A KISS WITH LASTING EFFECT
We’ve all heard of unilateral (one-sided) hearing loss that results from trauma, loud noise, or overzealous use of a cotton swab, but a kiss? As improbable as it may seem, there have been documented cases of an innocent kiss creating enough suction on the ear opening to damage the eardrum. This type of injury, known as “cochlear ear-kiss injury,” commonly occurs among babies and small children, whose vulnerability stems from their small ear canals. Further complicating the problem is that the kiss-induced injury may occur among babies and no one will be aware of it until an ear exam is performed. In the meantime, young and old alike are cautioned about this potential problem of which few people are aware.
P.S. Those with “cochlear ear-kiss injury” exhibit a characteristic pattern of hearing loss in which hearing is most diminished in the frequency range of consonants such as “ch” and “sh.”
LOST HEARING FOR NO GOOD REASON
Just one person in seven aged 50 and older who could benefit from wearing a hearing instrument actually wears one. This translates into almost 23 million Americans who either don’t know they have clinically significant hearing loss or choose not to get the help they need to overcome the loss. Why are people so reluctant to use a device that could prove so beneficial? According to a recent analysis related to hearing loss from the ongoing National Health and Nutrition Examination Survey, some mistakenly believe that hearing loss is an inconsequential part of aging; others cite insufficient healthcare coverage for hearing instruments and hearing loss treatment. The truth is, however, that affordable instruments can change lives for the better.
P.S. Research shows hearing loss to be linked with decreased cognitive function, the risk of developing dementia, a negative impact on relationships, work performance impairment, and a decreased quality of life.
HOW BABY’S HEARING DEVELOPS
There is good reason why pregnant women talk to their unborn children. Fetuses reportedly respond to loud noises about seven weeks before full-term delivery. Once born, they seem to be quite sensitive to the location, frequency, pitch, and volume of sounds. During the second month of life, babies are more attuned to a wider range of sounds, particularly medium-range sounds which seem to soothe them. Moreover, infants can hear higher frequencies than adults, which largely accounts for why adults speak to them in high-pitched voices. By age six months, babies can discriminate among different speech sounds and detect a wide array of pitches. At this point, babies will look around to see where loud noise is coming from.
P.S. Aside from having their hearing tested by audiometry, which assesses frequency perception, children can undergo tympanometry, which uses a probe to measure sound waves bounced off the eardrum.
CAN A HEARING INSTRUMENT HELP YOU?
The ability of a hearing instrument to help you with your hearing loss largely depends on what type of loss you have. If you hear fairly well but have trouble making out what people are saying to you, or experience difficulty hearing in noisy environments, it is likely that you have a “sensorineural” loss. This type of hearing loss, which is the most common type by a wide margin, is caused by problems in the inner ear. Most often, the culprits are the tiny “hair cells” (nerve endings) that have become damaged or destroyed, usually due to exposure to loud noise. The good news is that this type of hearing loss can usually be helped with a hearing instrument.
P.S. One main type of hearing loss is “conductive” loss, which involves problems in the middle or outer ear.
The eardrum, a thin layer of tissue that separates the ear canal from the middle ear, vibrates when sound waves hit it. In turn, those vibrations pass through the bones of the middle ear and are transformed into electrical signals that are sent to the brain. When the eardrum ruptures (due to very loud noises, ear infections, pressure changes between the inside and outside of the eardrum, injury, and foreign objects inserted into the ear), hearing loss, earache, discharge, and/or loud buzzing noises can result. Inspection of the ear with an otoscope can help determine the extent of damage. Fortunately, any associated hearing loss can be expected to be short term, and the tissue will repair itself within two months.
P.S. To prevent rupture of the eardrum, do not insert objects (especially cotton-tipped swabs) into the ears.
RIGHT ON THE BUTTON
The great strides in hearing instrument design can be partially attributed to the tiny batteries that power sophisticated digital systems. However, this capability comes with a potential price. To young children, button batteries look like shiny coins. And as young children are prone to do, they often put things in their mouths that pose a danger. A swallowed button battery may become lodged in the esophagus, where it introduces an electrical current that flows through the tissue without children betraying any signs of obvious injury. The number of small children treated in emergency rooms for swallowed batteries has nearly doubled in the past two decades. Hearing instrument users must do their part to prevent these occurrences.
P.S. Batteries of all types should be kept out of the sight of small children, just as pills, household cleaners, and sharp objects are.
SECOND THOUGHTS ABOUT HEARING LOSS
While it may not come as a surprise that smoking is linked with increased risk of hearing loss, it may come as a revelation to many that teens exposed to secondhand smoke may be at higher risk for hearing loss. While these findings do not necessarily prove that secondhand smoke directly causes hearing loss, it certainly provides one more good reason to not smoke and to stay away from smokers. It must also be pointed out that most of the teens with secondhand smoke exposure and hearing loss did not know that their hearing was impaired. This is important because lack of hearing may be affecting their learning and speech skills without anyone realizing it.
P.S. At the very least, teens should be made to realize that smoking leads to hearing loss.
MUSIC TO PARENTS’ EARS?
Parents of adolescent children may want to take careful note of a 24-year study that found that high-frequency hearing loss among girls with an average age of 16 nearly doubled from 10.1% to 19.2%. During the last seven years of the study, which involved 8,710 girls, personal music player use grew fourfold from 18.3% to 76.4%. During that same period, the proportion of girls with tinnitus nearly tripled, from 4.6% to 12.5%. While there certainly may be other factors at play in causing the significant increase in hearing problems, exposure to loud music must be seen as a primary culprit. With this in mind, parents are urged to educate their children on the proper use of MP3 players.
P.S. According to the study mentioned above, of the girls who experienced tinnitus (ringing, buzzing in the ears), 99.7% used personal music players.
LIKE FATHER LIKE SON?
Because tinnitus (ringing in the ears) has been reported to occur among members of the same family, experts have wondered whether it is an inherited disorder. To answer this question, researchers analyzed data from nearly 13,000 spouses, more than 27,600 parents and offspring, and nearly 11,500 siblings. Beyond that, information from 28,000 other people was accumulated in a questionnaire. This information showed that there is no indication that tinnitus is passed down through genes. Researchers were quick to point out, however, that their findings do not necessarily mean that all forms of tinnitus can rule out genetics as a causative factor. In some cases of tinnitus, genes may indeed play a role.
