issue of Tinnitus Tbday. Thearticle did not offer anything relevant to thetreatment of tinnitus. And it did not mention aproposed homeopathic treatment to which itcould argue against. ATA has previously beenopen to various treatments. My fear is that thisarticle is signaling a shift in your philosophy.When I was diagnosed with tinnitus, I askedmy doctor about ginkgo. He passed it off asbeing unproven and "anecdotal." Driven to nearinsanity, I tried it anJ'i,;,ray with very positive success. I've also experienced varied success with

other nutritional products. Had I listened to theM.D., I would be miserable today.Since tinnitus appears to have many causes,it is logical that it will eventually have manysuccessful treatments. Unfortunately, each treatment might only "cure" a small percentage of thetotal population. If history is any indicator, such"cures" will initially be discounted by the medical establishment as unproven. If your publication becomes a mouthpiece for the medical/pharmaceutical establishment, it will be a sadday for tinnitus sufferers. Marc Heatherington,Salem, OR, [email protected] forwarded Mr. Heatherington's letter on toDr. Nagler, whose comments follow.While researching all the available literatureon homeopathic treatment of tinnitus in preparation for writing the article referenced above,

which demonstrates to statistical satisfaction theefficacy of any homeopathic medicament in tinnitus treatment. In the conclusion of my article Isuggested that in spite of that fact, I thought thathomeopaths and practitioners of traditionalWestern medicine should try to work together inthe best interests of tinnitus sufferers because"science" may not hold all the answers. I believesuch an approach (encouraging Western physicians to be open-minded) is very relevant andvery much in keeping with the ATA's philosophy.Stephen Nagler, M.D., F.A.C.S., 980 JohnsonFerry Rd. NE #760, Atlanta, GA 30342,

404/531-3979.Editor's Note:In his homeopathy article, Dr. Nagler discussesa non-scientifically based form ofmedicine from ascientific perspective. He explains why "logically#homeopathy should not work, even though for somepeople it has. The American medical establishmentadheres to strict standards for research. Naglersimply did not waver from them.We occasionally receive objections to our lettersand articles that pertain to alternative therapies,favorably or unfavorably discussed. In fairness, wewill continue to include discussion ofall tinnitustreatments that emanate from the "alternative East#or the "established West" - in an attempt to bridgethe gap between the two.

I n August of 1988, I was diagnosed with anarthritic disease of the spine called ankylosing spondylitis. I went to a doctor whoadvised neck hyperextensions. (I was to movemy neck around with a backward tilt beyond thenormal limit.) The exercises were inappropriatefor my neck condition, as I came to find out.Nevertheless I performed them to the pointwhere my neck vertebrae cracked very loudly.

One day in October of 1988, after havingdone my hyperextension exercises, I developedan extremely severe headache. An hour later, Inoticed a ringing in my ears. The headache lasted 36 hours, bu t the ringing became a permanent part of my life and has continued for nineyears. With this constant ringing, a promisingelectronics career evaporated and I have been


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Letters to the Editor (continued)I am going public with my illness for three

primary reasons: 1) I hope that more doctors willbe willing to investigate this condition andexplore treatments. 2) Since I already hadadvanced cervical spinal clisease, I should havebeen warned to approach neck exercise very cautiously. 3) I wish to generate interest in tinnitus,including my variety which is not easily diag-nosed, in the hope that more research moneymight be directed toward its treatment.What happened to me is rare, but can occurwith upper cervical trauma such as whiplash.Arteries, which can literally move in the brain inresponse to repeated manipulations, lay on theauditory nerves. In December 1989, I first sawMargareta B. Ml?>ller, M.D. at the University ofPittsburgh who mentioned this diagnosis as apossibility. When arteties move onto cranialnerves, they can cause vascular compressiveconditions such as neuralgia, hemifacial spasm,dizziness, and tinnitus.

Since this is a mechanical shifting of arteriesin my brain, I believe that only the microvascular decompression operation can help me.(I tried the medication Klonopin with no effect.)But until this procedure's success rate is mu chimproved, I will live with the constant ringing.I work and live as normally as possible. Buthaving two incurable conditions makes li femuch harder than it should be. Let us all hopethat with continued awareness and funding,tinnitus of all origins will someday be treatableand cured.Brian McFall, 1722 Highland Ave. , #2B,West Mifflin, PA 15122

The American Tinnitus Association and theeditors of Tinnitus 7bday welcome your letters.Please let us know in advance if we can includeyour address and phone number with your lette r in the event i t is selected for publishing.

AIR BAGS ONE YEAR LATERby Barbara Thbachnick, Clients Services Manager

At the time of this printing, the rule-makingcommittee of the National Highway TrafficSafety Administration (NHTSA) has not yetreleased its ruling pertaining to consumerrequests for choice regarding active vehicle ai rbags. (Consumers in the U.S . have been askingthe transportation agency for a choice regardingthis safety feature for more than one year.)

Sma11 adults, the elderly, all children, andthe infirm are known to be at risk from air bagdeployment. The close proximity of a person'shead, neck, and chest to deploying air bags hascaused over 80 ai r bag-related deaths in thiscoun try to date. Thousands of additional ai r baginjuries - from minor to incapacitating - havealso been reported. Damage to the auditorysystem from excessive ai r bag noise is includedin these statistics.Under public pressure, NHTSA announced atemporary plan earlier this yea r to allow deacti

flooded with requests, and in response sent nearly 5000 letters authorizing air bag deactivation.Most recipients of those authorizations havesince found that the documents carry littleweight. Mechanics and dealerships are simplynot honoring them. Liz Neblett, public affairsspecialist for NHTSA, apologizes for the lack ofcompliance. "We can't force [mechanics] to dothe disconnects. I wish we could."

In the meantime, in the midst of a flurry ofai r bag recalls and promises of "smarter" air bagtechnology, car dealers are sitting tight, waitingfor the final word from the government. Howmight the debate result? NHTSA offers a hint: aretraction of the authorizations for air bag disconnects, allowing ca r manufacturers instead tomake air bag on/ off switches available to customers by early next year. The comment hasalready met resistance from some car manufacturers like Honda. Available or not, they saythey will no t offer the switch. The pending airbag decision - and potentially the decision


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Book ReviewJack A. Vernon, Ph.D. (ed.), Tinnitus: 'freatmentand Relief. Allyn and Bacon, 1998, reviewed byHarvey A. Pines, Ph.D.

\Nhat more appropriate title for a book byDr. Jack Vernon than Tinnitus: Treatment andRelief? For many years, Dr. Vernon has been asource of helpful information for those seekingrelief from their tinnitus. His willingness to talkand correspond with people about possible treatments has become legend. His "Questions an dAnswers" column in Tinnitus Tbday furtherexemplifies these efforts. Now, in this new edited volume, Dr. Vernon has put his unique stampon a book that I believe will become a majorresource for the average person seeking answersto tinnitus-related questions.

This volume assembles a wide range ofpapers with a common focus - tinnitus treatment and relief. W11ile reviewing this book Icould almost imagine Dr. Vernon saying to eachof the notable contributors, "Look, we needinformation about your subject that the averageperson can understand. Wtite what people needto know in a way that doesn't oversimplify whatyou have to say but does communicate it clearly. And include some of the questions peoplewould be likely to ask about your topic alongwith brief answers to those questions."And, for the most part, that is what theexpert contributors to this book have done .Reading the titles in this volume was like hearing echoes of questions raised in my own support group. Indeed, a copy of this book shouldbelong to all our support groups. I can easilyenvision reaching for this volume when a question comes up at a meeting and saying, "Well,let's see what's been written about this in JackVernon's book."Want to know about ginkgo? Look it up inthe index and find Dr. Ross Coles' discussion ofit. Wondering if there are any safe and effectivedrugs to treat tinnitus? An entire chapter by Dr.Robert Brummett has this question as its title.Has your tinnitus thrown you into a state ofdepression? Read what Drs. Dobie and Sullivanhave to say about "Antidepressant Drugs and

read (and I'm a psychologist) discuss our mentalreactions to tinnitus and how we can modifythose reactions to decrease our distress. Thesechapters would be equally useful to hearing professionals seeking insight into the thinking oftinnitus patients. Heard about "maskers" but notsure whether they are really useful or exactlywhat they do? Dr. Robert Johnson's chapter ispractically a reference work on the subject.Wondering what gets stimulated with electricalstimulation? See Dr. Steven Staller's chapte1:Been diagnosed with hyperacusis and want toknow more about it? Jack Vernon an d LindaPress discuss this disorder. Want to know moreabout the work of Drs. Jastreboff and Hazell onhabituation therapy? Read their chapter on theirinfluential neurophysiological model and learnhow i t has been used to develop a treatmentprotocol reported to be producing promisingresults. And if you are, like me, a regular readerof Dr. Vernon's Q&A column, check out theunique question and answer section at the endof each chapter.

