Hearing Loss Help  

by Neil Bauman, Ph.D.

A man explained,

Austin TX is a large and sophisticated city, but I haven’t been able to find a single hearing aid dispenser who has the equipment for using real ear speech mapping. My readings tell me that speech mapping is the one essential thing I should do when buying new hearing aids but it seems unavailable here.

The last audiologist I talked to said that certain models of hearing aids now have circuits that do the same job as the traditional probe and collar for mapping. If so, I assume the audiologist would need to have the proprietary software (and coupler?) for that brand of hearing aid. In researching online I’ve come across implied references to a Siemens model and the Starkey S series and Starkey Zon, but no actual solid information.

My question: do you know whether there are BTE models that have the circuitry for doing the same job as the traditional real ear speech mapping?

Unfortunately, what you have found is true all over the country. Real ear testing is not being done like it should be. Since it is part of the code of “best practices” for audiologists, you’d think all audiologists would be using it in order to give their clients the best possible hearing aid fitting. If audiologists won’t follow their best practices, it should not be surprising that hearing aid dispensers, as opposed to audiologists, are even less likely than audiologists to do real-ear testing.

Real ear testing is important to knowing whether the fitting is truly matching your hearing loss or not.

Now, to answer your question about hearing aids doing the same job as real ear testing, since I’m no expert on this, I asked one prominent audiologist, who is a proponent of real ear testing, what his thoughts were on the subject.

He replied:

There is some truth in what the writer says indirectly. The major manufacturers are getting much closer to prescribed targets with their first fits. They are also getting clever and seem to be using the speaker as a microphone to do an estimated RECD (Real Ear to Coupler Difference). While this isn’t actually ANSI standard real ear measurement, it does make a very good attempt to take ear canal acoustics into account. You will not find much, if any, documentation on these techniques as they fall into the realm of “trade secrets”.

Ideally, more hearing aid fitters should use independent probe microphone measurements [real ear testing] and speech mapping, but since that is not the case, the manufacturers are implementing ways to improve fittings and decrease the number of returns for credit.

Thus, it appears that real ear testing is still the best way to know your hearing aids match your hearing needs, but if you can’t find someone in your area that does real ear testing, then your next best alternative is to be fitted by someone that uses RECD.

by Neil Bauman, Ph.D.

If you are hard of hearing, you need to learn to advocate for yourself and your unique hearing needs. One lady did just that. Here is her story.

I asked about an interpreter or CART [real time captioning] for cardiac catheterization and this is how it turned out.

I went to the catheterization laboratory the week before the actual catheterization and talked to the people who would be working with me. They agreed that they could have someone drop their mask to talk to me and that it would be the same person each time. They said that the things I’d be asked were so few they didn’t think I would need an interpreter during the procedure. However, it was up to me whether I wanted one for before and after—when the important stuff was discussed and explained. I opted not to get an interpreter because I knew apart from the procedure itself, I could ask them to repeat things and/or write them down for me. As a result, I would not be stressed.

When I showed up a week later for the actual catheterization they all remembered me. (No doubt, the “Face Me I Read Lips” sticker I wore on my gown also helped. This was a sticker not a button because we’d be in a “no metal allowed” room.)

Shortly after returning home, I started to run a fever. I was prescribed anti-inflammatories and antibiotics. During the day my pain increased, then my right leg started to swell (the one where they entered my artery), then my right leg turned colder than my left. My doctor said, “Get to the emergency room now!” At the ER, they did ultrasounds of my artery and both veins. I had blood clots (deep vein thrombosis) in each vein that were impairing blood flow. I was put on bed rest and given anti-coagulants and clot-buster medicines.

My cardiologist, his partner, the interventional cardiologist, a new hematologist, my primary care doctor and the hospitalist (assigned by my insurance company to coordinate care while I was in the hospital) decided that the interventional guy would go into the veins in the back of my knee and remove as much of the clots as he could via catheters at the catheterization laboratory.

