TINNITUS NEWS DAILY - Tinnitus and Veterans
Did you know?
Tinnitus is the No. 1 service-connected disability among veterans returning from theMiddle East conflicts. In 2008, compensation for tinnitus disability in the VA medical system alone exceeded $500 million and is projected to exceed $1.1 billion and affect more that 800,000 veterans by 2011.
Veterans and Tinnitus
Wounded Soldier Needs Help to Get Dog
Published : Friday, 03 Jul 2009, 9:40 AM EDT
Edited by Steve Dixon
DOUGLAS COUNTY, Ga. - Combat medic Brian Hall was a soldier with E Troop, 108th Cavalry of Georgia's Army National Guard 48th Brigade.
On September 13th, 2005, Hall was injured inIraq by an improvised explosive device (IED).
Hall received a severe head injury which put him into a coma and on a ventilator for about three weeks. Hall has had five surgeries, has a drain in his brain cavity, and plate replacements for portions of his skull.
Hall also suffers fromtinnitus (ringing in the ear), hearing impairment, blood clots of the brain, a heart condition due to the blast trauma, double vision, and many other afflictions as a result of the injury.
The last three years have been a struggle for former combat medic.
"I didn't fully comprehend how bad I was, till the President pinned the Purple Heart on my chest. It was surreal," said Hall.
What have followed are several surgeries -- he has a plate in his head, remains sensitive to light, is often in pain and fatigued.
"It was really bad when they were having construction in our neighborhood and I'd hear the banging of hammers and it would throw me into panic attacks -- sometimes flashbacks," said Hall.
Hall's wife, Jessica, said, "He has short term memory issues. So he can't remember certain things. When he first came home, he had to have a list of brush your teeth, shave, put on clothes and he'd have to go down the list."
Out in front of the Hall home is a flagpole - placed there two years ago by friends and family members. Hall said he tries to raise and lower the flag everyday in memory of the men he lost inIraq.
In addition to the recognition Hall has received for his service, friends are trying to raise $6,000 to provide him with a service dog. The dog would help him get through his day.
"The dog would be trained to wake me up, to turn on lights and reorient me to the environment I'm in," he said.
Jessica said, "The dog comes in the house ahead of you and it's supposed to come in, turn the lights on, walk around the house, basically clearing the room, just like a soldier would."
Doctors recommend that he obtain a psychiatric service dog to aid him in his daily life.
The House of Hoytt -- a kennel that raised war dogs for the Army during World War II andVietnam -- is willing to provide a psychiatric service dog to Brian for $6,000, which is half of their normal fee.
The dog would be nationally registered and able to go everywhere with Brian.
Douglas CORE -- a not-for-profit organization associated with Douglas County government -- needs 600 people to donate $10 each to pay for the needed service to Hall.
Donations are tax-deductible. Checks may be made payable to Douglas CORE. All proceeds will go towards the purchase of T-Rex, a Doberman service dog who is being trained to assist Brian, and who will be ready by late summer.
Donations may be mailed to: Douglas CORE8700 Hospital Drive
Douglas County Courthouse
Hearing Loss No. 1 Diagnosis forU.S. Soldiers inAfghanistan
A U.S. Army soldier with 1st Battalion, 32nd Infantry Regiment, 10th Mountain Division, fires at insurgents attacking from the hills surrounding the remotevillage ofBarge Matal during Operation Mou
U.S. Army Spcs. Patrick Wilson (left) and Evaristo Garcia fire a 120 mm high-explosive mortar round during a coordinated illumination exercise at Forward Operating Base Mizan,Afghanistan, on Sept. 2
Air Force Col. Joseph Brennan (l.), the ear, nose and throat doctorat theU.S.-runStaff Sgt.HeathN.CraigJointTheaterHospital demonstrates how the portable hearing test machine works
Stephen Franklin, retired Air Force navigator turned rocket scientist, provided engineering oversight for the rocket that launched the Lunar Crater Observation and Sensing Satellite, or LCROSS, which
When gearing up for a mission inAfghanistan, a service member wouldn't dream of forgetting their helmet, gloves, weapon, eye protection or body armor. But what about hearing protection?
According to Air Force Staff Sgt. Lee Adams, an ear, nose and throat (ENT) technician at Bagram Air Field, more than 50 percent of the patients seen in the ENT walk-in clinics are there for hearing-related issues.
The first question I ask a patient who comes in with a hearing complaint is, 'Were you wearing hearing protection?' says Air Force Col. Joseph A. Brennan, the ENT doctor at Bagram. Since I arrived here in May, I have not had one service member answer yes to that question.
Deployed service members are exposed to many dangers while in combat zones. According to Brennan, many troops do not use hearing protection while out on missions because they feel that the hearing protection negatively affects their ability to do their job and complete their missions.
I was inIraq in 2004 and 2005 in Fallujah, with the Marines and the Army's 1st Infantry Division and we just couldn't get folks to wear their hearing protection, said Brennan. We understand. It's like the old Army helmets: soldiers were complaining they couldn't shoot with them. So even though they offered better protection, which as a doctor is what I care about, the fight is most important.
While in Iraq, Brennan saw more than 600 outpatients in an ENT clinic, and hearing loss was the No. 1 diagnosis there, just as it is today in Afghanistan.
When service members are exposed to loud noises such as improvised explosive devices (IEDs) the primary cause of hearing loss in bothIraq andAfghanistan they are at risk of either conductive or sensorineural hearing loss and tinnitus.
Conductive hearing loss can usually be fi xed surgically, with the causes ranging from damaged ear bones to wax in the external canal of the ear. In sensorineural hearing loss, the nerve in the inner ear has been damaged. There is no way to surgically fix this and the only treatment is hearing aids.
Tinnitus is another form of hearing damage. It is a ringing or whining inside a person's ear that can result from damage to the nerve.
There are two forms of tinnitus: objective and subjective. If a person has objective tinnitus, the sound inside the ear can be measured with a device used by ENTs. With subjective tinnitus, only the person with tinnitus can hear the sound - it is not measurable in any way.
There is no cure for tinnitus. Tinnitus can be masked, however. A tiny device, a type of hearing aid, replaces noise caused by tinnitus with a less annoying, more natural sound inside the ear, according to Brennan.
Another common problem is blown-out eardrums, which can heal on their own. A hole in an eardrum is considered a form of conductive hearing loss. This means that sound is not reaching the nerve in the inner ear that transmits sound to the brain.
InIraq in 2004, there was a soldier who was in two IED blasts. The second explosion really blew out his eardrums and he could not hear a thing, said Brennan. The soldier's sergeant and his fellow soldiers were on a rooftop in a firefight. The bullets were buzzing by his head. His sergeant had to tackle him to get him out of the line of fire, because the soldier couldn't hear his comrades yelling for him to take cover.
According to Brennan, this story demonstrates why hearing protection is so important to soldiers. A hearing-impaired soldier not only puts himself in danger, but also his fellow soldiers.
Even if a person suffers hearing loss in only one ear, they can still be a danger, says Brennan. Their hearing directionality is impaired, and they will not be able to tell which direction a sound like a whizzing bullet is coming from.
Since hearing damage affects the safety of military personnel and others around them, soldiers with hearing loss can be discharged from the military or forced to re-classify into a different job specialty, where they won't be exposed to loud noises that could further damage their hearing.
Active-duty personnel who have combat-related hearing loss receive hearing aids, and after they leave the military, the Veteran's Administration provides the service member hearing aids as needed, Brennan said.
