Hearing Loss Help  

by Neil Bauman, Ph.D.

The Massachusetts Commission for the Deaf and Hard of Hearing has just released “The Savvy Consumer’s Guide to Hearing Loss.” This excellent 184 page book, by Karen Rockow, Ph. D,. herself hard of hearing, and now with a cochlear implant, gives a lot of practical coping strategies for people new to hearing loss. “It is filled with invaluable information for all those who find themselves in the difficult transition from being “hearing” to becoming deaf or severely hard of hearing.”

The good news is that it won’t cost you a penny if you download it (in PDF format) by clicking on the above link. I think you’ll enjoy this informative book—and learn a lot in the process.

by Neil Bauman, Ph.D.

A lady asked,

My son is 5 years old and will be entering Kindergarten in the fall. We are currently trying to fit him with new hearing aids. His left ear has reverse slope loss. 65db @ 250 60db @ 500, 45 @ 1000, 25 @ 2000-8000. His current ear mold has a vent to allow natural high sounds to enter.

His right ear has the more common ski-slope. loss from 40 @ 500 all the way to 110 @ 4000 The right ear mold is completely closed.

My audiologist told me that in order to obtain the correct amount of low frequency amplification in the left ear she would need to close the mold. Somehow that seems less than perfect and doesn’t sit right with me.

It may be theoretically true that he needs to have an ear mold with no vent so lots of low frequency amplification can be pumped into his left ear, but it doesn’t work out in practice. This is because people with reverse slope hearing loss don’t want or need all the low frequency sounds. Amplifying these sounds to “normal” is actually counterproductive. This is because it makes it so we can’t understand speech as well. All the research shows, and those of us with reverse slope losses firmly declare, that we need less low frequency amplification than what is theoretically true.

Few audiologists apparently know how to properly fit people with reverse slope losses—so they go by the theory—and it is wrong. All the adults with reverse slope losses that I have heard from have told me the same story—their audiologists insist on setting their aids wrong to begin with (too much low frequency amplification and not enough in the high frequencies). They insisted that their audiologists adjust them in the reverse before they were happy.

She then asks: “Do you agree that it may be the only way to achieve help in the low frequencies? Does it matter that the mold had an opening and now it will need to be closed but that the high frequencies have good hearing?”

Here’s the problem. With reverse slope losses, we hear the highs. When we wear hearing aids, there are only two ways we can do this. One is if the ear molds have large vent holes. The second way is if the hearing aids are wide band aids (and almost none are) and amplify up to 16,000 Hz or so. (Most hearing aids only amplify up to 6,000 Hz or so.) Thus, by wearing hearing aids, we hear less than we should—unless provision is made for us to hear the high and very high frequency sounds upon which we so much depend.

You would do well to read my unabridged article on the subject of reverse slope hearing loss, The Bizarre World of Extreme Reverse-Slope (or Low Frequency Hearing Loss—especially the final section—which gives tips for properly setting hearing aids for reverse slope losses. Be warned, it’s 32 pages long—but it is very easy to read.

by Neil Bauman, Ph.D.

The Washington Post (June 26, 2008) ran a piece entitled “Sudden Hearing Loss May Portend Stroke” The first three paragraphs read:

Sudden hearing loss may foreshadow a stroke by as much as two years,” say Taiwanese researchers.

The researchers analyzed five years of follow-up data on 1,423 patients hospitalized for an acute episode of sudden hearing loss and found they were more than 1.5 times more likely to suffer a stroke than a control group of 5,692 patients hospitalized for an appendectomy.

The findings, published in the current issue of Stroke, haven’t been duplicated in other research and should be interpreted with caution.

The article then goes on to muddy the waters and reaches no clear conclusions.

What the researchers don’t seem to realize is that this can make sense. if a person has a build-up of “gunk” in their arteries (to use a fancy medical term), and if that gunk should travel to one of the arteries in (or leading to) the inner ear and block blood flow there, the result is sudden and drastic hearing loss.

If the same gunk had traveled to the brain and blocked an artery there, the result would have been a stroke. Same condition—just a different location.

Now, since the arteries in the inner ear are among the smallest in the body, it doesn’t take much to block them. Thus such episodes of sudden hearing loss truly may indicate an underlying problem that, if not fixed, may lead to strokes and heart attacks if bigger pieces of gunk lodge in the brain or heart respectively. Thus it behooves us to heed warnings such as sudden hearing loss of vascular origin.