P.S. Symptoms of tinnitus can be treated with hearing instruments and maskers (a device that is worn like a traditional hearing instrument that produces pleasant sounds).
HAVE YOU HEARD ABOUT OPEN-FIT INSTRUMENTS?
The biggest news involving hearing instruments in recent years revolves around the introduction and widespread popular acceptance of “open-fit” hearing instruments. What makes these instruments so special is their design, which places miniature digital components completely behind the ear, which eliminates the need for a mold. From there, a small plastic tube attached to the business end of the instrument brings sound to the ear canal. Popular excitement with this type of hearing instrument stems primarily from the fact that it is so comfortable. There is no mold to insert in the ear, and the ear canal remains open, so there is no occlusive (plugged) effect. Open-fit instruments also remain hidden behind the ear and are less visible.
P.S. It takes a while for the brain to accustom itself to hearing sounds differently with a new hearing instrument.
YOU SHOULD LISTEN, IF YOU CAN’T HEAR
As long as the statistics remain unchanged, it bears repeating that an estimated 2 million Americans who could benefit from using a hearing instrument choose not to. Among older individuals, stigma still surrounds hearing-instrument use largely because people think that wearing hearing instruments makes them look older. However, aging is a fact of life, as are the facts that 10% of people ages 65 to 75 and 25% of those ages 75 years and older have hearing loss. Denying these facts can be downright dangerous, as hearing loss makes driving or crossing busy streets more dangerous. Other potential consequences are family discord, social isolation, and miscommunication at work due to missed conversations, directions, or reminders. No one should suffer needlessly.
P.S. Today’s in-the-canal (ITC) and completely-in-the-canal (CIC) hearing instruments are barely noticeable.
TAKING EXCESSIVE NOISE TO HEART
It is well documented that prolonged exposure to excessive noise harms hearing. With this in mind, hearing protection is required in work places where the noise level exceeds 85 decibels. In addition, past research has suggested that exposure to loud noise also raises a person’s heart attack risk. More recently, one study now shows that the risk of heart attack increases as noise increases. That is, while the risk of heart attack increases at noise levels above 60 decibels (about the level of conversation in a restaurant), the risk increases incrementally between 40 and 80 decibels. When one considers that 70 decibels is the level of noise coming from freeway traffic (at 15 meters), there is reason to be concerned.
P.S. For every 10-decibel increase, the perceived loudness of sound doubles.
CLOSE YOUR EYES AND LISTEN
If you have ever closed your eyes in order to listen to music more clearly, you probably already intuitively appreciate the advantage of doing so. The same logic pertains to the reported ability of blind people to hear sound more clearly than sighted individuals. Researchers studying this effect undertook a study in which they exposed listeners to a harmonic tonethat sounded like a single note but had layers of “harmonicity.” They found that those who spent 90 minutes in a blindfold were better able to distinguish the layered sound than they had been before being blindfolded. This increased hearing ability can be attributed to the brain’s capacity to increase input from one sense in the absence of another.
P.S. Research shows that the senses do not work independently of one another, but interact in a web-like structure.
HOW DO YOU HEAR UNDERWATER?
If we generally rely on airborne pressure waves to perceive sound, how do we hear underwater? The answer rests with “bone conduction,” which bypasses both the outer ear and the ossicles of the middle ear. Instead, sound comes through the mastoid, which is the bone that lies behind the ear. In some ways, bone conduction is better than air-conducted hearing in that it enables us to hear higher frequencies. While we can onlyhear between 20 and 20,000 hertz through the air, we can perceive up to 200,000 hertz when submerged underwater. Researchers may someday use this knowledge to improve hearing instrument design. Currently, bone-conduction hearing instruments are used by individuals with outer- and/or middle-ear abnormalities.
P.S. Humans hear best between about 500 to 3,000 hertz, which corresponds to therange of human speech.
Are you middle-aged or older with a hearing impairment that you are reluctant to address because you think that a hearing instrument will make you look old? If so, look carefully at one of the Bluetooth behind-the-ear headsets currently on the market that allow users to take telephone calls without using their hands. These cutting-edge devices are favored by runners who want to remain “connected” as well as by businesspeople who cannot afford to miss calls. These individuals and others openly wear these pieces of remarkable equipment as badges of honor. They do not conceal them. Yet, they look very much like today’s most popular type of hearing instrument, the open-fit design.
P.S. If anyone were to actually spot your open-fit hearing instrument and ask what it was, you could say that this sleek bit of technology “keeps (you) connected.”
Have you ever wondered why restaurants, clothing stores, and other retail establishments are so noisy?According to one study of New York City restaurants, bars, stores, and gyms, one-third of them were found to have noise levels deemed to be dangerous. However, the Occupational Safety and Health Administration (OSHA), which is responsible for workplace safety, usually only investigates if a complaint is made. This mechanism plays right into the hands of restauranteurs and retailers who play loud music to manipulate customers. It seems the louder the music and/or conversation level, the less people talk and the more (and faster) they eat or buy. Loud music is also used to attract younger consumers. Resultant hearing loss is unfortunately a secondary consideration.
P.S. A spin class (also known as studio cycling) can generate noise up to 100 decibels, a level at which hearing loss can occur within 15minutes without adequate hearing protection.
When hearing instrument users are asked about their biggest concerns with regard to their hearing devices, many indicate they are worried about participating in activities that pose the risk of damaging their instruments. Concerns include walking in the rain, showering, sitting in a whirlpool tub, walking vigorously, and participating in sports and various hobbies. Some actually curtail their participation in these and other activities in order to avoid submerging, dropping, or contaminating their instruments. To address these issues, the hearing instrument industry has developed devices that are waterproof, shock-resistant, and dustproof. Baby Boomers in particular are interested in maximizing their hearing ability without worrying about restrictions. Those who share these concerns and expectations need only ask their hearing professionals.
P.S. An IP (Ingress Protection) Rating, which indicates the degree of protectionprovided by an enclosure, can be used to rate the degree to which a hearinginstrument resists water and dust.