I t would be nice to say that every chapter isas informative and well written as the ones Ihave mentioned. Unfortunately, that is almostnever the case in an edited volume. You willfind a few technical papers that would be ofinterest primarily to medical professionals.However, these are only a minority of the chapters. I t would also have helped if papers on common topics had been grouped together andappropriate headings placed in the table of contents. But there is an index and the chaptertitles are very informative by themselves.

I'm told this is a book thatDr. Vernon has beenworking on for quitea while. Well, it'shere, and it wasworth waiting for.Dr. Pines is a psycholo-gist and a tinnitussupport group facilitator.He can be reached atCanisius College, Dept. of


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TINNITUS Treatment and Relief

edited by Jack A. Vernon, Ph.D.,Professor Emeritus ofOtolaryngology, OHSUVERY SPECIAL PRICES:ATA Members - $22 plus $4 postageNon-Members - $27 plus $4 postage(Published price- $26.95 U.S.I$37.95 Canada)TO ORDERBy Mail:ATA, PO Box 5, Portland OR 97207-0005By Fax:503/248-0024By Thlephone:503/248-9985 xl4 (8:30a.m . - 5:00p.m. PST)Check, VISA, MasterCardRush delivery available on orders received byNoon on December 12 - Call for cost

The 18th European Instructional Courseon 11Tinnitus and Its Management''April 5-9, 1998- Nottingham, England

This course addresses the causes, scientific background, investigations, and management of tinnitus. I twill consist of lectures with case discussions, videos,practical demonstrations, and two workshop sessions.The course is suitable for otologists, otolaryngologists,scientists, technicians, and hearing therapists who areinvolved in clinical or research work on tinnitus. Thecourse is held on the campus of the University ofNottingham.Course organizers: Jonathan Hazell and Ross Coles.Faculty: Adrian Davis, David Baguley, Jean Baskill,Thrry Buffin, Lucy Hanscombe, Altan Kayan, MargaretJastreboff, Laurence McKenna, Catherene McKinney,and Jacqueline Sheldrake.

The course fee is 640 (residential), 560 (nonresidential). Both fees include comprehensive notes,lunches, and dinners. The residential option alsoincludes bed and breakfast in a hall of residence. Earlyapplication is advised. There is an upper limit of 80 delegates. Closing date for applications: February 27, 1998,by which date all fees must be paid. Scholarships (covering course fee and accommodation, not travel) are tobe awarded- details will be supplied upon request.For registration details contact: Julie Whittington,Conference Nottingham, Regent House Clinton Avenue,Nottingham NG5 lAZ, United Kingdom'Tel: +44 (0115) 985 6545 Fax: +44 (0115) 985 6533Email: info@confnottingham. co. uk

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ATXs New''Treatments Brochure''by Barbara Tabachnick, Client Services ManagerOur new brochure, Tinnitus 'Iteatments- What's New, What Works, is designed to educate healthcare providers - family doctors (who are most often the tinnitus sufferer's first medical contact)internists, ear specialists, audiologists, psychologists - in fact, any professional who treats tinnituspatients. Currently we are distributing these brochures to professionals who attend national healthmeetings.How You Can Help -

Write or call us for free Tinnitus 'Iteatment - What's New, What Works brochures to take to yourdoctor or doctors. We'll send you up to 10 copies (or more if you have more contacts).Please send us the names and addresses of the professionals to whom you give the brochures.This is a tremendous help. We'll then send additional information about tinnitus and the ATA tothese new professional contacts.So far, the doctors have been thrilled to get this information. We are thrilled, too, to relay to them

the scope of treatment options and to lay it squarely on the line about what to say, and what not tosay (most notably, "go home and live with it") to tinnitus patients. We want health professionals totake this new brochure, and go home and work with it.Please let us know ifyou can help.(Excerpts from brochure)Tinnitus Treatments-"What's New-"What Works

Tinnitus, a ringing or other noise in theears or head, affects more than 50 millionAmericans.For most, the symptom is annoying thoughnot intrusive. However, there are 12 millionpeople with chronic and distressing tinnitus whoare seeking answers and relief.

In the majority of tinnitus patient/ doctorinteractions, the answers do not come. Sometimes it is because a recommended treatmentdoes no t work. Other times it is because the tinnitus sufferer is told by his or her physician to"go home and learn to live with it" - a counterproductive comment that has left untold numbers of sufferers feeling despondent. Most often,it is because the health care provider does notknow of a treatment to suggest.

Tinnitus has become a very specialized fieldin medicine. The long wait to get into tinnitusclinics across the U.S. gives testimony to theneed for this focused care. But a person who istroubled by tinnitus will usually see a family

Whatever your area of practice, the followinginformation can help you develop supportiveand effectual treatment plans for these veryspecial patients.Causes of TinnitusThe most common cause of tinnitus is exposure to excessively loud noise - either a singleintense event (like a gun shot blast), or longterm exposure.

A small percentage of tinnitus cases arisefrom medical conditions. Hypertension, acousticneuroma, thyroid disease, vascular disorder,temporo-mandibular jaw joint disorder, earinfection, impacted cerumen, nutritional deficiency, an aneurysm, multiple sclerosis, andother disorders can produce the symptom oftinnitus.

There are also more than 200 knownprescription and OTC drugs that cause orexacerbate tinnitus. In some cases, the tinnituswill lessen or disappear when the offendingdrug is discontinued.Patient Evaluation

A complete medical history of the patientcan identify or rule out an underlying physicalcause of tinnitus. In some cases, successful


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''T B h ''eatments roc ure (continued)An audiological evaluation of tinnitus will

establish the patient's baseline hearing level ,plus the tinnitus pitch and volume levels. Thesedata are essential to know before any soundgenerating treatment can be prescribed andused effectively. (Note: Tinnitus severity, asrated by the patient, does not correspond to themeasured loudness or pitch of the tinnitus.)

The psychological state of the tinnituspatient demands consideration. Chronic tinnituscan cause sleep disruption as well as legitimateand serious bouts of depression. The emotionalcomponent of tinnitus must be examined andaddressed with equal strength.Treatments That Work

Subjective tinnitus can be relieved by introduction of specific sound, by medication, bycounseling, and by reducing stress. There ispublished evidence of effectiveness for thefollowing treatments.

Clinical Masking. Wearable, ear-level maskersproduce a broad bandwidth of sound - usually3,000-12,000Hz- that encompasses the frequency and volume of the tinnitus. The neutralmasker sound is generally a more acceptablesound than the tinnitus. Success with masking isbased on the observed phenomenon that nonthreatening external sound can bring relief tothe tinnitus ear.A combination hearing aid and masker,called a tinnitus instrument, is used most often.(Approximately 70% of tinnitus patients havehearing loss.) The hearing aid part is adjustedfirst; the masker volume and frequency arethen set to a comfortable listening level.Patients are monitored for six months to assessimprovements.For some patients with hearing loss, theuse of hearing aids alone abates the distress oftinnitus. Ambient sounds brought back to theear can effectively mask tinnitus .

Tinnitus Retraining Therapy (TRT). This newtherapy is a result of understanding how different areas of the brain are involved in tinnitus.TRT attempts to interfere with the tinnitus

signal in the brain by introducing a broadbandfrequency- usually 1,000-6,000Hz- throughwearable ear-level noise generators. Theseinstruments are se t to a volume quieter than thelevel needed to mask the patient's tinnitus.Directive counseling is used to de-mystifythe tinnitus for the patient, and is an essentialcomponent to this therapy. For some patients,the counseling combined with the advice toavoid silence is sufficient.Tinnitus Retraining Therapy gradually promotes tinnitus habituation, wherein the patientbecomes no longer aware of and annoyed by thetinnitus . Tinnitus patients are asked to wear twonoise generators a minimum of eight hours aday for 18 to 24 months. 'JYpical improvement isseen within six months. Patients are remindedto "enrich" their environment with constant lowlevel sound. Follow-up assessments are made forseveral years. Hyperacusis, a super-sensitivity tosound, can be treated with a variation of TRT.