Because I had met the folks at the catheterization laboratory and they had accommodated me before, this time they were the ones talking about how they were going to make sure I could hear/understand. I was going to be on my stomach this time with my head in a pillow, no glasses and only one hearing aid on my “better” ear. They told me to close my eyes and then each came and talked to me to see who I could understand best (a man with a deep voice) and he was made my primary communication person. They also got the interventional cardiologist (who didn’t know me) to work with them on communication during the two hour procedure.

While I’m sure the Versed calmed me, knowing that I would have decent communication was in itself quite calming.

I’m glad I made the effort to discuss beforehand a number of communications options. Together we chose those that worked best for us all. And thankfully they worked just as well during the stressful emergency situation. I call that successful advocacy.

I do too. That was very successful advocacy. And I wouldn’t be surprised if the next they work on a hard of hearing person, they will suggest the same strategies. Way to go!

by Neil Bauman, Ph.D.

A man explained,

I have pica. I found that Aspirin filled my pica cravings. So I started chewing up 5 or 6 Aspirin (325 mg each) a day. I was also temporarily taking Hydrocodone (10 mg). That’s when the ringing and buzzing started.

I’m not surprised that your ears ring and buzz now. The medical term for this is tinnitus. Aspirin is well-known for causing tinnitus, especially at higher doses, although some people are sensitive to aspirin at much lower doses, and if they have salicylate intolerance—at minute doses. The conventional wisdom is that 5 or 6 adult Aspirin a day typically will cause your ears to ring and buzz. This is exactly what you have found. That amount of Aspirin can also cause hearing loss and other side effects.

The good news is that for most people, when they stop taking Aspirin, within a couple of days their tinnitus begins to fade away, and over the course of two weeks or so, their hearing starts coming back.

In rarer cases, this does not happen and these unfortunate people are left with both permanent tinnitus and hearing loss.

If you value your ears (and the rest of your body—your stomach for one—as Aspirin causes your stomach to bleed) you will stop taking the Aspirin and work to get your pica (cravings for dirt, clay, sand, etc.) under control. As you may know, in a number of cases, pica has been linked to a deficiency in zinc or iron in your natural diet so you may want to get that checked out.

(Note: in this case, this man subsequently found that his pica cravings were caused by low iron levels due to his dialysis treatments.)

If you want to look up all the ototoxic side effects of Aspirin or other drugs, see my book “Ototoxic Drugs Exposed” 3rd edition. This book contains information on the ototoxicity of 877 drugs, 35 herbs and 148 chemicals.

by Neil Bauman, Ph.D.

A lady wrote,

I think part of the problem is that with invisible hearing aids, our hearing losses are an invisible problem. I think if we had hearing aids as big as wheelchairs it would make people more attuned to the fact that we’re struggling to hear.

You are right of course. But would you want to live back in the times when hearing aids really were visible? For example, consider the Model 1A, the first hearing aid produced by RadioEar back in 1925. Then you really would be struggling. Not only was it not invisible (somewhat smaller than the size of your dining room buffet), but it would be difficult to lug around—weighing in at 185 pounds! Apparently it was a bit much for the ladies, so in 1929 they made some “minor” changes and got the weight down to a svelte 135 pounds! You then could almost put it in a wheelchair to lug it around!

Or try Western Electric’s first hearing aid, the Model 10-A of 1923. It came in a mahogany finished birch cabinet 4′ x 3′ x1′ and weighed a whopping 220 pounds! The price was $2,250 not including storage batteries and installation charges. That was 8.6 TIMES the cost of a brand new car at the time when you could buy a brand-new Model T for $260.00. In today’s equivalent dollars compared to the price of modern cars, that hearing aid would now cost somewhere around $129,000.00.

I think I’ll take my much smaller, lighter, less visible and cheaper hearing aids any day and just let people know I have a hearing loss when the subject comes up!

(Neil is also the owner and curator of “The Hearing Aid Museum“.)

by Neil Bauman, Ph.D.