With IEDs being the number-one problem for Coalition forces inAfghanistan, it is no surprise that IEDs are the No. 1 reason for hearing loss among service members. Service members need to protect themselves from this very real problem and new technology is always being developed to help in the fight against hearing loss.
The best kind of earplug, which the military is actually working on at the Air Force research lab on Wright-Patterson Air Force base inOhio, uses what is called active hearing protection, Brennan said. A person would wear this device on the inside or outside of their ear. For instance, if you were walking through the woods, this earplug would amplify the sounds around you, but the moment the noise reached a harmful level, the earplug would protect your ear and eliminate the sound, essentially plugging your ears.
This new form of earplug is ideal because it increases a person's awareness, but also protects the service member's ears. Normal earplugs employ what's called passive hearing protection. They have the same effect as plugging your ears with your fingers, according to Brennan.
Hearing protection is just as important to aU.S. military service member's safety as their body armor and helmet. A soldier who suffers severe hearing loss could find his career ending as quickly as if he had suffered other combat-related injuries. Military personnel should listen to their leadership about wearing proper hearing protection while they can still hear the warnings.
It's Not Rocket Science
Smart Veterans Seek Better Hearing
BY Michael Ream
Even as the military hopes to develop more effective hearing protection, the noise of war in particular, blasts from improvised explosive devices (IEDs) can still easily shatter eardrums and cause hearing problems.
Many veterans who were fortunate enough never to be in the line of fire are nonetheless finding, years after their service is over, that healthy hearing was part of their sacrifice for our country. One such veteran is Stephen Franklin, 59, who served on active duty for 20 years after graduating from the Air Force Academy in 1972.
Franklin currently works as an engineer at United Launch Alliance, a Colorado-based company that helps launch spacecraft. He is part of an eight-person team that puts together test launches and addresses every potential problem with an upcoming launch.Franklin is also representative of many veterans because, with intervention such as wearing hearing aids and using assistive listening devices, he has been able to improve his hearing, enabling him to function better in his job, enjoy time with his family and have better quality of life.
Franklin recently spoke to Hearing Health about dealing with his hearing problems:
It was a gradual thing. When I was in the Air Force, I was around loud planes, loud cars and even louder music. Typical young man stuff. I think all that together just wore my hearing down. There was no specific incident that caused my hearing loss.
I flew for 10 years in a KC-135. It's an aerial refueling aircraft. I traveled a great deal and had a lot of fun! We always had headsets and we also wore those little foam earplugs. But that jet was very loud. I don't know the numbers but I know it was one of the louder jets, based on the fact that it was pretty much hollow inside except for the fuel tanks. So it was a loud plane.
When I was in my 30s, about the time my career was finishing up, passing the flight physicals was a bit more of a challenge. I had to really struggle to make sure I could pass the hearing test.
In a conference-type setting, when I was in a large room and someone would be speaking from across the room, sometimes I didn't hear every word that was said and I'd have to have them repeat it or speak up, or embarrass myself by responding to what I thought I heard. Not a good thing to do!
Franklin noticed hearing problems at home as well.
The first thing I noticed was, sleeping on my right side versus my left side, the ambient noise in the room was different. I noticed that when I slept with my right ear down, it was quieter. That became more pronounced as I got into my 40s. By that time, I was wrapping up my Air Force career, and I was no longer flying; I was doing command and- control-type work.
I think it was just a progressive change as I got into my 40s; the higher range of hearing was noticeably missing. I was turning the television up and I noticed I had to focus on people's faces a lot more when they were talking.
After suffering from hearing difficulties for several years,Franklin consulted an audiologist. He was diagnosed with high-frequency hearing loss in both ears.
In 2002, I think, when I was living inCalifornia, I saw an audiologist, knowing that I did have a problem, but just to verify how bad it was. I was surprised that both ears were impacted. Since I didn't have any information to go on, I thought it was just one-sided.
When I saw the results of the hearing test, I tried different types of hearing aids and I did not like the in-the canal type because of the sensation it gave me. So we settled on a pair with behind-the-ear design. They were much more comfortable to wear and maintain. Those were Phonak hearing aids.
Franklin stopped wearing hearing aids in 2006.
I really wasn't happy with the performance, so I was wearing them less and less and then I stopped wearing them altogether. Looking back, it was just correcting a narrow band of hearing so that the full spectrum wasn't being treated and I found that bothersome.
My hearing problems were a little bit worse, but I just dealt with it which was selfish thinking. Conversations at home with my wife and television volume had to be much louder than were comfortable for her, because it was hard for me to hear. I would sit about twice as close to the television as she did. These are the things I had to do to cope.
Franklin switched to his current hearing aids in early 2009.
I use Siemens Pure 700 now it's also behind-the-ear. My new hearing aids are much easier to personalize shaping the spectrum of sound that's augmented by the hearing aids to a much greater degree than my previous hearing aids. The range of coverage is different. Rather than just treating the middle range, which is where the majority of sound comes through, the upper and lower ends (of the range) are addressed as well.
It's much better at work, too. I was in a conference room for a large meeting and I was sitting at a table in the center of the room. People were behind me talking and I couldn't hear them very well, because we were set up for music and surround-sound, so I had my hearing aids set to that. Suddenly, a person who was far behind me spoke. I could hear clearly; I didn't have to turn around and focus on them. I thought that was pretty neat!
Michael Reamis a freelance journalist.
Reduced Cost ALDs forVets
WilliamsSound, a global manufacturer of wireless listening technology, has teamed with the Military Audiology Association to offer the Retiree Assistive Listening Device (RALD™) program to retired and active-duty military service members and their families. The RALD program was created to provide these veterans and service men and women access to assistive listening devices (ALDs) at a reduced cost, along with free personalized telephone support.
ALDs are devices to help individuals with hearing difficulties hear more clearly in a wide array of social situations, whether those needs are specific to listening on the phone, to a television, in a group setting or during one-on-one conversations. An ALD is designed to pick up sounds from the sound source and bring it directly to the listener's ear, without the distraction of background noise.
For more information visitwww.williamssound.com/rald andwww.militaryaudiology.org
The Buzz That Veterans Hear
A weather officer for nine years, Capt. Nathan Green is now working with the 316th Operations Support Squadron at Andrews Air Force Base.(By Susan Biddle For TheWashington Post)
Wounded last year inBaghdad, Air Force Capt. Nathan Green has joined a treatment program for service members affected by ringing in the ears.(By Susan Biddle For TheWashington Post)
By Tom Wilkinson
Washington Post Staff Writer
Tuesday, March 10, 2009
Capt. Nathan Green remembers the alarm sounding that day last April inBaghdad's Green Zone. He remembers running, and then the loud explosion of the rocket hitting 30 feet behind him. He was knocked unconscious, suffered a traumatic brain injury and now hears the high-pitched whine and static buzz of an AM radio. All the time.
Except there is no AM radio. Green, 32, an Air Force weather officer for nine years, has tinnitus, or ringing in the ears.
There is no cure, though there is ongoing research to find one. Relief most often comes through various methods of "managing" the condition.
Nobody knows quite how big a group Green has joined. Based on a 2007 survey, the Centers for Disease Control and Prevention estimates that some 23 million people in the country hear something when there is no external sound present. The American Tinnitus Association (ATA), figures the number may be 50 million, based on a survey done forGallaudetUniversity in the 1990s.