Having said that, there are lots of causes of sudden hearing loss that have nothing at all to do with vascular issue. Thus, don’t think if you get sudden hearing loss, you will get a stroke later—but it might be a precursor if you already have vascular issues.

by Neil Bauman, Ph.D.

A lady asked:

I’m currently trying out a loaner PockeTalker Pro. There’s also a PockeTalker Ultra. I’ve downloaded the spec sheets on both, but I’m still not clear on what the difference is between the two models. Do you know?

The Pro is the older PockeTalker model. Williams Sound didn’t think it looked sexy enough anymore, so they came up with a newer design and called it the Ultra. Basically, the differences are cosmetic. The amplifiers produce about the same volume. One difference is that the Ultra has an external tone control. With the Pro, you have to open it up and use a screwdriver to adjust the tone.

The Pro comes with a case which you wear on your belt. In contrast the Ultra has a lanyard so you can hang it around your neck. The batteries are different too. The Pro uses two double A batteries while the Ultra uses two triple A batteries. You can see the PockeTalker Ultra here.

by Neil Bauman, Ph.D.

In response to my article “Setting Up Your Digital-to-Analog Converter Box” (July 15, 2008) , a reader supplied some more valuable information.

Steve wrote:

The most recent issue brings up the topic of the Digital TV conversion. There are a couple of things that the web sites do not mention, I thought your readers might like to know what I have learned.

1. Do not use the coupon(s) initially to buy a converter box. If you decide to return the box, you will probably not get the coupon value returned even though the store gets paid for redeeming the coupon.

I had to return two boxes after testing each one at my home. One didn’t receive digital signals on two stations in my area. Another had such a bad user interface and remote control that I deem it to be less than useful.

When I decided on the converter box I liked, I took it back to the store and effectively returned it and bought it again this time using the $40 coupon. The store people understood this tactic very well.

Be sure to check out all of the features you will use, especially the closed caption setup if you need it. Not all boxes are easy to set up for these options.

2. Attaching a converter box to a VCR will not allow you to use the VCR programming features to change the channel during a recording session. For example if you want to set your VCR to record channel 2 from 7 to 8 PM, and then record channel 4 from 8 to 9 PM, this will no longer work with the converter box supplying the TV channel signal. You have to preset the converter box to the channel you want to record and then program the VCR to record on the input channel (such as channel 3 or 4 or the line input) for the amount of time you want to record. Changing the channel selection on the VCR will cause it to record nothing since the converter box is supplying the TV channel signal to channel 3, 4, or line input.

I have not found any Digital TV converter box that will change channels at a programmed time.

There are a few DVD and VCR boxes that have digital tuners that will allow you to program them like you are used to with your older analog VCR. These cost more than $200.

3. If you do decide to use the two converter box setup (one for the TV and one for a VCR), be sure that the two converter boxes are from different manufacturers (not just different brand names but actually different manufacturers). If you have two from the same manufacturer, there is a very high probability that the remote control from one will work both boxes. There is even the possibility that one remote from a different brand will operate both boxes—change the channel on the box connected to the TV and the channel on the box for the VCR will probably change too.

There are also other possible issues with antenna signals (UHF), older splitters and amplifiers, as well as, using older cable from the antenna to the converter box that could be a problem setting up a digital TV converter box.

I hope your readers find this useful.

I’m sure they will. Thanks so much Steve for your insights on this issue!

by Neil Bauman, Ph.D.

For some people, the tinnitus they hear all day long—every day—makes it hard to cope with life. Eddy is one such person. Now totally deaf and almost blind, she writes, “The noises in my head almost drive me nuts. They change constantly. I know, that people could go nuts with what I am going through. I am not surprised if some end up committing suicide or in a mental hospital.”

In spite of her horrible tinnitus, Eddy is a poet and finds relief in her poetry. Her poem “From Music to the Sound of Hell” gives a bit of insight into what her bad tinnitus really is like.

From Music to the Sound of Hell

Once—my voice rang out with joyful glee,
Others used to sing with me.
Once—I played accordion, mouth organ, and mandolin;
I even played the organ, and the violin.
My ears were very sensitive:
To them it was offensive—
To be subjected to the sound
The clock beside my bed made—and I found—
To get some rest
It would be best
To hide it under a hat;
Henceforth, I did just that.

Now—times have changed;
My hearing is deranged,
I cannot sing,
No instrument will bring—
The music I intend to send.
No lovely tune I hear,
Loud noise I have to bear
In both my ears and head
During days- and nights in bed,
Which never gives me peace.
I do not find release
From humming, strumming, banging, clanging,
Slapping, clapping, hissing, sizzling, howling, growling,
Orchestrated sounds.
There are no bounds—no limits set—
To my regret
For this destructive torture.