A lady asked,

I would like to find out where I can learn sign language. I have flash cards from the Internet but that is not helpful enough. It has been recommended that I learn, but there doesn’t seem to be any place available in this area to teach me. Thank you for all the help from you I have received from your eZine and web-site.

Another lady explained,

I lost most of my hearing due to chemotherapy medications (but cured of the cancer). I am interested in my husband and I learning ASL. What do you suggest? I don’t work so costly programs won’t work for me.

I understand your situations. However, I have two important questions for you to consider.

First, who recommended you learn American Sign Language (ASL)? Was it a Deaf counselor, or was it a hard of hearing person? You need to know that these are two very different cultures in many ways—and you live in the hearing culture.

Second, why would you want to learn a foreign language (ASL) if you can’t even find anyone in your area to teach you? Who are you going to sign to? If you don’t use it, you’ll lose it.

Unless you want to join the Deaf community, you are probably much better off learning how to successfully live with your hearing loss by using speechreading, hearing aids, assistive devices and using the myriads of hearing loss coping strategies.

That said, I’m definitely not against learning some sign language. In fact, my wife and I sign a few basic signs to each other, but we are by no means fluent. We do not sign ASL, but PSE (pidgin signed English). Hard of hearing people typically use PSE rather than ASL because it is easier—it uses ASL signs but in English word order. However, we mostly use the four above-mentioned coping strategies rather than sign.

However, if you still want to learn to sign, more power to you. I’ve found that a number of churches that have deaf ministries also have free ASL classes. So that is the first thing you should try. I’d also check with the deaf and hard of hearing services organization in your area. You might also ask around the Deaf community and see what they recommend.

You can also find some good on-line ASL stuff—not classes as such, but ASL dictionaries that show you how to sign the word you specify. This doesn’t teach you the grammar, but you do learn the proper vocabulary. In addition, some sites have animations for fingerspelling that are quite challenging, so you can become quite proficient reading fingerspelling from the on-line fingerspelling sites.

Here are a few sign language sites to get you started.

Bill Vicars’ basic page teaches you 100 signs to get you started in learning ASL vocabulary, and you can learn much more from his more advanced (complete) website homepage.

The ASL Pro website.

In addition, the following are from the Deaf and Hard of Hearing Services Center in Virginia. You have to scroll way down the page to reach them, but you’ll find numerous resources to help you learn signing. Here are some of them. (These are all hyperlinked on the website so you can just click on them there.

Sign Language – Baby Signs
Sign Language Resources
Signing Time

Sign Language – Comedy
All Deaf’s Jokes & Funny Stories
ASL Video: Double Deaf!
CODA Brothers
Dangers of CI!
DeafJoke.TV
OIC Movies

Sign Language – Fingerspelling
Dr. Bill Vicar’s ASL Fingerspelling Practice
Dr. Bill Vicar’s Fingerspelling Tutor
Funbrain – Sign the Alphabet
Sign Language Resources

Sign Language – Kids
ASLphabet
Children’s Songs
K8AIT Kids Signs
Sign Language Resources
Signing Time Kids

Sign Language – Religion
Children’s Songs
Deaf Missions Religions Signs
Hymns
Sign Language Resources

Sign Language Dictionary
About Deafness Sign Language Dictionary Resources
ASL Pro
Deaf Newspaper’s Sign for Word
Hand Speak
Life Print
Michigan State U. Communication Technology Laboratory
Sign Language Resources
TerpTopic’s Online Dictionary Resources
Think Quest

Also,  the “Family Health Reference to ASL“  gives you a lot more places to learn and practice ASL, especially the sections headed “Learning the Alphabet and Numbers” and “Popular Phrases”.

One more thing. If you’ve ever wanted to learn how to write ASL or any other signed language (and yes, signed languages can be written), check out the extensive lessons available on the Sign Writing website.

by Neil Bauman, Ph.D.

A man wrote,

I am seeking information about ultrasonic dental scaling and hearing damage.