That survey suggests that about 12 million people have the kind of chronic condition that prompts them to seek medical attention; about 2 million have such a severe case that it is disabling, interfering with sleep, concentration, social interaction and work.
Aging plays a role in the occurrence of tinnitus, as do some physical ailments. But loud noise and subsequent damage to the ear -- the inner ear in particular -- is the principal culprit. The sources of such noise are all around us: sirens, rock concerts, blow dryers, jackhammers, chain saws, power mowers, farm and lawn tractors. Adding to the din is a whole bunch of military things, which explains why tinnitus is the No. 1 service-connected disability forIraq veterans.
Anything above 85 decibels, about the sound of normal traffic that you can hear with the car windows up, can be damaging. And there is also a growing concern that members of the younger generation are at risk, as they crank up their MP3 players and iPods.
Tinnitus has drawn increased attention lately because the Department of Veterans Affairs counted about 400,000 veterans affected by the condition through 2006 and reported in 2008 that just over 93,000 returningIraq veterans were affected. (The Army issues earplugs, but whether they're used is another question.)
The math is unforgiving, given that many of these military people are young. Tinnitus commonly gets a 10 percent disability rating, which translates to $1,320 a year per individual. Fifty years of such payments for that 2008 group of 93,000 runs a little over $6 billion. And the number of those affected is going up: Tinnitus disability payments increased 16 percent between 2005 and 2006.
Research on the disease has been limited. The ATA says that the combined public-private research money came to a little over $3 million in 2007. The organization is pushing for larger government -- particularly Defense Department -- biomedical research grants.
Beethoven and Letterman
Tinnitus is not a new phenomenon. Hippocrates spoke of it. Beethoven had it. Pete Townsend, lead guitarist for the Who, describes a serious case. William Shatner and David Letterman, who both have it, discussed it on a Letterman show.
They all describe the same thing: ringing, roaring, hissing, chirping, buzzing or clicking when there is no external sound generator.
Scientists generally think the starting point for the condition is the inner ear, the cochlea. There are tens of thousands of cells in the cochlea, each tipped with hair bundles called stereocilia. They are instrumental in converting incoming sound vibrations to neural activity that is distributed, via the auditory nerve, to various parts of the brain for processing.
"The cells in the inner ear are laid out like a piano keyboard," Craig Kasper, a doctor of audiology in private practice inNew York, said in a telephone interview. "Each of those picks up a specific frequency, and when specific hair cells die, it's like those particular piano keys don't work, they don't hit the strings." The high frequencies seem to go first.
The cruel fact is that, in humans, when those hairs are damaged, they don't regenerate. In birds and chickens, yes; in humans, no.
So why the ringing?
The initial suggestion was that the perceived sound was generated by the ear. But Pawel Jastreboff and other pioneers in the field postulated that the real generation lay in certain parts of the brain. Research with brain imaging techniques, particularly by Richard Salvi, who directs the Center for Hearing and Deafness at the State University of New York atBuffalo, confirmed that.
He and others are continuing with that research, which suggests that the brain reacts to the auditory lapse from hair cell damage in a couple of interrelated ways.
The disappearance of sound, it is suggested, can awaken in the brain the memory of sound. And the auditory lapse produces spontaneous activity in the brain. The combination of those factors can result in the phantom sound. It is as if, when the inner ear's hair cells die, the brain says, "Wait a minute, I'm meant to be hearing something and I'm not. Here's something to fill that void."
Salvi likens it to listening to the radio in your car. "As you get farther away from the radio station and don't hear it as well, you have a tendency to turn up the volume," he said in a telephone interview. The brain tries to compensate in a similar fashion. And because of the communication between various parts of the brain, the absence of information from the hair cells gets run through the emotion control station, which is called the limbic system. That can produce anxiety, stress, sometimes depression. All of those, the medical people say, can increase the perceived constancy and intensity of the tinnitus.
Green, for instance, says his tinnitus is "significantly worse in high-stress situations." He also has migraines as a result of his brain injury, and he notes that the tinnitus makes the migraines worse. "It feeds on itself and exacerbates the problem."
Tuning It Out
What to do?
Any possible underlying physical conditions (jaw, neck, cervical spine problems, for example) should be identified and treated. Tinnitus sometimes disappears with such treatment. Check your medicines. The ATA counts more than 200 over-the-counter medicines (even aspirin in large doses) that list tinnitus as a possible side effect. An old treatment for arthritis pain was to take increasing does of aspirin until you hear ringing in your ears, then reduce it until it stops. That is no longer prescribed.
Hearing aids can sometimes help by picking up enough ambient sound to override the tinnitus. Other alternatives involve "tinnitus management," often combining counseling and sound therapy. The goal is to suppress the perceived sound, "to pull tinnitus into the background," said Kasper, who attributes the sound of the nonexistent tea kettle he hears to the seven teenage years he spent playing bass guitar in a punk band.
"You want to make it like a refrigerator: You hear it starting up, but the brain immediately recognizes that sound as inconsequential and dismisses it," Kasper said. Accomplishing that takes into account what those in the trade call the brain's plasticity: its ability to absorb, learn, memorize, forget, discard and, in general, remap the connections between neurons.
The success rate with these therapies varies with individuals, but the results have been generally encouraging.
The initial phase of counseling provides perspective. The knowledge that tinnitus, while usually accompanied by some hearing loss, doesn't mean total hearing loss, generally relieves stress.
"What it's not is as important to the patients as what it is," said Michele Spencer, a doctor of audiology who, with Margaret Jylkka, administers a clinical tinnitus treatment program atBethesda'sNationalNavalMedicalCenter. They are in the beginning stages of the program, and Green is one of the initial participants.
Questionnaires start the process, which tries to put an objective measure on a highly subjective subject, and to pinpoint the situations in which the tinnitus is worse.
Two group sessions follow. The first deals with perspective -- what tinnitus is and isn't -- and opens a forum to talk about it. And the participants work on developing their own individual "sound plans."
Green, like many others, tried something on his own to neutralize tinnitus before getting involved in theBethesda program. "I couldn't sleep, and I figured I had to have some kind of background noise to get to sleep." So he put a fan in the bedroom, "always turned on high whether it was 40 degrees or 90 degrees."
While it provided some relief, "it drove my wife crazy. You looked at our bed, you saw one thin sheet on my side and five covers on her side" to block out the sound.
The sound plan Green worked on atBethesda creates a background by choosing or combining three kinds of sound: environmental sounds (rain, waterfall), music (unlikely to be Coldplay or Lil Wayne, "but if it works, put it in," said Green) or speech (such as talk radio).
The second session gauges the success of the individual sound plan. This is the ultimate mix and match. "You try multiple things until you hit it," Spencer said.
If that is unsuccessful,Bethesda will send the patients to other places -- often the hearing and balance center at the University of Maryland Medical Center inBaltimore -- for wearable devices that might help.
There are several programs involving such devices: tinnitus retraining therapy, tinnitus masking therapy, tinnitus activities treatment, and a program from a private concern called Neuromonics. In general, these employ sound generators that fit in the ear and are used in conjunction with the other procedures of each program, some of which last up to 18 months.
Progress in understanding tinnitus is constant, some of it thanks to advances in brain imaging techniques, such as the functional MRI scan, which can pinpoint parts of the brain where activity is occurring. Jaw-clenching, for example, can aggravate or calm tinnitus in some individuals. An fMRI can show what parts of the brain are firing when that happens.