Counseling. Depression and/ or anxiety canaccompany tinnitus. Sometimes a sympatheticresponse from a well-informed physician can bereassuring enough to reduce the tinnituspatient's anxiety. Occasionally, professionalcounseling and interim medications are needed.Cognitive therapy can help patients alter theway they react to their tinnitus through theidentification and elimination of negativethought and behavior patterns. Many patientsalso find it a great relief to talk about tinnitus ina support group setting.

Drug Therapy. Various anesthetics, antidepressants, anticonvulsants, anti-anxiety agents,and antihistamines are beneficial to some tinnitus patients. Nortriptyline (Pamelor), alprazolam(Xanax), furosemide (Lasix), clonazepam(Klonopin), and other medications have beenused to relieve tinnitus and associated sleepdisturbances.The potential for undesirable drug sideeffects must be weighed against the potential fortinnitus rel ief. The published papers of theseand all tinnitus-related drugs are available fromthe ATA bibliography.

Biofeedback and Other Relaxation Techniques.


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''T B h ''eatments roc ure (continued)techniques. Biofeedback is a method of relaxation that allows the patient to control his or herown heart rate, blood pressure, breathing, andmuscle tension. I t is often used as an adjunct toother tinnitus treatments. Other methods ofstress reduction include meditation, exercise,yoga, self-hypnosis, and the use of relaxationtapes.

Bedside Masking. Thbletop maskers producea stable broadband sound similar to FM static.These adjustable devices are most useful atnight when the absence of ambient soundenhances the focus on tinnitus. Several varietiesof tabletop maskers produce soothing environmental sounds.

Alternative Treatments. Western medicine hasnot yet solved the mystery of tinnitus. But whentinnitus persists, so do tinnitus patients! Manyhave turned to "alternative" health practitioners(such as naturopaths, craniosacral therapists,and chiropractors), and to the Internet to findothers with tinnitus in hopes of finding relief.Herbal remedies, ginkgo biloba, vitaminsupplements, dietary modifications, andacupuncture have all been tried with someanecdotal success. Hyperbadc oxygen, magnets,and lasers have been studied and used fortinnitus relief outside the U.S.What you can do for your tinnituspatients

Listen to the patient's questions - and answerthem! Compassion and knowledge are formidable clinical tools.Suggest treatment options. Be willing to tryseveraL For some patients, a combination oftreatments is more effective than a singletreatment.Refer patients to professionals in different fieldswhen warranted. ALWAYS give the distressedtinnitus patient somewhere to go, someoneto call, or something to do .

._ Stay informed about tinnitus. Cliniciantraining and continuing education classes intinnitus patient management are offeredyear-round at professional meetings.

Encourage your patients to join ATA.ATA members receive the quarterly journalTinnitus Thday, support network and clinician referral directories, al l of our brochures,and discounts on related books and tapes.Support the American Tinnitus Association.With your annual professional membershipof $35, you receive the same benefits plusfree brochures for your patients. If youactively treat tinnitus patients, you canapply to join ATA's Professional ReferralNetwork.

Current ResearchIn the past few years, tinnitus research -

both laboratory and clinical - has taken off insignificant and hopeful directions. The NationalInstitutes for Deafness and other Communication Disorders and the ATA have awarded nearlytwo million dollars for tinnitus research. Themost current research targets the brain'sinvolvement in the perception of tinnitus.AboutATA

ATA's mission - to promote relief, prevention, and the eventual cure of tinnitus for thebenefit of present and future generations - canbe fostered with your efforts.

Tinnitus is often as frustrating for thepatient to resolve as it is for the clinician totreat. But a new fervor for this field of study isbringing the hope of widespread tinnitus reliefcloser every day.On behalf of thetinnitus sufferers inthis country, weencourage your interes t and welcome yoursupport.


14/29

Calling for Helpby Barbara Thbachnick,Client Services ManagerIf you are troubled, it can be agodsend to find someone totalk to. The better fortune(although no trouble would bethe best fortune) is to findsomeone to talk to who hasmade it over the hurdles youare just beginning to face.'Trauma survivors are living proof that people

can indeed make i t to the other side. They canbolster others with information; soothe withinspiration. They are a resource like no otherbecause they are, as Thomas Powell writes"fluent in the language of the problem."

Sixteen years ago, ATA decided to build abridge between those who needed support andthose who could give it. And so, our supportnetwork was born. A "network of one" at itsinception (a lone self-help group in NewJersey), it is now a national and internationalvolunteer collective. Some people sign on asgroup leaders, some as pen pals, some as telephone contacts. Hundreds have joined andretired from the network over the years.Thday, an ATA Self-Help/Support Networklist is sent to every new ATA member. (If you'vemisplaced your list, ask us for a new one.) Weencourage you to use it freely. And as you do,you might find that you connect better withsome people than with others. It's completelyunderstandable. Many of us go through severaldoctors, for example, before we find one whoseems to be a good fit.When and how to call for help

I t is acceptable to caU our support networkvolunteers between 10:00 a.m. and 7:00p.m.Some have noted special time preferences forreceiving calls. Check the listings. Please payattention to time zones if you are calling outsideof your own. (Note: the east coast is three hourslater than the west coast.) In an emergency, callyour doctor or local hospital. There is always away to speak with a physician, even after hours.

When you call for support but reach ananswering machine, leave a message. However,consider that children (and adults too) can accidentally erase calls, and machines can fail tocopy entire messages. Call the support personagain in a day or so if you don't hear back.

If you reach the answering machine of someone who is not in a free calling area, absolutelycall back another time. I f you want to be called"collect," say so on the message and leave yournumber. For most of our volunteers, it is financially out of the question to return long-distancecalls. Please remember that if it is long-distancefor you, it is long-distance in return.All manner of people call for support. Somewill call everyone on the list regardless of thedistance. Others want only to talk to a "local,"and on that front we can often oblige. (Manyvolunteers have joined our network to fill a localsupport network void.) Some people call only forinformation and inadvertently find friendship.One ATA member told me that while he has notyet used the list we sent him, he keeps it fo1dedneatly in his wallet and carries it with him at alltimes - jus t in case. Sounds to me like he uses itevery day.If you have the pluck and the heart and thetime to help others on the phone or as a tinnitussupport group leader, let us know. We could sureuse the help!

NewATA Support ContactsTo these and all of our wonderful volunteers, weoffer thanks, and thanks, and ever thanks.New Support Group Facilitators

Lee Gulley4318 Toll Gate LaneBellbrook, OH 45305937/848-7079andRuth Bradshaw937/783-4613

New Support Pen Pal:Vivien Oram


15/29

Tinnitus Survey Updateby Stefan P Kruszewski, M.D.

Since my first two art1c1es were published inTinnitus Tbday, more than one thousand lettershave come to me from national and internation-al locations. The response has been, unfortu-nately, overwhelming. I use the word"unfortunately" because the severity of theproblem and the ignorance on the part of themedical community remain significant. As ATAis already aware, we must do everything wecan to change the medical community's viewof tinnitus and its effects on individuals.I continue to try to do my share. I speak andwrite to individuals from around the countryand the world. I respond individually to everyletter. There is a reason for this. One, I believethat everyone deserves a personal response.Moreover, each story is different, necessitatingseparate replies. Having suffered with tinnitusfor over nine years, I empathize with all personswho experience this problem. I am still respond-ing to letters that I received more than oneyear ago.Along with many of my responses, J sentlengthy questionnaires regarding their tinnitus,hyperacusis, and their thoughts relating to theseproblems. The questions were detailed andcomprehensive. Perhaps as a measure of thedevastation of the difficulty, the response to thequestionnaires has been equally overwhelming.

The results of the questionnaires arepresently being tabulated and statistically ana-lyzed with the intent ofbeing published in anupcoming article. As I examine tinnitus in manyways, I might be able to help define commoncauses and remedies that could help others. As Icontinue to interview peoplewith tinnitus, I am struck,validated by the questionnaires,that this disease is multifactorial.

