Letters: Ways to control tinnitus
Re “Can We dial Down the Noise?” April 12: Our medical device company has tested a variety of products designed to help people cope with tinnitus. Our research has shown minimal effectiveness with these products. However, the quality-of-life scores for some people improve because they feel they are taking action in coping with the sound. The people whose quality-of-life scores improve the most tend to be those who control the pitch, intensity and/or volume of the sound by actively managing their intake of caffeine, sugar, salt, over-the-counter pain relievers and alcohol with sulfites.
My own experience parallels our research findings. After suffering with tinnitus for more than 20 years, I now know that if I choose a cafe mocha, a handful of pretzels or a glass of red wine with dessert, the result will be an increase in the volume and intensity of the ringing for eight hours or more. On the days I abstain from caffeine, aspirin, alcohol and minimize sugar and salt intake, the ringing is much more subdued.
Richard Harbaugh, founding partner, Consilium
Irvine
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One thing that most writers fail to mention is the caution with which those on anti-coagulant therapy should approach any “remedy.” This can be true of diet as well as herbal supplements.
Gingko, garlic and many other so-called natural remedies can promote bleeding; others may interfere with the action of anti-coagulants. The fact that the makers of Quietus do not state the ingredients should be a huge red flag.
Kathy Kuczynski
El Toro
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When I read that Barbra Streisand has learned to live with tinnitus in both ears since she was l6, the ringing in my left ear seemed quite manageable.
Ruth Kramer ZIony
Los Feliz
Assisted-suicide skepticism
I am an attorney in Washington state, where physician-assisted suicide is legal. Marc Seigel’s article [“Assisted Suicide Episode Hits the Mark,” April 12] about our law fails to address elder abuse, coercion and/or patients being killed on an involuntary basis.
Our law’s key provisions include that an heir who will benefit from the death is allowed to help the patient sign up for the lethal dose; patients do not have the right to consent at the time of death; even prosecutors are required to treat the death (voluntary or not) as “natural.”
For more information, please see my article in the Washington State Bar News.
Physician-assisted suicide is sold to the public with engaging slogans about “choice” and benign sounding-euphemisms. Physician-assisted suicide is instead a recipe for elder abuse and worse. Don’t let “death with dignity” come to California.
Margaret Dore
Seattle
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I am an attorney and a person with disabilities. Marc Siegel’s article on the “Grey’s Anatomy” episode about physician-assisted suicide states that the show’s prediction of six months to live was “fairly realistic.” His statement is based on a reported median average for the illness at issue.
What the article overlooks is that for any one person, the prediction may be completely wrong. I have had asthma all my life, diabetes for 20 years and congestive heart failure for 10 years. Yet, as the Sondheim song says, “I’m still here.”
On a couple of occasions, I have found myself in the hospital with a major illness, deeply depressed and thinking suicidal thoughts. If physician-assisted suicide were legal here and I had yielded to the depression, I would have missed some of the best times of my life and would not be writing you now.
Physician-assisted suicide is bad public policy.
Stanton J. Price
Glendale
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I am a doctor in Oregon, where physician-assisted suicide is legal. Shortly after our law was enacted, a woman in her mid-50s was referred to me with anal canal cancer. Upon learning of the cancer, she developed a hopeless feeling and decided to forgo treatment so that she could qualify for our new law and kill herself.
She nonetheless continued to meet with me and ultimately agreed to chemotherapy and radiation. Her cancer disappeared, she did not require surgery and she had normal bowel function. About six years later, I saw her in a restaurant and she came over and gratefully exclaimed, “You saved my life!”
With assisted suicide legal, I could have instead encouraged her to kill herself. I did save her life. I urge you to keep physician-assisted suicide out of California.
Kenneth Stevens, MD
Sherwood, Ore.
Making medicine work
As a patient and student nurse, I was a bit put off by Dr. Ulene’s feature on the importance of communication between physician and patient and almost stopped reading it [“Patient, Doctor: Work Together,” April 12].
Although she addressed some important points, overall I think Dr. Ulene missed the mark by assuming patients know or care about what it’s like to be a physician today. Patients care about, are often very worried about, their health — in particular, whatever brought them to see the physician/nurse practitioner that day. I believe it is the responsibility of the physician/nurse practitioner to set the tone for the communication.
Greeting a patient, apologizing if you are late and asking the patient to tell you what brought them in while attentively listening can set the tone for a relationship of trust and caring. From there, the physician/nurse practitioner can guide the conversation by clarifying the patient’s concerns and setting up a realistic plan.
Expecting patients to know what is “unnecessarily time-consuming” or what it means to be “direct and concise” when speaking to a health professional is unrealistic. Physicians/nurse practitioners are trained to know what to ask and how to ask it. Therefore, the responsibility is on them to tease out the critical components of the patient’s story and focus their line of questioning there.
Trese Biagini, student nurse
UC San Francisco
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