Despite all the advances, for many patients learning to quiet or live with tinnitus remains a matter of constant adjustment and experimentation. Green has now been able to replace his noisy fan at night with a quieter humidifier -- and he and his wife are sleeping more peacefully.
Two-thirds of Afghan war veterans are suffering from hearing damage
The intense noise of the battlefield is afflicting British troops
Sunday 20 December 2009
More than two-thirds of British troops returning fromAfghanistan are suffering severe and permanent hearing damage, according to the most comprehensive study into one of the less well-known side-effects of the conflict inHelmand.
Internal defence documents reveal that of 1,250 Royal Marine commandos who served inAfghanistan, 69% suffered hearing damage due to the intense noise of combat. The findings indicate that complaints such as tinnitus or almost complete deafness among combat troops are considerably greater than previously reported. One audiologist said the report revealed that hearing loss was endemic among Afghan veterans, with many suffering defects that could bar them from frontline service.
The intensity of the conflict inHelmand and its close-combat fighting, roadside devices and the noise of low-flying coalition aircraft caused the problems, according to the Ministry of Defence study. The report, dated 7 December and written by military consultant surgeon Chris Pearson, warns that the known scale of the problem might prove to be the "tip of the iceberg" because only the most severe forms of hearing loss, grave enough to bar troops from frontline service, are officially reported.
Professor Mark Haggard, honorary vice-president of Deafness ResearchUK, which is working with the MoD to resolve the problem, said: "The issue has become systemic, endemic. Combat gunfire and explosions mean significant numbers are turning up with significant hearing problems."
Hearing tests were conducted on 1,254 troops from 42 Commando Royal Marines following their six-month tour inHelmand between April and October 2008. Analysis by the defence audiology service found that 865 of the Marines displayed signs of severe hearing damage caused by loud noise. Of these, 410 were classified as having more extreme cases.
Pearson, who is calling for further studies into the issue, concluded that 69% of the Royal Marines had "audiometric evidence consistent with NIHL [noise-induced hearing loss]".
British employers must not subject staff to noise levels over 85 decibels for prolonged periods. Haggard said the blast of a gun or "medium" explosion measured 140dB, equivalent to hearing a jet plane taking off about 40m away. The sound of a pneumatic drill at two metres distance measures 126dB while an alarm clock is 90dB. The normal pain threshold is around 120dB.
The MoD study, The Extent of Operational NIHL, also points towards major problems among reservists deployed toHelmand. Pearson's report reveals that one in 10 Territorial Army recruits also experienced a significant degree of hearing loss following their tour of duty which was "unlikely to be due to anything other than noise or blast".
Tests comparing the Royal Marines fromAfghanistan with service personnel from an RAF base in theUK found that 17.7% had severe ear damage compared with 5.2% of the RAF personnel.
The MoD report also scrutinised in detail the medical records of 73 soldiers who had served inHelmand province and found that 67 had problems with their hearing. Of these 39 were diagnosed with noise-induced hearing loss with 16 new cases of hearing problems thought to be from "blast injury".
An MoD spokesman said they were trying out new ear protection for personnel on operations to protect them from the effects of loud explosions and gunfire. He said: "The system uses a custom moulded earplug with an inbuilt microphone to cut the noise impact of loud explosions while still giving the wearer the ability to hear colleagues. Feedback from trials with soldiers in training and in theatre have allowed the rapid development of new, easy-to-fit earplugs that stay in place."
Soldier's story illustrates risks of hearing loss in war
By Gregg Zoroya,USA TODAY - 8/4/2008
The bombs along theBaghdad road exploded one after the other, leaving one soldier unconscious and another screaming from his wounds. Staff Sgt. Kevin Dunne's squad was under attack. Rifle and machine gun fire pinned them down. Then shots from a sniper.
Dunne yelled orders, but he and his squad were at a disadvantage.
Dunne says he couldn't hear well enough to tell where the sniper fire was coming from. "I had no idea," he wrote in an e-mail toUSA TODAY.
In the four months before the April 7 attack, the chief physician atFort Hood,Texas, had warned that Dunne's hearing was so bad that he should be removed from combat duties. Others in the Army overruled him and sent Dunne back toIraq for his third combat tour.
Now, a member of Dunne's squad — Sgt. Richard Vaughn, 22, ofSan Diego — lay dead from a sniper's bullet. "He was lying in the middle of the street motionless," Dunne wrote. "I blame myself a lot for not being able to identify the threat simply because of the way I heard the shots."
Hearing loss is one of the most common ailments that affects troops sent back to combat, according to the Pentagon and government researchers. One in four soldiers serving inIraq orAfghanistan have damaged hearing, the Army says. In addition, a recent study from the RAND Corp. reported one in five combat veterans suffer post-traumatic stress disorder (PTSD) or depression. Back pain, leg injuries and other muscular-skeletal problems are the top ailments of troops in the war zone, says Ellen Embrey, deputy assistant secretary of Defense for force health protection and readiness.
Dunne, who inIraq was part of the 4th Infantry Division atFortHood, is now back home. Besides his hearing problems, he shows signs of PTSD and has severe back problems.
After more than five years of war marked by multiple deployments, many combat veterans are developing long-term health problems, raising the risk that ailing troops are being sent back into combat.
Since 2003, 43,000 troops who were classified as medically unfit in the weeks prior to deployment were still sent to war, Pentagon statistics show. That number began to drop after 2003, but the trend has reversed in the last two years. The U.S. Central Command, which oversees troops inIraq andAfghanistan, is drafting rules that could make it more difficult to send unfit troops to war.
"As much as I wanted to get out there …, I'm seriously physically challenged by not being able to hear," Dunne wrote. "The guys to my left and right don't deserve anything to happen to them because of my personal pride."
'Feeling like I'm 50'
Dunne returned fromIraq in June. "I'm now at 29, feeling like I'm 50," he wrote before leavingBaghdad.
He has fought off and on inIraq since 2003, when his unit was profiled byUSA TODAY. Dunne has been in occasional contact with the newspaper since then.
Meanwhile, Dunne began a series of routine medical exams and screenings to understand the war's toll on him. Doctors found:
• Hearing loss, which declined dramatically during Dunne's first tour. Army audiological records show loss in various frequencies, particularly in his left ear, says Anthony Cacace, an audiologist and professor atWayneStateUniversity inDetroit. Cacace reviewed Dunne's medical test records provided byUSA TODAY.
The weakness leaves him struggling to hear consonant sounds, especially if there is background noise.
"He's going to have one hell of a time understanding what people say, if he can't get visual cues," Cacace says, adding Dunne has the hearing of a 70-year-old in his right ear and worse than that in his left.
• Severe lower back pain dating to his firstIraq tour from April 2003 to April 2004. By his third tour, Dunne required regular painkiller injections.
• PTSD symptoms after his second tour, when Dunne was near a suicide bomb explosion.
• Tinnitus, or ringing in the ears that never stops. To sleep, he listens to rock music on his iPod, a common means of coping for troops with tinnitus, says Army Maj. Dan Ohama, an audiologist working inBaghdad.
Service-connected back and neck injuries have left nearly 50,000 Iraq- and Afghanistan-era veterans permanently disabled, Department of Veterans Affairs records show. The VA has treated 75,000 such veterans for PTSD and placed nearly 35,000 on permanent disability. And almost 70,000 suffer from tinnitus, VA records show.
In December, weeks before Dunne went toIraq for his third tour, his company commander spelled out the staff sergeant's chief physical problems. The soldier's battle-damaged hearing, Capt. Alex Garn wrote, "limits his ability to identify enemy locations by sound, hear commands from his team leaders, hear radio traffic over a squad radio, or speak with local nationals in combat, which could have negative ramifications to the mission."