In terms of this disorderhaving multiple etiologies, I wouldlike to offer a sampling of commentsfrom the questionnaires thus farreceived. The following answers, in

response to "which situations make tinnitusworse,'' appear in at least 50% of the question-naires received:l . Stress and anxiety.2. Diabetes and hypertension.3. Any kind of hearing loss, with high

frequency hearing loss noted most often.4. Changes in humidity.5. Unexpected noises.6. Sudden weather changes.7. Cold weather.8. Increase in "ringing" following sleep.9. Significant life changes (divorce, bankruptcy,

retirement noted most often).10. Diets high in fat.11. Sedentary life styles.12. Earlier history of head injury.13. Earlier history of chronic loud noise ormusic, in recreation or in work.

These variables also appear in almost 50% ofthe answers thus far received:1. Most individuals can precisely date the onset

of their tinnitus.2. Herbs, such as ginseng and ginkgo biloba,work for some people but not for others.3. Most sufferers have seen at least five physi-cians, of which usually four are specialists.

4. Alcohol and caffeine provide variableresponses in individuals.5. Hyperacusis is often viewed as a separateproblemAt the end of March 1998, I will be doing my

final analysis of the questionnaires. In themeanwhile, if you would like a questionnaire(whether or not you have written to me previ-ously), please write or call me for one. I onlyask that it be returned to me as soon

as possible. The more information 1receive, the more information avail-able for analysis.Stefan P Kruszewski, M.D., is the

Medical Director of the Institute forBehavioral Health, 450 Washington Street,Pottsville, PA 17901phone 7171621-5016, fax. 7171622-7720.


16/29

A New Director -A New DirectionOregon Hearing Research Center's Alfred Nuttall, Ph.D.by Barbara Thbachnick, Client Services ManagerAlfred L. Nuttall, Ph.D., assumed a professorship and the directorship of the OregonHearing Research Center (OHRC) in the fall of1996. With it, he assumed the imposing task offilling the shoes of Jack Vernon - an icon quiterevered by tinnitus patients and clinicians alikefor his decades-long dedication to the study oftinnitus.How did Dr. Nuttall take to the task? Asany dedicated, nationa lly honored researcherwould- with great excitement. His two NIHfunded researchgrants came with

him from the KresgeHearing ResearchInstitute at theUniversity ofMichigan to OHRC.Both grants are funded for approximatelyfive more years. Thefocus of theresearch: studyingthe mechanicalresponses of periph

Alfred L Nuttall, Ph.D. ery hair cells in theOrgan of Corti, and investigating the blood flowto the inner ear.Will his research move us closer to understanding the mechanisms of tinnitus? Dr. Nuttallstrongly believes so. Below he discusses hisgoals for the Center and the future of tinnitusresearch in Oregon.

BT: Your research over many years hasfocused exclusively on the physiology ofcochlear hair cells and cochlear blood flow.Does tinnitus enter into the picture of yourresearch?AN: Although my work is not specifically ontinnitus, that is, the word tinnitus is no t in thetitle of the grants, the work is very important tothe understanding of various types of tinnitus.One branch of my research covers the basicphysiological mechanisms of the inner ear haircells, how they function, and how they are

the input they receive from nerve fibers.Changes in the response of hair cells in thecochlea - or the loss of the hair cells altogether- are very likely responsible for some forms oftinnitus. So research on hair cell mechanismswill definitely lead to an understanding of theforms of tinnitus pathology related to those haircells. Other types of tinnitus, like those thatoriginate in the central nervous system, mighthave entirely different mechanisms and myresearch doesn't cover that area.

BT: In one of your current research projects,you are studying the effects of salicylate on theblood flow to the inner ear. Tinnitus is a welldocumented result of excessive salicylate. Canyou project how your research wil1 further ourunderstanding of this?AN : Salicylate, like some toxic venoms, isone of those very interesting drugs that can behelpful or toxic depending on the dose. Drugslike these become research tools. For example,we know that salicylate affects the blood flow inthe inner ear, and has an independent effect onthe hair cells in the inner ear. Now we want toknow exactly how salicylate affects blood flow, ifthe changes in blood flow are linked to tinnitus,and if an abnormally low cochlea blood flowcauses or enhances tinnitus because of the concurrent effect of the salicylate on the hair cells.It's in these details that we will find some of theanswers.

BT: What have your studies shown regardinginner ear blood flow and endolymphatichydrops?AN: The study ofhydrops (or Meniere's disease) is difficult because there is no really goodanimal model yet for Meniere's that mimics allof the symptoms. Animals that are surgicallygiven endolymphatic hydrops have reducedhearing but no vestibular irregularity, which isthe most common symptom of Meniere's. Thenewest research on hydrops has shown thathydrops itself causes not only hearing changesbut changes in the reactivity to the blood supplyin the inner ear. The accumulation of fluid inthe endolymphatic space causes, as we know,


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A New Director


18/29

{(lbday"Show Gets Results!Thanks Due to All for Patience During Telephone Tie Up

by Cora Lee (Corky) Stewart,Program Development DirectorWhen the NBC uTbday" Show dida segment on tinnitusSeptember 15 it was "good news- bad news" personified!First on the "good" list is thatthey not only chose to do thesegment but that they involvedATA in the planning. Theyfilmed an interview with William Shatner and weprovided considerable background informationplus the names of several tinnitus experts aspotential participants. The producer chose

Stephen M. Nagler, M.D., F.A.C.S. to be in the studio fielding questions from the show's co-hostMatt Lauer. This, too, is high on the "good" list.Dr. Nagler is well-versed in tinnitus as both doctor and sufferer and has proven to be a popularand articulate tinnitus spokesman at ATARegional Meetings. Besides, even before he waselected ATA Director, he was an outspoken advocate of membership in ATA, so we were confidentthat he would cover all bases.We were no t disappointed. Mr. Shatner toldhow an explosion on the Star Trek se t left him(and co-star Leonard Nimoy) with tinnitus. Hedemonstrated the sound he hears and eloquentlyconveyed the gamut of emotions experienced bytinnitus sufferers, even admitting considering suicide before finding help. Using an ear model anda sound simulator, Dr. Nagler followed with a succinct explanation of us t what tinnitus is, how itcan sound, how it can happen, and the affects itcan have on the sufferer. Despi te the need to doso "quickly," he was able to tick off the fourthings a person should do if he or she has or'suspects having, tinnitus:"The first thing is to find a board-certifiedENT doctor, or an otologist, an ear doctor, who is~ T E R E S T E D in tinnitus, so you won't wind upWith the 'Go home and learn to live with it! Wedon't need that anymore. It's inappropriate,unacceptable. The second thing is to join theAmerican Tinnitus Association in PortlandOregon. Very, very important. You get floodedwith information and data. The third thing is toprotect your auditory system. Tinnitus doesn't

Sound is good for the auditory system. And avoidloud noises; protect yourself from loud noises.And the fourth thing to do is write to your congressman; we need money*. We need money sothat I'm out of a job. We need a cure. All we haveis very good treatment, but we don't have a cure."(* money for research. ATA receives no Federalf t - ~ . n d i n g ) Viewers did what Dr. Nagler said to do - theycalled ATA. That was very good. So what was"bad" about the situation? Telephone overload!As careful stewards of the funds entrusted tous by contributors, we keep operating expenses toa minimum by having just what is necessary todo the job (only one office, a small staff, volunteer support, etc.). We recently upgraded ourtelephone system to get greater voice mailcapabilities; under normal conditions (around3,000 calls a month) it will be adequate for several years. We are investigating alternative arrange

ments for the special occasions when it isstrained (such as the airing of the "TbdayN Show),but we are moving cautiously to minimize cost.Also, you don't just add extra lines at the snap ofa finger. And, even if you could, who wouldanswer them? And how do you know when you'llneed them? It's like a store gearing up for holidays - except that is a predictable event. We'reseldom aware in advance when such publicitywill happen or what sort of response it will generate. When we do have control, we encouragewriting to us; our response v.rill be just as fast.At any rate, even knowing about the 'JbdayShow in advance, we had to bite the bullet andmake do with our existing set-up which did,indeed, get swamped. From the first showing onthe east coast (5:30 AM our time), all eight of ourtelephone lines were filled and continued to befor the next three weeks. Many callers got busysignals; others were shunted into unexpected"mail boxes" and several were told by the automated attendant that the mail boxes were full.Understandably, a few got angry, but most persevered to eventually get through. In the first twoweeks, we processed 7,000 new requests forinformation (and even managed to talk with oneor two existing members as well).We greatly appreciate everyone's patienceand perseverence this time and for future "media


19/29

Toll-Free Really Isn'tMost of the calls received as a result of the11Thday" show came over ATA's 800 number.That means they were free to the caller but itis important to note that ATA pays for eachand every call on a per-minute basis.

