August 26, 2014: 6:45 am: Dr. NeilHearing Loss

by Neil Bauman, Ph.D.

Who would have thought that hearing loss would be tied to sleep apnea? Yet that is exactly what researchers recently discovered.

Sleep apnea (AP-nee-ah) is a disorder in which you have one or more pauses in breathing or shallow breaths while you sleep. Breathing pauses can last from a few seconds to minutes. They may occur 30 times or more an hour.

In a study of 13,967 people with sleep apnea, 9.9% of this population had at least moderate sleep apnea.

Researchers defined moderate sleep apnea as 15 or more sleep apnea events per hour. Sleep apnea events included apneas (complete cessation of airflow) and hypopneas (partial cessation of airflow).

In this same population, 19.0% had high-frequency hearing loss. (Note: the researchers defined high frequency hearing loss as hearing loss greater than 25 dB at 2, 3, 4, 6 and 8 kHz. They defined low-frequency loss as hearing loss greater than 25 dB at 0.5 and 1 kHz). 8.4% of the study population had both high and low frequency hearing loss. Only 1.5% had just low-frequency hearing loss.

After adjusting for a number of factors, sleep apnea was associated with a 31% increase in people with high-frequency hearing loss, a 38% increase in people with both high and low frequency hearing loss and a 90% increase in people with low-frequency hearing loss.

Interestingly enough, as the number of apnea events increased (above the baseline 15 events per hour) so did the percentage of people with high-frequency hearing loss. However, there was no such correlation in those with low-frequency hearing loss.

Researchers also found that hearing loss was more prevalent among people with a higher body mass index (are overweight), and those that self-reported they snored or had sleep apnea.

What causes this increase in hearing loss in people with sleep apnea? According to lead author, Dr. Amit Chopra, “Potential pathways linking sleep apnea and hearing impairment may include adverse effects of sleep apnea on vascular supply to the cochlea [reduced blood (and thus oxygen) reach the inner ear] via inflammation and vascular remodeling or noise trauma from snoring.” (Perhaps they also need to do a study on hearing losses in wives caused by their husband’s snoring.)

Therefore, if you have sleep apnea, it would seem wise to seek treatment for it before it causes you (more) hearing loss.
________

Source: Sleep apnea tied to hearing loss in large study.

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August 16, 2014: 6:43 am: Dr. NeilLoop Systems

by Neil Bauman, Ph.D.

Donna contacted me about how to help her mother-in-law, Lois, better hear her TV. I explained about the wonders of loop systems. Then her husband Sam phoned me to ask how to best loop her bedroom.

As we talked, I explained there were three ways he could hook the loop up for his mom. The first way was to loop the whole room, but since there was no easy way to hide the loop wires, he rejected that. The second way was to use a loop pad. The down side of the loop pad is you need to be directly over the loop pad in order to get the best signal. This meant Lois would need to stay in one place in the bed whenever she watched her TV. I suggested a third alternative—to loop the bed itself and have a small area carpet at the foot of the bed to hide the wires going from the bed to the TV.

Sam liked this idea the best. I explained how he could plug one end of the loop wire into the back of the loop amplifier, run it around the wooden legs of the bed three times to make a 3-turn loop, and then run it back to the loop amplifier, trim it to length and plug it in—as simple as that.

By looping the bed, Lois could be anywhere on the bed and still hear her TV wonderfully well.

The upshot of this was they ordered the Univox DLS-50 loop amplifier and a 100′ roll of wire. A week or two later, I received an email from Donna. It speaks for itself. Here it is.

Donna wrote,

At Jerry’s suggestion, my husband Sam and I contacted Neil Bauman (neil@hearinglosshelp.com ) and purchased a room loop system for my mother-in-law’s TV. This past weekend, we looped the wires around her bed as Neil suggested, attached the wires to the TV—and a miracle occurred.

We turned all the volume off on the TV. Sam and I did not have to ask Lois if she could hear the television—there was such a look of wonder and joy on her face! I’m sorry we did not video it! Lois is delighted with the quality of the sound.

For the first time in years, she can hear the television. She told us that she has never watched any of the shows that have caught the public imagination, like Mad Men or Downton Abbey, since she couldn’t hear the dialogue and the captions did not capture the nuances of the programs. Now she can be part of the mainstream once again. Lois spent hours that night feasting on television, but is tearing herself away in order to check out looped venues at museums, etc.

So thank you Neil! The device was easy to set up and was very reasonable, in fact, priceless.

_____________

If you’d like to do the same thing and hear beautiful, clear sound from your TV, all you need to do is order the DLS-50 loop amplifier and a roll of wire (black or white—your choice).
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The Univox DLS-50 is only $189.00 and the roll of wire is $11.99. Priority shipping is $11.40 so the grand total is $212.39 (excluding state tax if you are in PA). Not a bad price for a “priceless” device.

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August 6, 2014: 6:36 am: Dr. NeilAssistive Devices

by Neil Bauman, Ph.D.

A concerned mother explained,

My daughter has mild to moderate bilateral hearing loss and wears hearing aids. In her Montessori classroom, they also use an FM system when appropriate. I have visited schools where they now use wireless soundfield systems. They seem great, especially for a traditional classroom setting. My question is, “Who is evaluating all of these devices, hearing aids (especially ones that communicate aid-to-aid), FM systems, soundfield systems, etc. for levels of radiation when used together?”

If you put a child with hearing aids, with an FM, and a sound field in a wireless environment, are they getting slowly “cooked”? I am not sure safety is taken into account when all of these technologies are applied layer upon layer—especially with children who have thinner skulls and developing brains.

I just don’t feel confident with the information I have been given. Your thoughts are appreciated.

You have posed an excellent question. Unfortunately (or fortunately depending how you see it), we live in an increasingly wireless world. Like practically every technology ever developed, there are good points and bad points to the all-pervading wireless revolution we are experiencing. The trick is to use the good while eliminating as much of the bad as possible. As so often happens, the “bad” is swept under the carpet and everyone pretends it isn’t causing any problems. That is happening with microwave wireless devices.

We Are Surrounded by Microwaves

Many/most of the wireless devices we use today operate in the microwave frequencies—typically between 1 GHz and 10 GHz or so. This means we are bathed in a microwave smog (some call it electro-smog) pretty-well every minute of every day (and all night too), and it is getting worse as more and more items we use are going wireless.

Besides the microwave ovens in our kitchens, think of all the other devices at home, work and school that emit microwaves. There are Wi-Fi routers and wireless modems, cell phones, smart phones, laptop computers, tablets, wireless baby monitors, DECT (Digitally Enhanced Cordless Technology) cordless phones, wireless video game consoles, wireless burglar alarms, wireless printers, Bluetooth devices of all kinds, and numbers of other wireless electronic devices.

That is not all. Outside our homes, schools and places of work there are other major sources of the electro-smog that surrounds us. These include nearby cell phone towers and all our neighbors’ electronic wireless devices and routers.

For hard of hearing people the list is even longer. We use RF (radio frequency) systems integrated with our hearing aids so we can hear distant speakers and our TVs. These operate in the 2.4 GHz band (microwave frequencies). Even hearing aids can now “talk” to each other and this is also done at 2.4 GHz. All the Bluetooth assistive devices operate in this same band. And in your school, so do the wireless sound-field systems.

Furthermore, there are more and more smart phone apps available to help us hear better, but to use them we need to use our cell phones (and remember, they also emit microwaves). As a result, we are bathed in even more microwaves than people with normal hearing.

Microwaves Negatively Affect Our Health

As scientists discovered back in the 1940s and 1950s with the development of radar and other technologies, microwaves were dangerous to human health. They are still just as dangerous today. Make no mistake about it. Surrounding ourselves in a microwave smog is not good for us.

Because of the power involved, microwave radiation from cell phone towers, cell phones and Wi-Fi routers are the primary culprits, not our hearing aids and assistive listening devices that also use microwave frequencies.

Note: exposure to radiation from cell towers is rapidly increasing with the deployment of 4G technology, but the average exposure from cell towers is still well below that of our cell phones themselves (1) because they are so much closer to our bodies (heads).

However, for hard of hearing people, adding wireless assistive devices to the mix just compounds the problem. Furthermore, hearing aids are right against the skull—so when they “talk” to each other via 2.4 GHz, even though the power output is very low, they just add to the electro-smog assaulting our bodies.

The dangers to our bodies from microwave radiation is of two kinds—thermal (heat) and non-thermal.