In November 2011, I experienced my first ultrasonic scaling and immediately felt the worst pain in my inner ear ever. After leaving the dentist I had fullness in my ears and constant tinnitus that continues to this day. For the first month I experienced distortion of familiar sounds and the inability the stereo-locate sound sources like birds in trees or automobiles approaching. Cars passing on a gravel road now sounded like a sheet of aluminum being dragged edgewise on asphalt and I no longer heard birds singing in the morning, just the constant ringing in my ears.

I have been a musician since my teens and after this incident it became near impossible to hear certain notes, others made my ears hurt and my uncle who played violin with me complained that I was doing something wrong when I was trying to accompany him. In addition, the constant ringing in my ears has undermined my sitting meditation practice to the point that I can no longer sit for an hour at a time because I get frustrated about the noise in my head.

Another man wrote,

Is noise-induced trauma from ultrasonic teeth cleaning tools usually temporary—even if your ears are already damaged by medications and infection?

The noise I experienced today was rather brief, but it really rattled my ears. The tool’s ultrasonic sound waves didn’t make much noise until it came into contact with the third tooth or so from the back (top teeth). The sound was at just the right pitch and intensity to rattle my ear(s). The same thing happened on the other side of my mouth side too. Other than those brief moments, I had no problems. The hygienist instructed me to wear ear plugs the next time, but I am concerned about sound transmission through the skull.

I am concerned that my ears may not recover. My tinnitus is not loud, but the trauma may have aggravated some hyperacusis. I hope and pray the tinnitus dies down over the next few days.

He added,

It’s day four, and my ears are not doing good. ’I’ve never seen them this sensitive before. I cant even watch my hand held DVD player without the sound (no ear phones) causing tinnitus and hyperacusis.

I am very concerned, and frankly, I am scared to death. Ringing in the ears is one thing, but extreme sound sensitivity is another. What can I do to help my situation? Listen to pink noise for a few minutes each day?

I asked this second man, “Were the teeth that rattled your ears teeth that had fillings in them? Or teeth that had root canals? I’m wondering if there was something peculiar about those particular teeth—since no other teeth bothered you.”

He replied,

Yes, those teeth have fillings, and a few have crowns. The ear discomfort started around # 3 & 4, and # 13 & 14. Truthfully, I don’t recall any ear discomfort while cleaning the lower teeth, but they have crowns and fillings as well, and a three tooth bridge on the left side.

I’ve never looked into ultrasonic tooth cleaning and resulting ear problems—tinnitus, hyperacusis or hearing loss. If anyone reading this has a story to share, I’d love to hear it. What happened to you and what were the results?

by Neil Bauman, Ph.D. with Christa

A concerned mother wrote,

My son has an overall moderate hearing loss. He wears hearing aids in both ears. He has a really hard time in the cafeteria. He is in second grade. He has difficulty keeping up with his peers’ conversations because of the noise level, background noise, reverberations, etc.

I have read, and it has been suggested, to have him eat in a small group outside of the cafeteria. He has done that for half the year. Now the school feels really strongly that they want him to start going back in the cafeteria and they feel that this is the best place for him—that he needs to learn to handle noisy situations like these. However, I am having trouble understanding why the rules change for the cafeteria. Why do acoustics seem to matter in the classroom but not for lunchtime? I have trouble understanding why “learning how to handle a noisy room” is more important than giving my son a chance to more easily socialize?

These are excellent questions and deserve a real answer—not the pseudo-logical muddled thinking that the school put forth.

I couldn’t do better than to quote the reply, Christa, a lady who grew up hard of hearing, and knows what it is like firsthand gave. (Incidentally, I also grew up with a severe hearing loss and also know first-hand that she is “spot on”.)

Christa explained,

Hard-of-hearing people cannot “get used” to noisy situations just by “wanting to”. This is a misconception that normal hearing people have, but it is just not possible, no matter how much we want it.