FEELING LEFT OUT?
No one likes to be excluded from a conversation; yet, many people with hearing problems actually make the choice to be left out by choosing not to use a hearing instrument. Only about one in five people with hearing loss who could benefit from wearing a hearing instrument actually wear one. Older people with impaired hearing often say that they do not want to wear a hearing instrument because it will make them look old. The simple answer to that question is that constantly asking conversation partners to speak up or repeat themselves draws more attention to age-related hearing loss (presbycusis) than wearing a barely noticeable “in-the-ear” hearing instrument. So, get in on the conversation!
P.S. Having to ask conversation partners to constantly repeat themselves eventually leads to talking less just to avoid the annoyance.
GETTING THE MOST OUT OF WHAT YOU HAVE
If you have ever purchased a microwave oven, you know that nearly all of the higher-grade models have a multitude of features, from convection cooking to meat-thawing functions. Many people, however, buy microwaves without ever using most of these convenient features. They simply select a time, push the start button, and wait for their reheated food. The same might be said for hearing instruments in that many users never avail themselves of the full potential of their hearing devices because they do not fully understand how to use them. In recognition of this potential underuse problem, hearing professionals go out of their way to elicit questions from hearing instrument users. It’s your job to avail yourself of these opportunities.
P.S. When selecting a hearing instrument, it is important that your dexterity level be in line with the level of manipulation required by the device for proper use.
HELPING SENIORS OVERCOME COMPLICATIONS
One of the most common complications of hospitalization among seniors is delirium. In fact, this rapidly developing and severe confusion that is accompanied by altered consciousness and an inability to focus affects as many as one-fifth of patients 65 and over who are admitted to hospitals. While there may be many causes of “hypoactive delirium,” which is characterized by drowsiness, being difficult to awake, and being withdrawn, sensory deprivation may play a role. Older patients are often separated from their hearing instruments and eyeglasses during a hospital stay. If so, patients can be left feeling disoriented and less able to function, which contributes to delirium. Reintroducing these important sensory aids may help older patients adapt better to hospitalization.
P.S. When deprived of the hearing instruments that they regularly use, seniors may feel isolated and disconnected. —
Many people are familiar with “white noise,” the electronic noise that accompanies the “snow” pattern on analogue TV screens, which appears when no transmission signal is found. While white noise contains every frequency in human hearing range in equal amounts, “pink noise” is a variant of white noise that has been filtered to reduce the volume at each octave (to compensate for the increase in the number of frequencies at each octave). So, why should you be interested in any of this? Well, when researchers recently exposed sleepers and daytime nappers to pink noise, they found that three-quarters of the study’s participants reported more restful sleep, and their brain activity showed signs of increased “stable sleep,” the most restful type.
P.S. The reason that the sound of falling rain is so restful is because it is steady and uninterrupted, much like pink noise.
ON AUTOMATIC PILOT
The goal of many hearing instrument manufacturers is to develop devices that automatically adjust to all situations, which means that the user can just sit back and enjoy. Today’s instruments may automatically compensate for continuous, non-fluctuating noise (such as the rumbling sound inside an airplane cabin). They are also generally able to amplify sounds without generating irritating feedback and are able to differentiate between loud and softer sounds. However, some hearing instrument users simply like to exert control for themselves. Research shows that about one-third of hearing instrument users still like to fiddle with volume controls, multiple memory controls, and/or remote controls. Either automatic control does not meet all their listening needs, or they are unwilling to give up control.
P.S. It is very important to work with a hearing specialist to select a hearing instrument that meets all of a client’s functional and lifestyle needs.
HEARING TEST FOR NEWBORNS
Because 1 to 6 out of every 1,000 children is born deaf, it is imperative that health professionals test newborns’ hearing. Of course, infants cannot answer for themselves, which has led to a unique screening method. Auditory Brainstem Response (ABR) is a simple, non-invasive procedure that involves the measurement of electrical impulses as a means of providing important information regarding a child’s auditory system. Simply put, ABR measures how sound travels through specific anatomical sites that act as “relay stations” along the auditory pathway from the outer ear to the brainstem. Once a computer is used to record the results of the test, the data can be compared to the norm to make an analysis of the child’s hearing.
P.S. Auditory Brain Response involves placing three or four small stickers on a child’s head, which are connected to leads going into a computer. During the course of the test, the child is asleep.
CAN JEWELRY CAUSE HEARING LOSS?
As children’s toys and trinkets containing lead have come to light as posing significant potential health dangers, cadmium has emerged as a lead replacement that seems to be no less dangerous. The U.S. government has identified cadmium as a carcinogen that accumulates in the body and remains there for years. In jewelry, overseas jewelry makers favor cadmium because it’s an inexpensive, soft metal that melts easily at low temperatures. Recently, a review of data from the National Health and Nutrition Examination Survey (NHANES) has led researchers to conclude that even low-level exposure to cadmium may increase the risk of hearing loss. While more research needs to be done, parents have one more reason to keep children away from cadmium-containing products.
P.S. Hearing loss is the third leading chronic condition experienced by adults ages 65 and older. By eliminating possible causes, such as accumulated exposure to cadmium and excess noise, etc., hearing may be better preserved.
Many tinnitus sufferers have found a way to live with the constant ringing in their ears; others are not so fortunate, as the buzzing sound in their ears is so pronounced that it is difficult to concentrate during the day or sleep at night. In either case, tinnitus sufferers can benefit from an evaluation from an audiologist. On the basis of that exam, either a hearing instrument or a masking device may be recommended. While the former makes sound so clear that the buzzing noise may recede, the latter drowns out the buzzing sound with a sound of a specific frequency. The important point to remember is that this is a common problem that is not “all in your head.”
P.S. Generally speaking, tinnitus intensifies with increased hearing loss.
OUT OF SIGHT, TOTALLY IN MIND
The biggest advantage of a completely-in-the-canal (CIC) hearing instrument is that it can be worn virtually undetected. For this reason alone, CIC instruments are among the most popular choices for those who are in need of their unique properties. In addition to their cosmetic advantage, CICs also have been noted to impart the acoustic advantages of greater directional sensitivity and localization. This means that the unique placement of CICs within the ear enables wearers to better locate sounds since the instrument takes advantage of the cup-like shape of the outer ear to gather incoming sounds. CICs may not only be the most natural-looking hearing instruments, they may also most closely approximate the natural acoustics of the ear.