“Cell phones radiate microwaves, as do microwave ovens. The exposure limits set by the Federal Communications Commission in the United States and by the International Commission on Non-Ionizing Radiation, Protecting for most countries in the European Union assume the only danger from microwave radiation would come from temperature increases in our brains, or from temperature increases to any other part of our bodies.” (2) In short, all the industry thinks of is thermal damage from microwaves heating up our cells and “cooking” us, They are not considering short and long term non-thermal microwave effects.

To be sure, thermal effects from microwaves can be a problem if we are close to a high-powered microwave antenna. But with most microwave devices (apart from our microwave ovens which are designed to cook things), internal cell heating from microwave radiation is the least of our worries.

Therefore, you shouldn’t have to worry about your child being “cooked” in school from all the microwave devices in use in the classroom. However, you do have to concern yourself with other health issues associated with microwaves from their non-thermal effects.

One such health risk is brain tumors/brain cancer. Brain tumors happen to real people from using microwave devices such as cell phones. Here is Enrico Grani’s story. He explains:

“I used cell phones for 10+ years extensively on and off, and because of this, I developed a brain tumor.

It 2007, about one week before my birthday, I was diagnosed with a 3 cm x 4 cm brain tumor. I had a stroke in late November 2006. An MRI examination revealed a brain tumor in the area of my brain next to my ear where I always held my cell phone—in the exact position where the cell phone’s antenna was located.

Cell phones are much more dangerous than anyone can possibly imagine. I would gladly trade in all my money (which isn’t much now) and every single material possession I have for the chance to have my brain function restored. I was foolish. Please don’t make the same mistake. Your brain is much more precious than the device called a cell phone.” (3)

“The first major indication that cell phones might be a health hazard came out of a massive research project funded by the Cellular Telephone Industry Association (CTIA). To the industry’s surprise and dismay, the results of the study came to the opposite conclusion from the one they were hoping for.

The study’s results included findings of:

— A nearly 300% increase in the incidence of genetic damage when human blood cells were exposed to radiation in the cellular frequency band.

— A significant increase in cell phone users’ risk of brain tumors at the brain’s outer edge, on whichever side the cell phone was held most often.

— A 60% greater chance of acoustic neuromas, a tumor affecting the nerve that controls hearing, among people who had used cell phones for six years or more.

— A higher rate of brain cancer deaths among handheld mobile phone users than among car phone users (car phones are mounted on the dashboard rather than held next your head and the antenna was typically outside the car).” (4)

This study by Dr. George Carlo reported “a statistically significant doubling of brain cancer risk; a statistically significant dose-response risk of acoustic neuroma with more than six years of cell phone use, and; findings of genetic damage in human blood when exposed to microwave (cell phone) radiation.” (2)

Another industry-funded research study showed that brain tumors are not just due to chance, but that there is a significant “20% increased risk of brain tumors for every year of cell phone use”. (2)

Independent researcher, Dr. Hardell and his team in Sweden found significantly increased risk of brain tumors from 10 or more years of cell phone (or cordless phone) use. Some of their findings included:

— “For every 100 hours of cell phone use, the risk of brain cancer increases by 5%.

— For every year of cell phone use, the risk of brain cancer increases by 8%.

— After 10 or more years of digital cell phone use, there is a 280% increased risk of brain cancer.

— For digital cell phone users who were teenagers or younger when they first started using a cell phone, there is a 420% increased risk of brain cancer.” (2)

In spite of what the cell phone industry’s public relations departments may say, “the link between cell phone use and brain tumors is well substantiated and backed by more than 100 scientific studies.” (5)

For starters, health conditions that are linked to cell phone use include 9 types of cancer/tumors (known as of 2013). These include gliomas (brain cancer), meningiomas (tumors of the meninges that encases the brain), salivary gland cancer, eye cancer, testicular cancer in males, breast cancer in females, thyroid cancer, leukemia and acoustic neuromas (tumors on the acoustic nerves resulting in hearing loss) (6), In fact, in 2004, the second Interphone study to be published raised considerable alarm when it reported a nearly 300% increased risk of acoustic neuroma. This is because when a cell phone is held to the ear, it is the acoustic nerve that receives the highest microwave exposure.) (2)

That is not all, the French national Agency for Food, Environmental and Occupational Safety. (ANSES), after evaluating more than 300 international studies, published a report highlighting the biological effects of EMR [electro-magnetic radiation] on humans and animals concerning sleep, male fertility and cognitive performance. (1)

Chronic exposure to even low-level radiation (like that from cell phones) in addition to causing a wide variety of cancers, can also impair immunity and contribute to Alzheimer’s disease, dementia, heart disease and many other ailments. (7)

For example, studies have found that cell phone radiation can affect mens’ fertility (decreased sperm count, reduced sperm motility and damaged sperm mitochondrial DNA). (6) This is because men, and particularly teenage boys, place their cell phones in their pants pockets when they are not holding them to their heads. In addition, one study reported an 80% increased risk of testicular cancer. When the cell phone was kept in the left pocket, then the left testicle developed cancer. When kept in the right pocket, than the right testicle developed cancer. (2)

How is it that microwave radiation can cause all these health problems? Dr. Mercola explains,

“Your body is a complex communication device for cells ‘talk’, tissues ‘talk’, organs ‘talk’ and organisms ‘talk’. At each of these levels, the communication includes finely tuned bio-electrical transmitters and receivers, which are tuned like tuning into a radio station. What happens when you expose a radio antenna to a significant amount of external noise? You get static from the noise—and that is what is happening to your body in today’s electro-smog environment.

Two of the more well-known biological impacts from electro-smog are the interruption of the brain wave pattern leading to behavior issues, and the interference to your body’s entire communication system, leading to abnormal neurological function such as dementia, chronic fatigue syndrome, and fibromyalgia.

At the cellular level, your cell membrane receptors (the brain of the cell) recognize electromagnetic fields at very low levels of exposure producing a stress response similar to that produced by exposure to heavy metals or toxic chemicals.

This can cause the cell membrane to go from an ‘active’ or permeable state where it allows nutrients in the toxins out, to an ‘inactive’ state where the cell membrane is impermeable. During a normal day, your cells will change states thousands of times, but when under constant environmental stress, the membranes can be locked in the inactive state. This is often referred to as ‘oxidative stress’ as nutrients are able to enter into the cell, while toxins (free radicals) are not allowed to leave.

There is also real evidence that this inactive state can even have geno-toxic effects, meaning electro-smog is toxic by both damaging DNA and preventing your body from repairing DNA, which can be the first step to cancer.” (7)

Unfortunately, it is our children that are slated to bear the brunt of these cancers. As Dr. Mercola also reports, “Young children are much more vulnerable to these risks than adults because of their thinner skulls, smaller heads, and still-developing brains and nervous systems. Their thinner skull bones allow for greater penetration of radiation. The radiation can enter all the way into the mid-brain where tumors are more deadly.” (4)

Furthermore, children’s brains can absorb up to three times as much radiation as compared to adults (1) since children’s brain tissue is more conductive and their smaller brains and softer brain tissue allows radiation to penetrate more effectively.

Dr. Mercola concludes, “Children’s cells reproduce more quickly, so they’re more susceptible to aggressive cell growth. Their immune systems are often also not as well developed as adults. Lastly, children face a far greater lifetime exposure. Not only should children not use cell phones, but adults should not use them (or Wi-Fi) around children.” (4)

You can see revealing graphics showing how deeply cell phone radiation penetrates a five-year-old child’s head (brain) as compared to the head (brain) of an adult.

By comparing the first and last graph, it is obvious that cell phone radiation would penetrate in excess of 60% of a five-year-old child’s brain. In contrast, it would penetrate less than 20% of an adult brain. (8) As microwave radiation penetrates deeper into the cranial cavity, it can result in more tumors in these areas of the brain.

Not only do children’s brains absorb microwaves more readily than adult brains do, children also have potentially a much longer period of exposure to microwave radiation because they are playing with and/or using wireless devices and cell phones from a very early age. (1)

“The younger the child is when he or she starts using a cell phone, the higher the risk. Since texting became popular, it is common that children sleep with their cell phones underneath their pillows. They set their cell phones to vibrate mode so their parents won’t hear the phone ring. Sleeping with a cell phone beneath a pillow results in a night-long exposure, every night.” (2)

Thus, we can expect microwave-related health problems in children much sooner than we would expect the same kinds of problems in older adults who were not exposed to microwaves for most of their lives.

Summing it up, it appears that the risk of getting a brain tumor from exposure to microwave radiation from cell phone use has the following characteristics:

— “The higher the cumulative hours of wireless phone use, the higher the risk.

— The higher the number of years since first wireless phone use, the higher the risk.