Background noise is a problem for almost every hard-of-hearing person I have met. Noise makes it too hard for us to hear what someone is saying, even if we really concentrate (which then makes us very tired). So, if you put me in a room with a lot of people, you are excluding me from the social life. The same thing will happen when your son is put back in the cafeteria. The school officials think they are doing the right thing by putting him back where the social life is, but actually, they are really excluding him from the social life by putting him in a noisy situation where he cant understand what is being said, even though he is hearing lots of sounds. To him, this is just noise.

That noise is very stressful and may be why he didn’t have much appetite. I usually avoid being in group social situations, but on occasion, I have been to restaurants where it was expected that I would partner my husband. There he is having a wonderful time enjoying the company. And there I am sitting there with a glazed look and polite smile on my face, not following the conversation and just longing for the night to be over so I can get back to my quiet home.

Hard of hearing people are usually only really socializing when they are one-on-one in a reasonably quiet situation or when the group is very small and they are very aware of only talking one at a time.

The other thing that happens is that noise can be most stressful or distressing for a hard of hearing person—especially if they suffer from recruitment. It is exactly the opposite of what we would expect—instead of noise bothering us less when we cant hear well, it bothers us more (a lot more).

I can remember when I was young and we had a chores roster. I couldn’t bear to do the vacuuming (I never realized it was related to my hearing then). I just couldn’t understand why my (normal hearing) little sister would happily trade washing the dishes for vacuuming. I jumped at the offer, but thought she was just being super nice. It is only now that I realize that vacuuming didn’t bother her at all and she liked doing something that took less time (this was in the days before dishwashers).

I don’t think it is possible to “learn to handle a noisy room” for some of us. If I was forced into this situation, it would stress me out every day. The school needs to talk to a hard of hearing advocate who can explain that it is not something under our control and is not something that it is possible to get used to.

Thanks for laying it on the line Christa. You are right on.

In a similar vein, a mother of a college student pointed out that going to college is no different than going to elementary school. The noise problem is still there.

She wrote,

My daughter has told me the same thing. In college she had a single dorm room so she could have quiet time. She often went to the cafeteria early to avoid the noise. Many times she would bring her food to her quiet room to eat. When she finally shared her condition and how it affected her, many friends stepped in and took turns eating with her in her dorm room.

I also struggled with classroom and other noise all through my days of schooling from Grade 1 through college. Dealing with noise and not being able to hear because of it is a health hazard. In fact, for a while, they thought I had ulcers from the stress of trying to hear when it was just not possible for my ears to pick out and understand speech sounds in the classroom, let alone in noisy cafeterias!

Even today—decades later—out of necessity, almost all of my socializing is done one-to-one where I have a hope of functioning as a somewhat normal hearing person. This is just the way it works for us, and no amount of fancy talking by school officials, hearing health care professionals or anyone else will ever change this fact.

by Neil Bauman, Ph.D.

A man was having trouble making his new TV work with his loop system. He wrote,

I recently purchased a Panasonic Viera TV. It only has a Toslink digital audio output jack. I purchased a Monoprice digital to analog converter (DAC). This works very nicely if I supply an HDMI input to the TV. But if I use a coaxial input, either from a cable system (QAM) or off-air (8-VSB), I get a beautiful picture, but no audio output. What’s going on?

My friend Robert McPherson (the owner of the Yahoo group BHNews) explained,

Your problem is that the Monoprice DAC you purchased only works with standard stereo signals [what is known as Pulse Code Modulation or PCM]. It cannot convert a 5.1 surround sound (Dolby) digital signal.

Unlike many/most TVs today, there is no user selection of digital audio output signal type with the Panasonic Viera sets. Rather it is dependent on the signal delivered to the TV. The Viera owner’s manual states, “When an ATSC (digital) channel is selected, the output from the DIGITAL AUDIO OUT jack will be Dolby Digital. When an NTSC (analog) channel is selected, the output will be PCM.”

In case you can’t decipher the above, it plain English it means that if you have this TV, you need a digital to analog converter that can decode BOTH Dolby and PCM digital audio signals. You can order either the Monoprice DAC (PCM only), or the Sewell DAC (both PCM and Dolby) here.

by Neil Bauman, Ph.D.