On Dec. 19, the chief physician and medical commander atFort Hood,Texas, where Dunne is based, urged that he be taken out of infantry. "At risk of continued hearing loss," Col. Jeffrey Clark wrote.
Clark was the only doctor on a five-member panel reviewing Dunne's fitness for combat on Dec. 19. He was overruled by the other four panelists.
Dunne's brigade commander and three senior sergeants agreed that Dunne should stay in infantry and go toIraq. "Hearing loss is present in all forms … in the Army," wrote one panelist, Master Sgt. Ulysses Martin. "It's impossible to validate whether he will lose his hearing more or less in the future. I feel that infantry is his best place."
One factor in their decision was Dunne's desire to return despite his hearing loss. He said he felt a responsibility to be with his platoon. His unit's young soldiers, he wrote fromIraq, "needed as much help as they can get."
"That's pride," says Geni Gillaspie, Dunne's girlfriend and the mother of his two children. "That's Kevin … wanting to lead his men and do the right thing."
The attitude impressed Dunne's brigade commander, Col. Theodore Martin.
"Very dedicated soldier," Martin wrote during the review. "Wants to stay infantry. This is his life. I vote he stays infantry."
Despite his desire to deploy, Dunne thought his commanders would limit his combat exposure because of his hearing loss. Garn had recommended in his memorandum that Dunne be given a hearing aide to wear into combat.
Neither happened. During that April firefight, Dunne realized he was truly handicapped.
"I came to terms with myself and realized that I was not as confident in my ability to continue my job," he wrote in an e-mail May 6. "It was better for me to realize this than to ignore it."
Even then, he said, he hesitated to speak up. "I don't know how to approach (commanders) and tell them of what my feelings are," he wrote in an e-mail April 26, "because I've been around long enough to know that I'll be looked at as a quitter."
Rules not followed
Army regulations allow troops with health problems to go to war if their job comports with their physical limitations and if there are resources in the combat zone — such as psychological counseling — to treat them.
But a Government Accountability Office report released June 10 found the rules are not always followed. It said that after doctors identified significant health issues among dozens of soldiers from three installations — Fort Drum and Forts Stewart and Benning in Georgia — infantry commanders failed to limit their duties or schedule review boards to determine whether they should be moved to different jobs or out of the Army.
Troops with hearing unfit for combat are showing up in the war zone, Ohama says. "We see cases of soldiers deploying when they did not meet the hearing standards," he says.
As troops prepare for war, medical officers need to be forceful, says S. Ward Casscells, the Pentagon's chief of military medicine. "The commander has to make the call based on the mission, but the doctors should make the case very clearly that deploying Cpl. X against his or her medical judgment is a decision that could be held against the commander," Casscells wrote in his Internet blog.
The risks of a mistake are too high, says James Martin, a retired colonel and expert on military culture atBrynMawrCollege inPennsylvania. "This is a disability you don't want to get worse," he says. "You don't want this person to be put in a position where he might hurt himself or others."
A new assignment
At the time of the April attack, the forward operating base inBaghdad where Dunne was deployed was under constant mortar and rocket fire. He sought counseling with one of the Army's combat stress teams.
"They say my symptoms are mimicking signs of depression. Who the hell knows what that means?" he wrote on May 6. "They gave me three sheets of paper with breathing techniques, another describing how to imagine being in a happy place … and to remind myself to relax when I started getting anxious."
With the installation under daily rocket or mortar fire, Dunne said, the recommendations were impractical. "For them to tell me to think happy (thoughts) is what will resolve my issues immediately — I have no faith in their judgment," he wrote May 22.
Dunne finally was moved from the front lines only after he complained by e-mail to Gillaspie, his mother, Diann Dunne, and afterUSA TODAY inquired about Dunne's combat fitness. He was given another hearing exam by Ohama inBaghdad. The results confirmed the earlier findings.
His current brigade commander, Col. Mark Dewhurst, cites the review board's decision in December as the reason Dunne was in combat. "Staff Sgt. Dunne attested that he could fulfill his duties," Dewhurst says.
The commander said he was not aware of any problems until theUSA TODAY query. "Dunne relayed that he did not want to let down his soldiers, so he did not report his condition."
Martin says it is a mistake to rely too heavily on the servicemember suffering the disability when it comes to the question of fitness. "You can't ask the person to make the determination because emotionally, they're too connected to wanting to overcome their disability."
In a telephone interview fromTexas, Dunne says he is uncertain about his long-term future.
Another fitness hearing is scheduled and he has been assigned to a rear-detachment unit. Dunne says he once dreamed of law enforcement, but that his hearing loss has put that out of reach.
So shortly before coming home, Dunne accepted an offer to re-enlist for three years with an $11,000 bonus. He hoped the Army would find a place for him away from combat.
Last week, he said he received some good news on that front — a new assignment as a casualty liaison officer for 4th Infantry Division wounded who arrive at the Army'sLandstuhlRegionalMedicalCenter inGermany. All casualties fromIraq andAfghanistan pass through that facility.
"I get back to helping out and doing things for these guys," he says. "I'm really excited."
Benefits may be available for those afflicted by tinnitus
01:00 AM EDT on Monday, July 20, 2009
Veterans who have served as members of the infantry firing weapons, as sailors working around heavy shipboard engines and machinery, or as airmen working on a noisy flight line near jet engines have all been exposed to some type of acoustical or noise trauma.
This trauma results from exposure to extremely loud noise at certain decibel levels for prolonged periods without proper hearing protection. This exposure may cause an immediate reduction or loss in hearing, which returns after leaving the noise source area. Also, an immediate ringing in one or both ears may result when near the noise, immediately after leaving the noise area, or when the person is in a quiet environment.
This ringing in the ears, called tinnitus, may resolve itself at first, but will become noticeable when you are in a quiet environment.
Any of the above scenarios may cause hearing loss, tinnitus, or both. If your exposure to loud noises such as gunfire, explosions, jet engines or other industrial noise from ship engines occurred during your service time and you were not given adequate hearing protection, you may be able to file a claim for entitlement to service connection for hearing loss, tinnitus, or both.
Such claims must be supported by a medical diagnosis of one or both of these conditions and must refer to your military situation’s noise exposure and that the condition is or was likely the result of that noise exposure. Also, a personal statement detailing your noise exposure during service time is required.
The personal documentation will assist the doctors who will evaluate you. It must include when, where, what, how and how often you were exposed to noise while in service. It must have personal data, the types and causes of noises you were exposed to while performing your job, length of exposure and if the noise took place in a combat zone and the type of environment or if you have suffered a combat injury due to an explosion.
Information on other necessary elements of your statement and levels of impairment compensation are available by calling the DAV National Service Office at the VA regional office inProvidence at (401) 223-3695. A claim for benefits can proceed when the medical diagnosis of a current hearing condition and your statement relating your condition to service is completed. The VA does provide hearing examinations for veterans.
Homeless outreach van to be dedicated
The Providence VA Medical Center will conduct a homeless outreach van dedication ceremony Monday at noon, in front of the main Ambulatory Care entrance onChalkstone Avenue, and the public is invited.
The homeless outreach van was donated by the family of U.S. Army 1st Lt. Gregory Zavota, aWest Point graduate who died in the line of duty on Oct. 7, 2007.