— The higher the radiated power from the cell phone, the higher the risk.

— The higher the exposure (use on the same side of head as the brain tumor), the higher the risk, and

— The younger the user, the higher the risk.” (2)
______________

As you can see, the real risk of all the microwave devices we (and our kids) are using is not their thermal effects, but their non-thermal effects. This is what we have to guard against.

The unabridged version of this article has whole sections of information on how this microwave problem is being covered up and downplayed, what other countries are doing to ameliorate this problem, and, most importantly, a comprehensive list of things you need to know and implement in your life and in the lives of your loved ones and kids in order to help reduce your/their radiation exposure from microwave devices, especially cell phones and Wi-Fi devices.

Just as not everyone who smokes gets lung cancer, so not every one who uses cell phones, Wi-Fi or other microwave devices will develop brain cancer or suffer other neurological damage. Some will and some won’t. There are many variables that contribute to your susceptibility. Since you don’t know which group you will fall into, it seems wise and prudent to act now and limit, as much as is reasonably possible, given your belief system and lifestyle, your exposure to microwaves, rather than wait until bad things begin to happen in your family. I’m already doing what I can. Are you?

_________

(1) References are listed in the unabridged article.

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July 28, 2014: 6:33 am: Dr. NeilCell Phones

by Neil Bauman, Ph.D.

Has this ever happened to you?

You “buried” your cell phone somewhere nearby and because of your poor hearing, you did not hear it ringing or see it blinking. And you didn’t feel it vibrating either. Result? Missed phone calls and/or missed text messages.

You depended on your cell phone’s alarm to wake you up for an early flight the next day, but you slept on your “good” ear and as a result you didn’t hear your phone’s alarm vainly trying to wake you up, so you missed your flight.

You wanted to be alerted whenever a phone call or text message came in, but you missed your cell phone’s “rings” because of your poor hearing and all the racket around you. As a result, you missed an important call (and now your boss is mad at you).

You were sleeping and your phone received a severe weather warning that a tornado was bearing down on you—but you were in such a deep sleep that your phone’s alarm failed to arouse you. (If that was the case, you’re unfortunately not reading this article now either.)

You’re concerned about the microwave radiation from your cell phone (see article in this issue). As a result, you want to keep your phone at a “safe” distance from your body. However, you realize you probably won’t hear, see or feel it ringing from that distance. What can you do?

If you relate to any of these (or similar) scenarios, you don’t have to worry anymore. Serene Innovations has done it again. They’ve come out with a cool new product that makes sure you won’t miss any more phone calls (or messages or alarms) while you sleep or are engrossed in something at your desk.

The Serene Innovations RF-200 Cell Phone Ringer/Flasher is one cool device. This new gizmo is a desktop or bed-table signaling device for landline and cell phones (at the same time if you want). It will notify you when you have incoming calls by phone, Skype, FaceTime and text messages.

You may find it so useful that you’ll want one for your bed-table at night (with bed shaker) and one for your desk (or wherever you spend most of your time) during the day.

The RF-200 is just so easy to use. All you do is set your cell phone in vibrate mode and place it in the cradle. The RF-200 does the rest. When the ring alerter “hears” (actually “feels”) a signal, it flashes lights, sounds a loud alerting signal, and if you have the bed shaker plugged in, shakes your bed or chair. This makes it easy to know someone is calling you and is really hard to ignore.

Even if you do miss a call—perhaps you were out of the room—the missed call lights stay on to alert you to that fact when you return. Just press the “reset” button on the top right corner to turn the lights off and its ready for the next call.

I love the fact that the RF-200 works with both landline and cell phones at the same time. You don’t need two different alerting gizmos to do this one job. (To use it with landline phones, simply plug the included 7′ long phone cord into the back of the RF-200 and into any phone wall jack.)

When one of your phones rings, it is easy to tell whether you should answer your landline phone or your cell phone because of the distinctive light and sound patterns.

When your cell phone rings, the two “side” lights and the two top corner lights flash consecutively in a clockwise rotating pattern. When a landline phone call comes in, the top “corner” lights on the RF-200 flash together.

The ringer pattern for cell phone calls is a lower-pitched tone that warbles 3 times, then pauses, then warbles 3 times, etc. The ringer pattern for a landline call is a higher-pitched tone that warbles 5 times, pauses, warbles 5 times, etc.

Another feature of the RF-200 is that it isn’t just for alerting you to phone calls. It can also alert you to text messages if you have a smart phone. How cool is that?

To use the text messaging alert, plug in the short coiled cord between the base unit and the earphone jack on your smart phone. Better yet, if you have an Android or iPhone, you can program them with a special text vibration pattern so you don’t even need the short coiled cord! You just place your phone on the cradle. It’s just that easy.

If you live in an area that has severe weather such as tornados, and you have Wireless Emergency Alerts (WEA) sent directly to your cell phone, the RF-200 will immediately alert you to any warnings in your area. When your cell phone receives an emergency alert, the RF-200 will immediately emit a unique ring and flash pattern. The ring sound is a high-low, high-low emergency vehicle sound that you’ll instantly recognize as an emergency “sound”. At the same time, the lights will flash in a repeated criss-cross pattern. There is no mistaking that this is an emergency alert and not a regular phone call alert!

One cool undocumented feature is that you can use the RF-200 with any cell phone app you have that vibrates your phone such as count down timers, wake-up alarms, etc. This doubles the functionality of the RF-200 at no extra cost. The ring and flasher pattern for such alerts/alarms are identical to those for cell phone calls/messages. After each alert/alarm, you need to hit the RESET button to turn off the lights.

Note: If you miss a cell phone call or text message (do not answer) all 4 flasher lights will stay on until you press the RESET button. This feature does not work with landline phone calls.

The lights and loud alarm will get your attention if you are up, but what happens if you are in a deep sleep? Not to worry. Get the optional bed shaker. With the optional bed shaker plugged in, you’ll not sleep through any more phone calls, messages, alarms, or alerts. Just put the bed shaker under your mattress or under your pillow and you WILL wake up when it begins vibrating.

If you are a “couch potato” you can slip the bed shaker module under a cushion on your sofa or lazy-boy chair—and again, you won’t miss another phone call or alert!

The bed shaker vibrates in two different patterns—for incoming cell phone calls/messages it is a pattern of a long vibration followed by a very short vibration. For incoming landline calls it is a series of long vibrations.

Another neat feature of the RF-200 is that it has a USB recharging port so you can recharge your phone while you work or sleep. Simply plug the recharging cord that came with your phone into the USB port. That way your cell phone will always be fully charged whenever you grab it. No more awaking to a dead cell phone (and missed calls).

The ring alerter is quite loud. It sure gets my attention, even with my severe hearing loss (when it is set on “Hi”). For people with normal or near-normal hearing, there is a “Lo” setting. And if you don’t want to wake up the baby (or disturb your boss), you can set it to “Off”. You will still be alerted by the bright blue flashing lights and (optional) bed shaker.

One more thing. The RF-200 is A/C powered, but gives you uninterrupted operation even if the power fails with its built-in battery backup. Just install 4 AA alkaline batteries (not included) and you’re all set.

If you’re already drooling over this cool gizmo, purchase the RF-200 Cell/Phone Ringer/Flasher for yourself. For daytime use (no bed shaker) it is only $68.50. For night-time use (includes bed shaker) it is $93.45.

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July 17, 2014: 6:30 am: Dr. NeilAssistive Devices

by Neil Bauman, Ph.D.

A lady explained,

I don’t know exactly what I need. I have behind-the-ear hearing aids and I’m extremely hard of hearing. My TV is not clear so I might need a loop system. Also, I can’t hear much in the car so I might need the PockeTalker, but your website says that you can use it for the TV too. Do I need both, or would the PockeTalker do the job for both? I’m on a budget so need your help. All of these things sound awfully technical for this old lady. Do you think I can figure them out?

I understand. Not everyone is technically inclined, but the solution need not be very technical. I’ll make it simple for you.

Before we get into the details of the specific assistive devices that will fit your budget, I’d like to address your problem of lack of clarity when listening to your TV (and the same applies to many other situations too).

Properly-installed and correctly-used assistive devices such as loop systems and personal amplifiers (PockeTalkers) give you clearer speech than your expensive hearing aids will. This is just the laws of physics in action. Briefly, let me explain.

The high-frequency components of speech carry most of the intelligibility of speech, yet these same high-frequency sounds do not travel very well in air (as sound waves). Thus, the farther you are from the sound source (your TV in this case), the weaker the high-frequency component becomes and the less you understand of speech (clarity goes down).