Staff andvolunteers give

personalattention to every

ATA contact.

Robin Jennings, ATA MailServices Coordinator

Evelyn Peasley, ATAProgram Services Assistant

Cathie Glennon, ATADatabase Manager

Maia Dock, ATA'sSecretary/Receptionist

Arnold Kagan, Volunteer

BEQUESTS:Investments in ATXs Futureby Cora Lee (Corky) Stewart,Program Development Director

During the past year, ATA received proceedsfrom three bequests. Mary Rose Cami11eri ofManchester, Connecticut bequeathed theAssociation $85,529; Anna Sherman of ChevyChase, Maryland provided $3,000; and AdamDean Moser of Bradford, Pennsylvania includedATA in his will for $68,832.

ATA staffers were both surprised and saddened by these significant gifts. You see, thesewere three friends we didn't know we had. AdamMoser's membership lapsed in 1987; to the bestof our knowledge, Mary Camilleri only had contact with us in 1993; and we have no record ofany contact from Anna Sherman. That meansthey were probably no t aware of research andtreatment advances made in the past few yearsor of the expanded efforts of ATA. That makestheir validation of our work doubly appreciated.But because we were unaware of their intentions,we sadly never got to thank them.Everyone knows that the lives we lead are theresult of the choices we make - or don't make.Careers, relationships, and quality of life are fartoo often determined by the lack of a decision.Estate planning is a prime example of peoplemaking the choices they want rather than leavingeverything to chance. We all know this, ye twhether due to apathy, ignorance, or procrastination, few act. Seven out of ten Americans diewithout an up-to-date will.Estate planning options are many but theadvantage of doing it early is that you can oftenrealize financial and income tax benefits whilesupporting organizations important to you duringyour lifetime. Obviously, this would be ATA'schoice since we like to keep our membersaround. If you've already included ATA in yourplanning, please le t us know so that we can properly thank you. If not, we would be happy towork with you or your advisors in the development of a plan that best meets your personal andfamily objectives. Please write for information orcal1 503/248-9985 x18. (See also this issue's insertabout Year-end Gifts.)

You can be confidant that any gift, bequest, ortrust for ATA is a financially sound investment inthe future.


20/29

Questions and Answersby Jack A. Vernon, Ph.D.

As those of you who have written to meknow, I personally respond to every letter Ireceive. However, please understand that due tothe confines of space we just cannot includeevery question and answer in this column.

And thank you for writing! I hope each ofyou will feel free to continue asking questionsof me. I also hope that each of you will not beshy about providing answers to the questions ofothers.[Q] Mr. J. S. from California asks i f depression can make tinnitus worse and i f sowhat can be done about it.

Other patients have expressed the sameconcern about depression. In manycases the tinnitus is the cause of thedepression. However, Mr. S. had bouts of

depression prior to developing tinnitus. Thusin Mr. S.'s case, a treatment for depression isindicated. The question is how to treat thedepression without also making the tinnitusworse. As many already know, anti-depressantmedications that are in the tricyclic family canexacerbate tinnitus (temporarily). We thereforeoften suggest the non-tricyclic drug Wellbutrinfor depression.But I would like to bring to your attentionsomething I recently read in the BerkeleyWellness Letter. Their article, "A Better neat-ment for Depression," discussed the effect of aplain old weed called St. John's wort. (The word"wort" comes from the Old English word forplant and this particular plant was named for St.John because it blooms around June 24th whichis the birthday of St. John the Baptist.) Unlikemost herbal"remedies," St. John's wort has beenstudied extensively, albeit not in the UnitedStates. For example, present day AIDSresearchers are studying its possible antiviralactivity. Evidentially St. John's wort has beenused extensively for depression in Germany.One estimate indicates that in 1994 Germanphysicians prescribed 66 million daily doses ofSt. John's wort for depression. One study published in the British Medical Journal reviewed23 studies of St. John's wort, three of which

were directed at depression. The results indicated that St. John's wort was somewhat moreeffective than the usual drugs prescribed fordepression - including Prozac. There were noreports of serious side effects in those studies.There was also no evidence that St. John's wortworked against very serious depression. TheU.S. National Institutes of Health is planning anextended study of St. John's wort. The BerkeleyWellness Letter concludes that there is no reason why one should not try St. John's wort formild or moderate depression providing one doesnot take it in conjunction with other anti-depressant medications. The reported minor sideeffects include gastrointestinal discomfort,fatigue, dry mouth, and slight dizziness. Theactive ingredient in St. John's wort is thechemical hypericin. For interested readers,Drs. Bloomfield, Nordfors, and McWilliamshave written a book entitled "Hypericum andDepression." I t is published by Prelude Press(800/543-3101) in paperback for $7.95.

Ms. P. in New Hampshire indicates that St.John's wort has greatly reduced her tinnitus, butone flower does not make a spring. If any of youtry St. John's wort for depression, I will be mostinterested in the results and especially interested to know if it has any effect upon tinnitus.[Q] Mr. A. in Pennsylvania indicates thathe has heard about a microvascularoperation performed in Pittsburgh thatrelieves tinnitus. Can we provide any information about this procedure?The microvascular decompression

operation for tinnitus is performed byDr. Peter Janetta at the University ofPittsburgh Medical College, Department ofNeurosurgery, 200 Lothrop Street, Suite B-400,Pittsburgh, PA 15219, phone number412/647-6778. I discussed this operation with

Dr. Janetta and while I have great respect forhim, I came away from our discussion a bituneasy. The purpose of microvascular surgeryis to move small blood vessels that are impinging upon the hearing nerve. But I have not seenevidence that confirms the presence ofbloodvessels on the hearing nerve. And i f they are,


21/29

Questions and Answers (continued)was more successful for patients who had theirtinnitus for less than two years. Mr.A., do contact Dr. Janetta for more direct informationabout his procedure.[Q] Ms. R. in Illinois sent advertisements fortwo herbal remedies for tinnitus both ofwhich claimed that "thousands havefound relief' and that it '1stops ringing in theears." She also asks if the following have anyeffect upon tinnitus: burdock root, dandelionroot, echinacea root, kelp, aloe, goldenseal root,and/or slippery elm bark.

I have limited faith in items that havenot been through the FDA where safetyand efficacy can be tested and demonstrated. Indeed without FDA guidelines to fol-

low, there is no guarantee that the product evencontains the indicated contents. Most likely thisis an array of herbal treatments for a variety ofcomplaints, but to my knowledge none of themhave an effect upon tinnitus. Most likely, too,they will not hurt or help you so if you try anyof them let us know the results.

[Q] Ms. T. from Illinois asks if any thingis done for tinnitus patients whoseproblem was induced by a single loudsound? She also asks i f here will ever be a curefor tinnitus.First about the single loud soundproducing tinnitus. The damageproduced to the inner ear by loudsounds is a time/intensity affair. Very loudsounds even over short durations can producedamage to the inner ear and less loud soundover longer durations can produce similardamage. I t doesn't much matter which kind of

sound trauma was produced. The resultingtinnitus, which may be temporary, usually hasa high-pitched tonal quality. And as far as thetreatment is concerned it is the same. I confesshowever that sometimes I think the tinnitusfrom a single loud blast is more difficult torelieve i f one is using masking for the relief.Regarding sound trauma le t me remind you thatpeople vary tremendously in their susceptibilityto such damage. Some people have stone ears

others have paper ears and even slightly loudexposures can produce hearing losses and tinnitus. Of course there are all grades of toughnessin between. In your case Ms. T., the pistol wasfired offwith others around yet only you developed tinnitus causing me to conclude that theothers have tough ears and you have tender ears.Regarding the possibility of a cure for tinnitus, le t me say here that I am confident that acure will be found - at least for some forms oft innitu s - and that it seems to hinge upon technical advancements in brain scanning devices.[Q] Ms. A. from Minnesota indicates thatshe has tried the faucet test severaltimes bu t can always hear her tinnitusover the water sounds. Even when she tun1edthe radio on real loud in addition to the watersounds she could sti11 hear her tinnitus. "Why,"she asks, "does masking with external soundsnot work for me?"