P.S. Completely-in-the-canal hearing instruments require a fair degree of manual dexterity when it comes to their insertion in (and removal from) the ear.
ARE YOU LOSING YOUR HAIR
As we get older, hair loss becomes a distinct inevitability for many men and women. As much as hair loss is largely a cosmetic concern, another type of age-related hair loss poses a more significant problem. The fact is that there are tiny hairs inside the inner ear that pick up sound waves and convert them into nerve signals that the brain interprets as sound. When these tiny receptors known as “hair cells” die or are damaged largely due to age-related inner-ear changes and excessive noise, they do not grow back. As a result, hearing loss occurs, beginning with the inability to hear high-frequency sounds. When this inability compromises conversation, it is time to get a hearing instrument.
P.S. So-called age-related hearing loss, “presbycusis,” is occurring at earlier ages as young people increasingly expose their ears to loud noise.
Research clearly indicates that untreated hearing impairment leads to a host of negative outcomes as those with hearing loss needlessly grapple with their inability to communicate effectively. Even though family, friends, and co-workers may pressure hearing-impaired individuals to come to terms with their problem, those suffering from hearing loss may feel too self-conscious or embarrassed to address the issue. Instead, many overcompensate for their hearing losses by pretending that they heard what was said, avoiding asking people to repeat themselves, or simply ignoring what was said. As a result, denial leads to social isolation, withdrawal, and even paranoia. These social and psychological effects can be overcome with the use of hearing devices that are barely noticeable.
P.S. Untreated hearing loss can lead to irritability, tension, stress, anger, negativism, rejection by others, impaired memory, less adaptability to learning new tasks, reduced coping skills, and reduced overall psychological health.
HEARING LOSS LINKED WITH DEMENTIA
According to a 12-year study involving men and women between the ages of 36 and 90, individuals suffering hearing loss are at increased risk of developing dementia as they age. Researchers found that even those with mild hearing loss had nearly twice the risk of developing dementia compared with those with normal hearing. The risk of dementia was found to increase three-fold for those with moderate hearing loss, and those with severe hearing impairment had a five-fold increase in dementia risk. While it is not yet clear whether hearing loss and dementia occur together or whether hearing loss leads to isolation that leads to dementia, there is no question that treatment with a hearing instrument provides clear benefits.
P.S. In the study mentioned above, the hearing loss/dementia link remained even after age and other potentially influential factors were removed from the equation.
A LOSING PROPOSITION
One of the many benefits of being fitted with binaural hearing instruments is that fitting each ear with a hearing instrument helps avert “adult-onset auditory sensory deprivation.” This term refers to the notion that the ear without the hearing instrument loses its ability to understand speech over time when compared to the ear with the hearing instrument. As the ear fitted with the hearing instrument assumes more of the responsibility for hearing, the nerves in the unaided ear weaken, and hearing ability declines. If this process goes on unaddressed, future fittings of the untreated ear with a hearing instrument may be decidedly more difficult. It is better to fit both ears with hearing instruments from the start.
P.S. Binaural hearing allows for better detection of the direction of sounds.
A PILL FOR HEARING LOSS?
With so many drugs on the market being used to treat everything from high blood pressure to depression, some wonder why there are currently no approved disease-modifying drugs for hearing loss. There is certainly a vast market for such drugs, considering that nearly a third of people aged 65 to 74 and half of those over 75 experience some degree of hearing loss. In recognition of the fact that developing hearing-loss drugs has blockbuster potential, some of the big pharmaceutical companies are taking the first steps toward creating such treatments. For instance, one major corporation is in the initial stages of testing a drug to treat age-related “sensorineural” (nerve-related) hearing loss by enhancing the function of existing hair cells.
P.S. Aside from regenerative approaches to treating hearing losses with drugs, there is also testing underway to develop drugs that prevent hearing loss.
KEEPING AN “OPEN” MIND
The most popular type of hearing instrument on the market today largely owes its huge following to the fact that it is so comfortable to wear. The “open-fit” hearing instrument is named so because it leaves the ear canal open. By delivering amplified sound to the ear via a clear plastic tube positioned at the opening of the ear canal, an open-fit instrument bypasses the need for a custom-fit ear mold that many wearers find uncomfortably occlusive (creating a blocked-up feeling in the ear). This improvement is made possible by advancements in feedback cancellation systems that eliminate annoying buzzing or whistling sounds created by feedback. Open-fit instruments also eliminate the hollow sound (“barrel effect”) often associated with custom-fit hearing aids.
P.S. The open-fit hearing instrument is made for people who prefer a simple, natural solution to their hearing problems.
BETTER HEARING REDUCES SENIORS’ RISK OF FALLING
While it may not make immediate sense as to why older adults with better hearing fall less, recent research shows it to be true. In fact, for every 10-decibel increase in hearing loss, the incidence of self-reported falls during the previous year has been found to increase by 40% among individuals between the ages of 40 and 69. This is an important finding because falls remain a primary cause of senior disability and dependence. At the same time, a recent study shows that only 14% of seniors with hearing loss use a hearing instrument. If this percentage could be increased, seniors might benefit from increased awareness of the surrounding environment that helps to reduce their risk of falling.
P.S. It is possible that improved function of the inner ear, which plays a role in helping the body maintain balance, might contribute to fewer falls among seniors who wear hearing instruments.
POWER TOOLS AND HEARING LOSS
Whether you work in the construction industry or are a hobbyist, you should take steps to prevent hearing loss related to power-tool use. According to a study involving more than 700 carpenters by an audiologist with the National Institute of Occupational Safety and Health, the average 55-year-old carpenter who had worked a lifetime on noisy job sites had suffered hearing loss on the order of 60 decibels (dB). A 25-dB loss is the threshold beyond which hearing loss is said to occur. As far as younger workers are concerned, the study found that the average 25-year-old carpenter has a hearing loss of 20 dB, which is about the same as a 50-year-old who was not exposed to loud noise.