Your expensive hearing aids have a problem because if these weak high-frequency sounds don’t reach your hearing aid’s microphones (and they don’t with increasing distance), your hearing aids can’t amplify these sounds. Thus speech sounds lack clarity and sound muffled.

This is where properly-used assistive devices come in. They take the sounds directly from the source and get them to your ears without their having to travel much through the air as sound waves. By doing this, they preserve the high-frequency sounds. The result is that you hear beautiful, clear speech.

Having said that, how much difference this will actually make to how well you understand speech also depends on how badly damaged your inner ears are, and also how well the hearing circuits in your brain are working. Neither hearing aids nor assistive devices can fix this. That is something you just have to live with.

What these devices WILL do is deliver to your ears the clearest speech signal possible. That way, you have the best chance of understanding speech as well (clearly) as is possible given your damaged hearing system.

Because I do not have 100% discrimination by any means, I do not understand everything I hear on my TV, even with the wonderful loop system I have installed. Therefore, I always have the closed captions turned on so I can read the words I still mis-hear. You should do the same.

Now that you have a realistic understanding of what you can expect from assistive devices, let’s look at the specific devices you mentioned.

Since you are on a tight budget, you want to get the most bang for your buck. What you need is an inexpensive device that is portable, flexible, easy to set up and easy to use under a variety of conditions.

When you look at it this way, a personal amplifier such as the PockeTalker beats out a room loop system as it is much more portable and easy to set up.

You also say, “All of these things sound awfully technical for this old lady. Do you think I can figure them out?”

The good news is that the PockeTalker is so easy to set up and use that even though you are not technically inclined—yes—you can do it! There are only two controls—an on-off/volume control wheel and a tone control. (I did say it was easy to use, didn’t I?)

Using the PockeTalker with the TV might not be as “nice” as using a room loop in that you’ll have a cord stretching from the TV to your PockeTalker, and if there is much background sound, the PockeTalker will pick up some of that racket—unlike a loop system which would pick up the sound from the TV and nothing else.

One of the things I like about the PockeTalker is that you can use it with, or without, your hearing aids. Thus, if your hearing aids break, or their batteries die on you, and you don’t have spares with you, you can still hear via the PockeTalker.

It’s easy to set up and use the PockeTalker with your TV. You can do it in 7 simple steps. Here they are.

The PockeTalker comes with a 12 foot extension cord and two plastic microphone clips.

1. Take one of the white plastic microphone clips, peel the paper off the back, align it so the “hole” is vertical, and stick it to the center of the grill of one of your TVs loudspeakers. (This will hold the microphone right against the TV’s loudspeaker.)

2. Unplug the microphone that comes with the PockeTalker (pull the “black thingy” on the top of the PockeTalker out of it’s jack) and plug it into the female end of the 12-foot extension cord.

3. Set the microphone/plug into the “hole” in the microphone clip on your TV and let the extension cord hang down to hold it in place.

4. Plug the male end of the extension cord into the microphone jack on the top of the PockeTalker (the jack from which you pulled the microphone).

Now you have two options. If your hearing aids have t-coils in them, switch them to t-coil mode.

5a. Plug a neckloop into the PockeTalker’s earphone jack. Put the neckloop around your neck.

Or, if you are not wearing your hearing aids,

5b Plug earbuds or earphones into the PockeTalker’s earphone jack and put the earbuds/earphones in your ears.

6. Turn your TV on and set the volume to a low level so you don’t blast the ears of any hearing people around.

7. Turn on the PockeTalker and set the volume so you can comfortably hear your TV.

That’s easy enough for you to do, isn’t it?

To use the PockeTalker in the car you can do exactly the same as above if you want to hook the PockeTalker to your car’s radio speakers. If you want to use the PockeTalker in the car to talk to a passenger, just skip steps 1 & 3 and pass the microphone on the extension cord to whomever is talking.

However, if there are only two of you in the car, then its tiring for your buddy to have to hold the microphone all the time in order to talk with you (and dangerous if your buddy also happens to be the driver). A much better solution (but it costs a few bucks more) is to do what I do and use a clip-on lapel microphone (which has a 3-foot cord attached to it) and clip it to the collar of your companion. Then you both can chat away and you’ll hear very well. I often do this with my wife when we are in the car. It also works well in noisy restaurants. (In the car, or at a restaurant, using the lapel microphone with it’s short 3-foot cord is much easier that trying to keep the 12 foot extension cord under control.)

Now we come to the important part. What do you need and how much does it cost?

1. PockeTalker ($129.50).

2a. If you are going to be using the t-coils on your hearing aids you’ll need a neckloop to hear via the PockeTalker ($47.95).

2b. If you are not going to be wearing your hearing aids, you’ll need a pair of earbuds or headphones. If you already have any you like, you can use them. You don’t need to buy more. However, you’ll need to get an adapter (which we can supply) or else you’ll only hear in one ear. (Earbuds for the PockeTalker that don’t need this adapter are $23.00.)

3. If you want the convenience of a lapel microphone with its short cord, you’ll need to get the lapel mic ($71.00).

Now comes the good part. If you’d like to save $68.00 off the above, instead of getting the PockeTalker, get it’s identical twin—the privately-labeled version—the Audable.

Furthermore, the Audable comes with deluxe headphones included so if you don’t wear your hearing aids, you can save an additional $23.00 on the earbuds if you don’t mind wearing headphones.

Note that the Audable does not come with the extension cord and TV microphone clips. (They are $12.00 extra.)

This should make your wallet happy. This is what I’d do if I were on a limited budget.

Order any/all of the above here.

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July 7, 2014: 6:26 am: Dr. NeilCoping Strategies

by Neil Bauman, Ph.D.

A concerned daughter wrote,

My step-dad has been hard of hearing since the 1990s due to being a gunner in Vietnam. Only in the last 8 years has he decided to not wear his hearing aids even though he got some updated ones just 3 years ago. I have seen the effects this has had on my entire family, especially my mother. He has basically ostracized himself and becomes very defensive when we ask him to put in his hearing aids because they are “uncomfortable.” If he does decide to put them in after we beg him he will only put one of the two in. He has several grandkids and just a couple of us kids who hate to see him go down this path of depression.

Just recently he took his computer in to get it repaired and when he got it back he discovered all the Microsoft programs were no longer on it. He refuses to go back and complain. The only conclusion my mom and I can come to about this is he gets frustrated extremely easily because he has a difficult time communicating with them. This example is just one of several others where he would much rather not deal with things than actually see a positive outcome.

I miss conversing with him. We all do. While he has a couple other health issues right now, his hearing it what has directly affected all of us for years. It pains us to see him spiraling down this path of depression. Do you have any words of advice that would assist me and my family? It might require another intervention (1st intervention was 3 years ago when we finally convinced him to buy more hearing aids).

What you are describing is not uncommon among elderly people, especially men. You want your dad to wear his hearing aids, and for some reasons (which we’ll look into), he doesn’t want to.

You want to force him to wear them as you believe they will really benefit him. You may be correct, however, the old adage, “You can lead a horse to water, but you can’t make him drink” not only applies to horses, but also to your father.

All is not lost however. The adage says you cannot make a horse drink—that is true—but you can do things to make the horse want to drink.

It all comes down to “benefits” vs. “costs”. When the horse gets thirsty enough (a cost) the need to slake his thirst (a benefit) will be powerful enough to overcome his stubbornness not to drink. Now here is the key. There is a simple way to make a horse want to drink—make him really thirsty by salting his oats!

Your dad looks at wearing hearing aids as a cost, not a benefit. You need to demonstrate to him that the benefits of wearing hearing aids (or other assistive listening devices) greatly outweigh the cost of not wearing them. Then, like the horse, he will be willing to satiate his need. In your father’s case it will be doing what is necessary in order to hear better.

At present, your dad doesn’t see any benefits to wearing his hearing aids, just costs. Thus he doesn’t wear them. I am the same way. Unless there is a very real and perceived benefit, my hearing aids stay in my pocket (where they are right now) because whenever I wear my hearing aids there are costs to me. Thus, in situations where I don’t perceive that the benefit to me is greater than the cost of not wearing them, I leave them off (or take them out). However, when I perceive that the benefit of wearing them outweighs the cost to me, I put them on. Your dad may view things the same way, whether he can articulate it clearly or not.

Let’s see how we can apply this benefit vs. cost analysis to your father and his hearing aids. First, I don’t believe interventions are the way to go. Notice the results of your last intervention. Yes, you all intervened. Yes, you “forced” him to get new hearing aids—the combined force of all your “nagging” (a cost) temporarily increased the benefit of doing what you all wanted (getting new hearing aids), so he acquiesced in order to get you all off his back.