The van is already being used for outreach to local shelters and has been an integral part of the medical center’s homeless outreach and primary-care program. Also, the van is part of a VA-financed study to determine optimal ways to connect homeless veterans to the VA for care and services. For more information about the van or the homeless outreach program, call Tom Antonaccio at (401) 457-3004.
‘Summer of Service’ program begins
VA Secretary Eric Shinseki recently escorted several veterans to their appointments at a VA medical center as part of President Obama’s “United We Serve” kickoff for the federal government’s Summer of Service program.
Each year more than 80,000 volunteers serve veterans through the VA Voluntary Service program. If you want to give your time and talents to support the care ofAmerica’s veterans, or if you want to help, but do not have time, there are still many ways you can assist. Fill out a volunteer form on the VA’s volunteer service page online at www.volunteer.va.gov/, and a local VAVS representative will contact you.
If you are interested in supportingU.S. military service members, visit Military.com’s Support our Troops Web page atwww.military.com/benefits/resources/support-our-troops.
•Veterans of Foreign Wars Gatchell Post 306 and Auxiliary units meet Monday at171 Fountain St.,Pawtucket, at 7 p.m.
•Fleet Reserve Association Quonset/Davisville Branch and Unit 42 will meet Tuesday, at 7 p.m., at theDavisvilleSeabeeMuseum at21 Iafrate Way.
•American Legion Post 12 will meet Tuesday at Saratoga Foundation headquarters,6854 Post Rd., NorthKingstown, at 7:30 p.m.
•43d Infantry Division Rhode Island Winged Victory Division will meet on Saturday, at 1 p.m., at the Arsenal,176 Benefit St.,Providence.
Send veterans’ meeting and news items to George W. Reilly at VeteransColumn@verizon.net or write to The Veterans Journal Column at The Providence Journal,75 Fountain St.,Providence,R.I.02902. Veterans’ meeting and feature items can be read and posted for free at http://projothebeat.com/.
That Buzz That Veterans Hear
On March 10, 2009 The Washington Postran a full feature on the continued increases of tinnitus in returning personnel fromIraq andAfghanistan. The article outlines how veterans develop tinnitus sustained from their blast injuries, and how they try to readjust to civilian life after their service to this country. In addition the American Tinnitus Association is credited for their work in bringing this issue to light in Congress and with the Department of Defense.
Hearings » Legislative Hearing on H.R. 1017, H.R. 1036, H.R. 2504, H.R. 2559, H.R. 2735, H.R. 3073, H.R. 3441, H.R. 2506, and Draft Discussions on Homelessness, Graduate Psychology Education, and Psychiatric Service Dogs
Statement of The Honorable Harry Teague
a Representative in Congress from the State ofNew Mexico
Mister Chairman and Ranking Member and fellow Subcommittee Members. I would like to take this opportunity and use my opening statement to speak on behalf of two bills that are before the committee today, H.R. 2504 and H.R. 2506.
H.R. 2504 addresses one of our greatest national travesties.
On any given night in our beloved country, there are roughly 70, 000 to 130,000 veterans that are homeless. They have no shelter from the elements; they sleep on the streets of the very cities that they fought to defend. After they have served our country faithfully, they are mostly forgotten and left behind.
The fact that this is allowed to happen is shameful.
Luckily, these veterans are not completely abandoned. The Department of Veterans Affairs and numerous state, local and non-governmental entities have stepped-up to the plate and created numerous programs to combat the problem of homeless veterans across the country.
These groups conduct operations that are aimed not only at getting veterans off the streets and into a shelter, but at finding ways to help veterans find employment , secure their own housing and stay in that housing. Veterans transitional facilities do more than offer a short-term solution to a homeless veteran; they hold true to the old proverb: “Give a man a fish and you feed him for a day. Teach a man to fish and you feed him for a lifetime.”
My bill, H.R 2504, amends Section 2013 of title 38 and increases the funding for these programs by $50 million dollars in the next fiscal year. It only makes sense that the programs that do the most good to give our veterans a home should receive more resources so that we can work towards what should be our goal: eradicating homelessness among our veterans.
I am honored to say that this bill is also supported by the National Coalition for Homeless Veterans.
I believe that is a noble effort, and I hope that my colleagues in the subcommittee and the Congress agree and I hope that they will support this legislation.
The second bill that I have before the committee is H.R. 2506, the “Veterans Hearing and Assessment Act.” This bill address an new health factor that is facing our troops – tinnitus.
Until recently, tinnitus – better known as ‘ringing in the ears’ – was little understood and even less addressed by the medical community. People suffering with tinnitus were often thought to have anxiety disorders, or, in some cases, to be delusional.
Fortunately, those misperceptions have changed, and tinnitus is now recognized as a serious clinical syndrome that impacts 12 million individuals on a chronic basis, 2 million of who are virtually incapacitated by the disorder. Tinnitus is generally becoming more common among our nation’s soldiers and veterans, particularly those who have been exposed to blast injuries inIraq andAfghanistan.
In addition to the personal impact of tinnitus on our veterans’ lives and well-being, the cost of tinnitus and its continuing rise in incidence is extremely alarming. Since 2001, service-connected disability payments for tinnitus has increased by 18 percent per year, and tinnitus is currently ranked by the Department of Veterans Affairs (VA) as the #1 service connected disability for returning soldiers. If current trends continue, tinnitus compensation for veterans will exceed $1 billion by the year 2011.
My bill, H.R. 2506, takes some important, common sense steps to address this problem. It requires that each member of the Armed Forces receives a hearing evaluation that includes screening for tinnitus before and after deployment. Why is this important?
Certain forms of sensory impairment are clearly visible to casual observation. However, hearing impairment, including tinnitus, may often go undetected or be misdiagnosed. Yet, along with vision, a soldier relies most on his or her hearing in order to remain safe when in a combat situation.
Impaired hearing, including tinnitus, impacts a soldier’s ability to respond appropriately in combat situations, jeopardizing not only the soldier’s life but those around him or her, and compromising the safety of the mission itself. We need to ensure that pre- and post- deployment screening includes an assessment of tinnitus, to help ensure a soldier’s safety while in the field and to assess the extent to which a soldier may have tinnitus as a result of their exposure to blast or other high noise levels.
Mr. Chairman, my legislation also would ensure that tinnitus will be recognized as a mandatory condition for research and treatment by the Department of Veterans Affairs Auditory Research Centers of Excellence. Recent studies strongly suggest a direct link between tinnitus and both Post Traumatic Stress Disorder (PTSD) and Traumatic Brain Injury (TBI). For this reason, improved understanding of the neurological mechanisms that trigger tinnitus and research into its treatment may also directly advance other ongoing research efforts to address the equally serious challenges of PTSD and TBI treatment.
We now know that tinnitus is a condition of the auditory system, not a ‘disease’ of the ear. Existing therapies may help mitigate the effects of tinnitus for some patients, but the extent of relief afforded to patients with tinnitus varies greatly. In short, they do not work for all individuals, and they do not cure tinnitus.
Scientific research into tinnitus has made some dramatic advances over the last decade, but we still have a long way to go to improve prevention and treatment for tinnitus, in order to help the millions of American veterans who experience tinnitus as a chronic, ongoing condition and hopefully, to find a cure for this debilitating condition. I thank the Committee for its time and consideration.
I would like to take this time to thank the staff members of the Health Subcommittee who lent their expertise during the drafting of these bills, and I thank Chairman Michaud and Ranking Member Brown for the opportunity to advance this two important pieces of legislation. This concludes my testimony.
