Tim Grieve

Did popping painkillers make Rush lose his hearing?

The drugs Limbaugh is rumored to have abused are known to cause sudden hearing loss. But his doctors insist there's a different diagnosis.

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When Rush Limbaugh announced two years ago that he had suddenly gone deaf, he was uncharacteristically circumspect about the possible cause. “There is a theory as to what’s happening,” Limbaugh told his listeners in October 2001, “but I’m going to keep that to myself. It’s not genetic. There’s something more going on than that.”

Was the “something more” Limbaugh’s abuse of painkillers?

The New York Daily News reported last week that Limbaugh is under investigation for buying “thousands of addictive pain killers from a black-market drug ring.” Relying heavily on a story that first appeared in the National Enquirer, the Daily News reported that Limbaugh’s former housekeeper claims to have supplied him with massive quantities of OxyContin, Lorcet and hydrocodone between 1998 and 2002.

Lorcet — which, like Vicodin, is a mixture of hydrocodone and acetaminophen — has been linked to sudden and profound hearing loss in patients who misuse or abuse the drug. First in 1999 and then more forcefully in the summer of 2001, physicians at the House Ear Clinic in Los Angeles warned doctors and consumers of a “possible correlation between permanent hearing loss” and hydrocodone-acetaminophen combinations such as Lorcet and Vicodin. The Los Angeles Times reported in September 2001 that doctors at House and other Southern California medical facilities had identified 48 patients who suffered hearing loss after taking exceptionally high doses of the drugs.

Coincidentally — or not — Limbaugh turned to the House Ear Institute after he began experiencing what doctors there called “rapidly progressive hearing loss” in May 2001. Limbaugh announced his hearing loss on Oct. 8, 2001, after listeners to his show began to notice that his voice had lost some of its usual basso profundo thunder. The news of Limbaugh’s hearing loss was greeted with something approaching mourning on the right; the White House expressed George W. Bush’s personal concern for Limbaugh and said that the president considered him a “national treasure.”

Three days later, doctors at House told reporters that they were treating Limbaugh for “hearing loss resulting from autoimmune inner ear disease,” or AIED. The doctors said that they based their diagnosis on Limbaugh’s “medical history and hearing tests.” However, they noted at the time that “Mr. Limbaugh does not display most of the symptoms associated with AIED.”

House physicians issued a statement late last week in which they stuck with their diagnosis of AIED, despite the surfacing of allegations that Limbaugh had abused one of the drugs House previously identified as causing hearing loss. “The AIED diagnosis has not changed, and the House Ear Clinic continues to consult Mr. Limbaugh regarding his treatment for this disorder, and to follow up with him regarding his cochlear implant,” they said.

In the statement, the House doctors said that hearing loss caused by an overdose of Vicodin-type drugs “usually occurs over a period of days,” while hearing loss caused by AIED typically occurs “over a period of several weeks to months.” Limbaugh’s hearing loss reportedly took several months, from May through September 2001.

But Dr. Gail Ishiyama, a UCLA neurotologist studying the mechanism that triggers hearing loss in Vicodin users, said that there is no real way to tell the difference between AIED and Vicodin-induced hearing loss — unless the patient confesses to drug abuse. “It can present very similarly,” she told Salon Monday, “and unless the patient tells you that they’re abusing the Vicodin or other pain medication, you wouldn’t know the difference.”

Ishiyama disagreed with House’s contention that hearing loss in drug cases happens faster than that in AIED cases. “Both typically are on the order of months, a few months or so,” she said. Ishiyama said that “the only difference” in how the two maladies present themselves is the patient’s history; if a patient denies abusing drugs, doctors “couldn’t really know” whether the patient suffered from AIED or drug-induced hearing loss.

“Patients don’t admit to the drug use, and it actually sounds like that was the case in his particular case,” Ishiyama said. “So many patients are reluctant to admit to their abuse even if they’re asked.” Ishiyama, who is conducting research under a grant from the National Institute of Deafness and Other Communication Disorders, said it is unfortunate that patients frequently withhold information about drug abuse from their doctors because evidence shows that drug-induced hearing loss may be halted if the drug use is stopped in time.

When asked about the AIED diagnosis late last week, House spokeswoman Christa Spieth Nuber initially told Salon that Limbaugh underwent blood tests during his diagnosis and treatment at House, and that the tests did not reveal any signs of drug abuse. Minutes later, however, Spieth Nuber called back to say that she had discussed Limbaugh’s case with Dr. Jennifer Derebery, one of the physicians who had treated Limbaugh, and that Derebery told her that Limbaugh had not, in fact, been tested for “toxicity” related to drug use. She said her earlier statement to the contrary had been an error based on her own mistaken assumption about the way Limbaugh’s case would have been handled.

Spieth Nuber said a toxicity test was not necessary in Limbaugh’s case because the House doctors had already made their AIED diagnosis based on a full medical evaluation, Limbaugh’s medical history — as provided to them by his earlier doctors and by Limbaugh himself — and the relatively slow nature of his hearing loss.

Ironically, when Limbaugh made his announcement in October 2001, he told listeners that they “would not believe the medication that is flowing through me in an attempt to reverse this.” He said: “I’m popping pills [and] I’m shooting up stuff. I’ve never done stuff like this before.” The medication ultimately proved ineffective, and Limbaugh received a cochlear implant in 2001, reportedly restoring much of his hearing and allowing him to continue working.