However, look at the results. Now that he has you off his back (a benefit), he won’t wear his fancy new hearing aids, or he grudgingly wears just one when you really press him (to get you off his back again), because he doesn’t see any real benefits—or more importantly, any perceived benefits—that greatly outnumber the cost to him of wearing them. This reveals that the intervention was ultimately not a success and just wasted a lot of dollars on new hearing aids that live in the dresser drawer, not on his ears.

Having another intervention will probably prove just as futile because you are not addressing the real, underlying problem—his lack of perceived benefit to wearing hearing aids vs. the perceived and real costs to him of wearing his hearing aids.

In this analysis, it is the perceived benefits and perceived costs that are important, not the real benefits and real costs, because we, as humans, typically act on what we perceive to be case—whether we are right or not.

To get at the root of the problem you have to keep asking the question, “Why?” Why does he not wear his hearing aids? Why is he tuning out and giving up? Why is he depressed?

Once you know the real answers, then you can address them—sometimes head on, and other times by being a bit sneaky and “salting his oats”.

Here are some of the reasons why a hard of hearing person like your father may seldom wear his hearing aids.

1. They do not significantly help him hear better.

In spite of all the hype spouted by the hearing aid manufacturers, and the well meaning intentions of audiologists and family members, there are still a good number of situations where wearing hearing aids does not give significant help. Noisy places or when you are at a distance from the speaker are the two main ones.

For example, the one place where you especially want him to hear—at family gatherings—is one place where hearing aids do not help numbers of hard of hearing people. I am one of them. In fact, I have never heard and understood what was being said at any family gatherings when wearing my hearing aids. I say this after having worn hearing aids for more than 60 years. For some of us hard of hearing people, hearing aids alone in such situations are not the answer.

We wonder, “Where is the benefit”? Since we still can’t follow much of what is being said no matter how much we strain to hear, there is little or no benefit to wearing hearing aids in such situations. However, there are a number of costs from our point of view. One cost is that all the straining to hear leaves us exhausted. Another cost is that all the meaningless racket leaves us tense and often results in headaches. Yet another cost is we often feel totally frustrated at not being able to follow a conversation. You see, we want to hear, yet just can’t understand what people are saying. Thus when you compare the benefits to the costs, the costs win out hands down. In such situations it is much more peaceful and easier on us to put our hearing aids in our pockets (so the racket doesn’t bother us) and tune out or leave the room.

Initially, we go with high hopes of being able to hear with our new hearing aids, but our hopes are quickly dashed when we realize they don’t help us hear (understand) much more than our old ones did. Eventually, we realize we’re never going to hear much and thus refuse to wear our hearing aids in such situations. The costs of wearing them are just too high. Basically, we give up because we know hearing aids aren’t going to work in that situation. I wouldn’t be at all surprised if your dad finds himself in the same situation.

Many of these costs are the family’s fault. You see, you want your dad to change and be hearing again—to hear and act like a person with normal hearing. This just isn’t going to happen.

Rather, the family members need to be willing to change and meet the hard of hearing person’s hearing needs. Unfortunately, few family members are willing, and dad gets left out—again.

Few hearing people understand the limitations of hearing aids. I’ve been in meetings where the leader is going to show a video and mentions the poor quality of the sound track. Then he says to us hard of hearing people—”Turn up your hearing aids and listen harder”. What he doesn’t realize is that first, we are listening as hard as we can—unlike hearing people who can hear with ease. Second, if all we needed to do is turn up our hearing aids, don’t you think we would have done that years ago? In most cases, turning up the volume on hearing aids just lets you hear louder gibberish. It doesn’t change gibberish into English!

What family members need to do is speak so dad (or any hard of hearing person present) can hear. This means speaking one at a time, speaking slowly and clearly, facing the hard of hearing person so he can speechread (even though the remarks are made to another family member), having adequate light on all faces for ease of speechreading (which may destroy the ambience you are trying to create), cut out any background sounds (shut doors or windows, have the kids play in another room, turn off the TV or background stereo music, etc.).

Unfortunately, few families are willing to do this—and thus dad (or mom) sits in the corner alone and zoned out. The good news is that it doesn’t have to be this way if the family members really wanted to meet his hearing needs.

One solution is for your dad to move to a separate, quiet room and have one family member at a time come and chat with him. He may do wonderfully well one-to-one—but tune out if he is part of the whole family gathering where he hears nothing but gibberish.

Note: doing this requires special effort by each family member. It has been my experience that family members all want to be together so they won’t miss anything. They want dad to be there too (included), but they don’t realize that dad is totally “out of it” in such situations and may feel deliberately excluded.

It’s the hearing people that need to be willing to change—dad can’t change his ears— but the hearing family members can change their habits and deliberately leave the family setting to chat with dad one-to-one.

Another thing that can work quite well at family gatherings is for dad to use assistive listening devices along with his hearing aids (or by themselves if he won’t wear his hearing aids). Again, these will only be successful if the other family members cooperate.

For example, a (wireless) FM system can really help your dad hear what is going on. All the family members need to do is speak into the remote FM microphone. The person speaking holds or wears the wireless microphone and dad switches his hearing aids to t-coil mode (or RF mode if he has fancy hearing aids with RF receivers built in). In t-coil mode he won’t hear anything except what comes through the FM microphone (which effectively cuts out most of the background noise). When the person wearing the microphone is talking, his voice will be ever so much louder than the background noise (since the mic is close to the speaker’s lips) and your dad will hear him clearly.

The problem is that when someone else says something, if dad is going to hear it, they must pass the microphone to the other person before they speak. However, this typically breaks down because people jump in with “one liners” without waiting for the microphone to be passed to them. So again, dad is left out.

A compromise is for only one person to wear the microphone. At least dad will then hear that one person. Here are some good choices for determining who should wear the microphone.

— Ask dad who he particularly wants to hear. Maybe it’s his brother whom he hasn’t seen for 10 years.

— Give the microphone to the “life of the party” since that person is going to be doing most of the talking anyway. That way he’ll miss the least (and hear lots of jokes, etc.).

— Give the microphone to the “wise one”—the person who may not have much to say, but whenever he says something it is worth hearing.

— Give the microphone to the person whom dad hears the best. Some people are easy to hear and others are very difficult to understand whether they are using a microphone or not.

You can see a couple of quality FM systems here.

2. Wearing his hearing aids hurts or is uncomfortable

Some people have sensitive ears and wearing hearing aids irritates their skin and is very uncomfortable or hurts. I have this problem as my skin is sensitive, and both my hearing aids and glasses hurt (burn) when I wear them for a few hours. It’s not that the ear molds are uncomfortable, or that I’m allergic to the materials in them (I use hypoallergenic molds), it’s just that the ear mold and hearing aid touching my skin hurts after a while. When the pain gets too much, I just take my hearing aids off. Thus, for me, wearing hearing aids always has a painful cost involved.

It’s not fair. My wife can put in her hearing aids and forget she has them on. No irritation or pain at all. I wish my ears would do the same, but they don’t.

I balance my desire to hear against the pain of wearing my hearing aids. At first my desire to hear wins out, but when the pain gets too much, then my desire to get rid of the pain wins out. My compromise is to wear my hearing aids when people are directly talking to me. The rest of the time I put them in my pocket ready for the next conversation. Maybe something like this is what your dad needs to try if that is his basic problem.

Another cause of pain is if the ear molds do not fit properly. This is easy to remedy. Either have the ear molds remade, or the sore spots filed off so they are comfortable. The idea is to reduce the cost to him of wearing his hearing aids, thus causing the cost/benefit ratio to swing in favor of the benefits of wearing hearing aids.

3. Amplified sounds “recruit” and hurt

Unless hearing aids are adjusted correctly (and the worse your hearing loss, the less likely they are adjusted correctly), certain sounds will “recruit”—that is, you perceive them as being much to loud. These sounds hurt and you wince. For example, I was out driving with my adult daughter yesterday, and when she took her seat belt off, the sound of the belt buckle hitting the door frame as it retracted “hurt” my ears. She has good hearing and is quite sensitive to sounds, yet the seat belt buckle noise didn’t bother her in the least. That is what recruitment is like. Other sounds that commonly recruit for numbers of people are cutlery clanking, dishes clunking, dogs barking and even the loud parts of words seeming to be much too loud.

Now here’s the problem. I can have my hearing aids adjusted to stop these loud (recruiting) sounds, but when the hearing aid fitter does that, it reduces my speech comprehension. The result is that speech sounds won’t recruit, but I can’t understand much of what a person is saying either. Therefore, in adjusting hearing aids, there is a fine line between speech intelligibility (comprehension) and sounds recruiting. You try to get as close to this fine line as you can, but it is still a compromise.

