by Neil Bauman, Ph.D.
A young lady explained:
I have been noticing for about 12 months now that I am really finding it hard to hear in bars, restaurants and noisy environments. Because of this, I yell when I am talking to those around me because I think the people I’m talking to can’t hear me. This then means I strain my vocal chords and the next morning can barely talk and it takes hours to warm up my voice. Also, my voice is gradually getting huskier.
At first I thought it was voice nodules so I went to an ENT and he checked everything and said ‘no, you’re fine—just stop yelling’ and left it at that.
It has gotten considerably worse in the last 6 months and I have finally realized that I am yelling because I can’t hear the people around me, and when I talk normally it sounds to me like I am whispering. (My sister actually said ‘Stop yelling! We can hear you fine. Can’t you hear us fine?’ If I was old I would understand, but I am only 26!
Is there anything I can do to stop this getting worse? Does this mean I have some loss of hearing? I work in the events industry. Could the loud show music that I am often exposed to be the reason for this? If yes, will continuing to work with loud music make this worse?
I would really appreciate any advice you can give me, I need some treatment but I’m not sure what I need at the moment!
I think you are beginning to realize that you must have a hearing loss, although you don’t want to believe it is true.
The truth is, you do indeed have a significant hearing loss, especially in the higher frequencies. When you get a hearing test, your audiogram will very likely show a significant hearing loss around 4,000 Hz. We call this a “noise notch”.
One of the first signs of hearing loss is that you can’t understand people when you are in noisy situations such as the bars and restaurants you mention.
Another sign is that you often speak (yell) louder than those around you because you don’t hear your voice as loud as you used to.
We are used to hearing our voices at a certain level—thus as we lose our hearing, we tend to talk louder so we can still hear our voices at the old level. The result, to those around us, is we sound like we are yelling.
I’m surprised that your ENT was so ignorant of hearing loss that he didn’t immediately suspect a hearing loss and had your hearing tested.
Although you are only 26, you have “old” ears. You have already damaged them from all the loud noise you have been around (and/or perhaps other factors such as taking ototoxic drugs).
In order to stop your hearing loss from getting worse, there are two things you need to do. First, avoid noisy places as much as possible. If the average sound level is above 80 dB or so, it is too loud and will eventually damage your ears.
Second, if you have to be in loud environments, wear ear protectors such as the foam ear plugs that you can get at almost any drugstore. These will work fine as long as they have a dB rating of 25 to 30 dB.
You need to see an audiologist and ask for a “complete audiological evaluation”. Your audiologist will then be able to tell you exactly what your degree of hearing loss is—and what you can do about it.
In quiet situations you will find that wearing hearing aids will really help you understand speech better. In noisy situations, take your hearing aids off and put in the ear protectors.
You need to start doing this now. Your voice box will love you for it—not to mention your ears, and also those around you to whom you’ve been “yelling”.