No one understands my pain.
My only wish is—to stay sane.
I learned to hide what bothers me,
Therefore, not a one can see
The devastating state I am in;
The horrible calamity
That frightfully engulfs me,
Keeps petrified me in my chair
In agony, and deep despair—
Not knowing what’s in store for me,
Praying: “Please God, let this be
The last of these unbearable attacks.
I do not mind—if I can’t hear,
Therefore, I have to bear
Cruel disrespect from all,
Just save me from the fall
Into this hellish nightmare.”

My body is deprived of sleep
That’s restful, long and deep.
More often than I care—
I doze off in my chair,
Don’t go to bed at all,
Why bother? I don’t fall
Asleep there anyway,
Night seems like day.
The discord music in my head
Never stops—Instead—
It’s getting worse each day.
I wish there were a way
To end this dreadful agony.

Edeltraut L. Scheffler-Plath.

(c) 1999. (Used by permission)

Edeltraut (Eddy as she likes to be called) has written a book of poems. If you like her unique brand of poetry, you might be interested in getting her book 101+ Poems from the Heart. It will tug at your heartstrings.

by Neil Bauman, Ph.D.

A hard of hearing lady wrote:

I have always been a person that has to have my “space” and feel personally violated if people stand too close (any closer than arm’s distance). I will literally get very uncomfortable, start sweating, panicky, if it is not a situation that I can remedy quickly. I have always thought that I was just an oddball who valued and guarded my “personal space”. A few months ago, I was talking to my audiologist about this and she said this is a very common trait among deaf and hard of hearing people. Have you ever experienced this? If this is a common trait, what is the mind’s reasoning behind it—a defense mechanism, or what?

The amount of personal space you want/need is a individual matter, so each of us may have a different idea as to the “right” amount of personal space we want. For example, one study showed that people who live in the wide open spaces want more personal space than those who live crowded together in downtown New York. This has nothing to do with hearing loss.

However, when you lose your hearing, your ideal personal space both expands and contracts at the same time. Let me explain this apparent oxymoron.

When we lose our hearing, it is true that we generally want more personal space, especially in possibly “threatening” situations. This is because we cannot adequately “hear” the intentions of those around us. Since we can’t trust our ears for early warning signals, our eyes have to take over this job, and our eyes can’t see in all directions at once. Thus, we want people to stay further away so we have more visual warning if they begin to make any “threatening” moves towards us.

For example, at night walking down a street, I don’t want anyone close behind me because they are out of my field of view and I can’t hear them. Thus, in such situations we want a lot more personal space than a person with normal hearing. That’s one side of the story.

The other side of the story is quite different. When we are conversing (and do not feel threatened), we often actually want less personal space so we can hear and speechread people better.

For example, one time I was out in the middle of the prairies (all the personal space in the world), but I still needed to get almost within arms length of the hearing person I was trying to talk with in order to hear her. It was obvious to me that I was invading her personal space, but I needed to be that close in order to hear her. Our needs for personal space in this situation were very different.

In contrast, another time I was talking to a hard of hearing lady in an almost empty arena. We were standing almost nose-to-nose in the middle of the arena having a good conversation. We didn’t feel like we were invading each other’s personal space. You see, our conversational personal space shrinks to fit our hearing losses.

Now that I am getting older I’m having a problem. My ears say I need less personal space—people need to be close in order for me to hear them. At the same time, my eyes say I need more personal space as they can’t focus that close to effectively speechread any more!

by Neil Bauman, Ph.D.

One of the things I have wished for, especially in emergency situations, was a radio that would display the text as well as the audio, so I could read the words that my poor ears miss—much as I do with captioning on the TV. You don’t have to miss many key words before you don’t understand what is really happening.

The good news is that captioned radio is coming—maybe even before the end of this year!

“A radio with closed captions, allowing hard of hearing listeners to ‘see’ radio shows is good news for millions of people with hearing loss, and one of the best new gadgets of the year, according to the BBC. The captions are shown on a screen on the receiver and will require the user to subscribe to a closed captioning service.”

According to an article in PC Magazine (01.06.08), “The systems works a lot like close captioning does for television. The company will piggy-back a data stream on the standard audio signal. The text can then be read on radios fitted with a display. The system will only work with digital broadcasts. Currently more than 1,500 radio stations are currently broadcasting in HD Radio in the United States.”