For example, I have to put up with a certain amount of recruitment in order to talk with my older daughter. That’s just the way her voice is for my ears. If the pain of recruitment becomes too much, then I take my hearing aids off because the cost/benefit ratio has now swung decidedly in favor of costs, not benefits. Unfortunately, the result is I can’t hear/understand what she then says.

That is why I like to converse one-to-one with people in quiet places—so there are no outside recruitment sources. When I do that, I typically hear quite well.

It could be that your dad has a problem with recruitment when wearing his hearing aids so the cost of wearing them is always greater than the benefits of chatting with family members.

I’d definitely investigate this. Audiologists want to set hearing aids so you can hear “normally” and for numbers of people this makes various sounds recruit. He needs his aids set so sounds don’t recruit. This will greatly reduce the perceived cost to him of wearing hearing aids, and thus the cost/benefit ratio may swing to the benefit side (which is what you really want).

Therefore, have his hearing aids tweaked up the best they can be, having regard for recruitment. This may take several tries to get it as good as possible.

4. He is not in the acceptance stage in the grieving process

An often-overlooked aspect of being willing to wear hearing aids is determined by where you are in the process of grieving for your hearing loss.

Typically, people who lose hearing go through the classic 5 steps of the grieving process—denial, anger, bargaining, depression and finally acceptance. It is only in the acceptance stage that hard of hearing people are willing to wear hearing aids. Here is why.

In the denial stage (which can last a considerable time), you “know” you don’t have a hearing loss so therefore, obviously you don’t need to wear hearing aids. Thus you refuse to consider the idea.

In the anger stage (which is typically of much shorter duration) you are mad at everyone and everything connected to your hearing loss. At this stage, you are too busy venting your anger to worry about getting and wearing hearing aids.

In the bargaining stage, you are bargaining with God or doctors to get your hearing back. Since at this point you feel your loss is going to be temporary, there is no point in wasting money buying hearing aids.

Finally, one day you realize that your hearing loss is here to stay—that denial, anger and bargaining didn’t work. So you conclude that nothing works. Thus you give up and slip into deep, dark depression.

Your dad may be stuck in the depression stage. (Some people get stuck here for years.) This is where you reach rock bottom. People in this stage will not (willingly) wear hearing aids because they are depressed—they just don’t care. “Nothing works—so hearing aids won’t work either”.

The good news is that he just has to progress one more step and he will move into the acceptance stage. It is only in this stage that he will be willing to do what he can do to help himself hear better. He will start with baby steps—so it is very important that these baby steps be successful.

A good “baby step” is to get close to him and talk with him face to face in a quiet room while he wears his hearing aids. When he realizes how well he can converse that way, it gives him hope that his hearing aids will work in other places too. Thus he will be encouraged to wear them more (and more) as he realizes that the benefits of his hearing aids now outweigh the costs of wearing them.

If he is still working through grieving for his hearing loss, you (and he) would do well to read my short book, “Grieving for Your Hearing Loss—the Rocky Road from Denial to Acceptance“. It has helped many.
________

Both you and your dad have to realize that hearing aids are not perfect by any means—so don’t expect them to be. Your dad needs to go back and have his hearing aids adjusted and tweaked a number of times to find the “fine line” compromise that will work the best for him. Then he needs to learn how to successfully cope in various situations rather than giving up.

He needs to take it slowly and realize that he can hear well in certain situations. Then, you can work with him to show him how he can hear well in other situations. Slowly he will be back into circulation again.

In this whole process, always remember the cost/benefit ratio. Work to reduce any perceived costs, and at the same time work to increase any perceived benefits. As the cost/benefit ratio swings to the benefit side, you’ll notice that he will willingly wear his hearing aids (and/or assistive devices) in situations where the benefits are much greater than the costs of not wearing them. And, as an additional benefit, you’ll be happier too!

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June 28, 2014: 6:16 am: Dr. NeilLoop Systems

by Neil Bauman, Ph.D.

A man asked,

Am I able to use the different loop systems or will my pacemaker prevent my using them?” An audiologist questioned, “Have you ever run into a person who can’t use a loop system due to pacemaker issues? We have some clients that have pacemakers and use loops, but one cardiologist told one guy that he can’t use remotes or a telecoil.

These are good questions and need real answers, not just a doctor blurting out the first thing that comes into his head without having any real knowledge of the subject.

If a cardiologist says a loop system will interfere with your pacemaker, find out on what he bases his decision. How many people does he know whose pacemakers were affected by loop systems? Can he name even one? Does he have a clue what a t-coil or neckloop or room loop is? Can he point to any research that shows that loops are incompatible with pacemakers?

As one person said,

I can imagine that a cardiologist, having little or no knowledge of telecoils or loop systems, would be biased toward pacemakers and his patients’ health, and thus advise against all neckloop use without having any scientific evidence to back him up.

What’s the truth about pacemakers and loop systems? Here’s what some loop manufacturer’s and installers say.

Ampetronic, one of the largest loop manufacturers in the world, posed this question on their website, “Do induction loops interfere with pacemakers?” They then answered,

A permanently installed induction loop system will not interfere with heart pacemakers if correctly designed and installed. It is possible that interference could occur due to a neck loop as provided with some receivers (for example with Infra-red, FM or similar systems). It is necessary to pin the neck loop away from the location of the pacemaker ensuring 150 mm or 6’’ separation between cable and pacemaker.

Interference could also be caused due to portable loops where the loop cable could be held close to the pacemaker.

The owner of inLOOP, another loop manufacturer, explained,

This is a question that would never get a favorable response from an attorney because there is no way to guarantee there could never be an issue with a pacemaker in an induction field. Pacemakers used to have magnetic switches that could be activated by strong electronic fields like microwaves. The new designs are 100% electronic and should not be affected by a properly installed and tuned loop system.

In other words, the chances of a loop system interfering with a pacemaker are exceedingly slim, but not impossible.

He continued,

I can share an experience we had with a student during one of our commercial loop installation training classes. I was in the process of explaining that the newer pacemakers would probably not have an issue, but if someone were right at the point of transmission there could possibly be more energy and a potential for greater risk.

At this point, one of the attendees who, himself, had a pacemaker, walked up to the commercial loop amplifier that was in use, picked it up and held it to his chest. He smiled and said, “Didn’t do anything to my heart.” His heart was fine, but for a split second mine stopped.

L______, a loop installer wrote,

I have a pacemaker and have asked about loops. I was told that I probably shouldn’t wear a neckloop because it puts the loop within a couple of inches of the pacemaker. However, there are no issues in a looped area, and I certainly spend lots of time in looped venues with no issues.

According to IEC standard 60118-4, the standard governing room loops, the maximum field strength of a properly-adjusted room loop is 400 milliamperes per meter (400 mA/m) (± 3 dB). Since that is the maximum, most of the time it’s well below that.

Is this enough to interfere with pacemakers? St. Jude Medical, makers of pacemakers, in their document “EMI in the Workplace Environment” state, “EMI field strengths encountered above those listed in Table 2 may cause device interference with an undesired device response.” So what is the maximum magnetic field strength their pacemakers are designed to withstand without any problems? The appropriate line in Table 2 reads, “Continuous Wave and/or Modulated Magnetic Fields (50/60 Hz)” shows a field strength limit of “80 A/m peak”.

Now, 80 A/m is another way of saying 80,000 mA/m. So their pacemakers are designed to function correctly in magnetic environments up to 80,000 mA/m. That is a whopping 200 times the power of the maximum magnetic field in a room loop set at 400 mA/m.

Thus it becomes quite obvious that room loop systems are perfectly safe for people wearing pacemakers and have a built-in safety factor of around 200.

The exception might be if the person grabbed the loop wire and held it tightly over their pacemaker, but even then, it may not cause a problem, but I’m not about to bet the farm on it.

Norman Lederman of Oval Window Audio explained,

The subject of pacemakers and induction loop systems comes up from time to time and we have extensively researched the topic, particularly in regard to perimeter area loops because that is what we manufacture.

According to pacemaker manufacturers’ technical specifications pertaining to interference issues, a properly designed and installed area loop (room, vehicle or counter top loop) operating in compliance with the most recent IEC 60118-4 standards will not interfere with pacemakers.

We share this information noting that in our 30 years in business we have heard of only one report in which a pacemaker user felt “uncomfortable” while making use of a room loop. He left the room and felt better. The connection between what he experienced and the room’s loop system was never clearly established.