Ms . A., masking does not work for everyone and you may be one such person.An alternative answer could be that youhave a hearing loss and that the hearing loss is

in the pitch region which corresponds to thepitch of your tinnitus. In this situation, you areunable to hear the part of the water sounds thatare required to mask your tinnitus. If your tinnitus is high-pitched and if you have a high-frequency hearing loss, then I would recommendthat it might be possible to mask your tinnituswith a tinnitus instrument which is a combination hearing aid and tinnitus masker. Since yourtinnitus seems to be in one ear for a time switching back and forth, it might be possible to useone tinnitus instrument (made by Starkey Co.)which can be shifted from ear to ear according toneed and with properly fitted ear inserts.Notice: Many ofyou have left messages requestingthat T phone you. I simply cannot afford to meetthose requests. Please feel free to call me on anyWednesday, 9:30a.m. -noon and1:30- 4:30p.m. (503/494-2187)Please send your questions to:Dr. Vernon c/o ATA, Tinnitus Thday,PO Box 5, Portland, OR 97207-0005.


22/29

THE SEARCH IS OVER!ANNOUNCING THE REVOLUTIONARY DTM-3

AUDIO CD TINNITUS MASKING SYSTEM" ..The DTM-3 effectively eliminates unwanted masking sounds below the tinnitus region,which to date has been the major fault with conventional masking. I am very enthusiasticabout the potential of this technology in the field of tinnitus masking."

Dr. Jack Vernon - leading authority on tinnitus masking

Petroff Audio Technologies announces amajor breakthrough in tinnitus maskingtechnology - the worlds's most advanceddigitally filtered tinnitus masking system.Recentlypresentedanddemonstratedatthe American Tinnitus Associationregional meetings in California, a highpercentage of attending physicians,audiologists, and individuals withtinnitus found that this new digitalsystem masked (sonically covered)tinnitus to their utmost expectations.A common observation was that thetechnology effectively masked tinnitus atsignificantly softer and more comfortablevolume levels than conventional maskers ornature sound devices.Another important system feature is that itproduces a spatial sound field thatseemingly surrounds the listener and furtherdistracts attention from tinnitus.These technological processes have beencaptured in a series of three carefullyrecorded audio COs, which operate onvirtually any CD player using eitherspeakers or headphones.

Three COs function together as acomplete system to provide optimummasking results under various daytimeand evening conditions.CD #1 "Digital Masking" provides fivedigital masking "ranges" intended fordaytime use while you may be involved inother activities. It is probable that several ofthe masking ranges are appropriate for yourtinnitus.CD #2 "Digital Masking & Relaxation"provides five digital masking rangescombined with relaxation messages andgentle nature sounds suitable for daytime orevening masking and relaxation.CD #3 "Digital Masking & Alpha-rhythms" provides five digital maskingranges in combination with relaxationmessages and alpha-rhythm sounds (anadvanced sound relaxation technique) foroptimum evening masking and relaxation.The end result is a cost-effective, simpleto-use system that provides advanced newtechnology, remarkably comfortable tinnitusmasking and a variety of pleasing audiorelaxation techniques.

Sales pending FDA clearance. For further information or a technical brochure, pleasecontact Petroff Audio Technologies, 6520 Platt Ave. #813, West Hills, CA 91307,


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Reducing Tinnitusby Gary Graybush

Some part of my auditory system was damaged in 1993 after a severe reaction to a prescription medication. That's when my tinnitusfirst started. There are now many physiologicaland environmental factors that affect this damaged area that did not affect it previously. To theextent that I can influence these factors I amIable to reduce the severity of my tinnitus which,at its worst, prevented me from working.Because of the damage to my audi tory system, pressure changes (internal vs. external ear)that were automatically balanced in the pastappear to be not so automatically balanced now.Meteorlogic, climatic, elevation, and situationfactors now become more influential. For me,high pressure weather systems are better thanlow pressure systems. Warm temperatures arebetter than cold temperatures. Low altitude isbetter than high altitude. (There was an immediate and significant reduction in my tinnitusupon moving from the mountains ofPennsylvania to the sands of Florida.) Normalblood pressure is better than elevated bloodpressure. Even relaxed facial muscles are betterthan tense ones. A lack of physical activity andfresh ai r are factors. Anything that affects theblood flow in my auditory system is now a factor. Anything.Based on my personal observations andextensive reading (Fit for Life, Rodale's CompleteBook of Vitamins, and more), I am sure that thefood I eat has a significant impact on many ofthe above factors. For example, saturated fatintake has a negative influence on me. So, too,cholesterol. Keeping my sodium intake to aminimum is also important. I've become a strictvegetarian (no meat, fish, dairy) and haverestricted my intake of simple carbohydratesand any foods that are processed or chemicallytreated. The vitamins and minerals that I needI get from my food selection and vitaminsupplements. I focus on vitamin C E the BI Iseries, zinc, beta-carotene (for vitamin A), potas-sium, magnesium, and iron. In the morning Ieat fresh fruit. Through the rest of the day I ea twhole grains (oatmeal, brown rice), pasta, pota

Food For Thoughtbuild up energy for activity and reduce energyfor rest. My "calorie from saturated fat" target isalways "as low as I can go.'' I drink distilledwater and caffeine/sodium/alcohol-free beverages. Eating like this away from home is sometimes a challenge. But I do it. There is alwaysa way. In a non-tinnitus situation, I might nottake such a strict stand. But since tinnitus isso relentless, I have to be just as relentless.The healthier I eat, the better I feel - with aseemingly parallel improvement in my tinnitus.I've learned that some medications canadversely affect tinnitus. I used to take medication for anxiety (partly due to tinnitus) but itproduced so many side effects that I had to stop- fortunately for me in retrospect. (If you aretaking medication, consult your doctor on this asI did. Note, too, that some vitamins and somemedications might not be good in combination.)In addition, I've tried to discipline myself toreduce stress and anxiety in natural ways, byremoving myself from negative situations thatI cannot change, by making time to slow down.The result has been less stress = less tinnitus =less need for medications = more natural waysto good health = less tinnitus.

What I am doing is not a quick fix becauseI believe it will take months and years to slowdown, stop, and reverse some of the damagingprocesses that have been going on in my bodyfor years and perhaps decades. The combinationof the stress in today's world, difficult individualcircumstances, and poor nutritional habits mayhave set many people up for a variety of maladies, like tinnitus. I still have tinnitus, but it hassteadily improved from the "dark days" of thepast. I think that my unwavering commitment toimplementing the theories and information thatI have acquired has resulted in that improvement. But I have been through enough withtinnitus so far to know not to be completely sureabout anything with regard to it. I t still can beannoying for reasons beyond my understanding,and my life is still affected by the restriction itimposes. I believe I am following some goodleads but I'm sure I only know half the story.


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On the Road to ATAAwarenessby Pat Daggett, Administrative Director

Entertainer Engelbert Humperdinck discussed his tinnitus in the September issue of"Las Vegas Style" magazine, which I happened toread while representing the ATA at this year'sInternational Hearing Society (IHS) Conventionin Las Vegas. I immediately directed informationabout the ATA and its services to him and hope

that we v.rillAmerican Tinnitus Associattoi be able to

Pat Daggett, left and Malvina Levy

enlist hissupport inthe future.TheiHSconventionitselfincludedapproximately 1100hearing aidspecialist registrants, with more than 2,000 totalattendees, including family members andexhibitors. The ATA booth was busy, with lots of

interest in our new brochure, "TinnitusTreatments - What's New, What Works"designed for hearing professionals.At the close of the II-IS Convention, I metGloria in San Francisco for the lOlst AnnualMeeting of the American Academy ofOtolaryngology (AAO). There was a strong international representation in the 9,000 plus registrants for this event and the ATA booth wasstripped of all available printed materials!Approximately 1,000 new contacts were added tothe mailing list. Again, the new "Treatments"brochure was popular.Pre-exhibit opening events included a meet-ing of the International Tinnitus Forum, whichfeatured a panel discussion on "IntratympanicDrug Therapy."