P.S. Over-the-ear earphones designed to enhance spoken words and filter out hazardous noises are recommended for workers in noisy environments.
PAINKILLERS’ LINK WITH HEARING LOSS
research has uncovered a potential link between painkiller use and hearing loss. The study, which examined the effects that acetaminophen, ibuprofen, and aspirin had on the hearing abilities of over 62,000 women between the ages of 31 and 48, found that using acetaminophen 2-3 days a week increased the risk of hearing loss by 11%, while taking the painkiller 4-5 days a week elevated the risk by 21%. As for ibuprofen, taking it 2-3 days a week raised the risk of hearing loss by 13%, taking it 4-5 days a week raised it by 21%, and taking it 6-7 days a week raised it by 24%. Aspirin use was not tied with hearing loss.
P.S. Many prescription medications, such as the antibiotic azithromycin, may have hearing loss or changes in hearing as potential side effects.
NOT YOUR FATHER’S HEARING INSTRUMENT
If you have been diagnosed with hearing loss that can be addressed with a hearing instrument, you may recall images of the clunky devices that your parents or grandparents wore. If so, you should know that modern hearing instruments bear no more resemblance to those pieces of equipment than a rotary-dial telephone looks or performs like an iPhone. Not only are today’s models much smaller (some fit cobmpletely out of sight in the ear canal) than their older counterparts, but they also harness digital technology that makes them exceedingly adaptable. For instance, noise-cancellation systems and programmability enable wearers to walk from a quiet environment into a noisy one without missing a word. Hear the difference for yourself.
P.S. Many hearing instruments are equipped with Bluetooth technology that enables users to go wirelessly to their phones and TV or into a theatre.
If you often have to ask conversation partners to repeat their comments, it is quite likely that you have a problem with your hearing that merits examination. Age-related hearing loss, known as “presbycusis,” occurs slowly and is inevitable as a person gets older. According to the National Institutes of Health, nearly one-third of adults between the ages of 65 and 74 and almost half of those 75 and older experience some degree of hearing loss. The first indication of hearing loss that many have is the inability to distinguish between high-frequency sounds. For instance, it may be difficult to tell the difference between consonants such as “s” and “th.” Fortunately, hearing instruments can help make conversation more clear.
P.S. If you have trouble following conversation and do not correct it with a hearing instrument, you are missing out on the most important form of human interaction, and your relationships may needlessly suffer.
BETTER HEARING FIGHTS DEPRESSION
If you are feeling depressed or anxious, you may want to have your hearing checked in addition to consulting with your doctor. Research shows that there is a potential link between hearing loss and depression and anxiety, and that those with hearing loss may be at increased risk for depression. This connection is understandable, especially among older individuals, in that lessened ability to communicate with others may lead to feelings of isolation, which contributes to depression. On the other hand, when people with mild to profound hearing loss are professionally fitted with hearing instruments, studies show that they experience fewer depressive symptoms, decreased anxiety, and less emotional instability. It bears watching for signs of either depression and/or hearing loss.
P.S. Hearing loss is the third most prevalent chronic health condition facing American seniors.
NOT SEEING IS BELIEVING
Many people reject the idea of wearing a hearing instrument because they believe doing so will make them look old. This perception is largely borne of a culture preoccupied with youthful appearance. Whether or not one agrees, there is no argument that today’s hearing instruments are so small that they are nearly invisible. For instance, completely-in-the-canal (CIC) instruments are so small that they fit entirely in the ear canal. Even instruments of the next largest size, in-the-canal (ITC), are so small that they are barely noticeable. These tiny instruments all but remove one of the biggest objections to being fitted for a hearing instrument. Even the most self-conscious individuals can scarcely object to a hearing instrument others cannot see.
P.S. Open-fit hearing instruments, which are exceedingly comfortable to wear primarily behind the ear, can hardly be seen, even in profile.
NEW TINNITUS TREATMENT
Tinnitus (the perception of persistent ringing or buzzing in the ears) is a problem that affects approximately 50 million Americans, according to the American Tinnitus Association. This bothersome, and sometimes incapacitating, problem is thought to be caused by damage to delicate inner-ear structures that triggers abnormal nerve impulses that the brain interprets as persistent ringing sounds. While many treatments are available, including hearing instruments that mask the sounds and promote better hearing in other frequencies, a new treatment takes a different course. By utilizing psychological training and audio therapy, researchers have found it possible to reduce stress and refocus the minds of tinnitus sufferers so that they can better overlook the problem. In effect, they “learn to live with it.”
P.S. Up to one-fifth of American adults are affected by tinnitus at some point in their lives. A comprehensive hearing test is the first step in addressing the problem.
CAN YOUR HAIR CELLS BE SAVED?
Proper hearing relies on thousands of tiny hair-like cells in the inner ear that convert sound waves into electrical impulses that are sent to the brain. Currently, the damage that these hair cells incur from exposure to excessive noise is irreversible. However, permanent noise-induced hearing loss may be minimized in the future if new research bears results. Research being conducted by the U.S. military to minimize the damaging effects of gunfire on soldiers’ ears reveals that taking 1,200 milligrams of the over-the-counter supplement N-acetylcysteine 12 hours before a noise event worked much better than earplugs alone at protecting Marines’ ears. For everyone, it is important to keep prolonged exposure to noise below the 80-decibel level with proper ear protection.
P.S. According to Israeli researchers, a daily 167-milligram dose of magnesium may offer protection against noise-induced hearing loss.
A COMFORTABLE FIT
One of the features that makes wearing a hearing instrument as comfortable and as natural as possible is a circuit known as “wide range dynamic compression.” This technical feature recognizes that the wearer does not necessarily want all sounds to be amplified equally. Instead, the circuit automatically adjusts the gain so that soft sounds are made louder and louder sounds will not be too loud or distorted. As a result, wearers may be better able to hear conversation over loud noise. In addition, wearers may be helped by the selection of directional microphones, which pick up sound from a narrow listening area. This feature also helps those wearing hearing instruments to better pick up the sounds they want to hear.
P.S. Digital hearing instruments with a multiple-memory feature can store more hearing programs, from which the wearer can select the one most suitable to the hearing situation.