Therefore, if a person complains of feeling “funny” when near a loop system, he is probably experiencing an anxiety attack, not the baleful effects of a magnetic field on his pacemaker.

Norman continues,

Loop pads and neck loops are a very different story and I personally believe that it is best for pacemaker users to avoid them. Two reasons for this conclusion include:

1. The field strength produced by the loop pad/neck loop is unknown because it is attached to an audio device whose output specifications are not universal or regulated by technical standards.

2. The close proximity of the loop pad or neck loop wire to the pacemaker greatly intensifies the electromagnetic field. Out of curiosity I have hooked up neck loops and loop pads to the headphone outputs of audio devices with resultant field measurements way off the scale re: 400 mA/m.

For interfacing telecoil equipped hearing aids with assistive listening systems, I generally recommend area loop systems because the field is diffused and consistent, with much lower average & peak levels in comparison to loop pads and neck loops.

John Woodgate, one of the world experts on loop systems, explained,

With neck loops you have to be very careful where you measure the field strength, because for any loop system the field strength gets very high near the loop wire.

This is why I have suggested a “looped hat” for people with pacemakers. That should ensure that there is no possibility of affecting a pacemaker, unless you take the hat off while it’s working, and clutch it to your chest, of course.

Loop pads are a bit different. The same principle applies that the field strength is very high near the loop conductor, but it can also be very high elsewhere.

This is because the loop is quite small, and the listening height is very large in proportion. So to get enough field strength at the ear height, the field strength even several inches above the pad is much higher. This also applies to chair-seat loops, which may be a bit bigger, but the listening height is also a bit bigger.

What this all means is that room loop systems should not pose any risk for a person wearing a pacemaker. The same holds true for people using Music Links and equivalent devices since the power in them is so small and they are kept at ear level.

Where a problem may arise is if you wear a neckloop, or sit on a loop pad or get too close to a counter loop or portable loop. In these cases, to guarantee your safety, you probably want to keep some distance between the loop wire and your pacemaker. As mentioned above, for neckloops, they recommend a safe distance being 6” (15 cm) or so.

If you have a loop pad (seat pad) and place it on the floor or under your seat cushion, likewise, there should be no problem as the field strength rapidly decreases as the distance increases.

However, there may be a problem if you put the loop pad on your headrest instead of sitting on it. That way it could be too close to your pacemaker, so you could conceivably have a problem.

And of course, if you have a pacemaker, never clutch a loop wire to your chest, or lay on the floor right over a loop wire.

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June 18, 2014: 6:13 am: Dr. NeilLarge Vestibular Aqueduct Syndrome

by Neil Bauman, Ph.D.

Not much was known about enlarged vestibular aqueducts (EVA) when I first wrote about it in 2002. Back then, it was called Large Vestibular Aqueduct Syndrome (LVAS). Now it is more-commonly referred to as EVA, but it is the same condition.

In the intervening years, researchers have done a number of studies on EVA and related conditions, such as Pendred syndrome, to try to ferret out exactly what causes the hearing loss, what genes are involved, etc, with an eye to finding an effective treatment for this condition.

One of the things that bothered researchers about EVA was that increasing hearing loss did not correlate with the increasing size of the vestibular aqueducts. Thus, it became obvious there must be some other mechanism, not the large vestibular aqueducts themselves, that caused the hearing loss.

The latest research focused on genetics—specifically on the SLC26A4 gene and its role in the expression of the pendrin protein and how that affects hearing. You can learn more about these latest findings in my recently-revised, comprehensive article on EVA.

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June 9, 2014: 6:08 am: Dr. NeilCoping Strategies

by Neil Bauman, Ph.D.

A man wrote,

Have you addressed the issue of “speech rate” as a factor in hearing loss and comprehension?

As I recall, the “optimal” speech rate is approximately 180 words per minute (wpm). Yet I find that the broadcast industry (radio and TV) are hiring commentators who speak at least 210 – 230 wpm. (Unfortunately I do not have access to the recording technology which would provide more definitive data.) This rapid rate is virtually unintelligible to any one with a significant hearing loss. And, as you know, this includes a large proportion of older people (65+), myself included!

The nightly MSNBC Television show is a good example—from very fast to perfect speed!

I’m interested in your knowledge and opinion on this trend. I am on a one man crusade to encourage the broadcast industry to “slow down” so we older folks, many with a hearing loss, can understand what they are saying!

My hat is off to you. I hope your crusade makes a difference. It will help countless millions of people.

You are so right that when people speak too fast, we often miss a lot. There are a number of reasons why. Let’s look at some of these.

1.  How fast our brains can process speech

If we have good hearing and a person is speaking at a moderate speed, our ears will pick up and our brains will process what we are hearing in real time, AND we will still have time to think about what we have heard. In other words, we will understand and assimilate the message.

However, as a person speaks faster and faster, we spend more and more of our time trying to “catch” the words spoken, and thus we have less and less time left over to try to assimilate what we have heard. This is where we begin to lose it. We know the person is talking, and often we know the general subject, but we miss the point he is making. And remember, this is in adults with both normal hearing and normal cognitive function.

The truth is, not all people are adults in their prime. More and more are becoming seniors. As we get older, we slow down. That is no secret. So it should be no surprise that our brains also slow down. As a result, it now takes longer for us to process speech. It also takes longer for us to assimilate what we have heard. Therefore, seniors are at a disadvantage, even when listening to a speaker who is speaking at a normal rate.

As the speech rate picks up, we seniors are at an even greater disadvantage. The result is that the faster a person speaks, the more we miss until listening to a speaker is largely a waste of time. That is why so many seniors tune out. It is all flying “over our heads” so to speak.

The same holds true for children who are just learning the language and need time to figure out “hard” words. This slows down their processing speed. It also holds true for people for whom English is not their first language. They need time to “retranslate” what was said. Furthermore, some people are not as cognitively fast as others, and thus need more time to process what they hear.

The above groups include a large percentage of the population. And note that so far, we haven’t even considered people with hearing loss.

Numbers of people with hearing loss fit into all the above categories to be sure. However, our hearing losses just compound our difficulty in understanding others. But even if a hard of hearing person is in the prime of adulthood and everything is working normally except that they don’t hear well, they still have problems.

You see, our “broken” ears miss words and parts of words (phonemes). Therefore, the information our ears send to our brains is full of holes and gaps. Think of a puzzle that has lots of pieces missing so you can’t recognize exactly what the picture is about. That is an analogy to what we hard of hearing people hear and understand.

Our brains have to work overtime to try to figure out the missing parts. We use what we already know of the subject, what we know of the structure of the language, what we can speechread, what we deduce from body language, etc. to try to make sense of what we heard. All this takes time. And by the time we have this figured out, we’ve missed the next few words so there are even more gaps to try to fill in.

Obviously, we need a person to speak more slowly to give our brains a chance to keep up. Speaking slowly with lots of pauses really helps us in this regard.

Not only do our brains need to try to figure out what we heard, they also need to try to reconcile what our ears heard with what our eyes saw (speechread). And this gives rise to some unexpected problems. You see, in English, lip movements only correspond to speech sounds about a third of the time. The rest of the time what we see and what we hear don’t have any direct correlation. Therefore, we can hear one word, and yet at the same time “see” an entirely different word on the speaker’s mouth.

Now we have a problem. Which do we believe—what our faulty ears thought they heard, or what our eyes thought they saw? For example, suppose we thought we heard the word “white”, but we saw the word “queen” on the person’s lips. Which was correct? You see, unfortunately for us, the words “queen” and “white” look identical on a speaker’s lips.

(Note: words that look the same on a person’s lips but sound differently are called homophenes. Don’t confuse homophenes with homonyms. Homonyms are words that sound the same but have different spellings such as “their—there” or “bear— bare”. Incidentally, all homonyms are also homophenes.)

Now, back to the words “queen” and “white”—maybe the context lets us know it had to be a color, so our brain puts in “white” and not “queen”. This mental gymnastics takes time.

Sometimes the choice is not so easy as there may be a number of words we need to substitute to try to find the right one. For example, the following words all look identical on a person’s lips—chews, jute, shoes, June, shoot, juice, choose and Jews. It can take our brains considerable time to figure out the right word—especially if the word is the one that sets the real meaning of the context. And this assumes we only have one word that is ambiguous. If there are two or more homophenes, the problem expands exponentially. Think of the above words and try to make sense of this sentence if you only see the words on the speaker’s lips. How long, if ever, will it take you to get it right? Here’s the sentence—”If he chews jute, will the juice fall on his shoes?”