The new radio is still in the development stage. But a spokesman for Harris Broadcast, a party to the project, told the Washington Times newspaper in Washington, D.C. recently that a radio with closed captioning capability may be in production by the end of 2008.

Now you know what you want for Christmas this year!

 by Neil Bauman, Ph.D.

A man wrote:

I’m curious about some increased ringing in my ears and a peculiar off again, on again, sensation that is quite distressing, namely when I am at work, if I open a map for instance (I work with maps all day), just the process of opening the maps, can give me a harsh metallic tinny noise in my ears, particularly my right ear. A similar feeling occurs when I lay a pen down on a glass surface or even sometimes when I am typing on the keyboard. This might go on for a day with my ears feeling stopped up somewhat, and then it will disappear and the next day I will be fine.

What you are describing sounds like recruitment kicking in. Recruitment is a by-product of sensorineural hearing loss, and makes you perceive normal sounds are louder (harsher) than normal. Since you have a high frequency hearing loss (to whatever degree), because of recruitment, you now perceive the high-frequency component of the sounds the maps make, the high-frequency component of the sound of the pen clinking on glass and also the high-frequency component of the keyboard clicks, or your fingernails on the keyboard—not at their normal level—but as much louder than normal. Thus, they sound harsh. If you have severe recruitment, they can sound so loud that they will hurt.

When your ears are feeling stopped up, you are experiencing additional hearing loss—and with the extra hearing loss, your recruitment would be kicking in worse, hence the annoying component to everyday sounds.

You need to try and figure out what is causing the stopped-up feeling by reviewing the sounds you exposed your ears to the previous day. No doubt, you are listening to something louder/longer than your ears like.

The man then asked, “Do you think it is safe to continue to wear earbuds while listening to audio books on my iPod for an hour or so a day? Are the deep in the ear ones a better choice because the volume doesn’t have to be turned up as loud?”

It doesn’t really matter what kind of earphones or earbuds you use with your iPod—the key is to keep the volume at a comfortable level. Those deep in the ear ones require less volume—that is true—but only because they are closer to the eardrum. In actual fact they vibrate your eardrums just as much as any other earbuds IF you set the volume so that what you hear sounds to you to be at the same level.

Note: you will not hurt your ears if you listen to your iPod (no matter what kind of earbuds you use) at approximately the same level as you hear people around you talking—so that is a good rule of thumb to follow.

 by Neil Bauman, Ph.D.

A mother wrote:

My beautiful daughter was born with impaired hearing, and the doctors said she would lose her hearing as she got older. She is now in her forties. With her hearing aid, she hears noises, but cannot understand speech because of the background noise she picks up. Is there a way to soften the background noise so she can hear conversations?

Your daughter is not alone. Did you know that this is the most common complaint people have about hearing aids—that they pick up so much noise you can’t understand speech?

Compounding this problem for your daughter is the fact she only has one ear—and you need two ears in order for your brain to help filter out noise.

Fancy new hearing aids claim (don’t believe everything you read) that they can filter out noise from speech (and some do a reasonable job in certain situations), but no hearing aids do the kind of job normally-hearing ears do.

There is one main secret to hearing speech in noise, and that is to get the microphone right up to the speaker’s lips so his/her voice is much louder than the surrounding noise. In order to do this you either have to have the person talk right into the hearing aid’s microphone (not practical at all), or you need to use an assistive device either in combination with the hearing aid or by itself.

For noisy situations, my choice is a PockeTalker with a super-directional microphone when standing or moving around (such as at a party or convention), or a lapel microphone if seated near the person such as in a car or restaurant.

If your daughter’s hearing aid has a t-coil in it (and all hearing aids should have t-coils), then she can switch to the t-coil setting. This turns the microphone off so it can’t pick up any noise, and at the same time turns on the t-coil. Then she wears a neckloop or Music Link plugged into the PockeTalker. She will hear via the t-coil in her hearing aid via the PockeTalker and neckloop.

These assistive devices aren’t expensive like hearing aids are—but they do cost a bit of money. For example, the PockeTalker is about $140.00, the neckloop or Music Link is around $50.00, the lapel microphone is about $70.00 and the super-directional microphone is about $120.00.

When it gets noisy, if I want to hear a person I have basically three choices. I either:

a. Ask them to move with me to a quieter location (if possible).

b. Speechread them and forget about trying to hear.

c. Whip out my PockeTalker and appropriate microphone and hear them that way.

You can learn more about the PockeTalker here.

The features, accessories and prices for the PockeTalker and the above two microphones are illustrated here.