FROM THE VERY BEGINNING
While genetics may play a role in hearing loss, 90 percent of children who are born deaf have parents with no hearing impairments. As important as it is to detect hearing impairment as early as possible, as recently as the 1990s, hearing problems often went undetected and untreated until a child reached two to four years of age. Since then, however, it has been recognized that a greater effort needed to be made to detect hearing loss in newborns, who get more than 90 percent of what they learn from incidental hearing. The first step in this direction is newborn screening, which has led to early intervention with hearing instruments in children as young as four to six months.
P.S. Even a mild or partial hearing loss can affect a child’s ability to speak and understand language.
DAILY ATTACKS ON YOUR HEARING
Prolonged exposure to loud noise leads to hearing loss. Damage begins to occur at 85 decibels (dB), which is about the level of noise that city traffic makes (as perceived from inside a car). For every three-decibel increase above that, the amount of time you can be safely exposed to noise without earplugs decreases by half. What does all this mean in practical terms? Well, if a power lawnmower produces noise at the 105-decibel level, you can safely endure it for only 2.8 minutes. At a concert or sport event, where noise is produced at 110 decibels, you have only 45 seconds before hearing damage begins. A car stereo pumped to full volume (140 decibels) leaves no time for protection.
P.S. If you think that listening to music at loud, hearing-damaging levels is important to you now, imagine a future in which you cannot fully hear sound due to noise exposure earlier in life.
HEARING PROTECTION IN A GLASS?
P.S. The findings of the study mentioned above should not lead readers to think that drinking red wine or red grape juice will make them immune to noise-induced hearing loss.
EARLY SYMPTOMS OF HEARING LOSS
Individuals exposed to persistently loud noise are likely to notice that their high-frequency hearing ability will be the first to be lost. Soon after, repeated exposure to loud noise is likely to cause hearing loss that extends into the range in which speech is spoken. It should then become clear that communication with others has been compromised, especially against the background of competing noise in restaurants and other public venues. If this difficulty doesn’t lead people suffering from the initial stages of hearing loss to schedule an audiological evaluation, the onset of high-pitched tinnitus (ringing in the ears) might make a bigger impression. At this level of hearing loss, a hearing instrument may be quite helpful in restoring conversational ability.
P.S. If hearing loss is work-related, workers’ compensation may pay for an audiological evaluation and hearing instrument.
CAN YOU HEAR FLASHES OF LIGHT?
While the eyes and ears may capture information and transmit it to the brain, it is largely up to the brain to interpret the information so that we can make sense of it. It may be reasonable to assume that since all our brains are at least somewhat different, we may hear and see differently than others do. In fact, recent research shows that some people’s brains actually compensate for their relatively small visual cortex size by transferring some unused information to the ears. As a result, some people interpret what they see as sound. While only some of this phenomenon can be explained by brain anatomy, future research may uncover more about the senses than we now know.
P.S. As research revolving around the brain and its many abilities continues to unfold, we may actually see hearing enhancement devices in the future that tap the brain’s sensing potential in ways that we can now hardly even imagine.
THE “RITE” INSTRUMENT FOR YOU?
One of the newest types of hearing instruments, known as “receiver-in-the-ear” (RITE), is very similar to the popular “open-fit” BTE (behind-the-ear) hearing instruments. The open-fit design consists of a small case that delivers sound through a narrow tube that is positioned right in front of the ear canal. This design affords unsurpassed comfort in that there is no earmold. As an improvement on this design, instead of funneling sound from the ear piece through a tube to the ear, a RITE hearing instrument brings the speaker right to the ear canal by replacing the tube with wiring with the speaker on its tip. By positioning the speaker closer to the ear, the RITE instrument delivers more and higher-quality sound.
P.S. By separating the speaker from the other components, a RITE hearing instrument’s behind-the-ear (BTE) portion is even smaller and more discrete than an open-fit’s BTE portion.
HARDLY REACHING OUR POTENTIAL
Only 14% of older adults with hearing loss (defined as an average hearing level of 25 dB or greater in both ears) wear hearing instruments, according to a recent analysis of data from the National Health and Nutritional Examination Surveys (NHANES). What this means is that 23 million Americans aged 50 and older with diagnosed hearing loss are not using hearing instruments that could help them hear better and live more satisfying lives. The news regarding individuals with only mild hearing loss in the 50-and-over age group is even more dismaying, with only 4% reporting hearing-instrument usage. Those not availing themselves of a hearing instrument are missing out on an opportunity to improve their health and overall enjoyment of life.
P.S. It is wrong to assume that hearing loss is an inconsequential part of the aging process. If left untreated, hearing loss contributes to dementia.
A CONSONANT PROBLEM
If you find it difficult to differentiate between consonants such as “sh,” “th,” or “p,” you may be experiencing age-related hearing loss (“presbycusis”). In speech, consonants, which generally have a higher frequency than vowels, provide the clues needed for determining what a person is saying. If not properly understood, conversation may prove difficult. Even if the problem is not serious enough to require the use of a hearing instrument, those experiencing age-related hearing loss may still benefit from the use of assistive hearing devices used for mild hearing loss. While hearing instruments can significantly improve the ability to communicate for those who need them, they will not restore hearing to normal. A period of adjustment is required for adaptation.
P.S. When first using a hearing instrument, the user will work closely with the hearing specialist to make the necessary adjustments so that the instrument will be comfortable and effective.
HEARING BEGINS BEFORE BIRTH
Pregnant women have reported feeling their unborn children move in response to loud noises at 31 weeks. Around 7 weeks later at birth, newborns can sense sound’s location, frequency, pitch, and volume. Parents should be alert to the fact that loud sounds startle the newly born while rhythmic, repetitive sounds tend to soothe them and put them to sleep. As children reach the second month of life, they become sensitive to a wider range of sounds. Depending on their mood, they will react to a variety of medium-range sounds differently. Infants can also hear higher frequencies than adults, which is why so many adults are predisposed to talking “baby talk” at pitches higher than those of their normal speaking voices.
P.S. Parents can test their young infant’s hearing at home by making a loud noise to see if it elicits a response.
OPEN YOUR EARS TO NEW DESIGN!