Depending on your mindset at the time, you might see, “If he June June, will the June fall on his June? Or if it is during the fall hunting season, your brain might lock onto the word “shoot” and you’d see, “If he shoot shoot, will the shoot fall on his shoot?” How long would it take you to substitute word after word until you got the right message? Probably never. Yet that’s what we deal with day after day.

This is why we so desperately need people to speak slowly and clearly and pause from time to time. Our brains need time to “catch up” and also “catch their breath” so to speak.

By now it should be obvious that when a person talks faster than normal, hard of hearing people, seniors and many others lose much of what is said. This is why radio announcers, in particular, need to slow down their speaking rate. When they speak fast, we miss their important information.

Let me give you two examples that I have noticed when listening to my car radio while driving.

Announcers speak particularly fast when reading advertisements. Speaking fast is thought to increase the excitement of the ad and thus motivate people to buy the product. However, I wonder if the “bright lights” in the radio/TV and advertising industries have ever stopped to think that when they rattle their ads off so fast, a large proportion of the population miss key words in their aids. The result is that their message is just not processed properly by many seniors and hard of hearing people so they do NOT buy their products. This means they waste a considerable portion of their advertising dollars—not exactly a bright decision on their part.

Our local radio station has a “TrafAx” (traffic accident) report so you can avoid accident sites and the consequent traffic congestion in your area. However, when the announcers give this report they immediately increase their speaking rate and rattle off the locations so fast that I’m not able to determine the locations they are talking about—so this piece of newsworthy information is useless to me (and to all the others in the same boat).

This not only applies to radio/TV announcers, but to presenters and speakers at conferences and other places. For example, in addition to speaking fast for the “excitement” effect, sometimes presenters talk faster (and faster) as they see they are running out of time and want to finish their speech. When they do this, we “lose it” and have to put up our hands and ask them to repeat it as we missed some important point. The result is that they are now even more pressed for time and rattle on faster and faster, and we need to interrupt them time and again (or totally miss everything).

There was a book that came out some years ago with a long title that basically said it all. It went something like this, “If You Don’t Have Time to Do It Right the First Time, When Will You Ever Have the Time to Do it Over Again?”

Therefore, it is much better to speak slowly and clearly the first time and cover the essentials and let everyone catch your points, than to speed through your presentation and leave half your audience in your dust. Think about this and remember to slow down!

2.  How fast our eyes can detect speech movements in order to speechread.

Many of us (hard of hearing people) speechread to try to make sense of what our faulty ears hear, and to fill in the gaps in what their ears totally miss. This makes speechreading critical to understanding what a person is saying.

In order to speechread, you first have to see the lip (and facial) movements the speaker is making.

Here is something I’ll bet few people have considered. Our eyes don’t have the ability to detect an unlimited number of movements per second. That is why films are set to run at 30 frames per second. At that point they appear to us to be flicker-free because our eyes can’t detect more than that number of movements per second.

In fact, our eyes can’t even process that many movements when it comes to UNDERSTANDING what we are seeing. And if our eyes can’t “grab” it, our brains certainly can’t process it.

For example, when a person talks at a normal rate, they make between 13 and 15 speech movements per second. Even that is too many movements per second for our eyes to accurately “grab”. In fact, our eyes can only pick up around 8 or 9 of these speech movements per second. This means if people are talking at a normal rate of speed, we miss between one quarter and one half of what they say just because our eyes can’t keep up.

That is not all, our brains also have to process what our eyes see. As we get older, our brains slow down as we have already seen, so it takes longer to process the signals our eyes send to our brains.

Therefore, it really helps if the person speaks slower and leaves pauses to give our brains a chance to catch up. So, slow down!

3. How fast we can read the captions.

I don’t watch any TV unless it is captioned. That is how important captioning is to my understanding a person talking. Unfortunately, the faster a person speaks, the faster the captions fly off the screen. Thus, if you are not a fast reader, the words fly off the screen before you get a chance to read them. As a result, you miss some, or much, of the dialogue.

Another aspect of captioning that few realize is that if a person speaks too fast, the captioner condenses what the person says to keep the captioning down to a reasonable speed so it doesn’t fly off the screen too fast.

This is great in order to try to caption a rapid speaker’s words, but it is no longer verbatim like it should be. And this causes more problems. You see, we typically both speechread the actors and read the captions at the same time. (Actually, we rapidly switch from one to the other and back again.) Problems arise when we see a person’s lips say one thing and the captions say something different. At that point we get confused. Now it takes even more time to figure out what was said. Thus, we get further and further behind.

The solution is simple. If people speak at a moderate speed, captioners will have enough time to caption everything verbatim, the words will not scroll up too fast, and we will have time both to read them and comprehend what was said.

Not only is speaking at a moderate pace important for elderly people, and for hard of hearing people, but it is also important for people who are not fast readers such as children, people with poor eyesight, people who have not had a lot of education and people for whom English is not their first language.

When you consider all these groups, the majority of the population fits into one or more of these categories. Therefore, unless public speakers (radio and TV announcers, actors, presenters, etc.) talk more slowly, most people watching their programs will miss part or most of what was said.

Some wag once wrote, “There are three kinds of people in this world—those that make things happen, those that watch things happen, and those that wonder what happened.”

When people speak too fast, so many of us are left in the dust wondering what happened! Yet the answer is so simple. Just “slow down”!

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May 30, 2014: 6:04 am: Dr. NeilAssistive Devices

by Neil Bauman, Ph.D.

A man asked,

All wireless sound systems I have tried to date have a slight delay that creates an echo effect with the TV speaker sound. Does the TV Sound Box have this problem?

Not according to my wife. She’s the one that uses the Sound Box in our house. (I use a loop system on my TV.) But this is because we have old tube type TVs, not new flat-screen TVs.

I think your problem is not in the devices you are trying to use, but in your TV itself.

Here’s what happens. Flat screen TVs take longer to “paint” the picture than to process the sound that goes with that picture. As a result, the TV manufacturers have built a delay into the audio circuit to keep both in sync.

However, some/many TV manufacturers did not build in the same delay on the signal going to the audio output jacks on their TVs. Thus, the sound from those jacks (and devices plugged into them such as the TV Sound Box, loop amplifiers, etc.) are out of sync with the sound from the TV’s speakers. (As you can appreciate, this is not the fault of the device, but the fault of the TV manufacturer.)

To their credit, some TVs have a feature in the menu to adjust the time delay for signals going to the audio output jacks. I’d check your TV and see if this is the case. If it has this feature, set the delay so that the sound from the assistive device you are using matches the sound reaching your ears from the TV’s speakers and you’ve solved the problem.

Now, to make things more complicated. For some reason you may find that there is a delay feature on your TV’s menu for the audio output jacks IF they are digital (Toslink or Coaxial), but not if they are analog (RCA). If your TV is like this, choose the digital audio output, but now you’ll need to get a digital to analog converter (DAC) to convert the signal back to analog.

And here it gets even more complicated. There are two versions of DACs and which one you get depends on your TV. If your TV puts out standard (PCM) stereo, then you can use a DAC such as the Monoprice DAC for $15.98.

However, if your TV outputs Dolby 5.1 surround sound, then you’ll need a more expensive DAC such as the Gefen Dolby digital converter for $129.00.

A less expensive alternative is the Dolby 5.1 Digital to Audio Converter from Parts Express. This one is only $39.85. Like the Gefen unit, this one also comes with a wall power adapter, but does not include a TOSLink cable to hook it up to your TV.

If your TV does not have a delay option in its menu, all is not lost. You can purchase a sound delay corrector (such as the Lip Sync Corrector) and put it between the audio output jacks on your TV and the device you are hooking up to those jacks. The sound delay corrector has a control on it to set the appropriate delay so you hear sounds via the TV’s speakers and your assistive device at exactly the same time.

You can get a Lip Sync Corrector for $78.71 or $84.15.

Note: these Lip Sync Correctors are analog devices—they use RCA jacks for both input and output. If your TV doesn’t have RCA output jacks, then you’ll have to get a Digital to Analog converter (DAC) as mentioned above, and a Toslink or coaxial cable to go from your TV to the DAC. You’ll also need a double male RCA patch cord to connect the output of the DAC to the sound delay corrector input, and an RCA to 1/8″ audio patch cord from there to the assistive device into which you are plugging it.

As you can see, depending on your TV, the solution can be relatively simple if your TV has the necessary features already built in, or it can get a bit complicated if your TV doesn’t have those features. But the good news is that, in any case, you can get around the problems one way or another and have the sound from your assistive devices in sync with the TV’s sound and picture.

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