MedEl just launched their RONDO, the first single-unit cochlear implant in the world. Now, for the first time, the microphone, speech processor, coil and batteries are all housed in a single unit.

As their press release states, “The fully-integrated design makes RONDO simple to wear, and is especially comfortable for people who wear glasses of any kind. With no cable and fewer parts, users benefit from enhanced durability.”

Even if you already have a MedEl cochlear implant, you can trade it in for the RONDO. This is because the RONDO can be used with MedEl’s existing CONCERT, SONATA, PULSAR and C40+ implants. It is also designed to be compatible with new sound coding strategies in the future.

You can learn more about MedEl’s RONDO cochlear implant here.

by Neil Bauman, Ph.D.

Here’s some good news. If you have a mild to moderate sloping hearing loss, and can’t afford expensive hearing aids costing several thousand dollars, here is another option available to you.

General Hearing Instruments, Inc, an American company based in Harahan, Louisiana has teamed up with Walmart and Sam’s Club stores in Texas to bring you affordable hearing aids. You can buy them in any of the Walmart or Sam’s Club stores in Texas, or via the Internet if you live elsewhere.

These pre-programmed digital ReadyWear line of hearing aids come in two styles—OTE (over-the-ear) and ITE (in-the-ear). You do not have to have a hearing test, although it would be wise to do so. (How else will you know whether these hearing aids have the power you need for your hearing loss?)

The Simplicity line are open-fit over-the-ear hearing aids. The open fit format allows you to hear natural sounds without occluding your ear canal and make it sound like you are hearing in a barrel. It comes in four models, the SmartTouch/Premier, the Digital, the Hi Fidelity and the Classic.

The Simply Soft line are in-the-ear hearing aids. The Simply Soft aids have a soft, silicone body that fits comfortably into your ear. Furthermore, its soft design allows it to constantly flex inside of your ear canal. Thus, you will not have to constantly reposition it while eating or talking. It comes in two models, the Premier/Smart Touch Digital and the Classic/Select.

Both of these hearing aids come with four settings allowing users to adjust to their environment, whether in restaurants, office meetings, or movie theaters.

You can try them without any risk as these hearing aids come with a 90-day, 100% money back guarantee.

As opposed to hearing aids sold through traditional channels and cost from $1500.00 to $3,500.00 per aid, the General Hearing Instruments aids typically cost considerably less at about $400.00 each.

I went to the Walmart website by clicking on the Walmart red Buy Now Arrow on the General Hearing Instruments website and found the prices for the Simplicity line ranged from $799.00 to $999.00 a pair depending on the models. The Simply Soft models ranged from $688 to $798.00 a pair.

The Sam’s Club website prices, also accessed by clicking on the Sam’s Club red Buy Now Arrow on the General Hearing Instruments website,  were a bit less, ranging from $718.00 to $758.00 for a pair of Simplicity aids, and $690.00 for a pair of Simply Soft Aids.

How good are these aids? Perhaps the best way to determine that is customer satisfaction. On the Sam’s Club site, there are 132 customer reviews for the Premier Simplicity aids.

Reading through these reviews is revealing. Although the vast majority of people gave a 5 star rating, there were numbers of people that weren’t so happy. Most negative reviews had to do with hearing in noise (a problem for most people with most aids so this is not peculiar to these aids), with the aids not being powerful enough (I think these people had more than just a moderate hearing loss), and reliability. However, from what I read, company service was excellent so they try hard to please you if you have any problems.

For more information about these General Hearing Instruments, Inc. hearing aids, click here.

Finally, these are one-size-fits all hearing aids. They are not custom-fit to your exact hearing loss. Nor do they have all the bells and whistles that expensive aids have. So, if you are interested, investigate these hearing aids with your eyes open. However, if you have the appropriate hearing loss and appropriate lifestyle, you may be very happy with these lower cost hearing aids.