Premiere Radio Networks, which distributes Limbaugh’s show, referred calls about his hearing loss to the House clinic. Meanwhile, Limbaugh has been circumspect about the allegations that he abused drugs — and silent altogether about any possible link between drug abuse and his hearing loss. On his radio show Monday, Limbaugh mentioned the drug-related allegations against him but offered no specific information.

“I am waiting to find out just exactly what I am facing legally, and until I know that, I’m not going to say anything — much less, I can’t,” Limbaugh told listeners Monday. “When such time comes, fear not, what there is to be known will be known and I will tell you. But until it is permissible and makes sense for me to tell you that, I can’t and I won’t.”

A farewell note

Some 4,000 posts later, this one will be my last.

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Three years ago, I took over War Room from my friend and editor Geraldine Sealey. Some 4,000 posts later, this one will be my last. I’m leaving Salon for Politico, where I’ve accepted a job as congressional bureau chief.

Alex Koppelman will be taking over War Room.

I want to thank Salon for giving me the freedom to do what I’ve been doing here. More important, I want to thank you, the readers, for making the work feel so worthwhile. I’ll miss our dialogue — even the frank exchanges — and I wish you all the best.

We’ll take that as a “no”

In the run-up to Bush's last State of the Union address, his press secretary ponders whether the country is better off than it was seven years ago.

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At today’s White House press gaggle, devoted almost entirely to George W. Bush’s final State of the Union address, a reporter asked Dana Perino a simple yes-or-no question: “Is the country better off now than seven years ago?”

Here’s how she answered:

“Certainly seven years ago — well, seven years ago, right before September 11th, I think that people would say that the country certainly felt better off. There’s been — once we were confronted with terrorists who would fly jumbo jets into buildings and kill thousands of our citizens in an instant, it created a sense of fear and nervousness about our security. And that’s why the president decided to take on the terrorists head on and go on the offense.

“And we have done that around the world. We have been successful so far in preventing another attack on our country. But it’s not for their lack of trying. And that’s another reason why the president — tonight you’ll hear him call on Congress to pass the Foreign Intelligence Surveillance Act reauthorization. They have until Friday to do that, and the president sees no reason why they shouldn’t be able to get that done.”

John Edwards’ “path to the nomination”

He'd be a contender if only someone else would drop out.

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The John Edwards campaign has just distributed a new “interested parties” memo. Its subject line is “Path to the nomination,” and we were looking forward to reading the rest: Having not yet won a state, having lost badly in first-in-the-South South Carolina and trailing far behind in the delegate count, how can Edwards win the Democratic presidential nomination?

We’ve read the memo, and we’re still not sure.

The “path to the nomination” seems to be as much of a hope as it is a plan. The Edwards campaign says an “online fundraising boom” has left it on “solid financial footing,” but it understates Edwards’ delegate deficit by focusing only on the delegates won in Iowa, New Hampshire, Nevada and South Carolina and by ignoring the super-delegates who have already aligned themselves with a candidate. By the Edwards campaign’s way of counting, Barack Obama leads the delegate count with 63, followed by Hillary Clinton at 48 and Edwards at 26. By CNN’s tally, Clinton has 230, Obama has 152 and Edwards has just 61.

Either way, it’s a long way to the 2,025 needed to win the nomination. How does Edwards get there? The Edwards campaigns say it expects that the Democratic presidential race “will narrow to one of the two celebrity candidates and us — and when that happens, we are confident that the remaining contests will break in our direction as voters are finally offered the choice the national media has ignored all year — the most progressive, most electable candidate in the race, John Edwards.”

That’s not an unreasonable scenario if you assume away the premise — that is, if you simply assume that at some point one of the “celebrity candidates” ceases to be a serious contender. But what’s the basis for making that assumption? On what set of facts would either Hillary Clinton or Barack Obama drop out of the race and leave Edwards free to face the other alone? That’s the critical assumption underlying the Edwards’ argument, and the justification for making it isn’t in the memo.

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Rezko arrest rains on the Obama parade

Already under indictment on fraud charges, longtime Obama supporter is taken into custody.

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It’s not all good news for Barack Obama: Longtime Obama supporter Tony Rezko, already under indictment on fraud charges, was reportedly arrested today on an alleged bond violation.

Endorsing Obama, Kennedy goes after the Clintons

Kennedy says that Obama will be ready on "Day 1."

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As Sen. Ted Kennedy endorsed Barack Obama today, he also made it clear why he’s not endorsing Hillary Clinton.

Although Kennedy called Clinton a “friend” and said she has been “at the forefront on issues ranging from healthcare to the rights of women around the world,” he also made a number of not-so-veiled stabs at the Clintons. Kennedy said that Obama refuses to be “trapped in the patterns of the past,” that he “cares passionately about the causes he believes in without demonizing those who hold a different view,” that he’s “tough-minded” but “also has an uncommon capacity to appeal to the better angels of our nature.”

While Bill Clinton has argued that Obama’s record on Iraq is far more mixed than Obama has suggested, Kennedy said that the voters know “the truth” about the matter. Kennedy stole one of the Clinton campaign’s lines — ready to lead on “Day 1″ — and applied it to Obama. And then, equating Obama with his late brother, Kennedy reminded the overflow crowd at American University that another former Democratic president — Harry Truman — once urged John F. Kennedy to “be patient” about seeking the White House.

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