Also, during the AAO meeting inSan Francisco, the ATA Scientific AdvisoryCommittee met to discuss the current programsand projects included in the new Strategic Plan,as well as research proposals. I t was agreed thatan effort will be made to obtain approval ofinsurance coverage for tinnitus tests, assess

I was asked to participate in Malvina Levy'ssupport group session, held at her clinic in SanFrancisco. I t appears to me that this group illustrates how people who experience tinnitus aremaking an effort to learn as much as possibleabout their condition and how this informationapplies to their specific case. This group haddone its homework.

The third week in September found me andmy husband, Walt, in Chicago, at the AmericanAcademy of Family Physicians annual convention. Although physician registration was atmore than 6,000, the location of our booth(away from the main traffic flow), as well asmiscommunication with the service staff in theexhibit hall, made for a frustrating experiencecompared to previous years. Although the family physicians had a difficult time finding us,those who did were enthusiastic and eager totalk with us. Hopefully, next year the meetingwill be functioning at its previous high standards- at least from our point of view!While in Chicago, I did get the opportunityto meet with Cheryl Raisenen's support groupand ATA Board members Sid Kleinman andMegan Vidis. (The new Vidis baby, Eli, sleptthrough most of the activity at a local Chineserestaurant and was admired by all.)

The myriad details involved in this kind ofoutreach get somewhat easier with experience,(airline and hotel reservations; application forexhibit space; ordering of furnishings for thebooth; shipping of display and materials; assembling display and manning the booth; etc.) bu teach location seems to have its own nuances.The challenge to have everything come togetheras planned is ongoing but when it does, it's asatisfYing experience. Look ou t world, we're outto get your attention!!

Welcome to the WorldEli Vidis NewmanBorn 8/4/97, 6 lbs., 8 oz.,20 in. long, very dark hair.Congratulations to ATA


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SPECIAL DONORS and TRIBUTESATA's Champions of Silence are a remarkable

group of donors who have demonstrated their commitment in the fight against tinni tus by making acontribution or research donation of $500 or more.Sponsor Members and Professional Associateshave contributed at the $100-$499 level. ResearchDonors have made research-restricted contributionsin any amount up to $499.

acknowledged with an appropriate card to thehonoree or family of the honoree. The gift amount isnever disclosed.

Our heartfelt thanks to all of these specialdonors!All contributions to the American TinnitusAssociation are tax-deductible.

ATA's Tribute fund is designated 100% forresearch. Tribute contributions are promptlyGIFTS FROM 7-16-97 to 10-15-97.

Champions of Gladys Justin Carr Joseph Koppelman Alfredo C. Teti Maur ice H. Miller,Silence Frederick W. Champ David J. Kovacic Wesley J. Thren Ph.D.Kenneth R. Cherry Marianne M. John D. Tormedis John T. Murray, M.D.(Membership Gary R. Chirlin Krockover William R. 'Ibwer, Jr. Carl M. Nechtman,Contributions of$500 Donald J. Cook Marie J . Kunkel Dan Vallimarescu M.D.and above) Daphne Suzanne Paul Lembo Megan Vidis Meredith K. L. Pang,Joe H. Anderson, Jr. Crocker-White, Gary E. Lanterman Eugene P. Vukelic M.D.Matthias B. Bowman Ph.D. Dr. Herbert A. Levin Linda A. Wainhouse Milagros E. Rios-Rob M. Crichton Mary Kay H . Davis Sondra Limeburner Thomas K. Webb Walker, M.A.,Michael D. Deakin, Richard S. Dirkes John R. Lucas Rita Weisner CCC -AC.P.A. H. Renwick Dunlap Joe Luoma Dr. T. Marty J. Lewis Romett, M.D.Philip Espinosa Joseph H. Eagan Romulus E. McCoy, Jr. Whiteman, David J. Sand, M.D.,Ray Faragher Josephine M. Elias Thomas F. McNulty Treasurer Clayton F.A.C.S.Jean and Lou Fockele Jeffrey A. Ferenz Richard L. Meiss School Employees Jeffrey R. SchlesingerGordon Family James and Donna F. N. Menalls Foundation, Inc. Patricia SimonettiFoundation, Inc. Fijolek Mr. and Mrs. Charle s Barry Whitesell Helena Solodar, M.S.Ronald K. Granger BrianT. Fitzpatrick Moon Bryan B. Williams Donna S. Wayner,Christopher v. Julius Flores, ll James C. Murphy Christopher R. Wilson Ph.D.Houghton Martin E. Fossler M. Frank Norman Gladys C. Young Harold Wenger, M.D.Marian B. Lovell Howard L. Franques, Teresa L. O'HalloranProfessional

James F. Wuth,Adam Dean Moser Jr. Thomas R. Ogren M.S .P.A.Dr. and Mrs. Jack B. Janice Garfinkle William Lee Parker, Sponsors Corporations withagler Perry Gault Ph.D. (ProfessionalMichael O'Malley, Robert Gilliam Bobby R. Payne Membership Matching GiftsO.D. L. Kirk Glenn Harvey A. Pines, Contributions from American ExpressAnn L. Price Nancy Gliko Ph.D. $100-$499) ARCOSponsor Members Andrew Good Chris Pracht Nancy J. Ahrens, B.C .- BankAmericaJane Green ,Jerome A. Rich H.I.S. BP America Inc.(Membership William N. Guill Beverly and Mel Ronald G. Amedee, John Hancock MutualContributions from Robert R. Harmon Rosenthal M.D. Life Insurance$100-$499) Avis L. Hartley Andrew J. Rosser AJan J. Arnold, M.D. CompanyFrank R. AJloccaPatcy Andrews AJfred E. Heller Emest Sagues John Seymour Berry Johnson & JohnsonSaul Hertzig, President Jack Salerno Bruce S. Bloom, M.D. Family ofJohn J. Banavige Charles Hertzig Edward R. Samuels Natasa Bratt, M.S. CompaniesIvan H. Behrmann Foundation Jean L. Schmidt Neil M. Daniels, Ph.D. J.P. Morgan & Co.Fran Belkin Manny Hillman Marlene K. Shaw Stephen Epstein, M.D. IncorporatedM. Craig Bell Max Horn Terry N. Sherman Jack R. Erwin, M.D. Reader's DigestWilliam D. Bethell Larry C. James, Jr. Marshall C. Smith Elio J. Fornatto, M.D.Jean A. Black Edith J. Johnson Peter F. Smith Chris B. Foster, M.D.Mario J. BonelJo L. Craig Johnstone Raymond and Sylvia Soraya Hoover, M.D.,Ronald R. Bowden George C. Juilfs Smith 1Seng Hung-Cheng,Charles T. Brown JoAnn Karkenny Ronald Snow M.D.Leffie Burton Lois S. Keeney Martin V Socha PaulJ. Jones, M.D.Ellen M. Camp Waldemar Kissel, Jr. Rkhard H. Spencer Robert J. Kohlenberg,William J. Knight Walter P. Strumski Ph.D.