US Soldiers inIraq,Afghanistan Suffering Hearing Loss
Posted by Paul Fiddian on 11/03/2008
Members of the US armed forces serving in Afghanistan or Iraq that have been exposed to roadside bomb blasts are returning home with auditory problems on a grand scale. Some have permanent loss of hearing while, others, tinnitus.
Consequently, theUS military is upping its efforts to provide US soldiers with greater protection against noise damage.
58,000US Soldiers Have Lost Hearing
The US Department of Veterans Affairs lists hearing damage at the top of the conditions it associates with the War on Terror. According to some analysts, the full extent of the situation may take decades to unravel. However, says the department, over 58,000 US soldiers who have served in eitherAfghanistan orIraq are now in receipt of disability payments related to hearing loss, while almost 70,000 are registered as having tinnitus.
Roadside Bombs Significant in Soldier Hearing Loss Issue
Roadside bombs are a prime contributor to the noise damage. When exploded, the blast is responsible for aggressive shifts in air pressure capable of rupturing the eardrum, and of breaking sensitive bones located inside the ear.
Furthermore, a substantial amount of combat is of the unexpected variety - firefights and ambushes for example - meaning that soldiers have to enter the fight minus the hearing protection they were issued with.
"They can't say, `Wait a minute, let me put my earplugs in,'" inner-ear specialist Dr. Michael E. Hoffer commented.
"They are in the fight of their lives."
Another factor, said Hoffer, is the refusal by certain soldiers to wear the ear protection at all, on the grounds that they would not be able to hear sounds that could, ultimately, kill them.
US Military Issuing Earplugs to Soldiers inIraq,Afghanistan
Auditory damage has been a risk associated with ground-based combat since explosive devices and similar weapons were first introduced. Picking up on this, theUS military was quick to issue earplugs for soldiers serving inAfghanistan andIraq.
However, the scale of the injuries suffered was still unexpected.
Since 2005, theUS military has responded with measures including issuing more effective earplugs, speaking to soldiers about the need to protect their hearing, and carrying out more tests on the battlefield to identity damage.
How effective any of these have been is not yet known. However, according to US Army audiology adviser to the surgeon general, Colonel Kathy Gates, officials think that they will soon see a substantial drop in the number of new cases.
60% ofUS Soldiers Exposed to Bomb Blasts Lose Hearing: Reports
The results of audiology reports carried out by the military highlight how 60 per cent of US soldiers exposed to bomb blasts consequently develop permanent loss of hearing, while 49 per cent experience tinnitus. The range of symptoms go from those felt in mild cases - in which troops are unable to hear low-volume speech, or low-pitched noises - to severe ones: absolute deafness, or a persistent loud ringing that hampers concentration.
Neither hearing loss nor tinnitus are curable at present.
The American Tinnitus Association expects the number ofUS service personnel receiving auditory-related disability payments to jump 18 per cent/ annum.
Figures produced by the Veterans Association, meanwhile, put the current scale of hearing damage on a level with veterans of the Second World War.
The weapons of war used on a modern battlefield can only be partially protected against in terms of hearing. Damage can occur when sound is at a level between 80 and 85 decibels - equivalent to the noise generated by a tank on the move. The most effective ear protection can still only reduce this by up to around 25 per cent.
This, says theBalboaNavalMedicalCenter's Dr Ben Balough, is insufficient when it comes to protecting the ears against a firefight or an explosion.
US Marines, US Navy Issuing Hi-Tech Earplugs
The US Marines and US Navy have recently been issuing soldiers with advanced QuietPro earplugs. At around $600/pair, they employ digital technology to block the noise of explosions or gunfire, but still permit those wearing them to experience other, more regular sounds. QuietPro is currently being assessed by the US Army.
Further testing is being carried out by the US Navy, which, in collaboration with BioHealth Group, is developing a "hearing pill". An initial trail of the pill was undertaken five years ago, in which 566 soldiers participated. Its results suggested that permanent loss of hearing could be reduced by up to 27 per cent, but tests continue.
In an unprecedented move, ear specialists have been deployed to combat zones, while troops are being tested pre- and post-battle if explosive devices were encountered during the fight.
"You have guys that don't want to admit they have a problem," Hoffer commented.
"But if they can't hear what they need to on patrol, they could jeopardize their lives, their buddies' lives and, ultimately, their mission."
Source - Armed Forces International'sUS Correspondent
U.S. troops losing hearing
March 11, 2008
SAN DIEGO (AP) -- Soldiers and Marines caught in roadside bombings and firefights inIraq andAfghanistan are coming home in epidemic numbers with permanent hearing loss and ringing in their ears, prompting the military to redouble its efforts to protect the troops from noise.
Hearing damage is the No. 1 disability in the war on terror, according to the Department of Veterans Affairs, and some experts say the true toll could take decades to become clear. Nearly 70,000 of the more than 1.3 million troops who have served in the two war zones are collecting disability for tinnitus, a potentially debilitating ringing in the ears, and more than 58,000 are on disability for hearing loss, the VA said.
""The numbers are staggering,"" said Theresa Schulz, a former audiologist with the Air Force, past president of the National Hearing Conservation Association and author of a 2004 report titled ""Troops Return With Alarming Rates of Hearing Loss.""
One major explanation given is the insurgency's use of a fearsome weapon the Pentagon did not fully anticipate: powerful roadside bombs. Their blasts cause violent changes in air pressure that can rupture the eardrum and break bones inside the ear.
Also, much of the fighting consists of ambushes, bombings and firefights, which come suddenly and unexpectedly, giving soldiers no time to use their military-issued hearing protection.
""They can't say, `Wait a minute, let me put my earplugs in,'"" said Dr. Michael E. Hoffer, a Navy captain and one of the country's leading inner-ear specialists. ""They are in the fight of their lives.""
In addition, some servicemen on patrol refuse to wear earplugs for fear of dulling their senses and missing sounds that can make the difference between life and death, Hoffer and others said. Others were not given earplugs or did not take them along when they were sent into the war zone. And some Marines weren't told how to use their specialized earplugs and inserted them incorrectly.
Hearing damage has been a battlefield risk ever since the introduction of explosives and artillery, and theU.S. military recognized it inIraq andAfghanistan and issued earplugs early on. But the sheer number of injuries and their nature — particularly the high incidence of tinnitus — came as a surprise to military medical specialists and outside experts.
The military has responded over the past three years with better and easier-to-use earplugs, greater efforts to educate troops about protecting their hearing, and more testing in the war zone to detect ear injuries.
The results aren't in yet on the new measures, but Army officials believe they will significantly slow the rate of new cases of hearing damage, said Col. Kathy Gates, the Army surgeon general's audiology adviser.
Considerable damage has already been done.
For former Staff Sgt. Ryan Kelly, 27, ofAustin,Texas, the noise of war is still with him more than four years after the simultaneous explosion of three roadside bombs nearBaghdad.
""It's funny, you know. When it happened, I didn't feel my leg gone. What I remember was my ears ringing,"" said Kelly, whose leg was blown off below the knee in 2003. Today, his leg has been replaced with a prosthetic, but his ears are still ringing.
""It is constantly there,"" he said. ""It constantly reminds me of getting hit. I don't want to sit here and think about getting blown up all the time. But that's what it does.""