If you suffer from hearing loss and have resisted the idea of getting a hearing instrument over concerns about comfort, you no longer have an excuse. Since “open-fit” hearing instruments were introduced, they have revolutionized the industry. No longer does wearing a hearing instrument require plugging the ear canal with a regular earmold. Instead, amplified sound is comfortably delivered through a thin, plastic tube to a point directly in front of the ear opening. The business end of an open-fit hearing instrument is a slender, low-profile component that is worn behind the ear. These instruments produce no occlusive effect that makes listening to one’s own voice seem unnatural. Open-fit hearing instruments are popular precisely because they seem so natural.
P.S. Very small open-fit hearing instruments are less conspicuous than hands-free Bluetooth devices.
HEARING DEFFICIT AND DEMENTIA
According to a study involving individuals between the ages of 36 and 90 over a dozen years, a direct relationship was found between hearing loss and the later development of dementia. In fact, for each 10-decibel loss in hearing, a two percent rise in the risk of dementia among study participants was noted. This link between hearing loss and dementia was found to persist even after other factors associated with cognitive disease (hypertension, diabetes, and smoking) were eliminated. Researchers explained the effect by pointing out that the brain devotes a lot of resources to hearing. If the incoming signal is muddled, the brain must allocate resources from other areas to hearing. As a result, other brain functions may suffer.
Hearing loss is one of the most prevalent chronic health conditions in the United States. It affects people of all ages, in all segments of the population, and across all socioeconomic levels. The type of hearing loss that affects many Americans usually develops slowly, is permanent and worsens with age. To schedule a hearing evaluation, please call FAMILY HEARING CARE CENTER at 781-337-1144. We are located at 543 Main St. (Rt. 18), across from the Stetson Bldg. in Weymouth. We have a second office in Bridgewater at 140 Bedford St. (508-279-0700). Please visit our website at www.familyhearing.net. Listen to Life Again.
P.S. Hearing loss leads to a sense of social isolation, which is linked to poorer health outcomes such as increased inflammation that can lead to heart disease and other life-limiting disorders.
LINEAR AND NON-LINEAR AMPLIFICATION
It helps for consumers to know that hearing instruments with “linear amplification,” which amplify all sounds equally, perform well in cases in which the hearing loss is flat and has a wide dynamic range at all frequencies. On the other hand, “non-linear amplification” applies the greatest amount of amplification to the frequencies that the hearing-impaired listener has the most difficulty hearing. At the same time, loud sounds receive little or no amplification. Generally speaking, non-linear hearing instruments perform best in cases where the hearing loss varies at different frequencies and has a narrower dynamic range. When it comes to choosing a hearing instrument, it is very important to base your selection on your specific hearing loss characteristics.
P.S. Most hearing instruments have a “clipping” function that prevents any gain from being added when the incoming sound exceeds a certain level.
A “CONTACT LENS FOR THE EAR”
Just as many people wear contact lenses that give little to no indication to onlookers that the wearer has anything in his or her eyes, hearing-impaired individuals may elect to wear “completely-in-the-canal” (CIC) hearing instruments that are virtually invisible. These devices sit so snugly in the ear canal that no one will ever realize that they are even there. CIC instruments have no effect on how users wear glasses or do their hair, and they allow the ears to capture sound in the way that nature intended. Completely-in-the-canal hearing instruments are perfect for anyone who wants to conduct his or her lifestyle in an active manner. However, this tiny instrument is not well-suited to every type of hearing loss.
P.S. Completely-in-the-canal hearing instruments require a relatively high degree of user dexterity and are not recommended for those suffering from arthritis.
REASON NOT TO SMOKE DURING PREGNANCY
Smoking during pregnancy has already been linked to giving birth to children with low birth weights, developmental disorders, and birth defects. The fact is that cigarette smoke contains thousands of chemicals that can adversely affect the unborn children of pregnant women. One of the more recent findings links smoking in pregnancy to babies who later experience hearing loss as teenagers. The study, which involved having nearly 1,000 teenagers take audio tests, showed a relatively modest link; however, it should be pointed out that even limited hearing loss can have a negative impact children’s learning and social skills. With this in mind, mothers who smoked during pregnancy may want to consider having their 12- to 15-year-olds’ hearing tested.
P.S. Research shows that exposure to secondhand smoke during adolescence is linked to hearing loss.
Ringing in the ears (“tinnitus”) affects an estimated 10%-15% of the worldwide adult population. This annoying condition, most commonly caused by exposure to loud noise, affects men more than women, especially as they get older. The majority of those with tinnitus also suffer from some degree of hearing loss. If so, the use of a hearing instrument can help by allowing the wearer to hear normal sounds more clearly, which helps divert attention away from the buzzing sounds. Amplifying sounds with a hearing instrument may also make it less likely that the brain’s sound-processing regions will produce tinnitus sounds. About half of people with both hearing loss and tinnitus report less buzzing when they wear a hearing instrument.
P.S. Loud noise may not only cause tinnitus (and hearing loss), but it may also make it worse.
While hearing specialists are largely concerned with the “cochlea” (the auditory portion of the inner ear), it is worth noting that another important part of the inner ear, the “vestibular system,” helps us maintain our balance. Specifically, the vestibular system contains three semi-circular canals that help us recognize our position in space. These canals contain tiny crystals that can become dislodged. As a result, “benign paroxysmal positional vertigo” (BPPV) may occur. Those who are suffering from this disorder may experience extreme dizziness caused by changes in the position of their heads. Fortunately, there is a simple and effective treatment, known as the “Epley maneuver,” that involves guiding the head through a series of controlled movements to reposition the loose crystals.
P.S. Ménière’s disease is a disorder of the inner ear that can cause dizziness, a low-pitched tinnitus (ringing in the ears), and hearing loss.
COMMON MEDICATIONS MAY PROMOTE HEARING LOSS
Aside from shielding yourself from loud noise, it may also help to monitor your intake of some common over-the-counter (OTC) medications when it comes to preventing hearing loss. Recent research suggests that frequent use of ibuprofen or acetaminophen may also contribute to hearing loss. According to the study, women who took these OTC pain relievers at least twice a week were at greater risk for hearing loss (as were men, who were also found to be susceptible to aspirin-related hearing loss). More frequent usage of the pain relievers was found to result in a 24 percent elevated risk of hearing loss. The damage may result from reduced blood flow to the cochlea, the snail-shaped mechanism of the inner ear.