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SPECIAL DONORS and TRIBUTES (continued)TRIBUTESIn Memory OfLouise BarrowsKen and GundaArf.c;tenJohn E. Greve(Birthday;Joanne'stwin brother)Jim and JoanneCooperRosalyn Miller(Mother)Sylvia EisenbergSusan MorelandStephen M. Nagler,M.D., F.A.C .SKen OtrembaMr. and Mrs. John H.SchleterSylvia SelzerSylvia EisenbergWilliam SiegelMrs. Betty FriedmanIn Honor OfJoseph G. Alam(Birthday)Rosalie and Jim TraverEd Connolly (Roadto Winning)Ed Connolly, Jr.Pawel J. Jastreboff,Ph.D., Sc.D.Stephen M. Nagler,M.D., F.A.C.S.Stephen M. Nagler,M.D., F.A.C.S.Dr. and Mrs. Jack B.NaglerEl i Vidis Newman(celebratingbirth of )Board of Directors ofthe AmericanTinnitusAssociationStephen M. Nagler,M.D., F.A.C.S.Megan VidisRobert E. Sandlin,Ph.D.Stephen M. Nagler,M.D., F.A.C.S.Jack A. Vernon,Ph.D.Stephen M. Nagler,M.D., F.A.C.S.Susan Partin

RESEARCHDONORSRobert H. and ArleneAdamsSally A. AndersonBeti E. ArgunMarilyn J. AshFrank AsteritaSylvia AvilesLaverne BachmayerJ. C. BakerPaul B. BakkomJoshua S. BarclayNancy L. BardachColleen BeckmanChristine L. BellSu7.annP. BP-rryMajor Joseph BersonLonnie BlackwellDiarmuid BoranBernard J. BorkFay W. BotnickRichard T. BrandAgnes BraunKaren L. BurkeHelen S. BurkeyMichael W. BurnhamMaria Helena Untura

CaetanoTimothy P. CaireElaine CandiotteJohanna K. CarmassiPauline S. CaylorDavid S. C. ChewDaniel E. Clifford,D.D.S.John F. CokerDonald J. CookDale L. CrawfordKathleen M. CreelyWendy CsokaGlen R. CuccinelloSarah D. DavisMarian R. DawsonAngela F. DelvillarMary T. DempseyMichael J . Denson,B.C.-H.I.S.Floriana DifabioLynn DitlovePatricia S. DostalekOtto J . DrescherDoyle K. Ellis, Sr.Eugene C. EdminsterRobert W. EichertDoris M. EiswertMaxine EldonDoyle K. Ellis, Sr.E. Lillian FeldsteinBetty L. FerdinandJoseph W. Fe1ioli

Harriet L. FlaccusAnn D. FoleyFranklin L. FountaineMary L. FrancisHoward L. Franques,Jr.Rex L. FrazerJune A. FreedmanIsaac FrishmanJack C. FullerRichard J. GambateseJoel Garris, M.D.Patrick J. GibbonsGillett Hearing AidCenterEd GiosciaJanet M. Gnall, Ph.D.Robert A. GoldJames P. GriffingGregory W. GrimHugh Groganlhrahim HamidehRobert W. HamiltonClayton R. HarrisJames and ColleenHartelNancy A. HartnettMargaret H. HartweinMaurice H. HeinsMargaret P. HeppeVincente G.HernandezE. Alan HildstromBill K. HissamGeorge R. HoffmanBetty L. HolidaySuzan M. HousworthMartha B. HuntMartha E. IacobucciRein IseCyril D. Ja1onRuby JamesRita Grethen JarrardMrs. Eldred M.JohnsonGeorge C. JuilfsJo Ann KarkennyHoward R. KatzR. L . KeheleyDonna KingstonWaldemar Kissel, Jr.Catherine C. KnightonPeter KobelanskyMichael D. KrouthCarol N. KulpRobert LabertewWilliam J. LandoltJudiS . LaneNorman J. LawPhillip W. LazierJanice M. LearyLorraine L. Lewis

Monique LiphamDuncan Macinnes, Jr.Walter W. MalinowskiRobert B. MarcusArlene G. MargolisTed MaupinMary J. McAlindonMartha M. McCardellTommy D. McComasRobert E. McGormanMary Lou MikowskiP. June MillerFrank R. MoreaMichael G. MorenCharles R. MoretzJulie MorinDonald Lee Morris, Jr.Arthur E. MyersEmil NatelliJackie NelsonJerry E. NorrisThresa L. O'HalloranJoseph OpitzCharles F. OrlofskyJohn K. OscarsonMichael F. OteroRoxanne G. ParkerWalter PedersenJean A. PinkepankMarilyn E. PriggeMary T PughVictor PultmanRobert PumarejoMajor Leonhard RaabeRuth RasorGeorge A. RebhDouglas E. Rehder;M.A., CCC-AGeorge ReimerGeraldine ReutherJudy T. RobinsonJoann J. RozierJoan M. SchadJennie M. SchlmnoskiJohn F. SchmidtJ. D. ScroggieRaphael F Segura, Jr.Calvin SelfGloria E. SennoErvin SeppRobert M. ShamesCharles SikesC. Daniella SiroskeySandy SlutskyDawn T. SmithPatricia A. SmithPatricia M. SmithRuth T. StanwayRoland 0. SwansonAlbena TenukasDavid A. TheisenVi T. Thurmond

Dan TonkelMay TorenJohn D. TormedisJean E. TowleStephen P. 'ItostorffMartin J. UnderhillThomas E. Underhill,D.D.S., M.D.Donald A. VassalloRichard W. VeeckWayne F. WallaceTim C. WallerNancy WatersIda Virginia WeimerMarvin S. WeinrebElaine WeissDaniel J. WenzMarcye B. WhiteBarbarajene WilliamsBryan B. WilliamsMadeline G. WoodruffStephane W. WrattenRichard W. WrightShirley A. WrzesinskiDoris E. YantisCecilia YeoHerman YoungRobert YoungRobert L. YoungKathy ZachokMarilu Zrimc


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Happiest ofHolidays

AMERICAN TINNITUS ASSOCIATIONP.O. Box 5, Portland, OR 97207-0005Forward and Address Correction


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'Tis theThe Holiday Season . . . a time ofgood will ... special remembrances . . . greetings fromfriends . . . and a flood ofrequests for contributions.You won'tfind an ATA appeal in your mailbox. It's not that we don't need contributions -we certainly do (the Association's existence depends on them), but we honoryour pastsupport too much to spend any of t on extra expensive mailings.B e s i d e s : ~ we believe you are already committed to the fight against tinnitus and will givewhatyou can to ATA withoutpersistent nagging from us.That said, we would like to point out the benefits - to you - of lanning charitable gifts,both present and uture.

T A X A D V A N T A G E S :


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ATA is a 50I(c)(3) organizatiotl which means tha.t al l donations it receives are tax-deductible; such gifts ar voluntary,without expectation ofanythitlg tangible itl return.

We know that ATA supporters contribute oo t for personal tax considerations but because they believe in the work rheAssociation is doing. However, we would be remiss if we didn't point our that there truly are sigoificanr tax advantages forqualified charitable donations. As an example, if you are in the 28% tax bracket and have given $5000 ro ATA during1997. you will save $1,400 on your taxes. Other savings when you file your tax return:

A GIFT TO ATA OF: $1,000 $ 1500 $2,000 $2.500 $5,000 $10,000J..ETS YOU OEDUCf: $280 $420 $560 $700 $1,400 $2,800

Your gift can be the accumulation ofseveral donations throughout the year, bur ro take advantage of the deduction, itmust be given by December 31 - t h i s is what prompts the flood of year-end appeals from charitable organizations.

Y O U R G I F T T O ATA C AN T A K E M A N Y F O R M S :X Giviog CASH (by check or charged ro your VISA or MasterCard) is the obvious and easiest way to show your suppon

while realizing immediate tax benefit.X Transferring appreciated SECURITiES or STOCK can be one of the more advantageous ways of contributing. If owned for

more than one year, the deduction taken can be for the full fair market value of the srock (in addition, capital gains taxesare bypassed).

X TRUSTS permit truly planned giving and can even include the ability to derive immediate benefits for you or your F.unilywhile providing immediate or later benefits for ATA. The variety of options for trusts are many - bur a financial or legaladvisor can help you design one char best firs your needs.

X Including ATA in your WILL is the way to perpetuate your support ofATN.s efforts o n behalf of tin nitus sufferers. Withinyour will, a bequest can be of a stared dollar amounr, specific property, or a certain percentage of the residuary estate. Wecan provide you with a sample statement that can help execute the document that will accomplish your personal objectiveswithin the laws of your state.

X BENEFICIARY DESIGNATIONofATA is another way of providing for a furure legacy without changing your will. Thiscan be done with your life insurance policy, IRA or other retirement plan, or savings account (spousal consent may berequired). You can even provide lifetime income for family members by leaving retirement assets in a trust that eventuallybenefits ATA.Any gift, bequest or trust for ATA is a financially sound investment in the futzere. we will be happy to work withyouand/or your advisors in developing a mutually beneficial and satisfling plan.

This information is based on d:u3 available at priming: it does not constinue legal or financial advice :md should noc be rdjed upon as a $Ubsticmc: for profess ional counseL

Tinnitus Today December 1997 Vol 22, No 4

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Transcript of Tinnitus Today December 1997 Vol 22, No 4