Sixty percent ofU.S. personnel exposed to blasts suffer from permanent hearing loss, and 49 percent also suffer from tinnitus, according to military audiology reports. The hearing damage ranges from mild, such as an inability to hear whispers or low pitches, to severe, including total deafness or a constant loud ringing that destroys the ability to concentrate. There is no known cure for tinnitus or hearing loss.
The number of servicemen and servicewomen on disability because of hearing damage is expected to grow 18 percent a year, with payments totaling $1.1 billion annually by 2011, according to an analysis of VA data by the American Tinnitus Association. Anyone with at least a 10 percent loss in hearing qualifies for disability.
From World War II and well throughVietnam, hearing damage has been a leading disability.
Despite everything that has been learned over the years,U.S. troops are suffering hearing damage at about the same rate as World War II vets, according to VA figures. But World War II andIraq cannot easily be compared. World War II was a different kind of war, waged to a far greater extent by way of vast artillery barrages, bombing raids and epic tank battles.
Given today's fearsome weaponry, even the best hearing protection is only partly effective — and only if it's properly used.
Some Marines were issued a $7.40 pair of double-sided earplugs, with one side designed to protect from weapons fire and explosions, the other from aircraft and tank noise. But the Marines were not given instructions in how to use the earplugs, and some cut them in half, while others used the wrong sides, making the devices virtually useless, Hoffer said. Today, instructions are handed out with the earplugs.
In any case, hearing protection has its limits. While damage can occur at 80 to 85 decibels — the noise level of a moving tank — the best protection cuts that by only 20 to 25 decibels. That is not enough to protect the ears against an explosion or a firefight, which can range upwards of 183 decibels, said Dr. Ben Balough, a Navy captain and chairman of otolaryngology at the Balboa Navy Medical Center in San Diego.
The Navy and Marines have begun buying and distributing state-of-the-art earplugs, known as QuietPro, that contain digital processors that block out damaging sound waves from gunshots and explosions and still allow users to hear everyday noises. They cost about $600 a pair.
The Army also has equipped every soldier being sent toIraq andAfghanistan with newly developed one-sided earplugs that cost about $8.50, and it has begun testing QuietPro with some troops.
In addition, the Navy is working with San Diego-based American BioHealth Group to develop a ""hearing pill"" that could protect troops' ears. An early study in 2003 on 566 recruits showed a 25 to 27 percent reduction in permanent hearing loss. But further testing is planned.
And for the first time in American warfare, for the past three years, hearing specialists or hearing-trained medics have been put on the front lines instead of just at field hospitals, Hoffer said.
Marines and soldiers are getting hearing tests before going on patrol and when they return to base if they were exposed to bombs or gunfire.
""You have guys that don't want to admit they have a problem,"" Hoffer said. ""But if they can't hear what they need to on patrol, they could jeopardize their lives, their buddies' lives and, ultimately, their mission.""
Bill Harding:VFW features new service for media representatives
By Bill Harding
January 17, 2008
Craig — New Online VFW Media Room: The VFW has a new service for media representatives and invites you to explore it at www.vfwmediaroom.org. The one-stop source featuresWashingtonD.C., news, as well as national leadership quotes and VFW priority goals. It will be updated as needed. A photo archive is planned, and submissions are invited.
Tap vs. Bottled - What should you drink?
Glug, glug, glug - that's the sound a number of us make as we sip bottled water in our cars, at the gym and behind our desks.
The sound you don't hear is the thwack of 60 million bottles a day being tossed intoU.S. landfills, where they can take up to 1,000 years to biodegrade. If that's not enough to turn your conscience a brighter shade of green, add this: Producing those bottles burns through 1.5 million barrels of crude oil annually - enough fuel to keep 100,000 cars running for a year. Recycling helps but reusing is even better. Invest in a couple of portable, dishwasher-safe, stainless steel bottles such as Klean Kanteens that won't leach nasty chemicals into your water. Don't get into the habit of refilling the water bottle you just emptied; the polyethylene terephthalate it's made of breaks down with multiple usage.
Period extension for compensation
The VA issued an interim final rule, effective Dec. 18, 2006, to amend its regulation, 38 C.F.R. § 3.317. The interim final rule amends the VA's adjudication regulations regarding compensation for disabilities resulting from undiagnosed illnesses suffered by veterans who served in the Persian Gulf War. The presumptive period was extended from Dec. 31, 2006, until Dec. 31, 2011, for qualifying chronic disabilities resulting from undiagnosed illnesses that must become manifest to a compensable degree in order that entitlement to compensation may be established.
Court decision for Bilateral Tinnitus
On April 5, 2005, the United States Court of Appeals for Veterans Claims handed down its decision in Smith v. Nicholson. The DAV had argued on behalf of Mr. Smith that he was entitled to two separate 10-percent disability ratings for service-connected tinnitus, i.e. ringing in his right and left ears. The Department of Veterans Affairs argued in Smith's case, as well as in the large number of other cases, that the VA Schedule for Rating Disabilities provided for only one 10-percent rating, regardless of whether the tinnitus was present in only one ear or both ears.
The Court held that: "Based on the plain language of the regulations, the Court holds that the pre-1999 and pre-June 13, 2003 versions of [diagnostic code] 6260 required the assignment of dual ratings for bilateral tinnitus."
Veterans who filed a claim for service connection for tinnitus in both ears, or who claimed an increased rating for that condition, before June 13, 2003, may be entitled to receive combined disability compensation based on two ten-percent ratings for tinnitus. Additionally, that law does not permit any such ratings to be reduced in the future, unless the severity of the tinnitus is shown to have actually improved.
The VA appealed that decision to the United States Court of Appeals for the Federal Circuit (Federal Circuit) on June 22, 2005. The Federal Circuit handed down its decision on June 19, 2006. That decision reversed the decision of the CAVC which held that veterans are entitled to two separate 10-percent ratings for service connected tinnitus in the left and right ears.
The Federal Circuit held that before its amendment in June 2003, diagnostic code 6260 was ambiguous as to whether tinnitus was a single disability and that the CAVC erred by failing to defer to the VA's reasonable interpretation of its own regulation.
The DAV filed a petition for a writ of certiorari with the Supreme Court of theUnited States (Supreme Court) on Sept. 19, 2006, on behalf of Mr. Smith. On Dec. 19, 2006, theUnited States filed its opposition to our petition for a writ of certiorari. The Supreme Court issued a decision on Jan. 22, 2007, in which it declined to hear Mr. Smith's petition.
The result of the Supreme Court's decision is that the Federal Circuit's decision is now final and binding as to all pending claims for separate disability ratings for bilateral tinnitus. The Courts of Appeals for Veterans Claims has no choice. It must follow the precedents of the Federal Circuit. Veterans are therefore not entitled to separate ratings for bilateral tinnitus.
Veteran/national dates this month
Jan 14: Churchill and Roosevelt meet inCasablanca in 1943
Jan 15: Martin Luther King Jr.'s birth observed
Jan. 17: Desert storm Air war began in 1991
Jan. 28:U.S. Coast Guard established in 1915
Viet Nam Peace Accord announced in 1973
Jan. 30 Viet Cong launched the Tet Offensive in 1968
For information on programs and/or other veterans' benefits, call or stop in the Moffat County VSO office at480 Barclay St. (west of the Bank of Colorado parking lot).
Call 970-824-3246 or use the fax 970-824-7108. Our e-mail address is email@example.com. The office is open from 8:30 a.m. to 12:30 p.m., Monday through Thursday. Other times can be arranged by appointment only. Bring a copy of your separation papers (DD-214) for application for VA programs and for filing at our office.