P.S. The cochlea contains nerve endings that are essential for hearing.
BONE CONDUCTION HEARING INSTRUMENT
While the root cause of “sensorineural hearing loss” is usually in the inner ear (most commonly due to damaged hair cells), “conductive hearing loss” involves problems with sending sound waves along the route from the outer ear to the ear drum to the middle ear. In cases of conductive hearing loss that cannot be adequately addressed medically, a bone conduction hearing instrument may prove very effective. One hearing instrument of this type allows sound to travel via the teeth through the bones to a functioning cochlea. Bypassing the outer and middle ear entirely enables the bone conduction hearing instrument to help those with conductive hearing loss to hear the sounds they have been missing.
P.S. Some bone conduction hearing instruments involve implanting a sound processor in the bone behind the ear that transforms sound waves into vibrations, which are then sent through the skull directly to the inner ear.
One big problem facing hearing professionals is that older individuals with hearing loss are not always aware of their hearing deficit. In most cases, the problem mounts so gradually that those affected adjust to the loss and alter their expectations. Thus, it is up to family, caregivers, and professionals to recognize hearing loss among elders and suggest that they undergo testing and be fitted with a hearing instrument (if suitable and necessary). Otherwise, seniors with limited hearing ability are less likely to take the necessary steps to make their lives better. Negative impacts of untreated hearing loss include depression, social isolation, dementia, anger, and low self-esteem. These and other unnecessary outcomes can be avoided with a simple hearing test.
P.S. It should be pointed out to seniors with hearing loss that continually asking people to repeat themselves is far less attractive than wearing any hearing instrument.
HAVING A BLAST
There is little doubt that long-term exposure to loud noise or even a single exposure to exceedingly loud sound can cause hearing damage. Widespread knowledge of this fact has led many to avoid listening to loud music on iPods and to limit attendance to loud concerts and other venues. However, there is one source of recreational noise exposure that exceeds all others in terms of damage done to hearing. Firing guns, whether for hunting or target practice, is a sport enjoyed by millions of Americans, young and old and men and women. With the loud noise (approximately 130-180 dB) that firing guns (especially rifles) engenders so close to the ears, gun enthusiasts are strongly encouraged to protect their hearing.
P.S. While the American workplace is largely regulated, most hearing loss occurs near the home (from lawn mowers and the like).
The type of hearing instrument known as “in-the-ear” (ITE) is also known as a custom hearing instrument. That is, it is individually manufactured to fit precisely inside the ear of the person for whom it is intended. This degree of customization is an important point because ITE hearing instruments must fit perfectly in the shell of the ear or (completely) in the ear canal if the instrument is going to perform up to expectation. One-size-fits-all does not work for a suit, and it certainly does not work when it comes to an ITE instrument. Consumers can expect the hearing instrument specialist to take every last detail into account when fitting an instrument that meets the user’s needs.
P.S. While only the very outermost portion of an in-the-canal (ITC) instrument may be visible, a completely-in-the-canal (CIC) instrument is not visible at all since it rests deeper in the ear canal.
There are two basic types of hearing loss: conductive and sensorineural. While the former is most often caused by problems such as infection, impacted ear wax, or fluid buildup, the latter results from damage to the sensory (“hair”) cells located in the cochlea of the inner ear or to the nerves that transmit sounds to the brain. Over time, hair cells grow old and die or become damaged by excessive noise. For these reasons, age-related hearing loss (“presbycusis”) and noise-induced hearing loss are the most common reasons for sensorineural hearing loss. This type of hearing loss can be effectively addressed with a hearing instrument. An evaluation by a qualified hearing professional can identify causes of hearing loss and possible treatments.
P.S. More than 80 percent of people with hearing impairment have sensorineural hearing loss.
SENIORS’ HEARING LOSS LINKED TO HOSPITALIZATION
As if hearing loss were not challenging enough all by itself, recent research points to its association with higher hospitalization rates and other negative health outcomes. According to the study, participants with hearing loss were more likely to have been hospitalized in the past year than their counterparts with normal hearing. In addition, hearing-impaired individuals were more likely to have a higher number of hospitalizations overall and were also more likely to have a history of cardiovascular risk factors and report poorer physical and mental health. While more study is needed to find out if hearing rehabilitation might reduce these unwanted associations, there is little doubt that a hearing instrument can make seniors feel better about themselves.
P.S. More than 60 percent of adults over the age of 70 suffer from hearing loss.
IS FURTHER ASSISTANCE NEEDED?
Most people associate treatment of sensorineural (nerve-related) hearing loss primarily with hearing devices that are worn in or near the ear. However, there is another category of hearing devices called “assistive listening devices” (ALDs) that help meet communication needs that cannot be solved solely with traditional hearing instruments. For instance, special devices have been developed to solve problems involving difficulty hearing the telephone, radio, or television, as well as the inability to hear the door chime, telephone ring, and alarm clock. Assistive listening devices and alerting equipment can either increase the loudness of a desired sound or transform an auditory alarm (such as a smoke signal) into a visual alarm (such as a strobe light).
P.S. There are assistive listening devices that help deliver sound directly to the ears of those who have trouble hearing in movie theaters, lecture halls, etc.
DISLIKE THE SOUND OF YOUR OWN VOICE?
Many people cringe at the sound of their own voices when they hear them played back on recording devices and videos. Why is this so often the case? Answering this question begins with an explanation that sound enters the ears in two ways—via the air and bone. When we hear air-conducted sound, the waves of sound travel through the eardrums, vibrate three bony ossicles, and finally reach the cochlea, which is the fluid-filled spiral structure that converts the vibrations into nerve impulses that are interpreted by the brain. However, when we speak, we hear both air-conducted and bone-conducted sound. Because the latter is perceived to be lower in frequency than the former, our voices seem high-pitched in recordings.
P.S. Bone-conduction hearing instruments take advantage of the fact that bone-conducted sound travels through the bones of the skull to reach the inner ear.